chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 30.0
Sex: F
Vaccine: COVID19
Symptoms: Alopecia, Angina pectoris, Back pain, Nervous system disorder, Rash
Clinical narrative: I?m addition to the heart pain, respiratory issues, rashes, nerve issues, sharp back pain for over a months and other issues I previously reported, I started noticing hair loss at my scalp a few months later. I thought maybe it?s because of stress from the pandemic, but it hasn?t been growing back, I?m only 32 experience female pattern hair loss, and I started looking online and others reported the same after their mRNA vaccine so I?m wondering if my hair loss could be due to my vaccine considering it didn?t start happening till after I was vaccinated.
Age: 30.0
Sex: F
Vaccine: COVID19
Symptoms: Respiratory disorder
Clinical narrative: I?m addition to the heart pain, respiratory issues, rashes, nerve issues, sharp back pain for over a months and other issues I previously reported, I started noticing hair loss at my scalp a few months later. I thought maybe it?s because of stress from the pandemic, but it hasn?t been growing back, I?m only 32 experience female pattern hair loss, and I started looking online and others reported the same after their mRNA vaccine so I?m wondering if my hair loss could be due to my vaccine considering it didn?t start happening till after I was vaccinated.
Sex: U
Vaccine: VARZOS, VARZOS
Symptoms: Herpes zoster, Vaccination failure
Clinical narrative: Shingles outbreak even after 2 doses of shingrix/Suspected vaccination failure; Shingle outbreak; This serious case was reported by a physician via sales rep and described the occurrence of vaccination failure in a patient who received Herpes zoster (Shingrix) for prophylaxis.   Co-suspect products included Herpes zoster (Shingrix) for prophylaxis.   Previously administered products included Zostavax.   On an unknown date, the patient received the 2nd dose of Shingrix and the 1st dose of Shingrix. On an unknown date, an unknown time after receiving Shingrix and Shingrix, the patient experienced vaccination failure (Verbatim: Shingles outbreak even after 2 doses of shingrix/Suspected vaccination failure) (serious criteria GSK medically significant) and shingles (Verbatim: Shingle outbreak). The outcome of the vaccination failure and shingles were unknown.   It was unknown if the reporter considered the vaccination failure and shingles to be related to Shingrix and Shingrix.     It was unknown if the company considered the vaccination failure and shingles to be related to Shingrix and Shingrix.   Additional Information: GSK receipt date: 27-JUN-2023 The physician reported that her and her partner medical provider had between 5 to 7 patients experience a shingles outbreak after the patient completed the full 2-dose series of Shingrix, doses unknown, 2 doses each patient at unknown intervals.  One patient had their series of Shingrix completed 4 to 5 years prior to the shingles outbreak and had Zostavax in the past prior to starting the Shingrix series. The outcome of the shingles outbreaks was reported as unknown. This case was considered as suspected vaccination failure as details regarding time to onset and laboratory test confirming shingles were unknown at the time of reporting. The reporter consented to follow up. This case is 1 out of 5 cases reported by the same reporter.; Sender's Comments:  US-GSK-US2023AMR089463:Same reporter US-GSK-US2023AMR089467:Same reporter US-GSK-US2023AMR089457:Same reporter US-GSK-US2023AMR089465:Same reporter
Sex: U
Vaccine: VARZOS, VARZOS
Symptoms: Herpes zoster, Vaccination failure
Clinical narrative: Got 2 Shingrix doses, Got Shingles outbreak/Suspected vaccination failure; Shingles outbreak in 2021; This serious case was reported by a physician via sales rep and described the occurrence of vaccination failure in a patient who received Herpes zoster (Shingrix) for prophylaxis.   Co-suspect products included Herpes zoster (Shingrix) for prophylaxis.   On an unknown date, the patient received the 2nd dose of Shingrix and the 1st dose of Shingrix. On an unknown date, an unknown time after receiving Shingrix and Shingrix, the patient experienced vaccination failure (Verbatim: Got 2 Shingrix doses, Got Shingles outbreak/Suspected vaccination failure) (serious criteria GSK medically significant) and shingles (Verbatim: Shingles outbreak in 2021). The outcome of the vaccination failure and shingles were unknown.   It was unknown if the reporter considered the vaccination failure and shingles to be related to Shingrix and Shingrix.     It was unknown if the company considered the vaccination failure and shingles to be related to Shingrix and Shingrix.   Additional Information: GSK receipt date: 27-JUN-2023 The physician reported that her and her partner medical provider had between 5 to 7 patients experience a shingles outbreak after the patient completed the full 2-dose series of Shingrix, doses unknown, 2 doses each patient at unknown intervals. One patient had the shingles outbreak in 2021.  The outcome of the shingles outbreaks was reported as unknown. This case was considered as suspected vaccination failure as details regarding time to onset and laboratory test confirming shingles were unknown at the time of reporting. The reporter consented to follow up. This case is 1 out of 5 cases reported by the same reporter.; Sender's Comments:  US-GSK-US2023AMR089463:Same reporter US-GSK-US2023AMR089464:Same reporter US-GSK-US2023AMR089467:Same reporter US-GSK-US2023AMR089457:Same reporter
Sex: U
Vaccine: VARZOS, VARZOS
Symptoms: Herpes zoster, Vaccination failure
Clinical narrative: Suspected vaccination failure; Shingles outbreak; This serious case was reported by a physician via sales rep and described the occurrence of vaccination failure in a elderly patient who received Herpes zoster (Shingrix) for prophylaxis.   Co-suspect products included Herpes zoster (Shingrix) for prophylaxis.   Additional patient notes included had no immunocompromising or immunosuppressing conditions.   On an unknown date, the patient received the 2nd dose of Shingrix and the 1st dose of Shingrix. On an unknown date, an unknown time after receiving Shingrix and Shingrix, the patient experienced vaccination failure (Verbatim: Suspected vaccination failure) (serious criteria GSK medically significant) and shingles (Verbatim: Shingles outbreak). The outcome of the vaccination failure and shingles were unknown.   It was unknown if the reporter considered the vaccination failure and shingles to be related to Shingrix and Shingrix.     It was unknown if the company considered the vaccination failure and shingles to be related to Shingrix and Shingrix.   Additional Information: GSK Receipt Date: 27-JUN-2023 The physician reported that the patient over 65 years old experienced a shingles outbreak after the completion of the full 2 dose series. The patient had no immunocompromising or immunosuppressing conditions. The outcomes of Shingles outbreaks was unknown and all other information was unknown. This case was considered as suspected vaccination failure as details regarding time to onset and laboratory test confirming shingles were unknown at the time of reporting. The reporter consented to follow up. This case is 1 out of 5 cases reported by the same reporter.; Sender's Comments:  US-GSK-US2023AMR089457:Same reporter US-GSK-US2023AMR089463:Same reporter US-GSK-US2023AMR089464:Same reporter US-GSK-US2023AMR089465:Same reporter
Sex: F
Vaccine: VARZOS
Symptoms: Herpes zoster, Vaccination failure
Clinical narrative: got the vaccine, still got shingles/Suspected Vaccination failure; got shingles; This serious case was reported by a consumer via interactive digital media and described the occurrence of vaccination failure in a female patient who received Herpes zoster (Shingles vaccine) for prophylaxis.   On an unknown date, the patient received Shingles vaccine. On an unknown date, an unknown time after receiving Shingles vaccine, the patient experienced vaccination failure (Verbatim: got the vaccine, still got shingles/Suspected Vaccination failure) (serious criteria GSK medically significant) and shingles (Verbatim: got shingles). The outcome of the vaccination failure was unknown and the outcome of the shingles was not reported.   It was unknown if the reporter considered the vaccination failure and shingles to be related to Shingles vaccine.     It was unknown if the company considered the vaccination failure and shingles to be related to Shingles vaccine.   Additional Information: GSK receipt date: 27-JUN-2023 This case was reported by a patient via interactive digital media. The reporter reported that his/her mom got the Shingles vaccine and still got shingles. This case was considered as suspected vaccination failure as details regarding completion of primary vaccination schedule, time to onset for shingles and laboratory confirmation regarding shingles were unknown at the time of reporting. The follow-up could not be possible as no contact details were available.
Age: 48.0
Sex: F
Vaccine: TDAP
Symptoms: Product storage error
Clinical narrative: Product Storage Error with Admin; This non-serious case was reported by a other health professional via call center representative and described the occurrence of incorrect storage of drug in a female patient who received DTPa (Reduced antigen) (Boostrix) (batch number 55RY7, expiry date 17-OCT-2025) for prophylaxis.   On 26-JUN-2023, the patient received Boostrix. On an unknown date, an unknown time after receiving Boostrix, the patient experienced incorrect storage of drug (Verbatim: Product Storage Error with Admin). The outcome of the incorrect storage of drug was unknown.   This report is made by GSK without prejudice and does not imply any admission or liability for the incident or its consequences.   Additional Information: GSK receipt date: 26-Jun-2023 The vaccine coordinator stated that Boostrix was 15.6 degree Fahrenheit and administered to the patient which led to incorrect storage of drug. The reporter consented to follow up via email. The case is linked with US2023088674, by same reporter.; Sender's Comments:  US-GSK-US2023088674:Same reporter
Sex: U
Vaccine: VARZOS
Symptoms: Rash
Clinical narrative: Rash after dose 1; This non-serious case was reported by a physician via call center representative and described the occurrence of rash in a patient who received Herpes zoster (Shingrix) for prophylaxis.   On an unknown date, the patient received the 1st dose of Shingrix. On an unknown date, an unknown time after receiving Shingrix, the patient experienced rash (Verbatim: Rash after dose 1). The outcome of the rash was unknown.   It was unknown if the reporter considered the rash to be related to Shingrix.     It was unknown if the company considered the rash to be related to Shingrix.   Additional Information: GSK Receipt Date: 27-JUN-2023 The physician asked that if a patient got the 1st Shingrix vaccine and developed a rash before getting the 2nd vaccine, did the patient still needed to get the 2nd vaccine. The reporter consented to follow up.
Sex: U
Vaccine: COVID19-2
Symptoms: Expired product administered, No adverse event
Clinical narrative: no adverse event; Pharmacist calling to report that Moderna Bivalent vaccine was administered after expiration date; This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Pharmacist calling to report that Moderna Bivalent vaccine was administered after expiration date) and NO ADVERSE EVENT (no adverse event) in a  patient of an unknown age and gender who received mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)) (batch no. 069H22A) for COVID-19 prophylaxis.     No Medical History information was reported.    On 23-Jun-2023, the patient received dose of mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)) (unknown route) 1 dosage form. On 23-Jun-2023,  after starting mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)), the patient experienced EXPIRED PRODUCT ADMINISTERED (Pharmacist calling to report that Moderna Bivalent vaccine was administered after expiration date). On an unknown date, the patient experienced NO ADVERSE EVENT (no adverse event). At the time of the report, EXPIRED PRODUCT ADMINISTERED (Pharmacist calling to report that Moderna Bivalent vaccine was administered after expiration date) and NO ADVERSE EVENT (no adverse event) outcome was unknown.        For mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)) (Unknown), the reporter considered NO ADVERSE EVENT (no adverse event) to be not related. No further causality assessment was provided for EXPIRED PRODUCT ADMINISTERED (Pharmacist calling to report that Moderna Bivalent vaccine was administered after expiration date).    No patient details were provided.  Concomitant product use was not provided by the reporter.  It was reported that dose was administered after 30-day Use by Date or after manufacturer Date of Expiry. Individual vial size was reported as 2.5 ml. Dates vial was initially stored was 19-Jun-2023, 22-Jun-2023, and 23-Jun-2023. Vial did not undergo any temperature excursions. Vials were administered on 19-Jun-2023 (1Patient), 22-Jun-2023 (2 patients), and 23-Jun-2023 (2 Patients). Reporter stated that he wanted to wait on the assessment as it was just 1 day after expiration date.  Treatment information was not provided.  This case contains information about patient 3rd out of 5 patients.   This case was linked to US-MODERNATX, INC.-MOD-2023-730746 (Linked Report).; Sender's Comments:  US-MODERNATX, INC.-MOD-2023-730746:Master case (Patient 1)
Sex: U
Vaccine: COVID19-2
Symptoms: Expired product administered, No adverse event
Clinical narrative: no adverse event; Moderna Bivalent vaccine was administered after expiration date from 3 Individual vials with same lot number.; This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Moderna Bivalent vaccine was administered after expiration date from 3 Individual vials with same lot number.) and NO ADVERSE EVENT (no adverse event) in a  patient of an unknown age and gender who received mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)) (batch no. 069H22A) for COVID-19 prophylaxis.     No Medical History information was reported.    On 22-Jun-2023, the patient received dose of mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)) (unknown route) 1 dosage form. On 22-Jun-2023,  after starting mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)), the patient experienced EXPIRED PRODUCT ADMINISTERED (Moderna Bivalent vaccine was administered after expiration date from 3 Individual vials with same lot number.). On an unknown date, the patient experienced NO ADVERSE EVENT (no adverse event). At the time of the report, EXPIRED PRODUCT ADMINISTERED (Moderna Bivalent vaccine was administered after expiration date from 3 Individual vials with same lot number.) and NO ADVERSE EVENT (no adverse event) outcome was unknown.        For mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)) (Unknown), the reporter considered NO ADVERSE EVENT (no adverse event) to be not related. No further causality assessment was provided for EXPIRED PRODUCT ADMINISTERED (Moderna Bivalent vaccine was administered after expiration date from 3 Individual vials with same lot number.).    No patient details were provided.  Concomitant product use was not provided by the reporter.  It was reported that dose was administered after 30-day Use by Date or after manufacturer Date of Expiry. Individual vial size was reported as 2.5 ml. Dates vial was initially stored was 19-Jun-2023, 22-Jun-2023, and 23-Jun-2023. Vial did not undergo any temperature excursions. Vials were administered on 19-Jun-2023 (1Patient), 22-Jun-2023 (2 patients), and 23-Jun-2023 (2 Patients). Reporter stated that he wanted to wait on the assessment as it was just 1 day after expiration date.  Suspect product dosage text was reported as unknown.  Treatment information was not provided.  This case contains information about patient 2nd out of 5 patients.   This case was linked to US-MODERNATX, INC.-MOD-2023-730746 (Linked Report).; Sender's Comments:  US-MODERNATX, INC.-MOD-2023-730746:Master case ( Patient 1 out of 5)
Age: 58.0
Sex: F
Vaccine: COVID19-2
Symptoms: Expired product administered, No adverse event
Clinical narrative: No adverse event; vaccine expired on 6-7-23 and was used to administer a vaccination on 6-29-23; This spontaneous case was reported by an other health care professional and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (vaccine expired on 6-7-23 and was used to administer a vaccination on 6-29-23) and NO ADVERSE EVENT (No adverse event) in a 58-year-old female patient who received mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)) (batch no. 042H22A) for COVID-19 prophylaxis.     There was no relevant medical history/conditions, allergy, concomitant diseases and risk factor.     On 29-Jun-2023, the patient received fourth dose of mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)) (unknown route) 1 dosage form. On 29-Jun-2023,  after starting mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)), the patient experienced EXPIRED PRODUCT ADMINISTERED (vaccine expired on 6-7-23 and was used to administer a vaccination on 6-29-23). On an unknown date, the patient experienced NO ADVERSE EVENT (No adverse event). At the time of the report, EXPIRED PRODUCT ADMINISTERED (vaccine expired on 6-7-23 and was used to administer a vaccination on 6-29-23) and NO ADVERSE EVENT (No adverse event) outcome was unknown.        For mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)) (Unknown), the reporter considered NO ADVERSE EVENT (No adverse event) to be not related. No further causality assessment was provided for EXPIRED PRODUCT ADMINISTERED (vaccine expired on 6-7-23 and was used to administer a vaccination on 6-29-23).    No concomitant medication was reported. It was reported that the patient did not receive any other vaccines in the 4 weeks prior to COVID-19 vaccine. The expiry date was reported as 07-JUN-2023. No treatment medication was reported.
Age: 0.17
Sex: F
Vaccine: UNK
Symptoms: Incorrect dose administered, No adverse event
Clinical narrative: some of the vaccine came out during injecting the dose of Pentacel with no reported adverse event; Initial information received on 29-Jun-2023 regarding an unsolicited valid non-serious case received from a other health professional.  This case involves a 2 months old female patient who experienced some of the vaccine came out during injecting the dose of Diphtheria/Tetanus/5 Hybrid AC pertussis/IPV(VERO)/HIB(PRP/T) vaccine [Pentacel (Vero)] with no reported adverse event.  The patient's past medical history, medical treatment(s), vaccination(s) and family history were not provided.  Concomitant medications included Pneumococcal Vaccine CONJ 7V (CRM197) (Prevnar) for Immunisation.  On 29-Jun-2023, the patient received dose of 0.5 ml dose 1 of standard strength of suspect Diphtheria/Tetanus/5 Hybrid AC pertussis/IPV(VERO)/HIB(PRP/T) vaccine suspension for injection (lot: UJ858AA) via intramuscular route in the left leg upper thigh for Immunization and some of the vaccine came out during injecting the dose with no reported adverse event (incorrect dose administered) (latency: same day).  Action taken: not applicable.  At time of reporting, the outcome was Unknown.  This suspected adverse reaction report is submitted and classified as a medication error solely and exclusively to ensure the marketing authorization holder's compliance with the requirements set out in the guidelines. The classification as a medical error is in no way intended, nor should it be interpreted or construed as an allegation or claim made by the marketing authorization holder that any third party has contributed to or is to be held liable for the occurrence of this medication error.
Age: 93.0
Sex: F
Vaccine: COVID19
Symptoms: Acute respiratory failure, Angiogram pulmonary abnormal, Asthma, Atrioventricular block first degree, Breast mass
Clinical narrative: Acute hypoxemic respiratory failure, resolved - Secondary to COVID-19 infection, bronchitis - CTPA: no evidence of PE or lobar consolidation, bilateral bronchial thickening suggestive of bronchitis - Strongly encourage pulmonary hygiene with I-S, vibratory pep therapy, encourage cough and deep breathing - Now on RA   COVID-19 - Presented with: fatigue, cough and hypoxia - Symptom onset: 4/6/23 - Positive COVID-19: 4/7 at FVD rapid test, PCR positive 4/9 at RMH - Vaccination status: vaccinated with Moderna with last dose 5/4/22 - CT Chest without evidence of PE or lobar consolidation - Received 2 doses of IV Remdesivir - Complete 5 day course of Decadron, can extend at SNF if indicated - Was prescribed Molnupiravir outpatient but has not yet started this medication (not available inpatient)   Bronchitis - Suspect viral bronchitis; however, given increased sputum production and CTPA evidence of bronchitis, cannot completely exclude bacterial component - Pulmonary hygiene as per above. - Procalcitonin WNL - Benefit of 5 days of treatment with azithromycin outweighs potential risk at this point - Azithromycin x 5 days, continue Robitussin around-the-clock   Elevated troponin - Troponin mildly elevated on admission without clinical signs or symptoms consistent with ACS - Per history has had mildly elevated troponin levels of 15-18 in the past - ECG notable for first-degree AV block without acute ST or T wave changes - Continue to monitor clinically, no further work-up indicated at present   Mild intermittent asthma - Not in acute intubation at present - Continue Albuterol MDI as needed   Esophagitis/duodenal ulcer - EGD 1/2023 with esophagitis and duodenal ulcer, GI recommended 8 weeks of PPI twice daily, de-escalated to once daily 3/28 - Continue Protonix once daily Cognitive impairment Vascular dementia - Chronic, suspect secondary to small vessel cerebrovascular disease - Continue Donepezil 5mg once daily   Essential tremor - Continue home nightly Gabapentin, Primidone and daily Propranolol   Mood disorder - Continue home Wellbutrin   Insomnia - Continue nightly Remeron and Melatonin   Cerebrovascular disease - CT imaging of the head (2022 (with chronic left frontal and bilateral cerebellar infarcts as well as chronic microvascular changes - Continue home ASA and statin   Right lower extremity weakness - Chronic, longstanding issue; was getting PT/OT without significant improvement in functional status over the last several hospitalizations - PT/OT consulted, recommending up to 5 (currently at ALF), discharge to SNF   Chronic lymphocytic lymphoma - Follows with Dr., currently undergoing outpatient surveillance - No active treatment plan at this time   Abnormal CT chest - Left breast 9 mm soft tissue nodule noted on CTPA - Given goals of care/DNRCC status would not recommend any further investigation at this time, can follow-up with PCP for further work-up outpatient if warranted; discussed with daughter, whom is in agreement
Age: 93.0
Sex: F
Vaccine: COVID19
Symptoms: Bronchitis, Bronchitis viral, COVID-19, Cerebellar infarction, Cerebrovascular disorder
Clinical narrative: Acute hypoxemic respiratory failure, resolved - Secondary to COVID-19 infection, bronchitis - CTPA: no evidence of PE or lobar consolidation, bilateral bronchial thickening suggestive of bronchitis - Strongly encourage pulmonary hygiene with I-S, vibratory pep therapy, encourage cough and deep breathing - Now on RA   COVID-19 - Presented with: fatigue, cough and hypoxia - Symptom onset: 4/6/23 - Positive COVID-19: 4/7 at FVD rapid test, PCR positive 4/9 at RMH - Vaccination status: vaccinated with Moderna with last dose 5/4/22 - CT Chest without evidence of PE or lobar consolidation - Received 2 doses of IV Remdesivir - Complete 5 day course of Decadron, can extend at SNF if indicated - Was prescribed Molnupiravir outpatient but has not yet started this medication (not available inpatient)   Bronchitis - Suspect viral bronchitis; however, given increased sputum production and CTPA evidence of bronchitis, cannot completely exclude bacterial component - Pulmonary hygiene as per above. - Procalcitonin WNL - Benefit of 5 days of treatment with azithromycin outweighs potential risk at this point - Azithromycin x 5 days, continue Robitussin around-the-clock   Elevated troponin - Troponin mildly elevated on admission without clinical signs or symptoms consistent with ACS - Per history has had mildly elevated troponin levels of 15-18 in the past - ECG notable for first-degree AV block without acute ST or T wave changes - Continue to monitor clinically, no further work-up indicated at present   Mild intermittent asthma - Not in acute intubation at present - Continue Albuterol MDI as needed   Esophagitis/duodenal ulcer - EGD 1/2023 with esophagitis and duodenal ulcer, GI recommended 8 weeks of PPI twice daily, de-escalated to once daily 3/28 - Continue Protonix once daily Cognitive impairment Vascular dementia - Chronic, suspect secondary to small vessel cerebrovascular disease - Continue Donepezil 5mg once daily   Essential tremor - Continue home nightly Gabapentin, Primidone and daily Propranolol   Mood disorder - Continue home Wellbutrin   Insomnia - Continue nightly Remeron and Melatonin   Cerebrovascular disease - CT imaging of the head (2022 (with chronic left frontal and bilateral cerebellar infarcts as well as chronic microvascular changes - Continue home ASA and statin   Right lower extremity weakness - Chronic, longstanding issue; was getting PT/OT without significant improvement in functional status over the last several hospitalizations - PT/OT consulted, recommending up to 5 (currently at ALF), discharge to SNF   Chronic lymphocytic lymphoma - Follows with Dr., currently undergoing outpatient surveillance - No active treatment plan at this time   Abnormal CT chest - Left breast 9 mm soft tissue nodule noted on CTPA - Given goals of care/DNRCC status would not recommend any further investigation at this time, can follow-up with PCP for further work-up outpatient if warranted; discussed with daughter, whom is in agreement
Age: 93.0
Sex: F
Vaccine: COVID19
Symptoms: Cognitive disorder, Computerised tomogram head abnormal, Computerised tomogram thorax abnormal, Cough, Duodenal ulcer
Clinical narrative: Acute hypoxemic respiratory failure, resolved - Secondary to COVID-19 infection, bronchitis - CTPA: no evidence of PE or lobar consolidation, bilateral bronchial thickening suggestive of bronchitis - Strongly encourage pulmonary hygiene with I-S, vibratory pep therapy, encourage cough and deep breathing - Now on RA   COVID-19 - Presented with: fatigue, cough and hypoxia - Symptom onset: 4/6/23 - Positive COVID-19: 4/7 at FVD rapid test, PCR positive 4/9 at RMH - Vaccination status: vaccinated with Moderna with last dose 5/4/22 - CT Chest without evidence of PE or lobar consolidation - Received 2 doses of IV Remdesivir - Complete 5 day course of Decadron, can extend at SNF if indicated - Was prescribed Molnupiravir outpatient but has not yet started this medication (not available inpatient)   Bronchitis - Suspect viral bronchitis; however, given increased sputum production and CTPA evidence of bronchitis, cannot completely exclude bacterial component - Pulmonary hygiene as per above. - Procalcitonin WNL - Benefit of 5 days of treatment with azithromycin outweighs potential risk at this point - Azithromycin x 5 days, continue Robitussin around-the-clock   Elevated troponin - Troponin mildly elevated on admission without clinical signs or symptoms consistent with ACS - Per history has had mildly elevated troponin levels of 15-18 in the past - ECG notable for first-degree AV block without acute ST or T wave changes - Continue to monitor clinically, no further work-up indicated at present   Mild intermittent asthma - Not in acute intubation at present - Continue Albuterol MDI as needed   Esophagitis/duodenal ulcer - EGD 1/2023 with esophagitis and duodenal ulcer, GI recommended 8 weeks of PPI twice daily, de-escalated to once daily 3/28 - Continue Protonix once daily Cognitive impairment Vascular dementia - Chronic, suspect secondary to small vessel cerebrovascular disease - Continue Donepezil 5mg once daily   Essential tremor - Continue home nightly Gabapentin, Primidone and daily Propranolol   Mood disorder - Continue home Wellbutrin   Insomnia - Continue nightly Remeron and Melatonin   Cerebrovascular disease - CT imaging of the head (2022 (with chronic left frontal and bilateral cerebellar infarcts as well as chronic microvascular changes - Continue home ASA and statin   Right lower extremity weakness - Chronic, longstanding issue; was getting PT/OT without significant improvement in functional status over the last several hospitalizations - PT/OT consulted, recommending up to 5 (currently at ALF), discharge to SNF   Chronic lymphocytic lymphoma - Follows with Dr., currently undergoing outpatient surveillance - No active treatment plan at this time   Abnormal CT chest - Left breast 9 mm soft tissue nodule noted on CTPA - Given goals of care/DNRCC status would not recommend any further investigation at this time, can follow-up with PCP for further work-up outpatient if warranted; discussed with daughter, whom is in agreement
Age: 93.0
Sex: F
Vaccine: COVID19
Symptoms: Electrocardiogram abnormal, Fatigue, Hypoxia, Lymphocytic lymphoma, Muscular weakness
Clinical narrative: Acute hypoxemic respiratory failure, resolved - Secondary to COVID-19 infection, bronchitis - CTPA: no evidence of PE or lobar consolidation, bilateral bronchial thickening suggestive of bronchitis - Strongly encourage pulmonary hygiene with I-S, vibratory pep therapy, encourage cough and deep breathing - Now on RA   COVID-19 - Presented with: fatigue, cough and hypoxia - Symptom onset: 4/6/23 - Positive COVID-19: 4/7 at FVD rapid test, PCR positive 4/9 at RMH - Vaccination status: vaccinated with Moderna with last dose 5/4/22 - CT Chest without evidence of PE or lobar consolidation - Received 2 doses of IV Remdesivir - Complete 5 day course of Decadron, can extend at SNF if indicated - Was prescribed Molnupiravir outpatient but has not yet started this medication (not available inpatient)   Bronchitis - Suspect viral bronchitis; however, given increased sputum production and CTPA evidence of bronchitis, cannot completely exclude bacterial component - Pulmonary hygiene as per above. - Procalcitonin WNL - Benefit of 5 days of treatment with azithromycin outweighs potential risk at this point - Azithromycin x 5 days, continue Robitussin around-the-clock   Elevated troponin - Troponin mildly elevated on admission without clinical signs or symptoms consistent with ACS - Per history has had mildly elevated troponin levels of 15-18 in the past - ECG notable for first-degree AV block without acute ST or T wave changes - Continue to monitor clinically, no further work-up indicated at present   Mild intermittent asthma - Not in acute intubation at present - Continue Albuterol MDI as needed   Esophagitis/duodenal ulcer - EGD 1/2023 with esophagitis and duodenal ulcer, GI recommended 8 weeks of PPI twice daily, de-escalated to once daily 3/28 - Continue Protonix once daily Cognitive impairment Vascular dementia - Chronic, suspect secondary to small vessel cerebrovascular disease - Continue Donepezil 5mg once daily   Essential tremor - Continue home nightly Gabapentin, Primidone and daily Propranolol   Mood disorder - Continue home Wellbutrin   Insomnia - Continue nightly Remeron and Melatonin   Cerebrovascular disease - CT imaging of the head (2022 (with chronic left frontal and bilateral cerebellar infarcts as well as chronic microvascular changes - Continue home ASA and statin   Right lower extremity weakness - Chronic, longstanding issue; was getting PT/OT without significant improvement in functional status over the last several hospitalizations - PT/OT consulted, recommending up to 5 (currently at ALF), discharge to SNF   Chronic lymphocytic lymphoma - Follows with Dr., currently undergoing outpatient surveillance - No active treatment plan at this time   Abnormal CT chest - Left breast 9 mm soft tissue nodule noted on CTPA - Given goals of care/DNRCC status would not recommend any further investigation at this time, can follow-up with PCP for further work-up outpatient if warranted; discussed with daughter, whom is in agreement
Age: 93.0
Sex: F
Vaccine: COVID19
Symptoms: Oesophagitis, Oesophagogastroduodenoscopy abnormal, Procalcitonin normal, SARS-CoV-2 test positive, Sputum increased
Clinical narrative: Acute hypoxemic respiratory failure, resolved - Secondary to COVID-19 infection, bronchitis - CTPA: no evidence of PE or lobar consolidation, bilateral bronchial thickening suggestive of bronchitis - Strongly encourage pulmonary hygiene with I-S, vibratory pep therapy, encourage cough and deep breathing - Now on RA   COVID-19 - Presented with: fatigue, cough and hypoxia - Symptom onset: 4/6/23 - Positive COVID-19: 4/7 at FVD rapid test, PCR positive 4/9 at RMH - Vaccination status: vaccinated with Moderna with last dose 5/4/22 - CT Chest without evidence of PE or lobar consolidation - Received 2 doses of IV Remdesivir - Complete 5 day course of Decadron, can extend at SNF if indicated - Was prescribed Molnupiravir outpatient but has not yet started this medication (not available inpatient)   Bronchitis - Suspect viral bronchitis; however, given increased sputum production and CTPA evidence of bronchitis, cannot completely exclude bacterial component - Pulmonary hygiene as per above. - Procalcitonin WNL - Benefit of 5 days of treatment with azithromycin outweighs potential risk at this point - Azithromycin x 5 days, continue Robitussin around-the-clock   Elevated troponin - Troponin mildly elevated on admission without clinical signs or symptoms consistent with ACS - Per history has had mildly elevated troponin levels of 15-18 in the past - ECG notable for first-degree AV block without acute ST or T wave changes - Continue to monitor clinically, no further work-up indicated at present   Mild intermittent asthma - Not in acute intubation at present - Continue Albuterol MDI as needed   Esophagitis/duodenal ulcer - EGD 1/2023 with esophagitis and duodenal ulcer, GI recommended 8 weeks of PPI twice daily, de-escalated to once daily 3/28 - Continue Protonix once daily Cognitive impairment Vascular dementia - Chronic, suspect secondary to small vessel cerebrovascular disease - Continue Donepezil 5mg once daily   Essential tremor - Continue home nightly Gabapentin, Primidone and daily Propranolol   Mood disorder - Continue home Wellbutrin   Insomnia - Continue nightly Remeron and Melatonin   Cerebrovascular disease - CT imaging of the head (2022 (with chronic left frontal and bilateral cerebellar infarcts as well as chronic microvascular changes - Continue home ASA and statin   Right lower extremity weakness - Chronic, longstanding issue; was getting PT/OT without significant improvement in functional status over the last several hospitalizations - PT/OT consulted, recommending up to 5 (currently at ALF), discharge to SNF   Chronic lymphocytic lymphoma - Follows with Dr., currently undergoing outpatient surveillance - No active treatment plan at this time   Abnormal CT chest - Left breast 9 mm soft tissue nodule noted on CTPA - Given goals of care/DNRCC status would not recommend any further investigation at this time, can follow-up with PCP for further work-up outpatient if warranted; discussed with daughter, whom is in agreement
Age: 93.0
Sex: F
Vaccine: COVID19
Symptoms: Troponin increased, Vascular dementia
Clinical narrative: Acute hypoxemic respiratory failure, resolved - Secondary to COVID-19 infection, bronchitis - CTPA: no evidence of PE or lobar consolidation, bilateral bronchial thickening suggestive of bronchitis - Strongly encourage pulmonary hygiene with I-S, vibratory pep therapy, encourage cough and deep breathing - Now on RA   COVID-19 - Presented with: fatigue, cough and hypoxia - Symptom onset: 4/6/23 - Positive COVID-19: 4/7 at FVD rapid test, PCR positive 4/9 at RMH - Vaccination status: vaccinated with Moderna with last dose 5/4/22 - CT Chest without evidence of PE or lobar consolidation - Received 2 doses of IV Remdesivir - Complete 5 day course of Decadron, can extend at SNF if indicated - Was prescribed Molnupiravir outpatient but has not yet started this medication (not available inpatient)   Bronchitis - Suspect viral bronchitis; however, given increased sputum production and CTPA evidence of bronchitis, cannot completely exclude bacterial component - Pulmonary hygiene as per above. - Procalcitonin WNL - Benefit of 5 days of treatment with azithromycin outweighs potential risk at this point - Azithromycin x 5 days, continue Robitussin around-the-clock   Elevated troponin - Troponin mildly elevated on admission without clinical signs or symptoms consistent with ACS - Per history has had mildly elevated troponin levels of 15-18 in the past - ECG notable for first-degree AV block without acute ST or T wave changes - Continue to monitor clinically, no further work-up indicated at present   Mild intermittent asthma - Not in acute intubation at present - Continue Albuterol MDI as needed   Esophagitis/duodenal ulcer - EGD 1/2023 with esophagitis and duodenal ulcer, GI recommended 8 weeks of PPI twice daily, de-escalated to once daily 3/28 - Continue Protonix once daily Cognitive impairment Vascular dementia - Chronic, suspect secondary to small vessel cerebrovascular disease - Continue Donepezil 5mg once daily   Essential tremor - Continue home nightly Gabapentin, Primidone and daily Propranolol   Mood disorder - Continue home Wellbutrin   Insomnia - Continue nightly Remeron and Melatonin   Cerebrovascular disease - CT imaging of the head (2022 (with chronic left frontal and bilateral cerebellar infarcts as well as chronic microvascular changes - Continue home ASA and statin   Right lower extremity weakness - Chronic, longstanding issue; was getting PT/OT without significant improvement in functional status over the last several hospitalizations - PT/OT consulted, recommending up to 5 (currently at ALF), discharge to SNF   Chronic lymphocytic lymphoma - Follows with Dr., currently undergoing outpatient surveillance - No active treatment plan at this time   Abnormal CT chest - Left breast 9 mm soft tissue nodule noted on CTPA - Given goals of care/DNRCC status would not recommend any further investigation at this time, can follow-up with PCP for further work-up outpatient if warranted; discussed with daughter, whom is in agreement
Age: 75.0
Sex: F
Vaccine: COVID19-2
Symptoms: Acute kidney injury, Acute respiratory failure, Asthenia, Atelectasis, Blood creatinine increased
Clinical narrative: The patient is a 75 y.o. female patient of a CNP with history of HTN, HLD, multiple hernia repairs, asthma, recent admission for ileus and bronchitis(dc 3/28) who presented to the Medical Center with cough, wheeze, dyspnea, generalized weakness, N/V/D.   Acute hypoxemic respiratory failure Covid-19 Virus Infection Community acquired pneumonia Dyspnea, hypoxia requiring 4LNC Multifactorial due to COVID and pneumonia CT chest in ED with dependent opacities atelectasis favored vs PNA; also nodule  Date of onset of COVID symptoms: 3/11 Date of covid positive test: 4/4 Vaccination status: vaccinated Imaging: As above Oxygen requirements on admission: 4L Current oxygen requirements: RA Urine antigen neg, sputum cx mixed flora Medical therapy: steroids, rocephin, and zithromax; started remdesivir as GI symptoms consistent with new COVID Consultants following: none  Anticipated special isolation end date: 4/14 Home oxygen evaluation completed and no home O2 needs identified; discharged on RA   Ileus Dx last admission; improved since Returns with GI symptoms again; although could all be COVID-related KUB on admission ileus vs mild bowel obstruction Passing BM's; last was 1d PTA Tolerated regular diet Continue bowel regimen   AKI Cr up to 2.02 on 4/5 from baseline ~1 Likely prerenal due to GI losses Continue hydration for now  SCr improved to 0.80 on 4/8   Steroid-induced Hyperglycemia BG ~100-200 since admission Likely due to steroids Monitor for now   Lung nodule RUL 1.7 cm nodule seen on CT, with borderline enlarged R hilar mediastinal LN Rec recheck CT in 3 months, PET-CT or tissue sampling  Generalized weakness Myalgia  Due to current illness Uses a walker at baseline Re-assess after treatment Mobilize as able Muscle aches likely related to COVID Norco prn ordered    HTN Holding home hydrochlorothiazide and losartan for AKI Continue home Norvasc and clonidine    Hx of Paradoxical VCD Hx of Polypoid corditis ENT consulted previous admission discovered 3/14 Laryngeal control therapy breathing exercises and outpt ENT f/u
Age: 75.0
Sex: F
Vaccine: COVID19-2
Symptoms: Bronchitis, COVID-19, Computerised tomogram thorax abnormal, Condition aggravated, Cough
Clinical narrative: The patient is a 75 y.o. female patient of a CNP with history of HTN, HLD, multiple hernia repairs, asthma, recent admission for ileus and bronchitis(dc 3/28) who presented to the Medical Center with cough, wheeze, dyspnea, generalized weakness, N/V/D.   Acute hypoxemic respiratory failure Covid-19 Virus Infection Community acquired pneumonia Dyspnea, hypoxia requiring 4LNC Multifactorial due to COVID and pneumonia CT chest in ED with dependent opacities atelectasis favored vs PNA; also nodule  Date of onset of COVID symptoms: 3/11 Date of covid positive test: 4/4 Vaccination status: vaccinated Imaging: As above Oxygen requirements on admission: 4L Current oxygen requirements: RA Urine antigen neg, sputum cx mixed flora Medical therapy: steroids, rocephin, and zithromax; started remdesivir as GI symptoms consistent with new COVID Consultants following: none  Anticipated special isolation end date: 4/14 Home oxygen evaluation completed and no home O2 needs identified; discharged on RA   Ileus Dx last admission; improved since Returns with GI symptoms again; although could all be COVID-related KUB on admission ileus vs mild bowel obstruction Passing BM's; last was 1d PTA Tolerated regular diet Continue bowel regimen   AKI Cr up to 2.02 on 4/5 from baseline ~1 Likely prerenal due to GI losses Continue hydration for now  SCr improved to 0.80 on 4/8   Steroid-induced Hyperglycemia BG ~100-200 since admission Likely due to steroids Monitor for now   Lung nodule RUL 1.7 cm nodule seen on CT, with borderline enlarged R hilar mediastinal LN Rec recheck CT in 3 months, PET-CT or tissue sampling  Generalized weakness Myalgia  Due to current illness Uses a walker at baseline Re-assess after treatment Mobilize as able Muscle aches likely related to COVID Norco prn ordered    HTN Holding home hydrochlorothiazide and losartan for AKI Continue home Norvasc and clonidine    Hx of Paradoxical VCD Hx of Polypoid corditis ENT consulted previous admission discovered 3/14 Laryngeal control therapy breathing exercises and outpt ENT f/u
Age: 75.0
Sex: F
Vaccine: COVID19-2
Symptoms: Diarrhoea, Dyspnoea, Gastrointestinal disorder, Hyperglycaemia, Hypoxia
Clinical narrative: The patient is a 75 y.o. female patient of a CNP with history of HTN, HLD, multiple hernia repairs, asthma, recent admission for ileus and bronchitis(dc 3/28) who presented to the Medical Center with cough, wheeze, dyspnea, generalized weakness, N/V/D.   Acute hypoxemic respiratory failure Covid-19 Virus Infection Community acquired pneumonia Dyspnea, hypoxia requiring 4LNC Multifactorial due to COVID and pneumonia CT chest in ED with dependent opacities atelectasis favored vs PNA; also nodule  Date of onset of COVID symptoms: 3/11 Date of covid positive test: 4/4 Vaccination status: vaccinated Imaging: As above Oxygen requirements on admission: 4L Current oxygen requirements: RA Urine antigen neg, sputum cx mixed flora Medical therapy: steroids, rocephin, and zithromax; started remdesivir as GI symptoms consistent with new COVID Consultants following: none  Anticipated special isolation end date: 4/14 Home oxygen evaluation completed and no home O2 needs identified; discharged on RA   Ileus Dx last admission; improved since Returns with GI symptoms again; although could all be COVID-related KUB on admission ileus vs mild bowel obstruction Passing BM's; last was 1d PTA Tolerated regular diet Continue bowel regimen   AKI Cr up to 2.02 on 4/5 from baseline ~1 Likely prerenal due to GI losses Continue hydration for now  SCr improved to 0.80 on 4/8   Steroid-induced Hyperglycemia BG ~100-200 since admission Likely due to steroids Monitor for now   Lung nodule RUL 1.7 cm nodule seen on CT, with borderline enlarged R hilar mediastinal LN Rec recheck CT in 3 months, PET-CT or tissue sampling  Generalized weakness Myalgia  Due to current illness Uses a walker at baseline Re-assess after treatment Mobilize as able Muscle aches likely related to COVID Norco prn ordered    HTN Holding home hydrochlorothiazide and losartan for AKI Continue home Norvasc and clonidine    Hx of Paradoxical VCD Hx of Polypoid corditis ENT consulted previous admission discovered 3/14 Laryngeal control therapy breathing exercises and outpt ENT f/u
Age: 75.0
Sex: F
Vaccine: COVID19-2
Symptoms: Ileus, Intestinal obstruction, Lung opacity, Malaise, Myalgia
Clinical narrative: The patient is a 75 y.o. female patient of a CNP with history of HTN, HLD, multiple hernia repairs, asthma, recent admission for ileus and bronchitis(dc 3/28) who presented to the Medical Center with cough, wheeze, dyspnea, generalized weakness, N/V/D.   Acute hypoxemic respiratory failure Covid-19 Virus Infection Community acquired pneumonia Dyspnea, hypoxia requiring 4LNC Multifactorial due to COVID and pneumonia CT chest in ED with dependent opacities atelectasis favored vs PNA; also nodule  Date of onset of COVID symptoms: 3/11 Date of covid positive test: 4/4 Vaccination status: vaccinated Imaging: As above Oxygen requirements on admission: 4L Current oxygen requirements: RA Urine antigen neg, sputum cx mixed flora Medical therapy: steroids, rocephin, and zithromax; started remdesivir as GI symptoms consistent with new COVID Consultants following: none  Anticipated special isolation end date: 4/14 Home oxygen evaluation completed and no home O2 needs identified; discharged on RA   Ileus Dx last admission; improved since Returns with GI symptoms again; although could all be COVID-related KUB on admission ileus vs mild bowel obstruction Passing BM's; last was 1d PTA Tolerated regular diet Continue bowel regimen   AKI Cr up to 2.02 on 4/5 from baseline ~1 Likely prerenal due to GI losses Continue hydration for now  SCr improved to 0.80 on 4/8   Steroid-induced Hyperglycemia BG ~100-200 since admission Likely due to steroids Monitor for now   Lung nodule RUL 1.7 cm nodule seen on CT, with borderline enlarged R hilar mediastinal LN Rec recheck CT in 3 months, PET-CT or tissue sampling  Generalized weakness Myalgia  Due to current illness Uses a walker at baseline Re-assess after treatment Mobilize as able Muscle aches likely related to COVID Norco prn ordered    HTN Holding home hydrochlorothiazide and losartan for AKI Continue home Norvasc and clonidine    Hx of Paradoxical VCD Hx of Polypoid corditis ENT consulted previous admission discovered 3/14 Laryngeal control therapy breathing exercises and outpt ENT f/u