chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 51.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Abnormal behaviour, Blood glucose increased, COVID-19, Hyperglycaemia, Mental status changes
Clinical narrative: Covid19 breakthrough.  1st vaccine received on 10/02/2021.  52 y/o with PMHx of Type 2 Diabetes presents to ED with AMS and Hyperglycemia.  Family states pt has been acting bizarre, is repeating herself and blood sugars have been running in the 300's.  Pt admits to not taking her medicine for the last month.  Pt afebrile and O2 sat on room air 100%.  Pt states she tested positive for Covid 2 weeks ago at work but the result on phone indicates a negative test result per MD note.  Admitted for management of blood glucose and psych eval.
Age: 51.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Repetitive speech, SARS-CoV-2 test positive, Vaccine breakthrough infection
Clinical narrative: Covid19 breakthrough.  1st vaccine received on 10/02/2021.  52 y/o with PMHx of Type 2 Diabetes presents to ED with AMS and Hyperglycemia.  Family states pt has been acting bizarre, is repeating herself and blood sugars have been running in the 300's.  Pt admits to not taking her medicine for the last month.  Pt afebrile and O2 sat on room air 100%.  Pt states she tested positive for Covid 2 weeks ago at work but the result on phone indicates a negative test result per MD note.  Admitted for management of blood glucose and psych eval.
Age: 12.0
Sex: F
Vaccine: COVID19
Symptoms: Dizziness, Dyspnoea, Tremor
Clinical narrative: Systemic: Allergic: Difficulty Breathing-Mild, Systemic: Dizziness / Lightheadness-Mild, Systemic: Shakiness-Mild, Additional Details: The patient described feeling shaky an lightheaded for about 4 min after vaccine was administered .patient had some water to drink, and stated she felt better. Nurse observered for 30 min, then the patient said she felt ok to leave.
Age: 5.0
Sex: M
Vaccine: COVID19
Symptoms: Product preparation issue
Clinical narrative: Error: Incorrect Reconstitution-
Age: 75.0
Sex: F
Vaccine: COVID19
Symptoms: Back pain, Chest X-ray abnormal, Cough, Dyspnoea, Lung opacity
Clinical narrative: Patient is fully vaccinated.  COVID positive 12/29/2021 at ED visit. Chief complaint, cough and shortness of breath.sat is 95% Back Pain from cough. BP 157/72  | Pulse 84  | Temp 97.9 °F (36.6 °C) (Oral)  | Resp 22  | Ht 157.5 cm (5' 2")  | Wt 92.5 kg (204 lb)  | SpO2 95%  | BMI 37.31 kg/m²  CXR: Opacities are seen in the bilateral mid to lower lungs. stable vitals, she will come back if worse. Patient discharged from ED.
Age: 60.0
Sex: M
Vaccine: COVID19
Symptoms: Dizziness, Fatigue, Lethargy, Pyrexia, Syncope
Clinical narrative: Systemic: Dizziness / Lightheadness-Severe, Systemic: Exhaustion / Lethargy-Severe, Systemic: Fainting / Unresponsive-Severe, Systemic: Fever-Severe
Age: 60.0
Sex: M
Vaccine: COVID19
Symptoms: Unresponsive to stimuli
Clinical narrative: Systemic: Dizziness / Lightheadness-Severe, Systemic: Exhaustion / Lethargy-Severe, Systemic: Fainting / Unresponsive-Severe, Systemic: Fever-Severe
Age: 26.0
Sex: F
Vaccine: COVID19
Symptoms: Shoulder injury related to vaccine administration
Clinical narrative: Error: Shoulder Joint Injury (prolonged pain, tingling, etc.)-
Age: 62.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Injection site bruising, Injection site erythema, Injection site pain, Injection site pruritus
Clinical narrative: Site: Bruising at Injection Site-Mild, Site: Itching at Injection Site-Mild, Site: Pain at Injection Site-Mild, Site: Redness at Injection Site-Mild, Site: Swelling at Injection Site-Mild, Systemic: Allergic: Itch (specify: facial area, extremities)-Medium, Systemic: Pain in her hand. Swelling started with her fingers. The swelling and pain keeps moving up her hand to her wrist. It is affecting her ability to move her hands as before/affecting her daily activities. Severe, Systemic: Joint Pain-Medium.
Age: 62.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site swelling, Joint swelling, Loss of personal independence in daily activities, Mobility decreased, Pain in extremity
Clinical narrative: Site: Bruising at Injection Site-Mild, Site: Itching at Injection Site-Mild, Site: Pain at Injection Site-Mild, Site: Redness at Injection Site-Mild, Site: Swelling at Injection Site-Mild, Systemic: Allergic: Itch (specify: facial area, extremities)-Medium, Systemic: Pain in her hand. Swelling started with her fingers. The swelling and pain keeps moving up her hand to her wrist. It is affecting her ability to move her hands as before/affecting her daily activities. Severe, Systemic: Joint Pain-Medium.
Age: 62.0
Sex: F
Vaccine: COVID19
Symptoms: Peripheral swelling, Pruritus
Clinical narrative: Site: Bruising at Injection Site-Mild, Site: Itching at Injection Site-Mild, Site: Pain at Injection Site-Mild, Site: Redness at Injection Site-Mild, Site: Swelling at Injection Site-Mild, Systemic: Allergic: Itch (specify: facial area, extremities)-Medium, Systemic: Pain in her hand. Swelling started with her fingers. The swelling and pain keeps moving up her hand to her wrist. It is affecting her ability to move her hands as before/affecting her daily activities. Severe, Systemic: Joint Pain-Medium.
Age: 6.0
Sex: M
Vaccine: COVID19
Symptoms: Product preparation issue
Clinical narrative: Error: Incorrect Reconstitution-
Age: 49.0
Sex: F
Vaccine: COVID19
Symptoms: Asthenia, Diarrhoea, Flushing, Hyperhidrosis, Nausea
Clinical narrative: Systemic: Diarrhea-Mild, Systemic: Fainting / Unresponsive-Mild, Systemic: Flushed / Sweating-Mild, Systemic: Nausea-Mild, Systemic: Weakness-Mild
Age: 49.0
Sex: F
Vaccine: COVID19
Symptoms: Syncope, Unresponsive to stimuli
Clinical narrative: Systemic: Diarrhea-Mild, Systemic: Fainting / Unresponsive-Mild, Systemic: Flushed / Sweating-Mild, Systemic: Nausea-Mild, Systemic: Weakness-Mild
Age: 56.0
Sex: M
Vaccine: COVID19
Symptoms: Injection site pruritus, Pruritus, Rash
Clinical narrative: Site: Itching at Injection Site-Medium, Systemic: Allergic: Itch (specify: facial area, extremeties)-Medium, Systemic: Allergic: Itch Generalized-Medium, Systemic: Allergic: Rash (specify: facial area, extremeties)-Medium, Systemic: Allergic: Rash Generalized-Medium
Age: 18.0
Sex: M
Vaccine: COVID19
Symptoms: Syncope, Unresponsive to stimuli
Clinical narrative: Systemic: Fainting / Unresponsive-Mild, Additional Details: Patient was alert, normal vitals, BP 121/80
Age: 53.0
Sex: M
Vaccine: COVID19
Symptoms: Burning sensation, Feeling hot, Hot flush
Clinical narrative: About 3 am woke up very hot but no fever.   Felt like I was burning up.  Ended up standing outside in 3 degree weather in shorts trying to cool down.   Had to do that several times.   Again no fever.    Took several hours to go away.   Occasionally still get for lack of better term hot flashes
Age: 51.0
Sex: F
Vaccine: COVID19
Symptoms: Asthenia, Blood glucose increased, COVID-19, Chills, Cough
Clinical narrative: COVID-19 breakthrough. Patient vaccinated on 05/24/2021. A 52-year-old woman with PMHx of asthma, anxiety, NIDDM and GERD; presented to ED with week-long complaints of fever, chills, sweats, lightheadedness, left flank pain, back spasms, generalized weakness, fatigue, drowsiness, polyuria, polydipsia and elevated blood sugars. Of note, she tested positive for COVID-19 on Jan 4 but symptoms of runny nose/cough resolved after 5 days. Patient admitted for DKA and COVID-19. T102.7. Patient started on IV abx.
Age: 51.0
Sex: F
Vaccine: COVID19
Symptoms: Diabetic ketoacidosis, Dizziness, Fatigue, Flank pain, Hyperhidrosis
Clinical narrative: COVID-19 breakthrough. Patient vaccinated on 05/24/2021. A 52-year-old woman with PMHx of asthma, anxiety, NIDDM and GERD; presented to ED with week-long complaints of fever, chills, sweats, lightheadedness, left flank pain, back spasms, generalized weakness, fatigue, drowsiness, polyuria, polydipsia and elevated blood sugars. Of note, she tested positive for COVID-19 on Jan 4 but symptoms of runny nose/cough resolved after 5 days. Patient admitted for DKA and COVID-19. T102.7. Patient started on IV abx.
Age: 51.0
Sex: F
Vaccine: COVID19
Symptoms: Muscle spasms, Polydipsia, Polyuria, Pyrexia, Rhinorrhoea
Clinical narrative: COVID-19 breakthrough. Patient vaccinated on 05/24/2021. A 52-year-old woman with PMHx of asthma, anxiety, NIDDM and GERD; presented to ED with week-long complaints of fever, chills, sweats, lightheadedness, left flank pain, back spasms, generalized weakness, fatigue, drowsiness, polyuria, polydipsia and elevated blood sugars. Of note, she tested positive for COVID-19 on Jan 4 but symptoms of runny nose/cough resolved after 5 days. Patient admitted for DKA and COVID-19. T102.7. Patient started on IV abx.
Age: 51.0
Sex: F
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive, Somnolence, Vaccine breakthrough infection
Clinical narrative: COVID-19 breakthrough. Patient vaccinated on 05/24/2021. A 52-year-old woman with PMHx of asthma, anxiety, NIDDM and GERD; presented to ED with week-long complaints of fever, chills, sweats, lightheadedness, left flank pain, back spasms, generalized weakness, fatigue, drowsiness, polyuria, polydipsia and elevated blood sugars. Of note, she tested positive for COVID-19 on Jan 4 but symptoms of runny nose/cough resolved after 5 days. Patient admitted for DKA and COVID-19. T102.7. Patient started on IV abx.
Age: 39.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Headache, Nausea, Pain
Clinical narrative: Chills, body aches, headache, nausea
Age: 66.0
Sex: M
Vaccine: COVID19
Symptoms: Abdominal pain, COVID-19, Computerised tomogram, Nasal congestion, Oropharyngeal pain
Clinical narrative: Patient is fully vaccinated and boosted on 11/14/2021.  COVID + on 12/31/2021 at visit to the ed.  Chief complaint: rectal bleeding and abdominal pain.  67-year-old male, history of MS presents to the ED complaining of lower abdominal pain, bloody stool that started today. Has had multiple bloody bowel movements. Crampy abdominal pain. Denies any nausea or vomiting. Does complain of sore throat and nasal congestion, mild URI symptoms. Denies any blood thinner medication or antiplatelet agents. No rectal pain. Has never had this happen before.  Also positive for congestion and sore throat. BP (!) 164/106  | Pulse 110  | Temp 100.1 °F (37.8 °C) (Oral)  | Resp 22  | Ht 180.3 cm (5' 11")  | Wt 86.2 kg (190 lb)  | SpO2 95%  | BMI 26.50 kg/m² CT scan showing multiple incidental findings including prostate enlargement, possible compression fractures. This was discussed at length with the patient, concern for possible metastatic disease. Possible prostate cancer.  Labs normal. Discharged from ED.
Age: 66.0
Sex: M
Vaccine: COVID19
Symptoms: Rectal haemorrhage, Respiratory symptom, Respiratory tract congestion
Clinical narrative: Patient is fully vaccinated and boosted on 11/14/2021.  COVID + on 12/31/2021 at visit to the ed.  Chief complaint: rectal bleeding and abdominal pain.  67-year-old male, history of MS presents to the ED complaining of lower abdominal pain, bloody stool that started today. Has had multiple bloody bowel movements. Crampy abdominal pain. Denies any nausea or vomiting. Does complain of sore throat and nasal congestion, mild URI symptoms. Denies any blood thinner medication or antiplatelet agents. No rectal pain. Has never had this happen before.  Also positive for congestion and sore throat. BP (!) 164/106  | Pulse 110  | Temp 100.1 °F (37.8 °C) (Oral)  | Resp 22  | Ht 180.3 cm (5' 11")  | Wt 86.2 kg (190 lb)  | SpO2 95%  | BMI 26.50 kg/m² CT scan showing multiple incidental findings including prostate enlargement, possible compression fractures. This was discussed at length with the patient, concern for possible metastatic disease. Possible prostate cancer.  Labs normal. Discharged from ED.
Age: 47.0
Sex: M
Vaccine: VARZOS
Symptoms: Cough, Fatigue, Injection site pain, Oropharyngeal pain, Pain
Clinical narrative: Body aches, fatigue, sore throat, pain at injection site, low fever ~100f, sinus congestion, cough
Age: 47.0
Sex: M
Vaccine: VARZOS
Symptoms: Pyrexia, Sinus congestion
Clinical narrative: Body aches, fatigue, sore throat, pain at injection site, low fever ~100f, sinus congestion, cough
Age: 83.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive, Vaccine breakthrough infection
Clinical narrative: COVID vaccine breakthrough case
Age: 31.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered, Nasopharyngitis
Clinical narrative: There was no adverse event to be reported .  However, the vaccine vial expiration date was on 01/22/2022, and patient received a dosage of expired vaccine.  Patient was contacted on 01/27/2022, and he reported  moderate common cold like symptoms.
Age: 53.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Chest pain, Computerised tomogram abnormal, Computerised tomogram thorax, Cough
Clinical narrative: Patient is fully vaccinated and boosted on 12/7/2021. chief complaint, corona virus concern.  Patient is positive for cough, chest pain and dizziness.  BP 130/74  | Pulse 89  | Resp 24  | SpO2 95%   CT chest is negative for PE, infiltrated present consistent with COVID. Referred for mAB therapy.  Discharged home. EKG IBM NSR 92, no acute ischemic changes
Age: 53.0
Sex: F
Vaccine: COVID19
Symptoms: Dizziness, Electrocardiogram normal, Lung infiltration
Clinical narrative: Patient is fully vaccinated and boosted on 12/7/2021. chief complaint, corona virus concern.  Patient is positive for cough, chest pain and dizziness.  BP 130/74  | Pulse 89  | Resp 24  | SpO2 95%   CT chest is negative for PE, infiltrated present consistent with COVID. Referred for mAB therapy.  Discharged home. EKG IBM NSR 92, no acute ischemic changes
Age: 65.0
Sex: F
Vaccine: VARZOS
Symptoms: Burning sensation, Dizziness, Injection site pain, Injection site paraesthesia, Injection site reaction
Clinical narrative: STARTING ON 1/16/2022 PATIENT REPORTED VERTIGO, DIZZINESS, SPINNING SENSATION, NAUSEA. SHE THEN STARTED WITH BURNING AND PARASTHESIAS IN THE LEFT ARM WHICH IS THE INJECTION ARM FOLLOWED BY PAIN RADIATING INTO THE LEFT NECK AND SCALP REGION
Age: 65.0
Sex: F
Vaccine: VARZOS
Symptoms: Nausea, Neck pain, Pain, Pain of skin, Paraesthesia
Clinical narrative: STARTING ON 1/16/2022 PATIENT REPORTED VERTIGO, DIZZINESS, SPINNING SENSATION, NAUSEA. SHE THEN STARTED WITH BURNING AND PARASTHESIAS IN THE LEFT ARM WHICH IS THE INJECTION ARM FOLLOWED BY PAIN RADIATING INTO THE LEFT NECK AND SCALP REGION
Age: 65.0
Sex: F
Vaccine: VARZOS
Symptoms: Vertigo
Clinical narrative: STARTING ON 1/16/2022 PATIENT REPORTED VERTIGO, DIZZINESS, SPINNING SENSATION, NAUSEA. SHE THEN STARTED WITH BURNING AND PARASTHESIAS IN THE LEFT ARM WHICH IS THE INJECTION ARM FOLLOWED BY PAIN RADIATING INTO THE LEFT NECK AND SCALP REGION
Age: 38.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Abnormal uterine bleeding, COVID-19, SARS-CoV-2 test positive
Clinical narrative: admitted for abnormal uterine bleeding on 1/27, found COVID + test
Age: 41.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Chest X-ray normal, Chest discomfort, Condition aggravated, Cough
Clinical narrative: Patient fully vaccinated. Chief complaint: Corona virus concerns. Patient presented to the ED with  secondary to worsening migraines and known history of COVID-19. Tested positive four days ago. Patient symptomatic for the past week. Patient suffers from chronic migraines and stated since having COVID-19, her migraines are worse. Patient reported associated cough, nausea, vomiting, headaches and generalized myalgias. Patient also concerned for intermittent chest discomfort. 12-lead EKG ST segments: normal. CXR: no radiographic evidence of acute cardiopulmonary disease. Treatment: Zofran, Toradol, Decadron and Benadryl. Patient instructed to come back to ED if symptoms worsen or situation changes. Discharged from ED.
Age: 41.0
Sex: F
Vaccine: COVID19
Symptoms: Electrocardiogram normal, Headache, Malaise, Migraine, Myalgia
Clinical narrative: Patient fully vaccinated. Chief complaint: Corona virus concerns. Patient presented to the ED with  secondary to worsening migraines and known history of COVID-19. Tested positive four days ago. Patient symptomatic for the past week. Patient suffers from chronic migraines and stated since having COVID-19, her migraines are worse. Patient reported associated cough, nausea, vomiting, headaches and generalized myalgias. Patient also concerned for intermittent chest discomfort. 12-lead EKG ST segments: normal. CXR: no radiographic evidence of acute cardiopulmonary disease. Treatment: Zofran, Toradol, Decadron and Benadryl. Patient instructed to come back to ED if symptoms worsen or situation changes. Discharged from ED.
Age: 41.0
Sex: F
Vaccine: COVID19
Symptoms: Nausea, SARS-CoV-2 test positive, Vomiting
Clinical narrative: Patient fully vaccinated. Chief complaint: Corona virus concerns. Patient presented to the ED with  secondary to worsening migraines and known history of COVID-19. Tested positive four days ago. Patient symptomatic for the past week. Patient suffers from chronic migraines and stated since having COVID-19, her migraines are worse. Patient reported associated cough, nausea, vomiting, headaches and generalized myalgias. Patient also concerned for intermittent chest discomfort. 12-lead EKG ST segments: normal. CXR: no radiographic evidence of acute cardiopulmonary disease. Treatment: Zofran, Toradol, Decadron and Benadryl. Patient instructed to come back to ED if symptoms worsen or situation changes. Discharged from ED.
Sex: U
Vaccine: COVID19
Symptoms: Epigastric discomfort, Muscular weakness, Musculoskeletal disorder, Pain in extremity
Clinical narrative: Left hand loss of function, left arm weakness & pain, & epigastric discomfort following receiving the Pfizer comirnaty vaccine
Age: 84.0
Sex: M
Vaccine: COVID19
Symptoms: Cold type haemolytic anaemia, Dyspnoea, Fatigue, Haemoglobin decreased, Platelet count decreased
Clinical narrative: On 3/6/21, pt received second dose of Moderna Covid Vaccine. He developed a diffuse skin rash and fatigue, he presented to the ED with progressive shortness of breath. He was diagnosed with cold-agglutinin hemolytic anemia. He was treated with steroids and was discharged from the hospital with a Hgb of 11.9.
Age: 84.0
Sex: M
Vaccine: COVID19
Symptoms: Rash
Clinical narrative: On 3/6/21, pt received second dose of Moderna Covid Vaccine. He developed a diffuse skin rash and fatigue, he presented to the ED with progressive shortness of breath. He was diagnosed with cold-agglutinin hemolytic anemia. He was treated with steroids and was discharged from the hospital with a Hgb of 11.9.
Age: 32.0
Sex: F
Vaccine: COVID19
Symptoms: Anger, Condition aggravated, Delusion, Mania, Paranoia
Clinical narrative: Induced psychosis.  My daughter, a 32 year old female, healthy, non-smoker, no comorbidities, taking 200 mgs clozaphine for eight years. Stable during this time except for one incident (Rx downgrade) four years ago. Patient has taken dose appropriately and bloodwork considered normal. 30 Rx cycle. Psychotic event appeared about ten days after 3rd Covid booster shot. All three were Pfizer mRNA. Patient was hospitalized but would not remain beyond mandatory 3 day hold. She is presenting with delusions, paranoia, and anger related mania. Some limited research has been written and published that identifies potential interactions of mRNA vaccines and Clozaphine. In some individuals they report high serum counts which suggests lower metabolic conversion of Clozapine. This would explain patients relapse as Clozapine absorption likely reduced to below therapeutic thresholds and psychosis results. I have tried contacting Clozapine, but they refuse to accept my call, citing only Doctors can use this line. The ER doctor agreed to have hospital pharmacist research this information. Five days later is was assigned to a Pharmacy student. The Manufacturers help line told me they can only investigate if a doctor specifically ask them. I can forward the journal reports to you if it helps. Additionally, and unrelated to this patient, there are other journal reports that Covid 19 virus can downgrade white blood cells counts. This is a key marker for practitioners to then reduce Clozapine dosage. The journal report advises Drs to NOT reduce Clozapine dosage as a result of Covid infection related to WCC reduction. There appears to be an interaction between Covid 19 vaccines and Clozapine in some patients. There appears to be an impact on the immune system from Covid 19 that sends a false remediation action to Drs prescribing Clozapine. The normal systems are not open to investigating at this time.
Age: 32.0
Sex: F
Vaccine: COVID19
Symptoms: Psychotic disorder
Clinical narrative: Induced psychosis.  My daughter, a 32 year old female, healthy, non-smoker, no comorbidities, taking 200 mgs clozaphine for eight years. Stable during this time except for one incident (Rx downgrade) four years ago. Patient has taken dose appropriately and bloodwork considered normal. 30 Rx cycle. Psychotic event appeared about ten days after 3rd Covid booster shot. All three were Pfizer mRNA. Patient was hospitalized but would not remain beyond mandatory 3 day hold. She is presenting with delusions, paranoia, and anger related mania. Some limited research has been written and published that identifies potential interactions of mRNA vaccines and Clozaphine. In some individuals they report high serum counts which suggests lower metabolic conversion of Clozapine. This would explain patients relapse as Clozapine absorption likely reduced to below therapeutic thresholds and psychosis results. I have tried contacting Clozapine, but they refuse to accept my call, citing only Doctors can use this line. The ER doctor agreed to have hospital pharmacist research this information. Five days later is was assigned to a Pharmacy student. The Manufacturers help line told me they can only investigate if a doctor specifically ask them. I can forward the journal reports to you if it helps. Additionally, and unrelated to this patient, there are other journal reports that Covid 19 virus can downgrade white blood cells counts. This is a key marker for practitioners to then reduce Clozapine dosage. The journal report advises Drs to NOT reduce Clozapine dosage as a result of Covid infection related to WCC reduction. There appears to be an interaction between Covid 19 vaccines and Clozapine in some patients. There appears to be an impact on the immune system from Covid 19 that sends a false remediation action to Drs prescribing Clozapine. The normal systems are not open to investigating at this time.
Age: 37.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: COVID-19, Chest X-ray abnormal, Dyspnoea, Lung infiltration, SARS-CoV-2 test positive
Clinical narrative: Covid19 breakthrough.  1st vaccine received 07/20/2021.  38 y/o PMHx of Asthma, smoking presents to ED with 3 day history of increasing SOB and wheezing despite utilizing home inhalers.  Upon arrival to ED, Pt's room air O2 sat &&%, placed on 15L NRB, then weaned to 4L NC.  Pt afebrile and CXR with patchy fluffy infiltrates Left mid lung.  Treated with IV steroids and Remdesivir.
Age: 37.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Vaccine breakthrough infection, Wheezing
Clinical narrative: Covid19 breakthrough.  1st vaccine received 07/20/2021.  38 y/o PMHx of Asthma, smoking presents to ED with 3 day history of increasing SOB and wheezing despite utilizing home inhalers.  Upon arrival to ED, Pt's room air O2 sat &&%, placed on 15L NRB, then weaned to 4L NC.  Pt afebrile and CXR with patchy fluffy infiltrates Left mid lung.  Treated with IV steroids and Remdesivir.
Age: 11.0
Sex: F
Vaccine: COVID19
Symptoms: No adverse event, Product preparation error
Clinical narrative: Pfizer Covid Vaccine not diluted- no adverse reaction noted
Age: 39.0
Sex: M
Vaccine: COVID19
Symptoms: Chronic spontaneous urticaria
Clinical narrative: 2 weeks after, I developed spontaneous urticaria; identical to the case study detailed here in a case study.
Age: 56.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal pain, Back pain, Calculus urinary, Cardiac arrest, Death
Clinical narrative: A 57 year old female patient with a clinical picture of 3 days of evolution consisting of colicky pain in the right flank radiating to the lumbar region, with fever quantified at 39 on Wednesday 01/13/22, it is focused as a urinary infection with renal lithiasis. Later, on 01/14/22 at approximately 3:00am, I understood that she presented mucocutaneous pallor, vomiting and hypotension. At 1pm on the same day dyspnea, tachypnea, hemodynamically unstable patient, saturation at 88 approximately does not improve with non-invasive oxygenation, presence of metabolic acidosis for which it is decided to intubate, patient has cardiac arrest that lasts approximately 5 minutes, he is referred to the ICU, on the way he makes 3 cardiac arrests. And on 01/15/22 he dies.
Age: 56.0
Sex: F
Vaccine: COVID19
Symptoms: Dyspnoea, Endotracheal intubation, Flank pain, Haemodynamic instability, Hypotension
Clinical narrative: A 57 year old female patient with a clinical picture of 3 days of evolution consisting of colicky pain in the right flank radiating to the lumbar region, with fever quantified at 39 on Wednesday 01/13/22, it is focused as a urinary infection with renal lithiasis. Later, on 01/14/22 at approximately 3:00am, I understood that she presented mucocutaneous pallor, vomiting and hypotension. At 1pm on the same day dyspnea, tachypnea, hemodynamically unstable patient, saturation at 88 approximately does not improve with non-invasive oxygenation, presence of metabolic acidosis for which it is decided to intubate, patient has cardiac arrest that lasts approximately 5 minutes, he is referred to the ICU, on the way he makes 3 cardiac arrests. And on 01/15/22 he dies.
Age: 56.0
Sex: F
Vaccine: COVID19
Symptoms: Intensive care, Metabolic acidosis, Mucocutaneous disorder, Pain, Pallor
Clinical narrative: A 57 year old female patient with a clinical picture of 3 days of evolution consisting of colicky pain in the right flank radiating to the lumbar region, with fever quantified at 39 on Wednesday 01/13/22, it is focused as a urinary infection with renal lithiasis. Later, on 01/14/22 at approximately 3:00am, I understood that she presented mucocutaneous pallor, vomiting and hypotension. At 1pm on the same day dyspnea, tachypnea, hemodynamically unstable patient, saturation at 88 approximately does not improve with non-invasive oxygenation, presence of metabolic acidosis for which it is decided to intubate, patient has cardiac arrest that lasts approximately 5 minutes, he is referred to the ICU, on the way he makes 3 cardiac arrests. And on 01/15/22 he dies.
Age: 56.0
Sex: F
Vaccine: COVID19
Symptoms: Pyrexia, Tachypnoea, Urinary tract infection, Vomiting
Clinical narrative: A 57 year old female patient with a clinical picture of 3 days of evolution consisting of colicky pain in the right flank radiating to the lumbar region, with fever quantified at 39 on Wednesday 01/13/22, it is focused as a urinary infection with renal lithiasis. Later, on 01/14/22 at approximately 3:00am, I understood that she presented mucocutaneous pallor, vomiting and hypotension. At 1pm on the same day dyspnea, tachypnea, hemodynamically unstable patient, saturation at 88 approximately does not improve with non-invasive oxygenation, presence of metabolic acidosis for which it is decided to intubate, patient has cardiac arrest that lasts approximately 5 minutes, he is referred to the ICU, on the way he makes 3 cardiac arrests. And on 01/15/22 he dies.
Age: 36.0
Sex: F
Vaccine: FLU4
Symptoms: Extra dose administered
Clinical narrative: Patient requested flu shot be given which was administered by nurse without checking records due to patient volume. Patient already received flu shot in September2021, verified with patient, she had forgotten.  PCP was informed, no further treatment necessary.  Nurse will always check records first before administering vaccines in the future.
Age: 19.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Vaccine administration error.  The Moderna Lot# 048F21A shipment expired on 01/22/22.  The vaccine was administered to the patient on 01/24/22.
Age: 31.0
Sex: F
Vaccine: COVID19
Symptoms: Cough, Diarrhoea, Rhinorrhoea
Clinical narrative: cough, sniffles, loose stool
Age: 31.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Chills, Cough, Headache, Migraine
Clinical narrative: Patient is fully vaccinated.  COVID positive at ED visit on 12/30/2021.  32-year-old female presenting with concern for Covid and also a migraine. Patient is positive for cough, chills, fever (101) and headache.  No real shortness of breath. Denies chest pain. BP 132/83  | Pulse 89  | Temp 99.6 °F (37.6 °C)  | Resp 18  | Ht 172.7 cm (5' 8")  | Wt 118 kg (260 lb)  | LMP 11/30/2021  | SpO2 96%  | BMI 39.53 kg/m² IV established. Headache cocktail ordered. Patient was feeling much better. Headache significantly improved. Discharged from ED.
Age: 31.0
Sex: F
Vaccine: COVID19
Symptoms: Pyrexia
Clinical narrative: Patient is fully vaccinated.  COVID positive at ED visit on 12/30/2021.  32-year-old female presenting with concern for Covid and also a migraine. Patient is positive for cough, chills, fever (101) and headache.  No real shortness of breath. Denies chest pain. BP 132/83  | Pulse 89  | Temp 99.6 °F (37.6 °C)  | Resp 18  | Ht 172.7 cm (5' 8")  | Wt 118 kg (260 lb)  | LMP 11/30/2021  | SpO2 96%  | BMI 39.53 kg/m² IV established. Headache cocktail ordered. Patient was feeling much better. Headache significantly improved. Discharged from ED.
Age: 39.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect dose administered
Clinical narrative: Patient received Pfizer COVID-19 vaccine dose 1 (3/26/2021) and dose 2 (4/16/2021). Patient qualified for 3rd dose in primary series due to immunocompromised state. Patient received Moderna booster dose of 0.25ml on 1/25/2022. Provider notified and provider contacted Moderna to receive  clinical clarification regarding volume of dose to be admitted to equal a primary series 3rd dose.  Instructed to administer an additional 0.25 mL dose of Moderna to bring patient total volume to 0.5ml. Additional 0.25ml of Moderna administered on 1/27/2022. Patient made aware and tolerated well.
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal pain upper, Back pain, COVID-19, Chest X-ray normal, Nausea
Clinical narrative: Covid-19 Breakthrough. 1st vaccine received on 05/12/2021. 73 y/o with PMHx of HTN, HLD, Asthma, CKD stage 3A, Depression, DJD, Chronic low back pain, Vitamin D deficiency, Anemia presents to ER with c/o epigastric pain radiating to back, nausea and vomiting. Patient afebrile, CXR-no acute changes, Room air sat 98%.
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Pain, SARS-CoV-2 test positive, Vaccine breakthrough infection, Vomiting
Clinical narrative: Covid-19 Breakthrough. 1st vaccine received on 05/12/2021. 73 y/o with PMHx of HTN, HLD, Asthma, CKD stage 3A, Depression, DJD, Chronic low back pain, Vitamin D deficiency, Anemia presents to ER with c/o epigastric pain radiating to back, nausea and vomiting. Patient afebrile, CXR-no acute changes, Room air sat 98%.
Age: 88.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Asymptomatic COVID-19, Infection, SARS-CoV-2 test positive
Clinical narrative: Breakthrough case after vaccination, Asymptomatic
Age: 66.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: positive COVID test
Age: 45.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Pyrexia
Clinical narrative: 1st shot, fever of 104.5 for 4 days, body aches and chills. 2nd shot, high fever for 5 days with highest of 105.1
Age: 80.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Asthenia, Computerised tomogram head abnormal, Confusional state, Electrocardiogram, Gait disturbance
Clinical narrative: Patient arrives to be seen for weakness.  Apparently patient's wife had a difficult time getting him up today and getting him dressed.  Patient does not seem to have any unilateral weakness.  Patient has dementia and his complete history is suspect.  Patient is really not sure why he is here.  Patient does not appear to be in any acute distress he is not seen coughing vomiting etc..
Age: 80.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Hydrocephalus, Pollakiuria
Clinical narrative: Patient arrives to be seen for weakness.  Apparently patient's wife had a difficult time getting him up today and getting him dressed.  Patient does not seem to have any unilateral weakness.  Patient has dementia and his complete history is suspect.  Patient is really not sure why he is here.  Patient does not appear to be in any acute distress he is not seen coughing vomiting etc..
Age: 52.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Vaccine administration error.  Moderna Lot# 048F21A   expired on 01/22/22.  Administered as a booster dose to the patient on 01/24/22.
Age: 96.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Pfizer 4/21/21 and 5/12/21. Positive on 1/27/22
Age: 81.0
Sex: M
Vaccine: COVID19
Symptoms: Unevaluable event
Clinical narrative: Moderna 3/3/21, 3/31/21, 11/17/21
Age: 83.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Pfizer 4/10/21 and 5/1/21. Positive on 1/28/22
Age: 23.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Vaccine administration error.  Moderna Lot# 048F21A  expired on 01/22/22.  Was administered to the patient as a booster dose on 01/24/22.
Age: 51.0
Sex: F
Vaccine: COVID19
Symptoms: Anticoagulant therapy, Arachnoid cyst, COVID-19, COVID-19 pneumonia, Chest pain
Clinical narrative: Patient is fully vaccinated.  COVID positive 12/31/2021 at admission to hospital. 51-year-old female who presented to the hospital with headaches, in the setting of an arachnoid cyst history.  Arachnoid cyst was seen once again on CT of the head without contrast.  She was evaluated by neurology, who deemed her stable for discharge with outpatient follow-up with neurosurgery.  She had a normal neurological exam and a stable CT of the head, and her headaches seem to be controlled with Tylenol. She also had some slight hypoxia, and was found to be covid positive with covid 19 pneumonia. Positive for chest pain.  She did exhibit a left lower lobe patchy infiltrate on the CT of the chest.  D dimer elevated. Lovenox given.  Negative for PE.  Normocytic anemia. She was given some breathing treatmentsand decadron, and remained on room air for the rest of her admission.  Stable for discharge.  Will follow up with neurosurgery.
Age: 51.0
Sex: F
Vaccine: COVID19
Symptoms: Computerised tomogram head abnormal, Computerised tomogram thorax normal, Fibrin D dimer increased, Headache, Hypoxia
Clinical narrative: Patient is fully vaccinated.  COVID positive 12/31/2021 at admission to hospital. 51-year-old female who presented to the hospital with headaches, in the setting of an arachnoid cyst history.  Arachnoid cyst was seen once again on CT of the head without contrast.  She was evaluated by neurology, who deemed her stable for discharge with outpatient follow-up with neurosurgery.  She had a normal neurological exam and a stable CT of the head, and her headaches seem to be controlled with Tylenol. She also had some slight hypoxia, and was found to be covid positive with covid 19 pneumonia. Positive for chest pain.  She did exhibit a left lower lobe patchy infiltrate on the CT of the chest.  D dimer elevated. Lovenox given.  Negative for PE.  Normocytic anemia. She was given some breathing treatmentsand decadron, and remained on room air for the rest of her admission.  Stable for discharge.  Will follow up with neurosurgery.
Age: 51.0
Sex: F
Vaccine: COVID19
Symptoms: Lung infiltration, Neurological examination normal, Normocytic anaemia, SARS-CoV-2 test positive
Clinical narrative: Patient is fully vaccinated.  COVID positive 12/31/2021 at admission to hospital. 51-year-old female who presented to the hospital with headaches, in the setting of an arachnoid cyst history.  Arachnoid cyst was seen once again on CT of the head without contrast.  She was evaluated by neurology, who deemed her stable for discharge with outpatient follow-up with neurosurgery.  She had a normal neurological exam and a stable CT of the head, and her headaches seem to be controlled with Tylenol. She also had some slight hypoxia, and was found to be covid positive with covid 19 pneumonia. Positive for chest pain.  She did exhibit a left lower lobe patchy infiltrate on the CT of the chest.  D dimer elevated. Lovenox given.  Negative for PE.  Normocytic anemia. She was given some breathing treatmentsand decadron, and remained on room air for the rest of her admission.  Stable for discharge.  Will follow up with neurosurgery.
Age: 43.0
Sex: F
Vaccine: COVID19
Symptoms: Blood pressure increased, Chest pain, Dyspnoea, Extrasystoles, Eye irritation
Clinical narrative: Right eye began burning in outside half aprox 20 minutes after injection (felt like I was poked hard in the eye). It has continued to burn since, and waters constantly. Little and temporary relief with eye drops after an initial and intense burning.   At approximately 10 pm, my resting heart are spiked to 90+ BMP and my respiratory rate increased. My blood pressure spiked to 187/142 (normally around 118/76 area). I practiced mindfulness breathing and my heart rate fluctuated from high 80?s to 100. I fell asleep and my hear monitor showed a sustained resting (sleeping) heart rate between 88-92 (10-12 am), 80-91 (12-1 am), 66-81 (1-2 am), 68-75 (2-3 am), and 70-76 (3 to 4 am, awake).  My normal resting heart rate is 61 and the range of my heart beat for the 28th was 58-172 with no physical activity (outside of short walking to/from pharmacy for vaccination and inside my home).  Periodically, my chest will hurt and fells like my heart skipped a beat if that makes sense, and takes my breath away.   My left eye continues to burn.
Age: 43.0
Sex: F
Vaccine: COVID19
Symptoms: Heart rate increased, Lacrimation increased, Ocular discomfort, Respiratory rate increased
Clinical narrative: Right eye began burning in outside half aprox 20 minutes after injection (felt like I was poked hard in the eye). It has continued to burn since, and waters constantly. Little and temporary relief with eye drops after an initial and intense burning.   At approximately 10 pm, my resting heart are spiked to 90+ BMP and my respiratory rate increased. My blood pressure spiked to 187/142 (normally around 118/76 area). I practiced mindfulness breathing and my heart rate fluctuated from high 80?s to 100. I fell asleep and my hear monitor showed a sustained resting (sleeping) heart rate between 88-92 (10-12 am), 80-91 (12-1 am), 66-81 (1-2 am), 68-75 (2-3 am), and 70-76 (3 to 4 am, awake).  My normal resting heart rate is 61 and the range of my heart beat for the 28th was 58-172 with no physical activity (outside of short walking to/from pharmacy for vaccination and inside my home).  Periodically, my chest will hurt and fells like my heart skipped a beat if that makes sense, and takes my breath away.   My left eye continues to burn.
Age: 40.0
Sex: F
Vaccine: COVID19
Symptoms: Angina pectoris, Dyspnoea, Sensory disturbance, Skin odour abnormal
Clinical narrative: A day after the vaccination I experienced a dirty (is the only way I can describe) feeling of some kind of toxin coming out of my skin mainly the worst in my hands but through out my body as well. I describe it as a shedding feeling with such a NASTY feeling on my skin. Shortness of breath and heart pain.
Age: 71.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Atelectasis, Blood lactic acid normal, COVID-19, Chest X-ray abnormal, Cough
Clinical narrative: This is a very pleasant white male does have a history of prior tobacco abuse, drinks socially, has a history of sleep apnea but does not wear CPAP who is vaccinated for Covid x2 although its been many many months, who presents after having some upper respiratory symptoms that started about 4 days ago to the best of his knowledge and then today did have some diarrhea and is starting to feel short of breath.  He did have an outpatient Covid test up and was positive.  He called his primary doctor to discuss the fact that he was feeling short of breath specially with exertion and Nate advised him to coming to the emergency department.  He has no history of heart disease denies any chest pain.  Denies any fever Associated Symptoms: cough, diarrhea, fatigue, shortness of breath, URI symptoms
Age: 71.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Diarrhoea, Dyspnoea, Dyspnoea exertional, Fatigue, Hypoxia
Clinical narrative: This is a very pleasant white male does have a history of prior tobacco abuse, drinks socially, has a history of sleep apnea but does not wear CPAP who is vaccinated for Covid x2 although its been many many months, who presents after having some upper respiratory symptoms that started about 4 days ago to the best of his knowledge and then today did have some diarrhea and is starting to feel short of breath.  He did have an outpatient Covid test up and was positive.  He called his primary doctor to discuss the fact that he was feeling short of breath specially with exertion and Nate advised him to coming to the emergency department.  He has no history of heart disease denies any chest pain.  Denies any fever Associated Symptoms: cough, diarrhea, fatigue, shortness of breath, URI symptoms
Age: 71.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Laboratory test normal, Myocardial necrosis marker normal, Oxygen saturation decreased, Pneumonia, Respiratory symptom
Clinical narrative: This is a very pleasant white male does have a history of prior tobacco abuse, drinks socially, has a history of sleep apnea but does not wear CPAP who is vaccinated for Covid x2 although its been many many months, who presents after having some upper respiratory symptoms that started about 4 days ago to the best of his knowledge and then today did have some diarrhea and is starting to feel short of breath.  He did have an outpatient Covid test up and was positive.  He called his primary doctor to discuss the fact that he was feeling short of breath specially with exertion and Nate advised him to coming to the emergency department.  He has no history of heart disease denies any chest pain.  Denies any fever Associated Symptoms: cough, diarrhea, fatigue, shortness of breath, URI symptoms
Age: 71.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: SARS-CoV-2 test positive
Clinical narrative: This is a very pleasant white male does have a history of prior tobacco abuse, drinks socially, has a history of sleep apnea but does not wear CPAP who is vaccinated for Covid x2 although its been many many months, who presents after having some upper respiratory symptoms that started about 4 days ago to the best of his knowledge and then today did have some diarrhea and is starting to feel short of breath.  He did have an outpatient Covid test up and was positive.  He called his primary doctor to discuss the fact that he was feeling short of breath specially with exertion and Nate advised him to coming to the emergency department.  He has no history of heart disease denies any chest pain.  Denies any fever Associated Symptoms: cough, diarrhea, fatigue, shortness of breath, URI symptoms
Age: 26.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Chest discomfort, Cough, Exposure to SARS-CoV-2, Oropharyngeal pain
Clinical narrative: Patient is fully vaccinated.  COVID positive 12/30/2021 at ED visit. She has had 3 days of rhinorrhea, ST, cough, chest tightness.+ sick contacts. Now with altered sense of smell. BP 108/52  | Pulse 79  | Temp 98.2 °F (36.8 °C) (Oral)  | Resp 17  | Ht 167.6 cm (5' 6")  | Wt 63 kg (139 lb)  | SpO2 98%  | BMI 22.44 kg/m² CXR neg. Labs ok. Conservative tx for covid. Discharged from ED.
Age: 26.0
Sex: F
Vaccine: COVID19
Symptoms: Parosmia, Rhinorrhoea, SARS-CoV-2 test positive
Clinical narrative: Patient is fully vaccinated.  COVID positive 12/30/2021 at ED visit. She has had 3 days of rhinorrhea, ST, cough, chest tightness.+ sick contacts. Now with altered sense of smell. BP 108/52  | Pulse 79  | Temp 98.2 °F (36.8 °C) (Oral)  | Resp 17  | Ht 167.6 cm (5' 6")  | Wt 63 kg (139 lb)  | SpO2 98%  | BMI 22.44 kg/m² CXR neg. Labs ok. Conservative tx for covid. Discharged from ED.
Age: 63.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: COVID-19, COVID-19 pneumonia, Chest X-ray abnormal, Confusional state, Critical illness
Clinical narrative: Moderna vaccinated x2 patient - last dose 05/1/21 - who admitted to hospital inpatient with COVID pneumonia and subsequently died.  Discharge note below:  "63 YO female w/ history of persistent asthma, prior cardiac arrest, depression, seizure disorder, polypharmacy presented to ER due to worsening confusion. She was found to be COVID 19 positive with pulmonary infiltrates on CXR. She was subsequently admitted to inpatient hospital but later transferred to another hospital due to increasing oxygen requirements.    Due to worsening respiratory status, she was transferred to ICU where she was subsequently intubated. Her hospitalization stay was further complicated by VRE UTI where he was started on Unasyn. She underwent tracheostomy and PEG placement 01/18/22 and then transferred to regular inpatient floor. She remained critically ill with ongoing encephalopathy therefore Palliative care met with family members who then elected DNR/DNI with care limitation code status (transition to comfort care if she is to deteriorate.  She remained critically ill and subsequently passed early morning of 01/27."
Age: 63.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Death, Encephalopathy, Endotracheal intubation, Enterococcal infection, Gastrostomy
Clinical narrative: Moderna vaccinated x2 patient - last dose 05/1/21 - who admitted to hospital inpatient with COVID pneumonia and subsequently died.  Discharge note below:  "63 YO female w/ history of persistent asthma, prior cardiac arrest, depression, seizure disorder, polypharmacy presented to ER due to worsening confusion. She was found to be COVID 19 positive with pulmonary infiltrates on CXR. She was subsequently admitted to inpatient hospital but later transferred to another hospital due to increasing oxygen requirements.    Due to worsening respiratory status, she was transferred to ICU where she was subsequently intubated. Her hospitalization stay was further complicated by VRE UTI where he was started on Unasyn. She underwent tracheostomy and PEG placement 01/18/22 and then transferred to regular inpatient floor. She remained critically ill with ongoing encephalopathy therefore Palliative care met with family members who then elected DNR/DNI with care limitation code status (transition to comfort care if she is to deteriorate.  She remained critically ill and subsequently passed early morning of 01/27."
Age: 63.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Intensive care, Lung infiltration, Respiratory disorder, SARS-CoV-2 test positive, Tracheostomy
Clinical narrative: Moderna vaccinated x2 patient - last dose 05/1/21 - who admitted to hospital inpatient with COVID pneumonia and subsequently died.  Discharge note below:  "63 YO female w/ history of persistent asthma, prior cardiac arrest, depression, seizure disorder, polypharmacy presented to ER due to worsening confusion. She was found to be COVID 19 positive with pulmonary infiltrates on CXR. She was subsequently admitted to inpatient hospital but later transferred to another hospital due to increasing oxygen requirements.    Due to worsening respiratory status, she was transferred to ICU where she was subsequently intubated. Her hospitalization stay was further complicated by VRE UTI where he was started on Unasyn. She underwent tracheostomy and PEG placement 01/18/22 and then transferred to regular inpatient floor. She remained critically ill with ongoing encephalopathy therefore Palliative care met with family members who then elected DNR/DNI with care limitation code status (transition to comfort care if she is to deteriorate.  She remained critically ill and subsequently passed early morning of 01/27."