chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 81.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Exposure to SARS-CoV-2, Illness, Malaise, SARS-CoV-2 test positive
Clinical narrative: generalized malaise. Illness started a couple days after contact with known COVID + visitor at her house.
Age: 31.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Vaccine administered beyond storage guidelines.
Age: 44.0
Sex: F
Vaccine: FLU4
Symptoms: Axillary pain, Breast pain, Feeling hot, Musculoskeletal chest pain, Musculoskeletal pain
Clinical narrative: Swelling, heat,, and pain of auxiliary, scapular, mammary, pectoral, intercostal spaces on right side
Age: 44.0
Sex: F
Vaccine: FLU4
Symptoms: Myalgia, Swelling
Clinical narrative: Swelling, heat,, and pain of auxiliary, scapular, mammary, pectoral, intercostal spaces on right side
Age: 60.0
Sex: F
Vaccine: COVID19
Symptoms: Acute psychosis, Anaemia, Anticoagulant therapy, Aspartate aminotransferase increased, Asthenia
Clinical narrative: Patient test positive for Covid on 10/29/2021. Patient received Moderna vaccine with 1st dose 025C21A on 05/17/2021 and 2nd dose 026D21A on 06/14/2021 Patient was on an inpatient Behavioral Health unit when tested positive. Patient was admitted to unit on 10/15/2021.  Per IM Progress Note from 10/29/2021:  Assessment/Plan  COVID-19 viral illness with upper respiratory symptoms    - patient is vaccinated UTI, s/p 5 days Keflex  Hypokalemia, resolved  Hypernatremia/Hyperchloremia - secondary to decreased po intake, resolved  Anemia?stable  Mildly elevated AST question significance  Acute psychosis?catatonic?improved  Bipolar and schizophrenia  Hyperlipidemia  Tobacco dependence  Chronic opioid and benzo use per chart review   Plan: Monitor vital signs every 6 hours, if O2 sat < 93% notify IM team Check chest x-ray  Check CBC with diff and CMP  Check inflammatory markers -  Elevated D-dimer, CRP, ferritin, LDH  Start Vitamin C, vitamin D, Melatonin, and zinc  Add incentive spirometer  Add Flonase nasal spray  Maintain COVID isolation  DVT prophylaxis - start Lovenox     Subjective     Patient is seen and examined in follow-up for COVID-19 as a new diagnosis.  Patient was complaining of cold-like symptoms while in inpatient psychiatry and was tested positive for COVID-19.  Patient states she did have 2 doses of Covid vaccine although she does not remember which one at Pharmacy in May and June.  She complains of nasal congestion, productive cough, chills and weakness.  She denies any loss of taste or smell but does admit to decreased appetite.  She denies any shortness of breath at this time.  She denies any fevers.  She denies any body aches.
Age: 60.0
Sex: F
Vaccine: COVID19
Symptoms: Bipolar disorder, Blood lactate dehydrogenase, C-reactive protein, COVID-19, Catatonia
Clinical narrative: Patient test positive for Covid on 10/29/2021. Patient received Moderna vaccine with 1st dose 025C21A on 05/17/2021 and 2nd dose 026D21A on 06/14/2021 Patient was on an inpatient Behavioral Health unit when tested positive. Patient was admitted to unit on 10/15/2021.  Per IM Progress Note from 10/29/2021:  Assessment/Plan  COVID-19 viral illness with upper respiratory symptoms    - patient is vaccinated UTI, s/p 5 days Keflex  Hypokalemia, resolved  Hypernatremia/Hyperchloremia - secondary to decreased po intake, resolved  Anemia?stable  Mildly elevated AST question significance  Acute psychosis?catatonic?improved  Bipolar and schizophrenia  Hyperlipidemia  Tobacco dependence  Chronic opioid and benzo use per chart review   Plan: Monitor vital signs every 6 hours, if O2 sat < 93% notify IM team Check chest x-ray  Check CBC with diff and CMP  Check inflammatory markers -  Elevated D-dimer, CRP, ferritin, LDH  Start Vitamin C, vitamin D, Melatonin, and zinc  Add incentive spirometer  Add Flonase nasal spray  Maintain COVID isolation  DVT prophylaxis - start Lovenox     Subjective     Patient is seen and examined in follow-up for COVID-19 as a new diagnosis.  Patient was complaining of cold-like symptoms while in inpatient psychiatry and was tested positive for COVID-19.  Patient states she did have 2 doses of Covid vaccine although she does not remember which one at Pharmacy in May and June.  She complains of nasal congestion, productive cough, chills and weakness.  She denies any loss of taste or smell but does admit to decreased appetite.  She denies any shortness of breath at this time.  She denies any fevers.  She denies any body aches.
Age: 60.0
Sex: F
Vaccine: COVID19
Symptoms: Chest X-ray, Chills, Decreased appetite, Differential white blood cell count, Drug dependence
Clinical narrative: Patient test positive for Covid on 10/29/2021. Patient received Moderna vaccine with 1st dose 025C21A on 05/17/2021 and 2nd dose 026D21A on 06/14/2021 Patient was on an inpatient Behavioral Health unit when tested positive. Patient was admitted to unit on 10/15/2021.  Per IM Progress Note from 10/29/2021:  Assessment/Plan  COVID-19 viral illness with upper respiratory symptoms    - patient is vaccinated UTI, s/p 5 days Keflex  Hypokalemia, resolved  Hypernatremia/Hyperchloremia - secondary to decreased po intake, resolved  Anemia?stable  Mildly elevated AST question significance  Acute psychosis?catatonic?improved  Bipolar and schizophrenia  Hyperlipidemia  Tobacco dependence  Chronic opioid and benzo use per chart review   Plan: Monitor vital signs every 6 hours, if O2 sat < 93% notify IM team Check chest x-ray  Check CBC with diff and CMP  Check inflammatory markers -  Elevated D-dimer, CRP, ferritin, LDH  Start Vitamin C, vitamin D, Melatonin, and zinc  Add incentive spirometer  Add Flonase nasal spray  Maintain COVID isolation  DVT prophylaxis - start Lovenox     Subjective     Patient is seen and examined in follow-up for COVID-19 as a new diagnosis.  Patient was complaining of cold-like symptoms while in inpatient psychiatry and was tested positive for COVID-19.  Patient states she did have 2 doses of Covid vaccine although she does not remember which one at Pharmacy in May and June.  She complains of nasal congestion, productive cough, chills and weakness.  She denies any loss of taste or smell but does admit to decreased appetite.  She denies any shortness of breath at this time.  She denies any fevers.  She denies any body aches.
Age: 60.0
Sex: F
Vaccine: COVID19
Symptoms: Drug withdrawal maintenance therapy, Fibrin D dimer increased, Full blood count, Hyperchloraemia, Hyperlipidaemia
Clinical narrative: Patient test positive for Covid on 10/29/2021. Patient received Moderna vaccine with 1st dose 025C21A on 05/17/2021 and 2nd dose 026D21A on 06/14/2021 Patient was on an inpatient Behavioral Health unit when tested positive. Patient was admitted to unit on 10/15/2021.  Per IM Progress Note from 10/29/2021:  Assessment/Plan  COVID-19 viral illness with upper respiratory symptoms    - patient is vaccinated UTI, s/p 5 days Keflex  Hypokalemia, resolved  Hypernatremia/Hyperchloremia - secondary to decreased po intake, resolved  Anemia?stable  Mildly elevated AST question significance  Acute psychosis?catatonic?improved  Bipolar and schizophrenia  Hyperlipidemia  Tobacco dependence  Chronic opioid and benzo use per chart review   Plan: Monitor vital signs every 6 hours, if O2 sat < 93% notify IM team Check chest x-ray  Check CBC with diff and CMP  Check inflammatory markers -  Elevated D-dimer, CRP, ferritin, LDH  Start Vitamin C, vitamin D, Melatonin, and zinc  Add incentive spirometer  Add Flonase nasal spray  Maintain COVID isolation  DVT prophylaxis - start Lovenox     Subjective     Patient is seen and examined in follow-up for COVID-19 as a new diagnosis.  Patient was complaining of cold-like symptoms while in inpatient psychiatry and was tested positive for COVID-19.  Patient states she did have 2 doses of Covid vaccine although she does not remember which one at Pharmacy in May and June.  She complains of nasal congestion, productive cough, chills and weakness.  She denies any loss of taste or smell but does admit to decreased appetite.  She denies any shortness of breath at this time.  She denies any fevers.  She denies any body aches.
Age: 60.0
Sex: F
Vaccine: COVID19
Symptoms: Hypernatraemia, Hypokalaemia, Hypophagia, Inflammatory marker test, Metabolic function test
Clinical narrative: Patient test positive for Covid on 10/29/2021. Patient received Moderna vaccine with 1st dose 025C21A on 05/17/2021 and 2nd dose 026D21A on 06/14/2021 Patient was on an inpatient Behavioral Health unit when tested positive. Patient was admitted to unit on 10/15/2021.  Per IM Progress Note from 10/29/2021:  Assessment/Plan  COVID-19 viral illness with upper respiratory symptoms    - patient is vaccinated UTI, s/p 5 days Keflex  Hypokalemia, resolved  Hypernatremia/Hyperchloremia - secondary to decreased po intake, resolved  Anemia?stable  Mildly elevated AST question significance  Acute psychosis?catatonic?improved  Bipolar and schizophrenia  Hyperlipidemia  Tobacco dependence  Chronic opioid and benzo use per chart review   Plan: Monitor vital signs every 6 hours, if O2 sat < 93% notify IM team Check chest x-ray  Check CBC with diff and CMP  Check inflammatory markers -  Elevated D-dimer, CRP, ferritin, LDH  Start Vitamin C, vitamin D, Melatonin, and zinc  Add incentive spirometer  Add Flonase nasal spray  Maintain COVID isolation  DVT prophylaxis - start Lovenox     Subjective     Patient is seen and examined in follow-up for COVID-19 as a new diagnosis.  Patient was complaining of cold-like symptoms while in inpatient psychiatry and was tested positive for COVID-19.  Patient states she did have 2 doses of Covid vaccine although she does not remember which one at Pharmacy in May and June.  She complains of nasal congestion, productive cough, chills and weakness.  She denies any loss of taste or smell but does admit to decreased appetite.  She denies any shortness of breath at this time.  She denies any fevers.  She denies any body aches.
Age: 60.0
Sex: F
Vaccine: COVID19
Symptoms: Nasal congestion, Nasopharyngitis, Productive cough, Respiratory symptom, SARS-CoV-2 test positive
Clinical narrative: Patient test positive for Covid on 10/29/2021. Patient received Moderna vaccine with 1st dose 025C21A on 05/17/2021 and 2nd dose 026D21A on 06/14/2021 Patient was on an inpatient Behavioral Health unit when tested positive. Patient was admitted to unit on 10/15/2021.  Per IM Progress Note from 10/29/2021:  Assessment/Plan  COVID-19 viral illness with upper respiratory symptoms    - patient is vaccinated UTI, s/p 5 days Keflex  Hypokalemia, resolved  Hypernatremia/Hyperchloremia - secondary to decreased po intake, resolved  Anemia?stable  Mildly elevated AST question significance  Acute psychosis?catatonic?improved  Bipolar and schizophrenia  Hyperlipidemia  Tobacco dependence  Chronic opioid and benzo use per chart review   Plan: Monitor vital signs every 6 hours, if O2 sat < 93% notify IM team Check chest x-ray  Check CBC with diff and CMP  Check inflammatory markers -  Elevated D-dimer, CRP, ferritin, LDH  Start Vitamin C, vitamin D, Melatonin, and zinc  Add incentive spirometer  Add Flonase nasal spray  Maintain COVID isolation  DVT prophylaxis - start Lovenox     Subjective     Patient is seen and examined in follow-up for COVID-19 as a new diagnosis.  Patient was complaining of cold-like symptoms while in inpatient psychiatry and was tested positive for COVID-19.  Patient states she did have 2 doses of Covid vaccine although she does not remember which one at Pharmacy in May and June.  She complains of nasal congestion, productive cough, chills and weakness.  She denies any loss of taste or smell but does admit to decreased appetite.  She denies any shortness of breath at this time.  She denies any fevers.  She denies any body aches.
Age: 60.0
Sex: F
Vaccine: COVID19
Symptoms: Schizophrenia, Serum ferritin, Tobacco user, Urinary tract infection
Clinical narrative: Patient test positive for Covid on 10/29/2021. Patient received Moderna vaccine with 1st dose 025C21A on 05/17/2021 and 2nd dose 026D21A on 06/14/2021 Patient was on an inpatient Behavioral Health unit when tested positive. Patient was admitted to unit on 10/15/2021.  Per IM Progress Note from 10/29/2021:  Assessment/Plan  COVID-19 viral illness with upper respiratory symptoms    - patient is vaccinated UTI, s/p 5 days Keflex  Hypokalemia, resolved  Hypernatremia/Hyperchloremia - secondary to decreased po intake, resolved  Anemia?stable  Mildly elevated AST question significance  Acute psychosis?catatonic?improved  Bipolar and schizophrenia  Hyperlipidemia  Tobacco dependence  Chronic opioid and benzo use per chart review   Plan: Monitor vital signs every 6 hours, if O2 sat < 93% notify IM team Check chest x-ray  Check CBC with diff and CMP  Check inflammatory markers -  Elevated D-dimer, CRP, ferritin, LDH  Start Vitamin C, vitamin D, Melatonin, and zinc  Add incentive spirometer  Add Flonase nasal spray  Maintain COVID isolation  DVT prophylaxis - start Lovenox     Subjective     Patient is seen and examined in follow-up for COVID-19 as a new diagnosis.  Patient was complaining of cold-like symptoms while in inpatient psychiatry and was tested positive for COVID-19.  Patient states she did have 2 doses of Covid vaccine although she does not remember which one at Pharmacy in May and June.  She complains of nasal congestion, productive cough, chills and weakness.  She denies any loss of taste or smell but does admit to decreased appetite.  She denies any shortness of breath at this time.  She denies any fevers.  She denies any body aches.
Age: 10.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Product administered to patient of inappropriate age
Clinical narrative: Child's parents scheduled a COVID vaccine appointment online and entered and confirmed the date of birth of 2009 (12 years). However, today (11/01/21), dad called and said that the date of birth on the vaccine card is incorrect. The child's real DOB is 2011 (10 years). This information was not given to the pharmacy at the time of vaccine administration. Pharmacist ensured child's name and DOB with the parent and they confirmed it as 2009 at the time of vaccine administration. Explained to mom that her daughter is outside of the age group for this vaccine but as per the date of birth provided at the time of giving the vaccine made her eligible for this vaccine.
Age: 80.0
Sex: F
Vaccine: VARZOS
Symptoms: Herpes zoster
Clinical narrative: Pt. states that after receiving the 2nd dose of Shingrix 02/13/2021, started experiencing symptoms 10/27/2021 of a Shingles outbreak across the chest and towards the back. Under treatment of Primary for Shingles.
Age: 63.0
Sex: F
Vaccine: FLU4
Symptoms: Haemorrhage, Urticaria
Clinical narrative: PT HAD MINOR BLEEDING THAT STOPPED WITHIN 3 SECONDS OF NEEDLE WITHDRAWAL; HOWEVER A WELT SOON FORMED THAT GREW TO MAXIMUM 1 INCH DIAMETER, 1CM HIGH WITHIN 30 SECONDS. PT WAS SAT BY PHARAMCY FOR OBSERVATION FOR 30 MINUTES AFTERWARDS. SHE INDICATED NO ADVERSE REACTION (PAIN, DIZZINESS, ETC). IT SEEMED MERELY TO BE A LARGE WELT. BY END OF 30 MIN, WELT HAD SHRUNK BY MORE THAN HALF ORIGINAL SIZE.  PT WAS COUNSELED ON SIGNS/SYMPTONS OF CLOTTING, INTERNAL BLEEDING, BRUISING. WHEN TO SEEK MEDICAL HELP, AND TO REACH OUT TO US IF ANYTHING DEVELOPES.
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Contusion
Clinical narrative: Patient reported several bruises up and down left and right forearm the day after receving the vaccine.
Age: 70.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect dose administered, Product preparation issue
Clinical narrative: Pfizer vial was diluted with 0.8ml of diluent instead of 1.8ml, so only one three 0.3ml doses were able to be drawn from the Pfizer vial instead of six.  Patient ended up with a bigger dose of Pfizer than what is recommended.  Patient was called and informed of receiving the incorrect dosage.  Patient had no worries, concerns or issues at the time.
Age: 37.0
Sex: M
Vaccine: COVID19
Symptoms: Hypersensitivity, Urticaria, Wheezing
Clinical narrative: Allergic reaction with urticaria, wheezing. Improved after benadryl, pepcid, decadron
Age: 33.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Alanine aminotransferase increased, Antinuclear antibody positive, Autoimmune hepatitis, Blood test, Smooth muscle antibody positive
Clinical narrative: Possible autoimmune hepatitis
Age: 29.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Vaccine administered beyond storage guidelines
Age: 32.0
Sex: F
Vaccine: COVID19
Symptoms: Cardiac stress test, Chest pain, Echocardiogram, Electrocardiogram, Electrocardiogram ambulatory
Clinical narrative: Chest pains occurring daily since 72 hours after the first Pfizer vaccine.
Age: 60.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Asymptomatic COVID-19, SARS-CoV-2 test positive
Clinical narrative: patient tested postive on 11/1. Asymptomatic
Age: 51.0
Sex: M
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Vaccine administered beyond storage guidelines
Age: 26.0
Sex: M
Vaccine: COVID19
Symptoms: Anticoagulant therapy, Asymptomatic COVID-19, SARS-CoV-2 test positive, Thrombosis prophylaxis
Clinical narrative: Patient tested positive for Covid on 10/29/2021. Patient received Pfizer vaccine with 1st dose EW0161 on 04/12/2021 and 2nd dose EW0182 on 05/03/2021.  Patient was on inpatient Behavioral Health unit when tested positive. Patient admitted to unit on 10/15/2021. Per IM Progress Note on 10/29/2021:  Assessment/Plan  COVID-19 viral infection, asymptomatic    ?Patient is vaccinated with Pfizer  Vitamin D Deficiency Schizoaffective disorder  GERD  Marijuana use disorder   Plan:  Monitor vital signs every 6 hours, if O2 sat < 93% notify IM team Add Vitamin C,  Melatonin, and zinc  Continue Vitamin D  Maintain COVID isolation  Add DVT prophylaxis - Lovenox qday  No further treatment/workup needed for COVID-19 at this time, if patient becomes symptomatic please notify IM team     Subjective     Patient is seen and examined due to COVID-19 viral infection.  There has been a Covid outbreak on patient's unit, therefore all patients were tested and patient tested positive. Patient states he was vaccinated with Pfizer vaccine. He denies any cold related symptoms at this time. He denies difficulty in breathing, cough, loss of taste or smell, nausea/vomiting, abdominal pain, weakness or muscle aches. He is concerned that this will prevent him from going home.
Age: 65.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Malaise, Pyrexia
Clinical narrative: Feverish, Intense chills throughout body, malaise.
Age: 60.0
Sex: M
Vaccine: COVID19
Symptoms: Chills, Condition aggravated, Extra dose administered, Fatigue, Headache
Clinical narrative: This was a Moderna booster 6 months after my Jansen vaccine.  I had a similar, not quite as bad reaction, to the Jansen.   Reaction to the Moderna booster:  Significant headaches, chills, muscle aches for four hours followed by an additional 18 hours of deep fatigue.  All AEs fully resolved
Age: 60.0
Sex: M
Vaccine: COVID19
Symptoms: Interchange of vaccine products, Myalgia
Clinical narrative: This was a Moderna booster 6 months after my Jansen vaccine.  I had a similar, not quite as bad reaction, to the Jansen.   Reaction to the Moderna booster:  Significant headaches, chills, muscle aches for four hours followed by an additional 18 hours of deep fatigue.  All AEs fully resolved
Age: 43.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect dose administered, Product preparation error
Clinical narrative: Pfizer vial was diluted with 0.8ml of diluent instead of 1.8ml, so only one three 0.3ml doses were able to be drawn from the Pfizer vial instead of six.  Patient ended up with a bigger dose of Pfizer than what is recommended.  Patient was called and informed of receiving the incorrect dosage.  Patient had no worries, concerns or issues at the time.
Age: 77.0
Sex: F
Vaccine: COVID19
Symptoms: Cardiogenic shock, Condition aggravated, Ventricular tachycardia
Clinical narrative: Pfizer-BioNTech COVID-19 Vaccine EUA: one day after receiving vaccine patient hospitalized for sustained ventricular tachycardia. Administered  one shock, electrolytes replaced, antiarrhythmic medications adjusted, and patient discharged to home medically stable in normal sinus rhythm with cardiology follow-up in place.
Age: 14.0
Sex: M
Vaccine: FLU4
Symptoms: Dizziness
Clinical narrative: Patient received annual flu shot. Patient was a little nervous about getting the flu shot. Patient stated that he did not see the needle. He stated that he felt a little prick. After getting the shot, he walked out of the immunization room stating that he felt okay. He walked around the store for a few minutes. After about 3 to 5 minutes, patient starting feeling faint. As patient was walking out of the store, he laid down on the floor. We called 911 and they arrived. They  assessed the patient and talked with him to see how he was feeling. Mom stated that they got the flu shot together every year and that this has never happened before. Afterwards, patient stated that he had not eaten anything. after being assessed, patient walked out of the store with mom to get food. Mom called back later that evening and stated that patient was doing great after he ate.
Age: 30.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered, No adverse event
Clinical narrative: NO ADVERSE EVENT OCCURED.  VACCINE ADMINSTERED PAST BUD
Age: 74.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Pain
Clinical narrative: Self-report: increased body aches, continuing after 6 months. My use of Gabapentin 300 mg has increased from 4x daily to 6x daily with less effectiveness than before
Age: 67.0
Sex: F
Vaccine: FLU4
Symptoms: Asthenia, Chills, Influenza, Migraine
Clinical narrative: The Fluzone HD 65+ PF 2021-22 INJ 0.7 ML vaccine gradually sapped my strength to the degree that I had trouble just getting up off the toilet that night. It also gave me a migraine headache which lasted overnight and into the next day, chills (but no fever), and the experience of an actual flu infection especially the first night. It felt ?too strong?. I?m reporting the experience because I think seniors should be advised and specifically warned about muscle weakness, especially if they live alone, and recommended to have someone on call or standby or even with them, as a safeguard. I live with my son, so that was not an issue for me, even though the experience was frightening.
Age: 70.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site rash, Rash erythematous
Clinical narrative: 8" x 2" erythema rash at injection site
Age: 73.0
Sex: M
Vaccine: COVID19
Symptoms: Extra dose administered, Wrong product administered
Clinical narrative: The patient acknowledged he was getting a pfizer shot but after the shot his wife said they wanted to shingrix instead. Tech and I both understood he wanted pfizer and was told it was his first shot but actually it was his fourth. his consent form does say shingles shot. I specifically asked if he was getting pfizer and he said yes. The patient was understanding and will return in a month for his first shingles shot.
Age: 54.0
Sex: M
Vaccine: COVID19
Symptoms: Interchange of vaccine products, Wrong product administered
Clinical narrative: Pt came to get his 2nd dose of Pfizer vaccine, but instead got Janssen-J&J
Age: 80.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19
Clinical narrative: Hospitalization for COVID infection
Age: 25.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered, No adverse event
Clinical narrative: NO ADVERSE EVENT OCCURED.  VACCINE ADMINSTERED PAST BEYOND USE DATE.
Age: 0.08
Sex: F
Vaccine: RV1
Symptoms: Abdominal rigidity, Abdominal wall operation, Aspiration, Chest X-ray abnormal, Condition aggravated
Clinical narrative: Patient inconsolable for 30 minutes. RN at bedside to assess prior to DC and pt presented with round-taunt abdomen. Bowel sounds hypoactive. Stooling x4 watery yellow/brown stools. Temp 97.5F.  X-ray with pneumatosis, no free air on decub. Has been having watery stools. Emesis 10 ml. OG placed with aspiration of 30 ml feculent fluid. Bloody stool in diaper.  Later decubitus film confirms small amount of free air. Will proceed with ex lap.  Patient returned from OR.   Surgical team noted that they did not find any perforation or ischemic bowel.  No resection was performed and the abdomen was closed.   Plan to extubate in AM, continue NPO, begin zosyn x 7 days and gentamicin x 2 days (if cultures remain negative).
Age: 0.08
Sex: F
Vaccine: RV1
Symptoms: Crying, Culture, Diarrhoea, Faeces discoloured, Frequent bowel movements
Clinical narrative: Patient inconsolable for 30 minutes. RN at bedside to assess prior to DC and pt presented with round-taunt abdomen. Bowel sounds hypoactive. Stooling x4 watery yellow/brown stools. Temp 97.5F.  X-ray with pneumatosis, no free air on decub. Has been having watery stools. Emesis 10 ml. OG placed with aspiration of 30 ml feculent fluid. Bloody stool in diaper.  Later decubitus film confirms small amount of free air. Will proceed with ex lap.  Patient returned from OR.   Surgical team noted that they did not find any perforation or ischemic bowel.  No resection was performed and the abdomen was closed.   Plan to extubate in AM, continue NPO, begin zosyn x 7 days and gentamicin x 2 days (if cultures remain negative).
Age: 0.08
Sex: F
Vaccine: RV1
Symptoms: Gastric aspiration procedure, Gastrointestinal sounds abnormal, Haematochezia, Intra-abdominal pressure increased, Laparoscopic surgery
Clinical narrative: Patient inconsolable for 30 minutes. RN at bedside to assess prior to DC and pt presented with round-taunt abdomen. Bowel sounds hypoactive. Stooling x4 watery yellow/brown stools. Temp 97.5F.  X-ray with pneumatosis, no free air on decub. Has been having watery stools. Emesis 10 ml. OG placed with aspiration of 30 ml feculent fluid. Bloody stool in diaper.  Later decubitus film confirms small amount of free air. Will proceed with ex lap.  Patient returned from OR.   Surgical team noted that they did not find any perforation or ischemic bowel.  No resection was performed and the abdomen was closed.   Plan to extubate in AM, continue NPO, begin zosyn x 7 days and gentamicin x 2 days (if cultures remain negative).
Age: 0.08
Sex: F
Vaccine: RV1
Symptoms: Nothing by mouth order, Pneumatosis, Pneumoperitoneum, Vomiting
Clinical narrative: Patient inconsolable for 30 minutes. RN at bedside to assess prior to DC and pt presented with round-taunt abdomen. Bowel sounds hypoactive. Stooling x4 watery yellow/brown stools. Temp 97.5F.  X-ray with pneumatosis, no free air on decub. Has been having watery stools. Emesis 10 ml. OG placed with aspiration of 30 ml feculent fluid. Bloody stool in diaper.  Later decubitus film confirms small amount of free air. Will proceed with ex lap.  Patient returned from OR.   Surgical team noted that they did not find any perforation or ischemic bowel.  No resection was performed and the abdomen was closed.   Plan to extubate in AM, continue NPO, begin zosyn x 7 days and gentamicin x 2 days (if cultures remain negative).
Age: 42.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Tested COVID positive after being fully vaccinated.
Age: 50.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Affective disorder, Blood test, Menstruation irregular, Psychotic disorder
Clinical narrative: Pt reports that her menstrual cycles were thrown completely off and still are, (3 cycles in less than 1 month), and She had near psychosis, with ongoing mood disturbance. She is certain it isn't menopause
Age: 24.0
Sex: F
Vaccine: COVID19
Symptoms: Disturbance in attention, Feeling abnormal, Feeling hot, Heart rate increased, Injection site warmth
Clinical narrative: - Skin hot to touch hours after the shot and still to this day. Overheating without sweating  - tachycardia. Resting heart rate will occasionally get above 100bpm, compared to the usual 60-70bpm. Became overly noticeable 1.5wks after shot - brain fog. In school and grades have started dropping since the week after the first injection. Struggling to concentrate - muscle weakness. Noticed 2 weeks after the shot
Age: 24.0
Sex: F
Vaccine: COVID19
Symptoms: Muscular weakness, Tachycardia
Clinical narrative: - Skin hot to touch hours after the shot and still to this day. Overheating without sweating  - tachycardia. Resting heart rate will occasionally get above 100bpm, compared to the usual 60-70bpm. Became overly noticeable 1.5wks after shot - brain fog. In school and grades have started dropping since the week after the first injection. Struggling to concentrate - muscle weakness. Noticed 2 weeks after the shot
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: Interchange of vaccine products, Vaccination error
Clinical narrative: Patient received  Moderna first dose on 10/27/21. In error, patient received a dose of Pfizer on 11/1/21.  Patient was examined and is feeling well. She will continue to be monitored.
Age: 51.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Chest discomfort, Computerised tomogram thorax abnormal, Electrocardiogram abnormal, Fatigue
Clinical narrative: Patient seen for knee pain, chest pressure and chronic fatigue. She eventually went to the emergency room.
Age: 51.0
Sex: F
Vaccine: COVID19
Symptoms: Fibrin D dimer increased, Pulmonary embolism, Sinus bradycardia
Clinical narrative: Patient seen for knee pain, chest pressure and chronic fatigue. She eventually went to the emergency room.
Age: 32.0
Sex: M
Vaccine: COVID19
Symptoms: Dyspnoea, Speech disorder
Clinical narrative: Patient received his 1st dose of Janssen COVID-19 in his left arm and about 1 minute after receiving the patient slumped in the chair. When the patient was able to speak to the pharmacist  he stated that he felt like he could not breathe. The patient was given 1 dose of epipen 0.3 mg and emergency services was called. A police officer and the EMT's arrived on the scene and took over the patient's care.
Age: 19.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect dose administered, Product preparation issue
Clinical narrative: Pfizer vial was diluted with 0.8ml of diluent instead of 1.8ml, so only one three 0.3ml doses were able to be drawn from the Pfizer vial instead of six.  Patient ended up with a bigger dose of Pfizer than what is recommended.  Patient was called and informed of receiving the incorrect dosage.  Patient had no worries, concerns or issues at the time.
Age: 36.0
Sex: M
Vaccine: COVID19
Symptoms: Dizziness, Eye pain, Eyelid ptosis, Fatigue, Headache
Clinical narrative: Constant headache starting at the base of the skull with regular escalation that is accompanied by lightheadedness, arm weakness, fatigue, eye pain, ptosis, and facial numbness. Headache has persisted since onset (4/13/2021) to the time of this reporting (11/1/2021). A MRI brain scan was normal, and traditional headache treatments have been ineffective. A CT myelogram also came back normal.
Age: 36.0
Sex: M
Vaccine: COVID19
Symptoms: Hypoaesthesia, Magnetic resonance imaging abnormal, Magnetic resonance imaging head, Muscular weakness, Spinal myelogram
Clinical narrative: Constant headache starting at the base of the skull with regular escalation that is accompanied by lightheadedness, arm weakness, fatigue, eye pain, ptosis, and facial numbness. Headache has persisted since onset (4/13/2021) to the time of this reporting (11/1/2021). A MRI brain scan was normal, and traditional headache treatments have been ineffective. A CT myelogram also came back normal.
Age: 54.0
Sex: F
Vaccine: COVID19
Symptoms: Muscle spasms, Postmenopausal haemorrhage
Clinical narrative: Cramping 2 days after the vaccine and then bleeding 2 weeks after.  I am 54 years old and haven't had a period in 4 years until after the first covid vaccination.  I am scheduled to see my OB/GYN this week.
Age: 55.0
Sex: F
Vaccine: COVID19
Symptoms: Acoustic stimulation tests, Body temperature increased, Lymphadenopathy, Tinnitus
Clinical narrative: Tinnitus onset day after shot.  Also had temperature of 100 F and swollen lymph node under left arm.  Tinnitus is the side effect that is being reported as it has not gone away and is constant.
Age: 45.0
Sex: F
Vaccine: COVID19
Symptoms: Lymph node pain
Clinical narrative: Soreness in underarm lymph node on day 2 on side of injection
Age: 84.0
Sex: F
Vaccine: COVID19
Symptoms: Asthenia, COVID-19, Chest X-ray abnormal, Diarrhoea, Fall
Clinical narrative: weakness and felt tired, diarrhea, hypoxia and required oxygen
Age: 84.0
Sex: F
Vaccine: COVID19
Symptoms: Fatigue, Hypoxia, Lung infiltration, Patella fracture, SARS-CoV-2 test positive
Clinical narrative: weakness and felt tired, diarrhea, hypoxia and required oxygen
Age: 49.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect dose administered, Product preparation issue
Clinical narrative: Pfizer vial was diluted with 0.8ml of diluent instead of 1.8ml, so only one three 0.3ml doses were able to be drawn from the Pfizer vial instead of six.  Patient ended up with a bigger dose of Pfizer than what is recommended.  Patient was called and informed of receiving the incorrect dosage.  Patient had no worries, concerns or issues at the time.
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Diarrhoea, Gastrointestinal pain, Headache, Lymph node pain
Clinical narrative: Started out as chills which became convocess chills, She had headaches, body aches and muscle aches. She had moderate GI pain meaning her guts hurt along with diaherra. She had a foreign lump in her right arm is long and swollen.  She said under her chin and neck areas are swollen and painful on the right side and it very much hurts when touching.
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Lymphadenopathy, Mass, Myalgia, Pain, Peripheral swelling
Clinical narrative: Started out as chills which became convocess chills, She had headaches, body aches and muscle aches. She had moderate GI pain meaning her guts hurt along with diaherra. She had a foreign lump in her right arm is long and swollen.  She said under her chin and neck areas are swollen and painful on the right side and it very much hurts when touching.
Age: 76.0
Sex: M
Vaccine: COVID19
Symptoms: Erythema, Pruritus
Clinical narrative: itching, red spots,
Age: 32.0
Sex: F
Vaccine: COVID19
Symptoms: Throat irritation, Throat tightness
Clinical narrative: Complained of burning and tightness to throat that got progressively worse.  Given EPI SubQ and transported via EMS to ED.
Age: 39.0
Sex: F
Vaccine: UNK
Symptoms: Lymph node pain, Lymphadenopathy, Vaccine positive rechallenge
Clinical narrative: after receiving my pfizer booster shot on Friday, enlarged lymph nodes under armpit, very painful,   Woke up with it Sunday morning and it is still painful,  This also happened when I received my second covid shot on March 9th 2021.  But it did not happen when I got the first shot on Jan 31st 2021.
Age: 35.0
Sex: F
Vaccine: COVID19
Symptoms: Asthenia, Headache, Migraine, Pain in extremity, Symptom recurrence
Clinical narrative: Day of Booster shot- soreness in arm,  Day 2- low energy,  headache  Day 3- lingering headache Day 4- lingering headache, borderline migraine
Age: 36.0
Sex: F
Vaccine: COVID19
Symptoms: Pityriasis rosea
Clinical narrative: Development of pityriasis rosea rash 1 week after Pfizer booster.
Age: 73.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Vaccine administered beyond storage guidelines.  Moderna analysis showed full effectiveness.
Age: 40.0
Sex: F
Vaccine: UNK
Symptoms: Polymenorrhoea, Vaginal haemorrhage
Clinical narrative: Pt reports vaginal bleeding starting the day after first covid vaccination. Unknown which vaccine was given Last period a week before vaccination day
Age: 102.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Acute kidney injury, Blood creatinine increased, Blood culture positive, Blood sodium decreased, COVID-19
Clinical narrative: Hospitalized 10/23/2021; COVID-19 positive 10/23/2021; fully vaccinated  Discharge Provider: MD Primary Care Provider at Discharge: MD Admission Date: 10/23/2021 Discharge Date: 10/26/2021   DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: COVID-19 [U07.1]   Patient is a wonderful 102 y.o. female with PMH of diabetes mellitus type 2, atrial fibrillation, hypertension, hyperlipidemia, CKD 3 who presented to the Emergency Department on 10/23 via EMS with increasing fatigue and lethargy secondary to covid19 infection.     Patient's VS were largely normal on presentation, labs initially were otherwise at baseline for patient and she didn't require oxygen.  CT head didn't show acute process.  Echo was obtained and showed normal LV function with possibly mildly reduced RV function.  Patient remained clinically stable and on room air however Cr uptrended and BP was low so lisinopril was held and fluid were given.  Patient continued to clinically do well and creatinine decreased on f/u check though Na was down to 129 (has been low at least since April) with both AKI and hyponatremia most likely being from poor PO intake.  Patient was seen by PT/OT who recommended SAR however patient and family opted for home care.  Patient was discharged with lisinopril held and she should avoid NSAIDs entirely going forward.  She will need close PCP f/u with repeat BMP to monitor sodium and creatinine.  Should sodium fail to improve would recommend obtaining urine sodium and osm to assess for SIADH.    Of note, patient had blood cultures obtained on presentation and on day before DC 1/2 cultures showed globicatella species; patient clinically did well off antibiotics with clinical improvement and this was felt most likely to be a contaminant.  ID (not officially consulted) did review case and recommended repeat BC which were obtained before DC but did not feel patient needed to stay in hospital for results with plan for either PCP to f/u on results if negative or hospital will reach out if cultures result as positive
Age: 102.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Computerised tomogram head normal, Echocardiogram normal, Fatigue, Hyponatraemia, Hypophagia
Clinical narrative: Hospitalized 10/23/2021; COVID-19 positive 10/23/2021; fully vaccinated  Discharge Provider: MD Primary Care Provider at Discharge: MD Admission Date: 10/23/2021 Discharge Date: 10/26/2021   DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: COVID-19 [U07.1]   Patient is a wonderful 102 y.o. female with PMH of diabetes mellitus type 2, atrial fibrillation, hypertension, hyperlipidemia, CKD 3 who presented to the Emergency Department on 10/23 via EMS with increasing fatigue and lethargy secondary to covid19 infection.     Patient's VS were largely normal on presentation, labs initially were otherwise at baseline for patient and she didn't require oxygen.  CT head didn't show acute process.  Echo was obtained and showed normal LV function with possibly mildly reduced RV function.  Patient remained clinically stable and on room air however Cr uptrended and BP was low so lisinopril was held and fluid were given.  Patient continued to clinically do well and creatinine decreased on f/u check though Na was down to 129 (has been low at least since April) with both AKI and hyponatremia most likely being from poor PO intake.  Patient was seen by PT/OT who recommended SAR however patient and family opted for home care.  Patient was discharged with lisinopril held and she should avoid NSAIDs entirely going forward.  She will need close PCP f/u with repeat BMP to monitor sodium and creatinine.  Should sodium fail to improve would recommend obtaining urine sodium and osm to assess for SIADH.    Of note, patient had blood cultures obtained on presentation and on day before DC 1/2 cultures showed globicatella species; patient clinically did well off antibiotics with clinical improvement and this was felt most likely to be a contaminant.  ID (not officially consulted) did review case and recommended repeat BC which were obtained before DC but did not feel patient needed to stay in hospital for results with plan for either PCP to f/u on results if negative or hospital will reach out if cultures result as positive
Age: 102.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Hypotension, Lethargy, SARS-CoV-2 test positive
Clinical narrative: Hospitalized 10/23/2021; COVID-19 positive 10/23/2021; fully vaccinated  Discharge Provider: MD Primary Care Provider at Discharge: MD Admission Date: 10/23/2021 Discharge Date: 10/26/2021   DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: COVID-19 [U07.1]   Patient is a wonderful 102 y.o. female with PMH of diabetes mellitus type 2, atrial fibrillation, hypertension, hyperlipidemia, CKD 3 who presented to the Emergency Department on 10/23 via EMS with increasing fatigue and lethargy secondary to covid19 infection.     Patient's VS were largely normal on presentation, labs initially were otherwise at baseline for patient and she didn't require oxygen.  CT head didn't show acute process.  Echo was obtained and showed normal LV function with possibly mildly reduced RV function.  Patient remained clinically stable and on room air however Cr uptrended and BP was low so lisinopril was held and fluid were given.  Patient continued to clinically do well and creatinine decreased on f/u check though Na was down to 129 (has been low at least since April) with both AKI and hyponatremia most likely being from poor PO intake.  Patient was seen by PT/OT who recommended SAR however patient and family opted for home care.  Patient was discharged with lisinopril held and she should avoid NSAIDs entirely going forward.  She will need close PCP f/u with repeat BMP to monitor sodium and creatinine.  Should sodium fail to improve would recommend obtaining urine sodium and osm to assess for SIADH.    Of note, patient had blood cultures obtained on presentation and on day before DC 1/2 cultures showed globicatella species; patient clinically did well off antibiotics with clinical improvement and this was felt most likely to be a contaminant.  ID (not officially consulted) did review case and recommended repeat BC which were obtained before DC but did not feel patient needed to stay in hospital for results with plan for either PCP to f/u on results if negative or hospital will reach out if cultures result as positive
Age: 60.0
Sex: F
Vaccine: FLU4
Symptoms: Injection site erythema, Injection site swelling
Clinical narrative: ARM AROUND INJECTION SITE BECAME RED. STATES FELT SWOLLEN. REDNESS EXTENDED FROM SHOULDER TO ABOVE ELBOW. SEEN AT URGENT CARE. STATED ARM NEVER WAS PAINFUL. ARM TODAY IS NOT RED OR SWOLLEN. NEVER INTERFERED WITH MOVEMENT OF ARM. STATES HAS HAPPENED 2 OTHER TIMES SHE RECIEVED VACCINE.
Age: 51.0
Sex: F
Vaccine: COVID19
Symptoms: Extra dose administered, Flushing, Hypoaesthesia, Hypoaesthesia oral, Pyrexia
Clinical narrative: I had taken some Tylenol due to a high fever after having the booster the day before (102.9) and went to sleep about 1 pm. I woke up about 3 pm and noted that my face felt like it was numb or asleep. The sensation started below my eyes on both sides of my face, extended down to what would be maybe below my upper lip, and also included my upper lip but not my nose. My face was somewhat flushed, but I assumed that was from the fevers I had been managing since 3 am. My face was not swollen, my tongue was normal in size and color and was not involved, and I had no difficulty breathing, swallowing, seeing, smelling, etc.
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Vaccine administered beyond storage guidelines.  Moderna analysis showed full effectiveness.
Age: 61.0
Sex: F
Vaccine: COVID19
Symptoms: Heart rate increased
Clinical narrative: As per Fitbit monitoring, resting heart rate raised from 69 to 73 beginning the day after the injection. Resting heart rate stayed at 73 for 2 days then dropped to 72, 71, 70, 68 each day following. Has remained at the 68/69 level since.
Age: 37.0
Sex: F
Vaccine: COVID19
Symptoms: Dysphagia, Feeling hot, Paraesthesia, Throat tightness
Clinical narrative: Pt reported feelings of tightness in throat, difficulty swallowing, tingling in face, and feeling warm. Vital signs obtained, O2 99%, HR 100-107, BP 133/81. Pt was able to drink water comfortably. Did not appear in any respiratory distress, no angioedema noted. Cetirizine administered. Pt was brought to ED via wheelchair accompanied by RN for further evaluation.
Age: 76.0
Sex: F
Vaccine: FLUA4
Symptoms: Injection site rash, Swelling face
Clinical narrative: rash at site of injection and puffy face
Age: 25.0
Sex: M
Vaccine: COVID19
Symptoms: Chills, Fatigue, Pain, Pyrexia
Clinical narrative: pt had 10 days of fever, fatigue, chills, and body aches
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect dose administered, Product preparation issue
Clinical narrative: Pfizer vial was diluted with 0.8ml of diluent instead of 1.8ml, so only one three 0.3ml doses were able to be drawn from the Pfizer vial instead of six.  Patient ended up with a bigger dose of Pfizer than what is recommended. Attempted phone call to the patient to inform them of receiving the incorrect dosage.  Patient has not called back- had to leave a message.
Age: 45.0
Sex: F
Vaccine: COVID19
Symptoms: Dysmenorrhoea, Menstrual disorder
Clinical narrative: Since my fist vaccine , I had  horribly severe & sharp menstrual cramps. They got so bad (9/10 on pain scale), I questioned if I would need to go to the hospital. The only thing I could do is take Motrin, and rock back-and-forth until the pain subsided enough for me to function.  I had to take Motrin around the clock until my menstrual cycle ended.  This is not normal for me.
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Vaccine administered beyond storage guidelines.  Moderna analysis showed full effectiveness.
Age: 79.0
Sex: M
Vaccine: COVID19
Symptoms: Asthenia, COVID-19, Oxygen saturation decreased, SARS-CoV-2 test positive
Clinical narrative: generalized weakness, decrease oxygen saturation 86-88% intermittently with rest
Age: 61.0
Sex: M
Vaccine: COVID19
Symptoms: Syncope
Clinical narrative: SYNCOPE
Age: 78.0
Sex: F
Vaccine: COVID19
Symptoms: Erythema, Pruritus, Swelling
Clinical narrative: Swelling-Itching-Redness Starting on 10/27/2021
Age: 67.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Vaccine administered beyond storage guidelines.  Moderna analysis showed full effectiveness.
Age: 51.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: fizer COVID vaccine with beyond use date (BUD) of 10/30/21 16:31 was erroneously dispensed for a patient. This was picked up from  pharmacy and brought to bedside for administration. RN administered at 17:30, an hour after 6 hour BUD assigned (7 hours after product drawn up). Confirmed that product was drawn up in ISO 5 environment and stored in fridge until dispense. Per Pfizer document with internal data, likely maintained potency. Repeat dose not given.
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Extra dose administered, Interchange of vaccine products
Clinical narrative: Patient is not having an adverse reaction. Patient had received 2 doses of Sinovac vaccine. Second dose was 4/29/21. Patient requested a booster dose of Janssen in order the return to another country. Booster was administered based on information that from CDC that if patient received a vaccine that is not authorized or approved by FDA may receive any FDA-authorized or approved vaccine 28 days following last dose on non-authorized vaccine. Filing report based on guidance of clinical coordinator due to lack of clear guidance surrounding boosters and vaccine not-authorized by the FDA.
Age: 84.0
Sex: F
Vaccine: PPV
Symptoms: Erythema, Induration, Pain in extremity, Peripheral swelling
Clinical narrative: Soreness, redness, swelling and hardness on inner part of upper arm.
Age: 59.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Cardiac arrest, Cardiogenic shock, Cyanosis, Death
Clinical narrative: pt arrived to hosp via EMS; EMS called due to increasing SOB; O2 sats 60s; placed on CPAP; cyanotic and no improvement; pt gave consent to be intubated in the field; pt was positive for COVID 1 wk before arriving at the hosp, completed remdesivir and steroids; PMH:  chronic respiratory failure, on 10-12 L O2 via NC and astral device at home; in ED pt was severely hypotensive with septic/cardiogenic shock; pt was made a DNR; he arrested in the ED and died