chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 54.0
Sex: F
Vaccine: COVID19-2
Symptoms: Metabolic encephalopathy, Muscle disorder, Proctitis, Pyrexia, SARS-CoV-2 test positive
Clinical narrative: Discharge Provider: MD Primary Care Provider: MD Admission Date: 3/24/2023 Discharge Date: Mar 30, 2023 PRESENTING PROBLEM: Dehydration [E86.0] Hypernatremia [E87.0] Acute cystitis without hematuria [N30.00] COVID-19 virus infection [U07.1]   HOSPITAL COURSE: 54-year-old female past medical history of cerebral palsy, spastic quadriplegia, bipolar disorder, chronic constipation who lives in nursing facility and presented from nursing facility for weakness, fatigue, abnormal labs.  At baseline patient is nonverbal although reported that she can communicate with few words intermittently.  Mother is her guardian.  Patient and mother diagnosed 5 days prior to admission with COVID-19 after developing fevers, fatigue.  In the ER, pt noted to be tachycardic.  Lab significant for sodium 151. COVID-19 +.  KUB showing gas pattern but no obstruction.  UA suggestive of urinary tract infection.  Patient was started IV fluids and IV antibiotic for suspected urinary tract infection and admitted to Medicine.  She was felt to be more confused than baseline feeding diagnosis metabolic encephalopathy.   After admission, sodium did improve IV hydration.  She was on IV Cipro for antibiotic treatment for urinary tract infection.  Urine culture came back showing E coli pan susceptible.  Mental status did improve as well.  She was cleared to have diet by SLP on 03/26.  Pt was continued on bowel regimen as pt has history of constipation and pt with recurrent issues with fecal impaction.  Patient did have bowel distension despite bowel regimen and repeat CT/abdomen performed consistent with proctitis with rectum distended with stool.  GI consulted and recommended Gastrografin enema.  Post Gastrografin enema patient was having good bowel movements with improvement and abdominal distension.  Day discharge patient appeared comfortable.  GI recommends that patient continue with tap water enema scheduled 2 times a day in place of MiraLax.  It is likely that patient is having constipation from her rectum muscles not working well GI recommends that enemas scheduled her best treatment to prevent recurrent impaction.  If patient continues to come back to the hospital for repeat admissions for impaction may need to consider colostomy in the future with Colorectal consult and this was explained to mom.  She was also started on new medication of Linzess and given that this new medication was started does not need to continue with senna.  Sodium normalized by discharge.  To continue with 2 more doses of Cipro to complete 7 days total of urinary tract infection treatment.
Age: 54.0
Sex: F
Vaccine: COVID19-2
Symptoms: Tachycardia, Urinary tract imaging, Urinary tract infection, Urine analysis abnormal
Clinical narrative: Discharge Provider: MD Primary Care Provider: MD Admission Date: 3/24/2023 Discharge Date: Mar 30, 2023 PRESENTING PROBLEM: Dehydration [E86.0] Hypernatremia [E87.0] Acute cystitis without hematuria [N30.00] COVID-19 virus infection [U07.1]   HOSPITAL COURSE: 54-year-old female past medical history of cerebral palsy, spastic quadriplegia, bipolar disorder, chronic constipation who lives in nursing facility and presented from nursing facility for weakness, fatigue, abnormal labs.  At baseline patient is nonverbal although reported that she can communicate with few words intermittently.  Mother is her guardian.  Patient and mother diagnosed 5 days prior to admission with COVID-19 after developing fevers, fatigue.  In the ER, pt noted to be tachycardic.  Lab significant for sodium 151. COVID-19 +.  KUB showing gas pattern but no obstruction.  UA suggestive of urinary tract infection.  Patient was started IV fluids and IV antibiotic for suspected urinary tract infection and admitted to Medicine.  She was felt to be more confused than baseline feeding diagnosis metabolic encephalopathy.   After admission, sodium did improve IV hydration.  She was on IV Cipro for antibiotic treatment for urinary tract infection.  Urine culture came back showing E coli pan susceptible.  Mental status did improve as well.  She was cleared to have diet by SLP on 03/26.  Pt was continued on bowel regimen as pt has history of constipation and pt with recurrent issues with fecal impaction.  Patient did have bowel distension despite bowel regimen and repeat CT/abdomen performed consistent with proctitis with rectum distended with stool.  GI consulted and recommended Gastrografin enema.  Post Gastrografin enema patient was having good bowel movements with improvement and abdominal distension.  Day discharge patient appeared comfortable.  GI recommends that patient continue with tap water enema scheduled 2 times a day in place of MiraLax.  It is likely that patient is having constipation from her rectum muscles not working well GI recommends that enemas scheduled her best treatment to prevent recurrent impaction.  If patient continues to come back to the hospital for repeat admissions for impaction may need to consider colostomy in the future with Colorectal consult and this was explained to mom.  She was also started on new medication of Linzess and given that this new medication was started does not need to continue with senna.  Sodium normalized by discharge.  To continue with 2 more doses of Cipro to complete 7 days total of urinary tract infection treatment.
Age: 78.0
Sex: M
Vaccine: COVID19-2
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: hospitalized with covid; fully vaccinated with 2 boosters
Age: 54.0
Sex: M
Vaccine: VARZOS
Symptoms: Administration site erythema, Administration site rash, Rash macular, Urticaria
Clinical narrative: She reported 3 red blotchy areas on the arm where the vaccine was administered. She also reported hives on her trunk.
Age: 75.0
Sex: F
Vaccine: COVID19-2
Symptoms: Diarrhoea
Clinical narrative: I experienced diarrhea that lasted for two months, using the restroom 3-4 times in the morning and 2-3 times in the evening.
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Pulmonary embolism
Clinical narrative: ACUTE PULMONARY EMBOLISM
Age: 59.0
Sex: F
Vaccine: COVID19-2
Symptoms: Abdominal distension, Blood test normal, Constipation, Gastrointestinal hypomotility, Pain
Clinical narrative: In February 2023 I had a lot of bloating, pain and constipation.  I took a lot of Gas-X and MiraLAX.  In mid-March my gut nearly shut down.  I had constant constipation and pain.  I went to urgent care end of March and early April.  I saw my doctor end of March and a gastroenterologist.  I am now on antibiotics and anti-cramping medicine.  We are monitoring everything to see what a final diagnosis.  I see her again in about 3 weeks.
Age: 72.0
Sex: M
Vaccine: COVID19
Symptoms: Arteriovenous fistula, Shock, Syncope
Clinical narrative: R57.9 SHOCK, UNSPECIFIED 7/3/2021 ACQUIRED ARTERIOVENOUS FISTULA R57.9 SHOCK, UNSPECIFIED 7/3/2021 SYNCOPE AND COLLAPSE
Age: 92.0
Sex: M
Vaccine: COVID19-2
Symptoms: COVID-19, Confusional state, Cough, Fall, Injury
Clinical narrative: Patient was seen at the PRIVACY ER for c/o fall with injury, confusion and cough. Patient was found to be Covid positive and was placed in observation status for evaluation and treament.
Age: 92.0
Sex: M
Vaccine: COVID19-2
Symptoms: SARS-CoV-2 test positive
Clinical narrative: Patient was seen at the PRIVACY ER for c/o fall with injury, confusion and cough. Patient was found to be Covid positive and was placed in observation status for evaluation and treament.
Age: 6.0
Sex: F
Vaccine: COVID19-2
Symptoms: Product storage error
Clinical narrative: Storage and Handling Incident.
Age: 93.0
Sex: F
Vaccine: COVID19
Symptoms: Deep vein thrombosis, Dyspnoea
Clinical narrative: I82.402 ACUTE DVT OF LEFT LEG, UNSPECIFIED VEIN 11/9/2021 SHORTNESS OF BREATH I82.409 ACUTE DVT, UNSPECIFIED VEIN 12/1/2021 SHORTNESS OF BREATH
Age: 97.0
Sex: M
Vaccine: COVID19
Symptoms: Acute kidney injury, COVID-19, COVID-19 pneumonia, Cough, Fatigue
Clinical narrative: Discharge Provider: MD Primary Care Provider: MD Admission Date: 3/25/2023 Discharge Date: Mar 28, 2023  PRESENTING PROBLEM: Other fatigue [R53.83] Pneumonia due to COVID-19 virus [U07.1, J12.82] COVID-19 [U07.1]   HOSPITAL COURSE: Patient is a 98 y.o. male with past medical history significant for CKD stage 3,  prostate cancer s/p prostatectomy presented to ED with complaint of cough and sore throat.  Patient was found to be COVID positive with mild acute kidney injury.  He was given IV fluids improved quickly.  He was discharged back to his facility.
Age: 97.0
Sex: M
Vaccine: COVID19
Symptoms: Oropharyngeal pain, SARS-CoV-2 test positive
Clinical narrative: Discharge Provider: MD Primary Care Provider: MD Admission Date: 3/25/2023 Discharge Date: Mar 28, 2023  PRESENTING PROBLEM: Other fatigue [R53.83] Pneumonia due to COVID-19 virus [U07.1, J12.82] COVID-19 [U07.1]   HOSPITAL COURSE: Patient is a 98 y.o. male with past medical history significant for CKD stage 3,  prostate cancer s/p prostatectomy presented to ED with complaint of cough and sore throat.  Patient was found to be COVID positive with mild acute kidney injury.  He was given IV fluids improved quickly.  He was discharged back to his facility.
Age: 42.0
Sex: M
Vaccine: COVID19-2
Symptoms: Asthenia, COVID-19, Cough, Fatigue, Feeling abnormal
Clinical narrative: I had a headache, fatigue, small cough, the next my symptoms were a little bit worse. I took a home COVID-19 test that came back positive. I called my doctor to do a telehealth visit and get Paxlovid. I did the five-day regimen tested negative was back at work for one day came home started to feel bad. I took a home COVID-19 test the next day, it was positive. I am in a clinical trial, I have not been told if I received the placebo or the real Paxlovid, but my symptoms got better quickly. I am very happy as the rebound was so much worse than the first time having COVID-19. I am not sure my energy level is back up, but I am getting there.
Age: 42.0
Sex: M
Vaccine: COVID19-2
Symptoms: Headache, SARS-CoV-2 test positive
Clinical narrative: I had a headache, fatigue, small cough, the next my symptoms were a little bit worse. I took a home COVID-19 test that came back positive. I called my doctor to do a telehealth visit and get Paxlovid. I did the five-day regimen tested negative was back at work for one day came home started to feel bad. I took a home COVID-19 test the next day, it was positive. I am in a clinical trial, I have not been told if I received the placebo or the real Paxlovid, but my symptoms got better quickly. I am very happy as the rebound was so much worse than the first time having COVID-19. I am not sure my energy level is back up, but I am getting there.
Age: 71.0
Sex: M
Vaccine: COVID19
Symptoms: Hypoxia, Symptom recurrence
Clinical narrative: HYPOXIA 12/9/2022 -- RECURRENCE OF SAME SYMPTOMS
Age: 86.0
Sex: F
Vaccine: COVID19
Symptoms: Aortic arteriosclerosis, Hypoxia, Respiratory failure
Clinical narrative: HYPOXEMIC RESPIRATORY FAILURE, UNSPECIFIED ACUITY 4/6/2022 ATHEROSCLEROSIS OF AORTA  HYPOXEMIA 4/15/2022 ATHEROSCLEROSIS OF AORTA
Age: 77.0
Sex: M
Vaccine: COVID19
Symptoms: Asthenia, COVID-19, Chest X-ray abnormal, Cough, Fibrin D dimer normal
Clinical narrative: Discharge Provider: MD Primary Care Provider: MD Admission Date: 3/24/2023 Discharge Date: 3/26/23  PRESENTING PROBLEM: Hypoxia [R09.02] COVID-19 [U07.1]   HOSPITAL COURSE: Patient is a 78 y.o. male with past medical history significant for follicular lymphoma s/p chemotherapy and radiation, remote history of diffuse large B cell NHL, type II DM, hyperlipidemia, hypertension, GERD, barrett's esophagus, frequent PVCs, aortic and mitral regurgitation, BPH, depression, and insomnia that presented with cough and weakness for one day, who tested positive for COVID 19 at home. He planned to get remdesivir as an outpatient with an infusion but became hypoxic and was noted to be significantly weak at the infusion center and was sent to the ED. There patient needing 2 liters oxygen, WBC 6.66 hgb 13.2. CXR with bilateral lower lobe infiltrates. D-dimer 220. Patient over 12 hours rapidly improved to room air and initially demanding to discharge home. After long risk/benefit discussion patient was willing to complete 3 doses of remdesvir at the hospital and then discharge home based on study. Walking O2 test was passed with patient only desaturating to 91% on ambulation. Given return precautions and discharged in stable condition on 3/26   For billing question COVID "resolved" during admission.
Age: 77.0
Sex: M
Vaccine: COVID19
Symptoms: Haemoglobin decreased, Hypoxia, Lung infiltration, Oxygen saturation decreased, SARS-CoV-2 test positive
Clinical narrative: Discharge Provider: MD Primary Care Provider: MD Admission Date: 3/24/2023 Discharge Date: 3/26/23  PRESENTING PROBLEM: Hypoxia [R09.02] COVID-19 [U07.1]   HOSPITAL COURSE: Patient is a 78 y.o. male with past medical history significant for follicular lymphoma s/p chemotherapy and radiation, remote history of diffuse large B cell NHL, type II DM, hyperlipidemia, hypertension, GERD, barrett's esophagus, frequent PVCs, aortic and mitral regurgitation, BPH, depression, and insomnia that presented with cough and weakness for one day, who tested positive for COVID 19 at home. He planned to get remdesivir as an outpatient with an infusion but became hypoxic and was noted to be significantly weak at the infusion center and was sent to the ED. There patient needing 2 liters oxygen, WBC 6.66 hgb 13.2. CXR with bilateral lower lobe infiltrates. D-dimer 220. Patient over 12 hours rapidly improved to room air and initially demanding to discharge home. After long risk/benefit discussion patient was willing to complete 3 doses of remdesvir at the hospital and then discharge home based on study. Walking O2 test was passed with patient only desaturating to 91% on ambulation. Given return precautions and discharged in stable condition on 3/26   For billing question COVID "resolved" during admission.
Age: 77.0
Sex: M
Vaccine: COVID19
Symptoms: White blood cell count normal
Clinical narrative: Discharge Provider: MD Primary Care Provider: MD Admission Date: 3/24/2023 Discharge Date: 3/26/23  PRESENTING PROBLEM: Hypoxia [R09.02] COVID-19 [U07.1]   HOSPITAL COURSE: Patient is a 78 y.o. male with past medical history significant for follicular lymphoma s/p chemotherapy and radiation, remote history of diffuse large B cell NHL, type II DM, hyperlipidemia, hypertension, GERD, barrett's esophagus, frequent PVCs, aortic and mitral regurgitation, BPH, depression, and insomnia that presented with cough and weakness for one day, who tested positive for COVID 19 at home. He planned to get remdesivir as an outpatient with an infusion but became hypoxic and was noted to be significantly weak at the infusion center and was sent to the ED. There patient needing 2 liters oxygen, WBC 6.66 hgb 13.2. CXR with bilateral lower lobe infiltrates. D-dimer 220. Patient over 12 hours rapidly improved to room air and initially demanding to discharge home. After long risk/benefit discussion patient was willing to complete 3 doses of remdesvir at the hospital and then discharge home based on study. Walking O2 test was passed with patient only desaturating to 91% on ambulation. Given return precautions and discharged in stable condition on 3/26   For billing question COVID "resolved" during admission.
Age: 66.0
Sex: F
Vaccine: COVID19
Symptoms: Acute respiratory failure, Chronic respiratory failure, Respiratory failure
Clinical narrative: J96.00 ACUTE RESPIRATORY FAILURE 7/2/2021 CHRONIC HYPOXEMIC RESPIRATORY FAILURE J96.92 HYPERCAPNIC RESPIRATORY FAILURE, UNSPECIFIED ACUITY 7/5/2021 CHRONIC HYPOXEMIC RESPIRATORY FAILURE J96.00 ACUTE RESPIRATORY FAILURE 7/2/2021 ACUTE RESPIRATORY FAILURE J96.92 HYPERCAPNIC RESPIRATORY FAILURE, UNSPECIFIED ACUITY 7/5/2021 ACUTE RESPIRATORY FAILURE
Age: 67.0
Sex: M
Vaccine: COVID19
Symptoms: Transient ischaemic attack
Clinical narrative: TRANSIENT CEREBRAL ISCHEMIA
Age: 8.0
Sex: M
Vaccine: COVID19-2
Symptoms: Product storage error
Clinical narrative: Storage and Handling Incident.
Age: 8.0
Sex: F
Vaccine: COVID19-2
Symptoms: Expired product administered
Clinical narrative: WE WERE INFORMED THAT THE VACCINE HAD BEEN IN THE FRIDGE BEYOND THE BEYOND USE DATE AND WAS NO LONGER EFFECTIVE.
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Neuropathy peripheral
Clinical narrative: PATIENT RECEIVED VACCINE FROM OUTSIDE SOURCE PERIPHERAL NEUROPATHY
Age: 79.0
Sex: M
Vaccine: COVID19
Symptoms: Abdominal pain lower, Acute kidney injury, Arthritis, Blood creatinine increased, Blood culture negative
Clinical narrative: Discharge Provider: DO Primary Care Provider at Discharge: MD Admission Date: 3/26/2023 Discharge Date: 03/29/2023   HOSPITAL COURSE: 1. COVID.  Patient is a 80 y.o. male presenting with cough and fatigue, testing positive on admission for COVID. At an outside ED, patient was hypoxic at 87% on room air, requiring 2 L NC to maintain sats greater than 90%. Also found to have a mild AKI, with Cr at 1.57 (baseline 0.86-1.24). He was then transferred to hospital for further management.  Patient was given fluids, steroids, and 3 day course Remdesivir for treatment of COVID; patient's hypoxia resolved and he remained on room air. His AKI resolved with fluid resuscitation. Patient also treated for acute exacerbation of COPD, treated with scheduled duo-nebs, in addition to symbicort (added to his home meds upon discharge).    2. Right second toe pain.  Patient complained of right second toe pain, possible cellulitis, was started on Keflex (3/27-3/29, 9 doses). X ray R foot obtained which showed no acute fracture, no evidence of osteomyelitis. Did show moderate great toe arthritis. Overall, patient's feet with discoloration of multiple toes.  upon outpatient follow up, would consider vasculitis, arterial insufficiency.  (We considered endocarditis, but blood cultures negative).   3. Clinical diverticulitis.  Day of discharge, patient with LLQ abdominal pain, suspect early diverticulitis, so patient sent home with 7 day course Augmentin (this will also continue to treat his cellulitis). No CT scan done as early diverticulitis might not show up and we would still have treated the patient. Patient scheduled with close follow up with his PCP, with instructions to seek care earlier if he develops fever, chills, nausea, or vomiting.    4. Cognitive dysfunction.  The patient did appear to have poor memory, not always remembering us from the day before and asking the same question multiple times.  We consult at SLP for cognitive evaluation.  On 3/28/23 he obtained the following scores:  MoCA 8.3= 24/30 with a Memory Index Score (MIS) of 4/15, BCRS = 7/35,  O-Log =30/30.  This is consistent with mild cognitive dysfunction.  Since acute illness and Covid in particular can cause as issues with memory, we would recommend referral for neuropsychiatric testing.   5. COPD.  Symbicort added for chronic management.       In addition to adding Symbicort for COPD, patient sent home with 7 day course prednisone to complete 10 day steroid course for COVID.
Age: 79.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Cellulitis, Chronic obstructive pulmonary disease, Cognitive disorder, Condition aggravated
Clinical narrative: Discharge Provider: DO Primary Care Provider at Discharge: MD Admission Date: 3/26/2023 Discharge Date: 03/29/2023   HOSPITAL COURSE: 1. COVID.  Patient is a 80 y.o. male presenting with cough and fatigue, testing positive on admission for COVID. At an outside ED, patient was hypoxic at 87% on room air, requiring 2 L NC to maintain sats greater than 90%. Also found to have a mild AKI, with Cr at 1.57 (baseline 0.86-1.24). He was then transferred to hospital for further management.  Patient was given fluids, steroids, and 3 day course Remdesivir for treatment of COVID; patient's hypoxia resolved and he remained on room air. His AKI resolved with fluid resuscitation. Patient also treated for acute exacerbation of COPD, treated with scheduled duo-nebs, in addition to symbicort (added to his home meds upon discharge).    2. Right second toe pain.  Patient complained of right second toe pain, possible cellulitis, was started on Keflex (3/27-3/29, 9 doses). X ray R foot obtained which showed no acute fracture, no evidence of osteomyelitis. Did show moderate great toe arthritis. Overall, patient's feet with discoloration of multiple toes.  upon outpatient follow up, would consider vasculitis, arterial insufficiency.  (We considered endocarditis, but blood cultures negative).   3. Clinical diverticulitis.  Day of discharge, patient with LLQ abdominal pain, suspect early diverticulitis, so patient sent home with 7 day course Augmentin (this will also continue to treat his cellulitis). No CT scan done as early diverticulitis might not show up and we would still have treated the patient. Patient scheduled with close follow up with his PCP, with instructions to seek care earlier if he develops fever, chills, nausea, or vomiting.    4. Cognitive dysfunction.  The patient did appear to have poor memory, not always remembering us from the day before and asking the same question multiple times.  We consult at SLP for cognitive evaluation.  On 3/28/23 he obtained the following scores:  MoCA 8.3= 24/30 with a Memory Index Score (MIS) of 4/15, BCRS = 7/35,  O-Log =30/30.  This is consistent with mild cognitive dysfunction.  Since acute illness and Covid in particular can cause as issues with memory, we would recommend referral for neuropsychiatric testing.   5. COPD.  Symbicort added for chronic management.       In addition to adding Symbicort for COPD, patient sent home with 7 day course prednisone to complete 10 day steroid course for COVID.
Age: 79.0
Sex: M
Vaccine: COVID19
Symptoms: Cough, Diverticulitis, Fatigue, Hypoxia, Memory impairment
Clinical narrative: Discharge Provider: DO Primary Care Provider at Discharge: MD Admission Date: 3/26/2023 Discharge Date: 03/29/2023   HOSPITAL COURSE: 1. COVID.  Patient is a 80 y.o. male presenting with cough and fatigue, testing positive on admission for COVID. At an outside ED, patient was hypoxic at 87% on room air, requiring 2 L NC to maintain sats greater than 90%. Also found to have a mild AKI, with Cr at 1.57 (baseline 0.86-1.24). He was then transferred to hospital for further management.  Patient was given fluids, steroids, and 3 day course Remdesivir for treatment of COVID; patient's hypoxia resolved and he remained on room air. His AKI resolved with fluid resuscitation. Patient also treated for acute exacerbation of COPD, treated with scheduled duo-nebs, in addition to symbicort (added to his home meds upon discharge).    2. Right second toe pain.  Patient complained of right second toe pain, possible cellulitis, was started on Keflex (3/27-3/29, 9 doses). X ray R foot obtained which showed no acute fracture, no evidence of osteomyelitis. Did show moderate great toe arthritis. Overall, patient's feet with discoloration of multiple toes.  upon outpatient follow up, would consider vasculitis, arterial insufficiency.  (We considered endocarditis, but blood cultures negative).   3. Clinical diverticulitis.  Day of discharge, patient with LLQ abdominal pain, suspect early diverticulitis, so patient sent home with 7 day course Augmentin (this will also continue to treat his cellulitis). No CT scan done as early diverticulitis might not show up and we would still have treated the patient. Patient scheduled with close follow up with his PCP, with instructions to seek care earlier if he develops fever, chills, nausea, or vomiting.    4. Cognitive dysfunction.  The patient did appear to have poor memory, not always remembering us from the day before and asking the same question multiple times.  We consult at SLP for cognitive evaluation.  On 3/28/23 he obtained the following scores:  MoCA 8.3= 24/30 with a Memory Index Score (MIS) of 4/15, BCRS = 7/35,  O-Log =30/30.  This is consistent with mild cognitive dysfunction.  Since acute illness and Covid in particular can cause as issues with memory, we would recommend referral for neuropsychiatric testing.   5. COPD.  Symbicort added for chronic management.       In addition to adding Symbicort for COPD, patient sent home with 7 day course prednisone to complete 10 day steroid course for COVID.
Age: 79.0
Sex: M
Vaccine: COVID19
Symptoms: Montreal cognitive assessment, Pain in extremity, Repetitive speech, SARS-CoV-2 test positive, Skin discolouration
Clinical narrative: Discharge Provider: DO Primary Care Provider at Discharge: MD Admission Date: 3/26/2023 Discharge Date: 03/29/2023   HOSPITAL COURSE: 1. COVID.  Patient is a 80 y.o. male presenting with cough and fatigue, testing positive on admission for COVID. At an outside ED, patient was hypoxic at 87% on room air, requiring 2 L NC to maintain sats greater than 90%. Also found to have a mild AKI, with Cr at 1.57 (baseline 0.86-1.24). He was then transferred to hospital for further management.  Patient was given fluids, steroids, and 3 day course Remdesivir for treatment of COVID; patient's hypoxia resolved and he remained on room air. His AKI resolved with fluid resuscitation. Patient also treated for acute exacerbation of COPD, treated with scheduled duo-nebs, in addition to symbicort (added to his home meds upon discharge).    2. Right second toe pain.  Patient complained of right second toe pain, possible cellulitis, was started on Keflex (3/27-3/29, 9 doses). X ray R foot obtained which showed no acute fracture, no evidence of osteomyelitis. Did show moderate great toe arthritis. Overall, patient's feet with discoloration of multiple toes.  upon outpatient follow up, would consider vasculitis, arterial insufficiency.  (We considered endocarditis, but blood cultures negative).   3. Clinical diverticulitis.  Day of discharge, patient with LLQ abdominal pain, suspect early diverticulitis, so patient sent home with 7 day course Augmentin (this will also continue to treat his cellulitis). No CT scan done as early diverticulitis might not show up and we would still have treated the patient. Patient scheduled with close follow up with his PCP, with instructions to seek care earlier if he develops fever, chills, nausea, or vomiting.    4. Cognitive dysfunction.  The patient did appear to have poor memory, not always remembering us from the day before and asking the same question multiple times.  We consult at SLP for cognitive evaluation.  On 3/28/23 he obtained the following scores:  MoCA 8.3= 24/30 with a Memory Index Score (MIS) of 4/15, BCRS = 7/35,  O-Log =30/30.  This is consistent with mild cognitive dysfunction.  Since acute illness and Covid in particular can cause as issues with memory, we would recommend referral for neuropsychiatric testing.   5. COPD.  Symbicort added for chronic management.       In addition to adding Symbicort for COPD, patient sent home with 7 day course prednisone to complete 10 day steroid course for COVID.
Age: 79.0
Sex: M
Vaccine: COVID19
Symptoms: X-ray limb abnormal
Clinical narrative: Discharge Provider: DO Primary Care Provider at Discharge: MD Admission Date: 3/26/2023 Discharge Date: 03/29/2023   HOSPITAL COURSE: 1. COVID.  Patient is a 80 y.o. male presenting with cough and fatigue, testing positive on admission for COVID. At an outside ED, patient was hypoxic at 87% on room air, requiring 2 L NC to maintain sats greater than 90%. Also found to have a mild AKI, with Cr at 1.57 (baseline 0.86-1.24). He was then transferred to hospital for further management.  Patient was given fluids, steroids, and 3 day course Remdesivir for treatment of COVID; patient's hypoxia resolved and he remained on room air. His AKI resolved with fluid resuscitation. Patient also treated for acute exacerbation of COPD, treated with scheduled duo-nebs, in addition to symbicort (added to his home meds upon discharge).    2. Right second toe pain.  Patient complained of right second toe pain, possible cellulitis, was started on Keflex (3/27-3/29, 9 doses). X ray R foot obtained which showed no acute fracture, no evidence of osteomyelitis. Did show moderate great toe arthritis. Overall, patient's feet with discoloration of multiple toes.  upon outpatient follow up, would consider vasculitis, arterial insufficiency.  (We considered endocarditis, but blood cultures negative).   3. Clinical diverticulitis.  Day of discharge, patient with LLQ abdominal pain, suspect early diverticulitis, so patient sent home with 7 day course Augmentin (this will also continue to treat his cellulitis). No CT scan done as early diverticulitis might not show up and we would still have treated the patient. Patient scheduled with close follow up with his PCP, with instructions to seek care earlier if he develops fever, chills, nausea, or vomiting.    4. Cognitive dysfunction.  The patient did appear to have poor memory, not always remembering us from the day before and asking the same question multiple times.  We consult at SLP for cognitive evaluation.  On 3/28/23 he obtained the following scores:  MoCA 8.3= 24/30 with a Memory Index Score (MIS) of 4/15, BCRS = 7/35,  O-Log =30/30.  This is consistent with mild cognitive dysfunction.  Since acute illness and Covid in particular can cause as issues with memory, we would recommend referral for neuropsychiatric testing.   5. COPD.  Symbicort added for chronic management.       In addition to adding Symbicort for COPD, patient sent home with 7 day course prednisone to complete 10 day steroid course for COVID.
Age: 66.0
Sex: M
Vaccine: COVID19
Symptoms: Deep vein thrombosis
Clinical narrative: ACUTE DVT OF RIGHT LEG, UNSPECIFIED VEIN
Age: 63.0
Sex: F
Vaccine: COVID19-2
Symptoms: Blood disorder, Infection
Clinical narrative: I experienced a small infection in my jaw line that almost formed a clot but it did not form, I also am experiencing a blood disease.
Age: 65.0
Sex: F
Vaccine: COVID19
Symptoms: Hypotension, Neuropathy peripheral, Symptom recurrence
Clinical narrative: PERIPHERAL NEUROPATHY HYPOTENSION 5/22/2022 -- RECURRENCE OF SAME SYMPTOMS
Age: 45.0
Sex: F
Vaccine: MMR, VARCEL
Symptoms: Erythema, Peripheral swelling, Skin warm
Clinical narrative: Patient reported developing a raised bump on her left arm where the varicella vaccine was given. She also mentioned redness and warmth to the touch. She states it was 4 days post receiving the vaccines that she noticed the reaction and lasted approximately 1-2 weeks. She did mention she is still noticing some redness and a bump to the day. She was advised to seek care for the reaction.
Age: 10.0
Sex: U
Vaccine: COVID19-2
Symptoms: Product storage error
Clinical narrative: Storage and Handling Incident
Age: 50.0
Sex: M
Vaccine: COVID19
Symptoms: Acute myocardial infarction, Catheterisation cardiac, Chest pain, Coronary arterial stent insertion, Dyspnoea exertional
Clinical narrative: STEMI (heart attack) - Patient had some dyspnea on exertion for several weeks and then developed chest pain around 10/25/21 - the chest pain became severe on 11/5/21 so he went to the local Hospital ER and was diagnosed with STEMI (heart attack) - he was life-flighted to alternate Hospital and had cardiac catheterization and a drug-eluting stent was placed in his left anterior descending coronary artery (all on 11/5/21)
Age: 50.0
Sex: M
Vaccine: COVID19
Symptoms: Laboratory test, Myocardial infarction
Clinical narrative: STEMI (heart attack) - Patient had some dyspnea on exertion for several weeks and then developed chest pain around 10/25/21 - the chest pain became severe on 11/5/21 so he went to the local Hospital ER and was diagnosed with STEMI (heart attack) - he was life-flighted to alternate Hospital and had cardiac catheterization and a drug-eluting stent was placed in his left anterior descending coronary artery (all on 11/5/21)
Age: 65.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal discomfort, Arthralgia, COVID-19, Fatigue, Feeding disorder
Clinical narrative: I woke up with a sore throat in March 2023.  It was painful to swallow.  I was nauseous and sick to my stomach.  I tested positive for COVID-19 on March 3, 2023.  The next day I was so sick I was unable to get out of bed.  For 4 days I was unable to keep any food down.  In the two weeks I was very fatigued.  I had a headache and body aches in my joints.  I am still a little fatigued.
Age: 65.0
Sex: F
Vaccine: COVID19
Symptoms: Headache, Malaise, Mobility decreased, Nausea, Odynophagia
Clinical narrative: I woke up with a sore throat in March 2023.  It was painful to swallow.  I was nauseous and sick to my stomach.  I tested positive for COVID-19 on March 3, 2023.  The next day I was so sick I was unable to get out of bed.  For 4 days I was unable to keep any food down.  In the two weeks I was very fatigued.  I had a headache and body aches in my joints.  I am still a little fatigued.
Age: 65.0
Sex: F
Vaccine: COVID19
Symptoms: Oropharyngeal pain, SARS-CoV-2 test positive
Clinical narrative: I woke up with a sore throat in March 2023.  It was painful to swallow.  I was nauseous and sick to my stomach.  I tested positive for COVID-19 on March 3, 2023.  The next day I was so sick I was unable to get out of bed.  For 4 days I was unable to keep any food down.  In the two weeks I was very fatigued.  I had a headache and body aches in my joints.  I am still a little fatigued.
Age: 18.0
Sex: F
Vaccine: FLUC4
Symptoms: Pain in extremity
Clinical narrative: Patient complain of a sore arm lasting for a few days.
Age: 44.0
Sex: F
Vaccine: HEP, MMR, TD, VARCEL
Symptoms: Headache, Myalgia, Swelling face, Visual impairment
Clinical narrative: Patient reports facial swelling, headaches, muscle aches, vision disturbances since time of vaccination
Age: 17.0
Sex: F
Vaccine: MENB, MNQ
Symptoms: Blood glucose normal, Electrocardiogram normal, Erythema, Hyperhidrosis, Hypoaesthesia
Clinical narrative: Phone call received from Mother 5/3/2023 at 1230 - details of the call and follow-up phone call 5/4/2023. Mother reported patient received her Men B and Men A 5/2/2023 in her RT Deltoid. Patient reported numbness and tingling to her RT arm and RT leg started approximately 2hrs after the administration. Mother reported RT arm appeared hot the rest of the evening. Patient participated in her soccer practice 5/2/2023 evening. Patient reported feeling nauseated after practice - she had a small amount of taco salad for dinner at 2230. Patient continued to c/o nausea overnight (no vomiting) and did not attend school 5/3/2023 due to nausea and c/o sore muscles (all over); numbness and tingling in RUE and RLL persisted all night 5/2/2023. Mother went home on her lunch break to check on Patient. Patienthad not eaten since the small portion of taco salad and had drank approximately 16oz of water 5/3 morning. Mother reported Patient appeared "gray" and Patient reported she felt like she was going to throw-up (persistent nausea); no vomiting. Patient reported her vision was abnormal and was "closing in" when she felt like she was going to throw-up. Mother reported Patient was "drenched" during the episode. When Patient went to the bathroom her extremities began to tense-up (started with hands and feet and progressed) and Patient could not move her extremities (sitting on the bathroom floor) - extremities appeared rigid per Mother and the symptom lasted approximately 10minutes and Mother reported Patient's extremities appeared red. No loss of consciousness. Mother called EMS and reported EMS evaluation/vital signs/EKG/and glucose were within normal limits. Patient was not transported to ED. Glucose 89. HR 72 and BPs 130/? and then 120/? - mother could not recall specifics of BP. Mother asked for guidance during call - Continue close observation; push fluids (goal of 120oz/day) and diet as tolerated. Seek Care if symptoms recur. Mother informed vaccine reaction would be reported. Mother verbalized understanding. No fever or illness prior to vaccine administration. Daily medications: Iron; Vitamin D; Accutane (no recent dose adjustment)
Age: 17.0
Sex: F
Vaccine: MENB, MNQ
Symptoms: Hypophagia, Loss of personal independence in daily activities, Mobility decreased, Muscle rigidity, Muscle tightness
Clinical narrative: Phone call received from Mother 5/3/2023 at 1230 - details of the call and follow-up phone call 5/4/2023. Mother reported patient received her Men B and Men A 5/2/2023 in her RT Deltoid. Patient reported numbness and tingling to her RT arm and RT leg started approximately 2hrs after the administration. Mother reported RT arm appeared hot the rest of the evening. Patient participated in her soccer practice 5/2/2023 evening. Patient reported feeling nauseated after practice - she had a small amount of taco salad for dinner at 2230. Patient continued to c/o nausea overnight (no vomiting) and did not attend school 5/3/2023 due to nausea and c/o sore muscles (all over); numbness and tingling in RUE and RLL persisted all night 5/2/2023. Mother went home on her lunch break to check on Patient. Patienthad not eaten since the small portion of taco salad and had drank approximately 16oz of water 5/3 morning. Mother reported Patient appeared "gray" and Patient reported she felt like she was going to throw-up (persistent nausea); no vomiting. Patient reported her vision was abnormal and was "closing in" when she felt like she was going to throw-up. Mother reported Patient was "drenched" during the episode. When Patient went to the bathroom her extremities began to tense-up (started with hands and feet and progressed) and Patient could not move her extremities (sitting on the bathroom floor) - extremities appeared rigid per Mother and the symptom lasted approximately 10minutes and Mother reported Patient's extremities appeared red. No loss of consciousness. Mother called EMS and reported EMS evaluation/vital signs/EKG/and glucose were within normal limits. Patient was not transported to ED. Glucose 89. HR 72 and BPs 130/? and then 120/? - mother could not recall specifics of BP. Mother asked for guidance during call - Continue close observation; push fluids (goal of 120oz/day) and diet as tolerated. Seek Care if symptoms recur. Mother informed vaccine reaction would be reported. Mother verbalized understanding. No fever or illness prior to vaccine administration. Daily medications: Iron; Vitamin D; Accutane (no recent dose adjustment)
Age: 17.0
Sex: F
Vaccine: MENB, MNQ
Symptoms: Myalgia, Nausea, Paraesthesia, Skin discolouration, Skin warm
Clinical narrative: Phone call received from Mother 5/3/2023 at 1230 - details of the call and follow-up phone call 5/4/2023. Mother reported patient received her Men B and Men A 5/2/2023 in her RT Deltoid. Patient reported numbness and tingling to her RT arm and RT leg started approximately 2hrs after the administration. Mother reported RT arm appeared hot the rest of the evening. Patient participated in her soccer practice 5/2/2023 evening. Patient reported feeling nauseated after practice - she had a small amount of taco salad for dinner at 2230. Patient continued to c/o nausea overnight (no vomiting) and did not attend school 5/3/2023 due to nausea and c/o sore muscles (all over); numbness and tingling in RUE and RLL persisted all night 5/2/2023. Mother went home on her lunch break to check on Patient. Patienthad not eaten since the small portion of taco salad and had drank approximately 16oz of water 5/3 morning. Mother reported Patient appeared "gray" and Patient reported she felt like she was going to throw-up (persistent nausea); no vomiting. Patient reported her vision was abnormal and was "closing in" when she felt like she was going to throw-up. Mother reported Patient was "drenched" during the episode. When Patient went to the bathroom her extremities began to tense-up (started with hands and feet and progressed) and Patient could not move her extremities (sitting on the bathroom floor) - extremities appeared rigid per Mother and the symptom lasted approximately 10minutes and Mother reported Patient's extremities appeared red. No loss of consciousness. Mother called EMS and reported EMS evaluation/vital signs/EKG/and glucose were within normal limits. Patient was not transported to ED. Glucose 89. HR 72 and BPs 130/? and then 120/? - mother could not recall specifics of BP. Mother asked for guidance during call - Continue close observation; push fluids (goal of 120oz/day) and diet as tolerated. Seek Care if symptoms recur. Mother informed vaccine reaction would be reported. Mother verbalized understanding. No fever or illness prior to vaccine administration. Daily medications: Iron; Vitamin D; Accutane (no recent dose adjustment)
Age: 17.0
Sex: F
Vaccine: MENB, MNQ
Symptoms: Visual impairment
Clinical narrative: Phone call received from Mother 5/3/2023 at 1230 - details of the call and follow-up phone call 5/4/2023. Mother reported patient received her Men B and Men A 5/2/2023 in her RT Deltoid. Patient reported numbness and tingling to her RT arm and RT leg started approximately 2hrs after the administration. Mother reported RT arm appeared hot the rest of the evening. Patient participated in her soccer practice 5/2/2023 evening. Patient reported feeling nauseated after practice - she had a small amount of taco salad for dinner at 2230. Patient continued to c/o nausea overnight (no vomiting) and did not attend school 5/3/2023 due to nausea and c/o sore muscles (all over); numbness and tingling in RUE and RLL persisted all night 5/2/2023. Mother went home on her lunch break to check on Patient. Patienthad not eaten since the small portion of taco salad and had drank approximately 16oz of water 5/3 morning. Mother reported Patient appeared "gray" and Patient reported she felt like she was going to throw-up (persistent nausea); no vomiting. Patient reported her vision was abnormal and was "closing in" when she felt like she was going to throw-up. Mother reported Patient was "drenched" during the episode. When Patient went to the bathroom her extremities began to tense-up (started with hands and feet and progressed) and Patient could not move her extremities (sitting on the bathroom floor) - extremities appeared rigid per Mother and the symptom lasted approximately 10minutes and Mother reported Patient's extremities appeared red. No loss of consciousness. Mother called EMS and reported EMS evaluation/vital signs/EKG/and glucose were within normal limits. Patient was not transported to ED. Glucose 89. HR 72 and BPs 130/? and then 120/? - mother could not recall specifics of BP. Mother asked for guidance during call - Continue close observation; push fluids (goal of 120oz/day) and diet as tolerated. Seek Care if symptoms recur. Mother informed vaccine reaction would be reported. Mother verbalized understanding. No fever or illness prior to vaccine administration. Daily medications: Iron; Vitamin D; Accutane (no recent dose adjustment)
Age: 10.0
Sex: M
Vaccine: FLUC4
Symptoms: Abdominal pain upper, Appendicectomy, Arthralgia, Blood test abnormal, Groin pain
Clinical narrative: Nov 7, 2022 - sudden stomach pains and vomiting. Sent to ER, emergency appendectomy.  Nov 27, 2022 - excruciating joint pain all over his body with concentration on thigh/groin area, Nov 29 1AM, he could not move his legs - called ambulance, brought by stretcher to ER tested for everything, diagnosed with reactive, toxic synovitis. Needed morphine, pain killers, cane to walk for several days. Still experiencing inflammation and bloodwork is not right.
Age: 10.0
Sex: M
Vaccine: FLUC4
Symptoms: Inflammation, Laboratory test, Mobility decreased, Pain in extremity, Synovitis
Clinical narrative: Nov 7, 2022 - sudden stomach pains and vomiting. Sent to ER, emergency appendectomy.  Nov 27, 2022 - excruciating joint pain all over his body with concentration on thigh/groin area, Nov 29 1AM, he could not move his legs - called ambulance, brought by stretcher to ER tested for everything, diagnosed with reactive, toxic synovitis. Needed morphine, pain killers, cane to walk for several days. Still experiencing inflammation and bloodwork is not right.
Age: 10.0
Sex: M
Vaccine: FLUC4
Symptoms: Vomiting, Walking aid user
Clinical narrative: Nov 7, 2022 - sudden stomach pains and vomiting. Sent to ER, emergency appendectomy.  Nov 27, 2022 - excruciating joint pain all over his body with concentration on thigh/groin area, Nov 29 1AM, he could not move his legs - called ambulance, brought by stretcher to ER tested for everything, diagnosed with reactive, toxic synovitis. Needed morphine, pain killers, cane to walk for several days. Still experiencing inflammation and bloodwork is not right.
Age: 69.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: COVID-19, Cough, Dyspnoea, SARS-CoV-2 test positive
Clinical narrative: 02/21/23 presents to ED for "cough" "shortness of breath". PMHx of "COPD, CKD, GERD, obesity, diabetes"
Age: 4.0
Sex: F
Vaccine: COVID19-2
Symptoms: No adverse event, Wrong product administered
Clinical narrative: THERE IS NO ADVERSE EVENT BUT THIS IS CONSIDERED A VACCINE ADMINISTRATION ERROR DUE TO THE LACK OF INFORMATION GIVEN TO US WHEN THE DOSING CHANGED WITH THE REMOVAL OF THE MONOVALENT VACCINE. WE DID NOT RECEIVE ANY UPDATED DOSING INSTRUCTIONS UNTIL THIS WEEK WHICH DID NOT GIVE CLEAR OR APPARENT DIRECTIONS INVOLVING CHANGE IN VIALS AND AGE INDICATIONS. THERE SHOULD HAVE BEEN A COMPLETE HALT IN VACCINATING UNTIL CLEAR AND CONCISE INSTRUCTIONS WERE MADE AVAILABLE TO THE HEALTHCARE INDUSTRY. CLEAR AND CONCISE DOES NOT MEAN SIFTING THROUGH 72 PAGES AND CLICKING ON MULTIPLE LINKS TO FIND THE NEEDLE IN THE HAYSTACK.  NOW WE HAVE A VACCINATION ERROR DUE TO THE LACK OF INFORMATION FROM THOSE IN CHARGE WHO DROPPED THE BALL. WE TAKE NO FAULT IN THIS ERROR. THIS PATIENT SHOULD HAVE RECEIVED THE BLUE CAP GRAY LABEL BIVALENT BUT RECEIVED THE YELLOW LABEL PINK TOP BIVALENT. (WHO USES THESE DESCRIPTIONS TO CLEARLY INSTRUCT PEOPLE ON WHAT TO DO?) THIS IS UNSAFE AND UNCLEAR. YOU ALSO ASSUME THAT WE HAVE KNOWLEDGE OF ALL THE VIALS AND DIFFERENT FORMULATIONS OUT THERE WHEN WE DON'T. YOU TOTALLY DROPPED THE BALL AND THIS ERROR RESTS ON THOSE WHO MAKE THE RULES AND INSTRUCTIONS.
Age: 23.0
Sex: M
Vaccine: COVID19-2, FLU4
Symptoms: Cough, Dyspnoea, HIV test negative, Myalgia, Nasopharyngitis
Clinical narrative: On 03/19/2023 I went  to the beach it was cold and windy , temperature of 65. After coming back from the beach I had a runny nose and I was sneezing.. It continued till 2  weeks. On 04/01/2023  I started  having a severe cough, runny nose,  muscles ache, shortness of breath and hard to breath. 04/09/2023 I had a appointment at the pharmacy for COVID-19 test  was negative, strep test was negative. They told  me that it was a common cold and prescribed me with a cough medication Brompheniramine- Pseudoephedrine- DM ( 5 days) .  On 04/15/2023 I had runny nose , cough, and muscles aches. On 04/21/2023 I went to get more tests done such at STD and HIV which was negative.  On 04/22/2023 I still have a dry cough,  and muscles aches. On 04/23/2023 I went to the doctor again I was prescribed with inhaler, Antibiotics ( Azithromycin) 6 days   and cough syrup ( Benzonatate). After finishing the medication  my symptoms reduced but it didn't go away completely. I try to use Vicks  but it lost it's effectiveness on me. This is something new that I am experience.  In total I went to the doctors like 3 times.  I will be scheduling another appointment  for the severe cough which I still have . I don't even have fever so no one is sure what is going on with me.