chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Sex: F
Vaccine: VARZOS
Symptoms: Expired product administered
Clinical narrative: Expired Shingrix was mistakenly administered to patient; This non-serious case was reported by a physician via sales rep and described the occurrence of expired vaccine used in a female patient who received Herpes zoster (Shingrix) (expiry date 18-SEP-2023) for prophylaxis.   On 01-NOV-2023, the patient received Shingrix. On 01-NOV-2023, an unknown time after receiving Shingrix, the patient experienced expired vaccine used (Verbatim: Expired Shingrix was mistakenly administered to patient). The outcome of the expired vaccine used was unknown.   Additional Information: GSK Receipt Date: 02-NOV-2023 It was reported that expired Shingrix was mistakenly administered to patient which led to expired vaccine used. Office realized it after administration had occurred. Advised office to document administration and let the patient know what happened.
Sex: M
Vaccine: RSV
Symptoms: Pain in extremity, Product administered at inappropriate site
Clinical narrative: localized pain started in left arm; vaccine was administered low' in his arm; This non-serious case was reported by a nurse via sales rep and described the occurrence of pain in arm in a male patient who received RSVPreF3 adjuvanted (Arexvy) for prophylaxis.   Concomitant products included COVID-19 VACCINE (COVID 19 VACCINE) and INFLUENZA VACCINE (FLU VACCINE (NAME UNKNOWN)).   On an unknown date, the patient received Arexvy (left arm). On an unknown date, 3 hrs after receiving Arexvy, the patient experienced pain in arm (Verbatim: localized pain started in left arm) and vaccine administered at inappropriate site (Verbatim: vaccine was administered low' in his arm). The outcome of the pain in arm was resolved and the outcome of the vaccine administered at inappropriate site was unknown.   It was unknown if the reporter considered the pain in arm to be related to Arexvy.     It was unknown if the company considered the pain in arm to be related to Arexvy.   Additional Information: GSK Receipt Date: 02-NOV-2023 The registered nurse reported that patient administered RSV vaccine in left arm. The patient also co administered Covid-19 and Flu vaccine in the right arm. The date was unknown. The patient stared localized pain in left arm about 3 to 4 hours after administration. The patient described the pain was grade 3. The patient was not certain if the pain was due to the vaccine. The patient thought the vaccine was administered low in his arm and pain may be due to poor technique, which led to vaccine administered at inappropriate site. Now the pain was resolved. The follow-up could not be possible as no contact details were available.
Sex: M
Vaccine: FLUX
Symptoms: Pain in extremity
Clinical narrative: pain in left arm; Reason for deletion: case created in error
Sex: U
Vaccine: VARZOS
Symptoms: Incomplete course of vaccination
Clinical narrative: I have received the first shot 14 month ago. Would like to get the second shot; This non-serious case was reported by a consumer via call center representative and described the occurrence of incomplete course of vaccination in a 86-year-old patient who received Herpes zoster (Shingrix) for prophylaxis.   The patient's past medical history included shingles (twice). Previously administered products included Shingrix (In 2022, an unknown date, 14 months ago received first dose ) and Zostavax (Years ago received a dose).   On an unknown date, the patient did not receive the 2nd dose of Shingrix. On an unknown date, an unknown time after receiving Shingrix, the patient experienced incomplete course of vaccination (Verbatim: I have received the first shot 14 month ago. Would like to get the second shot). The outcome of the incomplete course of vaccination was unknown.   Additional Information: GSK Receipt Date: 2-NOV-2023  The reporter received the first shot 14 month ago and wanted to get the second shot. The patient asked if he need to get the first shot again, or how he may proceed. Till the time of reporting, the patient did not receive the 2nd dose of Shingrix, which led to incomplete course of vaccination.
Sex: U
Vaccine: RSV, VARZOS
Symptoms: Intercepted product selection error, Product packaging confusion
Clinical narrative: packaging confusion between Shingrix and Arexvy; nearly gave Arexvy instead of Shingrix due to package confusion; This non-serious case was reported by a pharmacist via sales rep and described the occurrence of product packaging confusion in a patient who received Herpes zoster (Shingrix) for prophylaxis.   Co-suspect products included RSVPreF3 adjuvanted (Arexvy) for prophylaxis.   On an unknown date, the patient received Shingrix and Arexvy. On an unknown date, an unknown time after receiving Shingrix and Arexvy, the patient experienced product packaging confusion (Verbatim: packaging confusion between Shingrix and Arexvy) and intercepted product selection error (Verbatim: nearly gave Arexvy instead of Shingrix due to package confusion). The outcome of the product packaging confusion and intercepted product selection error were unknown.   Additional Information: GSK Receipt Date: 02-NOV-2023 It was reported that the customer did not administered incorrect brand to a patient, but nearly did. The reporter stated that the packaging of Arexvy was so similar to Shingrix which he uses very regularly, that he nearly gave Arexvy to a patient meant to receive Shingrix which led to product packaging confusion and intercepted product selection error. He recognized the error when double checking and did not incorrectly administer but felt that there was a high risk that the two packages could be confused leading to accidental administration of one of the vaccines.
Age: 32.0
Sex: F
Vaccine: FLUC4
Symptoms: Anxiety, Erythema, Immediate post-injection reaction, Injection site pain, Injection site swelling
Clinical narrative: Following injection immediate stinging/burning as if stung by bees. 1-2 hours swelling of injection site the size of a baseball. Redness and tenderness to the skin. Extra salivation and anxiety due to the reaction. Administered oral diphenhydamine 25 mg at 17:30. Site continued to be swollen until 19:00. 11/10/2023 at 05:00 redness and swelling had subsided but R arm muscle feels hard and sore.
Age: 32.0
Sex: F
Vaccine: FLUC4
Symptoms: Myalgia, Myosclerosis, Pain of skin, Salivary hypersecretion
Clinical narrative: Following injection immediate stinging/burning as if stung by bees. 1-2 hours swelling of injection site the size of a baseball. Redness and tenderness to the skin. Extra salivation and anxiety due to the reaction. Administered oral diphenhydamine 25 mg at 17:30. Site continued to be swollen until 19:00. 11/10/2023 at 05:00 redness and swelling had subsided but R arm muscle feels hard and sore.
Age: 89.0
Sex: M
Vaccine: FLU4
Symptoms: Exposure via skin contact, Immunisation, Syringe issue, Underdose
Clinical narrative: Equipment malfunction. When I pressed on the plunger, the vaccine,(liquid) leaked down his arm. Very little to no vaccine was administered.   I prepared and administered a second vaccine with no issues.
Age: 12.0
Sex: M
Vaccine: FLU4, HPV9
Symptoms: Bell's palsy, Eye pain, Facial paralysis, Facial paresis, Hypoaesthesia oral
Clinical narrative: 11/1/2023 3:00pm Right eye pain 11/2/2023 7:00am numbness right side of tongue 11/2/2023 3:00pm face weakness  11/3/2023 7:00am full paralysis right side of face 11/3/2023 9:00 ER diagnosis Bell's Palsy Treatment given 20ml of prednisolone once daily for 10 days, 5ml of Acyclovir 5 times a day for 10 days and over the counter eye drops
Age: 12.0
Sex: M
Vaccine: FLU4, HPV9
Symptoms: Laboratory test
Clinical narrative: 11/1/2023 3:00pm Right eye pain 11/2/2023 7:00am numbness right side of tongue 11/2/2023 3:00pm face weakness  11/3/2023 7:00am full paralysis right side of face 11/3/2023 9:00 ER diagnosis Bell's Palsy Treatment given 20ml of prednisolone once daily for 10 days, 5ml of Acyclovir 5 times a day for 10 days and over the counter eye drops
Sex: U
Vaccine: RSV
Symptoms: Insomnia
Clinical narrative: could not sleep last; This non-serious case was reported by a consumer via interactive digital media and described the occurrence of insomnia in a patient who received RSVPreF3 adjuvanted (Arexvy) for prophylaxis.   On 01-NOV-2023, the patient received Arexvy. In NOV-2023, an unknown time after receiving Arexvy, the patient experienced insomnia (Verbatim: could not sleep last). The outcome of the insomnia was not reported.   It was unknown if the reporter considered the insomnia to be related to Arexvy.     It was unknown if the company considered the insomnia to be related to Arexvy.   Additional Information: GSK Receipt date: 02-NOV-2023 This case was reported by patient via (Open field AE monitoring) interactive digital media. A patient reported that he/she had shot one day before reporting (yesterday) and could not slept last. Follow up was not possible, as no contact details were available.
Age: 7.0
Sex: M
Vaccine: FLU4
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth
Clinical narrative: Left upper arm swollen, warm to the touch and red
Age: 70.0
Sex: F
Vaccine: FLU4
Symptoms: Blood electrolytes, Chills, Clostridium test negative, Decreased appetite, Diarrhoea
Clinical narrative: 10/24  in evening- developed achiness in muscles, fever of 99.6, chills 10/25- morning achiness worsened, fever of 102,6, diarrhea 10/26- fever continued, diarrhea worsened (every 2 hours with cramping), achiness, anorexia, lethargy 10/27- diarrhea every 2 hours with cramping, anorexia, lethargy 10/28-lethargy, diarrhea with cramping, went to ER at Hospital, received  1 L of LR, ruled out C Dif, discharged with diet instructions, additional stool sample provided 10/29 -  diarrhea and cramping continued, stool sample QNS, MD prescribed antibiotic Z 10/30-  diarrhea and cramping continued 10/31- diarrhea and cramping lessened 11/1 - stools soft and no cramping 11/2 -stools returning to normal
Age: 70.0
Sex: F
Vaccine: FLU4
Symptoms: Faeces soft, Full blood count, Gastrointestinal pain, Lethargy, Myalgia
Clinical narrative: 10/24  in evening- developed achiness in muscles, fever of 99.6, chills 10/25- morning achiness worsened, fever of 102,6, diarrhea 10/26- fever continued, diarrhea worsened (every 2 hours with cramping), achiness, anorexia, lethargy 10/27- diarrhea every 2 hours with cramping, anorexia, lethargy 10/28-lethargy, diarrhea with cramping, went to ER at Hospital, received  1 L of LR, ruled out C Dif, discharged with diet instructions, additional stool sample provided 10/29 -  diarrhea and cramping continued, stool sample QNS, MD prescribed antibiotic Z 10/30-  diarrhea and cramping continued 10/31- diarrhea and cramping lessened 11/1 - stools soft and no cramping 11/2 -stools returning to normal
Age: 70.0
Sex: F
Vaccine: FLU4
Symptoms: Pyrexia
Clinical narrative: 10/24  in evening- developed achiness in muscles, fever of 99.6, chills 10/25- morning achiness worsened, fever of 102,6, diarrhea 10/26- fever continued, diarrhea worsened (every 2 hours with cramping), achiness, anorexia, lethargy 10/27- diarrhea every 2 hours with cramping, anorexia, lethargy 10/28-lethargy, diarrhea with cramping, went to ER at Hospital, received  1 L of LR, ruled out C Dif, discharged with diet instructions, additional stool sample provided 10/29 -  diarrhea and cramping continued, stool sample QNS, MD prescribed antibiotic Z 10/30-  diarrhea and cramping continued 10/31- diarrhea and cramping lessened 11/1 - stools soft and no cramping 11/2 -stools returning to normal
Age: 69.0
Sex: F
Vaccine: HEP, VARZOS
Symptoms: Computerised tomogram head, Electrocardiogram, Full blood count, Memory impairment, Metabolic function test
Clinical narrative: Forgetfulness 3 days after receiving vaccines, went to ER examined and sent home.  Referred to  Neurology
Age: 69.0
Sex: F
Vaccine: HEP, VARZOS
Symptoms: Urine analysis
Clinical narrative: Forgetfulness 3 days after receiving vaccines, went to ER examined and sent home.  Referred to  Neurology
Age: 42.0
Sex: F
Vaccine: FLU4
Symptoms: Headache, Hypoaesthesia, Injection site erythema, Injection site nodule
Clinical narrative: The first symptom started later Saturday with numbness to my fingers on my right side.   Then both feet have went numb. The numbness in my right arm stops at my elbow and both legs stop at my knees.   I've also have had headache with no relief from Tylenol.  I also after the right arm numbness started have numbness noted on my face starting at my bottom lip down to my chin.    I have redness or nodule to the injection site.    I was supervisor last night so I went to see PA to see what he had thought before I decide to leave work and check in to the ER.    He recommend taking Benadryl to see if it was a reaction  I did and my symptoms got better   I strongly believe I'm allergic to it and worried a lot if it may be Gullian Barre syndrome.
Age: 69.0
Sex: F
Vaccine: VARZOS
Symptoms: Abdominal pain upper, Asthenia, Chills, Headache, Injection site pain
Clinical narrative: Headache, chills, body aches, stomach pain, nausea, weakness, pain at injection site.
Age: 69.0
Sex: F
Vaccine: VARZOS
Symptoms: Nausea, Pain
Clinical narrative: Headache, chills, body aches, stomach pain, nausea, weakness, pain at injection site.
Age: 72.0
Sex: M
Vaccine: VARZOS
Symptoms: Injection site pain
Clinical narrative: Sore arm around the injection site.
Age: 72.0
Sex: F
Vaccine: COVID19-2, FLU4
Symptoms: Arthralgia, Asthenia, COVID-19, Computerised tomogram head normal, Dizziness
Clinical narrative: BRIEF OVERVIEW: Admission Date: 8/28/2023 Discharge Date: 8/30/2023 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Dizziness [R42] Hypoxia [R09.02] Stroke-like symptoms [R29.90] COVID-19 virus infection [U07.1]   HOSPITAL COURSE: The patient is a 73-year-old female who presented the hospital complaints of weakness.  Given the nature of patient's symptoms initial concern was for possible acute CVA.  The patient did test positive for COVID on admission and was found to be hypoxic.  CT of the head was obtained in the emergency department and without acute findings.  MRI was subsequently performed and also was negative for acute etiology.  Patient's symptoms were felt to be secondary to infectious etiology given her positive COVID status.  With Decadron the patient improvement of her respiratory status and overall symptoms.  She was additionally sent for MRI of the cervical spine given her complaints right shoulder pain and associated neuropathy.  MRI of the neck was without significant spinal stenosis.  Today the patient has been weaned to room air and is without complaints of shortness of breath.  She feels steady on her feet and his comfortable being discharged home today.  Recommendations for follow-up have been discussed with the patient and she is being discharged home today in stable condition
Age: 72.0
Sex: F
Vaccine: COVID19-2, FLU4
Symptoms: Hypoxia, Magnetic resonance imaging normal, Magnetic resonance imaging spinal normal, Neurological symptom, Neuropathy peripheral
Clinical narrative: BRIEF OVERVIEW: Admission Date: 8/28/2023 Discharge Date: 8/30/2023 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Dizziness [R42] Hypoxia [R09.02] Stroke-like symptoms [R29.90] COVID-19 virus infection [U07.1]   HOSPITAL COURSE: The patient is a 73-year-old female who presented the hospital complaints of weakness.  Given the nature of patient's symptoms initial concern was for possible acute CVA.  The patient did test positive for COVID on admission and was found to be hypoxic.  CT of the head was obtained in the emergency department and without acute findings.  MRI was subsequently performed and also was negative for acute etiology.  Patient's symptoms were felt to be secondary to infectious etiology given her positive COVID status.  With Decadron the patient improvement of her respiratory status and overall symptoms.  She was additionally sent for MRI of the cervical spine given her complaints right shoulder pain and associated neuropathy.  MRI of the neck was without significant spinal stenosis.  Today the patient has been weaned to room air and is without complaints of shortness of breath.  She feels steady on her feet and his comfortable being discharged home today.  Recommendations for follow-up have been discussed with the patient and she is being discharged home today in stable condition
Age: 72.0
Sex: F
Vaccine: COVID19-2, FLU4
Symptoms: SARS-CoV-2 test positive
Clinical narrative: BRIEF OVERVIEW: Admission Date: 8/28/2023 Discharge Date: 8/30/2023 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Dizziness [R42] Hypoxia [R09.02] Stroke-like symptoms [R29.90] COVID-19 virus infection [U07.1]   HOSPITAL COURSE: The patient is a 73-year-old female who presented the hospital complaints of weakness.  Given the nature of patient's symptoms initial concern was for possible acute CVA.  The patient did test positive for COVID on admission and was found to be hypoxic.  CT of the head was obtained in the emergency department and without acute findings.  MRI was subsequently performed and also was negative for acute etiology.  Patient's symptoms were felt to be secondary to infectious etiology given her positive COVID status.  With Decadron the patient improvement of her respiratory status and overall symptoms.  She was additionally sent for MRI of the cervical spine given her complaints right shoulder pain and associated neuropathy.  MRI of the neck was without significant spinal stenosis.  Today the patient has been weaned to room air and is without complaints of shortness of breath.  She feels steady on her feet and his comfortable being discharged home today.  Recommendations for follow-up have been discussed with the patient and she is being discharged home today in stable condition
Age: 3.0
Sex: M
Vaccine: FLU4
Symptoms: Nausea, Pallor, Somnolence, Throat irritation, Vomiting
Clinical narrative: Within 5 mins of flu administration, child complained of itchy throat and nausea. Appeared pale and sleepy. Had emesis twice.  Given oral benadryl and examined/vitals taken. Normal vitals including pulse ox and BP. Symptoms resolved within 15 mins. Observed in clinic for >90 mins. Cont to have normal vitals. Father cautioned about possible biphasic reaction.
Age: 82.0
Sex: F
Vaccine: RSV
Symptoms: Facial paralysis, Swelling face
Clinical narrative: Swelling of left side of jaw, slight drooping at corner of mouth
Age: 66.0
Sex: M
Vaccine: COVID19
Symptoms: Acute respiratory failure, Blood lactic acid, Bronchial secretion retention, C-reactive protein increased, COVID-19
Clinical narrative: BRIEF OVERVIEW: Discharge Provider: DO Primary Care Provider at Discharge: DO Admission Date: 8/27/2023 Discharge Date: 8/28/2023  DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Acute on chronic respiratory failure with hypoxia (HCC) [J96.21] Acute respiratory failure due to COVID-19 (HCC) [U07.1, J96.00]   HOSPITAL COURSE: Patient is a 68 year old male with a history of COPD, OSA, DM2, recurrent non-small cell lung cancer with mass in RUL stage IV currently on immunotherapy that presented to the ED with increased shortness of breath, cough, and fever (reported 100.9) that started on 8/22 (last immunotherapy). He denies any pain, nausea, vomiting, diarrhea, edema, palpitations. Vital signs were significant for hypoxia to 84% on room air, stabilized with 2 liters O2 per NC, tachypnea in the low 20s, and hypertension. Lab work was significant for hyperglycemia, lactic acid 2.1, leukopenia 3.57, and covid positivity. CT of the chest showed RUL tumor with mass invading mediastinum unchanged, and stable mucous plugging and tree in bud opacities in the LUL (suspicious for metastasis. No PE, no new consolidation. He was given IV fluids and nebulized bronchodilators in ED. He was admitted observation for acute on chronic respiratory failure with hypoxia related to covid-19 for further supportive care and monitoring.    The patients oxygenation and work of breathing improved overnight with supportive care including dexamethasone. Leukopenia and lactic acidosis resolved. CPR and D-dimer mildly elevated. It was noted that he had significant improvement in work of breathing with nebulized bronchodilators in the ED. The patient does not have a nebulizer at home, one will be ordered. He was discharged home in stable condition with home oxygen as prior, duoneb with nebulizer, tessalon short course as needed, and recommendations to pick up guaifenesin at pharmacy. Oncology follow up has been rescheduled for September.
Age: 66.0
Sex: M
Vaccine: COVID19
Symptoms: Computerised tomogram thorax abnormal, Cough, Dyspnoea, Fibrin D dimer increased, Hyperglycaemia
Clinical narrative: BRIEF OVERVIEW: Discharge Provider: DO Primary Care Provider at Discharge: DO Admission Date: 8/27/2023 Discharge Date: 8/28/2023  DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Acute on chronic respiratory failure with hypoxia (HCC) [J96.21] Acute respiratory failure due to COVID-19 (HCC) [U07.1, J96.00]   HOSPITAL COURSE: Patient is a 68 year old male with a history of COPD, OSA, DM2, recurrent non-small cell lung cancer with mass in RUL stage IV currently on immunotherapy that presented to the ED with increased shortness of breath, cough, and fever (reported 100.9) that started on 8/22 (last immunotherapy). He denies any pain, nausea, vomiting, diarrhea, edema, palpitations. Vital signs were significant for hypoxia to 84% on room air, stabilized with 2 liters O2 per NC, tachypnea in the low 20s, and hypertension. Lab work was significant for hyperglycemia, lactic acid 2.1, leukopenia 3.57, and covid positivity. CT of the chest showed RUL tumor with mass invading mediastinum unchanged, and stable mucous plugging and tree in bud opacities in the LUL (suspicious for metastasis. No PE, no new consolidation. He was given IV fluids and nebulized bronchodilators in ED. He was admitted observation for acute on chronic respiratory failure with hypoxia related to covid-19 for further supportive care and monitoring.    The patients oxygenation and work of breathing improved overnight with supportive care including dexamethasone. Leukopenia and lactic acidosis resolved. CPR and D-dimer mildly elevated. It was noted that he had significant improvement in work of breathing with nebulized bronchodilators in the ED. The patient does not have a nebulizer at home, one will be ordered. He was discharged home in stable condition with home oxygen as prior, duoneb with nebulizer, tessalon short course as needed, and recommendations to pick up guaifenesin at pharmacy. Oncology follow up has been rescheduled for September.
Age: 66.0
Sex: M
Vaccine: COVID19
Symptoms: Hypertension, Hypoxia, Immunosuppressant drug therapy, Lactic acidosis, Leukopenia
Clinical narrative: BRIEF OVERVIEW: Discharge Provider: DO Primary Care Provider at Discharge: DO Admission Date: 8/27/2023 Discharge Date: 8/28/2023  DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Acute on chronic respiratory failure with hypoxia (HCC) [J96.21] Acute respiratory failure due to COVID-19 (HCC) [U07.1, J96.00]   HOSPITAL COURSE: Patient is a 68 year old male with a history of COPD, OSA, DM2, recurrent non-small cell lung cancer with mass in RUL stage IV currently on immunotherapy that presented to the ED with increased shortness of breath, cough, and fever (reported 100.9) that started on 8/22 (last immunotherapy). He denies any pain, nausea, vomiting, diarrhea, edema, palpitations. Vital signs were significant for hypoxia to 84% on room air, stabilized with 2 liters O2 per NC, tachypnea in the low 20s, and hypertension. Lab work was significant for hyperglycemia, lactic acid 2.1, leukopenia 3.57, and covid positivity. CT of the chest showed RUL tumor with mass invading mediastinum unchanged, and stable mucous plugging and tree in bud opacities in the LUL (suspicious for metastasis. No PE, no new consolidation. He was given IV fluids and nebulized bronchodilators in ED. He was admitted observation for acute on chronic respiratory failure with hypoxia related to covid-19 for further supportive care and monitoring.    The patients oxygenation and work of breathing improved overnight with supportive care including dexamethasone. Leukopenia and lactic acidosis resolved. CPR and D-dimer mildly elevated. It was noted that he had significant improvement in work of breathing with nebulized bronchodilators in the ED. The patient does not have a nebulizer at home, one will be ordered. He was discharged home in stable condition with home oxygen as prior, duoneb with nebulizer, tessalon short course as needed, and recommendations to pick up guaifenesin at pharmacy. Oncology follow up has been rescheduled for September.
Age: 66.0
Sex: M
Vaccine: COVID19
Symptoms: Lung opacity, Pyrexia, SARS-CoV-2 test positive, Tachypnoea
Clinical narrative: BRIEF OVERVIEW: Discharge Provider: DO Primary Care Provider at Discharge: DO Admission Date: 8/27/2023 Discharge Date: 8/28/2023  DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Acute on chronic respiratory failure with hypoxia (HCC) [J96.21] Acute respiratory failure due to COVID-19 (HCC) [U07.1, J96.00]   HOSPITAL COURSE: Patient is a 68 year old male with a history of COPD, OSA, DM2, recurrent non-small cell lung cancer with mass in RUL stage IV currently on immunotherapy that presented to the ED with increased shortness of breath, cough, and fever (reported 100.9) that started on 8/22 (last immunotherapy). He denies any pain, nausea, vomiting, diarrhea, edema, palpitations. Vital signs were significant for hypoxia to 84% on room air, stabilized with 2 liters O2 per NC, tachypnea in the low 20s, and hypertension. Lab work was significant for hyperglycemia, lactic acid 2.1, leukopenia 3.57, and covid positivity. CT of the chest showed RUL tumor with mass invading mediastinum unchanged, and stable mucous plugging and tree in bud opacities in the LUL (suspicious for metastasis. No PE, no new consolidation. He was given IV fluids and nebulized bronchodilators in ED. He was admitted observation for acute on chronic respiratory failure with hypoxia related to covid-19 for further supportive care and monitoring.    The patients oxygenation and work of breathing improved overnight with supportive care including dexamethasone. Leukopenia and lactic acidosis resolved. CPR and D-dimer mildly elevated. It was noted that he had significant improvement in work of breathing with nebulized bronchodilators in the ED. The patient does not have a nebulizer at home, one will be ordered. He was discharged home in stable condition with home oxygen as prior, duoneb with nebulizer, tessalon short course as needed, and recommendations to pick up guaifenesin at pharmacy. Oncology follow up has been rescheduled for September.
Age: 41.0
Sex: F
Vaccine: COVID19, HEP
Symptoms: Asthenia, Chills, Dehydration, Diarrhoea, Headache
Clinical narrative: nausea started around 3pm on 11/6 followed by fever, chills, and headache around 10pm. Fever and chills lasts about 14 hours and the headaches lasted around 36 hours. The nausea and diarrhea has yet to stop and it?s now 11/10. I can?t do any normal activities or go to work because I?m too weak from not being able to eat much and the dehydration.
Age: 41.0
Sex: F
Vaccine: COVID19, HEP
Symptoms: Hypophagia, Impaired work ability, Loss of personal independence in daily activities, Nausea, Pyrexia
Clinical narrative: nausea started around 3pm on 11/6 followed by fever, chills, and headache around 10pm. Fever and chills lasts about 14 hours and the headaches lasted around 36 hours. The nausea and diarrhea has yet to stop and it?s now 11/10. I can?t do any normal activities or go to work because I?m too weak from not being able to eat much and the dehydration.
Age: 31.0
Sex: F
Vaccine: COVID19
Symptoms: Mechanical urticaria
Clinical narrative: Dermatographia started about 11-12 days after vaccination and continued for 3-4 months after vaccination. Improved with steroids and prolonged course of cetirizine.
Age: 63.0
Sex: M
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Refrigerated vaccine was administered 2 days after the Beyond Used Date.  Beyond Use Date was 11/01/2023. Vaccine was administered on 11/03/2023.
Age: 78.0
Sex: M
Vaccine: COVID19-2
Symptoms: Acute kidney injury, COVID-19, Condition aggravated, Death, Deep vein thrombosis
Clinical narrative: BRIEF OVERVIEW: Discharge Provider: MD Primary Care Physician at Discharge: None Physician, DO None Admission Date: 8/25/2023   DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Severe sepsis [A41.9, R65.20]   HOSPITAL COURSE: 78-year-old gentleman with dementia presented with hypernatremia and a positive COVID test found at his ECF.  Ultimately diagnosed here with severe sepsis, COVID, PNA, UTI, respiratory failure, bilateral DVTs, hypernatremia, AKI.  Family elected comfort care. He ultimately succumbed to his illness 8/27/23 at 1915 with family at bedside.
Age: 78.0
Sex: M
Vaccine: COVID19-2
Symptoms: Hypernatraemia, Illness, Pneumonia, Respiratory failure, SARS-CoV-2 test positive
Clinical narrative: BRIEF OVERVIEW: Discharge Provider: MD Primary Care Physician at Discharge: None Physician, DO None Admission Date: 8/25/2023   DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Severe sepsis [A41.9, R65.20]   HOSPITAL COURSE: 78-year-old gentleman with dementia presented with hypernatremia and a positive COVID test found at his ECF.  Ultimately diagnosed here with severe sepsis, COVID, PNA, UTI, respiratory failure, bilateral DVTs, hypernatremia, AKI.  Family elected comfort care. He ultimately succumbed to his illness 8/27/23 at 1915 with family at bedside.
Age: 78.0
Sex: M
Vaccine: COVID19-2
Symptoms: Sepsis, Urinary tract infection
Clinical narrative: BRIEF OVERVIEW: Discharge Provider: MD Primary Care Physician at Discharge: None Physician, DO None Admission Date: 8/25/2023   DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Severe sepsis [A41.9, R65.20]   HOSPITAL COURSE: 78-year-old gentleman with dementia presented with hypernatremia and a positive COVID test found at his ECF.  Ultimately diagnosed here with severe sepsis, COVID, PNA, UTI, respiratory failure, bilateral DVTs, hypernatremia, AKI.  Family elected comfort care. He ultimately succumbed to his illness 8/27/23 at 1915 with family at bedside.
Age: 74.0
Sex: F
Vaccine: COVID19-2
Symptoms: Computerised tomogram head normal, Electrocardiogram normal, Full blood count, Headache, Hypertensive emergency
Clinical narrative: Previously well controlled bp on Labetalol 50 mg bid and losartan 50 mg qd.  1 day after COVID vaccine, developed headaches, nausea, swelling of the feet, and bp up to 218/104,  193/94,  194/86, 195/85. No other changes, healthy low salt diet, no other triggers.  Seen in the office on 10/10 for headache and pitting edema, w BP 221/112 , sent to ED for hypertensive emergency- labs and CT head normal. Increased labetalol to 100 mg bid, bp lowered w additional labetalol dose.  Seen again in ED 10/12 for persistently high bp and headaches. BP 187/88 in ED additional losartan dose added.  10/12 tele visit w PCP for ongoing plan:  given a day by day plan for med adjustments according to BP and tracking symptoms. Daily checkins with PCP until bp controlled on Labetalol 100 mg tid and losartan 50 mg BID.  As of 11/10 still needing higher doses for bp control. feels well
Age: 74.0
Sex: F
Vaccine: COVID19-2
Symptoms: Metabolic function test, Nausea, Oedema, Peripheral swelling, Troponin normal
Clinical narrative: Previously well controlled bp on Labetalol 50 mg bid and losartan 50 mg qd.  1 day after COVID vaccine, developed headaches, nausea, swelling of the feet, and bp up to 218/104,  193/94,  194/86, 195/85. No other changes, healthy low salt diet, no other triggers.  Seen in the office on 10/10 for headache and pitting edema, w BP 221/112 , sent to ED for hypertensive emergency- labs and CT head normal. Increased labetalol to 100 mg bid, bp lowered w additional labetalol dose.  Seen again in ED 10/12 for persistently high bp and headaches. BP 187/88 in ED additional losartan dose added.  10/12 tele visit w PCP for ongoing plan:  given a day by day plan for med adjustments according to BP and tracking symptoms. Daily checkins with PCP until bp controlled on Labetalol 100 mg tid and losartan 50 mg BID.  As of 11/10 still needing higher doses for bp control. feels well
Age: 74.0
Sex: F
Vaccine: COVID19-2
Symptoms: Urine analysis normal
Clinical narrative: Previously well controlled bp on Labetalol 50 mg bid and losartan 50 mg qd.  1 day after COVID vaccine, developed headaches, nausea, swelling of the feet, and bp up to 218/104,  193/94,  194/86, 195/85. No other changes, healthy low salt diet, no other triggers.  Seen in the office on 10/10 for headache and pitting edema, w BP 221/112 , sent to ED for hypertensive emergency- labs and CT head normal. Increased labetalol to 100 mg bid, bp lowered w additional labetalol dose.  Seen again in ED 10/12 for persistently high bp and headaches. BP 187/88 in ED additional losartan dose added.  10/12 tele visit w PCP for ongoing plan:  given a day by day plan for med adjustments according to BP and tracking symptoms. Daily checkins with PCP until bp controlled on Labetalol 100 mg tid and losartan 50 mg BID.  As of 11/10 still needing higher doses for bp control. feels well
Age: 85.0
Sex: M
Vaccine: COVID19-2, FLUA4
Symptoms: Asthenia, Blood culture negative, Blood sodium decreased, COVID-19, Chest X-ray normal
Clinical narrative: BRIEF OVERVIEW: Admission Date: 8/24/2023 Discharge Date: Aug 30, 2023 Discharge Disposition:  home or self care   DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Hyponatremia [E87.1] Neutropenic fever [D70.9, R50.81] COVID [U07.1] COVID-19 [U07.1]   HOSPITAL COURSE:   86-year-old male with medical history of AFib, neutropenia, past alcohol abuse sober for 10 years, hyponatremia presented to the hospital for chest discomfort and confusion.  Patient was accompanied by his wife who helped provide the majority of the history.  Two days prior to hospitalization patient was experiencing a cough which is progressively gotten worse.  Nonproductive and not associated with any degree of dyspnea.  Has also been feeling generalized weakness and fatigue.  Was brought into the hospital for worsening confusion ultimately.  Has had 2 TIAs in the past.  On arrival to the hospital was febrile.  COVID-19 testing was positive.  No respiratory symptoms however.  Was also found to be hyponatremic at 126..  Chest x-ray was negative for acute infiltrate and patient was breathing comfortably on room air.  Patient was preemptively placed on cefepime for neutropenic fevers.  Patient was having fluctuating fevers throughout hospitalization.  Patient mentation also waxed and waned.  Did require hypertonic saline drip with quick resolution of hyponatremia and mentation changes.  Was found to be euvolemic and was put on a fluid restriction and sodium chloride tablets with continued improvement.  Fevers began to wane and patient remained afebrile for greater than 48 hours.  Blood cultures remain negative.  Pancytopenia workup was started however ultimately no specific cause was identified.  Has had follow-up with Hematology and Oncology as an outpatient who wanted to perform bone marrow biopsy several years ago however was declined by patient.  Did reach out to Hematology and Oncology who did not suggest any further inpatient workup and recommended referral for outpatient workup.  Patient is stable today and is requesting discharge home.  Will be discharged home with supportive cough medicine, referral to Hematology and Oncology.  Strict follow-up with PCP recommended within 5 days.
Age: 85.0
Sex: M
Vaccine: COVID19-2, FLUA4
Symptoms: Chest discomfort, Confusional state, Cough, Fatigue, Febrile neutropenia
Clinical narrative: BRIEF OVERVIEW: Admission Date: 8/24/2023 Discharge Date: Aug 30, 2023 Discharge Disposition:  home or self care   DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Hyponatremia [E87.1] Neutropenic fever [D70.9, R50.81] COVID [U07.1] COVID-19 [U07.1]   HOSPITAL COURSE:   86-year-old male with medical history of AFib, neutropenia, past alcohol abuse sober for 10 years, hyponatremia presented to the hospital for chest discomfort and confusion.  Patient was accompanied by his wife who helped provide the majority of the history.  Two days prior to hospitalization patient was experiencing a cough which is progressively gotten worse.  Nonproductive and not associated with any degree of dyspnea.  Has also been feeling generalized weakness and fatigue.  Was brought into the hospital for worsening confusion ultimately.  Has had 2 TIAs in the past.  On arrival to the hospital was febrile.  COVID-19 testing was positive.  No respiratory symptoms however.  Was also found to be hyponatremic at 126..  Chest x-ray was negative for acute infiltrate and patient was breathing comfortably on room air.  Patient was preemptively placed on cefepime for neutropenic fevers.  Patient was having fluctuating fevers throughout hospitalization.  Patient mentation also waxed and waned.  Did require hypertonic saline drip with quick resolution of hyponatremia and mentation changes.  Was found to be euvolemic and was put on a fluid restriction and sodium chloride tablets with continued improvement.  Fevers began to wane and patient remained afebrile for greater than 48 hours.  Blood cultures remain negative.  Pancytopenia workup was started however ultimately no specific cause was identified.  Has had follow-up with Hematology and Oncology as an outpatient who wanted to perform bone marrow biopsy several years ago however was declined by patient.  Did reach out to Hematology and Oncology who did not suggest any further inpatient workup and recommended referral for outpatient workup.  Patient is stable today and is requesting discharge home.  Will be discharged home with supportive cough medicine, referral to Hematology and Oncology.  Strict follow-up with PCP recommended within 5 days.
Age: 85.0
Sex: M
Vaccine: COVID19-2, FLUA4
Symptoms: Fluid intake restriction, Hyponatraemia, Mental status changes, Pancytopenia, SARS-CoV-2 test positive
Clinical narrative: BRIEF OVERVIEW: Admission Date: 8/24/2023 Discharge Date: Aug 30, 2023 Discharge Disposition:  home or self care   DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Hyponatremia [E87.1] Neutropenic fever [D70.9, R50.81] COVID [U07.1] COVID-19 [U07.1]   HOSPITAL COURSE:   86-year-old male with medical history of AFib, neutropenia, past alcohol abuse sober for 10 years, hyponatremia presented to the hospital for chest discomfort and confusion.  Patient was accompanied by his wife who helped provide the majority of the history.  Two days prior to hospitalization patient was experiencing a cough which is progressively gotten worse.  Nonproductive and not associated with any degree of dyspnea.  Has also been feeling generalized weakness and fatigue.  Was brought into the hospital for worsening confusion ultimately.  Has had 2 TIAs in the past.  On arrival to the hospital was febrile.  COVID-19 testing was positive.  No respiratory symptoms however.  Was also found to be hyponatremic at 126..  Chest x-ray was negative for acute infiltrate and patient was breathing comfortably on room air.  Patient was preemptively placed on cefepime for neutropenic fevers.  Patient was having fluctuating fevers throughout hospitalization.  Patient mentation also waxed and waned.  Did require hypertonic saline drip with quick resolution of hyponatremia and mentation changes.  Was found to be euvolemic and was put on a fluid restriction and sodium chloride tablets with continued improvement.  Fevers began to wane and patient remained afebrile for greater than 48 hours.  Blood cultures remain negative.  Pancytopenia workup was started however ultimately no specific cause was identified.  Has had follow-up with Hematology and Oncology as an outpatient who wanted to perform bone marrow biopsy several years ago however was declined by patient.  Did reach out to Hematology and Oncology who did not suggest any further inpatient workup and recommended referral for outpatient workup.  Patient is stable today and is requesting discharge home.  Will be discharged home with supportive cough medicine, referral to Hematology and Oncology.  Strict follow-up with PCP recommended within 5 days.
Age: 53.0
Sex: F
Vaccine: COVID19-2
Symptoms: Paraesthesia oral
Clinical narrative: The patient received covid vaccine and flu shot together at 0924 am. Around 0943 am patient complained of a tingling sensation around her mouth
Age: 60.0
Sex: F
Vaccine: COVID19, FLU4
Symptoms: Product storage error
Clinical narrative: Refrigerated vaccine was administered 2 days after the Beyond Use Date.  Beyond Use Date was 11/01/2023.  Vaccine administered on 11/03/2023.
Age: 86.0
Sex: M
Vaccine: FLUA4, VARZOS
Symptoms: Agitation, Condition aggravated, Loss of personal independence in daily activities, Pain, Somnolence
Clinical narrative: Patient reported that their tremors have gotten "much worse", in addition to feeling pain, sleepiness, agitation and general loss of function in the 2 days after the vaccine
Age: 86.0
Sex: M
Vaccine: FLUA4, VARZOS
Symptoms: Tremor
Clinical narrative: Patient reported that their tremors have gotten "much worse", in addition to feeling pain, sleepiness, agitation and general loss of function in the 2 days after the vaccine
Age: 72.0
Sex: M
Vaccine: COVID19
Symptoms: Acute respiratory failure, Asthenia, COVID-19, Cerebrovascular accident, Chest X-ray normal
Clinical narrative: BRIEF OVERVIEW: Admission Date: 8/24/2023 Discharge Date: Aug 27, 2023 Discharge Disposition:  home health care svc  DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Hypoxia [R09.02] COVID-19 virus infection [U07.1] Acute respiratory failure due to COVID-19 (HCC) [U07.1, J96.00]   HOSPITAL COURSE: Pt. is a 74 year old male with PMH of type 2 diabetes, hypertension, Meniere's disease, chronic pain, NPH s/p VP shunt placed Feb 2022, and recent stroke May 2023. Pt. presented to the ED with SOB, cough, and generalized weakness. He was diagnosed outpatient with COVID19, but continued to worsen and came to the ED. He was found to be hypoxic and admitted to the hospital. He was started on remdesivir and decadron. Chest x-ray showed no acute abnormalities. He was quickly weaned off of supplemental O2 and his symptoms improved. PT/OT recommended home with home PT. Discharge was delayed due to home safety concerns. PT/OT re-evaluated the pt. and continued to recommended home with assist. After talking to Granddaughter pt. will have assistance at home. He will complete a ten day course of decadron outpatient. Follow up with his PCP outpatient. Pt. is discharging in improved and stable condition
Age: 72.0
Sex: M
Vaccine: COVID19
Symptoms: Cough, Dyspnoea, Hypoxia, Ventriculo-peritoneal shunt
Clinical narrative: BRIEF OVERVIEW: Admission Date: 8/24/2023 Discharge Date: Aug 27, 2023 Discharge Disposition:  home health care svc  DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Hypoxia [R09.02] COVID-19 virus infection [U07.1] Acute respiratory failure due to COVID-19 (HCC) [U07.1, J96.00]   HOSPITAL COURSE: Pt. is a 74 year old male with PMH of type 2 diabetes, hypertension, Meniere's disease, chronic pain, NPH s/p VP shunt placed Feb 2022, and recent stroke May 2023. Pt. presented to the ED with SOB, cough, and generalized weakness. He was diagnosed outpatient with COVID19, but continued to worsen and came to the ED. He was found to be hypoxic and admitted to the hospital. He was started on remdesivir and decadron. Chest x-ray showed no acute abnormalities. He was quickly weaned off of supplemental O2 and his symptoms improved. PT/OT recommended home with home PT. Discharge was delayed due to home safety concerns. PT/OT re-evaluated the pt. and continued to recommended home with assist. After talking to Granddaughter pt. will have assistance at home. He will complete a ten day course of decadron outpatient. Follow up with his PCP outpatient. Pt. is discharging in improved and stable condition
Age: 83.0
Sex: M
Vaccine: COVID19-2
Symptoms: COVID-19, Echocardiogram abnormal, Fatigue, Hypokinesia, Magnetic resonance imaging heart
Clinical narrative: Discharge Provider: MD  Primary Care Provider : DO    Admission Date: 8/24/2023 Discharge Date: 8/27/2023    CONDITION ON DISCHARGE: Stable and improved. Admitted as an Inpatient    HOSPITAL COURSE:   Came with fatigue and was found to have covid. He did not have any oxygen requirement, but improved with nebs and steroids.   He was found to have a troponin elevation to > 1000 and septal hypokinesis on echo. Cardiology recommended heparin drip for 48 hours, stabilization of covid, then transfer for Cardiac MRI.   He was transferred on Sunday for MRI Monday.   A further discharge summary will follow that admission.   He Has DM2, CKD, BPH, HTN ,HLD, chronic back and neck pain.
Age: 83.0
Sex: M
Vaccine: COVID19-2
Symptoms: Troponin increased
Clinical narrative: Discharge Provider: MD  Primary Care Provider : DO    Admission Date: 8/24/2023 Discharge Date: 8/27/2023    CONDITION ON DISCHARGE: Stable and improved. Admitted as an Inpatient    HOSPITAL COURSE:   Came with fatigue and was found to have covid. He did not have any oxygen requirement, but improved with nebs and steroids.   He was found to have a troponin elevation to > 1000 and septal hypokinesis on echo. Cardiology recommended heparin drip for 48 hours, stabilization of covid, then transfer for Cardiac MRI.   He was transferred on Sunday for MRI Monday.   A further discharge summary will follow that admission.   He Has DM2, CKD, BPH, HTN ,HLD, chronic back and neck pain.
Age: 71.0
Sex: M
Vaccine: RSV
Symptoms: Headache, Influenza like illness, Injection site pain
Clinical narrative: He got his vaccine, and when he got it he told him that it burned really bad, and he had had that sensation before but it would go away, and he walked home and it was still burning, and just continued.  The next day it was slightly going away but he still felt it, and that continued and then he took some Advil. He had a headache also in the back of his head, and took some Advil and that relieved the symptoms temporarily.  He still had the headache, but not as bad as it was before.  It felt like it was like a muscle just bouncing off his head.  He is still getting his headaches still.   He has flu-like symptoms and does not know if he should proceed with the other vaccines that he is supposed to get due to this reaction.    He also had a flu shot a month ago and did not have any reaction at all.  This is the first time that anything has happened to him from a vaccine.
Age: 86.0
Sex: M
Vaccine: COVID19-2
Symptoms: Acute kidney injury, Acute respiratory failure, Asthenia, Atrial fibrillation, Blood creatinine
Clinical narrative: Discharge Physician:  MD Primary Care Physician: MD   Date of Admission: 8/23/2023 Discharge Date: 8/29/2023 Room Number: 2022/2022-1  PRESENTING PROBLEM: Acute respiratory failure with hypoxia [J96.01] Acute renal failure, unspecified acute renal failure type [N17.9] Acute hypoxemic respiratory failure due to COVID-19 [U07.1, J96.01] COVID-19 virus infection [U07.1]   HOSPITAL COURSE: Patient is a 86 y.o. male past medical history diabetes, HLD, HTN, CAD, RA, BPH who presents with weakness and a fall.    In the Emergency Department, he had labs showing AKI with Cr of 1.49. His procal was negative, lactic acid elevated at 3.8. He had no leukocytosis. He was found to be febrile on presentation and tested positive for COVID. He was given IVF and tylenol with improvement of his symptoms. He became hypoxic requiring supplemental oxygen and was treated with decadron. CXR was negative. The hospitalist team was contacted for admission and further management. Hypoxia rapidly resolved and covid 19 therapy was not continued. PT/OT evaluated recommended SAR. MSW/CM consulted for discharge planning. Local wound care for bilateral knee scrapes was performed. Discussed Afib on EKG and therapeutic anticoagulation. After consideration family and patient agreed to start eliquis. Initially recommended by PT for pt to discharge to SAR. Pt improved during admit, so was eventually discharged home with HHC under the care of his daughters.    Electrolytes were monitored and repleted PRN throughout the admission. 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