chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 75.0
Sex: F
Vaccine: COVID19-2
Symptoms: Nausea, Pneumonia, Pulmonary hilar enlargement, Pulmonary mass, SARS-CoV-2 test positive
Clinical narrative: The patient is a 75 y.o. female patient of a CNP with history of HTN, HLD, multiple hernia repairs, asthma, recent admission for ileus and bronchitis(dc 3/28) who presented to the Medical Center with cough, wheeze, dyspnea, generalized weakness, N/V/D.   Acute hypoxemic respiratory failure Covid-19 Virus Infection Community acquired pneumonia Dyspnea, hypoxia requiring 4LNC Multifactorial due to COVID and pneumonia CT chest in ED with dependent opacities atelectasis favored vs PNA; also nodule  Date of onset of COVID symptoms: 3/11 Date of covid positive test: 4/4 Vaccination status: vaccinated Imaging: As above Oxygen requirements on admission: 4L Current oxygen requirements: RA Urine antigen neg, sputum cx mixed flora Medical therapy: steroids, rocephin, and zithromax; started remdesivir as GI symptoms consistent with new COVID Consultants following: none  Anticipated special isolation end date: 4/14 Home oxygen evaluation completed and no home O2 needs identified; discharged on RA   Ileus Dx last admission; improved since Returns with GI symptoms again; although could all be COVID-related KUB on admission ileus vs mild bowel obstruction Passing BM's; last was 1d PTA Tolerated regular diet Continue bowel regimen   AKI Cr up to 2.02 on 4/5 from baseline ~1 Likely prerenal due to GI losses Continue hydration for now  SCr improved to 0.80 on 4/8   Steroid-induced Hyperglycemia BG ~100-200 since admission Likely due to steroids Monitor for now   Lung nodule RUL 1.7 cm nodule seen on CT, with borderline enlarged R hilar mediastinal LN Rec recheck CT in 3 months, PET-CT or tissue sampling  Generalized weakness Myalgia  Due to current illness Uses a walker at baseline Re-assess after treatment Mobilize as able Muscle aches likely related to COVID Norco prn ordered    HTN Holding home hydrochlorothiazide and losartan for AKI Continue home Norvasc and clonidine    Hx of Paradoxical VCD Hx of Polypoid corditis ENT consulted previous admission discovered 3/14 Laryngeal control therapy breathing exercises and outpt ENT f/u
Age: 75.0
Sex: F
Vaccine: COVID19-2
Symptoms: Sputum culture positive, Urine antigen test, Vomiting, Wheezing
Clinical narrative: The patient is a 75 y.o. female patient of a CNP with history of HTN, HLD, multiple hernia repairs, asthma, recent admission for ileus and bronchitis(dc 3/28) who presented to the Medical Center with cough, wheeze, dyspnea, generalized weakness, N/V/D.   Acute hypoxemic respiratory failure Covid-19 Virus Infection Community acquired pneumonia Dyspnea, hypoxia requiring 4LNC Multifactorial due to COVID and pneumonia CT chest in ED with dependent opacities atelectasis favored vs PNA; also nodule  Date of onset of COVID symptoms: 3/11 Date of covid positive test: 4/4 Vaccination status: vaccinated Imaging: As above Oxygen requirements on admission: 4L Current oxygen requirements: RA Urine antigen neg, sputum cx mixed flora Medical therapy: steroids, rocephin, and zithromax; started remdesivir as GI symptoms consistent with new COVID Consultants following: none  Anticipated special isolation end date: 4/14 Home oxygen evaluation completed and no home O2 needs identified; discharged on RA   Ileus Dx last admission; improved since Returns with GI symptoms again; although could all be COVID-related KUB on admission ileus vs mild bowel obstruction Passing BM's; last was 1d PTA Tolerated regular diet Continue bowel regimen   AKI Cr up to 2.02 on 4/5 from baseline ~1 Likely prerenal due to GI losses Continue hydration for now  SCr improved to 0.80 on 4/8   Steroid-induced Hyperglycemia BG ~100-200 since admission Likely due to steroids Monitor for now   Lung nodule RUL 1.7 cm nodule seen on CT, with borderline enlarged R hilar mediastinal LN Rec recheck CT in 3 months, PET-CT or tissue sampling  Generalized weakness Myalgia  Due to current illness Uses a walker at baseline Re-assess after treatment Mobilize as able Muscle aches likely related to COVID Norco prn ordered    HTN Holding home hydrochlorothiazide and losartan for AKI Continue home Norvasc and clonidine    Hx of Paradoxical VCD Hx of Polypoid corditis ENT consulted previous admission discovered 3/14 Laryngeal control therapy breathing exercises and outpt ENT f/u
Age: 73.0
Sex: M
Vaccine: COVID19-2
Symptoms: Acute respiratory failure, Angiogram pulmonary abnormal, Blood glucose increased, COVID-19, Dyspnoea
Clinical narrative: Patient is a 73 y.o. male patient of DO with history of atypical flutter S/P ablation 2020, HTN, IDDM, peripheral neuropathy, chronic back pain, morbid obesity, OSA unable to tolerate CPAP presented to Hospital with hypoxia related to covid19 (3/30) who required 2 liters NC on admission (baseline oxygen none).  Started on Decadron, remdesivir, slowly weaned off of oxygen, developed hyperglycemia secondary to Decadron, today he is feeling much better on room air, back to baseline.  Feels comfortable going home   Acute hypoxemic respiratory failure Covid-19 Virus Infection Date of onset of symptoms: 3/30 Symptoms present on admission: sob Date of covid positive test: 3/31 Vaccination status: vaccinated Imaging: CTPA (3/31) no PE. Ground-glass right lower lobe nodule adjacent to the fissure measuring up to 9 mm mildly increased in size compared to 06/22/2022.  Baseline oxygen PTA: RA Oxygen requirements on admission: 2 liters NC Current oxygen requirements: Saturating well on room air Medical therapy: remdesivir and steroids while in the hospital Consultants following: none on admission Anticipated special isolation end date: 4/9     Hx atypical atrial flutter S/P ablation 2020 Essential HTN Toprol 25 mg daily, Lisinopril 40 mg daily, doxazosin daily Patient advised to check BP twice a day. Same place, same machine, same time. Maintain log and follow up with primary care physician in 1 week. Call primary care physician office if SBP consistently >180 or <90    HLD Resuming atorvastatin 40 mg daily IDDM Type2 A1c: 6.7 (2/28/23)-- on Humalog 15 units prandial, Levemir 18 units BID Check blood sugars ac & HS Currently on: Humalog (conservative) SSI, Humalog (Prandial): 10 units with meals, and Lantus 18 units BID ordered Blood sugar elevated in the hospital while on Decadron As per patient is blood sugar runs 130?180 at home on his home regimen Patient advised to check blood sugar three times a day before meals. Maintain log and follow up with primary care physician in 1 week to adjust dose of insulin accordingly. Call primary care physician office if blood sugar consistently >300 or <60    Chronic back pain Anxiety/depression Insomnia Resuming BuSpar 15 mg TID, Trazodone 100 mg HS PRN, Duloxetine 60 mg, Tizanidine 4 mg, venlafaxine, Hydroxyzine 25 mg TID PRN
Age: 73.0
Sex: M
Vaccine: COVID19-2
Symptoms: Glycosylated haemoglobin normal, Hyperglycaemia, Hypoxia, Lung opacity, SARS-CoV-2 test positive
Clinical narrative: Patient is a 73 y.o. male patient of DO with history of atypical flutter S/P ablation 2020, HTN, IDDM, peripheral neuropathy, chronic back pain, morbid obesity, OSA unable to tolerate CPAP presented to Hospital with hypoxia related to covid19 (3/30) who required 2 liters NC on admission (baseline oxygen none).  Started on Decadron, remdesivir, slowly weaned off of oxygen, developed hyperglycemia secondary to Decadron, today he is feeling much better on room air, back to baseline.  Feels comfortable going home   Acute hypoxemic respiratory failure Covid-19 Virus Infection Date of onset of symptoms: 3/30 Symptoms present on admission: sob Date of covid positive test: 3/31 Vaccination status: vaccinated Imaging: CTPA (3/31) no PE. Ground-glass right lower lobe nodule adjacent to the fissure measuring up to 9 mm mildly increased in size compared to 06/22/2022.  Baseline oxygen PTA: RA Oxygen requirements on admission: 2 liters NC Current oxygen requirements: Saturating well on room air Medical therapy: remdesivir and steroids while in the hospital Consultants following: none on admission Anticipated special isolation end date: 4/9     Hx atypical atrial flutter S/P ablation 2020 Essential HTN Toprol 25 mg daily, Lisinopril 40 mg daily, doxazosin daily Patient advised to check BP twice a day. Same place, same machine, same time. Maintain log and follow up with primary care physician in 1 week. Call primary care physician office if SBP consistently >180 or <90    HLD Resuming atorvastatin 40 mg daily IDDM Type2 A1c: 6.7 (2/28/23)-- on Humalog 15 units prandial, Levemir 18 units BID Check blood sugars ac & HS Currently on: Humalog (conservative) SSI, Humalog (Prandial): 10 units with meals, and Lantus 18 units BID ordered Blood sugar elevated in the hospital while on Decadron As per patient is blood sugar runs 130?180 at home on his home regimen Patient advised to check blood sugar three times a day before meals. Maintain log and follow up with primary care physician in 1 week to adjust dose of insulin accordingly. Call primary care physician office if blood sugar consistently >300 or <60    Chronic back pain Anxiety/depression Insomnia Resuming BuSpar 15 mg TID, Trazodone 100 mg HS PRN, Duloxetine 60 mg, Tizanidine 4 mg, venlafaxine, Hydroxyzine 25 mg TID PRN
Age: 61.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Acute myeloid leukaemia, Condition aggravated, Cytogenetic analysis, Fatigue, Nausea
Clinical narrative: Leukemia, AML, He is day ~21 Decitabine and day 14 VEnclexta for now confirmed t-AML. NGS and cytogenetics returned complex cytogenetics with RUXN1-MECOM fusion t(3;21) TET2 x 2 DNMT3A and RUNX1 genes.  THis is all c/w treatment-related AML.  Besides fatigue and minimal nausea, he has no focal complaints.  No fever, on LVQ ppx due to severe NTP.
Age: 61.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Next-generation sequencing
Clinical narrative: Leukemia, AML, He is day ~21 Decitabine and day 14 VEnclexta for now confirmed t-AML. NGS and cytogenetics returned complex cytogenetics with RUXN1-MECOM fusion t(3;21) TET2 x 2 DNMT3A and RUNX1 genes.  THis is all c/w treatment-related AML.  Besides fatigue and minimal nausea, he has no focal complaints.  No fever, on LVQ ppx due to severe NTP.
Age: 68.0
Sex: M
Vaccine: COVID19-2
Symptoms: Acute respiratory failure, COVID-19, Chest X-ray abnormal, Dyspnoea, Lung opacity
Clinical narrative: He is a 68 y.o. male patient of MD with history of COPD/Emphysema, Amyloidosis, Asthma, Beta Thalassemia, PAF s/p PPM and Watchman device, DM2, HFpEF, HTN, OAB, Prostate Cancer presented to the Medical Center with shortness of breath found to have COVID-19 .   Acute Respiratory Failure with hypoxia, resolved Presented with shortness of breath Sat > 90% on room air in ER but increased work of breathing Secondary to COVID-19 Weaned to room air (3/31) Pulm followed   Covid-19 Virus Infection Date of onset of symptoms: 3/30 Symptoms present on admission: Shortness of breath Date of covid positive test: 3/31 Vaccination status: vaccinated and boosted Imaging: CXR (3/30) with mild perihilar opacities, interstitial thickening, small R pleural effusion Oxygen requirements on admission: BIPAP, for increased work of breathing, no hypoxia Current oxygen requirements: Room air Medical therapy: steroids, will discharge on 6mg dexamethasone to complete 10 day course Consultants following: Pulm Anticipated special isolation end date: 4/10/23   COPD/Emphysema Asthma No acute exacerbation Continue home Atrovent, Albuterol, Breo Ellipta, Spiriva   DM2, not on long term insulin A1C pending Holding home jardiance, linagliptan SSI Resume home meds at discharge   HTN Continue home aldactone and torsemide   Chronic HFpEF EF 60-65% per history Euvolemic on exam Continue home aldactone and torsemide PAF S/P PPM and Watchman Continue home amiodarone Continue home eliquis   Gout Continue home allopurinol Pt states not taking colchicine   BPH Continue home flomax
Age: 68.0
Sex: M
Vaccine: COVID19-2
Symptoms: Pleural effusion, Positive airway pressure therapy, SARS-CoV-2 test positive
Clinical narrative: He is a 68 y.o. male patient of MD with history of COPD/Emphysema, Amyloidosis, Asthma, Beta Thalassemia, PAF s/p PPM and Watchman device, DM2, HFpEF, HTN, OAB, Prostate Cancer presented to the Medical Center with shortness of breath found to have COVID-19 .   Acute Respiratory Failure with hypoxia, resolved Presented with shortness of breath Sat > 90% on room air in ER but increased work of breathing Secondary to COVID-19 Weaned to room air (3/31) Pulm followed   Covid-19 Virus Infection Date of onset of symptoms: 3/30 Symptoms present on admission: Shortness of breath Date of covid positive test: 3/31 Vaccination status: vaccinated and boosted Imaging: CXR (3/30) with mild perihilar opacities, interstitial thickening, small R pleural effusion Oxygen requirements on admission: BIPAP, for increased work of breathing, no hypoxia Current oxygen requirements: Room air Medical therapy: steroids, will discharge on 6mg dexamethasone to complete 10 day course Consultants following: Pulm Anticipated special isolation end date: 4/10/23   COPD/Emphysema Asthma No acute exacerbation Continue home Atrovent, Albuterol, Breo Ellipta, Spiriva   DM2, not on long term insulin A1C pending Holding home jardiance, linagliptan SSI Resume home meds at discharge   HTN Continue home aldactone and torsemide   Chronic HFpEF EF 60-65% per history Euvolemic on exam Continue home aldactone and torsemide PAF S/P PPM and Watchman Continue home amiodarone Continue home eliquis   Gout Continue home allopurinol Pt states not taking colchicine   BPH Continue home flomax
Age: 12.0
Sex: M
Vaccine: HEP
Symptoms: No adverse event, Product administered to patient of inappropriate age, Wrong product administered
Clinical narrative: pt is under 18, given vaccine for >18 yo. no side effects were reported. pt only knew of the wrong vaccine when they went for the 2nd dose 11 months later
Age: 62.0
Sex: M
Vaccine: COVID19
Symptoms: Acute respiratory failure, Anticoagulant therapy, Asthma, Atrial fibrillation, Blood culture negative
Clinical narrative: FINAL DIAGNOSIS:   1. Covid 19 2.  Acute hypoxemic respiratory failure secondary to COVID-19 3. A. Fib with chronic anticoagulation 4. BMI 44  5. HTN 6. HLD  7. OSA  9. Hypokalemia  10.  Asthma     REASON FOR HOSPITALIZATION AND ADMITTING DIAGNOSIS:   Shortness of Breath, Chest Pain, and Fever Hypokalemia  Acute respiratory failure with hypoxia (HCC)  Pneumonia due to COVID-19 virus    HOSPITAL COURSE:  Per HPI: Patient is a 64 y.o. year-old male, who presented with SOB.  Patient reports has been not feeling well for about a week.  Has previously received COVID-vaccine 2 years ago Johnson & Johnson.  States that he took a COVID test this past weekend and it was positive he started to feel much worse and presented to the emergency department.  In the ER he had an oxygen saturation in the mid 80s.  He does not normally wear oxygen but does have obstructive sleep apnea.  Denies any chest pains.   .Covid-19 Virus Infection Date of onset of symptoms: 3/28/2023 Symptoms present on admission: Hypoxemia/cough Date of covid positive test: 4/4/2023 Vaccination status: Received J&J Imaging:   Chest x-ray with new patchy density suggesting infiltrates within the perihilar aspect of the left mid chest and the right lung base/CT pulmonary artery study revealed no evidence of pulmonary embolism.  Moderate involvement of all lobes of the lung by patchy and groundglass airspace disease compatible with multifocal pneumonia such as viral COVID-pneumonia.  No pneumothorax or pleural effusion. Oxygen requirements on admission:   1 L nasal cannula Current oxygen requirements: Currently on room air at discharge Medical therapy: Completed remdesivir regimen/Decadron for 10 days Consultants following: Evaluated by infectious disease Anticipated special isolation end date: 5 days of quarantine/5 days a mask at discharge. Consultants following: Evaluated by infectious disease Anticipated special isolation end date: 5 days of quarantine/5 days a mask at discharge.    Potassium was 3.3 on day of discharge and this is likely secondary to patient's use of Lasix and hydrochlorothiazide.  I will keep him on potassium 20 mill equivalents daily until he follows with his family physician and they can continue to refill and check the patient's potassium level. His sodium is additionally 133 and this is likely secondary to Decadron use as well as diuretic use.   Blood cultures revealed no growth to date. Troponin was negative x2 and patient had recent heart cath.   Procalcitonin was normal this is likely not a bacterial pneumonia or infection at this time.   Patient reports he did not require any oxygen supplementation last night during sleep.  He reports that he does not need any assistance from care management at discharge.
Age: 62.0
Sex: M
Vaccine: COVID19
Symptoms: Blood potassium decreased, Blood sodium decreased, COVID-19, COVID-19 pneumonia, Catheterisation cardiac
Clinical narrative: FINAL DIAGNOSIS:   1. Covid 19 2.  Acute hypoxemic respiratory failure secondary to COVID-19 3. A. Fib with chronic anticoagulation 4. BMI 44  5. HTN 6. HLD  7. OSA  9. Hypokalemia  10.  Asthma     REASON FOR HOSPITALIZATION AND ADMITTING DIAGNOSIS:   Shortness of Breath, Chest Pain, and Fever Hypokalemia  Acute respiratory failure with hypoxia (HCC)  Pneumonia due to COVID-19 virus    HOSPITAL COURSE:  Per HPI: Patient is a 64 y.o. year-old male, who presented with SOB.  Patient reports has been not feeling well for about a week.  Has previously received COVID-vaccine 2 years ago Johnson & Johnson.  States that he took a COVID test this past weekend and it was positive he started to feel much worse and presented to the emergency department.  In the ER he had an oxygen saturation in the mid 80s.  He does not normally wear oxygen but does have obstructive sleep apnea.  Denies any chest pains.   .Covid-19 Virus Infection Date of onset of symptoms: 3/28/2023 Symptoms present on admission: Hypoxemia/cough Date of covid positive test: 4/4/2023 Vaccination status: Received J&J Imaging:   Chest x-ray with new patchy density suggesting infiltrates within the perihilar aspect of the left mid chest and the right lung base/CT pulmonary artery study revealed no evidence of pulmonary embolism.  Moderate involvement of all lobes of the lung by patchy and groundglass airspace disease compatible with multifocal pneumonia such as viral COVID-pneumonia.  No pneumothorax or pleural effusion. Oxygen requirements on admission:   1 L nasal cannula Current oxygen requirements: Currently on room air at discharge Medical therapy: Completed remdesivir regimen/Decadron for 10 days Consultants following: Evaluated by infectious disease Anticipated special isolation end date: 5 days of quarantine/5 days a mask at discharge. Consultants following: Evaluated by infectious disease Anticipated special isolation end date: 5 days of quarantine/5 days a mask at discharge.    Potassium was 3.3 on day of discharge and this is likely secondary to patient's use of Lasix and hydrochlorothiazide.  I will keep him on potassium 20 mill equivalents daily until he follows with his family physician and they can continue to refill and check the patient's potassium level. His sodium is additionally 133 and this is likely secondary to Decadron use as well as diuretic use.   Blood cultures revealed no growth to date. Troponin was negative x2 and patient had recent heart cath.   Procalcitonin was normal this is likely not a bacterial pneumonia or infection at this time.   Patient reports he did not require any oxygen supplementation last night during sleep.  He reports that he does not need any assistance from care management at discharge.
Age: 62.0
Sex: M
Vaccine: COVID19
Symptoms: Chest X-ray abnormal, Chest pain, Computerised tomogram thorax abnormal, Cough, Diuretic therapy
Clinical narrative: FINAL DIAGNOSIS:   1. Covid 19 2.  Acute hypoxemic respiratory failure secondary to COVID-19 3. A. Fib with chronic anticoagulation 4. BMI 44  5. HTN 6. HLD  7. OSA  9. Hypokalemia  10.  Asthma     REASON FOR HOSPITALIZATION AND ADMITTING DIAGNOSIS:   Shortness of Breath, Chest Pain, and Fever Hypokalemia  Acute respiratory failure with hypoxia (HCC)  Pneumonia due to COVID-19 virus    HOSPITAL COURSE:  Per HPI: Patient is a 64 y.o. year-old male, who presented with SOB.  Patient reports has been not feeling well for about a week.  Has previously received COVID-vaccine 2 years ago Johnson & Johnson.  States that he took a COVID test this past weekend and it was positive he started to feel much worse and presented to the emergency department.  In the ER he had an oxygen saturation in the mid 80s.  He does not normally wear oxygen but does have obstructive sleep apnea.  Denies any chest pains.   .Covid-19 Virus Infection Date of onset of symptoms: 3/28/2023 Symptoms present on admission: Hypoxemia/cough Date of covid positive test: 4/4/2023 Vaccination status: Received J&J Imaging:   Chest x-ray with new patchy density suggesting infiltrates within the perihilar aspect of the left mid chest and the right lung base/CT pulmonary artery study revealed no evidence of pulmonary embolism.  Moderate involvement of all lobes of the lung by patchy and groundglass airspace disease compatible with multifocal pneumonia such as viral COVID-pneumonia.  No pneumothorax or pleural effusion. Oxygen requirements on admission:   1 L nasal cannula Current oxygen requirements: Currently on room air at discharge Medical therapy: Completed remdesivir regimen/Decadron for 10 days Consultants following: Evaluated by infectious disease Anticipated special isolation end date: 5 days of quarantine/5 days a mask at discharge. Consultants following: Evaluated by infectious disease Anticipated special isolation end date: 5 days of quarantine/5 days a mask at discharge.    Potassium was 3.3 on day of discharge and this is likely secondary to patient's use of Lasix and hydrochlorothiazide.  I will keep him on potassium 20 mill equivalents daily until he follows with his family physician and they can continue to refill and check the patient's potassium level. His sodium is additionally 133 and this is likely secondary to Decadron use as well as diuretic use.   Blood cultures revealed no growth to date. Troponin was negative x2 and patient had recent heart cath.   Procalcitonin was normal this is likely not a bacterial pneumonia or infection at this time.   Patient reports he did not require any oxygen supplementation last night during sleep.  He reports that he does not need any assistance from care management at discharge.
Age: 62.0
Sex: M
Vaccine: COVID19
Symptoms: Dyspnoea, Hyperlipidaemia, Hypertension, Hypokalaemia, Hypoxia
Clinical narrative: FINAL DIAGNOSIS:   1. Covid 19 2.  Acute hypoxemic respiratory failure secondary to COVID-19 3. A. Fib with chronic anticoagulation 4. BMI 44  5. HTN 6. HLD  7. OSA  9. Hypokalemia  10.  Asthma     REASON FOR HOSPITALIZATION AND ADMITTING DIAGNOSIS:   Shortness of Breath, Chest Pain, and Fever Hypokalemia  Acute respiratory failure with hypoxia (HCC)  Pneumonia due to COVID-19 virus    HOSPITAL COURSE:  Per HPI: Patient is a 64 y.o. year-old male, who presented with SOB.  Patient reports has been not feeling well for about a week.  Has previously received COVID-vaccine 2 years ago Johnson & Johnson.  States that he took a COVID test this past weekend and it was positive he started to feel much worse and presented to the emergency department.  In the ER he had an oxygen saturation in the mid 80s.  He does not normally wear oxygen but does have obstructive sleep apnea.  Denies any chest pains.   .Covid-19 Virus Infection Date of onset of symptoms: 3/28/2023 Symptoms present on admission: Hypoxemia/cough Date of covid positive test: 4/4/2023 Vaccination status: Received J&J Imaging:   Chest x-ray with new patchy density suggesting infiltrates within the perihilar aspect of the left mid chest and the right lung base/CT pulmonary artery study revealed no evidence of pulmonary embolism.  Moderate involvement of all lobes of the lung by patchy and groundglass airspace disease compatible with multifocal pneumonia such as viral COVID-pneumonia.  No pneumothorax or pleural effusion. Oxygen requirements on admission:   1 L nasal cannula Current oxygen requirements: Currently on room air at discharge Medical therapy: Completed remdesivir regimen/Decadron for 10 days Consultants following: Evaluated by infectious disease Anticipated special isolation end date: 5 days of quarantine/5 days a mask at discharge. Consultants following: Evaluated by infectious disease Anticipated special isolation end date: 5 days of quarantine/5 days a mask at discharge.    Potassium was 3.3 on day of discharge and this is likely secondary to patient's use of Lasix and hydrochlorothiazide.  I will keep him on potassium 20 mill equivalents daily until he follows with his family physician and they can continue to refill and check the patient's potassium level. His sodium is additionally 133 and this is likely secondary to Decadron use as well as diuretic use.   Blood cultures revealed no growth to date. Troponin was negative x2 and patient had recent heart cath.   Procalcitonin was normal this is likely not a bacterial pneumonia or infection at this time.   Patient reports he did not require any oxygen supplementation last night during sleep.  He reports that he does not need any assistance from care management at discharge.
Age: 62.0
Sex: M
Vaccine: COVID19
Symptoms: Lung disorder, Lung opacity, Malaise, Obstructive sleep apnoea syndrome, Procalcitonin normal
Clinical narrative: FINAL DIAGNOSIS:   1. Covid 19 2.  Acute hypoxemic respiratory failure secondary to COVID-19 3. A. Fib with chronic anticoagulation 4. BMI 44  5. HTN 6. HLD  7. OSA  9. Hypokalemia  10.  Asthma     REASON FOR HOSPITALIZATION AND ADMITTING DIAGNOSIS:   Shortness of Breath, Chest Pain, and Fever Hypokalemia  Acute respiratory failure with hypoxia (HCC)  Pneumonia due to COVID-19 virus    HOSPITAL COURSE:  Per HPI: Patient is a 64 y.o. year-old male, who presented with SOB.  Patient reports has been not feeling well for about a week.  Has previously received COVID-vaccine 2 years ago Johnson & Johnson.  States that he took a COVID test this past weekend and it was positive he started to feel much worse and presented to the emergency department.  In the ER he had an oxygen saturation in the mid 80s.  He does not normally wear oxygen but does have obstructive sleep apnea.  Denies any chest pains.   .Covid-19 Virus Infection Date of onset of symptoms: 3/28/2023 Symptoms present on admission: Hypoxemia/cough Date of covid positive test: 4/4/2023 Vaccination status: Received J&J Imaging:   Chest x-ray with new patchy density suggesting infiltrates within the perihilar aspect of the left mid chest and the right lung base/CT pulmonary artery study revealed no evidence of pulmonary embolism.  Moderate involvement of all lobes of the lung by patchy and groundglass airspace disease compatible with multifocal pneumonia such as viral COVID-pneumonia.  No pneumothorax or pleural effusion. Oxygen requirements on admission:   1 L nasal cannula Current oxygen requirements: Currently on room air at discharge Medical therapy: Completed remdesivir regimen/Decadron for 10 days Consultants following: Evaluated by infectious disease Anticipated special isolation end date: 5 days of quarantine/5 days a mask at discharge. Consultants following: Evaluated by infectious disease Anticipated special isolation end date: 5 days of quarantine/5 days a mask at discharge.    Potassium was 3.3 on day of discharge and this is likely secondary to patient's use of Lasix and hydrochlorothiazide.  I will keep him on potassium 20 mill equivalents daily until he follows with his family physician and they can continue to refill and check the patient's potassium level. His sodium is additionally 133 and this is likely secondary to Decadron use as well as diuretic use.   Blood cultures revealed no growth to date. Troponin was negative x2 and patient had recent heart cath.   Procalcitonin was normal this is likely not a bacterial pneumonia or infection at this time.   Patient reports he did not require any oxygen supplementation last night during sleep.  He reports that he does not need any assistance from care management at discharge.
Age: 62.0
Sex: M
Vaccine: COVID19
Symptoms: Pyrexia, SARS-CoV-2 test positive, Troponin normal
Clinical narrative: FINAL DIAGNOSIS:   1. Covid 19 2.  Acute hypoxemic respiratory failure secondary to COVID-19 3. A. Fib with chronic anticoagulation 4. BMI 44  5. HTN 6. HLD  7. OSA  9. Hypokalemia  10.  Asthma     REASON FOR HOSPITALIZATION AND ADMITTING DIAGNOSIS:   Shortness of Breath, Chest Pain, and Fever Hypokalemia  Acute respiratory failure with hypoxia (HCC)  Pneumonia due to COVID-19 virus    HOSPITAL COURSE:  Per HPI: Patient is a 64 y.o. year-old male, who presented with SOB.  Patient reports has been not feeling well for about a week.  Has previously received COVID-vaccine 2 years ago Johnson & Johnson.  States that he took a COVID test this past weekend and it was positive he started to feel much worse and presented to the emergency department.  In the ER he had an oxygen saturation in the mid 80s.  He does not normally wear oxygen but does have obstructive sleep apnea.  Denies any chest pains.   .Covid-19 Virus Infection Date of onset of symptoms: 3/28/2023 Symptoms present on admission: Hypoxemia/cough Date of covid positive test: 4/4/2023 Vaccination status: Received J&J Imaging:   Chest x-ray with new patchy density suggesting infiltrates within the perihilar aspect of the left mid chest and the right lung base/CT pulmonary artery study revealed no evidence of pulmonary embolism.  Moderate involvement of all lobes of the lung by patchy and groundglass airspace disease compatible with multifocal pneumonia such as viral COVID-pneumonia.  No pneumothorax or pleural effusion. Oxygen requirements on admission:   1 L nasal cannula Current oxygen requirements: Currently on room air at discharge Medical therapy: Completed remdesivir regimen/Decadron for 10 days Consultants following: Evaluated by infectious disease Anticipated special isolation end date: 5 days of quarantine/5 days a mask at discharge. Consultants following: Evaluated by infectious disease Anticipated special isolation end date: 5 days of quarantine/5 days a mask at discharge.    Potassium was 3.3 on day of discharge and this is likely secondary to patient's use of Lasix and hydrochlorothiazide.  I will keep him on potassium 20 mill equivalents daily until he follows with his family physician and they can continue to refill and check the patient's potassium level. His sodium is additionally 133 and this is likely secondary to Decadron use as well as diuretic use.   Blood cultures revealed no growth to date. Troponin was negative x2 and patient had recent heart cath.   Procalcitonin was normal this is likely not a bacterial pneumonia or infection at this time.   Patient reports he did not require any oxygen supplementation last night during sleep.  He reports that he does not need any assistance from care management at discharge.
Age: 47.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Amenorrhoea, Hot flush, Menstrual disorder
Clinical narrative: I lost my menstrual cycle the month after I was fully vaccinated.  It has only returned 2 times in 24 months since I've been vaccinated. I was fully vaccinated as of 4/25/21, then in May, my cycle was very light.  I never got a menstrual cycle in June of 2021.  I had horrible hot flashes for June, July, August, and part of September.  Then I had one menstrual cycle again in October of 2021.  It disappeared again, and I've only had 1 other menstrual cycle since I'd been vaccinated, it was in January of 2023.  I believe that the vaccine caused early menopause.  It precisely stopped when I received the full vaccination, and I had never missed a period in my entire life before that.  It cannot be a coincidence in my opinion.
Age: 14.0
Sex: M
Vaccine: HPV9
Symptoms: Dysphemia, Speech disorder
Clinical narrative: He started to have a severe stutter. He had never stuttered before. Had a lot of difficulty with speech. We have encourage healthier eating, speech therapy, alternative therapies and speech therapy. Now speech has much improved as of 2023.
Sex: U
Vaccine: MMR, MMRV
Symptoms: No adverse event, Product storage error, Wrong product administered
Clinical narrative: No additional AE; HCP called to report that the patient was given PROQUAD instead of MMR II.; temperature excursion; This spontaneous report was received from a pharmacist referring to a patient of unknown age and gender. Information about the patient's pertinent medical history, concurrent conditions and concomitant medications was not provided.  On 10-MAY-2023, the patient was vaccinated with improperly stored dose of measles, mumps, rubella and varicella (Oka-Merck) virus vaccine live rHA(PROQUAD) injection (lot #W029552, expiration date 14-MAR-2024, exact dose, route of administration and anatomical location were not provided) for prophylaxis, instead of dose of measles, mumps, and rubella (Wistar RA 27-3) virus vaccine, live (M-M-R II) injection (Wrong vaccine administered, Product storage error).  On unknown dates, the measles, mumps, rubella and varicella (Oka-Merck) virus vaccine live rHA(PROQUAD)suffered from a non supported temperature excursion of 8 degrees Celsius for 1152 hours. No additional adverse events (AEs) or product quality complaints (PQC) were reported (No adverse event).
Sex: U
Vaccine: MMR, MMRV
Symptoms: No adverse event, Product storage error, Wrong product administered
Clinical narrative: temperature excursion; No additional AE; HCP called to report that the patient was given PROQUAD instead of MMR II.; This spontaneous report was received from a pharmacist referring to a patient of unknown age and gender. Information about the patient's pertinent medical history, concurrent conditions and concomitant medications was not provided.  On 26-JUN-2023, the patient was vaccinated with improperly stored dose of measles, mumps, rubella and varicella (Oka-Merck) virus vaccine live rHA(PROQUAD) injection (lot #W029552, expiration date 14-MAR-2024, exact dose, route of administration and anatomical location were not provided) for prophylaxis, instead of dose of measles, mumps, and rubella (Wistar RA 27-3) virus vaccine, live (M-M-R II) injection (Wrong vaccine administered, Product storage error).  On unknown dates, the measles, mumps, rubella and varicella (Oka-Merck) virus vaccine live rHA(PROQUAD)suffered from a non supported temperature excursion of 8 degrees Celsius for 2304 hours. No additional adverse events (AEs) or product quality complaints (PQC) were reported (No adverse event).
Sex: U
Vaccine: VARCEL
Symptoms: No adverse event, Product storage error
Clinical narrative: No additional AE; HCP calling to report an AE regarding the VARIVAX vaccine. HCP reported that a patient was administered an improperly stored vaccine.; This spontaneous report was received from a nurse referring to a patient of unknown age and gender. Information about the patient's pertinent medical history, concurrent conditions and concomitant medications was not provided.  On 29-JUN-2023, the patient was vaccinated with improperly stored dose of varicella virus vaccine live (Oka/Merck) (VARIVAX) injection (lot #W034912, expiration date 02-NOV-2024, exact dose, route of administration and anatomical location were not provided) for prophylaxis.  On unknown dates, the suspect vaccine experienced a temperature excursion. No additional adverse events (AEs) or product quality complaints (PQC) were reported (no adverse event).
Sex: U
Vaccine: VARCEL
Symptoms: Expired product administered, No adverse event
Clinical narrative: HCP reports no signs or symptoms noted. HCP has no further AE information.; HCP called to report a dose of VARIVAX that expired on 6/28/2023 was administered on 6/30/2023. Sterile Diluent used was also expired as of 1/26/2023.; This spontaneous report was received from an other health professional and refers to a patient of unknown age and gender. No information on patient's medical history, current conditions and concomitant medications was provided.      On 30-JUN-2023 the patient was vaccinated with expired dose of varicella virus vaccine live (oka/merck) (VARIVAX) lot # U020240, which is valid lot number and expiration date was established as 28-JUN-2023, 0.5 milliliter for prophylaxis (dose number, route and site of administration were not provided). Other suspect therapies included expiered sterile diluent (STERILE DILUENT) lot # T022569 and expiration date 26-JAN-2023 for prophylaxis (expired product administered and no adverse event
Sex: U
Vaccine: RV5
Symptoms: Diarrhoea, Gastroenteritis rotavirus, Laboratory test, Rotavirus test positive
Clinical narrative: We've a young infant with significant diarrhea, rotavirus positive shortly after receiving RotaTeq; This spontaneous report has been received from a pharmacist, via a company representative, regarding a young infant patient of unknown age and gender. The patient's pertinent medical history, previous drug reactions or allergies and concomitant medications were not reported.  On an unspecified date, the patient was administered a dose of Rotavirus Vaccine, Live, Oral, Pentavalent (ROTATEQ) oral liquid, as prophylaxis (strength, dose, scheme, route and anatomical location of administration, lot number and expiration date were not reported).  On an unspecified date shortly after receiving Rotavirus Vaccine, Live, Oral, Pentavalent (ROTATEQ), the patient experienced a significant diarrhea, with rotavirus positive test shortly after receiving (Gastroenteritis rotavirus). The outcome of the event was not reported.  The patient's immunodeficiency work up was on-going. The treatment team was considering whether the patient may have vaccine-acquired rotavirus disease and would like to send for strain typing The causal relationship between Gastroenteritis rotavirus and Rotavirus Vaccine, Live, Oral, Pentavalent (ROTATEQ) was not provided.   Upon internal review, the event Gastroenteritis rotavirus was determined to be medically significant.
Sex: U
Vaccine: RAB
Symptoms: Product administration error, Product preparation error
Clinical narrative: The nurse reconstituted the vaccine and then had to be gone for half hour before administering Rabavert; The nurse reconstituted the vaccine and then had to be gone for half hour before administering Rabavert; Case reference number US-BN-2022-001079 is a spontaneous case report initially received on 13-May-2022 from a pharmacist via Communications (reference number: USBAV22-0184) and concerns a patient of unknown age or gender.  The patient's medical history and concomitant medication details were not provided.  On an unknown date, the patient was vaccinated with RabAvert vaccine ((Inactivated, Strain Flury LEP) (PCEC); batch number was not provided), at a dose of 2.5 IU, administered intramuscularly, for unknown indication. It was also reported that the nurse reconstituted the vaccine and then had to be gone half an hour before administering the vaccine to the patient (explicitly coded as 'vaccine preparation error' and 'product administration error').  At the time of this report, it was unknown if the patient experienced any adverse events.  No further information was provided.; Reporter's Comments: A patient of unknown age or gender was vaccinated with RabAvert for unknown indication. Reportedly, the nurse reconstituted the vaccine and then had to be gone half an hour before administering the vaccine to the patient, which is considered as product preparation error and product administration error. No associated adverse events have been reported with the reported medication error. Product preparation error and product administration error are considered as listed per company convention. The patient's medical history and concomitant medication details were not provided. Product preparation error and product administration error have been considered as not related to the suspect vaccine, but to a human factor. This case is considered as non-serious.; Sender's Comments: A patient of unknown age or gender was vaccinated with RabAvert for unknown indication. Reportedly, the nurse reconstituted the vaccine and then had to be gone half an hour before administering the vaccine to the patient, which is considered as product preparation error and product administration error. No associated adverse events have been reported with the reported medication error. Product preparation error and product administration error are considered as listed per company convention. The patient's medical history and concomitant medication details were not provided. Product preparation error and product administration error have been considered as not related to the suspect vaccine, but to a human factor. This case is considered as non-serious.
Sex: M
Vaccine: RAB
Symptoms: Incomplete course of vaccination
Clinical narrative: At the end of 2018 and first of 2019, the patient received the first two doses of RabAvert and did not come back; Case reference number US-BN-2022-001120 is a spontaneous case report initially received on 23-May-2022 from other health professional via Communication (reference number: USBAV22-0215) and concerns a 42-year-old male patient.  The patient's medical history and concomitant medication details were not provided.  On unspecified dates in 2018 and 2019, the patient received the first and the second dose of RabAvert (Rabies Virus (Inactivated, Strain Flury LEP) (PCEC), batch numbers were not provided), at dose reported as 'one vaccine per dose', at an unknown route and site of administration for pre-exposure immunization.   As reported, the patient did not come back to get anymore (explicitly coded as *'incomplete course of vaccination'*), and now he called and wanted to finish the series.   At the time of this report, it was unknown whether the patient experienced any adverse events from the vaccine.   All updated information is blended into the case narrative above, with the corrected information presented between asterisks (*).  Need for significant case correction identified on 13-Jun-2022 for the information received on 23-May-2022, included recoding of the event (from 'missed dose' to 'incomplete course of vaccination').; Reporter's Comments: A 42-year-old male patient received the first and the second dose of RabAvert for pre exposure immunization, on unspecified dates in 2018 and 2019, and reportedly, the patient did not come back to get anymore, which is considered as incomplete course of vaccination. It was unknown whether the patient experienced any adverse events from the vaccine with the reported medication error. Incomplete course of vaccination is considered as listed per company convention. The patient's medical history and concomitant medication details were not provided. Incomplete course of vaccination has been considered as not related to the suspect vaccine, but to a human factor. This case is considered as non-serious.; Sender's Comments: A 42-year-old male patient received the first and the second dose of RabAvert for pre exposure immunization, on unspecified dates in 2018 and 2019, and reportedly, the patient did not come back to get anymore, which is considered as incomplete course of vaccination. It was unknown whether the patient experienced any adverse events from the vaccine with the reported medication error. Incomplete course of vaccination is considered as listed per company convention. The patient's medical history and concomitant medication details were not provided. Incomplete course of vaccination has been considered as not related to the suspect vaccine, but to a human factor. This case is considered as non-serious.
Sex: U
Vaccine: RAB
Symptoms: Product dose omission issue, Product storage error
Clinical narrative: Rabavert vaccine was out of the fridge for a few hours and it ended up not being administered to a patient; Rabavert vaccine was out of the fridge for a few hours and it ended up not being administered to a patient; Case reference number US-BN-2022-001126 is a spontaneous case report initially received on 23-May-2022 from pharmacist via Communication (reference number USBAV22-0216) and concerns a patient of unknown age or gender.  The patient's medical history and concomitant medications details were not provided.  On an unknown date, RabAvert vaccine (rabies virus (inactivated, strain flury lep) (pcec), batch number: not reported) had a temperature excursion. The vaccine was out of the fridge for a few hours (explicitly coded as 'product storage error') and it ended up not being administered to a patient (explicitly coded as 'missed dose').  At the time of this report, it was unknown which dose this was or if the patient experienced adverse event.   No further information was provided.; Reporter's Comments: A patient of unknown age or gender was going to be vaccinated with RabAvert for unknown indication, but RabAvert vaccine had a temperature excursion. The vaccine was out of the fridge for a few hours and it ended up not being administered to a patient, which is considered as product storage error and product dose omission issue. No associated adverse evets have been reported with the reported medication error. Product storage error and product dose omission issue are considered as listed per company convention. The patient's medical history and concomitant medications details were not provided. Product storage error and product dose omission issue have been considered as not related to the suspect vaccine, but to a human factor. This case is considered as non-serious.; Sender's Comments: A patient of unknown age or gender was going to be vaccinated with RabAvert for unknown indication, but RabAvert vaccine had a temperature excursion. The vaccine was out of the fridge for a few hours and it ended up not being administered to a patient, which is considered as product storage error and product dose omission issue. No associated adverse evets have been reported with the reported medication error. Product storage error and product dose omission issue are considered as listed per company convention. The patient's medical history and concomitant medications details were not provided. Product storage error and product dose omission issue have been considered as not related to the suspect vaccine, but to a human factor. This case is considered as non-serious.