chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 38.0
Sex: F
Vaccine: COVID19
Symptoms: Fatigue, Somnolence, Swollen tongue
Clinical narrative: Extreme fatigue, sleepiness, tongue swelling, onset about a week after vaccination. This occurred with previous covid shots as well (previous vaers reports)
Age: 70.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Encephalitis autoimmune, Fatigue, Gait disturbance, Generalised tonic-clonic seizure, Hypophagia
Clinical narrative: Patient admitted 9/29/21 with concern for autoimmune encephalitis. Per wife pt first developed abnormal taste and sense of smell in February after receiving his second dose of Moderna vaccine. Symptoms were so severe that would cause nausea and decreased oral intake. He was also feeling fatigue and at times had gait imbalance. He was evaluated by ENT at that time. In May while they were at a camping trip he has a grand mal seizure. Received moderna vaccine on 1/31/21 and 2/27/21.  Unclear if these symptoms are related to vaccine.  Per note from 8/27/21: "The MRI appearance and significant resolution over 2 - 3 months is most consistent with an autoimmune encephalitis, particularly given that all of his symptoms began shortly after vaccination (the Covid vaccination)."
Age: 70.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Magnetic resonance imaging head abnormal, Nausea, Parosmia, Taste disorder
Clinical narrative: Patient admitted 9/29/21 with concern for autoimmune encephalitis. Per wife pt first developed abnormal taste and sense of smell in February after receiving his second dose of Moderna vaccine. Symptoms were so severe that would cause nausea and decreased oral intake. He was also feeling fatigue and at times had gait imbalance. He was evaluated by ENT at that time. In May while they were at a camping trip he has a grand mal seizure. Received moderna vaccine on 1/31/21 and 2/27/21.  Unclear if these symptoms are related to vaccine.  Per note from 8/27/21: "The MRI appearance and significant resolution over 2 - 3 months is most consistent with an autoimmune encephalitis, particularly given that all of his symptoms began shortly after vaccination (the Covid vaccination)."
Age: 34.0
Sex: F
Vaccine: COVID19
Symptoms: Abnormal cord insertion, Maternal exposure during pregnancy, Whole body scan
Clinical narrative: Second pregnancy, due date of 12/25/2021. Velamentous cord insertion detected on 20-week anatomy scan.
Age: 25.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Fatigue, Palpitations, Pyrexia
Clinical narrative: A day later, I was exhausted had fever and chills. I had heart palpitation. I did not see a doctor and it went way after 3 weeks.
Age: 24.0
Sex: F
Vaccine: COVID19
Symptoms: Extra dose administered, Headache, Pain
Clinical narrative: Received my COVID booster vaccine. By the evening, not even 8 hours later, I presented with body aches and a headache. Into the next day, I still present with these symptoms
Age: 36.0
Sex: F
Vaccine: COVID19
Symptoms: Epistaxis, Thrombosis
Clinical narrative: Per original - extreme bloody noses -several per day with blood clots.
Age: 67.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Amnesia, Blood test, Computerised tomogram, Creutzfeldt-Jakob disease, Death
Clinical narrative: what began as memory loss and irritability was followed by loss of motor skills,  later diagnosed as Cruetzfeldt-Jakobs disease.  Death occurred early morning 10/29/2021.
Age: 67.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Irritability, Lumbar puncture, Magnetic resonance imaging, Motor dysfunction
Clinical narrative: what began as memory loss and irritability was followed by loss of motor skills,  later diagnosed as Cruetzfeldt-Jakobs disease.  Death occurred early morning 10/29/2021.
Age: 61.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Tested COVID positive on 11/17/2021
Age: 5.0
Sex: F
Vaccine: COVID19
Symptoms: Product preparation issue
Clinical narrative: The nurse stated that she reconstituted the 5-11 year old  Pfizer Covid-19 vaccine with 1.8 ml of 0.9% of normal saline instead of 1.3 ml.
Age: 19.0
Sex: F
Vaccine: COVID19
Symptoms: Activated partial thromboplastin time, Contusion, Differential white blood cell count, Full blood count
Clinical narrative: 3-4 days after vaccination, pt developed bruising on her legs. over the next week, the bruising has continued. she currently has extensive bruised all over both legs. has 2 small faint bruises on L upper arm
Age: 52.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered, No adverse event
Clinical narrative: Vaccine expiration was 11/7/2021 and was administered on 11/12/2021.  Mistook expiration date to read 11/17/2021 instead of 11/7/2021.  No adverse events or outcomes to recipient.
Age: 82.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: COVID-19, COVID-19 pneumonia, Culture urine positive, Cystitis, Decreased appetite
Clinical narrative: Hospitalized 11/11/2021; COVID-19 positive 11/11/2021; fully vaccinated  BRIEF OVERVIEW: Discharge Provider: , MD Primary Care Provider: , MD Admission Date: 11/11/2021 Discharge Date: Nov 15, 2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Acute cystitis without hematuria Pneumonia due to COVID-19 virus    HOSPITAL COURSE: Pt is an 83-year-old woman with a past medical history significant for hypertension, depression/anxiety who presented with encephalopathy and a positive COVID test from a facility. Admitted to the HCF and started on dexamethasone, remdesivir, and ceftriaxone empirically for suspected UTI. Over next day, mental status improved and back closer to baseline. Also able to wean oxygen down to RA on 11/14. Urine did ultimately grow pansens e.coli.  Patient completed 3 days of Rocephin.  Mentally patient remained clear without further encephalopathy.  There respiratory status remained stable on room air.  On the day of discharge 11/15 patient states that she is feeling well and would like to return home.
Age: 82.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Dysgeusia, Encephalopathy, Eructation, Escherichia infection, Faeces discoloured
Clinical narrative: Hospitalized 11/11/2021; COVID-19 positive 11/11/2021; fully vaccinated  BRIEF OVERVIEW: Discharge Provider: , MD Primary Care Provider: , MD Admission Date: 11/11/2021 Discharge Date: Nov 15, 2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Acute cystitis without hematuria Pneumonia due to COVID-19 virus    HOSPITAL COURSE: Pt is an 83-year-old woman with a past medical history significant for hypertension, depression/anxiety who presented with encephalopathy and a positive COVID test from a facility. Admitted to the HCF and started on dexamethasone, remdesivir, and ceftriaxone empirically for suspected UTI. Over next day, mental status improved and back closer to baseline. Also able to wean oxygen down to RA on 11/14. Urine did ultimately grow pansens e.coli.  Patient completed 3 days of Rocephin.  Mentally patient remained clear without further encephalopathy.  There respiratory status remained stable on room air.  On the day of discharge 11/15 patient states that she is feeling well and would like to return home.
Age: 82.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Gastric occult blood positive, Mental status changes, Nausea, Occult blood, SARS-CoV-2 test positive
Clinical narrative: Hospitalized 11/11/2021; COVID-19 positive 11/11/2021; fully vaccinated  BRIEF OVERVIEW: Discharge Provider: , MD Primary Care Provider: , MD Admission Date: 11/11/2021 Discharge Date: Nov 15, 2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Acute cystitis without hematuria Pneumonia due to COVID-19 virus    HOSPITAL COURSE: Pt is an 83-year-old woman with a past medical history significant for hypertension, depression/anxiety who presented with encephalopathy and a positive COVID test from a facility. Admitted to the HCF and started on dexamethasone, remdesivir, and ceftriaxone empirically for suspected UTI. Over next day, mental status improved and back closer to baseline. Also able to wean oxygen down to RA on 11/14. Urine did ultimately grow pansens e.coli.  Patient completed 3 days of Rocephin.  Mentally patient remained clear without further encephalopathy.  There respiratory status remained stable on room air.  On the day of discharge 11/15 patient states that she is feeling well and would like to return home.
Age: 82.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Urinary tract infection, Vomiting, Weight decreased
Clinical narrative: Hospitalized 11/11/2021; COVID-19 positive 11/11/2021; fully vaccinated  BRIEF OVERVIEW: Discharge Provider: , MD Primary Care Provider: , MD Admission Date: 11/11/2021 Discharge Date: Nov 15, 2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Acute cystitis without hematuria Pneumonia due to COVID-19 virus    HOSPITAL COURSE: Pt is an 83-year-old woman with a past medical history significant for hypertension, depression/anxiety who presented with encephalopathy and a positive COVID test from a facility. Admitted to the HCF and started on dexamethasone, remdesivir, and ceftriaxone empirically for suspected UTI. Over next day, mental status improved and back closer to baseline. Also able to wean oxygen down to RA on 11/14. Urine did ultimately grow pansens e.coli.  Patient completed 3 days of Rocephin.  Mentally patient remained clear without further encephalopathy.  There respiratory status remained stable on room air.  On the day of discharge 11/15 patient states that she is feeling well and would like to return home.
Age: 35.0
Sex: F
Vaccine: COVID19
Symptoms: Headache, Lymph node pain, Lymphadenopathy
Clinical narrative: Severe headache for 8+ hours morning after vaccine then developed painful swollen axillary lymph nodes on same side as vaccine, moderate pain for 24 hours then continuing mild pain
Age: 57.0
Sex: F
Vaccine: COVID19
Symptoms: Headache, Lymphadenopathy, Pain
Clinical narrative: headache, body aches - neck and back, mild lymphadenopathy left axilla
Age: 45.0
Sex: M
Vaccine: COVID19
Symptoms: Lymphadenopathy
Clinical narrative: Left axillary lymphadenopathy
Age: 14.0
Sex: M
Vaccine: COVID19
Symptoms: Product administered to patient of inappropriate age
Clinical narrative: Patient inadvertently received Moderna vaccine, even though it is currently not FDA approved for individuals under the age of 18. Pediatrician reached out to the CDC, and was advised to  continue with the Pfizer series. Patient did not develop any acute severe s/sx from the vaccine and is expected to return to the clinic within the next week to complete his COVID-19 series.
Age: 27.0
Sex: F
Vaccine: COVID19
Symptoms: Anosmia, COVID-19, Cough, Rhinorrhoea, SARS-CoV-2 test positive
Clinical narrative: I had lost my smell. I had a cough and runny nose. I went to the doctor's office on 11/14/2021 and was diagnosed with COVID-19.
Age: 33.0
Sex: F
Vaccine: COVID19
Symptoms: Tinnitus
Clinical narrative: Tinnitus.  Daily short episodes of tinnitus in my right ear.
Age: 56.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect dose administered, Needle issue
Clinical narrative: During administration the attachable needle came loose resulting in vaccine spillage and an incomplete injection. It is very likely that less than 50% of medication was injected but patient did not want to repeat the vaccination in the opposite arm which is the recommendation by the cdc
Age: 65.0
Sex: F
Vaccine: COVID19
Symptoms: Tremor
Clinical narrative: Shaking of jaw involentary an hands
Age: 46.0
Sex: M
Vaccine: COVID19
Symptoms: Arthralgia, Audiogram, Shoulder injury related to vaccine administration, Tinnitus
Clinical narrative: new onset tinnitus 1 week after and shoulder pain (SIRVA)
Age: 38.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Vaccine administered beyond the Best Used Date but before expiration date.
Age: 35.0
Sex: M
Vaccine: COVID19
Symptoms: Blood test, Deafness, Ear discomfort, Tinnitus
Clinical narrative: 2 days post vaccine, 10/30/2021- I woke up deaf. I could not hear anything for like 20 minutes. A high pitch tone for lack of a better words. I could not hear anything out of either ear. I obviously freaked out, but it started to come back and I thought that was weird. It happened again and it happened more frequently. I have episodes where I hear a tone. My ear will pop and I will not be able to hear for a few moments, and it comes back. Sometimes I can't sleep because I hear a tone that I can't shut up. 11/18/2021-Doctor looked at my ears. I do not have a history of tinnitus. He said my ears look physically fine and referred me to a specialist. The doctor also ordered me a battery of blood work. This continues to happen frequently every day.
Age: 40.0
Sex: M
Vaccine: COVID19
Symptoms: Condition aggravated, Hypertension
Clinical narrative: Extremely high blood pressure that medication has not been able to control
Age: 12.0
Sex: M
Vaccine: COVID19, HPV9, MNQ, TDAP
Symptoms: Incorrect dose administered
Clinical narrative: A 12 year old patient was given a low dose (orange top) for 5-11 years of  age  Covid Vaccine.  Patient had no symptoms of the 30 minutes being observed. Patient was discharged shortly after.  Supervisor called mother and informed that low dose (orange top) 5- 11 year old covid vaccine was administered and would returned 21 days after last dose for full dose (purple top) 12 and up.
Age: 53.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Arthralgia, Back pain, Blood test, Condition aggravated, Magnetic resonance imaging normal
Clinical narrative: Have gotten worse daily with joint pain and swelling in hands and feet since this vaccine and my lumbar fusion which I was pain free has started pain same time with mri showing no changes but yet pain out of the blue only to get worse and had a RH factor of 21.8 in lab.. was fine until all this started around end of august
Age: 53.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Peripheral swelling, Rheumatoid factor negative
Clinical narrative: Have gotten worse daily with joint pain and swelling in hands and feet since this vaccine and my lumbar fusion which I was pain free has started pain same time with mri showing no changes but yet pain out of the blue only to get worse and had a RH factor of 21.8 in lab.. was fine until all this started around end of august
Age: 44.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered, No adverse event
Clinical narrative: Vaccine administered on 11/12/2021, expiration date was 11/7/202.  Mistook expiration date to be 11/17/2021.  No adverse event or outcome to recipient.
Age: 77.0
Sex: F
Vaccine: UNK
Symptoms: Blood test, Chest X-ray abnormal, Chills, Computerised tomogram thorax normal, Lung opacity
Clinical narrative: Bi-Lateral pneumonia
Age: 77.0
Sex: F
Vaccine: UNK
Symptoms: Pneumonia
Clinical narrative: Bi-Lateral pneumonia
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: Biopsy, Breast cancer, Breast mass, Mammogram abnormal, Ultrasound scan abnormal
Clinical narrative: Doctor visit on 26Apr2021, on 4/7/2021 doctor visit, on 4/8/2021 ultrasound and mammograms on 4/26/2021. After 1st dose didn't feel well tiredness but for 2nd dose I found a lump upper breast on left and two lumps. One on 4/7 and 2nd 4/26/2021. 5/13/2021 was diagnosed as breast cancer. After the biopsy, I had 5 months of chemotherapy and going for double Mastectomy on 29Nov2021.
Age: 30.0
Sex: M
Vaccine: COVID19
Symptoms: Acoustic stimulation tests, Audiogram, Tinnitus
Clinical narrative: Sudden onset tinnitus. No prior history of tinnitus previously. Tinnitus is constant ringing/droning in both ears exacerbated by laying down.
Age: 65.0
Sex: M
Vaccine: COVID19
Symptoms: Priapism
Clinical narrative: Priapism approx. 12 hours after receiving Moderna COVID vaccine. Evaluated in emergency department,  priapism resolved with penile aspiration.
Age: 84.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Acidosis hyperchloraemic, Asthenia, Atelectasis, Blood ketone body, Blood pressure decreased
Clinical narrative: Hospitalized 11/11/2021; COVID-19 positive 11/11/2021; fully vaccinated plus booster  BRIEF OVERVIEW: Discharge Provider: MD Primary Care Provider: ANP Admission Date: 11/11/2021 Discharge Date: Nov 15, 2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Hypocalcemia [E83.51] Hypokalemia [E87.6] Weakness [R53.1] COVID-19 [U07.1]   HOSPITAL COURSE: Patient is a 84 y.o. male with past medical history for CHF, HTN, atrial fibrillation, T2DM, CKD. He presented to ER with 3 days of decreased intake, fatigue, malaise and weakness.  His COVID19 pcr is positive. Labs notable for hypokalemia, hypocalcemia, hyperchloremic non gap acidosis, elevated beta hydroxybutyrate and leukocytosis. CXR with similar appearance of cardiomegaly, minimal CHF and bibasilar atelectasis. Patient given monocolonal AB on 11/13.  Continued to do well and remain on room air.  Electrolytes normalized with IVFs and replacement.  Patient also treated for a urinary tract infection with 3 days of IV Rocephin.  Culture was not available.  Patient with good PO intake and able to ambulate well on day of discharge.  Patient feels ready to discharge home.  Advised holding Lasix and checking daily weights as concerned that po intake may not be truly back to baseline yet and do not want patient to returned to dehydrated state with electrolyte abnormalities seen on admission.  Recommend lab work within 1 week with PCP.  Metformin also held on discharge until patient feels his food intake returns to baseline
Age: 84.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: COVID-19, Cardiac failure congestive, Cardiomegaly, Chest X-ray abnormal, Condition aggravated
Clinical narrative: Hospitalized 11/11/2021; COVID-19 positive 11/11/2021; fully vaccinated plus booster  BRIEF OVERVIEW: Discharge Provider: MD Primary Care Provider: ANP Admission Date: 11/11/2021 Discharge Date: Nov 15, 2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Hypocalcemia [E83.51] Hypokalemia [E87.6] Weakness [R53.1] COVID-19 [U07.1]   HOSPITAL COURSE: Patient is a 84 y.o. male with past medical history for CHF, HTN, atrial fibrillation, T2DM, CKD. He presented to ER with 3 days of decreased intake, fatigue, malaise and weakness.  His COVID19 pcr is positive. Labs notable for hypokalemia, hypocalcemia, hyperchloremic non gap acidosis, elevated beta hydroxybutyrate and leukocytosis. CXR with similar appearance of cardiomegaly, minimal CHF and bibasilar atelectasis. Patient given monocolonal AB on 11/13.  Continued to do well and remain on room air.  Electrolytes normalized with IVFs and replacement.  Patient also treated for a urinary tract infection with 3 days of IV Rocephin.  Culture was not available.  Patient with good PO intake and able to ambulate well on day of discharge.  Patient feels ready to discharge home.  Advised holding Lasix and checking daily weights as concerned that po intake may not be truly back to baseline yet and do not want patient to returned to dehydrated state with electrolyte abnormalities seen on admission.  Recommend lab work within 1 week with PCP.  Metformin also held on discharge until patient feels his food intake returns to baseline
Age: 84.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Decreased appetite, Electrolyte imbalance, Fall, Fatigue, Hypocalcaemia
Clinical narrative: Hospitalized 11/11/2021; COVID-19 positive 11/11/2021; fully vaccinated plus booster  BRIEF OVERVIEW: Discharge Provider: MD Primary Care Provider: ANP Admission Date: 11/11/2021 Discharge Date: Nov 15, 2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Hypocalcemia [E83.51] Hypokalemia [E87.6] Weakness [R53.1] COVID-19 [U07.1]   HOSPITAL COURSE: Patient is a 84 y.o. male with past medical history for CHF, HTN, atrial fibrillation, T2DM, CKD. He presented to ER with 3 days of decreased intake, fatigue, malaise and weakness.  His COVID19 pcr is positive. Labs notable for hypokalemia, hypocalcemia, hyperchloremic non gap acidosis, elevated beta hydroxybutyrate and leukocytosis. CXR with similar appearance of cardiomegaly, minimal CHF and bibasilar atelectasis. Patient given monocolonal AB on 11/13.  Continued to do well and remain on room air.  Electrolytes normalized with IVFs and replacement.  Patient also treated for a urinary tract infection with 3 days of IV Rocephin.  Culture was not available.  Patient with good PO intake and able to ambulate well on day of discharge.  Patient feels ready to discharge home.  Advised holding Lasix and checking daily weights as concerned that po intake may not be truly back to baseline yet and do not want patient to returned to dehydrated state with electrolyte abnormalities seen on admission.  Recommend lab work within 1 week with PCP.  Metformin also held on discharge until patient feels his food intake returns to baseline
Age: 84.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Hypokalaemia, Hypophagia, Hypotension, Hypovolaemia, Leukocytosis
Clinical narrative: Hospitalized 11/11/2021; COVID-19 positive 11/11/2021; fully vaccinated plus booster  BRIEF OVERVIEW: Discharge Provider: MD Primary Care Provider: ANP Admission Date: 11/11/2021 Discharge Date: Nov 15, 2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Hypocalcemia [E83.51] Hypokalemia [E87.6] Weakness [R53.1] COVID-19 [U07.1]   HOSPITAL COURSE: Patient is a 84 y.o. male with past medical history for CHF, HTN, atrial fibrillation, T2DM, CKD. He presented to ER with 3 days of decreased intake, fatigue, malaise and weakness.  His COVID19 pcr is positive. Labs notable for hypokalemia, hypocalcemia, hyperchloremic non gap acidosis, elevated beta hydroxybutyrate and leukocytosis. CXR with similar appearance of cardiomegaly, minimal CHF and bibasilar atelectasis. Patient given monocolonal AB on 11/13.  Continued to do well and remain on room air.  Electrolytes normalized with IVFs and replacement.  Patient also treated for a urinary tract infection with 3 days of IV Rocephin.  Culture was not available.  Patient with good PO intake and able to ambulate well on day of discharge.  Patient feels ready to discharge home.  Advised holding Lasix and checking daily weights as concerned that po intake may not be truly back to baseline yet and do not want patient to returned to dehydrated state with electrolyte abnormalities seen on admission.  Recommend lab work within 1 week with PCP.  Metformin also held on discharge until patient feels his food intake returns to baseline
Age: 84.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Malaise, SARS-CoV-2 test positive, Urinary tract infection, Urine analysis
Clinical narrative: Hospitalized 11/11/2021; COVID-19 positive 11/11/2021; fully vaccinated plus booster  BRIEF OVERVIEW: Discharge Provider: MD Primary Care Provider: ANP Admission Date: 11/11/2021 Discharge Date: Nov 15, 2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Hypocalcemia [E83.51] Hypokalemia [E87.6] Weakness [R53.1] COVID-19 [U07.1]   HOSPITAL COURSE: Patient is a 84 y.o. male with past medical history for CHF, HTN, atrial fibrillation, T2DM, CKD. He presented to ER with 3 days of decreased intake, fatigue, malaise and weakness.  His COVID19 pcr is positive. Labs notable for hypokalemia, hypocalcemia, hyperchloremic non gap acidosis, elevated beta hydroxybutyrate and leukocytosis. CXR with similar appearance of cardiomegaly, minimal CHF and bibasilar atelectasis. Patient given monocolonal AB on 11/13.  Continued to do well and remain on room air.  Electrolytes normalized with IVFs and replacement.  Patient also treated for a urinary tract infection with 3 days of IV Rocephin.  Culture was not available.  Patient with good PO intake and able to ambulate well on day of discharge.  Patient feels ready to discharge home.  Advised holding Lasix and checking daily weights as concerned that po intake may not be truly back to baseline yet and do not want patient to returned to dehydrated state with electrolyte abnormalities seen on admission.  Recommend lab work within 1 week with PCP.  Metformin also held on discharge until patient feels his food intake returns to baseline
Age: 35.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Asymptomatic COVID-19, SARS-CoV-2 test positive
Clinical narrative: COVID + on 11-17-2021, asymptomatic at time of test. symptomatic starting 11-18-2021
Age: 73.0
Sex: F
Vaccine: COVID19
Symptoms: Malaise, Pain
Clinical narrative: After 12 hours from the vaccine, I started lose body function. Felt terrible and after I woke up, I was then able to get some Tylenol and the next day my body just ached. After a few weeks of body aches, I went to my PCP and received bloodwork. Bloodwork was done however results have not come back yet from PCP. PCP examined thoroughly and could not find anything wrong and that my antibodies had begun attacking my body. I am also having pain in my right side starting from above my hips going into my right side.
Age: 29.0
Sex: F
Vaccine: COVID19
Symptoms: Hypoaesthesia, Injection site hypoaesthesia, Injection site pain, Injection site reaction, Mobility decreased
Clinical narrative: After the initial arm pain subsided from second Covid shot,  a few days later my whole arm (the arm I received vaccination in) would go numb, I couldn?t feel it at all. There is also a pain which feels like it is in the muscle tissue where I received my shot. This pain prevents me from having full range of motion of my arm. I find it difficult to use this arm now to lift, and I can?t sleep in the position I normally had prior to Covid shot (arm above head). This pain has been going on for almost 3 months now.  I had absolutely no issues prior to the Covid vaccination, had I?ve ruled out any other injury (as I have not gotten injured this past 4 months).
Age: 29.0
Sex: F
Vaccine: COVID19
Symptoms: Pain in extremity
Clinical narrative: After the initial arm pain subsided from second Covid shot,  a few days later my whole arm (the arm I received vaccination in) would go numb, I couldn?t feel it at all. There is also a pain which feels like it is in the muscle tissue where I received my shot. This pain prevents me from having full range of motion of my arm. I find it difficult to use this arm now to lift, and I can?t sleep in the position I normally had prior to Covid shot (arm above head). This pain has been going on for almost 3 months now.  I had absolutely no issues prior to the Covid vaccination, had I?ve ruled out any other injury (as I have not gotten injured this past 4 months).
Age: 54.0
Sex: F
Vaccine: COVID19
Symptoms: Lymphadenopathy, Neck pain, Vomiting
Clinical narrative: Pt. states that after receiving the 3rd Booster of Phizer 11/17/2021, started experiencing symptoms of pain in the neck and collarbone, armpit swelling (left arm), and vomiting. Symptoms have subsided but the armpit swelling remaining and increasing in the size. No noted Primary visit/communications.
Age: 50.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal pain, Blood test normal, Chest pain, Electrocardiogram normal, X-ray normal
Clinical narrative: Extreme chest pain for 3 days moderate chest pain 3 weeks and continued chest pain that wont go away Extreme abdominal pain for 7 days
Age: 58.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Product storage error
Clinical narrative: VACCINE HELD AT IMPROPER TEMPERATURE.
Age: 80.0
Sex: M
Vaccine: COVID19
Symptoms: Cerebrovascular accident, Speech disorder, Transient ischaemic attack
Clinical narrative: PATIENT DAUGHTER STATED FATHER HAD REACTION. HE WAS NOT ABLE TO SPEAK, IT LOOK LIKE HE HAD A STROKE. WENT TO HOSPITAL BUT NO STROKE OR TIA WAS DETERMINED. HOSPITAL BELIEVES IT WAS REACTION TO VACCINE
Age: 63.0
Sex: F
Vaccine: FLU4
Symptoms: Hypoaesthesia, Paraesthesia, Product administered at inappropriate site
Clinical narrative: Shot given high up in right deltoid within 24 hrs had tingling and numbness in right hand first 3 fingers. This has not gone away  and is only in arm thAt got vaccine.  I think the RN hit nerve from giving too high up in arm.
Age: 35.0
Sex: F
Vaccine: COVID19
Symptoms: Cerebrovascular accident, Confusional state, Fatigue, Mobility decreased, Pain in extremity
Clinical narrative: The first day after vaccine my arm was really swollen.  On the second day my arm was really swollen; i couldn't lift my arm as it was double my size of my regular arm; i couldnt lift my arm above my waist and it was pain 10/10 on movement.  Also I felt like I had a stroke like symptom as I felt groggy, confused.  I was really tired and fatigued for next few days.  After the 3rd or 4th day the swelling went down and I didnt feel groogy and confused.  But I did feel tired for the rest of the week
Age: 35.0
Sex: F
Vaccine: COVID19
Symptoms: Peripheral swelling, Somnolence
Clinical narrative: The first day after vaccine my arm was really swollen.  On the second day my arm was really swollen; i couldn't lift my arm as it was double my size of my regular arm; i couldnt lift my arm above my waist and it was pain 10/10 on movement.  Also I felt like I had a stroke like symptom as I felt groggy, confused.  I was really tired and fatigued for next few days.  After the 3rd or 4th day the swelling went down and I didnt feel groogy and confused.  But I did feel tired for the rest of the week
Age: 49.0
Sex: F
Vaccine: COVID19
Symptoms: Anaemia, Haemoglobin decreased, Heavy menstrual bleeding, Menstruation irregular
Clinical narrative: IRREGULAR MENSTRUAL CYCLE, EXTREMELY HEAVY MENSTRUAL BLEEDING CAUSING HOSPITAL ADMISSION FOR ANEMIA.
Age: 49.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Product storage error
Clinical narrative: VACCINE HELD AT IMPROPER TEMPERATURE
Age: 58.0
Sex: M
Vaccine: PPV
Symptoms: Arthralgia, Back pain, Contusion, Injection site erythema, Injection site swelling
Clinical narrative: significant swelling in left arm below injection sight engaulfing the bicep/tricep area.  Significant shoulder/arm and upper back pain and soreness, warmth, redness at swelling.  As all of that all diminished 48 hours later, affected area displays a large yellow bruise.
Age: 58.0
Sex: M
Vaccine: PPV
Symptoms: Injection site warmth, Pain in extremity
Clinical narrative: significant swelling in left arm below injection sight engaulfing the bicep/tricep area.  Significant shoulder/arm and upper back pain and soreness, warmth, redness at swelling.  As all of that all diminished 48 hours later, affected area displays a large yellow bruise.
Age: 52.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Burning sensation
Clinical narrative: Burning sensation in muscles.
Age: 39.0
Sex: F
Vaccine: FLU4
Symptoms: Inappropriate schedule of product administration, Injected limb mobility decreased, Limb discomfort, Pain, Tenderness
Clinical narrative: Injection too high, given into the joint space. Increasing arm tenderness, pain with lifting and range of motion. Continues at 2 weeks out
Age: 37.0
Sex: F
Vaccine: COVID19
Symptoms: Muscle spasms, Myalgia
Clinical narrative: Whole body muscle cramps/pain. Started at 12:00 pm following day of vaccine. Lasted 9 hours. Was not able to get up off floor for 9 hours.
Age: 32.0
Sex: U
Vaccine: COVID19
Symptoms: Expired product administered, No adverse event
Clinical narrative: Vaccine administered on 11/12/2021, expiration date was 11/7/202.  Mistook expiration date to be 11/17/2021.  No adverse event or outcome to recipient.
Age: 5.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: The nurse stated that she reconstituted the 5-11 year old  Pfizer Covid-19 vaccine with 1.8 ml of 0.9% of normal saline instead of 1.3 ml.
Age: 56.0
Sex: F
Vaccine: COVID19
Symptoms: Gait disturbance, Laboratory test abnormal, Muscle injury, Muscle spasms, Muscle strain
Clinical narrative: On 4/14/2021 at about 4:00PM, I started experiencing painful muscle spasms in my left calf. I tried to get rid of the pain by walking it off and scratching my leg, but the more I walked, the worse it got. I don't like taking a lot of medicines, so I took 81mg of aspirin. I waited and the pain eased a bit. I also had hot ginger tea with lemon and honey and hoped it would help me relax a bit. I then prepared dinner and later went to bed. I woke up at about 3:00-3:30AM on 4/15/2021 to go to the bathroom and noticed the pain was returning, so I took a hot shower and hoped it would help the muscles relax. I then went back to bed and woke up at 8:30AM. I went to get breakfast and noticed the pain had returned and was even worse than it had been at 3:00AM, so I took some more aspirin. The pain eased a bit and I was able to go on with my day. On 4/16/2021, the pain returned and was so bad that I could hardly walk. I tried to find someone to take me to the ER, but I couldn't find anyone, so I made do by taking aspirin every 6-8 hours to help ease the pain. On 4/17/2021, my sister called me and asked if I was still in pain. I told her I was, so she took me to the ER at Memorial Hospital. The ER staff told me I had probably pulled or injured a muscle, though I hadn't done anything to injure my leg. They wrapped my leg in a tight bandage and advised me to rest and to try to refrain from using my leg as much as possible. However, I found that the bandage made the pain worse, so I removed the bandaged and tried elevating my leg. Over the following 2 weeks, I continued to experience leg pain and swelling. On 4/30/2021, I went to Health for an upper endoscopy. They noticed my leg was swollen and asked if I was in pain, and I told them I was. They decided not to perform the endoscopy and had me wheeled over to the ER. At the ER, I underwent tests, and they found a blood clot. I was promptly given Eliquis and was kept until about 5:00 PM, so they could monitor me and ensure the medicine was working. They gave me a week's supply of Eliquis and told me to go to my PCP to get another prescription for Eliquis when I ran out. I tried to get in to see my regular PCP, but he was booked solid, so I switched to another doctor, who has been following my case ever since. I am currently still taking Eliquis, and I no longer experience the pain I did before I started taking it. I am scheduled to see doctor on 12/1/2021, and he plans to check to see if the clot has dissolved.
Age: 56.0
Sex: F
Vaccine: COVID19
Symptoms: Pain, Pain in extremity, Peripheral swelling, Thrombosis
Clinical narrative: On 4/14/2021 at about 4:00PM, I started experiencing painful muscle spasms in my left calf. I tried to get rid of the pain by walking it off and scratching my leg, but the more I walked, the worse it got. I don't like taking a lot of medicines, so I took 81mg of aspirin. I waited and the pain eased a bit. I also had hot ginger tea with lemon and honey and hoped it would help me relax a bit. I then prepared dinner and later went to bed. I woke up at about 3:00-3:30AM on 4/15/2021 to go to the bathroom and noticed the pain was returning, so I took a hot shower and hoped it would help the muscles relax. I then went back to bed and woke up at 8:30AM. I went to get breakfast and noticed the pain had returned and was even worse than it had been at 3:00AM, so I took some more aspirin. The pain eased a bit and I was able to go on with my day. On 4/16/2021, the pain returned and was so bad that I could hardly walk. I tried to find someone to take me to the ER, but I couldn't find anyone, so I made do by taking aspirin every 6-8 hours to help ease the pain. On 4/17/2021, my sister called me and asked if I was still in pain. I told her I was, so she took me to the ER at Memorial Hospital. The ER staff told me I had probably pulled or injured a muscle, though I hadn't done anything to injure my leg. They wrapped my leg in a tight bandage and advised me to rest and to try to refrain from using my leg as much as possible. However, I found that the bandage made the pain worse, so I removed the bandaged and tried elevating my leg. Over the following 2 weeks, I continued to experience leg pain and swelling. On 4/30/2021, I went to Health for an upper endoscopy. They noticed my leg was swollen and asked if I was in pain, and I told them I was. They decided not to perform the endoscopy and had me wheeled over to the ER. At the ER, I underwent tests, and they found a blood clot. I was promptly given Eliquis and was kept until about 5:00 PM, so they could monitor me and ensure the medicine was working. They gave me a week's supply of Eliquis and told me to go to my PCP to get another prescription for Eliquis when I ran out. I tried to get in to see my regular PCP, but he was booked solid, so I switched to another doctor, who has been following my case ever since. I am currently still taking Eliquis, and I no longer experience the pain I did before I started taking it. I am scheduled to see doctor on 12/1/2021, and he plans to check to see if the clot has dissolved.
Age: 58.0
Sex: M
Vaccine: COVID19
Symptoms: Pain in extremity, Peripheral swelling
Clinical narrative: 1 week after vaccination, pt experienced intense pain and swelling of the left thumb joint which lasted for awhile, and resolved by taking otc NSAID.
Age: 70.0
Sex: F
Vaccine: COVID19, FLUA4
Symptoms: Arthralgia, Back pain, Brain natriuretic peptide increased, Burning sensation, Erythema
Clinical narrative: pt developed cellulitis around the injection site down her left arm. It was bright red, hot and sore to the touch.  Lymph nodes were swollen under armpit.  She had severe pain in knees, hands and back.  She had a constant burning pain from her neck down her back.  She could not turn her head because her neck was sore.  All of her joints were hurting and she could hardly move.  She contacted her PCP for treatment and prescribed antibiotics.  She had an appt already scheduled w/ her clinic on 10/14/21 with another physician.  She did not get any help so she contacted her PCP.   She had lab work.  Her BNP numbers were high.  She was prescribed lidocaine patches on 10/21 and  Physical Therapy.  She started PT on 11/1/21 and INI therapy was prescribed. Dexamethasone 4mg for Iontophoresis.  She saw Cardio doctor on 11/12/21.  She was prescribed Lasix.  She finally got to see her PCP on 11/16/21.  She is currently taking lidocaine patches as needed and the Dexamethasone during PT treatment.  She started taking prednisone on 11/17/21.  She will FU w/ PCP and Cardio Doctor if needed and is currently being treated by a Chiropractor.
Age: 70.0
Sex: F
Vaccine: COVID19, FLUA4
Symptoms: Feeling hot, Injection site cellulitis, Laboratory test, Lymphadenopathy, Mobility decreased
Clinical narrative: pt developed cellulitis around the injection site down her left arm. It was bright red, hot and sore to the touch.  Lymph nodes were swollen under armpit.  She had severe pain in knees, hands and back.  She had a constant burning pain from her neck down her back.  She could not turn her head because her neck was sore.  All of her joints were hurting and she could hardly move.  She contacted her PCP for treatment and prescribed antibiotics.  She had an appt already scheduled w/ her clinic on 10/14/21 with another physician.  She did not get any help so she contacted her PCP.   She had lab work.  Her BNP numbers were high.  She was prescribed lidocaine patches on 10/21 and  Physical Therapy.  She started PT on 11/1/21 and INI therapy was prescribed. Dexamethasone 4mg for Iontophoresis.  She saw Cardio doctor on 11/12/21.  She was prescribed Lasix.  She finally got to see her PCP on 11/16/21.  She is currently taking lidocaine patches as needed and the Dexamethasone during PT treatment.  She started taking prednisone on 11/17/21.  She will FU w/ PCP and Cardio Doctor if needed and is currently being treated by a Chiropractor.
Age: 70.0
Sex: F
Vaccine: COVID19, FLUA4
Symptoms: Neck pain, Pain in extremity, Tenderness
Clinical narrative: pt developed cellulitis around the injection site down her left arm. It was bright red, hot and sore to the touch.  Lymph nodes were swollen under armpit.  She had severe pain in knees, hands and back.  She had a constant burning pain from her neck down her back.  She could not turn her head because her neck was sore.  All of her joints were hurting and she could hardly move.  She contacted her PCP for treatment and prescribed antibiotics.  She had an appt already scheduled w/ her clinic on 10/14/21 with another physician.  She did not get any help so she contacted her PCP.   She had lab work.  Her BNP numbers were high.  She was prescribed lidocaine patches on 10/21 and  Physical Therapy.  She started PT on 11/1/21 and INI therapy was prescribed. Dexamethasone 4mg for Iontophoresis.  She saw Cardio doctor on 11/12/21.  She was prescribed Lasix.  She finally got to see her PCP on 11/16/21.  She is currently taking lidocaine patches as needed and the Dexamethasone during PT treatment.  She started taking prednisone on 11/17/21.  She will FU w/ PCP and Cardio Doctor if needed and is currently being treated by a Chiropractor.
Age: 39.0
Sex: F
Vaccine: COVID19
Symptoms: Menstrual disorder, Menstruation delayed, Menstruation irregular
Clinical narrative: Irregular menstrual cycle.  I track my cycle every month due to hormonal migraines and it has always been exactly 27/28 days apart and lasted no more than 7 days total.  After my second Pfizer shot I started getting irregular periods.    July 2021:  started, stopped for a couple days, started again Aug 2021:  two periods, Aug 11th and again 21 days later on Aug 31st Sep 2021:  none Oct 2021:  38 days from Aug 31st Nov 2021: 43 days later Nov 19th (spotting)
Age: 34.0
Sex: F
Vaccine: COVID19
Symptoms: Dysmenorrhoea, Fatigue, Heavy menstrual bleeding
Clinical narrative: Patient has history of hypothyroidism. No current prescription medications. Reported in two months since vaccine an increase in fatigue and "body heaviness" as well as more painful and heavier periods. Is under care of what patient described as "health specialist." No current primary care provider nor has patient sought care for these symptoms at any other medical facility.
Age: 83.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: COVID-19, COVID-19 pneumonia, Chest X-ray abnormal, SARS-CoV-2 test positive
Clinical narrative: Pt received pfizer vaccine on 03/18/21 and 04/08/21. While inpatient, pt tested positive for COVID. CXR showed developing COVID pneumonia.
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: Condition aggravated, Genital herpes, Molluscum contagiosum, Psoriasis
Clinical narrative: flared patient's genital herpes, psoriasis & molluscum; caused outbreaks.
Age: 5.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: The nurse stated that she reconstituted the 5-11 year old  Pfizer Covid-19 vaccine with 1.8 ml of 0.9% of normal saline instead of 1.3 ml.
Age: 9.0
Sex: F
Vaccine: COVID19
Symptoms: Chest discomfort, Feeling abnormal, Feeling cold, Hypoaesthesia, Malaise
Clinical narrative: Pt was brought down by the staff c/o general malaise, feeling cold. As pt. sat with me longer she c/o chest discomfort and pain in both her arms and legs. Pt sat with me for 15 min and returned to normal activities. Came down 1 hour later with new c/o chest discomfort worsening and numbness in both hands and fingers and weakness and numbness in her legs. Pt said she feels "awful"
Age: 9.0
Sex: F
Vaccine: COVID19
Symptoms: Muscular weakness, Pain in extremity
Clinical narrative: Pt was brought down by the staff c/o general malaise, feeling cold. As pt. sat with me longer she c/o chest discomfort and pain in both her arms and legs. Pt sat with me for 15 min and returned to normal activities. Came down 1 hour later with new c/o chest discomfort worsening and numbness in both hands and fingers and weakness and numbness in her legs. Pt said she feels "awful"
Age: 40.0
Sex: M
Vaccine: COVID19
Symptoms: Chest pain, Dizziness, Headache, Pain in extremity
Clinical narrative: I experienced sharp chest pains that started in the upper center of my chest and traveled to my arm and legs, lightheadedness and headaches.
Age: 60.0
Sex: F
Vaccine: COVID19
Symptoms: Fatigue, Pyrexia
Clinical narrative: I think I just had a fever and was very tired.
Age: 29.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered, No adverse event
Clinical narrative: Vaccine administered on 11/12/2021, expiration date was 11/7/202.  Mistook expiration date to be 11/17/2021.  No adverse event or outcome to recipient.
Age: 50.0
Sex: F
Vaccine: COVID19
Symptoms: Fatigue, Lymph node pain, Lymphadenopathy, Pyrexia
Clinical narrative: exhaustion and fever for 18 hours painful, swollen lymph node under left arm for 43 hours now (still present)
Age: 8.0
Sex: M
Vaccine: COVID19
Symptoms: Product preparation issue
Clinical narrative: The nurse stated that she reconstituted the 5-11 year old  Pfizer Covid-19 vaccine with 1.8 ml of 0.9% of normal saline instead of 1.3 ml.
Age: 83.0
Sex: F
Vaccine: COVID19
Symptoms: Agonal respiration, Bradycardia, Cardiac arrest, Chest discomfort, Death
Clinical narrative: This is an 83-year-old female who presents today with  "weird feeling on her chest" and bilateral ear pain that woke her up this morning. PT headache. No vision changes. No numbness, weakness, or tingling. No dysphagia/dysarthria. Pt says she's unable to quantify for me. Patient says she did receive her booster shot for coronavirus on Friday. Patient says she did have a bloody nose yesterday. No cough or shortness of breath. Patient does have a significant past medical history for a sending aortic aneurysm last seen 4.7 cm. Patient follows with heart doctor.
Age: 83.0
Sex: F
Vaccine: COVID19
Symptoms: Dyspnoea, Dysstasia, Ear pain, Headache, Heart rate decreased
Clinical narrative: This is an 83-year-old female who presents today with  "weird feeling on her chest" and bilateral ear pain that woke her up this morning. PT headache. No vision changes. No numbness, weakness, or tingling. No dysphagia/dysarthria. Pt says she's unable to quantify for me. Patient says she did receive her booster shot for coronavirus on Friday. Patient says she did have a bloody nose yesterday. No cough or shortness of breath. Patient does have a significant past medical history for a sending aortic aneurysm last seen 4.7 cm. Patient follows with heart doctor.
Age: 7.0
Sex: F
Vaccine: COVID19
Symptoms: Electroencephalogram, Head injury, Loss of consciousness, Tonic convulsion
Clinical narrative: CHILD HAD COVID VACCINE, FEW MINUTES LATER LOST CONSCIOUSNESS, HIT HER HEAD, THEN HAD TONIC LIKE SEIZURE, WOKE UP AND PASSED OUT SEVERAL MINUTES LATER AND HAD MORE TONIC ACTIVITY AND WAS TAKEN TO ER
Age: 40.0
Sex: F
Vaccine: COVID19
Symptoms: Anxiety, Arthralgia, Chest pain, Electrocardiogram ambulatory, Electrocardiogram normal
Clinical narrative: Within 1 week of receiving my 2nd dose of the Moderna COVID-19 vaccine, I started experiencing issues with anxiety.  I experienced a full blown anxiety attack for the first time in my life.  Afterwards anxiety continued and affected my sleep for a period of one month.  Since 11/01/21 I have been experiencing rapid heartbeat, vibrating feeling in my chest/heart area, pain in chest/left shoulder blade, pain in left elbow joint. I went to the emergency room on 11/01/21 due to rapid heartbeat.  EKG, labs and monitoring were all normal at the time.  I received a cardiac event monitor to wear and was prescribed a beta blocker. I am currently following up with my primary care physician and cardiologist.
Age: 40.0
Sex: F
Vaccine: COVID19
Symptoms: Heart rate increased, Laboratory test normal, Musculoskeletal pain, Sleep disorder
Clinical narrative: Within 1 week of receiving my 2nd dose of the Moderna COVID-19 vaccine, I started experiencing issues with anxiety.  I experienced a full blown anxiety attack for the first time in my life.  Afterwards anxiety continued and affected my sleep for a period of one month.  Since 11/01/21 I have been experiencing rapid heartbeat, vibrating feeling in my chest/heart area, pain in chest/left shoulder blade, pain in left elbow joint. I went to the emergency room on 11/01/21 due to rapid heartbeat.  EKG, labs and monitoring were all normal at the time.  I received a cardiac event monitor to wear and was prescribed a beta blocker. I am currently following up with my primary care physician and cardiologist.
Age: 55.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Product storage error
Clinical narrative: VACCINE HELD AT IMPROPER TEMPERATURES
Age: 41.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal pain, Dyspepsia, Epistaxis, Menstruation irregular, Pregnancy test negative
Clinical narrative: After I received the 8/20/21 vaccine, I had a normal menstruation cycle from 8/23-8/25.  Since then, I did not have a regular period in September or October.  I did have severe abdominal cramping on 10/30.   On 11/05/21, I threw up due to unrelated heartburn and a side effect of the puking was a severe nosebleed.   I have never had a nosebleed before that day.