chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 85.0
Sex: M
Vaccine: COVID19
Symptoms: Pulmonary oedema, Respiratory failure, SARS-CoV-2 test positive, Sepsis, Shock
Clinical narrative: Patient is an 87 year old  male with a history of Afib, mechanical MV,  Anemia, NSCLC, 3rd degree AV block s/p AICD, Heart Failure, CKD IV, who presented to Facility 10/31/23 with shock, hypoxic respiratory failure requiring ICU stay and transferred out of the ICU with improvement after finding COVID-19, Pseudomonas Pneumonia with course complicated with dysphagia and respiratory failure and decision made to pursue comfort care. He passed away on 11/13/23 at 0645.    1. End Of Life Care: secondary to dysphagia, cachexia, persistent respiratory failure. Palliative followed. Comfort medications provided.  2. Acute Respiratory Failure: Secondary to mucous plugging, pulmonary edema, pneumonia with COVID-19 and Pseudomonas. Repeat bronchoscopy on 11/4/23. Pulmonology followed. Given intolerance to BiPAP and worsening overall condition decision made to pursue comfort care. 3. COVID 19: Positive PCR from bronchial washings on 11/4/23.  Began on Remdesivir for 5 days ending 11/9/2023, s/p decadron.  4. Pseudomonas Pneumonia with Sepsis: sepsis now resolved, positive from bronch washings on 11/4/2023.  Began on Cefepime on 11/5/23, switched to IV Cipro 11/6/23 but stopped after transition to CC 11/8/23  5. AKI on CKD stage 4: Thought to be due to shock with baseline creatinine around 2-2.3. Comfort care.  6. Chronic Anemia: Hb stable in the 9s. Stopped trending CBC give goals of care. 7. Thrombocytopenia: likely reactive. Platelets 135k on 11/6/23.   8. Atrial Fibrillation: symptomatic care 9. Chronic Systolic Heart Failure: TTE on 11/1/23 with EF of 32%.  10. Dysphagia: MBS 11/8/23 with aspiration to all substances. Comfort care with comfort diet.    Patient passed away on 11/13/23 at 0645. Spoke with patient's grandson and chaplain met with patient's wife and grandson as well.
Age: 85.0
Sex: M
Vaccine: COVID19
Symptoms: Thrombocytopenia
Clinical narrative: Patient is an 87 year old  male with a history of Afib, mechanical MV,  Anemia, NSCLC, 3rd degree AV block s/p AICD, Heart Failure, CKD IV, who presented to Facility 10/31/23 with shock, hypoxic respiratory failure requiring ICU stay and transferred out of the ICU with improvement after finding COVID-19, Pseudomonas Pneumonia with course complicated with dysphagia and respiratory failure and decision made to pursue comfort care. He passed away on 11/13/23 at 0645.    1. End Of Life Care: secondary to dysphagia, cachexia, persistent respiratory failure. Palliative followed. Comfort medications provided.  2. Acute Respiratory Failure: Secondary to mucous plugging, pulmonary edema, pneumonia with COVID-19 and Pseudomonas. Repeat bronchoscopy on 11/4/23. Pulmonology followed. Given intolerance to BiPAP and worsening overall condition decision made to pursue comfort care. 3. COVID 19: Positive PCR from bronchial washings on 11/4/23.  Began on Remdesivir for 5 days ending 11/9/2023, s/p decadron.  4. Pseudomonas Pneumonia with Sepsis: sepsis now resolved, positive from bronch washings on 11/4/2023.  Began on Cefepime on 11/5/23, switched to IV Cipro 11/6/23 but stopped after transition to CC 11/8/23  5. AKI on CKD stage 4: Thought to be due to shock with baseline creatinine around 2-2.3. Comfort care.  6. Chronic Anemia: Hb stable in the 9s. Stopped trending CBC give goals of care. 7. Thrombocytopenia: likely reactive. Platelets 135k on 11/6/23.   8. Atrial Fibrillation: symptomatic care 9. Chronic Systolic Heart Failure: TTE on 11/1/23 with EF of 32%.  10. Dysphagia: MBS 11/8/23 with aspiration to all substances. Comfort care with comfort diet.    Patient passed away on 11/13/23 at 0645. Spoke with patient's grandson and chaplain met with patient's wife and grandson as well.
Age: 0.17
Sex: M
Vaccine: DTPPVHBHPB, FLU4, PNC13, RV5
Symptoms: No adverse event, Product administered to patient of inappropriate age
Clinical narrative: Individual did not experience any adverse reactions.  Influenza was given under recommended age.
Age: 56.0
Sex: F
Vaccine: COVID19-2
Symptoms: Acute kidney injury, Asthenia, COVID-19, Chest X-ray normal, Cough
Clinical narrative: Patient is a 56 y.o. female patient of MD with history of history of multiple sclerosis, hypertension hyperlipidemia and degenerative joint disease  presented to Hospital with fever, generalized weakness, found to have COVID infection and AKI.   Covid-19 Virus Infection Generalized weakness Date of onset of symptoms: 11/7/2023 Symptoms present on admission: Fever, weakness, dry cough, myalgias.  Symptoms resolving by time of discharge Date of covid positive test: 11/9/23 Vaccination status: vaccinated Imaging: Chest x-ray, negative for acute cardiopulmonary process Oxygen requirements on admission: None  Current oxygen requirements: none  Medical therapy: Paxlovid initiated 11/11/2023, continue on discharge for 2 additional days to complete 5 days therapy Consultants following: ID  Anticipated special isolation end date: 11/19/23   Leukopenia: Likely secondary to COVID-19 Follow-up CBC in outpatient setting to demonstrate resolution   Chronic primary progressive multiple sclerosis Monitor, not in flare   Acute kidney injury, resolved Likely prerenal in the setting of COVID-19 infection and decreased fluid intake Holding losartan and hydrochlorothiazide BP relatively controlled throughout hospitalization.  Continue to hold hydrochlorothiazide on discharge until follow-up with PCP.  Resume losartan   Reported loose or diarrhea Resolving inpatient with hold of home stool softeners Continue to monitor   Hypertension Hold losartan hydrochlorothiazide as above BP relatively controlled throughout hospitalization.  Continue to hold hydrochlorothiazide on discharge until follow-up with PCP.  Resume losartan Hyperlipidemia On statin therapy and Zetia   History of hyperuricemia On allopurinol   Vestibular neuritis Taking meclizine as needed   Obesity: BMI 38 Dietary and lifestyle modifications Follow-up with PCP
Age: 56.0
Sex: F
Vaccine: COVID19-2
Symptoms: Diarrhoea, Fluid intake reduced, Leukopenia, Myalgia, Pyrexia
Clinical narrative: Patient is a 56 y.o. female patient of MD with history of history of multiple sclerosis, hypertension hyperlipidemia and degenerative joint disease  presented to Hospital with fever, generalized weakness, found to have COVID infection and AKI.   Covid-19 Virus Infection Generalized weakness Date of onset of symptoms: 11/7/2023 Symptoms present on admission: Fever, weakness, dry cough, myalgias.  Symptoms resolving by time of discharge Date of covid positive test: 11/9/23 Vaccination status: vaccinated Imaging: Chest x-ray, negative for acute cardiopulmonary process Oxygen requirements on admission: None  Current oxygen requirements: none  Medical therapy: Paxlovid initiated 11/11/2023, continue on discharge for 2 additional days to complete 5 days therapy Consultants following: ID  Anticipated special isolation end date: 11/19/23   Leukopenia: Likely secondary to COVID-19 Follow-up CBC in outpatient setting to demonstrate resolution   Chronic primary progressive multiple sclerosis Monitor, not in flare   Acute kidney injury, resolved Likely prerenal in the setting of COVID-19 infection and decreased fluid intake Holding losartan and hydrochlorothiazide BP relatively controlled throughout hospitalization.  Continue to hold hydrochlorothiazide on discharge until follow-up with PCP.  Resume losartan   Reported loose or diarrhea Resolving inpatient with hold of home stool softeners Continue to monitor   Hypertension Hold losartan hydrochlorothiazide as above BP relatively controlled throughout hospitalization.  Continue to hold hydrochlorothiazide on discharge until follow-up with PCP.  Resume losartan Hyperlipidemia On statin therapy and Zetia   History of hyperuricemia On allopurinol   Vestibular neuritis Taking meclizine as needed   Obesity: BMI 38 Dietary and lifestyle modifications Follow-up with PCP
Age: 56.0
Sex: F
Vaccine: COVID19-2
Symptoms: SARS-CoV-2 test positive
Clinical narrative: Patient is a 56 y.o. female patient of MD with history of history of multiple sclerosis, hypertension hyperlipidemia and degenerative joint disease  presented to Hospital with fever, generalized weakness, found to have COVID infection and AKI.   Covid-19 Virus Infection Generalized weakness Date of onset of symptoms: 11/7/2023 Symptoms present on admission: Fever, weakness, dry cough, myalgias.  Symptoms resolving by time of discharge Date of covid positive test: 11/9/23 Vaccination status: vaccinated Imaging: Chest x-ray, negative for acute cardiopulmonary process Oxygen requirements on admission: None  Current oxygen requirements: none  Medical therapy: Paxlovid initiated 11/11/2023, continue on discharge for 2 additional days to complete 5 days therapy Consultants following: ID  Anticipated special isolation end date: 11/19/23   Leukopenia: Likely secondary to COVID-19 Follow-up CBC in outpatient setting to demonstrate resolution   Chronic primary progressive multiple sclerosis Monitor, not in flare   Acute kidney injury, resolved Likely prerenal in the setting of COVID-19 infection and decreased fluid intake Holding losartan and hydrochlorothiazide BP relatively controlled throughout hospitalization.  Continue to hold hydrochlorothiazide on discharge until follow-up with PCP.  Resume losartan   Reported loose or diarrhea Resolving inpatient with hold of home stool softeners Continue to monitor   Hypertension Hold losartan hydrochlorothiazide as above BP relatively controlled throughout hospitalization.  Continue to hold hydrochlorothiazide on discharge until follow-up with PCP.  Resume losartan Hyperlipidemia On statin therapy and Zetia   History of hyperuricemia On allopurinol   Vestibular neuritis Taking meclizine as needed   Obesity: BMI 38 Dietary and lifestyle modifications Follow-up with PCP
Age: 85.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: VACCINE GIVEN AFTER VIABILITY DATE
Age: 51.0
Sex: F
Vaccine: COVID19-2, FLUC4
Symptoms: Dysmenorrhoea, Menopause, Menstrual disorder
Clinical narrative: Dysmenorrhea during perimenopause. Pattern of the cycle started light and is gradually heavier with time, which is opposite the usual pattern. Prior to this, the cycle was 62 days long.
Age: 63.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Catheterisation cardiac normal, Chest X-ray abnormal, Chest pain, Echocardiogram abnormal
Clinical narrative: Patient is a 63 y.o. female who resides at home and presented from ED  on 11/3/2023 with chest pain and elevated troponin.  Also found to be COVID positive.  She was found to have new onset Cardiomyopathy with EF reduction.  LHC performed which showed no CAD - most consistent with viral vs Stress Induced CM.         Assessment and Plan   Cardiac Injury -Presented with chest pain, fever - found to have Covid and elevated Troponin with positive delta (110 > 242) -Echo as below, LHC without evidence of obstructive CAD. - Continue GDMT.  Repeat echocardiogram as an outpatient.   Cardiomyopathy HFrEF, without exacerbation -Unclear if ischemic versus stress/viral cardiomyopathy -Echo with EF 35 to 40% - LDL 81, A1c 5.7% - LHC without CAD as above.  Continue BB and ARB; repeat echocardiogram to assess for EF recovery.   Covid-19 Virus Infection -Symptoms consisted of rhinorhea, chest congestion, fever -Date of covid positive test: 11/3/23 (just returned from a Cruise) -Vaccinated with recent booster -CXR shows patchy opacity overlying the left lower lung zone  -Not requiring supple oxygen, room air sat mid 90's -Afebrile, non-toxic appearing   Pre-Diabetes Obesity - BMI 30.51 - A1c 5.7%. - Continue dietary and lifestyle modification as tolerated.   Depression -Continue Wellbutri
Age: 63.0
Sex: F
Vaccine: COVID19
Symptoms: Ejection fraction decreased, Glycosylated haemoglobin normal, Ischaemic cardiomyopathy, Left ventricular failure, Low density lipoprotein normal
Clinical narrative: Patient is a 63 y.o. female who resides at home and presented from ED  on 11/3/2023 with chest pain and elevated troponin.  Also found to be COVID positive.  She was found to have new onset Cardiomyopathy with EF reduction.  LHC performed which showed no CAD - most consistent with viral vs Stress Induced CM.         Assessment and Plan   Cardiac Injury -Presented with chest pain, fever - found to have Covid and elevated Troponin with positive delta (110 > 242) -Echo as below, LHC without evidence of obstructive CAD. - Continue GDMT.  Repeat echocardiogram as an outpatient.   Cardiomyopathy HFrEF, without exacerbation -Unclear if ischemic versus stress/viral cardiomyopathy -Echo with EF 35 to 40% - LDL 81, A1c 5.7% - LHC without CAD as above.  Continue BB and ARB; repeat echocardiogram to assess for EF recovery.   Covid-19 Virus Infection -Symptoms consisted of rhinorhea, chest congestion, fever -Date of covid positive test: 11/3/23 (just returned from a Cruise) -Vaccinated with recent booster -CXR shows patchy opacity overlying the left lower lung zone  -Not requiring supple oxygen, room air sat mid 90's -Afebrile, non-toxic appearing   Pre-Diabetes Obesity - BMI 30.51 - A1c 5.7%. - Continue dietary and lifestyle modification as tolerated.   Depression -Continue Wellbutri
Age: 63.0
Sex: F
Vaccine: COVID19
Symptoms: Lung opacity, Myocardial injury, Pyrexia, Respiratory tract congestion, Rhinorrhoea
Clinical narrative: Patient is a 63 y.o. female who resides at home and presented from ED  on 11/3/2023 with chest pain and elevated troponin.  Also found to be COVID positive.  She was found to have new onset Cardiomyopathy with EF reduction.  LHC performed which showed no CAD - most consistent with viral vs Stress Induced CM.         Assessment and Plan   Cardiac Injury -Presented with chest pain, fever - found to have Covid and elevated Troponin with positive delta (110 > 242) -Echo as below, LHC without evidence of obstructive CAD. - Continue GDMT.  Repeat echocardiogram as an outpatient.   Cardiomyopathy HFrEF, without exacerbation -Unclear if ischemic versus stress/viral cardiomyopathy -Echo with EF 35 to 40% - LDL 81, A1c 5.7% - LHC without CAD as above.  Continue BB and ARB; repeat echocardiogram to assess for EF recovery.   Covid-19 Virus Infection -Symptoms consisted of rhinorhea, chest congestion, fever -Date of covid positive test: 11/3/23 (just returned from a Cruise) -Vaccinated with recent booster -CXR shows patchy opacity overlying the left lower lung zone  -Not requiring supple oxygen, room air sat mid 90's -Afebrile, non-toxic appearing   Pre-Diabetes Obesity - BMI 30.51 - A1c 5.7%. - Continue dietary and lifestyle modification as tolerated.   Depression -Continue Wellbutri
Age: 63.0
Sex: F
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive, Stress cardiomyopathy, Troponin increased, Viral cardiomyopathy
Clinical narrative: Patient is a 63 y.o. female who resides at home and presented from ED  on 11/3/2023 with chest pain and elevated troponin.  Also found to be COVID positive.  She was found to have new onset Cardiomyopathy with EF reduction.  LHC performed which showed no CAD - most consistent with viral vs Stress Induced CM.         Assessment and Plan   Cardiac Injury -Presented with chest pain, fever - found to have Covid and elevated Troponin with positive delta (110 > 242) -Echo as below, LHC without evidence of obstructive CAD. - Continue GDMT.  Repeat echocardiogram as an outpatient.   Cardiomyopathy HFrEF, without exacerbation -Unclear if ischemic versus stress/viral cardiomyopathy -Echo with EF 35 to 40% - LDL 81, A1c 5.7% - LHC without CAD as above.  Continue BB and ARB; repeat echocardiogram to assess for EF recovery.   Covid-19 Virus Infection -Symptoms consisted of rhinorhea, chest congestion, fever -Date of covid positive test: 11/3/23 (just returned from a Cruise) -Vaccinated with recent booster -CXR shows patchy opacity overlying the left lower lung zone  -Not requiring supple oxygen, room air sat mid 90's -Afebrile, non-toxic appearing   Pre-Diabetes Obesity - BMI 30.51 - A1c 5.7%. - Continue dietary and lifestyle modification as tolerated.   Depression -Continue Wellbutri
Age: 80.0
Sex: M
Vaccine: COVID19-2
Symptoms: Acute respiratory failure, Arthralgia, Asthenia, Bone scan abnormal, COVID-19
Clinical narrative: Patient is a 81 y.o. male patient of DO with history of COPD, HFpEF, hypertension, hyperlipidemia, Parkinson disease, physical deconditioning presented to Hospital with complaints of shortness of breath with exertion, frequent falls.   Acute respiratory failure with hypoxia?resolved Presented with shortness of breath Easily desats with acute to 80s, with minimal exertion Combination of post-COVID 19, CHF, COPD Was able to wean to room air this a.m. Supplemental O2 if required   Covid-19 Virus Infection Date of onset of symptoms: 10/29/2023 Symptoms present on admission: Shortness of breath with exertion Date of covid positive test: Official testing positive on 10/20/2023, but was tested positive on 10/17 with home COVID-19 test.  After discussion with infectious control isolation is continued, will discontinue steroids as well Vaccination status: vaccinated Imaging: CT without acute pathology Oxygen requirements on admission: 2 L Current oxygen requirements: RA Medical therapy: steroids Consultants following: N/A Anticipated special isolation end date: No need for isolation     COPD Not in exacerbation Continue bronchodilators as needed and scheduled   Right knee pain X-ray concerning for displacement/dislodgment radiolucent portion  of the prosthesis  Was ordered NM three-phase bone scan, will order while in the hospital NM triphase bone scan?concerning for healing fracture Discussed with Dr., no surgical intervention is planned Continue PT/OT after discharge, with partial weightbearing Continue ROM exercises, outpatient follow-up with orthopedic surgery Follow-up information is in AVS  Chronic HFpEF Overall euvolemic appearing But has few crackles at the bases on auscultation Given x1 dose of Lasix in ED     Paroxysmal atrial fibrillation Rhythm NSR Rate control Not on systemic anticoagulation     Generalized weakness Physical deconditioning Recurrent falls Combination of COVID infection, physical deconditioning Obesity, COPD and CHF, and right knee pain DC to SNF      Parkinson's disease Continue home Sinemet   Dementia without behavioral disturbances Continue home meds      Anxiety and depression Continue home Zoloft/BuSpar   Chronic antibiotic use Patient on Keflex 500 mg twice daily To my knowledge presumed for suppressive therapy for knee infection? However cannot localize any documentation about this I recommend follow-up with prescribing physician To further discuss if long-term antibiotic therapy is warrante
Age: 80.0
Sex: M
Vaccine: COVID19-2
Symptoms: Cardiac failure congestive, Chronic obstructive pulmonary disease, Computerised tomogram normal, Condition aggravated, Dyspnoea
Clinical narrative: Patient is a 81 y.o. male patient of DO with history of COPD, HFpEF, hypertension, hyperlipidemia, Parkinson disease, physical deconditioning presented to Hospital with complaints of shortness of breath with exertion, frequent falls.   Acute respiratory failure with hypoxia?resolved Presented with shortness of breath Easily desats with acute to 80s, with minimal exertion Combination of post-COVID 19, CHF, COPD Was able to wean to room air this a.m. Supplemental O2 if required   Covid-19 Virus Infection Date of onset of symptoms: 10/29/2023 Symptoms present on admission: Shortness of breath with exertion Date of covid positive test: Official testing positive on 10/20/2023, but was tested positive on 10/17 with home COVID-19 test.  After discussion with infectious control isolation is continued, will discontinue steroids as well Vaccination status: vaccinated Imaging: CT without acute pathology Oxygen requirements on admission: 2 L Current oxygen requirements: RA Medical therapy: steroids Consultants following: N/A Anticipated special isolation end date: No need for isolation     COPD Not in exacerbation Continue bronchodilators as needed and scheduled   Right knee pain X-ray concerning for displacement/dislodgment radiolucent portion  of the prosthesis  Was ordered NM three-phase bone scan, will order while in the hospital NM triphase bone scan?concerning for healing fracture Discussed with Dr., no surgical intervention is planned Continue PT/OT after discharge, with partial weightbearing Continue ROM exercises, outpatient follow-up with orthopedic surgery Follow-up information is in AVS  Chronic HFpEF Overall euvolemic appearing But has few crackles at the bases on auscultation Given x1 dose of Lasix in ED     Paroxysmal atrial fibrillation Rhythm NSR Rate control Not on systemic anticoagulation     Generalized weakness Physical deconditioning Recurrent falls Combination of COVID infection, physical deconditioning Obesity, COPD and CHF, and right knee pain DC to SNF      Parkinson's disease Continue home Sinemet   Dementia without behavioral disturbances Continue home meds      Anxiety and depression Continue home Zoloft/BuSpar   Chronic antibiotic use Patient on Keflex 500 mg twice daily To my knowledge presumed for suppressive therapy for knee infection? However cannot localize any documentation about this I recommend follow-up with prescribing physician To further discuss if long-term antibiotic therapy is warrante
Age: 80.0
Sex: M
Vaccine: COVID19-2
Symptoms: Dyspnoea exertional, Fall, Hypoxia, Oxygen saturation decreased, Physical deconditioning
Clinical narrative: Patient is a 81 y.o. male patient of DO with history of COPD, HFpEF, hypertension, hyperlipidemia, Parkinson disease, physical deconditioning presented to Hospital with complaints of shortness of breath with exertion, frequent falls.   Acute respiratory failure with hypoxia?resolved Presented with shortness of breath Easily desats with acute to 80s, with minimal exertion Combination of post-COVID 19, CHF, COPD Was able to wean to room air this a.m. Supplemental O2 if required   Covid-19 Virus Infection Date of onset of symptoms: 10/29/2023 Symptoms present on admission: Shortness of breath with exertion Date of covid positive test: Official testing positive on 10/20/2023, but was tested positive on 10/17 with home COVID-19 test.  After discussion with infectious control isolation is continued, will discontinue steroids as well Vaccination status: vaccinated Imaging: CT without acute pathology Oxygen requirements on admission: 2 L Current oxygen requirements: RA Medical therapy: steroids Consultants following: N/A Anticipated special isolation end date: No need for isolation     COPD Not in exacerbation Continue bronchodilators as needed and scheduled   Right knee pain X-ray concerning for displacement/dislodgment radiolucent portion  of the prosthesis  Was ordered NM three-phase bone scan, will order while in the hospital NM triphase bone scan?concerning for healing fracture Discussed with Dr., no surgical intervention is planned Continue PT/OT after discharge, with partial weightbearing Continue ROM exercises, outpatient follow-up with orthopedic surgery Follow-up information is in AVS  Chronic HFpEF Overall euvolemic appearing But has few crackles at the bases on auscultation Given x1 dose of Lasix in ED     Paroxysmal atrial fibrillation Rhythm NSR Rate control Not on systemic anticoagulation     Generalized weakness Physical deconditioning Recurrent falls Combination of COVID infection, physical deconditioning Obesity, COPD and CHF, and right knee pain DC to SNF      Parkinson's disease Continue home Sinemet   Dementia without behavioral disturbances Continue home meds      Anxiety and depression Continue home Zoloft/BuSpar   Chronic antibiotic use Patient on Keflex 500 mg twice daily To my knowledge presumed for suppressive therapy for knee infection? However cannot localize any documentation about this I recommend follow-up with prescribing physician To further discuss if long-term antibiotic therapy is warrante
Age: 80.0
Sex: M
Vaccine: COVID19-2
Symptoms: Post-acute COVID-19 syndrome, Rales, SARS-CoV-2 test positive, Sinus rhythm, X-ray limb abnormal
Clinical narrative: Patient is a 81 y.o. male patient of DO with history of COPD, HFpEF, hypertension, hyperlipidemia, Parkinson disease, physical deconditioning presented to Hospital with complaints of shortness of breath with exertion, frequent falls.   Acute respiratory failure with hypoxia?resolved Presented with shortness of breath Easily desats with acute to 80s, with minimal exertion Combination of post-COVID 19, CHF, COPD Was able to wean to room air this a.m. Supplemental O2 if required   Covid-19 Virus Infection Date of onset of symptoms: 10/29/2023 Symptoms present on admission: Shortness of breath with exertion Date of covid positive test: Official testing positive on 10/20/2023, but was tested positive on 10/17 with home COVID-19 test.  After discussion with infectious control isolation is continued, will discontinue steroids as well Vaccination status: vaccinated Imaging: CT without acute pathology Oxygen requirements on admission: 2 L Current oxygen requirements: RA Medical therapy: steroids Consultants following: N/A Anticipated special isolation end date: No need for isolation     COPD Not in exacerbation Continue bronchodilators as needed and scheduled   Right knee pain X-ray concerning for displacement/dislodgment radiolucent portion  of the prosthesis  Was ordered NM three-phase bone scan, will order while in the hospital NM triphase bone scan?concerning for healing fracture Discussed with Dr., no surgical intervention is planned Continue PT/OT after discharge, with partial weightbearing Continue ROM exercises, outpatient follow-up with orthopedic surgery Follow-up information is in AVS  Chronic HFpEF Overall euvolemic appearing But has few crackles at the bases on auscultation Given x1 dose of Lasix in ED     Paroxysmal atrial fibrillation Rhythm NSR Rate control Not on systemic anticoagulation     Generalized weakness Physical deconditioning Recurrent falls Combination of COVID infection, physical deconditioning Obesity, COPD and CHF, and right knee pain DC to SNF      Parkinson's disease Continue home Sinemet   Dementia without behavioral disturbances Continue home meds      Anxiety and depression Continue home Zoloft/BuSpar   Chronic antibiotic use Patient on Keflex 500 mg twice daily To my knowledge presumed for suppressive therapy for knee infection? However cannot localize any documentation about this I recommend follow-up with prescribing physician To further discuss if long-term antibiotic therapy is warrante
Age: 70.0
Sex: F
Vaccine: VARZOS
Symptoms: Influenza like illness, Rash erythematous, Tenderness
Clinical narrative: red and then dark rash approximately 6 inches long by 3 inches wide, irregular shape. painful to the touch, felt like a bruise, flu like symptoms
Age: 64.0
Sex: F
Vaccine: FLUA4
Symptoms: No adverse event, Product administered to patient of inappropriate age
Clinical narrative: Patient was given High dose but was only 64, no reaction.
Age: 0.33
Sex: F
Vaccine: HIBV
Symptoms: Crying, Discomfort, Dyskinesia, Infantile colic, Screaming
Clinical narrative: The child began to be colicky which turned into being inconsolable, to the point where there was nothing we the parents could do to stop her from absolute scream crying. She would also contort her body in an unusual manner, leading us to believe that she was very uncomfortable. The symptoms lasted for ~14 days. We were unaware at the time of what to do, so we consoled her the best we could.
Age: 83.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: VACCINE GIVEN AFTER VIABILITY DATE
Age: 73.0
Sex: F
Vaccine: COVID19
Symptoms: Acute respiratory failure, Angiogram pulmonary normal, Atelectasis, Blood culture negative, COVID-19
Clinical narrative: Patient is a 74 y.o. F with a PMH of IDDM2 and schizoaffective disorder with recent hospitalization 7/18/23-8/7/23 for respiratory failure requiring BIPAP, pulmonary edema, and possible CAP. She presented to hospital on 11/4/23 after being found unresponsive at SNF requiring bipap on admit and ICU stay. She was found to have COVID 19 infection, hypercarbia and UTI. Course complicated by ileus. Company consulted on 11/6/23 to assume care out of MICU.    1. Acute Hypoxic and Hypercarbic Respiratory Failure: on 2L O2 at baseline. Prior admit for similar and required BIPAP. Respiratory failure then thought to be due to atelectasis, pulmonary edema, and possible CAP. TTE 7/19/23 with LVEF 60%, normal diastolic function. Prior notes mentioned concern for possible ILD and suspected OSA/OHS. Presented with hypoxia and hypercarbia with pCO2 in 90's requiring BIPAP. Also with COVID. CTPA 11/4/23 with no acute PE. Improved slowly to baseline 2L NC O2 and nightly CPAP.  2. COVID 19 Infection: With respiratory failure on admit. Blood cx 11/4/23 remained negative. Weaned to baseline O2. Continued PO Decadron through 11/13/23.  3. UTI: UCx 11/4/23 grew Klebsiella. Completed keflex on 11/10/23.  4. Ileus: noted on KUB 11/8/23. She refused NG. Had BMs and trialed diet with good tolerance. KUB 11/9/23 largely unchanged. Added bowel regimen and reglan with improvement. Tolerated diet and had BMs 11/12/23.  5. Acute Metabolic Encephalopathy: Noted on admit and likely due to hypercapnia. Resolved.  6. IDDM2: Known hx, A1c 8 % on 7/18/23. Home PO meds held. Lantus and SSI continued.  7. HTN: Per hx, home meds continued.  8. Anemia: chronic, stable ~11. 9. Movement Disorder: with BUE tremors x 3 years. Evaluated in 3/2023, suspected drug-induced. Home med continued.  10. Schizoaffective Disorder: Continued home meds.  11. Morbid obesity: BMI greater then 40 diet and exercise encouraged. 12. OSA: she has home CPAP but ws not using; she now plans to use it nightly. 13. Lung Nodules: 5x7mm non-calcified nodule in Left lung base on admit imaging. Follow up CT in 6-12 months recommended.  14. Code Status:DNR-CCA
Age: 73.0
Sex: F
Vaccine: COVID19
Symptoms: Culture urine positive, Echocardiogram, Echocardiogram normal, Ejection fraction, Glycosylated haemoglobin increased
Clinical narrative: Patient is a 74 y.o. F with a PMH of IDDM2 and schizoaffective disorder with recent hospitalization 7/18/23-8/7/23 for respiratory failure requiring BIPAP, pulmonary edema, and possible CAP. She presented to hospital on 11/4/23 after being found unresponsive at SNF requiring bipap on admit and ICU stay. She was found to have COVID 19 infection, hypercarbia and UTI. Course complicated by ileus. Company consulted on 11/6/23 to assume care out of MICU.    1. Acute Hypoxic and Hypercarbic Respiratory Failure: on 2L O2 at baseline. Prior admit for similar and required BIPAP. Respiratory failure then thought to be due to atelectasis, pulmonary edema, and possible CAP. TTE 7/19/23 with LVEF 60%, normal diastolic function. Prior notes mentioned concern for possible ILD and suspected OSA/OHS. Presented with hypoxia and hypercarbia with pCO2 in 90's requiring BIPAP. Also with COVID. CTPA 11/4/23 with no acute PE. Improved slowly to baseline 2L NC O2 and nightly CPAP.  2. COVID 19 Infection: With respiratory failure on admit. Blood cx 11/4/23 remained negative. Weaned to baseline O2. Continued PO Decadron through 11/13/23.  3. UTI: UCx 11/4/23 grew Klebsiella. Completed keflex on 11/10/23.  4. Ileus: noted on KUB 11/8/23. She refused NG. Had BMs and trialed diet with good tolerance. KUB 11/9/23 largely unchanged. Added bowel regimen and reglan with improvement. Tolerated diet and had BMs 11/12/23.  5. Acute Metabolic Encephalopathy: Noted on admit and likely due to hypercapnia. Resolved.  6. IDDM2: Known hx, A1c 8 % on 7/18/23. Home PO meds held. Lantus and SSI continued.  7. HTN: Per hx, home meds continued.  8. Anemia: chronic, stable ~11. 9. Movement Disorder: with BUE tremors x 3 years. Evaluated in 3/2023, suspected drug-induced. Home med continued.  10. Schizoaffective Disorder: Continued home meds.  11. Morbid obesity: BMI greater then 40 diet and exercise encouraged. 12. OSA: she has home CPAP but ws not using; she now plans to use it nightly. 13. Lung Nodules: 5x7mm non-calcified nodule in Left lung base on admit imaging. Follow up CT in 6-12 months recommended.  14. Code Status:DNR-CCA
Age: 73.0
Sex: F
Vaccine: COVID19
Symptoms: Hypercapnia, Hypoxia, Ileus, Intensive care, Klebsiella test positive
Clinical narrative: Patient is a 74 y.o. F with a PMH of IDDM2 and schizoaffective disorder with recent hospitalization 7/18/23-8/7/23 for respiratory failure requiring BIPAP, pulmonary edema, and possible CAP. She presented to hospital on 11/4/23 after being found unresponsive at SNF requiring bipap on admit and ICU stay. She was found to have COVID 19 infection, hypercarbia and UTI. Course complicated by ileus. Company consulted on 11/6/23 to assume care out of MICU.    1. Acute Hypoxic and Hypercarbic Respiratory Failure: on 2L O2 at baseline. Prior admit for similar and required BIPAP. Respiratory failure then thought to be due to atelectasis, pulmonary edema, and possible CAP. TTE 7/19/23 with LVEF 60%, normal diastolic function. Prior notes mentioned concern for possible ILD and suspected OSA/OHS. Presented with hypoxia and hypercarbia with pCO2 in 90's requiring BIPAP. Also with COVID. CTPA 11/4/23 with no acute PE. Improved slowly to baseline 2L NC O2 and nightly CPAP.  2. COVID 19 Infection: With respiratory failure on admit. Blood cx 11/4/23 remained negative. Weaned to baseline O2. Continued PO Decadron through 11/13/23.  3. UTI: UCx 11/4/23 grew Klebsiella. Completed keflex on 11/10/23.  4. Ileus: noted on KUB 11/8/23. She refused NG. Had BMs and trialed diet with good tolerance. KUB 11/9/23 largely unchanged. Added bowel regimen and reglan with improvement. Tolerated diet and had BMs 11/12/23.  5. Acute Metabolic Encephalopathy: Noted on admit and likely due to hypercapnia. Resolved.  6. IDDM2: Known hx, A1c 8 % on 7/18/23. Home PO meds held. Lantus and SSI continued.  7. HTN: Per hx, home meds continued.  8. Anemia: chronic, stable ~11. 9. Movement Disorder: with BUE tremors x 3 years. Evaluated in 3/2023, suspected drug-induced. Home med continued.  10. Schizoaffective Disorder: Continued home meds.  11. Morbid obesity: BMI greater then 40 diet and exercise encouraged. 12. OSA: she has home CPAP but ws not using; she now plans to use it nightly. 13. Lung Nodules: 5x7mm non-calcified nodule in Left lung base on admit imaging. Follow up CT in 6-12 months recommended.  14. Code Status:DNR-CCA
Age: 73.0
Sex: F
Vaccine: COVID19
Symptoms: Metabolic encephalopathy, Obstructive sleep apnoea syndrome, PCO2 increased, Pickwickian syndrome, Positive airway pressure therapy
Clinical narrative: Patient is a 74 y.o. F with a PMH of IDDM2 and schizoaffective disorder with recent hospitalization 7/18/23-8/7/23 for respiratory failure requiring BIPAP, pulmonary edema, and possible CAP. She presented to hospital on 11/4/23 after being found unresponsive at SNF requiring bipap on admit and ICU stay. She was found to have COVID 19 infection, hypercarbia and UTI. Course complicated by ileus. Company consulted on 11/6/23 to assume care out of MICU.    1. Acute Hypoxic and Hypercarbic Respiratory Failure: on 2L O2 at baseline. Prior admit for similar and required BIPAP. Respiratory failure then thought to be due to atelectasis, pulmonary edema, and possible CAP. TTE 7/19/23 with LVEF 60%, normal diastolic function. Prior notes mentioned concern for possible ILD and suspected OSA/OHS. Presented with hypoxia and hypercarbia with pCO2 in 90's requiring BIPAP. Also with COVID. CTPA 11/4/23 with no acute PE. Improved slowly to baseline 2L NC O2 and nightly CPAP.  2. COVID 19 Infection: With respiratory failure on admit. Blood cx 11/4/23 remained negative. Weaned to baseline O2. Continued PO Decadron through 11/13/23.  3. UTI: UCx 11/4/23 grew Klebsiella. Completed keflex on 11/10/23.  4. Ileus: noted on KUB 11/8/23. She refused NG. Had BMs and trialed diet with good tolerance. KUB 11/9/23 largely unchanged. Added bowel regimen and reglan with improvement. Tolerated diet and had BMs 11/12/23.  5. Acute Metabolic Encephalopathy: Noted on admit and likely due to hypercapnia. Resolved.  6. IDDM2: Known hx, A1c 8 % on 7/18/23. Home PO meds held. Lantus and SSI continued.  7. HTN: Per hx, home meds continued.  8. Anemia: chronic, stable ~11. 9. Movement Disorder: with BUE tremors x 3 years. Evaluated in 3/2023, suspected drug-induced. Home med continued.  10. Schizoaffective Disorder: Continued home meds.  11. Morbid obesity: BMI greater then 40 diet and exercise encouraged. 12. OSA: she has home CPAP but ws not using; she now plans to use it nightly. 13. Lung Nodules: 5x7mm non-calcified nodule in Left lung base on admit imaging. Follow up CT in 6-12 months recommended.  14. Code Status:DNR-CCA
Age: 73.0
Sex: F
Vaccine: COVID19
Symptoms: Pulmonary imaging procedure abnormal, Pulmonary mass, Pulmonary oedema, Respiratory failure, Unresponsive to stimuli
Clinical narrative: Patient is a 74 y.o. F with a PMH of IDDM2 and schizoaffective disorder with recent hospitalization 7/18/23-8/7/23 for respiratory failure requiring BIPAP, pulmonary edema, and possible CAP. She presented to hospital on 11/4/23 after being found unresponsive at SNF requiring bipap on admit and ICU stay. She was found to have COVID 19 infection, hypercarbia and UTI. Course complicated by ileus. Company consulted on 11/6/23 to assume care out of MICU.    1. Acute Hypoxic and Hypercarbic Respiratory Failure: on 2L O2 at baseline. Prior admit for similar and required BIPAP. Respiratory failure then thought to be due to atelectasis, pulmonary edema, and possible CAP. TTE 7/19/23 with LVEF 60%, normal diastolic function. Prior notes mentioned concern for possible ILD and suspected OSA/OHS. Presented with hypoxia and hypercarbia with pCO2 in 90's requiring BIPAP. Also with COVID. CTPA 11/4/23 with no acute PE. Improved slowly to baseline 2L NC O2 and nightly CPAP.  2. COVID 19 Infection: With respiratory failure on admit. Blood cx 11/4/23 remained negative. Weaned to baseline O2. Continued PO Decadron through 11/13/23.  3. UTI: UCx 11/4/23 grew Klebsiella. Completed keflex on 11/10/23.  4. Ileus: noted on KUB 11/8/23. She refused NG. Had BMs and trialed diet with good tolerance. KUB 11/9/23 largely unchanged. Added bowel regimen and reglan with improvement. Tolerated diet and had BMs 11/12/23.  5. Acute Metabolic Encephalopathy: Noted on admit and likely due to hypercapnia. Resolved.  6. IDDM2: Known hx, A1c 8 % on 7/18/23. Home PO meds held. Lantus and SSI continued.  7. HTN: Per hx, home meds continued.  8. Anemia: chronic, stable ~11. 9. Movement Disorder: with BUE tremors x 3 years. Evaluated in 3/2023, suspected drug-induced. Home med continued.  10. Schizoaffective Disorder: Continued home meds.  11. Morbid obesity: BMI greater then 40 diet and exercise encouraged. 12. OSA: she has home CPAP but ws not using; she now plans to use it nightly. 13. Lung Nodules: 5x7mm non-calcified nodule in Left lung base on admit imaging. Follow up CT in 6-12 months recommended.  14. Code Status:DNR-CCA
Age: 73.0
Sex: F
Vaccine: COVID19
Symptoms: Urinary tract imaging abnormal, Urinary tract infection
Clinical narrative: Patient is a 74 y.o. F with a PMH of IDDM2 and schizoaffective disorder with recent hospitalization 7/18/23-8/7/23 for respiratory failure requiring BIPAP, pulmonary edema, and possible CAP. She presented to hospital on 11/4/23 after being found unresponsive at SNF requiring bipap on admit and ICU stay. She was found to have COVID 19 infection, hypercarbia and UTI. Course complicated by ileus. Company consulted on 11/6/23 to assume care out of MICU.    1. Acute Hypoxic and Hypercarbic Respiratory Failure: on 2L O2 at baseline. Prior admit for similar and required BIPAP. Respiratory failure then thought to be due to atelectasis, pulmonary edema, and possible CAP. TTE 7/19/23 with LVEF 60%, normal diastolic function. Prior notes mentioned concern for possible ILD and suspected OSA/OHS. Presented with hypoxia and hypercarbia with pCO2 in 90's requiring BIPAP. Also with COVID. CTPA 11/4/23 with no acute PE. Improved slowly to baseline 2L NC O2 and nightly CPAP.  2. COVID 19 Infection: With respiratory failure on admit. Blood cx 11/4/23 remained negative. Weaned to baseline O2. Continued PO Decadron through 11/13/23.  3. UTI: UCx 11/4/23 grew Klebsiella. Completed keflex on 11/10/23.  4. Ileus: noted on KUB 11/8/23. She refused NG. Had BMs and trialed diet with good tolerance. KUB 11/9/23 largely unchanged. Added bowel regimen and reglan with improvement. Tolerated diet and had BMs 11/12/23.  5. Acute Metabolic Encephalopathy: Noted on admit and likely due to hypercapnia. Resolved.  6. IDDM2: Known hx, A1c 8 % on 7/18/23. Home PO meds held. Lantus and SSI continued.  7. HTN: Per hx, home meds continued.  8. Anemia: chronic, stable ~11. 9. Movement Disorder: with BUE tremors x 3 years. Evaluated in 3/2023, suspected drug-induced. Home med continued.  10. Schizoaffective Disorder: Continued home meds.  11. Morbid obesity: BMI greater then 40 diet and exercise encouraged. 12. OSA: she has home CPAP but ws not using; she now plans to use it nightly. 13. Lung Nodules: 5x7mm non-calcified nodule in Left lung base on admit imaging. Follow up CT in 6-12 months recommended.  14. Code Status:DNR-CCA
Age: 53.0
Sex: F
Vaccine: COVID19
Symptoms: Acute kidney injury, Acute respiratory failure, Asthma, Blood creatinine normal, Blood culture negative
Clinical narrative: Patient is a 54 y.o. female patient of MD with history of MRDD, COPD, asthma, urea cycle metabolism disorder, stereotypic movement disorder, Raynaud's disease, organic personality syndrome, and convulsions who presented to Mansfield Hospital from a group home with shortness of breath.   Sepsis  Acute hypoxemic respiratory failure COVID Pneumonia COPD/Asthma The patient presented from a group home with shortness of breath.   COVID positive, Influenza negative.  Blood Cult x2 (10/22)- NGTD CXR (10/22)-showed bibasilar predominant infiltrates Sputum culture, MRSA swab, UA/culture negative ID followed, critical care followed Finished dexamethasone and remdesivir course Continue bronchodilators Weaned off BiPAP, currently on nasal cannula DC telemetry Discontinue COVID isolation on 11/2       Altered Mental Status possible acute metabolic encephalopathy secondary to hypoxia Likely in the setting of respiratory acidosis, elevated CO2 Weaned off BiPAP Initially had been holding clonazepam, seroquel, and risperdal  Slowly start to resume back medications per neurology Wean off Precedex as able continue monitor mental status Neurology followed - recommendations increase Seroquel, continue carbamazepine, topiramate, Keppra   Shock Likely secondary to sedation Has resolved, continue monitor blood pressure closely MRDD Insomnia Home medications include; benztropine, carbamazepine, clonazepam, doxepin, escitalopram, melatonin, Seroquel, risperidone, and topiramate Had been holding clonazepam, Seroquel, and risperdal Started back on Seroquel, risperidone   Bradycardia Likely due to Precedex, will continue to monitor Avoid AV nodal blockers Improved   Mild hypernatremia with sodium 147 likely due to inadequate fluid intake Acute kidney injury with creatinine 1.1 on 11/1 Half-normal saline at rate 70 mill per hour started on 11/1 Sodium improving today 147 and kidney function back to normal 0.08
Age: 53.0
Sex: F
Vaccine: COVID19
Symptoms: Blood sodium increased, COVID-19, COVID-19 pneumonia, Carbon dioxide increased, Cardiac telemetry
Clinical narrative: Patient is a 54 y.o. female patient of MD with history of MRDD, COPD, asthma, urea cycle metabolism disorder, stereotypic movement disorder, Raynaud's disease, organic personality syndrome, and convulsions who presented to Mansfield Hospital from a group home with shortness of breath.   Sepsis  Acute hypoxemic respiratory failure COVID Pneumonia COPD/Asthma The patient presented from a group home with shortness of breath.   COVID positive, Influenza negative.  Blood Cult x2 (10/22)- NGTD CXR (10/22)-showed bibasilar predominant infiltrates Sputum culture, MRSA swab, UA/culture negative ID followed, critical care followed Finished dexamethasone and remdesivir course Continue bronchodilators Weaned off BiPAP, currently on nasal cannula DC telemetry Discontinue COVID isolation on 11/2       Altered Mental Status possible acute metabolic encephalopathy secondary to hypoxia Likely in the setting of respiratory acidosis, elevated CO2 Weaned off BiPAP Initially had been holding clonazepam, seroquel, and risperdal  Slowly start to resume back medications per neurology Wean off Precedex as able continue monitor mental status Neurology followed - recommendations increase Seroquel, continue carbamazepine, topiramate, Keppra   Shock Likely secondary to sedation Has resolved, continue monitor blood pressure closely MRDD Insomnia Home medications include; benztropine, carbamazepine, clonazepam, doxepin, escitalopram, melatonin, Seroquel, risperidone, and topiramate Had been holding clonazepam, Seroquel, and risperdal Started back on Seroquel, risperidone   Bradycardia Likely due to Precedex, will continue to monitor Avoid AV nodal blockers Improved   Mild hypernatremia with sodium 147 likely due to inadequate fluid intake Acute kidney injury with creatinine 1.1 on 11/1 Half-normal saline at rate 70 mill per hour started on 11/1 Sodium improving today 147 and kidney function back to normal 0.08
Age: 53.0
Sex: F
Vaccine: COVID19
Symptoms: Chest X-ray abnormal, Chronic obstructive pulmonary disease, Culture urine negative, Dyspnoea, Fluid intake reduced
Clinical narrative: Patient is a 54 y.o. female patient of MD with history of MRDD, COPD, asthma, urea cycle metabolism disorder, stereotypic movement disorder, Raynaud's disease, organic personality syndrome, and convulsions who presented to Mansfield Hospital from a group home with shortness of breath.   Sepsis  Acute hypoxemic respiratory failure COVID Pneumonia COPD/Asthma The patient presented from a group home with shortness of breath.   COVID positive, Influenza negative.  Blood Cult x2 (10/22)- NGTD CXR (10/22)-showed bibasilar predominant infiltrates Sputum culture, MRSA swab, UA/culture negative ID followed, critical care followed Finished dexamethasone and remdesivir course Continue bronchodilators Weaned off BiPAP, currently on nasal cannula DC telemetry Discontinue COVID isolation on 11/2       Altered Mental Status possible acute metabolic encephalopathy secondary to hypoxia Likely in the setting of respiratory acidosis, elevated CO2 Weaned off BiPAP Initially had been holding clonazepam, seroquel, and risperdal  Slowly start to resume back medications per neurology Wean off Precedex as able continue monitor mental status Neurology followed - recommendations increase Seroquel, continue carbamazepine, topiramate, Keppra   Shock Likely secondary to sedation Has resolved, continue monitor blood pressure closely MRDD Insomnia Home medications include; benztropine, carbamazepine, clonazepam, doxepin, escitalopram, melatonin, Seroquel, risperidone, and topiramate Had been holding clonazepam, Seroquel, and risperdal Started back on Seroquel, risperidone   Bradycardia Likely due to Precedex, will continue to monitor Avoid AV nodal blockers Improved   Mild hypernatremia with sodium 147 likely due to inadequate fluid intake Acute kidney injury with creatinine 1.1 on 11/1 Half-normal saline at rate 70 mill per hour started on 11/1 Sodium improving today 147 and kidney function back to normal 0.08