chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 17.0
Sex: F
Vaccine: HPV9, MNQ
Symptoms: Musculoskeletal stiffness, Pallor, Unresponsive to stimuli
Clinical narrative: About 5 minutes after vaccine administration, patient reported feeling very anxious. She became unresponsive and limp and was holding her breath. RN held patient head and neck for support and called for help/assistance. Patients arms and legs became stiff while sitting in chair. Patients face became very pale, and her lips appeared to be white. Her jaws were clinched at this time. 2nd RN assisted by maneuvering patients jaw to maintain open airway. 3rd RN assisted with checking vitals and calling 911. Pt began to take breaths on her own and began to respond to staff and was able to answer questions and follow commands. All assisting staff remained with patient until Ambulance arrived for transport and monitoring.
Age: 16.0
Sex: F
Vaccine: MMR
Symptoms: Inappropriate schedule of product administration, No adverse event
Clinical narrative: No reported symptoms or adverse reaction. Patient was not due for vaccine.
Age: 17.0
Sex: F
Vaccine: TD
Symptoms: Expired product administered, No adverse event, Product storage error
Clinical narrative: Patient came into the clinic for Mantoux for school. Pt was given Tubersol (TB) Mantoux in the left forearm. However, upon review of the inventory on 9/13/2024, pt was given TB that has been open in the refrigerator for 30+ days. Therefore, the vaccine was expired at the time of administration to the patient. There was no harm to the patient. No reaction noted.
Age: 11.0
Sex: M
Vaccine: HPV9, MNQ, TDAP
Symptoms: Rash, Swelling face, Throat clearing
Clinical narrative: 9/11/24 1057-Mom calls and reports that child was just released from the ER. She report that child started having a rash on his neck/chin area that began to worsen this morning. She reports that child's face was "puffy". She reports that he kept clearing his throat. The mother called the pediatrician and was referred to the ER. Child was seen in the ER this morning and stayed for "observation for two hours". She reports that child was given an antihistamine. She thinks that he may have been given a steroid also but she was not certain. She reports that the child has now improved and is ready to get some food. She is just concerned that this could have been a reaction to one of the vaccines he received on Monday. 9/11/24- 1328 Phoned and followed up with mother. She reports that child is doing "fine". She reports that "rash is improved". Discussed and encouraged seeking allergy testing for child as child has additional childhood vaccines in these series. Mother voices agreement and understanding.
Age: 64.0
Sex: F
Vaccine: COVID19, FLUC4
Symptoms: Delirium, Lymphadenopathy, Pyrexia
Clinical narrative: Patient reported fever, swelling of the lymph nodes on the arm the Covid shot was given, and "delirium" overnight.
Age: 0.33
Sex: M
Vaccine: RV5
Symptoms: No adverse event, Product administered to patient of inappropriate age
Clinical narrative: Infants current age is 4 months, 2 days, not in the age range to have first dose administered. Notified Immunization branch and was told to complete VAERS form. Contacted Mother about vaccine administration, infant has not had any adverse reaction at this time.
Age: 85.0
Sex: F
Vaccine: PNC20
Symptoms: Erythema, Skin warm, Swelling
Clinical narrative: right arm is red, hot and swollen 7 days after event.
Age: 10.0
Sex: M
Vaccine: HPV9
Symptoms: Amnesia, Confusional state, Fall, Head injury, Headache
Clinical narrative: Patient left the exam room to check out with his father. He fainted at the check out desk. He fell straight back and hit the back of his head on carpeted floor. Had a 20-30 second loss of consciousness. He was brought back into an exam room and examined by nurse practitioner. He was noted to have significant drowsiness, confusion, memory loss surrounding the event, and two episodes of emesis. Had persistent head pain and nausea. He was transferred to the Emergency Department for further evaluation, observation, and management.
Age: 10.0
Sex: M
Vaccine: HPV9
Symptoms: Loss of consciousness, Nausea, Somnolence, Syncope, Vomiting
Clinical narrative: Patient left the exam room to check out with his father. He fainted at the check out desk. He fell straight back and hit the back of his head on carpeted floor. Had a 20-30 second loss of consciousness. He was brought back into an exam room and examined by nurse practitioner. He was noted to have significant drowsiness, confusion, memory loss surrounding the event, and two episodes of emesis. Had persistent head pain and nausea. He was transferred to the Emergency Department for further evaluation, observation, and management.
Age: 79.0
Sex: F
Vaccine: FLUA4, FLUA4
Symptoms: Extra dose administered
Clinical narrative: Patient received two doses of the flu shot for this season
Age: 4.0
Sex: F
Vaccine: DTAPIPV, MMRV, MMRV
Symptoms: Expired product administered, No adverse event
Clinical narrative: Patient was given ProQuad MMRV vaccine on 9/13/2024 that expired on 9/8/2024.  Parent of patient reported no adverse reactions as of 9/16/2024.
Age: 5.0
Sex: F
Vaccine: COVID19-2
Symptoms: Incorrect dose administered, No adverse event, Product administered to patient of inappropriate age
Clinical narrative: PATIENT RECEIVED ADULT SPIKEVAX 0.5ML INSTEAD OF PEDIATRIC DOSAGE.  ERROR WAS DISCOVERED 2 WEEKS LATER VACCINE ADMINISTRATION.  I SPOKE WITH MOM  AND THE PATIENT HAD NO ADVERSE EVENTS TO REPORT FROM RECEIVING THE ADULT DOSE.
Age: 66.0
Sex: M
Vaccine: COVID19
Symptoms: Mobility decreased, Pain, Product administered at inappropriate site, Pyrexia, Shoulder injury related to vaccine administration
Clinical narrative: pt reports limited arm movement, fever, body aches. Starting the day after the vaccine was administer. He saw his doctor 4 days after vaccine and doctor states he has a vaccine related shoulder injury due to vaccine given too high. pt was prescribed steroids.
Age: 68.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: HOSPITALIZATION RELATED TO COVID 19 FOLLOWING COMPLETION OF PRIMARY COVID VACCINE SERIES
Age: 1.08
Sex: F
Vaccine: MMR
Symptoms: Expired product administered
Clinical narrative: Patient given MMR vaccine that expired on 9/15/2024.  Pt mother notified of incident. Mother did not appear to be upset.
Age: 35.0
Sex: F
Vaccine: COVID19, FLU4
Symptoms: Exposure during pregnancy, Immediate post-injection reaction, Injection site pain, Injection site reaction, Joint range of motion decreased
Clinical narrative: I arrived at the pharmacy clinic for two vaccines: covid and flu on 8/30/24  at 6:00pm. At the time, I was 25 weeks pregnant and having an uncomplicated, very healthy course of pregnancy. The vaccination administrator (RPh) administered both vaccines to the upper left arm, which I noted was higher on the shoulder than I was used to receiving. It is worth noting that he was not particularly friendly during the encounter as suggested by not responding to comments and being very brief. Immediately following the vaccination, I struggled to pick up my purse with my left arm. I assumed this was typical tenderness associated with vaccinations that would be short lived as I've had similar symptoms enduring 24-48 hours previously. This arm pain, however, escalated to becoming quite acute and has remained acute since 8/30/24 until the present date. The symptoms include function impairment in arm that can be described as significant pain when using left arm/shoulder, significant limited range of movement in left arm/shoulder, and pain/muscle tension in arm/shoulder while arm is at rest. Treatments have included using pregnancy-approved pain medication of Tylenol that results in no improvement in symptoms. Treatment has also included using a warm compress per my PCP's suggestion, Dr., and resting the arm which has resulted in no improvement of stated symptoms.  I also reported the symptoms to my OBGYN, Dr., on 9/16 for a routine pregnancy check up. The nurse reported that enduring vaccine site pain is not typical for pregnancy and is suggestive of incorrect vaccine administration by above stated provider.
Age: 35.0
Sex: F
Vaccine: COVID19, FLU4
Symptoms: Muscle tightness, Musculoskeletal disorder, Pain, Pain in extremity, Product administered at inappropriate site
Clinical narrative: I arrived at the pharmacy clinic for two vaccines: covid and flu on 8/30/24  at 6:00pm. At the time, I was 25 weeks pregnant and having an uncomplicated, very healthy course of pregnancy. The vaccination administrator (RPh) administered both vaccines to the upper left arm, which I noted was higher on the shoulder than I was used to receiving. It is worth noting that he was not particularly friendly during the encounter as suggested by not responding to comments and being very brief. Immediately following the vaccination, I struggled to pick up my purse with my left arm. I assumed this was typical tenderness associated with vaccinations that would be short lived as I've had similar symptoms enduring 24-48 hours previously. This arm pain, however, escalated to becoming quite acute and has remained acute since 8/30/24 until the present date. The symptoms include function impairment in arm that can be described as significant pain when using left arm/shoulder, significant limited range of movement in left arm/shoulder, and pain/muscle tension in arm/shoulder while arm is at rest. Treatments have included using pregnancy-approved pain medication of Tylenol that results in no improvement in symptoms. Treatment has also included using a warm compress per my PCP's suggestion, Dr., and resting the arm which has resulted in no improvement of stated symptoms.  I also reported the symptoms to my OBGYN, Dr., on 9/16 for a routine pregnancy check up. The nurse reported that enduring vaccine site pain is not typical for pregnancy and is suggestive of incorrect vaccine administration by above stated provider.
Age: 35.0
Sex: F
Vaccine: COVID19, FLU4
Symptoms: Tenderness, Wrong technique in product usage process
Clinical narrative: I arrived at the pharmacy clinic for two vaccines: covid and flu on 8/30/24  at 6:00pm. At the time, I was 25 weeks pregnant and having an uncomplicated, very healthy course of pregnancy. The vaccination administrator (RPh) administered both vaccines to the upper left arm, which I noted was higher on the shoulder than I was used to receiving. It is worth noting that he was not particularly friendly during the encounter as suggested by not responding to comments and being very brief. Immediately following the vaccination, I struggled to pick up my purse with my left arm. I assumed this was typical tenderness associated with vaccinations that would be short lived as I've had similar symptoms enduring 24-48 hours previously. This arm pain, however, escalated to becoming quite acute and has remained acute since 8/30/24 until the present date. The symptoms include function impairment in arm that can be described as significant pain when using left arm/shoulder, significant limited range of movement in left arm/shoulder, and pain/muscle tension in arm/shoulder while arm is at rest. Treatments have included using pregnancy-approved pain medication of Tylenol that results in no improvement in symptoms. Treatment has also included using a warm compress per my PCP's suggestion, Dr., and resting the arm which has resulted in no improvement of stated symptoms.  I also reported the symptoms to my OBGYN, Dr., on 9/16 for a routine pregnancy check up. The nurse reported that enduring vaccine site pain is not typical for pregnancy and is suggestive of incorrect vaccine administration by above stated provider.
Age: 65.0
Sex: F
Vaccine: PNC20
Symptoms: Gait disturbance, Immediate post-injection reaction, Injection site pain, Injury associated with device, Musculoskeletal stiffness
Clinical narrative: She got her vaccine, she had pain in the arm, the needle hurt going in.  She had the vaccine way at the top of her shoulder and felt it was too far up and had immediate pain, mostly just the needle stick.  The arm pain was not excruciating, but it was hurting.  She also had arm stiffness afterwards.  She also had some nausea the next 2 days or so, which did subside.  She continues to have the arm pain when she tries to lie on it as it is too painful.  She has been rubbing it and massaging it.   She had the shingles vaccine the first week in August and has been having dizziness on occasion and when she stands up she feels like she is missing a step, and does go away as she gets moving.  She has not taken anything for her symptoms.  She has not seen her doctor for her symptoms either.  She was having some palpitations, but does not know if that has anything to do with it.  She saw her doctor on Friday and that's when she got the vaccine.  Her doctor felt that the palpitations could be from stress, drinking coffee 2-3 days in a row and that it could be the caffeine.  She has also been having pins and needles sensation really bad in both of her hands, which he said that it could be carpal tunnel.  did some neurological tests on it, and mentions some testing, and her wearing a heart monitor and to check with the cardiologist to see if there was anything on.  A lot of her symptoms came on after taking the 2nd Shingles vaccine, which is the first time she has taken it this year.   She did some Ibuprofen for her recent symptoms last night.
Age: 65.0
Sex: F
Vaccine: PNC20
Symptoms: Nausea, Pain in extremity, Palpitations, Paraesthesia, Product administered at inappropriate site
Clinical narrative: She got her vaccine, she had pain in the arm, the needle hurt going in.  She had the vaccine way at the top of her shoulder and felt it was too far up and had immediate pain, mostly just the needle stick.  The arm pain was not excruciating, but it was hurting.  She also had arm stiffness afterwards.  She also had some nausea the next 2 days or so, which did subside.  She continues to have the arm pain when she tries to lie on it as it is too painful.  She has been rubbing it and massaging it.   She had the shingles vaccine the first week in August and has been having dizziness on occasion and when she stands up she feels like she is missing a step, and does go away as she gets moving.  She has not taken anything for her symptoms.  She has not seen her doctor for her symptoms either.  She was having some palpitations, but does not know if that has anything to do with it.  She saw her doctor on Friday and that's when she got the vaccine.  Her doctor felt that the palpitations could be from stress, drinking coffee 2-3 days in a row and that it could be the caffeine.  She has also been having pins and needles sensation really bad in both of her hands, which he said that it could be carpal tunnel.  did some neurological tests on it, and mentions some testing, and her wearing a heart monitor and to check with the cardiologist to see if there was anything on.  A lot of her symptoms came on after taking the 2nd Shingles vaccine, which is the first time she has taken it this year.   She did some Ibuprofen for her recent symptoms last night.
Age: 17.0
Sex: M
Vaccine: MNQ
Symptoms: Circumstance or information capable of leading to medication error, Extra dose administered
Clinical narrative: Parent requested that we get the patient up to date on vaccines. Patients records were not up to date in our system or database. Patients primary care Dr contacted me to let me know that he got notification that we gave a vaccine. He informed me that his office gave the patient his second dose of menveo on April 01, 2024.
Age: 81.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: COVID-19, Fall, SARS-CoV-2 test positive
Clinical narrative: Falls since positive COVID home test on August 22, 2024.
Age: 82.0
Sex: F
Vaccine: VARZOS
Symptoms: Neck pain
Clinical narrative: Severe neck ache 6 days
Age: 68.0
Sex: M
Vaccine: COVID19, COVID19, COVID19, COVID19, COVID19-2
Symptoms: Chills, Cough, Oropharyngeal pain, Respiratory tract congestion, Rhinorrhoea
Clinical narrative: Cough, sore throat, runny nose, congestion, intermittent chills
Age: 68.0
Sex: M
Vaccine: COVID19, COVID19, COVID19, COVID19, COVID19-2
Symptoms: SARS-CoV-2 test
Clinical narrative: Cough, sore throat, runny nose, congestion, intermittent chills
Age: 13.0
Sex: F
Vaccine: UNK
Symptoms: No adverse event, Wrong product administered
Clinical narrative: Pt received combination proquad but recommended dose is separate varicella and MMR.  No adverse reaction reported.  Pt required both vaccinations.  Vaccination is valid and requires no followup care.
Age: 54.0
Sex: F
Vaccine: RSV, TDAP, VARZOS
Symptoms: Product administered to patient of inappropriate age, Wrong product administered
Clinical narrative: Erroneously administered RSV vaccine to patient not indicated to get based on age or health comorbidities.
Age: 68.0
Sex: F
Vaccine: FLUA4
Symptoms: No adverse event, Product storage error
Clinical narrative: This patient did not suffer any adverse effects (as listed in the DOH criteria) from the administration of this flu vaccine.  There was a temperature excursion that affected several vaccines, this being one of them. A medical assistant, received a miscommunication and mistakenly administered the vaccine to the patient before it was pulled from the inventory.
Age: 51.0
Sex: F
Vaccine: VARZOS
Symptoms: Herpes zoster
Clinical narrative: Patient has diagnosis of Shingles. Ophthalmic branch of the trigeminal nerve encompass the forehead upper eyelid and the anterior scalp up to the vertex.
Age: 79.0
Sex: F
Vaccine: RSV
Symptoms: Circumstance or information capable of leading to medication error, Extra dose administered, No adverse event
Clinical narrative: There has been no adverse event reported.  Simply reporting that the patient notated on their form that they had never received an RSV shot but after the shot was given, it was found out she had already received the same vaccine on 3/28/24.  Attempted to reach patient with no call back.  Reached her doctor's office and had them document.
Age: 4.0
Sex: F
Vaccine: DTAPHEPBIP
Symptoms: No adverse event, Wrong product administered
Clinical narrative: No adverse event reported.  RN administered Pediarix in place of Twinrix.  Twinrix is recommended for 4th in series.  Vaccination is valid and requires no follow up action.
Age: 30.0
Sex: F
Vaccine: COVID19
Symptoms: Pemphigoid
Clinical narrative: bullous pemphigoid 40-48 hours after vaccine. getting worse as of 72 hours after vaccine
Age: 63.0
Sex: M
Vaccine: COVID19
Symptoms: Abdominal pain, Chest X-ray normal, Chest discomfort, Computerised tomogram head normal, Dyspnoea
Clinical narrative: Presesnted to medical staff with chest tightness,dyspnea, abdominal cramping, tachycardia and tachypnea. Was transported to the emergency department, where he was evaluated.   Diagnosed with "Acute HA syndrome" probably due to covid booster given yesterday.  Per paperwork, EKG, head CT, CXR, labs and UA were reassuring. In the ED it appears he was given IV NS, ketorolac, prochlorparazine, acetaminophen, diphenhydramine.  Recommended APAP, IBU prn on return.
Age: 63.0
Sex: M
Vaccine: COVID19
Symptoms: Electrocardiogram normal, Full blood count normal, Immunisation reaction, Tachycardia, Tachypnoea
Clinical narrative: Presesnted to medical staff with chest tightness,dyspnea, abdominal cramping, tachycardia and tachypnea. Was transported to the emergency department, where he was evaluated.   Diagnosed with "Acute HA syndrome" probably due to covid booster given yesterday.  Per paperwork, EKG, head CT, CXR, labs and UA were reassuring. In the ED it appears he was given IV NS, ketorolac, prochlorparazine, acetaminophen, diphenhydramine.  Recommended APAP, IBU prn on return.
Age: 63.0
Sex: M
Vaccine: COVID19
Symptoms: Urine analysis normal
Clinical narrative: Presesnted to medical staff with chest tightness,dyspnea, abdominal cramping, tachycardia and tachypnea. Was transported to the emergency department, where he was evaluated.   Diagnosed with "Acute HA syndrome" probably due to covid booster given yesterday.  Per paperwork, EKG, head CT, CXR, labs and UA were reassuring. In the ED it appears he was given IV NS, ketorolac, prochlorparazine, acetaminophen, diphenhydramine.  Recommended APAP, IBU prn on return.
Age: 24.0
Sex: M
Vaccine: HEP
Symptoms: Product administered to patient of inappropriate age, Underdose
Clinical narrative: Pediatric dose given to patient instead of adult dose.
Age: 59.0
Sex: M
Vaccine: COVID19
Symptoms: Acute respiratory failure, Angiogram pulmonary abnormal, Blood potassium decreased, Brain natriuretic peptide increased, COVID-19
Clinical narrative: Admit date: 9/6/2024   Discharge date: 9/8/24  Attending Physician at the Time of Discharge: DO  Summary HPI: Patient is a 62 y.o. year old male with a medical history including CVA, Afib, hyperlipidemia, hypertension, OSA?  presents with worsening shortness of breath fever and cough.   Patient states about a week ago started presenting with worsening shortness of breath, fever and cough, shortness of breath got really severe that he was not able to give few steps without getting shortness of breath. Reports orthopnea. For the past several month patient report paroxysmal nocturnal dyspnea. Denies h/o of smoking.    On the emergency department, patient was found to shortness of breath desating to 88% with ambulation, covid + . CTA showed no PE,  and mild cardiomegaly. Patient admitted to the impatient unit for further management acute dyspnea  Please see admission H&P for further details.  Summary of Hospitalization: Patient was admitted with acute hypoxic respiratory failure due to an acute exacerbation of chronic diastolic congestive heart failure as well as acute viral illness secondary to COVID-19. -Echocardiogram reviewed from January 2024, EF 50-55%. CTA 9/6 revealed no PE and evidence of mild cardiomegaly.BNP on admission was 2837, troponins normal at 19 and 16. He was provided IV diuresis and then transitioned to oral. He was able to maintain adequate saturation on room air. He demonstrated a negative fluid balance of 2230 ml. His weight decreased from 140.6 kg to 133.8 kg. He was provided lasix at discharge. Elevations in LFT"s were attributed to passive hepatic congestion from the CHF. Potassium supplementation was provided on the day of discharge due to low potassium of 3.3 with diuresis.  Discharged to Home.
Age: 59.0
Sex: M
Vaccine: COVID19
Symptoms: Cardiac failure congestive, Cardiomegaly, Chronic left ventricular failure, Condition aggravated, Congestive hepatopathy
Clinical narrative: Admit date: 9/6/2024   Discharge date: 9/8/24  Attending Physician at the Time of Discharge: DO  Summary HPI: Patient is a 62 y.o. year old male with a medical history including CVA, Afib, hyperlipidemia, hypertension, OSA?  presents with worsening shortness of breath fever and cough.   Patient states about a week ago started presenting with worsening shortness of breath, fever and cough, shortness of breath got really severe that he was not able to give few steps without getting shortness of breath. Reports orthopnea. For the past several month patient report paroxysmal nocturnal dyspnea. Denies h/o of smoking.    On the emergency department, patient was found to shortness of breath desating to 88% with ambulation, covid + . CTA showed no PE,  and mild cardiomegaly. Patient admitted to the impatient unit for further management acute dyspnea  Please see admission H&P for further details.  Summary of Hospitalization: Patient was admitted with acute hypoxic respiratory failure due to an acute exacerbation of chronic diastolic congestive heart failure as well as acute viral illness secondary to COVID-19. -Echocardiogram reviewed from January 2024, EF 50-55%. CTA 9/6 revealed no PE and evidence of mild cardiomegaly.BNP on admission was 2837, troponins normal at 19 and 16. He was provided IV diuresis and then transitioned to oral. He was able to maintain adequate saturation on room air. He demonstrated a negative fluid balance of 2230 ml. His weight decreased from 140.6 kg to 133.8 kg. He was provided lasix at discharge. Elevations in LFT"s were attributed to passive hepatic congestion from the CHF. Potassium supplementation was provided on the day of discharge due to low potassium of 3.3 with diuresis.  Discharged to Home.
Age: 59.0
Sex: M
Vaccine: COVID19
Symptoms: Cough, Diuretic therapy, Dyspnoea, Dyspnoea exertional, Dyspnoea paroxysmal nocturnal
Clinical narrative: Admit date: 9/6/2024   Discharge date: 9/8/24  Attending Physician at the Time of Discharge: DO  Summary HPI: Patient is a 62 y.o. year old male with a medical history including CVA, Afib, hyperlipidemia, hypertension, OSA?  presents with worsening shortness of breath fever and cough.   Patient states about a week ago started presenting with worsening shortness of breath, fever and cough, shortness of breath got really severe that he was not able to give few steps without getting shortness of breath. Reports orthopnea. For the past several month patient report paroxysmal nocturnal dyspnea. Denies h/o of smoking.    On the emergency department, patient was found to shortness of breath desating to 88% with ambulation, covid + . CTA showed no PE,  and mild cardiomegaly. Patient admitted to the impatient unit for further management acute dyspnea  Please see admission H&P for further details.  Summary of Hospitalization: Patient was admitted with acute hypoxic respiratory failure due to an acute exacerbation of chronic diastolic congestive heart failure as well as acute viral illness secondary to COVID-19. -Echocardiogram reviewed from January 2024, EF 50-55%. CTA 9/6 revealed no PE and evidence of mild cardiomegaly.BNP on admission was 2837, troponins normal at 19 and 16. He was provided IV diuresis and then transitioned to oral. He was able to maintain adequate saturation on room air. He demonstrated a negative fluid balance of 2230 ml. His weight decreased from 140.6 kg to 133.8 kg. He was provided lasix at discharge. Elevations in LFT"s were attributed to passive hepatic congestion from the CHF. Potassium supplementation was provided on the day of discharge due to low potassium of 3.3 with diuresis.  Discharged to Home.
Age: 59.0
Sex: M
Vaccine: COVID19
Symptoms: Echocardiogram abnormal, Echocardiogram normal, Ejection fraction decreased, Fluid balance negative, Liver function test increased
Clinical narrative: Admit date: 9/6/2024   Discharge date: 9/8/24  Attending Physician at the Time of Discharge: DO  Summary HPI: Patient is a 62 y.o. year old male with a medical history including CVA, Afib, hyperlipidemia, hypertension, OSA?  presents with worsening shortness of breath fever and cough.   Patient states about a week ago started presenting with worsening shortness of breath, fever and cough, shortness of breath got really severe that he was not able to give few steps without getting shortness of breath. Reports orthopnea. For the past several month patient report paroxysmal nocturnal dyspnea. Denies h/o of smoking.    On the emergency department, patient was found to shortness of breath desating to 88% with ambulation, covid + . CTA showed no PE,  and mild cardiomegaly. Patient admitted to the impatient unit for further management acute dyspnea  Please see admission H&P for further details.  Summary of Hospitalization: Patient was admitted with acute hypoxic respiratory failure due to an acute exacerbation of chronic diastolic congestive heart failure as well as acute viral illness secondary to COVID-19. -Echocardiogram reviewed from January 2024, EF 50-55%. CTA 9/6 revealed no PE and evidence of mild cardiomegaly.BNP on admission was 2837, troponins normal at 19 and 16. He was provided IV diuresis and then transitioned to oral. He was able to maintain adequate saturation on room air. He demonstrated a negative fluid balance of 2230 ml. His weight decreased from 140.6 kg to 133.8 kg. He was provided lasix at discharge. Elevations in LFT"s were attributed to passive hepatic congestion from the CHF. Potassium supplementation was provided on the day of discharge due to low potassium of 3.3 with diuresis.  Discharged to Home.
Age: 59.0
Sex: M
Vaccine: COVID19
Symptoms: Orthopnoea, Oxygen saturation decreased, Pyrexia, SARS-CoV-2 test positive, Troponin
Clinical narrative: Admit date: 9/6/2024   Discharge date: 9/8/24  Attending Physician at the Time of Discharge: DO  Summary HPI: Patient is a 62 y.o. year old male with a medical history including CVA, Afib, hyperlipidemia, hypertension, OSA?  presents with worsening shortness of breath fever and cough.   Patient states about a week ago started presenting with worsening shortness of breath, fever and cough, shortness of breath got really severe that he was not able to give few steps without getting shortness of breath. Reports orthopnea. For the past several month patient report paroxysmal nocturnal dyspnea. Denies h/o of smoking.    On the emergency department, patient was found to shortness of breath desating to 88% with ambulation, covid + . CTA showed no PE,  and mild cardiomegaly. Patient admitted to the impatient unit for further management acute dyspnea  Please see admission H&P for further details.  Summary of Hospitalization: Patient was admitted with acute hypoxic respiratory failure due to an acute exacerbation of chronic diastolic congestive heart failure as well as acute viral illness secondary to COVID-19. -Echocardiogram reviewed from January 2024, EF 50-55%. CTA 9/6 revealed no PE and evidence of mild cardiomegaly.BNP on admission was 2837, troponins normal at 19 and 16. He was provided IV diuresis and then transitioned to oral. He was able to maintain adequate saturation on room air. He demonstrated a negative fluid balance of 2230 ml. His weight decreased from 140.6 kg to 133.8 kg. He was provided lasix at discharge. Elevations in LFT"s were attributed to passive hepatic congestion from the CHF. Potassium supplementation was provided on the day of discharge due to low potassium of 3.3 with diuresis.  Discharged to Home.
Age: 59.0
Sex: M
Vaccine: COVID19
Symptoms: Viral infection, Weight decreased
Clinical narrative: Admit date: 9/6/2024   Discharge date: 9/8/24  Attending Physician at the Time of Discharge: DO  Summary HPI: Patient is a 62 y.o. year old male with a medical history including CVA, Afib, hyperlipidemia, hypertension, OSA?  presents with worsening shortness of breath fever and cough.   Patient states about a week ago started presenting with worsening shortness of breath, fever and cough, shortness of breath got really severe that he was not able to give few steps without getting shortness of breath. Reports orthopnea. For the past several month patient report paroxysmal nocturnal dyspnea. Denies h/o of smoking.    On the emergency department, patient was found to shortness of breath desating to 88% with ambulation, covid + . CTA showed no PE,  and mild cardiomegaly. Patient admitted to the impatient unit for further management acute dyspnea  Please see admission H&P for further details.  Summary of Hospitalization: Patient was admitted with acute hypoxic respiratory failure due to an acute exacerbation of chronic diastolic congestive heart failure as well as acute viral illness secondary to COVID-19. -Echocardiogram reviewed from January 2024, EF 50-55%. CTA 9/6 revealed no PE and evidence of mild cardiomegaly.BNP on admission was 2837, troponins normal at 19 and 16. He was provided IV diuresis and then transitioned to oral. He was able to maintain adequate saturation on room air. He demonstrated a negative fluid balance of 2230 ml. His weight decreased from 140.6 kg to 133.8 kg. He was provided lasix at discharge. Elevations in LFT"s were attributed to passive hepatic congestion from the CHF. Potassium supplementation was provided on the day of discharge due to low potassium of 3.3 with diuresis.  Discharged to Home.
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Asthenia, Blood creatinine, Blood culture negative, Brain natriuretic peptide, COVID-19
Clinical narrative: Admission Date: 9/9/2024 Discharge Date: Sep 11, 2024 Discharge Disposition:  home or self care   Active Issues Requiring Follow-up: PCP follow up DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: AMS (altered mental status) [R41.82]  HOSPITAL COURSE: This is a 76 y.o. male with h/o ESRD on HD, HTN, BPH, RA, MR s/p transcatheter edge-to-edge mitral repair, recurrent pleural effusions s/p thoracotomy/total lung decortication/VATS w/ talc pleurodesis presenting to the ED for evaluation of AMS  Patient states he developed nonproductive cough as well as intermittent chills about 3 days ago, also has been using 3-4L O2 (normally on 2L) thought his symptoms would go away with HD however became altered after session today and was brought to the ED for further evaluation. Patient continues to feel weak, endorses persistent dry cough, fever/chills. Patient denies dizziness, lightheadedness, nausea, vomiting, chest pain, palpitation, abd pain.   In the ED, pt febrile to 38.%, satuarting well on 4L O2. Lab work grossly nonacute, Cr, BNP, Hgb around baseline. Mild leukocytosis with WBC 12.6. CXR w/ infiltrate L>R though appears stable from his previous study. (HPI per DR)  Sepsis, present on admission -secondary to COVID-19 viral infection, CXR without acute process, antibiotics provided in ED but not continued upon admission -blood cultures 9/9 negative to date. He improved clinically and today feels fine and back to baseline of 1L NC (on 1-2 at home). Plan is for discharge home to follow up with PCP Discharged to Home.
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Chest X-ray abnormal, Chills, Cough, Haemodialysis, Haemoglobin
Clinical narrative: Admission Date: 9/9/2024 Discharge Date: Sep 11, 2024 Discharge Disposition:  home or self care   Active Issues Requiring Follow-up: PCP follow up DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: AMS (altered mental status) [R41.82]  HOSPITAL COURSE: This is a 76 y.o. male with h/o ESRD on HD, HTN, BPH, RA, MR s/p transcatheter edge-to-edge mitral repair, recurrent pleural effusions s/p thoracotomy/total lung decortication/VATS w/ talc pleurodesis presenting to the ED for evaluation of AMS  Patient states he developed nonproductive cough as well as intermittent chills about 3 days ago, also has been using 3-4L O2 (normally on 2L) thought his symptoms would go away with HD however became altered after session today and was brought to the ED for further evaluation. Patient continues to feel weak, endorses persistent dry cough, fever/chills. Patient denies dizziness, lightheadedness, nausea, vomiting, chest pain, palpitation, abd pain.   In the ED, pt febrile to 38.%, satuarting well on 4L O2. Lab work grossly nonacute, Cr, BNP, Hgb around baseline. Mild leukocytosis with WBC 12.6. CXR w/ infiltrate L>R though appears stable from his previous study. (HPI per DR)  Sepsis, present on admission -secondary to COVID-19 viral infection, CXR without acute process, antibiotics provided in ED but not continued upon admission -blood cultures 9/9 negative to date. He improved clinically and today feels fine and back to baseline of 1L NC (on 1-2 at home). Plan is for discharge home to follow up with PCP Discharged to Home.
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Leukocytosis, Lung infiltration, Mental status changes, Pyrexia, Sepsis
Clinical narrative: Admission Date: 9/9/2024 Discharge Date: Sep 11, 2024 Discharge Disposition:  home or self care   Active Issues Requiring Follow-up: PCP follow up DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: AMS (altered mental status) [R41.82]  HOSPITAL COURSE: This is a 76 y.o. male with h/o ESRD on HD, HTN, BPH, RA, MR s/p transcatheter edge-to-edge mitral repair, recurrent pleural effusions s/p thoracotomy/total lung decortication/VATS w/ talc pleurodesis presenting to the ED for evaluation of AMS  Patient states he developed nonproductive cough as well as intermittent chills about 3 days ago, also has been using 3-4L O2 (normally on 2L) thought his symptoms would go away with HD however became altered after session today and was brought to the ED for further evaluation. Patient continues to feel weak, endorses persistent dry cough, fever/chills. Patient denies dizziness, lightheadedness, nausea, vomiting, chest pain, palpitation, abd pain.   In the ED, pt febrile to 38.%, satuarting well on 4L O2. Lab work grossly nonacute, Cr, BNP, Hgb around baseline. Mild leukocytosis with WBC 12.6. CXR w/ infiltrate L>R though appears stable from his previous study. (HPI per DR)  Sepsis, present on admission -secondary to COVID-19 viral infection, CXR without acute process, antibiotics provided in ED but not continued upon admission -blood cultures 9/9 negative to date. He improved clinically and today feels fine and back to baseline of 1L NC (on 1-2 at home). Plan is for discharge home to follow up with PCP Discharged to Home.
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: White blood cell count increased
Clinical narrative: Admission Date: 9/9/2024 Discharge Date: Sep 11, 2024 Discharge Disposition:  home or self care   Active Issues Requiring Follow-up: PCP follow up DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: AMS (altered mental status) [R41.82]  HOSPITAL COURSE: This is a 76 y.o. male with h/o ESRD on HD, HTN, BPH, RA, MR s/p transcatheter edge-to-edge mitral repair, recurrent pleural effusions s/p thoracotomy/total lung decortication/VATS w/ talc pleurodesis presenting to the ED for evaluation of AMS  Patient states he developed nonproductive cough as well as intermittent chills about 3 days ago, also has been using 3-4L O2 (normally on 2L) thought his symptoms would go away with HD however became altered after session today and was brought to the ED for further evaluation. Patient continues to feel weak, endorses persistent dry cough, fever/chills. Patient denies dizziness, lightheadedness, nausea, vomiting, chest pain, palpitation, abd pain.   In the ED, pt febrile to 38.%, satuarting well on 4L O2. Lab work grossly nonacute, Cr, BNP, Hgb around baseline. Mild leukocytosis with WBC 12.6. CXR w/ infiltrate L>R though appears stable from his previous study. (HPI per DR)  Sepsis, present on admission -secondary to COVID-19 viral infection, CXR without acute process, antibiotics provided in ED but not continued upon admission -blood cultures 9/9 negative to date. He improved clinically and today feels fine and back to baseline of 1L NC (on 1-2 at home). Plan is for discharge home to follow up with PCP Discharged to Home.
Age: 1.67
Sex: M
Vaccine: DTAP, FLU4, IPV, PNC20
Symptoms: No adverse event, Product storage error
Clinical narrative: Pt  received IPOL that was later deemed as not to be used due to temperature excursion. Pt has not signs or symptoms of any adverse outcome.
Age: 73.0
Sex: M
Vaccine: COVID19
Symptoms: Breakthrough COVID-19, SARS-CoV-2 RNA, SARS-CoV-2 test positive
Clinical narrative: HOSPITALIZATION RELATED TO COVID-19 FOLLOWING COMPLETION OF PRIMARY COVID VACCINE SERIES
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: Acute myocardial infarction, Anxiety, Bereavement, Blood calcium increased, Blood creatinine
Clinical narrative: Admission Date: 9/9/2024 Discharge Date: Sep 12, 2024 Discharge Disposition:  home or self care DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: ST elevation myocardial infarction (STEMI), unspecified artery [I21.3] HF (heart failure) [I50.9] NSTEMI (non-ST elevated myocardial infarction) [I21.4]  HOSPITAL COURSE: Patient is a 67yr old female with a history of CAD, COPD, GERs, Seizuere 2/2 TBI, Takotsubo cardiomyopathy who presented with chest pain and SOB. She is seen today in room post cath. She says she feels better but has some indigestion/dyspepsia.   Takotsubo cardiomyopathy - Elevated trop is secondary to takotsubo cardiomyopathy confirmed post cath. She has just been through a stressful time as her husband just passed away. Plan is for DAPT, statin,  and to follow up with cards to start GDMT with BB, ACE/ARB/ARNI, sGLT2 and spironolactone as tolerated. She feels better today and plan is for discharge to follow up with cardiology.  CAD with mild LAD stenosis - incidental finding s/p successful stenting of the mid LAD. Plan is for ASA, plavix, statin.  Anxiety with Depression in setting of recent bereavement - will place on trazodone 25mg prn and to follow up with PCP.  Discharged to Home.                   EMERGENCY  09/04/2024  CHIEF COMPLAINT: GENERALIZED BODY ACHES  Assessment/Plan  DIAGNOSIS at time of disposition:  1. COVID  2. Nausea and vomiting, unspecified vomiting type   ED Course as of 09/05/24 0103 Wed Sep 04, 2024 1341 Patient 67-year-old female presenting for generalized body aches, nausea, nonbloody, nonbilious vomiting.  On exam appears unwell but overall nontoxic, not septic.  Grossly seen vomiting clear emesis in trash bin.  Presentation suggestive of possible uncomplicated viral GI illness; colitis/enteritis, acute gastropathy.  Hepatobiliary etiologies considered however no right upper quadrant abdominal pain.  Pancreatitis possible.  Will provide symptomatic treatment and collect laboratory studies assess for elevated lipase, cholestasis or other signs of acute intra-abdominal pathology.  Low concern for atypical ACS.  Thu Sep 05, 2024 0052 SARS-CoV-2 (COVID-19), Influenza A/B, RSV PCR(!) Positive for COVID.  Labs notable for hemolyzed potassium, minimally elevated calcium appeared.  No evidence of cholestasis.  Hemoglobin creatinine stable.  Patient given antiemetics, analgesics and fluid rehydration with moderate improvement of symptoms.  Discussed close outpatient follow-up and strict return precautions and she was agreeable.  Discharged to Home
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: Blood potassium abnormal, COVID-19, Cardiac failure, Catheterisation cardiac abnormal, Chest pain
Clinical narrative: Admission Date: 9/9/2024 Discharge Date: Sep 12, 2024 Discharge Disposition:  home or self care DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: ST elevation myocardial infarction (STEMI), unspecified artery [I21.3] HF (heart failure) [I50.9] NSTEMI (non-ST elevated myocardial infarction) [I21.4]  HOSPITAL COURSE: Patient is a 67yr old female with a history of CAD, COPD, GERs, Seizuere 2/2 TBI, Takotsubo cardiomyopathy who presented with chest pain and SOB. She is seen today in room post cath. She says she feels better but has some indigestion/dyspepsia.   Takotsubo cardiomyopathy - Elevated trop is secondary to takotsubo cardiomyopathy confirmed post cath. She has just been through a stressful time as her husband just passed away. Plan is for DAPT, statin,  and to follow up with cards to start GDMT with BB, ACE/ARB/ARNI, sGLT2 and spironolactone as tolerated. She feels better today and plan is for discharge to follow up with cardiology.  CAD with mild LAD stenosis - incidental finding s/p successful stenting of the mid LAD. Plan is for ASA, plavix, statin.  Anxiety with Depression in setting of recent bereavement - will place on trazodone 25mg prn and to follow up with PCP.  Discharged to Home.                   EMERGENCY  09/04/2024  CHIEF COMPLAINT: GENERALIZED BODY ACHES  Assessment/Plan  DIAGNOSIS at time of disposition:  1. COVID  2. Nausea and vomiting, unspecified vomiting type   ED Course as of 09/05/24 0103 Wed Sep 04, 2024 1341 Patient 67-year-old female presenting for generalized body aches, nausea, nonbloody, nonbilious vomiting.  On exam appears unwell but overall nontoxic, not septic.  Grossly seen vomiting clear emesis in trash bin.  Presentation suggestive of possible uncomplicated viral GI illness; colitis/enteritis, acute gastropathy.  Hepatobiliary etiologies considered however no right upper quadrant abdominal pain.  Pancreatitis possible.  Will provide symptomatic treatment and collect laboratory studies assess for elevated lipase, cholestasis or other signs of acute intra-abdominal pathology.  Low concern for atypical ACS.  Thu Sep 05, 2024 0052 SARS-CoV-2 (COVID-19), Influenza A/B, RSV PCR(!) Positive for COVID.  Labs notable for hemolyzed potassium, minimally elevated calcium appeared.  No evidence of cholestasis.  Hemoglobin creatinine stable.  Patient given antiemetics, analgesics and fluid rehydration with moderate improvement of symptoms.  Discussed close outpatient follow-up and strict return precautions and she was agreeable.  Discharged to Home
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: Colitis, Coronary arterial stent insertion, Coronary artery disease, Coronary artery stenosis, Death of relative
Clinical narrative: Admission Date: 9/9/2024 Discharge Date: Sep 12, 2024 Discharge Disposition:  home or self care DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: ST elevation myocardial infarction (STEMI), unspecified artery [I21.3] HF (heart failure) [I50.9] NSTEMI (non-ST elevated myocardial infarction) [I21.4]  HOSPITAL COURSE: Patient is a 67yr old female with a history of CAD, COPD, GERs, Seizuere 2/2 TBI, Takotsubo cardiomyopathy who presented with chest pain and SOB. She is seen today in room post cath. She says she feels better but has some indigestion/dyspepsia.   Takotsubo cardiomyopathy - Elevated trop is secondary to takotsubo cardiomyopathy confirmed post cath. She has just been through a stressful time as her husband just passed away. Plan is for DAPT, statin,  and to follow up with cards to start GDMT with BB, ACE/ARB/ARNI, sGLT2 and spironolactone as tolerated. She feels better today and plan is for discharge to follow up with cardiology.  CAD with mild LAD stenosis - incidental finding s/p successful stenting of the mid LAD. Plan is for ASA, plavix, statin.  Anxiety with Depression in setting of recent bereavement - will place on trazodone 25mg prn and to follow up with PCP.  Discharged to Home.                   EMERGENCY  09/04/2024  CHIEF COMPLAINT: GENERALIZED BODY ACHES  Assessment/Plan  DIAGNOSIS at time of disposition:  1. COVID  2. Nausea and vomiting, unspecified vomiting type   ED Course as of 09/05/24 0103 Wed Sep 04, 2024 1341 Patient 67-year-old female presenting for generalized body aches, nausea, nonbloody, nonbilious vomiting.  On exam appears unwell but overall nontoxic, not septic.  Grossly seen vomiting clear emesis in trash bin.  Presentation suggestive of possible uncomplicated viral GI illness; colitis/enteritis, acute gastropathy.  Hepatobiliary etiologies considered however no right upper quadrant abdominal pain.  Pancreatitis possible.  Will provide symptomatic treatment and collect laboratory studies assess for elevated lipase, cholestasis or other signs of acute intra-abdominal pathology.  Low concern for atypical ACS.  Thu Sep 05, 2024 0052 SARS-CoV-2 (COVID-19), Influenza A/B, RSV PCR(!) Positive for COVID.  Labs notable for hemolyzed potassium, minimally elevated calcium appeared.  No evidence of cholestasis.  Hemoglobin creatinine stable.  Patient given antiemetics, analgesics and fluid rehydration with moderate improvement of symptoms.  Discussed close outpatient follow-up and strict return precautions and she was agreeable.  Discharged to Home