chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 80.0
Sex: M
Vaccine: COVID19
Symptoms: Procalcitonin normal
Clinical narrative: Discharge Provider: MD Primary Care Provider: MD Admission Date: 3/1/2023 Discharge Date: 3/5/2023   Clinical Narrative: Patient was admitted for acute chronic obstructive pulmonary disease exacerbation and COVID-19, however his cough has much improved, he has remained on room since the day after he was admitted and saturating in the mid 90s, he denies any chest pain.  He was started on IV remdesivir on admission and has completed 4 days.  He remains afebrile with no shortness of breath no chest pain.  Leukocytosis today is felt to be reactive from steroids would repeated procalcitonin lactic acid today which but normal.  Physician at the extended care facility to repeat complete blood count within 1 week.  Examination reveals no wheeze, since he is on room air with no shortness of breath we may discontinue steroids today on discharge since he has had a total of 4 days Decadron He was evaluated by General surgery during this admission to assist with these bilateral Unna boot He was evaluated by PT/OT for history of falls and will be transferred to extended care facility for rehabilitation Patient is on Coumadin for anticoagulation and he was subtherapeutic on admission, with subsequently bridged with Lovenox, his INR however today is 2.7 so we will discontinue Lovenox bridge.  Potassium was 3.2 this morning and he received a total of 40 mEq of potassium replacement   Please see the following problem-list oriented Hospital Course below:   No new Assessment & Plan notes have been filed under this hospital service since the last note was generated. Service: Hospitalist
Age: 1.0
Sex: F
Vaccine: MMRV
Symptoms: Urticaria
Clinical narrative: 6 days after administration patient developed hives.
Age: 44.0
Sex: M
Vaccine: COVID19-2
Symptoms: Ageusia, Anosmia, COVID-19, Discharge, Fatigue
Clinical narrative: I had a small red spot around the injection spot that went away in 24 hours. I started not feeling well on 01/13/2023 as I had a lot of drainage and flu like symptoms. I test positive for COVID-19 on 01/14/2023. I had a telehealth visit with my provider. I did not receive a prescription but advised to take ADVIL or TYLENOL as needed. As of today, I don't have my sense of smell or taste and fatigue. It's getting better but I'm not back to normal.
Age: 44.0
Sex: M
Vaccine: COVID19-2
Symptoms: Influenza like illness, Injection site erythema, Malaise, SARS-CoV-2 test positive
Clinical narrative: I had a small red spot around the injection spot that went away in 24 hours. I started not feeling well on 01/13/2023 as I had a lot of drainage and flu like symptoms. I test positive for COVID-19 on 01/14/2023. I had a telehealth visit with my provider. I did not receive a prescription but advised to take ADVIL or TYLENOL as needed. As of today, I don't have my sense of smell or taste and fatigue. It's getting better but I'm not back to normal.
Age: 84.0
Sex: F
Vaccine: COVID19-2
Symptoms: Acute respiratory failure, Alanine aminotransferase increased, Aspartate aminotransferase increased, Asthenia, COVID-19
Clinical narrative: Discharge Physician: MD Primary Care Physician: DO  Date of Admission: 2/28/2023 Discharge Date: 3/2/2023 Room Number:   PRESENTING PROBLEM: Hypoxia  Generalized weakness COVID-19 virus infection Acute respiratory disease due to COVID-19 virus    HOSPITAL COURSE: Patient is a 84 y.o. female who presented with nausea, congestion, and diarrhea. Patient has history of HTN, Hypothyroid, GERD, and autoimmune hepatitis in which she is on long term daily prednisone. Patient reported spouse developed mild congestion and fatigue on 2/20/2023. On 2/24 she developed a cough, congestion with progressive shortness of breath and fatigue. Patient stated she developed diarrhea on on 2/26/2023 with severe nausea and decreased oral intake. Due to continued diarrhea and fatigue patient presented to ED for further evaluation.    In the ED, patient was found to be COVID positive with hyponatremia, hypokalemia, mildly hyperglycemia, with mildly elevated AST, ALT but similar to baseline. Chest xray showed no acute cardiopulmonary process. Patient was shown to be hypoxic requiring 2L n/c and therefore was admitted to the hospitalist service for acute respiratory failure and COVID 19. Patient was weened to 1L NC. She had home oxygen evaluation and will need 1L NC at home which patient is agreeable to. She is also agreeable to home health nursing. Patient had resolution of diarrhea and was able to tolerate general diet.    Electrolytes were monitored and repleted PRN throughout the admission and normalized today. She will be sent on prednisone taper and albuterol inhaler. Patient clinically improved and hemodynamically stable for discharge.  Discussed plan of care discharge with patient including outpatient follow-up PCP within 7 days. Patient voiced understanding was agreeable with plan of care discharge.
Age: 84.0
Sex: F
Vaccine: COVID19-2
Symptoms: Chest X-ray normal, Cough, Diarrhoea, Dyspnoea, Electrolyte depletion
Clinical narrative: Discharge Physician: MD Primary Care Physician: DO  Date of Admission: 2/28/2023 Discharge Date: 3/2/2023 Room Number:   PRESENTING PROBLEM: Hypoxia  Generalized weakness COVID-19 virus infection Acute respiratory disease due to COVID-19 virus    HOSPITAL COURSE: Patient is a 84 y.o. female who presented with nausea, congestion, and diarrhea. Patient has history of HTN, Hypothyroid, GERD, and autoimmune hepatitis in which she is on long term daily prednisone. Patient reported spouse developed mild congestion and fatigue on 2/20/2023. On 2/24 she developed a cough, congestion with progressive shortness of breath and fatigue. Patient stated she developed diarrhea on on 2/26/2023 with severe nausea and decreased oral intake. Due to continued diarrhea and fatigue patient presented to ED for further evaluation.    In the ED, patient was found to be COVID positive with hyponatremia, hypokalemia, mildly hyperglycemia, with mildly elevated AST, ALT but similar to baseline. Chest xray showed no acute cardiopulmonary process. Patient was shown to be hypoxic requiring 2L n/c and therefore was admitted to the hospitalist service for acute respiratory failure and COVID 19. Patient was weened to 1L NC. She had home oxygen evaluation and will need 1L NC at home which patient is agreeable to. She is also agreeable to home health nursing. Patient had resolution of diarrhea and was able to tolerate general diet.    Electrolytes were monitored and repleted PRN throughout the admission and normalized today. She will be sent on prednisone taper and albuterol inhaler. Patient clinically improved and hemodynamically stable for discharge.  Discussed plan of care discharge with patient including outpatient follow-up PCP within 7 days. Patient voiced understanding was agreeable with plan of care discharge.
Age: 84.0
Sex: F
Vaccine: COVID19-2
Symptoms: Electrolyte substitution therapy, Fatigue, Hyperglycaemia, Hypokalaemia, Hyponatraemia
Clinical narrative: Discharge Physician: MD Primary Care Physician: DO  Date of Admission: 2/28/2023 Discharge Date: 3/2/2023 Room Number:   PRESENTING PROBLEM: Hypoxia  Generalized weakness COVID-19 virus infection Acute respiratory disease due to COVID-19 virus    HOSPITAL COURSE: Patient is a 84 y.o. female who presented with nausea, congestion, and diarrhea. Patient has history of HTN, Hypothyroid, GERD, and autoimmune hepatitis in which she is on long term daily prednisone. Patient reported spouse developed mild congestion and fatigue on 2/20/2023. On 2/24 she developed a cough, congestion with progressive shortness of breath and fatigue. Patient stated she developed diarrhea on on 2/26/2023 with severe nausea and decreased oral intake. Due to continued diarrhea and fatigue patient presented to ED for further evaluation.    In the ED, patient was found to be COVID positive with hyponatremia, hypokalemia, mildly hyperglycemia, with mildly elevated AST, ALT but similar to baseline. Chest xray showed no acute cardiopulmonary process. Patient was shown to be hypoxic requiring 2L n/c and therefore was admitted to the hospitalist service for acute respiratory failure and COVID 19. Patient was weened to 1L NC. She had home oxygen evaluation and will need 1L NC at home which patient is agreeable to. She is also agreeable to home health nursing. Patient had resolution of diarrhea and was able to tolerate general diet.    Electrolytes were monitored and repleted PRN throughout the admission and normalized today. She will be sent on prednisone taper and albuterol inhaler. Patient clinically improved and hemodynamically stable for discharge.  Discussed plan of care discharge with patient including outpatient follow-up PCP within 7 days. Patient voiced understanding was agreeable with plan of care discharge.
Age: 84.0
Sex: F
Vaccine: COVID19-2
Symptoms: Hypophagia, Hypoxia, Nausea, Respiratory tract congestion, SARS-CoV-2 test positive
Clinical narrative: Discharge Physician: MD Primary Care Physician: DO  Date of Admission: 2/28/2023 Discharge Date: 3/2/2023 Room Number:   PRESENTING PROBLEM: Hypoxia  Generalized weakness COVID-19 virus infection Acute respiratory disease due to COVID-19 virus    HOSPITAL COURSE: Patient is a 84 y.o. female who presented with nausea, congestion, and diarrhea. Patient has history of HTN, Hypothyroid, GERD, and autoimmune hepatitis in which she is on long term daily prednisone. Patient reported spouse developed mild congestion and fatigue on 2/20/2023. On 2/24 she developed a cough, congestion with progressive shortness of breath and fatigue. Patient stated she developed diarrhea on on 2/26/2023 with severe nausea and decreased oral intake. Due to continued diarrhea and fatigue patient presented to ED for further evaluation.    In the ED, patient was found to be COVID positive with hyponatremia, hypokalemia, mildly hyperglycemia, with mildly elevated AST, ALT but similar to baseline. Chest xray showed no acute cardiopulmonary process. Patient was shown to be hypoxic requiring 2L n/c and therefore was admitted to the hospitalist service for acute respiratory failure and COVID 19. Patient was weened to 1L NC. She had home oxygen evaluation and will need 1L NC at home which patient is agreeable to. She is also agreeable to home health nursing. Patient had resolution of diarrhea and was able to tolerate general diet.    Electrolytes were monitored and repleted PRN throughout the admission and normalized today. She will be sent on prednisone taper and albuterol inhaler. Patient clinically improved and hemodynamically stable for discharge.  Discussed plan of care discharge with patient including outpatient follow-up PCP within 7 days. Patient voiced understanding was agreeable with plan of care discharge.
Age: 84.0
Sex: M
Vaccine: COVID19-2
Symptoms: Cough, Pyrexia, Respiratory tract congestion, Throat irritation
Clinical narrative: Was travelling out of the country and started having a dry cough. A week later was congested and had a high fever. Went to Doctor and was prescribed Antibiotics (not sure of name). Gradually got better, but still has a scratchy throat.
Age: 26.0
Sex: M
Vaccine: TDAP
Symptoms: Asthenia, Pain, Pyrexia
Clinical narrative: The patient is having full body weakness,  pain,and  fevers
Age: 66.0
Sex: F
Vaccine: VARZOS
Symptoms: Headache, Injection site erythema, Injection site swelling, Pain in extremity, Pruritus
Clinical narrative: Normal pain in my right arm. Swelling at the site of injection with a 6 inch diameter of swelling and redness. I have severe itching all over my body but mostly on the left side of my torso... it seems to be under my skin not on the surface of my skin like as if my muscles itch. Headache on the first day.
Age: 59.0
Sex: M
Vaccine: COVID19-2
Symptoms: COVID-19, Chest discomfort, Fatigue, Oropharyngeal pain, Pain
Clinical narrative: I tested positive for COVID-19 on 1/27/23. I had fatigue, body aches, chest tightness, sore throat. I just thought I had a cold but when I took an at home test it was positive immediately. I went to the doctor, and they tested me again and I tested positive immediately, was prescribed benzonatate. No other medications were prescribed. I requested PAXLOVID and he refused.
Age: 59.0
Sex: M
Vaccine: COVID19-2
Symptoms: SARS-CoV-2 test positive
Clinical narrative: I tested positive for COVID-19 on 1/27/23. I had fatigue, body aches, chest tightness, sore throat. I just thought I had a cold but when I took an at home test it was positive immediately. I went to the doctor, and they tested me again and I tested positive immediately, was prescribed benzonatate. No other medications were prescribed. I requested PAXLOVID and he refused.
Age: 102.0
Sex: F
Vaccine: COVID19-2
Symptoms: Anticoagulant therapy, Aspartate aminotransferase increased, Atrial fibrillation, Blood bilirubin increased, Blood glucose normal
Clinical narrative: Discharge Provider: MD Primary Care Provider: MD Admission Date: 2/27/2023 Discharge Date: Mar 3, 2023  PRESENTING PROBLEM: Subdural hematoma  Hypoxia  Fall from standing, initial encounter  COVID-19    HOSPITAL COURSE: Patient is a 103 y.o. female with a past medical history of atrial fibrillation on apixaban, hyperlipidemia, choledocholithiasis status post ERCP in 2019, presenting after a fall at her independent living facility.  The patient suffered an unwitnessed fall at approximately 6:00 p.m. on 02/27 was brought to the emergency department.  The patient is extremely hard of hearing and is unable to provide history.  In the emergency department the patient was afebrile but tachycardic to the 130s.  EKG showed atrial fibrillation with RVR. She was started on metoprolol with good response in heart rates.  The patient was found to be COVID positive.  Chest x-ray showed bilateral infiltrates consistent with edema.  BNP was elevated to 4000, though stable from prior.  Troponins mildly elevated but flat.  The patient did become hypoxic and required 2 L nasal cannula.  Labs were significant for glucose of 121, bili of 1.2, AST of 51, hemoglobin of 12, white blood cell count of 629, platelets 245.  CT head was obtained that showed a subdural hematoma as well as small amount of subarachnoid hemorrhage.  Neurosurgery was contacted, as well as the patient's son/durable power of attorney, and per report from the emergency department the emergency department physician was also able to converse with the patient.  It was noted that the patient and her son did not want to pursue any surgical intervention under any circumstances.  Given the desire for no surgical intervention emergency department did discuss with Neurosurgery and felt that the patient did not require transfer to Hospital. The patient was subsequently admitted to the medicine service for further care.    Repeat CT head was stable with no further bleeding. Eliquis was stopped. Her mentation improved, though at times quite difficult to communicate with because of how hard of hearing she is, even with hearing aids.    She required oxygen from both fluid overload from CHF and COVID. She was started on steroids for COVID. She was diuresed with Lasix and improvement in oxygenation. Oxygen requirements were weaned. She did require some oxygen and pulmonary rehab was consulted who recommended 1L at rest and 3L with activity. Given her clinical stability she was discharged back to her assisted living facility on 3/3/23.  Patient passed away on 3/3/23 at Assisted Living Facility
Age: 102.0
Sex: F
Vaccine: COVID19-2
Symptoms: Brain natriuretic peptide increased, COVID-19, Cardiac failure congestive, Chest X-ray abnormal, Computerised tomogram head abnormal
Clinical narrative: Discharge Provider: MD Primary Care Provider: MD Admission Date: 2/27/2023 Discharge Date: Mar 3, 2023  PRESENTING PROBLEM: Subdural hematoma  Hypoxia  Fall from standing, initial encounter  COVID-19    HOSPITAL COURSE: Patient is a 103 y.o. female with a past medical history of atrial fibrillation on apixaban, hyperlipidemia, choledocholithiasis status post ERCP in 2019, presenting after a fall at her independent living facility.  The patient suffered an unwitnessed fall at approximately 6:00 p.m. on 02/27 was brought to the emergency department.  The patient is extremely hard of hearing and is unable to provide history.  In the emergency department the patient was afebrile but tachycardic to the 130s.  EKG showed atrial fibrillation with RVR. She was started on metoprolol with good response in heart rates.  The patient was found to be COVID positive.  Chest x-ray showed bilateral infiltrates consistent with edema.  BNP was elevated to 4000, though stable from prior.  Troponins mildly elevated but flat.  The patient did become hypoxic and required 2 L nasal cannula.  Labs were significant for glucose of 121, bili of 1.2, AST of 51, hemoglobin of 12, white blood cell count of 629, platelets 245.  CT head was obtained that showed a subdural hematoma as well as small amount of subarachnoid hemorrhage.  Neurosurgery was contacted, as well as the patient's son/durable power of attorney, and per report from the emergency department the emergency department physician was also able to converse with the patient.  It was noted that the patient and her son did not want to pursue any surgical intervention under any circumstances.  Given the desire for no surgical intervention emergency department did discuss with Neurosurgery and felt that the patient did not require transfer to Hospital. The patient was subsequently admitted to the medicine service for further care.    Repeat CT head was stable with no further bleeding. Eliquis was stopped. Her mentation improved, though at times quite difficult to communicate with because of how hard of hearing she is, even with hearing aids.    She required oxygen from both fluid overload from CHF and COVID. She was started on steroids for COVID. She was diuresed with Lasix and improvement in oxygenation. Oxygen requirements were weaned. She did require some oxygen and pulmonary rehab was consulted who recommended 1L at rest and 3L with activity. Given her clinical stability she was discharged back to her assisted living facility on 3/3/23.  Patient passed away on 3/3/23 at Assisted Living Facility
Age: 102.0
Sex: F
Vaccine: COVID19-2
Symptoms: Condition aggravated, Death, Diuretic therapy, Electrocardiogram abnormal, Fall
Clinical narrative: Discharge Provider: MD Primary Care Provider: MD Admission Date: 2/27/2023 Discharge Date: Mar 3, 2023  PRESENTING PROBLEM: Subdural hematoma  Hypoxia  Fall from standing, initial encounter  COVID-19    HOSPITAL COURSE: Patient is a 103 y.o. female with a past medical history of atrial fibrillation on apixaban, hyperlipidemia, choledocholithiasis status post ERCP in 2019, presenting after a fall at her independent living facility.  The patient suffered an unwitnessed fall at approximately 6:00 p.m. on 02/27 was brought to the emergency department.  The patient is extremely hard of hearing and is unable to provide history.  In the emergency department the patient was afebrile but tachycardic to the 130s.  EKG showed atrial fibrillation with RVR. She was started on metoprolol with good response in heart rates.  The patient was found to be COVID positive.  Chest x-ray showed bilateral infiltrates consistent with edema.  BNP was elevated to 4000, though stable from prior.  Troponins mildly elevated but flat.  The patient did become hypoxic and required 2 L nasal cannula.  Labs were significant for glucose of 121, bili of 1.2, AST of 51, hemoglobin of 12, white blood cell count of 629, platelets 245.  CT head was obtained that showed a subdural hematoma as well as small amount of subarachnoid hemorrhage.  Neurosurgery was contacted, as well as the patient's son/durable power of attorney, and per report from the emergency department the emergency department physician was also able to converse with the patient.  It was noted that the patient and her son did not want to pursue any surgical intervention under any circumstances.  Given the desire for no surgical intervention emergency department did discuss with Neurosurgery and felt that the patient did not require transfer to Hospital. The patient was subsequently admitted to the medicine service for further care.    Repeat CT head was stable with no further bleeding. Eliquis was stopped. Her mentation improved, though at times quite difficult to communicate with because of how hard of hearing she is, even with hearing aids.    She required oxygen from both fluid overload from CHF and COVID. She was started on steroids for COVID. She was diuresed with Lasix and improvement in oxygenation. Oxygen requirements were weaned. She did require some oxygen and pulmonary rehab was consulted who recommended 1L at rest and 3L with activity. Given her clinical stability she was discharged back to her assisted living facility on 3/3/23.  Patient passed away on 3/3/23 at Assisted Living Facility
Age: 102.0
Sex: F
Vaccine: COVID19-2
Symptoms: Haemoglobin normal, Hypervolaemia, Hypoxia, Laboratory test abnormal, Lung infiltration
Clinical narrative: Discharge Provider: MD Primary Care Provider: MD Admission Date: 2/27/2023 Discharge Date: Mar 3, 2023  PRESENTING PROBLEM: Subdural hematoma  Hypoxia  Fall from standing, initial encounter  COVID-19    HOSPITAL COURSE: Patient is a 103 y.o. female with a past medical history of atrial fibrillation on apixaban, hyperlipidemia, choledocholithiasis status post ERCP in 2019, presenting after a fall at her independent living facility.  The patient suffered an unwitnessed fall at approximately 6:00 p.m. on 02/27 was brought to the emergency department.  The patient is extremely hard of hearing and is unable to provide history.  In the emergency department the patient was afebrile but tachycardic to the 130s.  EKG showed atrial fibrillation with RVR. She was started on metoprolol with good response in heart rates.  The patient was found to be COVID positive.  Chest x-ray showed bilateral infiltrates consistent with edema.  BNP was elevated to 4000, though stable from prior.  Troponins mildly elevated but flat.  The patient did become hypoxic and required 2 L nasal cannula.  Labs were significant for glucose of 121, bili of 1.2, AST of 51, hemoglobin of 12, white blood cell count of 629, platelets 245.  CT head was obtained that showed a subdural hematoma as well as small amount of subarachnoid hemorrhage.  Neurosurgery was contacted, as well as the patient's son/durable power of attorney, and per report from the emergency department the emergency department physician was also able to converse with the patient.  It was noted that the patient and her son did not want to pursue any surgical intervention under any circumstances.  Given the desire for no surgical intervention emergency department did discuss with Neurosurgery and felt that the patient did not require transfer to Hospital. The patient was subsequently admitted to the medicine service for further care.    Repeat CT head was stable with no further bleeding. Eliquis was stopped. Her mentation improved, though at times quite difficult to communicate with because of how hard of hearing she is, even with hearing aids.    She required oxygen from both fluid overload from CHF and COVID. She was started on steroids for COVID. She was diuresed with Lasix and improvement in oxygenation. Oxygen requirements were weaned. She did require some oxygen and pulmonary rehab was consulted who recommended 1L at rest and 3L with activity. Given her clinical stability she was discharged back to her assisted living facility on 3/3/23.  Patient passed away on 3/3/23 at Assisted Living Facility
Age: 102.0
Sex: F
Vaccine: COVID19-2
Symptoms: Platelet count normal, Pulmonary oedema, SARS-CoV-2 test positive, Subarachnoid haemorrhage, Subdural haematoma
Clinical narrative: Discharge Provider: MD Primary Care Provider: MD Admission Date: 2/27/2023 Discharge Date: Mar 3, 2023  PRESENTING PROBLEM: Subdural hematoma  Hypoxia  Fall from standing, initial encounter  COVID-19    HOSPITAL COURSE: Patient is a 103 y.o. female with a past medical history of atrial fibrillation on apixaban, hyperlipidemia, choledocholithiasis status post ERCP in 2019, presenting after a fall at her independent living facility.  The patient suffered an unwitnessed fall at approximately 6:00 p.m. on 02/27 was brought to the emergency department.  The patient is extremely hard of hearing and is unable to provide history.  In the emergency department the patient was afebrile but tachycardic to the 130s.  EKG showed atrial fibrillation with RVR. She was started on metoprolol with good response in heart rates.  The patient was found to be COVID positive.  Chest x-ray showed bilateral infiltrates consistent with edema.  BNP was elevated to 4000, though stable from prior.  Troponins mildly elevated but flat.  The patient did become hypoxic and required 2 L nasal cannula.  Labs were significant for glucose of 121, bili of 1.2, AST of 51, hemoglobin of 12, white blood cell count of 629, platelets 245.  CT head was obtained that showed a subdural hematoma as well as small amount of subarachnoid hemorrhage.  Neurosurgery was contacted, as well as the patient's son/durable power of attorney, and per report from the emergency department the emergency department physician was also able to converse with the patient.  It was noted that the patient and her son did not want to pursue any surgical intervention under any circumstances.  Given the desire for no surgical intervention emergency department did discuss with Neurosurgery and felt that the patient did not require transfer to Hospital. The patient was subsequently admitted to the medicine service for further care.    Repeat CT head was stable with no further bleeding. Eliquis was stopped. Her mentation improved, though at times quite difficult to communicate with because of how hard of hearing she is, even with hearing aids.    She required oxygen from both fluid overload from CHF and COVID. She was started on steroids for COVID. She was diuresed with Lasix and improvement in oxygenation. Oxygen requirements were weaned. She did require some oxygen and pulmonary rehab was consulted who recommended 1L at rest and 3L with activity. Given her clinical stability she was discharged back to her assisted living facility on 3/3/23.  Patient passed away on 3/3/23 at Assisted Living Facility
Age: 102.0
Sex: F
Vaccine: COVID19-2
Symptoms: Tachycardia, Troponin increased, White blood cell count increased
Clinical narrative: Discharge Provider: MD Primary Care Provider: MD Admission Date: 2/27/2023 Discharge Date: Mar 3, 2023  PRESENTING PROBLEM: Subdural hematoma  Hypoxia  Fall from standing, initial encounter  COVID-19    HOSPITAL COURSE: Patient is a 103 y.o. female with a past medical history of atrial fibrillation on apixaban, hyperlipidemia, choledocholithiasis status post ERCP in 2019, presenting after a fall at her independent living facility.  The patient suffered an unwitnessed fall at approximately 6:00 p.m. on 02/27 was brought to the emergency department.  The patient is extremely hard of hearing and is unable to provide history.  In the emergency department the patient was afebrile but tachycardic to the 130s.  EKG showed atrial fibrillation with RVR. She was started on metoprolol with good response in heart rates.  The patient was found to be COVID positive.  Chest x-ray showed bilateral infiltrates consistent with edema.  BNP was elevated to 4000, though stable from prior.  Troponins mildly elevated but flat.  The patient did become hypoxic and required 2 L nasal cannula.  Labs were significant for glucose of 121, bili of 1.2, AST of 51, hemoglobin of 12, white blood cell count of 629, platelets 245.  CT head was obtained that showed a subdural hematoma as well as small amount of subarachnoid hemorrhage.  Neurosurgery was contacted, as well as the patient's son/durable power of attorney, and per report from the emergency department the emergency department physician was also able to converse with the patient.  It was noted that the patient and her son did not want to pursue any surgical intervention under any circumstances.  Given the desire for no surgical intervention emergency department did discuss with Neurosurgery and felt that the patient did not require transfer to Hospital. The patient was subsequently admitted to the medicine service for further care.    Repeat CT head was stable with no further bleeding. Eliquis was stopped. Her mentation improved, though at times quite difficult to communicate with because of how hard of hearing she is, even with hearing aids.    She required oxygen from both fluid overload from CHF and COVID. She was started on steroids for COVID. She was diuresed with Lasix and improvement in oxygenation. Oxygen requirements were weaned. She did require some oxygen and pulmonary rehab was consulted who recommended 1L at rest and 3L with activity. Given her clinical stability she was discharged back to her assisted living facility on 3/3/23.  Patient passed away on 3/3/23 at Assisted Living Facility
Age: 77.0
Sex: F
Vaccine: COVID19-2
Symptoms: COVID-19, Influenza virus test, Malaise, Oropharyngeal pain, SARS-CoV-2 test
Clinical narrative: Started to feel sick Tuesday but I thought it was due to pollen I had a temperature, and my throat was sore. Went you the doctor and discovered it was COVID-19 and was given PAXLOVID. I took the medication for 5 days and I was given cough medication. I did recover after taking the medication.
Age: 77.0
Sex: F
Vaccine: COVID19-2
Symptoms: Streptococcus test
Clinical narrative: Started to feel sick Tuesday but I thought it was due to pollen I had a temperature, and my throat was sore. Went you the doctor and discovered it was COVID-19 and was given PAXLOVID. I took the medication for 5 days and I was given cough medication. I did recover after taking the medication.
Age: 67.0
Sex: F
Vaccine: COVID19-2
Symptoms: Brain fog, COVID-19, Cough, Fatigue, Nasopharyngitis
Clinical narrative: In the evening of February of 26th it felt like I was getting a head cold.  It progressed to coughing, congestion and low-grade, at which point I decided to use home COVID-19 test that came back positive. I retested the next day to make sure that it was indeed positive. I called my doctor and let them know I had tested positive for COVID-19, they called in a prescription for the Paxlovid. I started taking it immediately. Within three days I started feeling better, the brain fog was gone, the fatigue took a little longer, but it is gone now.
Age: 67.0
Sex: F
Vaccine: COVID19-2
Symptoms: Respiratory tract congestion, SARS-CoV-2 test positive
Clinical narrative: In the evening of February of 26th it felt like I was getting a head cold.  It progressed to coughing, congestion and low-grade, at which point I decided to use home COVID-19 test that came back positive. I retested the next day to make sure that it was indeed positive. I called my doctor and let them know I had tested positive for COVID-19, they called in a prescription for the Paxlovid. I started taking it immediately. Within three days I started feeling better, the brain fog was gone, the fatigue took a little longer, but it is gone now.
Age: 21.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: pt was given the original vaccine instead of the bivalent booster, pt was notified, no harm to patient was involved, just primary series given by accident, notified patient to get bivalent booster in 2 months
Age: 4.0
Sex: M
Vaccine: MNQ
Symptoms: No adverse event, Wrong product administered
Clinical narrative: Dr prescribed by accident and given, no adverse event
Age: 80.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Mental status changes
Clinical narrative: Patient came to the ED with altered mental status and admitted to the hospital with Covid.
Age: 73.0
Sex: F
Vaccine: COVID19-2
Symptoms: Abnormal dreams, COVID-19, Cough, Fatigue, Feeling abnormal
Clinical narrative: 12/12/2022   I woke up during the middle of the night and was having a very real dream, I felt strange and began having a runny nose. I was a little incoherent and went back to sleep. The next morning when I woke up, I realized I had been dreaming or hallucinating.  I began having cold symptoms. I also had a fever. 12/13/22 I went to the doctor?s office and tested negative for Flu and COVID. I was given Tamiflu. My symptoms got worse. I was very tired for a few days. On 12/16/22  I took an at home COVID test which was positive.  I called the doctor and was prescribed Paxlovid.  I took the Paxlovid. I was never really sick, just a runny nose, a little bit of cough, fatigued and had a dream or was hallucinating. I was over it fairly soon. Then on  12/26/22, I woke up feeling bad and tested positive again for COVID.  I had a runny nose and a little bit of a temperature.  It took only a few days to get over it.
Age: 73.0
Sex: F
Vaccine: COVID19-2
Symptoms: Hallucination, Incoherent, Influenza virus test negative, Middle insomnia, Nasopharyngitis
Clinical narrative: 12/12/2022   I woke up during the middle of the night and was having a very real dream, I felt strange and began having a runny nose. I was a little incoherent and went back to sleep. The next morning when I woke up, I realized I had been dreaming or hallucinating.  I began having cold symptoms. I also had a fever. 12/13/22 I went to the doctor?s office and tested negative for Flu and COVID. I was given Tamiflu. My symptoms got worse. I was very tired for a few days. On 12/16/22  I took an at home COVID test which was positive.  I called the doctor and was prescribed Paxlovid.  I took the Paxlovid. I was never really sick, just a runny nose, a little bit of cough, fatigued and had a dream or was hallucinating. I was over it fairly soon. Then on  12/26/22, I woke up feeling bad and tested positive again for COVID.  I had a runny nose and a little bit of a temperature.  It took only a few days to get over it.
Age: 73.0
Sex: F
Vaccine: COVID19-2
Symptoms: Pyrexia, Rhinorrhoea, SARS-CoV-2 test positive
Clinical narrative: 12/12/2022   I woke up during the middle of the night and was having a very real dream, I felt strange and began having a runny nose. I was a little incoherent and went back to sleep. The next morning when I woke up, I realized I had been dreaming or hallucinating.  I began having cold symptoms. I also had a fever. 12/13/22 I went to the doctor?s office and tested negative for Flu and COVID. I was given Tamiflu. My symptoms got worse. I was very tired for a few days. On 12/16/22  I took an at home COVID test which was positive.  I called the doctor and was prescribed Paxlovid.  I took the Paxlovid. I was never really sick, just a runny nose, a little bit of cough, fatigued and had a dream or was hallucinating. I was over it fairly soon. Then on  12/26/22, I woke up feeling bad and tested positive again for COVID.  I had a runny nose and a little bit of a temperature.  It took only a few days to get over it.
Age: 82.0
Sex: M
Vaccine: COVID19
Symptoms: Cough, Dyspnoea
Clinical narrative: Pt presented to the ED with shortness of breath and cough.  Patient was admitted to the hospital for covid evaluation.
Age: 70.0
Sex: M
Vaccine: COVID19
Symptoms: Echocardiogram normal, Ischaemic cerebral infarction, Ischaemic stroke, Laboratory test normal, Magnetic resonance imaging head abnormal
Clinical narrative: Patient suffered acute ischemic stroke on 7/26/22.   The symptoms were mild at onset and involved intermittent paresthesias in R face.   Went to ED and was admitted overnight.  Brain MRI showed ischemic infarcts in the deep white matter.  Embolic workup with echo and carotids clear.   Symptoms resolved quickly.   He is absolutely convinced the Moderna vaccine given in Nov 2021 caused this and demanded that an event report be filed with VAERS.
Age: 70.0
Sex: M
Vaccine: COVID19
Symptoms: Paraesthesia
Clinical narrative: Patient suffered acute ischemic stroke on 7/26/22.   The symptoms were mild at onset and involved intermittent paresthesias in R face.   Went to ED and was admitted overnight.  Brain MRI showed ischemic infarcts in the deep white matter.  Embolic workup with echo and carotids clear.   Symptoms resolved quickly.   He is absolutely convinced the Moderna vaccine given in Nov 2021 caused this and demanded that an event report be filed with VAERS.
Age: 48.0
Sex: F
Vaccine: COVID19-2
Symptoms: COVID-19, Chills, SARS-CoV-2 test positive, Tendonitis
Clinical narrative: I had minor chills after receiving the vaccine for a few hours. I tested positive for COVID-19 on 11/03/2022. I had a telehealth visit with my doctor. I was advised to keep hydrated and rest  As of today, I have tendonitis in both ears. I have been referred to an ENT.
Age: 0.42
Sex: U
Vaccine: COVID19
Symptoms: Product administered to patient of inappropriate age
Clinical narrative: Pfizer Sars-cov-2 Vaccination 6 mos - 4 y.o, Given 1 day before 6 month mark.
Age: 61.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Antinuclear antibody positive, Autoimmune disorder, Biopsy, Blood test, Urticaria
Clinical narrative: I started breaking out in Hives on 10/3/2021, many blood tests done and results were positive ANA blood test, autoimmune disease. Doctor stated vaccines triggered my system into overdrive causing daily hives
Age: 48.0
Sex: F
Vaccine: COVID19
Symptoms: Paraesthesia oral
Clinical narrative: After the first injection, within 10 minutes, I noticed that the tip of my tongue and part of my lips were tingling. It resolved within a few hours and with no intervention. It was unclear if it was associated with the vaccine.
Age: 59.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Dyspnoea, SARS-CoV-2 test positive
Clinical narrative: Patient presents to the ED with shortness of breath. He tested positive for covid. Patient was hospitalized for covid evaluation, oxygen saturation was in the 70s. Patient was treated with remdesivir.
Age: 7.0
Sex: M
Vaccine: COVID19
Symptoms: Laparotomy, No adverse event
Clinical narrative: Vaccine administered 2/27/2023 with BUD on vial 2/28/23, however, later we realized the original vial box expiration date was 2/25/23.  Called Moderna to notify and evaluate the case. They sent their email response indicating  "the vaccine administered on February 27, 2023 from lot number AR6965B maintained the activity necessary to protect against the SARS-CoV-2 (covid-19) virus at time of administration". We attempted communication with the patient but the phone number we have is not working. To this moment no adverse effects have been reported.
Age: 37.0
Sex: F
Vaccine: COVID19-2
Symptoms: Breast mass, Magnetic resonance imaging breast abnormal
Clinical narrative: A lump was found on my left breast in February 2023 (6x5x4mm). The only reason I got the breast MRI was because I was found to have the Braca1 gene found after I had my colonoscopy. At this time, I am not having a biopsy. I will be having a mastectomy soon.
Age: 65.0
Sex: F
Vaccine: HEP, PNC20
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth, Pyrexia
Clinical narrative: Complained of pain, arm redness, swelling and warmth to right upper arm at injection site the morning after prevnar vaccine injection. Subjective fever two nights.
Age: 15.0
Sex: F
Vaccine: COVID19-2
Symptoms: Incorrect product formulation administered
Clinical narrative: Covid Monovalent was order but patient receive bivalent
Age: 55.0
Sex: M
Vaccine: COVID19, FLUA4
Symptoms: Fatigue, Weight increased
Clinical narrative: Two months after vaccine, started feeling really fatigued and gaining weight.
Age: 9.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered, No adverse event
Clinical narrative: Vaccine administered 2/27/2023 with BUD on vial 2/28/23, however, later we realized the original vial box expiration date was 2/25/23. Called Moderna to notify and evaluate the case. They sent their email response indicating  "the vaccine administered on February 27, 2023 from lot number AR6965B maintained the activity necessary to protect against the SARS-CoV-2 (covid-19) virus at time of administration". We attempted communication with the patient but the phone number we have is not working. To this moment no adverse effects have been reported.
Age: 1.75
Sex: F
Vaccine: DTAPIPV
Symptoms: No adverse event, Product administered to patient of inappropriate age
Clinical narrative: Kinrix was given outside of the age range. No adverse reactions happened
Age: 68.0
Sex: M
Vaccine: COVID19-2
Symptoms: COVID-19, Cough, Headache, Malaise, Pyrexia
Clinical narrative: I was positive for COVID-19 on 22DEC2022, I was feeling very sick. I had a fever runny nose, headache and coughing. I started feeling better about 2 days later, I saw urgent care and they gave me PAXLOVID which made me feel better.
Age: 68.0
Sex: M
Vaccine: COVID19-2
Symptoms: Rhinorrhoea, SARS-CoV-2 test positive
Clinical narrative: I was positive for COVID-19 on 22DEC2022, I was feeling very sick. I had a fever runny nose, headache and coughing. I started feeling better about 2 days later, I saw urgent care and they gave me PAXLOVID which made me feel better.
Age: 32.0
Sex: F
Vaccine: COVID19
Symptoms: Exposure during pregnancy
Clinical narrative: At the time of receiving this vaccine, I was 26 weeks and 2 days pregnant. My son was born on October 25, 2022 (at 38w1d) weighing 7 pounds 8 ounces. His circumcision was performed on his second day of life and the site would not stop bleeding. After multiple unsuccessful applications of surgicel gauze, a pediatric urologist gave him three stitches. His penis bruising turned black over the subsequent two weeks.   Additionally, on day three of life, his bilirubin was tested and came back at 19.9 mg/dL. He spent three days in a bilirubin light therapy box. During that time we did daily heel pricks to reevaluate his bili levels. Results were 20.1 on day two and 13.1 mg/dL on day three. There was significant bruising associated with the daily heel pricks.  At two weeks old (11-8-22), his umbilical cord fell out and his belly button began to bleed. We then had a CBC done and found his platelets count was 9,000/uL. We were admitted to Hospital for 2 days. Dr (hematologist) diagnosed child with autoimmune thrombocytopenia and administered an IVIG as well as a platelet transfusion. After the transfusions his platelets were up to 49,000 and we were discharged from the hospital.   At six weeks old (12-6-22), we had a follow up blood draw and child's platelets were at 50,000/uL.   At seven weeks old (12-13-22), we were readmited to Hospital with platelet count down to 18,000 and bilirubin back up to 10. We were observed for two days and released with an expectation to continue follow ups with Dr.   At eight weeks old (12-20-22), Dr ran another blood work and child's platelets were up to 211,000.   At 12 weeks old (1-19-23), Dr  ran another blood work and child's platelets were at 138,000 K/mm3 (L). At that time Dr determined child's platelets were stable and we no longer needed additional monitoring.
Age: 11.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered, No adverse event
Clinical narrative: Vaccine was administered on 2-27-2023 with BUD (Beyond Use Date) in vial 2-28-23, however, we later realized that the original box of the vial had an expiration date of 2-25-23. Moderna was called to be notify and evaluate the case. They sent their response via email indicating - "the vaccine administered on February 27, 2023 from lot number AR6965B maintained the activity necessary to protect against the SARS-CoV-2 (covid-19) virus at time of administration". We tried to contact the patient but the phone number we have is not working. So far no adverse effects have been reported.
Age: 71.0
Sex: M
Vaccine: COVID19-2
Symptoms: Expired product administered, No adverse event, Product storage error, Vaccination error
Clinical narrative: The error was an administration error where the vaccine was used 6 days after the bud date.  The vial was moved from  the freezer on 1/30/23 to the frig, the vial stayed in the frig  until 3/7/23 about 1:50 pm, and the vaccine from that vial was administered on 3/7/23 about 2:05 pm.  I have contacted Moderna about the stability after the BUD and they replied that the vaccine maintained the activity necessary to protect against the SARS-CoV-2 (COVID-19) virus at time of administration.    I contacted the patient about side effects and the patient reported no side effects.
Age: 3.0
Sex: M
Vaccine: DTAPIPV
Symptoms: No adverse event, Product administered to patient of inappropriate age
Clinical narrative: Kinrix given outside of suggested age range, no adverse reactions.
Age: 16.0
Sex: F
Vaccine: HPV9, MENB
Symptoms: Administration site erythema, Administration site reaction, Administration site swelling, Muscular weakness
Clinical narrative: Patient presented  to clinic 2 days after vaccine administration with redness, swelling and weakness on arm where injection was administered.
Age: 57.0
Sex: M
Vaccine: COVID19-2
Symptoms: COVID-19, Decreased appetite, Nasal congestion, Oropharyngeal pain, Pyrexia
Clinical narrative: The symptoms began on that Monday evening with scratchy throat. By 8pm, I was running a fever. For about 3 days, I ran a fever between 101-102. Then there was a 4th day with my fever being 100 before the fever finally broke after 4 days. Starting on the 2nd or 3rd day, I developed nasal congestion and drainage. I had a week or more of nasal congestion, drainage, and occasional sore throat related to that drainage. I felt really back to normal on day 9 or 10. I was pretty functional days 6-8 but only about 90% there. Still with some nasal congestion at that point, but more of just an annoyance. I tested on day 1 24 hours in with an at home test which was positive. Late day 2 was when I had my video conference with the NP. I was prescribed Paxlovid, but she recommended that the medication may not do much for me. I never took the Paxlovid. That was the only healthcare interaction I had. I just treated it with a lot of rest and liquids. I also didn't have much of an appetite for 4 days. Appetite was back to normal by day 5.
Age: 57.0
Sex: M
Vaccine: COVID19-2
Symptoms: Rhinorrhoea, SARS-CoV-2 test positive, Throat irritation
Clinical narrative: The symptoms began on that Monday evening with scratchy throat. By 8pm, I was running a fever. For about 3 days, I ran a fever between 101-102. Then there was a 4th day with my fever being 100 before the fever finally broke after 4 days. Starting on the 2nd or 3rd day, I developed nasal congestion and drainage. I had a week or more of nasal congestion, drainage, and occasional sore throat related to that drainage. I felt really back to normal on day 9 or 10. I was pretty functional days 6-8 but only about 90% there. Still with some nasal congestion at that point, but more of just an annoyance. I tested on day 1 24 hours in with an at home test which was positive. Late day 2 was when I had my video conference with the NP. I was prescribed Paxlovid, but she recommended that the medication may not do much for me. I never took the Paxlovid. That was the only healthcare interaction I had. I just treated it with a lot of rest and liquids. I also didn't have much of an appetite for 4 days. Appetite was back to normal by day 5.
Age: 92.0
Sex: M
Vaccine: COVID19
Symptoms: Acute kidney injury, Blood creatinine increased, Blood lactic acid, COVID-19, Chills
Clinical narrative: This is a 93-year-old male patient that presents to the ER today with complaints of cough, fever along with vomiting x2 days.  The patient states he only vomited once and that was 2 days ago.  Today he denies any chest pain, shortness of breath, wheezing, abdominal pain or nausea and vomiting.  He denies any diarrhea.  He did call his primary care provider who felt that he should be evaluated in the ER today due to his age.  The patient is alert, cooperative and oriented x3.  He does appear nontoxic.  His son is at the bedside.  He does have a history of pacemaker, hypertension, sleep apnea, coronary artery disease and hyperlipidemia. Associated Symptoms: chills, cough, fever, nausea, URI symptoms, vomiting