chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 98.0
Sex: F
Vaccine: COVID19
Symptoms: Deep vein thrombosis, Dysphagia, Echocardiogram, Fibrin D dimer increased, General physical health deterioration
Clinical narrative: Hospital Course:  The patient was admitted with right sided weakness. She was found to have a Left parital CVA. She was also found to have COVID 19. The patient was not hypoxic and did not get treated for the Covid 19. She also had persistant afib. She was not able to swallow so she was maintained on a amiodarone gtt. She had an elevated D.dimer. CTA of the chest did not show a PE but she was found to have bilateral lower extremity DVT's. In speaking with the patient and her daughter they did not want any further testing or procedures done. The patient wanted to go home. The daughter, who is in her 70's, was not able to take care of all her needs so they decided on comforte care and wished to go to inpatient hospice. The patinet was not able to swallow her meds. I told the daughter an the pt that if we do comforte care I can let her eat but she needs to understand that her risk of aspiration is high. She voiced understanding and wished to go with comfortae care. I will let the patient eat.    Consults to:  Neurology, cardiology.    Significant Diagnostic Studies:  CT head, CTA chest, CTA head and neck. MRI brain. 2d echo.    Procedure(s): none.    Disposition:Home with hospice.    Discharge Condition:  Poor.
Age: 98.0
Sex: F
Vaccine: COVID19
Symptoms: Hemiparesis, Hypokalaemia, Magnetic resonance imaging head, Transient ischaemic attack, Troponin increased
Clinical narrative: Hospital Course:  The patient was admitted with right sided weakness. She was found to have a Left parital CVA. She was also found to have COVID 19. The patient was not hypoxic and did not get treated for the Covid 19. She also had persistant afib. She was not able to swallow so she was maintained on a amiodarone gtt. She had an elevated D.dimer. CTA of the chest did not show a PE but she was found to have bilateral lower extremity DVT's. In speaking with the patient and her daughter they did not want any further testing or procedures done. The patient wanted to go home. The daughter, who is in her 70's, was not able to take care of all her needs so they decided on comforte care and wished to go to inpatient hospice. The patinet was not able to swallow her meds. I told the daughter an the pt that if we do comforte care I can let her eat but she needs to understand that her risk of aspiration is high. She voiced understanding and wished to go with comfortae care. I will let the patient eat.    Consults to:  Neurology, cardiology.    Significant Diagnostic Studies:  CT head, CTA chest, CTA head and neck. MRI brain. 2d echo.    Procedure(s): none.    Disposition:Home with hospice.    Discharge Condition:  Poor.
Age: 98.0
Sex: F
Vaccine: COVID19
Symptoms: Urinary tract infection
Clinical narrative: Hospital Course:  The patient was admitted with right sided weakness. She was found to have a Left parital CVA. She was also found to have COVID 19. The patient was not hypoxic and did not get treated for the Covid 19. She also had persistant afib. She was not able to swallow so she was maintained on a amiodarone gtt. She had an elevated D.dimer. CTA of the chest did not show a PE but she was found to have bilateral lower extremity DVT's. In speaking with the patient and her daughter they did not want any further testing or procedures done. The patient wanted to go home. The daughter, who is in her 70's, was not able to take care of all her needs so they decided on comforte care and wished to go to inpatient hospice. The patinet was not able to swallow her meds. I told the daughter an the pt that if we do comforte care I can let her eat but she needs to understand that her risk of aspiration is high. She voiced understanding and wished to go with comfortae care. I will let the patient eat.    Consults to:  Neurology, cardiology.    Significant Diagnostic Studies:  CT head, CTA chest, CTA head and neck. MRI brain. 2d echo.    Procedure(s): none.    Disposition:Home with hospice.    Discharge Condition:  Poor.
Age: 11.0
Sex: M
Vaccine: HPV9, MNQ, TDAP
Symptoms: No adverse event, Product preparation error
Clinical narrative: On August 26th at 0949 a RN went to obtain a Menveo vaccination. She noted one bottle of diluent without a powder to go with the diluent.  Staff interviewed involving the 5 previous patient administrations.  They all confirm they did not drop or break an orange vial of powder.  Unable to determine which patient received the incorrect diluent for the Menveo powder.  No adverse events.  All 5 patients are being contacted for re-vaccination of Menveo vaccine.
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Covid-19 booster dose given from vial that expired 03/18/2022.
Age: 47.0
Sex: F
Vaccine: COVID19
Symptoms: Breath sounds abnormal, COVID-19, Calculus urinary, Computerised tomogram abdomen abnormal, Dysuria
Clinical narrative: Physician Discharge Summary    Age: 48 y.o. Birthday:  1/6/1974 Admit Date: 7/10/2022  8:22 PM Discharge Date:       Admit Date:  7/10/2022 Discharge Date:  7/12/2022    Discharge Diagnosis: Principal Problem:   Ureteral stone with hydronephrosis Active Problems:   HTN (hypertension)       HPI: 48 y.o. female with PMH of GERD and HTN, prior kidney stones, who presented from for persistent flank pain. CT there with right sided ureteral stone and some hydronephrosis. Pain unable to be controlled as outpatient and returned to ER prompting transfer for urology services. No cp, sob, fevers. Pain worse with urination. Comes in waves, radiating to groin on right."   Hospital Course: the following problems were addressed during this visit:   * Ureteral stone with hydronephrosis New.  Urology planning cysto, right ureteroscopy, laser lithotripsy, stone extraction, right retrograde pyelogram, right ureteral stent placement today. DC later if urology is ok   o Covid+: new.  Covid stat positive.  Covid rapid negative today.  Will need another negative test 8 hours from the last for this to be false positive.  Will order one o HTN: borderline.  Cont home meds on dc.  Monitor BP at home and fu with pcp o GERD: cont PPI             Review of Systems:  Review of Systems  Respiratory: Negative for shortness of breath.   Cardiovascular: Negative for chest pain.  Gastrointestinal: Negative for abdominal pain.        Physical Exam: Blood pressure 169/81, pulse 82, temperature 97.8 °F (36.6 °C), temperature source Oral, resp. rate 18, height 5' 6" (167.6 cm), weight 87.1 kg (192 lb), SpO2 98 %. Physical Exam Constitutional:      General: She is not in acute distress. Eyes:     General: No scleral icterus. Cardiovascular:     Rate and Rhythm: Normal rate and regular rhythm.  Pulmonary:     Breath sounds: Decreased breath sounds present. No wheezing.  Abdominal:     Tenderness: There is no abdominal tenderness.  Skin:    General: Skin is warm and dry.  Neurological:     Mental Status: She is alert and oriented to person, place, and time.  Psychiatric:        Mood and Affect: Mood normal.              Consults:   IP CONSULT TO UROLOGY   Significant Diagnostic Studies:    none     Disposition:  home   Discharge Condition:  fair
Age: 47.0
Sex: F
Vaccine: COVID19
Symptoms: Flank pain, Groin pain, Hydronephrosis, Pain, SARS-CoV-2 test negative
Clinical narrative: Physician Discharge Summary    Age: 48 y.o. Birthday:  1/6/1974 Admit Date: 7/10/2022  8:22 PM Discharge Date:       Admit Date:  7/10/2022 Discharge Date:  7/12/2022    Discharge Diagnosis: Principal Problem:   Ureteral stone with hydronephrosis Active Problems:   HTN (hypertension)       HPI: 48 y.o. female with PMH of GERD and HTN, prior kidney stones, who presented from for persistent flank pain. CT there with right sided ureteral stone and some hydronephrosis. Pain unable to be controlled as outpatient and returned to ER prompting transfer for urology services. No cp, sob, fevers. Pain worse with urination. Comes in waves, radiating to groin on right."   Hospital Course: the following problems were addressed during this visit:   * Ureteral stone with hydronephrosis New.  Urology planning cysto, right ureteroscopy, laser lithotripsy, stone extraction, right retrograde pyelogram, right ureteral stent placement today. DC later if urology is ok   o Covid+: new.  Covid stat positive.  Covid rapid negative today.  Will need another negative test 8 hours from the last for this to be false positive.  Will order one o HTN: borderline.  Cont home meds on dc.  Monitor BP at home and fu with pcp o GERD: cont PPI             Review of Systems:  Review of Systems  Respiratory: Negative for shortness of breath.   Cardiovascular: Negative for chest pain.  Gastrointestinal: Negative for abdominal pain.        Physical Exam: Blood pressure 169/81, pulse 82, temperature 97.8 °F (36.6 °C), temperature source Oral, resp. rate 18, height 5' 6" (167.6 cm), weight 87.1 kg (192 lb), SpO2 98 %. Physical Exam Constitutional:      General: She is not in acute distress. Eyes:     General: No scleral icterus. Cardiovascular:     Rate and Rhythm: Normal rate and regular rhythm.  Pulmonary:     Breath sounds: Decreased breath sounds present. No wheezing.  Abdominal:     Tenderness: There is no abdominal tenderness.  Skin:    General: Skin is warm and dry.  Neurological:     Mental Status: She is alert and oriented to person, place, and time.  Psychiatric:        Mood and Affect: Mood normal.              Consults:   IP CONSULT TO UROLOGY   Significant Diagnostic Studies:    none     Disposition:  home   Discharge Condition:  fair
Age: 47.0
Sex: F
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive
Clinical narrative: Physician Discharge Summary    Age: 48 y.o. Birthday:  1/6/1974 Admit Date: 7/10/2022  8:22 PM Discharge Date:       Admit Date:  7/10/2022 Discharge Date:  7/12/2022    Discharge Diagnosis: Principal Problem:   Ureteral stone with hydronephrosis Active Problems:   HTN (hypertension)       HPI: 48 y.o. female with PMH of GERD and HTN, prior kidney stones, who presented from for persistent flank pain. CT there with right sided ureteral stone and some hydronephrosis. Pain unable to be controlled as outpatient and returned to ER prompting transfer for urology services. No cp, sob, fevers. Pain worse with urination. Comes in waves, radiating to groin on right."   Hospital Course: the following problems were addressed during this visit:   * Ureteral stone with hydronephrosis New.  Urology planning cysto, right ureteroscopy, laser lithotripsy, stone extraction, right retrograde pyelogram, right ureteral stent placement today. DC later if urology is ok   o Covid+: new.  Covid stat positive.  Covid rapid negative today.  Will need another negative test 8 hours from the last for this to be false positive.  Will order one o HTN: borderline.  Cont home meds on dc.  Monitor BP at home and fu with pcp o GERD: cont PPI             Review of Systems:  Review of Systems  Respiratory: Negative for shortness of breath.   Cardiovascular: Negative for chest pain.  Gastrointestinal: Negative for abdominal pain.        Physical Exam: Blood pressure 169/81, pulse 82, temperature 97.8 °F (36.6 °C), temperature source Oral, resp. rate 18, height 5' 6" (167.6 cm), weight 87.1 kg (192 lb), SpO2 98 %. Physical Exam Constitutional:      General: She is not in acute distress. Eyes:     General: No scleral icterus. Cardiovascular:     Rate and Rhythm: Normal rate and regular rhythm.  Pulmonary:     Breath sounds: Decreased breath sounds present. No wheezing.  Abdominal:     Tenderness: There is no abdominal tenderness.  Skin:    General: Skin is warm and dry.  Neurological:     Mental Status: She is alert and oriented to person, place, and time.  Psychiatric:        Mood and Affect: Mood normal.              Consults:   IP CONSULT TO UROLOGY   Significant Diagnostic Studies:    none     Disposition:  home   Discharge Condition:  fair
Age: 12.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Patient received a vaccine dose, which had been left out from the previous day of work, Thursday 08/25/2022. It was administered on 08/29/2022. Patient contacted and they are fine. I advised to monitor for symptoms. They will be ok to take another dose.
Age: 75.0
Sex: F
Vaccine: COVID19
Symptoms: Death, Pulse absent, Respiratory arrest, Resuscitation
Clinical narrative: Resident noted in bed without pulse/respiration at 4:40 am on 8/29/22. CPR was initiated per nursing home staff. EMS arrived to take over care and transferred to the hospital, however resident expired at hospital ED.
Age: 72.0
Sex: F
Vaccine: COVID19
Symptoms: Unevaluable event
Clinical narrative: 11/16/1948
Age: 61.0
Sex: F
Vaccine: COVID19
Symptoms: Blood test, COVID-19, Dry mouth, Laboratory test normal, Lacrimation decreased
Clinical narrative: I contracted COVID-19 on 12/10/2021. I did a virtual visit with my doctor to confirm my positive status but did not require any doctor care. Sometime in January of 2022 I began having significant discomfort in my mouth. I do have food allergies and the sensation was somewhat like that, so I sort of ignored it and watched what I ate. I received my booster in 02/2022. I continued having these mouth problems but couldn't really pin down any foods that were causing it. I saw my dentist who recommended that I change my toothpaste and see my doctor. I changed tooth paste and then saw my doctor in March of 2022. He suggested that I see an ENT and a Rheumatologist because it had gotten so bad that it felt like I had no saliva. So, it went from an irritation to significant dry mouth. I saw an ENT and a Rheumatologist and an Ophthalmologist. The rheumatologist ruled out all auto immune deficiencies and recommended another medication for saliva production, Cevimeline. I started that medication in June. The Ophthalmologist said that I had slightly low tear production and I will be following up with the rheumatologist in October.
Age: 61.0
Sex: F
Vaccine: COVID19
Symptoms: Oral discomfort
Clinical narrative: I contracted COVID-19 on 12/10/2021. I did a virtual visit with my doctor to confirm my positive status but did not require any doctor care. Sometime in January of 2022 I began having significant discomfort in my mouth. I do have food allergies and the sensation was somewhat like that, so I sort of ignored it and watched what I ate. I received my booster in 02/2022. I continued having these mouth problems but couldn't really pin down any foods that were causing it. I saw my dentist who recommended that I change my toothpaste and see my doctor. I changed tooth paste and then saw my doctor in March of 2022. He suggested that I see an ENT and a Rheumatologist because it had gotten so bad that it felt like I had no saliva. So, it went from an irritation to significant dry mouth. I saw an ENT and a Rheumatologist and an Ophthalmologist. The rheumatologist ruled out all auto immune deficiencies and recommended another medication for saliva production, Cevimeline. I started that medication in June. The Ophthalmologist said that I had slightly low tear production and I will be following up with the rheumatologist in October.
Age: 16.0
Sex: M
Vaccine: COVID19
Symptoms: Product administered to patient of inappropriate age
Clinical narrative: patient under age
Age: 72.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Asthenia, COVID-19, Dyspnoea, Fatigue, Oxygen saturation decreased
Clinical narrative: Hospitalization: admitted 7/19/2022; discharged 8/18/2022. Presentation to the ED: patient presented to the emergency department due to progressively worsening shortness of breath associated with wheezing,overall fatigue and generalized weakness, and decreased oxygen saturation. COVID-19 + date: 8/28/22 Treatment: increased supplemental oxygen, no COVID prophalyxis was given. Discharge to: SNF.
Age: 72.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: SARS-CoV-2 test positive, Wheezing
Clinical narrative: Hospitalization: admitted 7/19/2022; discharged 8/18/2022. Presentation to the ED: patient presented to the emergency department due to progressively worsening shortness of breath associated with wheezing,overall fatigue and generalized weakness, and decreased oxygen saturation. COVID-19 + date: 8/28/22 Treatment: increased supplemental oxygen, no COVID prophalyxis was given. Discharge to: SNF.
Age: 54.0
Sex: F
Vaccine: COVID19
Symptoms: Anticoagulant therapy, Atrial fibrillation, COVID-19, Cardiac stress test, Dialysis
Clinical narrative: Physician Discharge Summary     Patient: PRIVATE Age:55 y.o. DOB:1/29/1967 Admit Date: 7/11/2022- Discharge Date:  7/13/2022      Principal Diagnoses:  Principal Problem:   Paroxysmal atrial fibrillation with RVR Active Problems:   COVID-19 virus detected   HTN (hypertension)   ESRD on dialysis     Discharge Diagnosis:  New Afib RVR, COVID 19, ESRD, HTN.    Hospital Course:  The patient was admitted with the above. She was converted back to SR with a cardizem gtt and she was placed on elequis and tambicor. . 2D echo did not show any acute abnormalities. She had a low risk stress test. She was noted to have COVID 19 but was not hypoxic on room air. She was asked to follow up outpatinet.    Consults to: Nephrology, Cardiology.    Significant Diagnostic Studies:  2D echo, Stress test.    Procedure(s): none    Disposition:  home   Discharge Condition:  fair
Age: 54.0
Sex: F
Vaccine: COVID19
Symptoms: Echocardiogram abnormal, End stage renal disease, Hypertension, SARS-CoV-2 test positive
Clinical narrative: Physician Discharge Summary     Patient: PRIVATE Age:55 y.o. DOB:1/29/1967 Admit Date: 7/11/2022- Discharge Date:  7/13/2022      Principal Diagnoses:  Principal Problem:   Paroxysmal atrial fibrillation with RVR Active Problems:   COVID-19 virus detected   HTN (hypertension)   ESRD on dialysis     Discharge Diagnosis:  New Afib RVR, COVID 19, ESRD, HTN.    Hospital Course:  The patient was admitted with the above. She was converted back to SR with a cardizem gtt and she was placed on elequis and tambicor. . 2D echo did not show any acute abnormalities. She had a low risk stress test. She was noted to have COVID 19 but was not hypoxic on room air. She was asked to follow up outpatinet.    Consults to: Nephrology, Cardiology.    Significant Diagnostic Studies:  2D echo, Stress test.    Procedure(s): none    Disposition:  home   Discharge Condition:  fair
Age: 61.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered, Medication error, Product storage error
Clinical narrative: Covid-19 booster dose of Moderna given from a vial that expired 03/18/2022.   Medication error reported to Moderna . Notification received August 29, 2022 stating, "Analysis of the vials associated with your storage excursion is complete.  The vaccine administered on August 23,2022 from lot number 012H21B maintained the activity necessary to protect against the SARS-CoV-2 (Covid-19) virus at time of administration."
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: Atrial fibrillation, Blood creatine phosphokinase normal, Blood magnesium, COVID-19, Cardiac failure congestive
Clinical narrative: Physician Discharge Summary     Patient: Age:65 y.o. DOB: Admit Date:  7/11/2022 Discharge Date:  7/12/2022      Principal Diagnoses:  Principal Problem:   Precordial chest pain Active Problems:   Acquired hypothyroidism   Diastolic CHF, chronic   PAF (paroxysmal atrial fibrillation)   Status post insertion of drug-eluting stent into left anterior descending (LAD) artery   Hypomagnesemia   COVID-19 virus infection   Essential hypertension     Discharge Diagnosis: Paroxysmal A. fib and Covid 19   Hospital Course: Patient is a 65 y.o. female  with past medical history per below  presented to the emergency room with complaints of sudden onset of midsternal chest pain nonradiating associated with dizziness. The patient rated her pain up to 4 on 1-10 pain scale and admitted to associated palpitations and diaphoresis. She denied any shortness of breath, nausea, vomiting, or any other GI or urinary symptoms. She denied any fever, chills, cough or sputum production. She is fully vaccinated against COVID-19 vitals and has received the booster. Patient had left heart catheterization done a few months ago with stents placed to the LAD and circumflex. The emergency room chest x-ray was done showing no acute findings and EKG showed sinus rhythm with no changes compared to previous. Labs showed CBC and CMP at baseline with normal CK and negative troponin with mildly low serum magnesium at 1.6. UA showed innumerable white blood cells and urine cultures pending. COVID-19 test is positive. Patient was admitted to Covid unit where she was managed and monitored closely. She has not required supplemental oxygen. She denies shortness of breath. She was seen by cardiologist this morning who recommended for her to continue NOAC.  Continue lopressor and dc labetalol. Change nifedipine to cardizem and add imdur. Cardiac stable for dc . F/u with Dr in 1 week. Patient's other comorbidities were managed while admitted. She has requested to be discharged home. She will be discharged home with strict instructions to observe Covid restrictions, stay masked and to follow-up with her PCP within 3-5 days.   Consults to: Cardiology   Significant Diagnostic Studies: Echo   Procedure(s): n/a   Disposition: Home   Discharge Condition: Stable
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: Catheterisation cardiac abnormal, Chest X-ray normal, Chest pain, Coronary arterial stent insertion, Dizziness
Clinical narrative: Physician Discharge Summary     Patient: Age:65 y.o. DOB: Admit Date:  7/11/2022 Discharge Date:  7/12/2022      Principal Diagnoses:  Principal Problem:   Precordial chest pain Active Problems:   Acquired hypothyroidism   Diastolic CHF, chronic   PAF (paroxysmal atrial fibrillation)   Status post insertion of drug-eluting stent into left anterior descending (LAD) artery   Hypomagnesemia   COVID-19 virus infection   Essential hypertension     Discharge Diagnosis: Paroxysmal A. fib and Covid 19   Hospital Course: Patient is a 65 y.o. female  with past medical history per below  presented to the emergency room with complaints of sudden onset of midsternal chest pain nonradiating associated with dizziness. The patient rated her pain up to 4 on 1-10 pain scale and admitted to associated palpitations and diaphoresis. She denied any shortness of breath, nausea, vomiting, or any other GI or urinary symptoms. She denied any fever, chills, cough or sputum production. She is fully vaccinated against COVID-19 vitals and has received the booster. Patient had left heart catheterization done a few months ago with stents placed to the LAD and circumflex. The emergency room chest x-ray was done showing no acute findings and EKG showed sinus rhythm with no changes compared to previous. Labs showed CBC and CMP at baseline with normal CK and negative troponin with mildly low serum magnesium at 1.6. UA showed innumerable white blood cells and urine cultures pending. COVID-19 test is positive. Patient was admitted to Covid unit where she was managed and monitored closely. She has not required supplemental oxygen. She denies shortness of breath. She was seen by cardiologist this morning who recommended for her to continue NOAC.  Continue lopressor and dc labetalol. Change nifedipine to cardizem and add imdur. Cardiac stable for dc . F/u with Dr in 1 week. Patient's other comorbidities were managed while admitted. She has requested to be discharged home. She will be discharged home with strict instructions to observe Covid restrictions, stay masked and to follow-up with her PCP within 3-5 days.   Consults to: Cardiology   Significant Diagnostic Studies: Echo   Procedure(s): n/a   Disposition: Home   Discharge Condition: Stable
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: Echocardiogram, Electrocardiogram normal, Essential hypertension, Full blood count, Hyperhidrosis
Clinical narrative: Physician Discharge Summary     Patient: Age:65 y.o. DOB: Admit Date:  7/11/2022 Discharge Date:  7/12/2022      Principal Diagnoses:  Principal Problem:   Precordial chest pain Active Problems:   Acquired hypothyroidism   Diastolic CHF, chronic   PAF (paroxysmal atrial fibrillation)   Status post insertion of drug-eluting stent into left anterior descending (LAD) artery   Hypomagnesemia   COVID-19 virus infection   Essential hypertension     Discharge Diagnosis: Paroxysmal A. fib and Covid 19   Hospital Course: Patient is a 65 y.o. female  with past medical history per below  presented to the emergency room with complaints of sudden onset of midsternal chest pain nonradiating associated with dizziness. The patient rated her pain up to 4 on 1-10 pain scale and admitted to associated palpitations and diaphoresis. She denied any shortness of breath, nausea, vomiting, or any other GI or urinary symptoms. She denied any fever, chills, cough or sputum production. She is fully vaccinated against COVID-19 vitals and has received the booster. Patient had left heart catheterization done a few months ago with stents placed to the LAD and circumflex. The emergency room chest x-ray was done showing no acute findings and EKG showed sinus rhythm with no changes compared to previous. Labs showed CBC and CMP at baseline with normal CK and negative troponin with mildly low serum magnesium at 1.6. UA showed innumerable white blood cells and urine cultures pending. COVID-19 test is positive. Patient was admitted to Covid unit where she was managed and monitored closely. She has not required supplemental oxygen. She denies shortness of breath. She was seen by cardiologist this morning who recommended for her to continue NOAC.  Continue lopressor and dc labetalol. Change nifedipine to cardizem and add imdur. Cardiac stable for dc . F/u with Dr in 1 week. Patient's other comorbidities were managed while admitted. She has requested to be discharged home. She will be discharged home with strict instructions to observe Covid restrictions, stay masked and to follow-up with her PCP within 3-5 days.   Consults to: Cardiology   Significant Diagnostic Studies: Echo   Procedure(s): n/a   Disposition: Home   Discharge Condition: Stable
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: Hypomagnesaemia, Hypothyroidism, Left ventricular failure, Metabolic function test, Palpitations
Clinical narrative: Physician Discharge Summary     Patient: Age:65 y.o. DOB: Admit Date:  7/11/2022 Discharge Date:  7/12/2022      Principal Diagnoses:  Principal Problem:   Precordial chest pain Active Problems:   Acquired hypothyroidism   Diastolic CHF, chronic   PAF (paroxysmal atrial fibrillation)   Status post insertion of drug-eluting stent into left anterior descending (LAD) artery   Hypomagnesemia   COVID-19 virus infection   Essential hypertension     Discharge Diagnosis: Paroxysmal A. fib and Covid 19   Hospital Course: Patient is a 65 y.o. female  with past medical history per below  presented to the emergency room with complaints of sudden onset of midsternal chest pain nonradiating associated with dizziness. The patient rated her pain up to 4 on 1-10 pain scale and admitted to associated palpitations and diaphoresis. She denied any shortness of breath, nausea, vomiting, or any other GI or urinary symptoms. She denied any fever, chills, cough or sputum production. She is fully vaccinated against COVID-19 vitals and has received the booster. Patient had left heart catheterization done a few months ago with stents placed to the LAD and circumflex. The emergency room chest x-ray was done showing no acute findings and EKG showed sinus rhythm with no changes compared to previous. Labs showed CBC and CMP at baseline with normal CK and negative troponin with mildly low serum magnesium at 1.6. UA showed innumerable white blood cells and urine cultures pending. COVID-19 test is positive. Patient was admitted to Covid unit where she was managed and monitored closely. She has not required supplemental oxygen. She denies shortness of breath. She was seen by cardiologist this morning who recommended for her to continue NOAC.  Continue lopressor and dc labetalol. Change nifedipine to cardizem and add imdur. Cardiac stable for dc . F/u with Dr in 1 week. Patient's other comorbidities were managed while admitted. She has requested to be discharged home. She will be discharged home with strict instructions to observe Covid restrictions, stay masked and to follow-up with her PCP within 3-5 days.   Consults to: Cardiology   Significant Diagnostic Studies: Echo   Procedure(s): n/a   Disposition: Home   Discharge Condition: Stable
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive, Sinus rhythm, Troponin normal, Urine analysis, White blood cells urine positive
Clinical narrative: Physician Discharge Summary     Patient: Age:65 y.o. DOB: Admit Date:  7/11/2022 Discharge Date:  7/12/2022      Principal Diagnoses:  Principal Problem:   Precordial chest pain Active Problems:   Acquired hypothyroidism   Diastolic CHF, chronic   PAF (paroxysmal atrial fibrillation)   Status post insertion of drug-eluting stent into left anterior descending (LAD) artery   Hypomagnesemia   COVID-19 virus infection   Essential hypertension     Discharge Diagnosis: Paroxysmal A. fib and Covid 19   Hospital Course: Patient is a 65 y.o. female  with past medical history per below  presented to the emergency room with complaints of sudden onset of midsternal chest pain nonradiating associated with dizziness. The patient rated her pain up to 4 on 1-10 pain scale and admitted to associated palpitations and diaphoresis. She denied any shortness of breath, nausea, vomiting, or any other GI or urinary symptoms. She denied any fever, chills, cough or sputum production. She is fully vaccinated against COVID-19 vitals and has received the booster. Patient had left heart catheterization done a few months ago with stents placed to the LAD and circumflex. The emergency room chest x-ray was done showing no acute findings and EKG showed sinus rhythm with no changes compared to previous. Labs showed CBC and CMP at baseline with normal CK and negative troponin with mildly low serum magnesium at 1.6. UA showed innumerable white blood cells and urine cultures pending. COVID-19 test is positive. Patient was admitted to Covid unit where she was managed and monitored closely. She has not required supplemental oxygen. She denies shortness of breath. She was seen by cardiologist this morning who recommended for her to continue NOAC.  Continue lopressor and dc labetalol. Change nifedipine to cardizem and add imdur. Cardiac stable for dc . F/u with Dr in 1 week. Patient's other comorbidities were managed while admitted. She has requested to be discharged home. She will be discharged home with strict instructions to observe Covid restrictions, stay masked and to follow-up with her PCP within 3-5 days.   Consults to: Cardiology   Significant Diagnostic Studies: Echo   Procedure(s): n/a   Disposition: Home   Discharge Condition: Stable
Age: 4.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered, No adverse event
Clinical narrative: Moderna Covid Vaccine given outside of 12 hour timeframe. Once punctured, the Moderna vaccine fact sheet states that vaccine is usable for up to 12 hours. The vial was first punctured at 1:38 pm on 8/29/22. Covid Vaccine dose given 9 hours past vaccine expiry of 12 hours post initial puncture. No adverse side effects or symptoms experienced by the patient. Vaccine was well kept in temperature monitored refrigerator at all times.
Age: 57.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site erythema, Injection site swelling, Injection site vesicles, Injection site warmth
Clinical narrative: The patient reports same-day symptoms including redness, warmness, and swelling around the injection site. Lasted for approx. 4 days, then self-resolved. Now has a fluid-filled blister at the injection site (pencil eraser size).
Age: 59.0
Sex: M
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: A vail had been left out from the previouse work day on 8/26/2022 and then administerd on 8/29/2022 patient was contacted and they said they were fine. I will follow up in the week. and advised them to call if anything came up
Age: 59.0
Sex: M
Vaccine: COVID19
Symptoms: Acute kidney injury, Blood creatinine, COVID-19, Chronic kidney disease, Computerised tomogram abdomen
Clinical narrative: Physician Discharge Summary     Patient: MRN:025222 Age:60 y.o. DOB:11/11/1961 Admit Date:  7/11/2022 Discharge Date:  7/13/2022      Principal Diagnoses:  Active Problems:   Acute renal failure   CKD (chronic kidney disease) stage 2, GFR 60-89 ml/min   Obstructive uropathy   Acute cystitis without hematuria   Type 2 diabetes mellitus, without long-term current use of insulin     Discharge Diagnosis: Bilateral ureteral stones, UTI, Acute on chronic stage 2 CKD, Dm2, COVID 19,    Hospital Course:  The patient was admitted with the above. He was treate for the UTI with levaquin. He had a lazer lithotrypsy done on the left with stent placement. He had basket extraction done on the right with stent placemeent. Nothing grew on cultuers. He was placed on levaquin to complete 7 days. His ace was held do to acute renal failure and his cr improved iwht IVF. He was not hypoxic so no active tx was initaiated for COVID 19. He was asked to follow up outpatinet.    Consults to: Urology.    Significant Diagnostic Studies:  CT abdomen and pelivs.    Procedure(s): Cystoscopy and stone extraction with bilateral stents as mentioned above.    Disposition:  home   Discharge Condition:  fair
Age: 59.0
Sex: M
Vaccine: COVID19
Symptoms: Culture negative, Cystitis, Cystoscopy abnormal, Lithotripsy, Nephrolithiasis
Clinical narrative: Physician Discharge Summary     Patient: MRN:025222 Age:60 y.o. DOB:11/11/1961 Admit Date:  7/11/2022 Discharge Date:  7/13/2022      Principal Diagnoses:  Active Problems:   Acute renal failure   CKD (chronic kidney disease) stage 2, GFR 60-89 ml/min   Obstructive uropathy   Acute cystitis without hematuria   Type 2 diabetes mellitus, without long-term current use of insulin     Discharge Diagnosis: Bilateral ureteral stones, UTI, Acute on chronic stage 2 CKD, Dm2, COVID 19,    Hospital Course:  The patient was admitted with the above. He was treate for the UTI with levaquin. He had a lazer lithotrypsy done on the left with stent placement. He had basket extraction done on the right with stent placemeent. Nothing grew on cultuers. He was placed on levaquin to complete 7 days. His ace was held do to acute renal failure and his cr improved iwht IVF. He was not hypoxic so no active tx was initaiated for COVID 19. He was asked to follow up outpatinet.    Consults to: Urology.    Significant Diagnostic Studies:  CT abdomen and pelivs.    Procedure(s): Cystoscopy and stone extraction with bilateral stents as mentioned above.    Disposition:  home   Discharge Condition:  fair
Age: 59.0
Sex: M
Vaccine: COVID19
Symptoms: Renal stone removal, Type 2 diabetes mellitus, Ureteral stent insertion, Urinary tract infection, Urinary tract obstruction
Clinical narrative: Physician Discharge Summary     Patient: MRN:025222 Age:60 y.o. DOB:11/11/1961 Admit Date:  7/11/2022 Discharge Date:  7/13/2022      Principal Diagnoses:  Active Problems:   Acute renal failure   CKD (chronic kidney disease) stage 2, GFR 60-89 ml/min   Obstructive uropathy   Acute cystitis without hematuria   Type 2 diabetes mellitus, without long-term current use of insulin     Discharge Diagnosis: Bilateral ureteral stones, UTI, Acute on chronic stage 2 CKD, Dm2, COVID 19,    Hospital Course:  The patient was admitted with the above. He was treate for the UTI with levaquin. He had a lazer lithotrypsy done on the left with stent placement. He had basket extraction done on the right with stent placemeent. Nothing grew on cultuers. He was placed on levaquin to complete 7 days. His ace was held do to acute renal failure and his cr improved iwht IVF. He was not hypoxic so no active tx was initaiated for COVID 19. He was asked to follow up outpatinet.    Consults to: Urology.    Significant Diagnostic Studies:  CT abdomen and pelivs.    Procedure(s): Cystoscopy and stone extraction with bilateral stents as mentioned above.    Disposition:  home   Discharge Condition:  fair
Age: 53.0
Sex: F
Vaccine: VARZOS
Symptoms: Injection site pain, Insomnia, Neck pain, Pain, Pain in extremity
Clinical narrative: L deltoid pain, radiating to hand and into L side of neck, unable to sleep due to pain, area very sensitive to touch
Age: 53.0
Sex: F
Vaccine: VARZOS
Symptoms: Sensitive skin
Clinical narrative: L deltoid pain, radiating to hand and into L side of neck, unable to sleep due to pain, area very sensitive to touch
Age: 16.0
Sex: F
Vaccine: HPV9, MNQ
Symptoms: Extra dose administered
Clinical narrative: GAVE THIRD HPV THAT WAS NOT NEEDED.
Age: 56.0
Sex: F
Vaccine: COVID19
Symptoms: Blood creatinine increased, Brain natriuretic peptide increased, COVID-19, COVID-19 pneumonia, Cardiac failure acute
Clinical narrative: Age: 57 y.o. Birthday:  Admit Date: 7/14/2022  8:58 AM Discharge Date: 7/18/2022     Discharge Diagnosis: Principal Problem:   COVID-19 Active Problems:   Acute on chronic diastolic congestive heart failure   Hypoxia   Anasarca   HTN (hypertension)   Diabetes mellitus       HPI AND HOSPITAL COURSE   History of Present Illness:  As per admission H&P, "The patient is a 57 y.o. female, presented on 7/14/2022 with the above. . The symptoms/labs were thought to be marked in severity and unstable. Onset several days ago. Associated symptoms include shortness of breath . Alleviated by none. The has a history of chronic hypoxic respirtory failure on 4 liters oxygen at home. She states that she has had increased leg swelling and shortness of breaht over the last 3 days. She has been coughing up white phlegm. She has not had any fevers or chills. In the ER she was noted to have pulmonary edema on CXR. She was also noted to be covid 19 positive. She is on 4 liters as I am seeing her. "       Patient is a 57 y.o. female who presented with shortness of breath.  She was managed for the following:   * COVID-19 Acute on chronic hypoxic respirtory failiure- due to COVID-19 pneumonia and CHF exacerbation.  She improved with treatment of the issues below, returned to her baseline 3L NC home requirement and remained stable.     COVID 19 Pneumonia - She completed 5 day course of remdesivir.  Will complete decadron taper on discharge.  Improved to baseline O2.     Acute on chroinc diasotlic CHF-  Patient had increased BNP and pulmonary edema on CXR.  She was diuresed with IV lasix and improved.  Had increased creatinine so asked patient to hold lasix on discharge and follow-up with PCP.    Acute on chronic stage 3a CKD- creatinine peaked at 2.0, likely from IV diuresis.  Was starting to trend down but not yet to baseline.  Patient wished to go home. Advised her to have labs repeated in one week, and hold lasix and metformin in the interim, follow-up with PCP.    DM2-  HgbA1c 5.1%, to hold metformin on dc.  Elevated during admission from steroids    E.coli UTI-  Treated with rocephin, resolved   Iron deficency anemia- continue iron         Physical Exam on the Date of Discharge: Blood pressure 145/71, pulse 59, temperature 97 °F (36.1 °C), resp. rate 16, height 5' 8" (172.7 cm), weight (!) 136.7 kg (301 lb 6.4 oz), last menstrual period 07/31/2015, SpO2 100 %. General - NAD, appears stated age, obese, HEENT - EOMI, PER, MMM, oropharynx clear, nasal cannula in place Chest - lungs clear bilaterally Heart - RRR, NS1S2, Abdomen - Soft, non-tender, non-distended, +BS,  Extremities - no edema Psych - AAOx3, affect appropriate Skin -, dry   Discharge Condition: improved   Disposition: home
Age: 56.0
Sex: F
Vaccine: COVID19
Symptoms: Cardiac failure congestive, Chest X-ray abnormal, Chronic kidney disease, Condition aggravated, Diabetes mellitus
Clinical narrative: Age: 57 y.o. Birthday:  Admit Date: 7/14/2022  8:58 AM Discharge Date: 7/18/2022     Discharge Diagnosis: Principal Problem:   COVID-19 Active Problems:   Acute on chronic diastolic congestive heart failure   Hypoxia   Anasarca   HTN (hypertension)   Diabetes mellitus       HPI AND HOSPITAL COURSE   History of Present Illness:  As per admission H&P, "The patient is a 57 y.o. female, presented on 7/14/2022 with the above. . The symptoms/labs were thought to be marked in severity and unstable. Onset several days ago. Associated symptoms include shortness of breath . Alleviated by none. The has a history of chronic hypoxic respirtory failure on 4 liters oxygen at home. She states that she has had increased leg swelling and shortness of breaht over the last 3 days. She has been coughing up white phlegm. She has not had any fevers or chills. In the ER she was noted to have pulmonary edema on CXR. She was also noted to be covid 19 positive. She is on 4 liters as I am seeing her. "       Patient is a 57 y.o. female who presented with shortness of breath.  She was managed for the following:   * COVID-19 Acute on chronic hypoxic respirtory failiure- due to COVID-19 pneumonia and CHF exacerbation.  She improved with treatment of the issues below, returned to her baseline 3L NC home requirement and remained stable.     COVID 19 Pneumonia - She completed 5 day course of remdesivir.  Will complete decadron taper on discharge.  Improved to baseline O2.     Acute on chroinc diasotlic CHF-  Patient had increased BNP and pulmonary edema on CXR.  She was diuresed with IV lasix and improved.  Had increased creatinine so asked patient to hold lasix on discharge and follow-up with PCP.    Acute on chronic stage 3a CKD- creatinine peaked at 2.0, likely from IV diuresis.  Was starting to trend down but not yet to baseline.  Patient wished to go home. Advised her to have labs repeated in one week, and hold lasix and metformin in the interim, follow-up with PCP.    DM2-  HgbA1c 5.1%, to hold metformin on dc.  Elevated during admission from steroids    E.coli UTI-  Treated with rocephin, resolved   Iron deficency anemia- continue iron         Physical Exam on the Date of Discharge: Blood pressure 145/71, pulse 59, temperature 97 °F (36.1 °C), resp. rate 16, height 5' 8" (172.7 cm), weight (!) 136.7 kg (301 lb 6.4 oz), last menstrual period 07/31/2015, SpO2 100 %. General - NAD, appears stated age, obese, HEENT - EOMI, PER, MMM, oropharynx clear, nasal cannula in place Chest - lungs clear bilaterally Heart - RRR, NS1S2, Abdomen - Soft, non-tender, non-distended, +BS,  Extremities - no edema Psych - AAOx3, affect appropriate Skin -, dry   Discharge Condition: improved   Disposition: home
Age: 56.0
Sex: F
Vaccine: COVID19
Symptoms: Diuretic therapy, Dyspnoea, Escherichia infection, Generalised oedema, Glycosylated haemoglobin normal
Clinical narrative: Age: 57 y.o. Birthday:  Admit Date: 7/14/2022  8:58 AM Discharge Date: 7/18/2022     Discharge Diagnosis: Principal Problem:   COVID-19 Active Problems:   Acute on chronic diastolic congestive heart failure   Hypoxia   Anasarca   HTN (hypertension)   Diabetes mellitus       HPI AND HOSPITAL COURSE   History of Present Illness:  As per admission H&P, "The patient is a 57 y.o. female, presented on 7/14/2022 with the above. . The symptoms/labs were thought to be marked in severity and unstable. Onset several days ago. Associated symptoms include shortness of breath . Alleviated by none. The has a history of chronic hypoxic respirtory failure on 4 liters oxygen at home. She states that she has had increased leg swelling and shortness of breaht over the last 3 days. She has been coughing up white phlegm. She has not had any fevers or chills. In the ER she was noted to have pulmonary edema on CXR. She was also noted to be covid 19 positive. She is on 4 liters as I am seeing her. "       Patient is a 57 y.o. female who presented with shortness of breath.  She was managed for the following:   * COVID-19 Acute on chronic hypoxic respirtory failiure- due to COVID-19 pneumonia and CHF exacerbation.  She improved with treatment of the issues below, returned to her baseline 3L NC home requirement and remained stable.     COVID 19 Pneumonia - She completed 5 day course of remdesivir.  Will complete decadron taper on discharge.  Improved to baseline O2.     Acute on chroinc diasotlic CHF-  Patient had increased BNP and pulmonary edema on CXR.  She was diuresed with IV lasix and improved.  Had increased creatinine so asked patient to hold lasix on discharge and follow-up with PCP.    Acute on chronic stage 3a CKD- creatinine peaked at 2.0, likely from IV diuresis.  Was starting to trend down but not yet to baseline.  Patient wished to go home. Advised her to have labs repeated in one week, and hold lasix and metformin in the interim, follow-up with PCP.    DM2-  HgbA1c 5.1%, to hold metformin on dc.  Elevated during admission from steroids    E.coli UTI-  Treated with rocephin, resolved   Iron deficency anemia- continue iron         Physical Exam on the Date of Discharge: Blood pressure 145/71, pulse 59, temperature 97 °F (36.1 °C), resp. rate 16, height 5' 8" (172.7 cm), weight (!) 136.7 kg (301 lb 6.4 oz), last menstrual period 07/31/2015, SpO2 100 %. General - NAD, appears stated age, obese, HEENT - EOMI, PER, MMM, oropharynx clear, nasal cannula in place Chest - lungs clear bilaterally Heart - RRR, NS1S2, Abdomen - Soft, non-tender, non-distended, +BS,  Extremities - no edema Psych - AAOx3, affect appropriate Skin -, dry   Discharge Condition: improved   Disposition: home
Age: 56.0
Sex: F
Vaccine: COVID19
Symptoms: Hypertension, Hypoxia, Iron deficiency anaemia, Left ventricular failure, Peripheral swelling
Clinical narrative: Age: 57 y.o. Birthday:  Admit Date: 7/14/2022  8:58 AM Discharge Date: 7/18/2022     Discharge Diagnosis: Principal Problem:   COVID-19 Active Problems:   Acute on chronic diastolic congestive heart failure   Hypoxia   Anasarca   HTN (hypertension)   Diabetes mellitus       HPI AND HOSPITAL COURSE   History of Present Illness:  As per admission H&P, "The patient is a 57 y.o. female, presented on 7/14/2022 with the above. . The symptoms/labs were thought to be marked in severity and unstable. Onset several days ago. Associated symptoms include shortness of breath . Alleviated by none. The has a history of chronic hypoxic respirtory failure on 4 liters oxygen at home. She states that she has had increased leg swelling and shortness of breaht over the last 3 days. She has been coughing up white phlegm. She has not had any fevers or chills. In the ER she was noted to have pulmonary edema on CXR. She was also noted to be covid 19 positive. She is on 4 liters as I am seeing her. "       Patient is a 57 y.o. female who presented with shortness of breath.  She was managed for the following:   * COVID-19 Acute on chronic hypoxic respirtory failiure- due to COVID-19 pneumonia and CHF exacerbation.  She improved with treatment of the issues below, returned to her baseline 3L NC home requirement and remained stable.     COVID 19 Pneumonia - She completed 5 day course of remdesivir.  Will complete decadron taper on discharge.  Improved to baseline O2.     Acute on chroinc diasotlic CHF-  Patient had increased BNP and pulmonary edema on CXR.  She was diuresed with IV lasix and improved.  Had increased creatinine so asked patient to hold lasix on discharge and follow-up with PCP.    Acute on chronic stage 3a CKD- creatinine peaked at 2.0, likely from IV diuresis.  Was starting to trend down but not yet to baseline.  Patient wished to go home. Advised her to have labs repeated in one week, and hold lasix and metformin in the interim, follow-up with PCP.    DM2-  HgbA1c 5.1%, to hold metformin on dc.  Elevated during admission from steroids    E.coli UTI-  Treated with rocephin, resolved   Iron deficency anemia- continue iron         Physical Exam on the Date of Discharge: Blood pressure 145/71, pulse 59, temperature 97 °F (36.1 °C), resp. rate 16, height 5' 8" (172.7 cm), weight (!) 136.7 kg (301 lb 6.4 oz), last menstrual period 07/31/2015, SpO2 100 %. General - NAD, appears stated age, obese, HEENT - EOMI, PER, MMM, oropharynx clear, nasal cannula in place Chest - lungs clear bilaterally Heart - RRR, NS1S2, Abdomen - Soft, non-tender, non-distended, +BS,  Extremities - no edema Psych - AAOx3, affect appropriate Skin -, dry   Discharge Condition: improved   Disposition: home