chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 52.0
Sex: M
Vaccine: COVID19-2, FLU4
Symptoms: Streptococcus test positive, Ultrasound pelvis abnormal, Ureteral stent insertion, Varicocele, Wheezing
Clinical narrative: Discharge Provider: Unknown * Primary Care Provider: Private MD Admission Date: 10/1/2022 Discharge Date: Oct 13, 2022  PRESENTING PROBLEM: Fournier's gangrene [N49.3] COVID-19 [U07.1]   HOSPITAL COURSE: Patient is a 52 y.o. male who present on 10/1 with fevers, chills, fatigue, and scrotal abscess. Pt. has a PMH of COPD, DM2, tobacco abuse, DVT no longer anticoagulated. Pt. reports for 1 week he had SOB and increased wheezing. He felt feverish on 9/28 and presented to his PCP office where he was diagnosed with a mild COPD exacerbation secondary to bronchitis. He was started on a prednisone taper and azithromycin. He also notes he had a small cyst on the left of his scrotum that he was able to get a small amount of pus out of. Over 2-3 days, it greatly increased in size with surrounding erythema and increasing pain.    Upon evaluation in the ED, labs with elevated glucose levels, WBC 23, Lactic acid 4.3 -> 0.8. Chest x-ray with mild basilar scarring or atelectasis. Scrotal U/S with right inguinal hernia, mild left variocele. CT abdomen pelvis with concerns for fournier's gangrene. He tested positive for COVID 19. He was admitted for further medical management of sepsis due to fournier's gangrene.   Urology was consulted and performed scrotal exploration, cystoscopy, left ureteral stent placement, scrotal resection and debridement on 10/01. Plastic surgery, Wound and Infectious disease were consulted. He was continue on IV antibiotics. He received ongoing wound care. He received analgesics as needed. Tissue cultures grew strep agalactiae as well as prevotella.  Eventually, Infectious Disease recommended 14 days of total therapy and he was able to switch to oral antibiotics in form of cefadroxil and metronidazole with plan for antibiotics through 10/15.   He received decadron and remdesivir for treatment of COVID 19. Oxygen was weaned as able he was eventually able to transition to room air with cessation of dexamethasone.       Assisted with management of blood sugars with insulin.   The patient had remain medically stable for several days and came out of enhanced isolation precautions. He was able to be transition to subacute rehab on 10/13/2022.  He will need outpatient follow up with Urology for outpatient left ureteroscopy in 3-4 weeks.
Age: 52.0
Sex: M
Vaccine: COVID19-2, FLU4
Symptoms: White blood cell count increased, Wound treatment
Clinical narrative: Discharge Provider: Unknown * Primary Care Provider: Private MD Admission Date: 10/1/2022 Discharge Date: Oct 13, 2022  PRESENTING PROBLEM: Fournier's gangrene [N49.3] COVID-19 [U07.1]   HOSPITAL COURSE: Patient is a 52 y.o. male who present on 10/1 with fevers, chills, fatigue, and scrotal abscess. Pt. has a PMH of COPD, DM2, tobacco abuse, DVT no longer anticoagulated. Pt. reports for 1 week he had SOB and increased wheezing. He felt feverish on 9/28 and presented to his PCP office where he was diagnosed with a mild COPD exacerbation secondary to bronchitis. He was started on a prednisone taper and azithromycin. He also notes he had a small cyst on the left of his scrotum that he was able to get a small amount of pus out of. Over 2-3 days, it greatly increased in size with surrounding erythema and increasing pain.    Upon evaluation in the ED, labs with elevated glucose levels, WBC 23, Lactic acid 4.3 -> 0.8. Chest x-ray with mild basilar scarring or atelectasis. Scrotal U/S with right inguinal hernia, mild left variocele. CT abdomen pelvis with concerns for fournier's gangrene. He tested positive for COVID 19. He was admitted for further medical management of sepsis due to fournier's gangrene.   Urology was consulted and performed scrotal exploration, cystoscopy, left ureteral stent placement, scrotal resection and debridement on 10/01. Plastic surgery, Wound and Infectious disease were consulted. He was continue on IV antibiotics. He received ongoing wound care. He received analgesics as needed. Tissue cultures grew strep agalactiae as well as prevotella.  Eventually, Infectious Disease recommended 14 days of total therapy and he was able to switch to oral antibiotics in form of cefadroxil and metronidazole with plan for antibiotics through 10/15.   He received decadron and remdesivir for treatment of COVID 19. Oxygen was weaned as able he was eventually able to transition to room air with cessation of dexamethasone.       Assisted with management of blood sugars with insulin.   The patient had remain medically stable for several days and came out of enhanced isolation precautions. He was able to be transition to subacute rehab on 10/13/2022.  He will need outpatient follow up with Urology for outpatient left ureteroscopy in 3-4 weeks.
Age: 9.0
Sex: F
Vaccine: COVID19-2
Symptoms: Pain in extremity
Clinical narrative: PARENT REPORTED PT HAVING SEVERE SORE ARM WHEN SHE WOKE UP NEXT MORNING ON 10/11/22. ALSO REPORTED GIVING HER IBUPROFEN BEFORE SHE WENT TO SCHOOL
Age: 57.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Death, SARS-CoV-2 test positive
Clinical narrative: PATIENT DECEASED ON    5-23-22  AND TESTED + AT MEDICAL CENTER 5-23-22 .
Age: 5.0
Sex: M
Vaccine: FLU4
Symptoms: Extra dose administered
Clinical narrative: Child received influenza vaccine at school clinic. When entering form in the registry, found that child had received his shots 2 days prior at his pediatrician's office. Spoke with child's mother and child is fine.
Age: 61.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: Patient received Monovalent instead of Bivalent booster
Age: 78.0
Sex: F
Vaccine: COVID19
Symptoms: Cellulitis, Induration, Infection, Limb mass, Nasopharyngitis
Clinical narrative: She got her vaccine, by that afternoon her arm started getting real hot.  The next day it swollen to almost double in size, and hurt bad.  She had fever of 101.5 for several days.  She went to the doctor and said that she had cellulitis and gave her an antibiotic which she was allergic to it and had diarrhea really bad.  She was then started on another antibiotic and got worse so she stopped taking that.  Her fever lasted for about 10 days and was not getting better and went to the ER and got a shot in her hip, and had to wait for 15 minutes, real thick.  She got better from that in about 4 days.    When she got her first booster on 12/8/21 she had a very similar reaction.  a nurse who felt that it was cellulitis and went to her PCP and that she had an infection that she had at the time of the vaccine.  It was a hard lump in her arm.  She went to the ER clinic and was given the shot in her hip.  He told her that he had seen arms that were that bad that had to be amputated.  The lump was not moving and did not move.   She recently went to an allergist and had testing done and was told that she was not allergic to anything.  She has been sick with a cold-like symptoms since January.   She did not get any reaction from the very first 2 boosters, and has never had a reaction and got the shingles vaccine 10 years ago, pneumonia vaccine about 5 years ago and gets the flu shot yearly with no reactions.    Her PCP does not believe in vaccines and told her not to get any of them.
Age: 78.0
Sex: F
Vaccine: COVID19
Symptoms: Pain in extremity, Peripheral swelling, Pyrexia, Skin warm
Clinical narrative: She got her vaccine, by that afternoon her arm started getting real hot.  The next day it swollen to almost double in size, and hurt bad.  She had fever of 101.5 for several days.  She went to the doctor and said that she had cellulitis and gave her an antibiotic which she was allergic to it and had diarrhea really bad.  She was then started on another antibiotic and got worse so she stopped taking that.  Her fever lasted for about 10 days and was not getting better and went to the ER and got a shot in her hip, and had to wait for 15 minutes, real thick.  She got better from that in about 4 days.    When she got her first booster on 12/8/21 she had a very similar reaction.  a nurse who felt that it was cellulitis and went to her PCP and that she had an infection that she had at the time of the vaccine.  It was a hard lump in her arm.  She went to the ER clinic and was given the shot in her hip.  He told her that he had seen arms that were that bad that had to be amputated.  The lump was not moving and did not move.   She recently went to an allergist and had testing done and was told that she was not allergic to anything.  She has been sick with a cold-like symptoms since January.   She did not get any reaction from the very first 2 boosters, and has never had a reaction and got the shingles vaccine 10 years ago, pneumonia vaccine about 5 years ago and gets the flu shot yearly with no reactions.    Her PCP does not believe in vaccines and told her not to get any of them.
Age: 51.0
Sex: F
Vaccine: COVID19
Symptoms: Granuloma annulare
Clinical narrative: Annulare Granuloma
Age: 89.0
Sex: F
Vaccine: COVID19, FLUA4
Symptoms: Abdominal cavity drainage, Abdominal infection, Abdominal pain, Acute kidney injury, Biliary dilatation
Clinical narrative: Discharge Provider: MD Primary Care Provider at Discharge: MD Admission Date: 9/30/2022 Discharge Date: 10/12/2022  PRESENTING PROBLEM: Intra-abdominal fluid collection Gastrointestinal hemorrhage, unspecified gastrointestinal hemorrhage type   Patient is a 89 yo Female with PMH of hypertension, hyperlipidemia, Afib on Eliquis, Overactive bladder on oxybutinin and debility using a wheelchair to go to office appointments with daughter who presented to the hospital for hematochezia noted by daughter.  Pt lives with daughter who is her primary caregiver.  It was also reported that pt had been having some intermittent abdominal pain.  In the ER, pt found to be hypertensive, WBC 11, hgb 12.3, Creatinine 1.13.  She had CT A/P performed which showed multiple fluid collections (6.3 x 2.3 x 2.9, 2.9 x 2.2 cm, 5.1 x 3.8 cm). General surgery was consulted who recommended non-operative mgt and IR consult for drainage. She was started on IV Zosyn and admitted to Medicine with Eliquis held in prep for procedure.  Surgery recommended she remain NPO.  Also, of note pt found to be COVID-19 positive, but no respiratory symptoms and satting > 90% on RA.  CXR did show streaky b/l airspace disease.    After admission, it was noted she had rectal bleeding felt could be secondary to hemorrhoid though internal colon mass not excluded and Surgery recommended GI consult for C-scope.  GI evaluated and did not recommend immediate scope given concern for diverticulitis causing fluid collections and would set this up in 6-8 weeks post discharge. GI did recommend pt MRCP/MRI given biliary dilatation seen on CT A/P. Infectious disease was consulted given concern for infectious fluid in abdominal and recommend conditioning IV antibiotics to ceftriaxone/metronidazole.  Pt did develop AKI, suspect due to volume depletion/dehydration and IVF increased.  She was noted to have limited UOP, UA with large blood and Urology consulted with Urine cx ordered and medical cytology of urine.  Urine cx ultimately showed no bacteria.  Urine cytology showed no malignancy.     In terms of COVID 19 diagnosis, was felt she would be probably benefit from remdesivir but held off given AKI with low GRF.    Patient had abdominal drain placed by IR on 10/03.  Culture result from fluid collected finalized as enterococcus, streptococcus and e.coli.  ID recommends 3-4 weeks of IV antibiotics with repeat CT imaging at end of therapy.   For patient's urinary retention/hematuria urology was consulted.  Urology recommends cystoscopy in 6-8 weeks.   MRCP came back showing possible hepatic mass. MRI abdomen with contrast was done, which showed multiple liver masses.     Nephrology was consulted and recommended Foley placement for accurate assessment of I/Os.  Kidney function improved and normalized.   She continued to have poor oral intake. Discussed prognosis with patient and family and daughter who is DPOA. Hospice was consulted. Code status was changed to comfort care.  Patient was discharged with hospice care.
Age: 89.0
Sex: F
Vaccine: COVID19, FLUA4
Symptoms: Bladder catheterisation, Blood creatinine increased, Blood urine present, COVID-19, Chest X-ray abnormal
Clinical narrative: Discharge Provider: MD Primary Care Provider at Discharge: MD Admission Date: 9/30/2022 Discharge Date: 10/12/2022  PRESENTING PROBLEM: Intra-abdominal fluid collection Gastrointestinal hemorrhage, unspecified gastrointestinal hemorrhage type   Patient is a 89 yo Female with PMH of hypertension, hyperlipidemia, Afib on Eliquis, Overactive bladder on oxybutinin and debility using a wheelchair to go to office appointments with daughter who presented to the hospital for hematochezia noted by daughter.  Pt lives with daughter who is her primary caregiver.  It was also reported that pt had been having some intermittent abdominal pain.  In the ER, pt found to be hypertensive, WBC 11, hgb 12.3, Creatinine 1.13.  She had CT A/P performed which showed multiple fluid collections (6.3 x 2.3 x 2.9, 2.9 x 2.2 cm, 5.1 x 3.8 cm). General surgery was consulted who recommended non-operative mgt and IR consult for drainage. She was started on IV Zosyn and admitted to Medicine with Eliquis held in prep for procedure.  Surgery recommended she remain NPO.  Also, of note pt found to be COVID-19 positive, but no respiratory symptoms and satting > 90% on RA.  CXR did show streaky b/l airspace disease.    After admission, it was noted she had rectal bleeding felt could be secondary to hemorrhoid though internal colon mass not excluded and Surgery recommended GI consult for C-scope.  GI evaluated and did not recommend immediate scope given concern for diverticulitis causing fluid collections and would set this up in 6-8 weeks post discharge. GI did recommend pt MRCP/MRI given biliary dilatation seen on CT A/P. Infectious disease was consulted given concern for infectious fluid in abdominal and recommend conditioning IV antibiotics to ceftriaxone/metronidazole.  Pt did develop AKI, suspect due to volume depletion/dehydration and IVF increased.  She was noted to have limited UOP, UA with large blood and Urology consulted with Urine cx ordered and medical cytology of urine.  Urine cx ultimately showed no bacteria.  Urine cytology showed no malignancy.     In terms of COVID 19 diagnosis, was felt she would be probably benefit from remdesivir but held off given AKI with low GRF.    Patient had abdominal drain placed by IR on 10/03.  Culture result from fluid collected finalized as enterococcus, streptococcus and e.coli.  ID recommends 3-4 weeks of IV antibiotics with repeat CT imaging at end of therapy.   For patient's urinary retention/hematuria urology was consulted.  Urology recommends cystoscopy in 6-8 weeks.   MRCP came back showing possible hepatic mass. MRI abdomen with contrast was done, which showed multiple liver masses.     Nephrology was consulted and recommended Foley placement for accurate assessment of I/Os.  Kidney function improved and normalized.   She continued to have poor oral intake. Discussed prognosis with patient and family and daughter who is DPOA. Hospice was consulted. Code status was changed to comfort care.  Patient was discharged with hospice care.
Age: 89.0
Sex: F
Vaccine: COVID19, FLUA4
Symptoms: Computerised tomogram abdomen abnormal, Condition aggravated, Culture positive, Culture urine negative, Dehydration
Clinical narrative: Discharge Provider: MD Primary Care Provider at Discharge: MD Admission Date: 9/30/2022 Discharge Date: 10/12/2022  PRESENTING PROBLEM: Intra-abdominal fluid collection Gastrointestinal hemorrhage, unspecified gastrointestinal hemorrhage type   Patient is a 89 yo Female with PMH of hypertension, hyperlipidemia, Afib on Eliquis, Overactive bladder on oxybutinin and debility using a wheelchair to go to office appointments with daughter who presented to the hospital for hematochezia noted by daughter.  Pt lives with daughter who is her primary caregiver.  It was also reported that pt had been having some intermittent abdominal pain.  In the ER, pt found to be hypertensive, WBC 11, hgb 12.3, Creatinine 1.13.  She had CT A/P performed which showed multiple fluid collections (6.3 x 2.3 x 2.9, 2.9 x 2.2 cm, 5.1 x 3.8 cm). General surgery was consulted who recommended non-operative mgt and IR consult for drainage. She was started on IV Zosyn and admitted to Medicine with Eliquis held in prep for procedure.  Surgery recommended she remain NPO.  Also, of note pt found to be COVID-19 positive, but no respiratory symptoms and satting > 90% on RA.  CXR did show streaky b/l airspace disease.    After admission, it was noted she had rectal bleeding felt could be secondary to hemorrhoid though internal colon mass not excluded and Surgery recommended GI consult for C-scope.  GI evaluated and did not recommend immediate scope given concern for diverticulitis causing fluid collections and would set this up in 6-8 weeks post discharge. GI did recommend pt MRCP/MRI given biliary dilatation seen on CT A/P. Infectious disease was consulted given concern for infectious fluid in abdominal and recommend conditioning IV antibiotics to ceftriaxone/metronidazole.  Pt did develop AKI, suspect due to volume depletion/dehydration and IVF increased.  She was noted to have limited UOP, UA with large blood and Urology consulted with Urine cx ordered and medical cytology of urine.  Urine cx ultimately showed no bacteria.  Urine cytology showed no malignancy.     In terms of COVID 19 diagnosis, was felt she would be probably benefit from remdesivir but held off given AKI with low GRF.    Patient had abdominal drain placed by IR on 10/03.  Culture result from fluid collected finalized as enterococcus, streptococcus and e.coli.  ID recommends 3-4 weeks of IV antibiotics with repeat CT imaging at end of therapy.   For patient's urinary retention/hematuria urology was consulted.  Urology recommends cystoscopy in 6-8 weeks.   MRCP came back showing possible hepatic mass. MRI abdomen with contrast was done, which showed multiple liver masses.     Nephrology was consulted and recommended Foley placement for accurate assessment of I/Os.  Kidney function improved and normalized.   She continued to have poor oral intake. Discussed prognosis with patient and family and daughter who is DPOA. Hospice was consulted. Code status was changed to comfort care.  Patient was discharged with hospice care.
Age: 89.0
Sex: F
Vaccine: COVID19, FLUA4
Symptoms: Haematuria, Haemoglobin normal, Hepatic mass, Hypertension, Hypophagia
Clinical narrative: Discharge Provider: MD Primary Care Provider at Discharge: MD Admission Date: 9/30/2022 Discharge Date: 10/12/2022  PRESENTING PROBLEM: Intra-abdominal fluid collection Gastrointestinal hemorrhage, unspecified gastrointestinal hemorrhage type   Patient is a 89 yo Female with PMH of hypertension, hyperlipidemia, Afib on Eliquis, Overactive bladder on oxybutinin and debility using a wheelchair to go to office appointments with daughter who presented to the hospital for hematochezia noted by daughter.  Pt lives with daughter who is her primary caregiver.  It was also reported that pt had been having some intermittent abdominal pain.  In the ER, pt found to be hypertensive, WBC 11, hgb 12.3, Creatinine 1.13.  She had CT A/P performed which showed multiple fluid collections (6.3 x 2.3 x 2.9, 2.9 x 2.2 cm, 5.1 x 3.8 cm). General surgery was consulted who recommended non-operative mgt and IR consult for drainage. She was started on IV Zosyn and admitted to Medicine with Eliquis held in prep for procedure.  Surgery recommended she remain NPO.  Also, of note pt found to be COVID-19 positive, but no respiratory symptoms and satting > 90% on RA.  CXR did show streaky b/l airspace disease.    After admission, it was noted she had rectal bleeding felt could be secondary to hemorrhoid though internal colon mass not excluded and Surgery recommended GI consult for C-scope.  GI evaluated and did not recommend immediate scope given concern for diverticulitis causing fluid collections and would set this up in 6-8 weeks post discharge. GI did recommend pt MRCP/MRI given biliary dilatation seen on CT A/P. Infectious disease was consulted given concern for infectious fluid in abdominal and recommend conditioning IV antibiotics to ceftriaxone/metronidazole.  Pt did develop AKI, suspect due to volume depletion/dehydration and IVF increased.  She was noted to have limited UOP, UA with large blood and Urology consulted with Urine cx ordered and medical cytology of urine.  Urine cx ultimately showed no bacteria.  Urine cytology showed no malignancy.     In terms of COVID 19 diagnosis, was felt she would be probably benefit from remdesivir but held off given AKI with low GRF.    Patient had abdominal drain placed by IR on 10/03.  Culture result from fluid collected finalized as enterococcus, streptococcus and e.coli.  ID recommends 3-4 weeks of IV antibiotics with repeat CT imaging at end of therapy.   For patient's urinary retention/hematuria urology was consulted.  Urology recommends cystoscopy in 6-8 weeks.   MRCP came back showing possible hepatic mass. MRI abdomen with contrast was done, which showed multiple liver masses.     Nephrology was consulted and recommended Foley placement for accurate assessment of I/Os.  Kidney function improved and normalized.   She continued to have poor oral intake. Discussed prognosis with patient and family and daughter who is DPOA. Hospice was consulted. Code status was changed to comfort care.  Patient was discharged with hospice care.
Age: 89.0
Sex: F
Vaccine: COVID19, FLUA4
Symptoms: Rectal haemorrhage, Renal impairment, SARS-CoV-2 test positive, Scan with contrast abnormal, Streptococcus test positive
Clinical narrative: Discharge Provider: MD Primary Care Provider at Discharge: MD Admission Date: 9/30/2022 Discharge Date: 10/12/2022  PRESENTING PROBLEM: Intra-abdominal fluid collection Gastrointestinal hemorrhage, unspecified gastrointestinal hemorrhage type   Patient is a 89 yo Female with PMH of hypertension, hyperlipidemia, Afib on Eliquis, Overactive bladder on oxybutinin and debility using a wheelchair to go to office appointments with daughter who presented to the hospital for hematochezia noted by daughter.  Pt lives with daughter who is her primary caregiver.  It was also reported that pt had been having some intermittent abdominal pain.  In the ER, pt found to be hypertensive, WBC 11, hgb 12.3, Creatinine 1.13.  She had CT A/P performed which showed multiple fluid collections (6.3 x 2.3 x 2.9, 2.9 x 2.2 cm, 5.1 x 3.8 cm). General surgery was consulted who recommended non-operative mgt and IR consult for drainage. She was started on IV Zosyn and admitted to Medicine with Eliquis held in prep for procedure.  Surgery recommended she remain NPO.  Also, of note pt found to be COVID-19 positive, but no respiratory symptoms and satting > 90% on RA.  CXR did show streaky b/l airspace disease.    After admission, it was noted she had rectal bleeding felt could be secondary to hemorrhoid though internal colon mass not excluded and Surgery recommended GI consult for C-scope.  GI evaluated and did not recommend immediate scope given concern for diverticulitis causing fluid collections and would set this up in 6-8 weeks post discharge. GI did recommend pt MRCP/MRI given biliary dilatation seen on CT A/P. Infectious disease was consulted given concern for infectious fluid in abdominal and recommend conditioning IV antibiotics to ceftriaxone/metronidazole.  Pt did develop AKI, suspect due to volume depletion/dehydration and IVF increased.  She was noted to have limited UOP, UA with large blood and Urology consulted with Urine cx ordered and medical cytology of urine.  Urine cx ultimately showed no bacteria.  Urine cytology showed no malignancy.     In terms of COVID 19 diagnosis, was felt she would be probably benefit from remdesivir but held off given AKI with low GRF.    Patient had abdominal drain placed by IR on 10/03.  Culture result from fluid collected finalized as enterococcus, streptococcus and e.coli.  ID recommends 3-4 weeks of IV antibiotics with repeat CT imaging at end of therapy.   For patient's urinary retention/hematuria urology was consulted.  Urology recommends cystoscopy in 6-8 weeks.   MRCP came back showing possible hepatic mass. MRI abdomen with contrast was done, which showed multiple liver masses.     Nephrology was consulted and recommended Foley placement for accurate assessment of I/Os.  Kidney function improved and normalized.   She continued to have poor oral intake. Discussed prognosis with patient and family and daughter who is DPOA. Hospice was consulted. Code status was changed to comfort care.  Patient was discharged with hospice care.
Age: 89.0
Sex: F
Vaccine: COVID19, FLUA4
Symptoms: Urinary retention, Urine analysis abnormal, Urine cytology normal, Urine output decreased, White blood cell count increased
Clinical narrative: Discharge Provider: MD Primary Care Provider at Discharge: MD Admission Date: 9/30/2022 Discharge Date: 10/12/2022  PRESENTING PROBLEM: Intra-abdominal fluid collection Gastrointestinal hemorrhage, unspecified gastrointestinal hemorrhage type   Patient is a 89 yo Female with PMH of hypertension, hyperlipidemia, Afib on Eliquis, Overactive bladder on oxybutinin and debility using a wheelchair to go to office appointments with daughter who presented to the hospital for hematochezia noted by daughter.  Pt lives with daughter who is her primary caregiver.  It was also reported that pt had been having some intermittent abdominal pain.  In the ER, pt found to be hypertensive, WBC 11, hgb 12.3, Creatinine 1.13.  She had CT A/P performed which showed multiple fluid collections (6.3 x 2.3 x 2.9, 2.9 x 2.2 cm, 5.1 x 3.8 cm). General surgery was consulted who recommended non-operative mgt and IR consult for drainage. She was started on IV Zosyn and admitted to Medicine with Eliquis held in prep for procedure.  Surgery recommended she remain NPO.  Also, of note pt found to be COVID-19 positive, but no respiratory symptoms and satting > 90% on RA.  CXR did show streaky b/l airspace disease.    After admission, it was noted she had rectal bleeding felt could be secondary to hemorrhoid though internal colon mass not excluded and Surgery recommended GI consult for C-scope.  GI evaluated and did not recommend immediate scope given concern for diverticulitis causing fluid collections and would set this up in 6-8 weeks post discharge. GI did recommend pt MRCP/MRI given biliary dilatation seen on CT A/P. Infectious disease was consulted given concern for infectious fluid in abdominal and recommend conditioning IV antibiotics to ceftriaxone/metronidazole.  Pt did develop AKI, suspect due to volume depletion/dehydration and IVF increased.  She was noted to have limited UOP, UA with large blood and Urology consulted with Urine cx ordered and medical cytology of urine.  Urine cx ultimately showed no bacteria.  Urine cytology showed no malignancy.     In terms of COVID 19 diagnosis, was felt she would be probably benefit from remdesivir but held off given AKI with low GRF.    Patient had abdominal drain placed by IR on 10/03.  Culture result from fluid collected finalized as enterococcus, streptococcus and e.coli.  ID recommends 3-4 weeks of IV antibiotics with repeat CT imaging at end of therapy.   For patient's urinary retention/hematuria urology was consulted.  Urology recommends cystoscopy in 6-8 weeks.   MRCP came back showing possible hepatic mass. MRI abdomen with contrast was done, which showed multiple liver masses.     Nephrology was consulted and recommended Foley placement for accurate assessment of I/Os.  Kidney function improved and normalized.   She continued to have poor oral intake. Discussed prognosis with patient and family and daughter who is DPOA. Hospice was consulted. Code status was changed to comfort care.  Patient was discharged with hospice care.
Age: 79.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: Patient received Monovalent instead of Bivalent booster
Age: 87.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: Patient given Monovalent instead of Bivalent booster
Age: 70.0
Sex: F
Vaccine: FLU4
Symptoms: Abdominal pain, Headache, Pain in extremity
Clinical narrative: Headache, sore arm, abdominal pain. Ongoing
Age: 21.0
Sex: F
Vaccine: FLUC4
Symptoms: Injection site hypoaesthesia, Neuralgia
Clinical narrative: Nerve pain, numbness from injection site to elbow
Age: 67.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: Patient received Monovalent instead of Bivalent booster
Age: 20.0
Sex: M
Vaccine: COVID19-2, DTAP, FLU4
Symptoms: Angioedema, Hypersensitivity, Urticaria
Clinical narrative: Patient received Tdap, covid and influenza vaccines simultaneously. Approximately 72 hours later developed gradual onset delayed hypersensitivity reaction progressing to confluent urticaria all over entire body including palms and scalp with severe angioedema particularly of the face over the course of one week. Patient continues to have progression of symptoms at week two. Patient is being prescribed loratadine, famotidine, prednisone and epinephrine prn.   Reaction is steroid responsive but patient rebounds when withdrawn.   Suspect autoimmune process triggered by vaccine or receiving three vaccines simultaneously.    Patient is being referred to specialist.
Age: 47.0
Sex: F
Vaccine: COVID19
Symptoms: Lymph node pain, Lymphadenopathy, Mammogram normal, Ultrasound scan abnormal
Clinical narrative: I started having tenderness and swelling in my right axillary gland. I had a scheduled mammogram, and it was noticed. It was still there several months later. I contacted the doctor and had them palpate it. In February I did get an ultrasound as it is persistent in soreness still noticeable. It has started to get a little better. The ultrasound showed a bit of swelling with no vascularization to the area. The provider indicated that they did not believe it was cancer based on the screening. Its not 100% resolved but after taking ProLon Fasting Mimicking Diet for 5 days to reduce inflammation in the body and it has seemed to help the symptoms.
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: Patient received Monovalent instead of Bivalent Booster
Age: 63.0
Sex: F
Vaccine: COVID19-2
Symptoms: Dry throat, Headache, Nasal congestion, Nasopharyngitis
Clinical narrative: Mild cold like symtoms, no fever, slight headache, mild stuffy nose, dry throat
Age: 68.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: Patient received Monovalent instead of Bivalent booster
Age: 49.0
Sex: F
Vaccine: COVID19-2, FLUC4
Symptoms: Cerumen removal, Ear discomfort, Immunisation reaction, Tinnitus
Clinical narrative: Developed tinnitus within hours of getting vaccine. Nurse practitioner examined and cleaned out built up suramin. Nurse practitioner advised that it's possible that the pressure build up from response to vaccine will diminish. Prescribed FLONASE. Ringing in right ear diminished slightly when ear cleaned out. Still remains in both ears.
Age: 7.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: The Vaccine was potentially received short-dated and recently expired.
Age: 29.0
Sex: F
Vaccine: FLU4
Symptoms: Exposure during pregnancy, Injection site erythema, Injection site induration, Injection site warmth
Clinical narrative: Redness / warmth around the site. Induration in the area of immunization. No systemic symptoms, afebrile.  Symptoms have persisted until 2 days later (10/14), and the area has not grown. Will continue to assess patient to ensure she does not develop cellulitis. Patient was 24 weeks, 2 days pregnant at the time of vaccination (EDD 1/30/2023).
Age: 74.0
Sex: M
Vaccine: FLU4
Symptoms: Chills, Dizziness, Dyspnoea, Eye swelling, Gait inability
Clinical narrative: RAPID HEARTBEAT FOR 90 MINUTES, SHORT OF BREATH, EYES SWOLLEN, DIZZY TO THE POINT WHERE I COULDN'T WALK , WHOLE BODY  MUSCULAR CONTRACTIONS FOR 90 MMINUTES, TREMORS AFTERWARDS, CHILLS FOLLOWED BY FEVER. STARTED AT 1:00 AM , PEAKED AT 2:00 AM, STARTED TO TAPER OFF AT 6:00, HEART RATE RETURNED TO NORMAL AT 9:00 AM
Age: 74.0
Sex: M
Vaccine: FLU4
Symptoms: Heart rate increased, Muscle contractions involuntary, Pyrexia, Tremor
Clinical narrative: RAPID HEARTBEAT FOR 90 MINUTES, SHORT OF BREATH, EYES SWOLLEN, DIZZY TO THE POINT WHERE I COULDN'T WALK , WHOLE BODY  MUSCULAR CONTRACTIONS FOR 90 MMINUTES, TREMORS AFTERWARDS, CHILLS FOLLOWED BY FEVER. STARTED AT 1:00 AM , PEAKED AT 2:00 AM, STARTED TO TAPER OFF AT 6:00, HEART RATE RETURNED TO NORMAL AT 9:00 AM
Age: 44.0
Sex: M
Vaccine: COVID19
Symptoms: Abdominal pain, Cerebrovascular accident, Death, Fatigue, Gait inability
Clinical narrative: For the next month, he experienced severe headaches worse than a migraine, overall body ache, and pain, abdominal pain, severe exhaustion unable to get up and walk due to fatigue. He had 3 doctor visits prior to having a stroke about 1 month after the vaccine. He was taken to the ER, and put on life support for 4 days. When life-support was stopped, he died.
Age: 44.0
Sex: M
Vaccine: COVID19
Symptoms: Headache, Life support, Mobility decreased, Pain
Clinical narrative: For the next month, he experienced severe headaches worse than a migraine, overall body ache, and pain, abdominal pain, severe exhaustion unable to get up and walk due to fatigue. He had 3 doctor visits prior to having a stroke about 1 month after the vaccine. He was taken to the ER, and put on life support for 4 days. When life-support was stopped, he died.
Age: 86.0
Sex: F
Vaccine: COVID19
Symptoms: Wrong product administered
Clinical narrative: Patient received Monovalent instead of Bivalent Booster
Age: 93.0
Sex: F
Vaccine: COVID19
Symptoms: Wrong product administered
Clinical narrative: Patient received Monovalent instead of bivalent booster
Age: 77.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: Patient received monovalent instead of bivalent booster
Age: 75.0
Sex: M
Vaccine: COVID19-2
Symptoms: Inappropriate schedule of product administration, No adverse event
Clinical narrative: Patient was scheduled to get Covid bivalent while at dialysis.  This was administered after looking through records and confirmed that he had not had the bivalent.  Afterwards, we received a call from Sr Living stating that he had his bivalent on 9/28/2022 with his Flu vaccine.  There was nothing documented showing that he had received the bivalent or any covid vaccine on that day.  The flu vaccine was documented but not the bivalent.  The covid should cross into our system.  It was also not listed as being given in the state registry.  The patient received 2 doses less than a month apart.  No adverse reactions as of this afternoon.
Age: 21.0
Sex: U
Vaccine: SMALLMNK
Symptoms: Cold sweat, Dizziness, Hyperhidrosis, Syncope
Clinical narrative: 2 minutes into observation, the patient experienced a syncopal episode lasting 10 seconds. The patient regained consciousness quickly and was oriented x 4. The patient had symptoms of clammy skin, diaphoretic, and lightheadedness. Legs elevated, water, icepacks, and lollipops provided. Vital signs within normal range. The patient stated he has a history of passing out with blood draws.  observation extended to additional 30 minutes. Pt stated symptoms fully resolved and left the site ambulatory and in stable condition.
Age: 72.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: Patient received monovalent instead of bivalent booster
Age: 61.0
Sex: F
Vaccine: COVID19
Symptoms: Scratch, Skin erosion, Urticaria
Clinical narrative: No symptoms for first 24 hrs, then I started noticing what I thought were bug bites on all 4 of my extremities.  After taking benadryl and scratching myself raw, I went to the Dr.s 72 hours post shot. This was my first Pfizer booster.  All 3 previous shots were Moderna.  I was diagnosed with hives and treated with a course of prednisone, which resolved the hives within 48 hrs.
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: Acute kidney injury, Anaemia, COVID-19, COVID-19 pneumonia, Cardiac arrest
Clinical narrative: She was + for covid 9-  16  -2021 at  Med Center.  She was admitted there apparently.  She was admitted 9-25-21 to Hospital  and discharged 11-18-21 and admitted to another hospital same date until  1-8-22  :    dx include  pneumonia due to covid, resp failure with hypoxia, acute kidney failure, cardiac arrest , copd, Hyperosmolality, anemia, hypertenisve heart disease, malnutrition,
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: Chronic obstructive pulmonary disease, Condition aggravated, Hyperosmolar state, Hypertensive heart disease, Malnutrition
Clinical narrative: She was + for covid 9-  16  -2021 at  Med Center.  She was admitted there apparently.  She was admitted 9-25-21 to Hospital  and discharged 11-18-21 and admitted to another hospital same date until  1-8-22  :    dx include  pneumonia due to covid, resp failure with hypoxia, acute kidney failure, cardiac arrest , copd, Hyperosmolality, anemia, hypertenisve heart disease, malnutrition,
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: Respiratory failure, SARS-CoV-2 test positive
Clinical narrative: She was + for covid 9-  16  -2021 at  Med Center.  She was admitted there apparently.  She was admitted 9-25-21 to Hospital  and discharged 11-18-21 and admitted to another hospital same date until  1-8-22  :    dx include  pneumonia due to covid, resp failure with hypoxia, acute kidney failure, cardiac arrest , copd, Hyperosmolality, anemia, hypertenisve heart disease, malnutrition,
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: Patient received monovalent instead of bivalent booster
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Asthenia, Dizziness, Hypersomnia, Mast cell activation syndrome, Mobility decreased
Clinical narrative: Dizziness, Horrible Pain in Arm for 5 days, Mast Cell Activation that lasted for 3 months, could hardly get out of bed for 3 weeks sleeping 14 hours a night and napping 4 hours during the day, slowly improved, extremely week, slowly recovering strength
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Pain in extremity
Clinical narrative: Dizziness, Horrible Pain in Arm for 5 days, Mast Cell Activation that lasted for 3 months, could hardly get out of bed for 3 weeks sleeping 14 hours a night and napping 4 hours during the day, slowly improved, extremely week, slowly recovering strength
Age: 65.0
Sex: F
Vaccine: FLU4
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth
Clinical narrative: Left arm was swollen, red and warm to touch 2" above elbow and 1" below site injection.
Age: 7.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: The vaccine was potentially received short-dated and recently expired.
Age: 25.0
Sex: F
Vaccine: COVID19-2
Symptoms: Lymphadenopathy
Clinical narrative: Right axillary adenopathy
Age: 0.25
Sex: F
Vaccine: DTAPHEPBIP, HIBV, PNC13, RV1
Symptoms: Peripheral swelling
Clinical narrative: Day after vaccinations, patient has bilateral feet swelling, no redness or pain noted by provider, some increase of temperature at 100.3. Not other symptoms noted
Age: 80.0
Sex: F
Vaccine: COVID19
Symptoms: Feeling abnormal
Clinical narrative: pt states she came out of two month long brain fog that she didn't realize she was in.  When she came out of this she counted back and it was about 2 days after getting her 4th Covid vaccine that the brain fog started. She after a couple of months it was like somebody turned a light on and she had not realized she was in this fog.  She no longer has these symptoms and did not have any problems after the last Covid booster.   1st Covid dose was 1/19/2021 lot# 042C20A, 2nd dose on 2/23/2021 lot# 030M20A, 3rd dose, 10/23/20221 lot # 017F21A, 5th dose 9/12/2022 lot # 457140C.
Age: 80.0
Sex: M
Vaccine: COVID19-2
Symptoms: Blood pressure fluctuation, Blood pressure increased
Clinical narrative: Patient experienced significant fluctuations on his Blood pressure readings- the blood pressure spikes up - not a regular one as per mentioned by the patient. He is currently on blood pressure medicines. He will be consulting his doctor  as soon as he get a chance.
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Fatigue, Injection site erythema, Injection site pain, Pyrexia
Clinical narrative: A little red spot and sore arm at the injection site for a day. I tested positive for COVID-19 with a home test on 08/02/2022. I had a low fever, runny nose, congestion and fatigue. I contacted my doctor the evening of 08/02/2022 and was given the prescription PAXLOVID. After 7 or 8 days I felt much better.
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test positive
Clinical narrative: A little red spot and sore arm at the injection site for a day. I tested positive for COVID-19 with a home test on 08/02/2022. I had a low fever, runny nose, congestion and fatigue. I contacted my doctor the evening of 08/02/2022 and was given the prescription PAXLOVID. After 7 or 8 days I felt much better.
Age: 76.0
Sex: F
Vaccine: COVID19
Symptoms: Asthenia, Chills, Fatigue, Malaise
Clinical narrative: She reports she is currently not feeling very well. Stated, "I got my covid booster yesterday...I guess that is what it is...I feel weak, tired, and have chills off and on." Patient reports she has not had as bad reactions to her previous covid vaccines as this one. Patient on Calquence for MCL.
Age: 65.0
Sex: F
Vaccine: COVID19-2
Symptoms: Rash
Clinical narrative: Patient noticed that she was covered all over her body with a non-itchy rash on Thursday 10/13/2022
Age: 72.0
Sex: F
Vaccine: FLUA4
Symptoms: Injection site pain
Clinical narrative: sore -painful - at injection site
Age: 90.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Death, SARS-CoV-2 test positive
Clinical narrative: TESTED  + FOR COVID ON      6-9-22                              ;DECEASED 6-12-22  ; I HAVE NO RECORDS ON THIS PATIENT
Age: 18.0
Sex: F
Vaccine: COVID19-2, FLUC4
Symptoms: Loss of consciousness, Seizure like phenomena
Clinical narrative: Patient got flu vaccine first then she got covid 19 bivalent vaccine and she passed out for few seconds then she passed out second time and had minor seizures like symptoms. I had to call 911 and paramedics took her vitals and they were normal.
Age: 66.0
Sex: F
Vaccine: COVID19
Symptoms: Cartilage injury, Magnetic resonance imaging, Periarthritis
Clinical narrative: Frozen shoulder and torn labrum No prior shoulder problems
Age: 62.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site swelling
Clinical narrative: 'Egg sized swelling right deltoid No redness, warmth or open area noted
Age: 38.0
Sex: F
Vaccine: FLU4
Symptoms: Wrong product administered
Clinical narrative: PT WAS SUPPOSED TO RECIEVE THE NEW MODERNA BIVALENT BOOSTER. HOWEVER, INSTEAD NURS ADMINISTERED FLUZONE HD
Age: 30.0
Sex: M
Vaccine: COVID19-2
Symptoms: Angioedema, Urticaria
Clinical narrative: 8 days after vaccine developed diffuse hives. three weeks after vaccine developed angioedema of lips.
Age: 74.0
Sex: M
Vaccine: FLUA4
Symptoms: Extra dose administered, Wrong product administered
Clinical narrative: PATIENT GIVEN FLUAD INSTEAD OF PFIZER  BIVALENT SHOT. 2ND FLU SHOT FOR YEAR
Age: 42.0
Sex: M
Vaccine: COVID19-2
Symptoms: Anticoagulant therapy, Blood test normal, Chest X-ray normal, Chest discomfort, Dizziness
Clinical narrative: I woke up with a lot of chest pressure and heart rate was elevated. My resting heart rate was elevated between 92 and 115 beats per minute. I was lightheaded and feeling general pain when lying on my left side. It was about 24 to 36 hours before I sought care. I went to the emergency room after calling my insurance provider, they recommended that I go to the hospital to ensure it was not a heart related. They gave me aspirin and a saline solution in a large syringe. There was no diagnosis and the doctor asked me to follow up with my PCP since the symptoms have subsided a lot. There is some light pressure still there, but it has been subsiding each they.
Age: 42.0
Sex: M
Vaccine: COVID19-2
Symptoms: Electrocardiogram normal, Heart rate increased, Pain
Clinical narrative: I woke up with a lot of chest pressure and heart rate was elevated. My resting heart rate was elevated between 92 and 115 beats per minute. I was lightheaded and feeling general pain when lying on my left side. It was about 24 to 36 hours before I sought care. I went to the emergency room after calling my insurance provider, they recommended that I go to the hospital to ensure it was not a heart related. They gave me aspirin and a saline solution in a large syringe. There was no diagnosis and the doctor asked me to follow up with my PCP since the symptoms have subsided a lot. There is some light pressure still there, but it has been subsiding each they.
Age: 68.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Death, SARS-CoV-2 test positive
Clinical narrative: TESTED + ON    1-13-22              DECEASED 1-14-22.
Age: 74.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Fatigue, Respiratory tract congestion, SARS-CoV-2 test positive, Throat irritation
Clinical narrative: On sunday the 12th I was very tired. The next day I had a scratchy throat, congestion and tested positive for COVID-19 on a home test. I've had worse colds so to me this was very mild. By wednesday I started feeling better but still testing positive. The next day I was given an antibody infusion. I was still testing positive o the 20th. After the 26th I was not positive anymore.
Age: 73.0
Sex: F
Vaccine: COVID19-2
Symptoms: Anxiety, Asthenia, Condition aggravated, Dysstasia, Head discomfort
Clinical narrative: Resident weak unable to stand, increased  anxiety complained of "..not feeling well increased pressure in my head.."
Age: 73.0
Sex: F
Vaccine: COVID19-2
Symptoms: Malaise
Clinical narrative: Resident weak unable to stand, increased  anxiety complained of "..not feeling well increased pressure in my head.."
Age: 71.0
Sex: F
Vaccine: COVID19-2, FLUA4
Symptoms: Extra dose administered, Wrong product administered
Clinical narrative: PATIENT CAME IN FOR PFIZER BIVALENT SHOT AND WAS ADMINISTERED FLUAD . 2ND FLU SHOT FOR YEAR
Age: 70.0
Sex: M
Vaccine: FLU4
Symptoms: Injected limb mobility decreased, Injection site pain, Myalgia, Pain in extremity
Clinical narrative: He got his vaccine, it was painful but not all that bad.  By the time he got home and got settled he started getting pain in his arm, and steadily has increased.  His arm hurts so bad that he is not able to lift his arm.  It is sore and sits in the chair and lets it hang.  He is not having any other symptoms other than the arm pain.  He has a lot of pain from his elbow and under his arm and thinks it may be related to lymph nodes.  He has shoulder pain down to his hand, severe pain.  He is on pain medicines and they are not touching the pain.  He has taken an extra Norco and Methadone with no relief.  He has also been putting warm compresses on it.  He did call his doctor, they told him that if he got more symptoms to be checked for COVID.  He has not gone to the ER for his pain.   The muscles in that arm are just really bad and in the arm only.    He has gotten the flu shots every year and has not had any reaction to any of those.
Age: 51.0
Sex: F
Vaccine: VARZOS
Symptoms: Rash
Clinical narrative: Patient called us on 10/14/22 saying that she woke up this morning and found a large rash covering her chest, she is unsure how long that rash was there for. Patient denies difficulty breathing, swelling, itching, or pain. Advised patient to call and follow up with pcp.
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Aphthous ulcer, Chapped lips, Skin exfoliation
Clinical narrative: My lips became very chapped, skin would be flaking off, and remains that way to this day. I started having canker sores inside my mouth. That have backed off a little, but my lips stay chapped. They have me taking hydrocortisone ointment twice a week. There really isn't anything they could give me for the canker sores.