chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 82.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Colonoscopy abnormal, Colostomy, Computerised tomogram abdomen abnormal, Constipation, Dysplasia
Clinical narrative: Patient with 2 Moderna COVID vaccines who admitted to hospital with COVID detected PCR.  Provider d/c note:  "83 y/o Female with a past medical history of HTN, nicotine dependence, HLD, CKD 3 and anxiety.  She developed LLQ abdominal pain and was found to have an apple core lesion by CT with uterine fundus infiltration in the ED.  Colonoscopy was completed 8/25/2022 by Dr. with pathology report showing adenoma with high-grade dysplasia with final diagnosis of metastatic mucinous adenocarcinoma.   Referral for sigmoid colectomy was made however the patient returned to the ED 8/27/2022 due to worsening abdominal pain, generalized weakness, poor PO intake and constipation.  The patient underwent exploratory laparotomy with small bowel resection and loop transverse colostomy.     When medically stable, the patient was discharged to Local Health facility for  acute inpatient rehabilitation of functional and cognitive deficits.  The patient was transferred with supplemental oxygen, which was continued to maintain the patient's saturations above 92%.  The patient did not report dyspnea but was noted to become hypoxic with exertion and when sleeping.     Symptoms related to these abovementioned conditions and events were well-controlled, and the patient was discharged medically stable and improved. There were no significant acute episodes that affected length of stay or tolerance to therapies. The patient was provided education regarding colostomy care.  At first she was reluctant however was able to follow instructions provided by nursing by the time of discharge."
Age: 82.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Explorative laparotomy, Hypophagia, Hypoxia, Metastatic neoplasm, Pathology test
Clinical narrative: Patient with 2 Moderna COVID vaccines who admitted to hospital with COVID detected PCR.  Provider d/c note:  "83 y/o Female with a past medical history of HTN, nicotine dependence, HLD, CKD 3 and anxiety.  She developed LLQ abdominal pain and was found to have an apple core lesion by CT with uterine fundus infiltration in the ED.  Colonoscopy was completed 8/25/2022 by Dr. with pathology report showing adenoma with high-grade dysplasia with final diagnosis of metastatic mucinous adenocarcinoma.   Referral for sigmoid colectomy was made however the patient returned to the ED 8/27/2022 due to worsening abdominal pain, generalized weakness, poor PO intake and constipation.  The patient underwent exploratory laparotomy with small bowel resection and loop transverse colostomy.     When medically stable, the patient was discharged to Local Health facility for  acute inpatient rehabilitation of functional and cognitive deficits.  The patient was transferred with supplemental oxygen, which was continued to maintain the patient's saturations above 92%.  The patient did not report dyspnea but was noted to become hypoxic with exertion and when sleeping.     Symptoms related to these abovementioned conditions and events were well-controlled, and the patient was discharged medically stable and improved. There were no significant acute episodes that affected length of stay or tolerance to therapies. The patient was provided education regarding colostomy care.  At first she was reluctant however was able to follow instructions provided by nursing by the time of discharge."
Age: 82.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: SARS-CoV-2 test positive, Small intestinal resection
Clinical narrative: Patient with 2 Moderna COVID vaccines who admitted to hospital with COVID detected PCR.  Provider d/c note:  "83 y/o Female with a past medical history of HTN, nicotine dependence, HLD, CKD 3 and anxiety.  She developed LLQ abdominal pain and was found to have an apple core lesion by CT with uterine fundus infiltration in the ED.  Colonoscopy was completed 8/25/2022 by Dr. with pathology report showing adenoma with high-grade dysplasia with final diagnosis of metastatic mucinous adenocarcinoma.   Referral for sigmoid colectomy was made however the patient returned to the ED 8/27/2022 due to worsening abdominal pain, generalized weakness, poor PO intake and constipation.  The patient underwent exploratory laparotomy with small bowel resection and loop transverse colostomy.     When medically stable, the patient was discharged to Local Health facility for  acute inpatient rehabilitation of functional and cognitive deficits.  The patient was transferred with supplemental oxygen, which was continued to maintain the patient's saturations above 92%.  The patient did not report dyspnea but was noted to become hypoxic with exertion and when sleeping.     Symptoms related to these abovementioned conditions and events were well-controlled, and the patient was discharged medically stable and improved. There were no significant acute episodes that affected length of stay or tolerance to therapies. The patient was provided education regarding colostomy care.  At first she was reluctant however was able to follow instructions provided by nursing by the time of discharge."
Age: 43.0
Sex: F
Vaccine: COVID19
Symptoms: Blood test, Inflammatory marker increased
Clinical narrative: I had routine blood work for my OBGYN and during that blood work my inflammation markers were slightly elevated. I was told to make dietary changes and will get a 2nd blood work next month.
Age: 73.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Nasopharyngitis, Oropharyngeal pain, Pyrexia, SARS-CoV-2 test positive
Clinical narrative: I first started having cold like symptoms with a sore throat and I took a COVID-19 home test that was expired and it was negative. The next day I had a mild fever and sore throat. I took another different home COVID-19 test and I tested positive with that and it being Sunday I was not able to contact my physician so on Monday morning I called the physician and he called me back. He inquired about my fever and sore throat and what I was taking for it and advised me to take TYLENOL and that relieved the sore throat and I got better. We talked about PAXLOVID but he stated that the side effects were bad and that I should just use over the counter medication and as of today I feel normal.
Age: 82.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Arthralgia, Asthenia, COVID-19, Cellulitis, Fatigue
Clinical narrative: On 9/20, patient developed fatigue, vomiting, and weakness. On 9/23 she had a fever of 103 F so was brought into the ED by her family. Patient had tested negative for COVID at her senior living facility however tested positive for COVID in the ED. She additionally had right leg cellulitis and associated swelling and pain to the legs and ankle. She was admitted from 9/23 - 9/27 with discharge diagnoses including COVID-19 infection with superimposed right lower lobe bacterial community-acquired pneumonia and sepsis secondary to right lower lob pneumonia and right lower extremity nonpurulent cellulitis. Patient has received the COVID vaccine and one booster.
Age: 82.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Joint swelling, Pain in extremity, Peripheral swelling, Pneumonia, Pneumonia bacterial
Clinical narrative: On 9/20, patient developed fatigue, vomiting, and weakness. On 9/23 she had a fever of 103 F so was brought into the ED by her family. Patient had tested negative for COVID at her senior living facility however tested positive for COVID in the ED. She additionally had right leg cellulitis and associated swelling and pain to the legs and ankle. She was admitted from 9/23 - 9/27 with discharge diagnoses including COVID-19 infection with superimposed right lower lobe bacterial community-acquired pneumonia and sepsis secondary to right lower lob pneumonia and right lower extremity nonpurulent cellulitis. Patient has received the COVID vaccine and one booster.
Age: 82.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Pyrexia, SARS-CoV-2 test positive, Sepsis, Vomiting
Clinical narrative: On 9/20, patient developed fatigue, vomiting, and weakness. On 9/23 she had a fever of 103 F so was brought into the ED by her family. Patient had tested negative for COVID at her senior living facility however tested positive for COVID in the ED. She additionally had right leg cellulitis and associated swelling and pain to the legs and ankle. She was admitted from 9/23 - 9/27 with discharge diagnoses including COVID-19 infection with superimposed right lower lobe bacterial community-acquired pneumonia and sepsis secondary to right lower lob pneumonia and right lower extremity nonpurulent cellulitis. Patient has received the COVID vaccine and one booster.
Age: 57.0
Sex: F
Vaccine: COVID19-2
Symptoms: Axillary pain, Feeling abnormal, Headache, Oedema peripheral, Pain
Clinical narrative: Received Wednesday 9/28/22, woke up Thursday morning at 4 AM feverish, body aches, headache just overall feeing bad, was able to get thru work.  Woke up Friday, 9/30/22 feeling much better, applied my deodorant and noticed my underarm (Rt) was swollen and sore.  Did go back to Employee Health to have them look- they recommended I notify PCP as well as CDC.  No other issues with Rt arm.
Age: 57.0
Sex: F
Vaccine: COVID19-2
Symptoms: Pyrexia
Clinical narrative: Received Wednesday 9/28/22, woke up Thursday morning at 4 AM feverish, body aches, headache just overall feeing bad, was able to get thru work.  Woke up Friday, 9/30/22 feeling much better, applied my deodorant and noticed my underarm (Rt) was swollen and sore.  Did go back to Employee Health to have them look- they recommended I notify PCP as well as CDC.  No other issues with Rt arm.
Age: 85.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Asthenia, COVID-19, Cough, Decreased appetite, Delirium
Clinical narrative: Patient with 3 COVID vaccines who admitted to hospital with complications from COVID in relation to COVID detected PCR.   Provider d/c note:  "Patient came in after a week of weakness, anorexia.  He had a cough for a while and was treated with Zithromax.  The patient was admitted and found to have COVID.  He was clinically stable.  Didn't need steroids or Remdesivir.  Patient had some issues with delirium at first but this has resolved. He continued to be weak and needed SNF admission.  This took a while as he was in isolation.  Isolation was completed.  He received his booster.  He didn't get a repeat COVID test before discharge as there is a high likelihood that it would still be positive."
Age: 85.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: SARS-CoV-2 test positive
Clinical narrative: Patient with 3 COVID vaccines who admitted to hospital with complications from COVID in relation to COVID detected PCR.   Provider d/c note:  "Patient came in after a week of weakness, anorexia.  He had a cough for a while and was treated with Zithromax.  The patient was admitted and found to have COVID.  He was clinically stable.  Didn't need steroids or Remdesivir.  Patient had some issues with delirium at first but this has resolved. He continued to be weak and needed SNF admission.  This took a while as he was in isolation.  Isolation was completed.  He received his booster.  He didn't get a repeat COVID test before discharge as there is a high likelihood that it would still be positive."
Age: 71.0
Sex: F
Vaccine: COVID19-2
Symptoms: Dizziness, Electrocardiogram normal, Hypopnoea, Hypotension, Loss of consciousness
Clinical narrative: About 10 minutes after the vaccine was given, patient came to the counter and told us she thought she was going to pass out.  We had her sit down, but she insisted on lying down.  We walked around to our office to do so.  Before we got sat down, she passed out.  She was lowered to the ground slowly and did not hit her head.  Staff from the doctor's office came to help. Her BP was low, HR was around 50bbm, breathing was shallow and quick.  She settled down very quickly after getting her legs elevated. She refused to remove her masks.  Dr's took her to adult medicine in the clinic to do an EKG.  On 9/29/22, we heard back from her and she is still feeling dizzy a week later.  She reported her EKG was normal.
Age: 71.0
Sex: F
Vaccine: COVID19-2
Symptoms: Respiration abnormal
Clinical narrative: About 10 minutes after the vaccine was given, patient came to the counter and told us she thought she was going to pass out.  We had her sit down, but she insisted on lying down.  We walked around to our office to do so.  Before we got sat down, she passed out.  She was lowered to the ground slowly and did not hit her head.  Staff from the doctor's office came to help. Her BP was low, HR was around 50bbm, breathing was shallow and quick.  She settled down very quickly after getting her legs elevated. She refused to remove her masks.  Dr's took her to adult medicine in the clinic to do an EKG.  On 9/29/22, we heard back from her and she is still feeling dizzy a week later.  She reported her EKG was normal.
Age: 37.0
Sex: F
Vaccine: COVID19
Symptoms: Dizziness, Dysmenorrhoea, Fatigue, Headache, Insomnia
Clinical narrative: I started bleeding and cramping, my period isn?t due for 2 more weeks. Headache, dizziness, insomnia, tiredness, nausea,.
Age: 37.0
Sex: F
Vaccine: COVID19
Symptoms: Menstruation irregular, Nausea
Clinical narrative: I started bleeding and cramping, my period isn?t due for 2 more weeks. Headache, dizziness, insomnia, tiredness, nausea,.
Age: 80.0
Sex: F
Vaccine: COVID19-2
Symptoms: Peripheral swelling
Clinical narrative: arm has swelling approximately 2" and raised approximately 0.25", counsel husband to treat symptoms: apap, nsaid, ice, benadryl , get further vaccines in series in different arm
Age: 6.0
Sex: F
Vaccine: FLU4
Symptoms: Circumstance or information capable of leading to medication error, Pain in extremity, Physical product label issue, Product administered to patient of inappropriate age, Wrong product administered
Clinical narrative: Nursing was at a vaccine outreach for public school administering several vaccine including flu shots. The influenza vaccine was in labeled zip lock bags in a cooler. This nurse grabbed for a regular influenza vaccine, but picked from the wrong bag and got a high dose influenza instead. The syringes for regular and high dose look very similar. The lot and expiration sticker was removed from the syringe. It was needled and then administered to the client's left deltoid. Well tolerated. Client then returned to class.  When the nurse returned to the clinic a few hours later to chart the vaccines administered at the outreach it was noted that a high dose vaccine was administered. This nurse reported to her supervisor. Called the school and spoke with the school nurse. The school nurse checked on the patient and she was "fine". This writer notified the client's physician and mother.  This writer called the mother this morning and she reports patient did complain of a sore arm today. Mother gave her Tylenol. No other complaints or side effects noted.
Age: 59.0
Sex: M
Vaccine: COVID19-2
Symptoms: Incorrect product formulation administered, No adverse event
Clinical narrative: Pfizer bivalent booster vaccine given when patient was due for monovalent primary series. No adverse effects on patient during administration or 15 minutes after
Age: 36.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect dose administered
Clinical narrative: DOSE #1 WAS GIVEN OUTSIDE OUR FACILITY UNKNOWN TO US.  DOSE #2 WAS GIVEN AS DOSE #1, #3 WAS GIVEN AS DOSE #2.
Age: 55.0
Sex: F
Vaccine: COVID19-2
Symptoms: Product storage error
Clinical narrative: Patient received a dose from a vial that had been used on a previous day. The vial used was actually pulled from the fridge and doses were withdrawn on 9/24/22. The vial was not appropriately  disposed of at that time. The technician then thought the vial was pulled for doses to be given on 9/26/22, but it was the vial from 9/24/22. Once this was discovered the patient received a dose from a new vial in  her opposite arm's deltoid.
Age: 63.0
Sex: F
Vaccine: COVID19-2
Symptoms: Feeling abnormal, Insomnia, Pain in extremity
Clinical narrative: Insomnia night after vaccination  Feeling ?drugged? day after vaccination  Sore arm
Age: 61.0
Sex: M
Vaccine: COVID19-2
Symptoms: Rash
Clinical narrative: Rash over large parts of the body, bilateral on both arms shoulder to fingers, and legs to the knees, front and back of torso, abdomen, and pelvis.
Age: 65.0
Sex: M
Vaccine: COVID19-2
Symptoms: Pruritus
Clinical narrative: Nothing happened for a couple of weeks until my body itches and it will go from one place to the other. At this moment no other symptoms.
Age: 31.0
Sex: F
Vaccine: COVID19-2
Symptoms: No adverse event, Product storage error
Clinical narrative: vaccine was punctured and room temp 23 1/2 hours, no reactions or symptoms thus far
Age: 27.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Chest discomfort, Cough, Fatigue, Headache
Clinical narrative: Had stuffy nose, fatigue and cough. Next day chest heaviness and a headache. Home COVID-19 test - positive. Called Dr. and got a prescription for PAXLOVID. Retested a week later with a home COVID-19 test and it was negative.
Age: 27.0
Sex: F
Vaccine: COVID19
Symptoms: Nasal congestion, SARS-CoV-2 test positive
Clinical narrative: Had stuffy nose, fatigue and cough. Next day chest heaviness and a headache. Home COVID-19 test - positive. Called Dr. and got a prescription for PAXLOVID. Retested a week later with a home COVID-19 test and it was negative.
Age: 65.0
Sex: F
Vaccine: COVID19
Symptoms: Angiogram pulmonary abnormal, Anticoagulant therapy, Atelectasis, COVID-19, Chest X-ray abnormal
Clinical narrative: Discharge Provider: MD  Primary Care Provider : ANP   Procedures to be scheduled by PCP: None   Results/Procedures requiring PCP followup: None   Admission Date: 9/22/2022 Discharge Date: 09/26/2022   Admitting Diagnoses: Community acquired pneumonia of left lower lobe of lung  PRESENTING PROBLEM:  Pneumonia [J18.9] UTI (urinary tract infection) [N39.0] Community acquired pneumonia of left lower lobe of lung [J18.9]   HOSPITAL COURSE: Patient is a 65 y.o. female who presented to hospital emergency department with complaints of cough.  Patient has past medical history of hypertension, hyperlipidemia, chronic obstructive pulmonary disease, depression, type 2 diabetes, GERD, essential tremors, neurogenic bladder, and she is wheelchair bound. Patient states that she has had a cough for approximately 1 week.  Denies fever or chills, but states that it has been productive and she has been experiencing shortness of breath and wheezing.  She presented to the emergency department for further evaluation.  In the emergency department, patient was hypoxic and with desaturation to the 80s.  She required supplemental oxygen at a rate of 2 liters/minute via nasal cannula.  Additionally, she was hypertensive, however, other vital signs were stable.  Complete blood count was unremarkable.  CMP showed hyperglycemia and hypokalemia.  Patient did not have lactic acidosis.  COVID-19 was negative.  Chest x-ray showed increased atelectasis and infiltrate in the left lung base.  Suspect left lower lobe pneumonia.  Patient has been transferred and admitted to Hospital for further evaluation management of left lower lobe pneumonia.   Patient had a film array performed which came back COVID positive.  Since she was not hypoxic she was not offered any COVID specific therapies.  D dimer was elevated so a CT angio was performed showing right sided pulmonary emboli.  Lower extremity dopplers showed left sided proximal and right sided distal DVT.  She was started on lovenox and transitioned to eliquis.  She was not felt to be a candidate for thrombectomy.  Echo showed normal cardiac function.  She completed a 5 day course of antibiotics for pneumonia.  Her urine did grow proteus but this was felt to be colonization, not infection.  On the day of discharge she was doing well and discharged home with home care in stable condition.  She will follow up with her PCP in one week.  It is anticipated she will have life long anticoagulation.
Age: 65.0
Sex: F
Vaccine: COVID19
Symptoms: Culture urine positive, Deep vein thrombosis, Dyspnoea, Echocardiogram normal, Fibrin D dimer increased
Clinical narrative: Discharge Provider: MD  Primary Care Provider : ANP   Procedures to be scheduled by PCP: None   Results/Procedures requiring PCP followup: None   Admission Date: 9/22/2022 Discharge Date: 09/26/2022   Admitting Diagnoses: Community acquired pneumonia of left lower lobe of lung  PRESENTING PROBLEM:  Pneumonia [J18.9] UTI (urinary tract infection) [N39.0] Community acquired pneumonia of left lower lobe of lung [J18.9]   HOSPITAL COURSE: Patient is a 65 y.o. female who presented to hospital emergency department with complaints of cough.  Patient has past medical history of hypertension, hyperlipidemia, chronic obstructive pulmonary disease, depression, type 2 diabetes, GERD, essential tremors, neurogenic bladder, and she is wheelchair bound. Patient states that she has had a cough for approximately 1 week.  Denies fever or chills, but states that it has been productive and she has been experiencing shortness of breath and wheezing.  She presented to the emergency department for further evaluation.  In the emergency department, patient was hypoxic and with desaturation to the 80s.  She required supplemental oxygen at a rate of 2 liters/minute via nasal cannula.  Additionally, she was hypertensive, however, other vital signs were stable.  Complete blood count was unremarkable.  CMP showed hyperglycemia and hypokalemia.  Patient did not have lactic acidosis.  COVID-19 was negative.  Chest x-ray showed increased atelectasis and infiltrate in the left lung base.  Suspect left lower lobe pneumonia.  Patient has been transferred and admitted to Hospital for further evaluation management of left lower lobe pneumonia.   Patient had a film array performed which came back COVID positive.  Since she was not hypoxic she was not offered any COVID specific therapies.  D dimer was elevated so a CT angio was performed showing right sided pulmonary emboli.  Lower extremity dopplers showed left sided proximal and right sided distal DVT.  She was started on lovenox and transitioned to eliquis.  She was not felt to be a candidate for thrombectomy.  Echo showed normal cardiac function.  She completed a 5 day course of antibiotics for pneumonia.  Her urine did grow proteus but this was felt to be colonization, not infection.  On the day of discharge she was doing well and discharged home with home care in stable condition.  She will follow up with her PCP in one week.  It is anticipated she will have life long anticoagulation.
Age: 65.0
Sex: F
Vaccine: COVID19
Symptoms: Full blood count normal, Hyperglycaemia, Hypertension, Hypokalaemia, Hypoxia
Clinical narrative: Discharge Provider: MD  Primary Care Provider : ANP   Procedures to be scheduled by PCP: None   Results/Procedures requiring PCP followup: None   Admission Date: 9/22/2022 Discharge Date: 09/26/2022   Admitting Diagnoses: Community acquired pneumonia of left lower lobe of lung  PRESENTING PROBLEM:  Pneumonia [J18.9] UTI (urinary tract infection) [N39.0] Community acquired pneumonia of left lower lobe of lung [J18.9]   HOSPITAL COURSE: Patient is a 65 y.o. female who presented to hospital emergency department with complaints of cough.  Patient has past medical history of hypertension, hyperlipidemia, chronic obstructive pulmonary disease, depression, type 2 diabetes, GERD, essential tremors, neurogenic bladder, and she is wheelchair bound. Patient states that she has had a cough for approximately 1 week.  Denies fever or chills, but states that it has been productive and she has been experiencing shortness of breath and wheezing.  She presented to the emergency department for further evaluation.  In the emergency department, patient was hypoxic and with desaturation to the 80s.  She required supplemental oxygen at a rate of 2 liters/minute via nasal cannula.  Additionally, she was hypertensive, however, other vital signs were stable.  Complete blood count was unremarkable.  CMP showed hyperglycemia and hypokalemia.  Patient did not have lactic acidosis.  COVID-19 was negative.  Chest x-ray showed increased atelectasis and infiltrate in the left lung base.  Suspect left lower lobe pneumonia.  Patient has been transferred and admitted to Hospital for further evaluation management of left lower lobe pneumonia.   Patient had a film array performed which came back COVID positive.  Since she was not hypoxic she was not offered any COVID specific therapies.  D dimer was elevated so a CT angio was performed showing right sided pulmonary emboli.  Lower extremity dopplers showed left sided proximal and right sided distal DVT.  She was started on lovenox and transitioned to eliquis.  She was not felt to be a candidate for thrombectomy.  Echo showed normal cardiac function.  She completed a 5 day course of antibiotics for pneumonia.  Her urine did grow proteus but this was felt to be colonization, not infection.  On the day of discharge she was doing well and discharged home with home care in stable condition.  She will follow up with her PCP in one week.  It is anticipated she will have life long anticoagulation.
Age: 65.0
Sex: F
Vaccine: COVID19
Symptoms: Lung infiltration, Metabolic function test abnormal, Oxygen saturation decreased, Pneumonia, Productive cough
Clinical narrative: Discharge Provider: MD  Primary Care Provider : ANP   Procedures to be scheduled by PCP: None   Results/Procedures requiring PCP followup: None   Admission Date: 9/22/2022 Discharge Date: 09/26/2022   Admitting Diagnoses: Community acquired pneumonia of left lower lobe of lung  PRESENTING PROBLEM:  Pneumonia [J18.9] UTI (urinary tract infection) [N39.0] Community acquired pneumonia of left lower lobe of lung [J18.9]   HOSPITAL COURSE: Patient is a 65 y.o. female who presented to hospital emergency department with complaints of cough.  Patient has past medical history of hypertension, hyperlipidemia, chronic obstructive pulmonary disease, depression, type 2 diabetes, GERD, essential tremors, neurogenic bladder, and she is wheelchair bound. Patient states that she has had a cough for approximately 1 week.  Denies fever or chills, but states that it has been productive and she has been experiencing shortness of breath and wheezing.  She presented to the emergency department for further evaluation.  In the emergency department, patient was hypoxic and with desaturation to the 80s.  She required supplemental oxygen at a rate of 2 liters/minute via nasal cannula.  Additionally, she was hypertensive, however, other vital signs were stable.  Complete blood count was unremarkable.  CMP showed hyperglycemia and hypokalemia.  Patient did not have lactic acidosis.  COVID-19 was negative.  Chest x-ray showed increased atelectasis and infiltrate in the left lung base.  Suspect left lower lobe pneumonia.  Patient has been transferred and admitted to Hospital for further evaluation management of left lower lobe pneumonia.   Patient had a film array performed which came back COVID positive.  Since she was not hypoxic she was not offered any COVID specific therapies.  D dimer was elevated so a CT angio was performed showing right sided pulmonary emboli.  Lower extremity dopplers showed left sided proximal and right sided distal DVT.  She was started on lovenox and transitioned to eliquis.  She was not felt to be a candidate for thrombectomy.  Echo showed normal cardiac function.  She completed a 5 day course of antibiotics for pneumonia.  Her urine did grow proteus but this was felt to be colonization, not infection.  On the day of discharge she was doing well and discharged home with home care in stable condition.  She will follow up with her PCP in one week.  It is anticipated she will have life long anticoagulation.
Age: 65.0
Sex: F
Vaccine: COVID19
Symptoms: Proteus test positive, Pulmonary embolism, SARS-CoV-2 test positive, Ultrasound Doppler abnormal, Urinary tract infection
Clinical narrative: Discharge Provider: MD  Primary Care Provider : ANP   Procedures to be scheduled by PCP: None   Results/Procedures requiring PCP followup: None   Admission Date: 9/22/2022 Discharge Date: 09/26/2022   Admitting Diagnoses: Community acquired pneumonia of left lower lobe of lung  PRESENTING PROBLEM:  Pneumonia [J18.9] UTI (urinary tract infection) [N39.0] Community acquired pneumonia of left lower lobe of lung [J18.9]   HOSPITAL COURSE: Patient is a 65 y.o. female who presented to hospital emergency department with complaints of cough.  Patient has past medical history of hypertension, hyperlipidemia, chronic obstructive pulmonary disease, depression, type 2 diabetes, GERD, essential tremors, neurogenic bladder, and she is wheelchair bound. Patient states that she has had a cough for approximately 1 week.  Denies fever or chills, but states that it has been productive and she has been experiencing shortness of breath and wheezing.  She presented to the emergency department for further evaluation.  In the emergency department, patient was hypoxic and with desaturation to the 80s.  She required supplemental oxygen at a rate of 2 liters/minute via nasal cannula.  Additionally, she was hypertensive, however, other vital signs were stable.  Complete blood count was unremarkable.  CMP showed hyperglycemia and hypokalemia.  Patient did not have lactic acidosis.  COVID-19 was negative.  Chest x-ray showed increased atelectasis and infiltrate in the left lung base.  Suspect left lower lobe pneumonia.  Patient has been transferred and admitted to Hospital for further evaluation management of left lower lobe pneumonia.   Patient had a film array performed which came back COVID positive.  Since she was not hypoxic she was not offered any COVID specific therapies.  D dimer was elevated so a CT angio was performed showing right sided pulmonary emboli.  Lower extremity dopplers showed left sided proximal and right sided distal DVT.  She was started on lovenox and transitioned to eliquis.  She was not felt to be a candidate for thrombectomy.  Echo showed normal cardiac function.  She completed a 5 day course of antibiotics for pneumonia.  Her urine did grow proteus but this was felt to be colonization, not infection.  On the day of discharge she was doing well and discharged home with home care in stable condition.  She will follow up with her PCP in one week.  It is anticipated she will have life long anticoagulation.
Age: 65.0
Sex: F
Vaccine: COVID19
Symptoms: Wheezing
Clinical narrative: Discharge Provider: MD  Primary Care Provider : ANP   Procedures to be scheduled by PCP: None   Results/Procedures requiring PCP followup: None   Admission Date: 9/22/2022 Discharge Date: 09/26/2022   Admitting Diagnoses: Community acquired pneumonia of left lower lobe of lung  PRESENTING PROBLEM:  Pneumonia [J18.9] UTI (urinary tract infection) [N39.0] Community acquired pneumonia of left lower lobe of lung [J18.9]   HOSPITAL COURSE: Patient is a 65 y.o. female who presented to hospital emergency department with complaints of cough.  Patient has past medical history of hypertension, hyperlipidemia, chronic obstructive pulmonary disease, depression, type 2 diabetes, GERD, essential tremors, neurogenic bladder, and she is wheelchair bound. Patient states that she has had a cough for approximately 1 week.  Denies fever or chills, but states that it has been productive and she has been experiencing shortness of breath and wheezing.  She presented to the emergency department for further evaluation.  In the emergency department, patient was hypoxic and with desaturation to the 80s.  She required supplemental oxygen at a rate of 2 liters/minute via nasal cannula.  Additionally, she was hypertensive, however, other vital signs were stable.  Complete blood count was unremarkable.  CMP showed hyperglycemia and hypokalemia.  Patient did not have lactic acidosis.  COVID-19 was negative.  Chest x-ray showed increased atelectasis and infiltrate in the left lung base.  Suspect left lower lobe pneumonia.  Patient has been transferred and admitted to Hospital for further evaluation management of left lower lobe pneumonia.   Patient had a film array performed which came back COVID positive.  Since she was not hypoxic she was not offered any COVID specific therapies.  D dimer was elevated so a CT angio was performed showing right sided pulmonary emboli.  Lower extremity dopplers showed left sided proximal and right sided distal DVT.  She was started on lovenox and transitioned to eliquis.  She was not felt to be a candidate for thrombectomy.  Echo showed normal cardiac function.  She completed a 5 day course of antibiotics for pneumonia.  Her urine did grow proteus but this was felt to be colonization, not infection.  On the day of discharge she was doing well and discharged home with home care in stable condition.  She will follow up with her PCP in one week.  It is anticipated she will have life long anticoagulation.
Age: 70.0
Sex: M
Vaccine: COVID19-2
Symptoms: Underdose
Clinical narrative: Medication Administration Error. Patient received 0.25 mL of Moderna bivalent vaccine instead of 0.5 mL at office visit.  The patient was contacted immediately once error was discovered and returned the same day for an addition 0.25 mL for the full dose.
Age: 70.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Anticoagulant therapy, COVID-19, Chest pain, Cough, Deep vein thrombosis
Clinical narrative: Patient tested positive for COVID on 9/14 - he was experiencing some coughs but overall felt symptomatically improved. However on 9/24 he was seen in the ED for right leg pain and some chest pain. He tested positive again for COVID while in the ED. He was found to have an occlusive right femoral DVT with scattered pulmonary emboli. Patient was admitted from 9/24-9/25 for vascular consultation due to acute DVT. Per vascular surgery consult, the provider felt the right femoral DVT was likely secondary to COVID-19 infection. Patient was started on Eliquis at discharge. Additionally, he has received the COVID vaccine and one booster.
Age: 70.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Pain in extremity, Peripheral vein occlusion, Pulmonary embolism, SARS-CoV-2 test positive
Clinical narrative: Patient tested positive for COVID on 9/14 - he was experiencing some coughs but overall felt symptomatically improved. However on 9/24 he was seen in the ED for right leg pain and some chest pain. He tested positive again for COVID while in the ED. He was found to have an occlusive right femoral DVT with scattered pulmonary emboli. Patient was admitted from 9/24-9/25 for vascular consultation due to acute DVT. Per vascular surgery consult, the provider felt the right femoral DVT was likely secondary to COVID-19 infection. Patient was started on Eliquis at discharge. Additionally, he has received the COVID vaccine and one booster.
Age: 3.0
Sex: M
Vaccine: HEPA, IPV
Symptoms: Wrong product administered
Clinical narrative: IPV was given in error instead of influenza vaccine
Age: 72.0
Sex: F
Vaccine: COVID19
Symptoms: Balance disorder, Blood test normal, Dysstasia, Fall
Clinical narrative: I could hardly stand up I lost my balance and fell, I took blood pressure and it was 80/40. Once I took my blood pressure I called my doctor to let him know I had fallen. I had an emergency appointment for the following day where he ordered blood work. He took me off of all of my blood pressure related medications. I am now back to walking a mile and doing my normal daily activities.
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Alanine aminotransferase increased, Aspartate aminotransferase increased, Blood thyroid stimulating hormone normal, Brain natriuretic peptide increased, COVID-19
Clinical narrative: Admission Date: 9/24/2022 Discharge Date: Sep 27, 2022 PRESENTING PROBLEM: Hepatitis [K75.9] Elevated troponin [R77.8] Allergic reaction, initial encounter [T78.40XA] Drug reaction, initial encounter [T50.905A]   HOSPITAL COURSE: Patient is 71-year-old female with past medical history of prior asbestos exposure and sinus bradycardia who is vaccinated x4 and diagnosis COVID-19 on 09/22 (symptoms started same day).  She was started on Paxlovid 9/23 and upon taking her 2nd dose 9/24 she broke out in hives diffusely, had wheezing, nausea, and abdominal pain so she presented to the emergency department.  LFTs were significantly elevated and BNP was mildly elevated. AST 1447 and ALT 948, BNP 978 on admission.  Gallbladder ultrasound negative.  Patient was given IV Solu-Medrol and then transitioned to oral prednisone 40 mg daily.  LFTs trended down and symptoms were improving but not resolved on 2nd hospital day.  That night her heart rate decreased into the 30s with EKG obtained 9/26 AM showing sinus bradycardia with HR of 36. She was feeling more lightheaded/dizzy especially with exertion.  Heart rate only increased to 50s with activity. Patient had mild electrolyte abnormalities which were corrected, TSH normal.  Cardiology consulted and recommended watching more night.  On 09/27/2022 with labs and vitals stable condition, having recovered from COVID infection, and recommendation from the electrophysiology team for ZIO patch placement the patient was discharged home with instructions to follow-up with her primary care physician as well as a Cardiology electrophysiology team.
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Condition aggravated, Dizziness, Electrocardiogram abnormal, Electrolyte imbalance, Heart rate decreased
Clinical narrative: Admission Date: 9/24/2022 Discharge Date: Sep 27, 2022 PRESENTING PROBLEM: Hepatitis [K75.9] Elevated troponin [R77.8] Allergic reaction, initial encounter [T78.40XA] Drug reaction, initial encounter [T50.905A]   HOSPITAL COURSE: Patient is 71-year-old female with past medical history of prior asbestos exposure and sinus bradycardia who is vaccinated x4 and diagnosis COVID-19 on 09/22 (symptoms started same day).  She was started on Paxlovid 9/23 and upon taking her 2nd dose 9/24 she broke out in hives diffusely, had wheezing, nausea, and abdominal pain so she presented to the emergency department.  LFTs were significantly elevated and BNP was mildly elevated. AST 1447 and ALT 948, BNP 978 on admission.  Gallbladder ultrasound negative.  Patient was given IV Solu-Medrol and then transitioned to oral prednisone 40 mg daily.  LFTs trended down and symptoms were improving but not resolved on 2nd hospital day.  That night her heart rate decreased into the 30s with EKG obtained 9/26 AM showing sinus bradycardia with HR of 36. She was feeling more lightheaded/dizzy especially with exertion.  Heart rate only increased to 50s with activity. Patient had mild electrolyte abnormalities which were corrected, TSH normal.  Cardiology consulted and recommended watching more night.  On 09/27/2022 with labs and vitals stable condition, having recovered from COVID infection, and recommendation from the electrophysiology team for ZIO patch placement the patient was discharged home with instructions to follow-up with her primary care physician as well as a Cardiology electrophysiology team.
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Hepatitis, Laboratory test normal, Liver function test increased, Malaise, Sinus bradycardia
Clinical narrative: Admission Date: 9/24/2022 Discharge Date: Sep 27, 2022 PRESENTING PROBLEM: Hepatitis [K75.9] Elevated troponin [R77.8] Allergic reaction, initial encounter [T78.40XA] Drug reaction, initial encounter [T50.905A]   HOSPITAL COURSE: Patient is 71-year-old female with past medical history of prior asbestos exposure and sinus bradycardia who is vaccinated x4 and diagnosis COVID-19 on 09/22 (symptoms started same day).  She was started on Paxlovid 9/23 and upon taking her 2nd dose 9/24 she broke out in hives diffusely, had wheezing, nausea, and abdominal pain so she presented to the emergency department.  LFTs were significantly elevated and BNP was mildly elevated. AST 1447 and ALT 948, BNP 978 on admission.  Gallbladder ultrasound negative.  Patient was given IV Solu-Medrol and then transitioned to oral prednisone 40 mg daily.  LFTs trended down and symptoms were improving but not resolved on 2nd hospital day.  That night her heart rate decreased into the 30s with EKG obtained 9/26 AM showing sinus bradycardia with HR of 36. She was feeling more lightheaded/dizzy especially with exertion.  Heart rate only increased to 50s with activity. Patient had mild electrolyte abnormalities which were corrected, TSH normal.  Cardiology consulted and recommended watching more night.  On 09/27/2022 with labs and vitals stable condition, having recovered from COVID infection, and recommendation from the electrophysiology team for ZIO patch placement the patient was discharged home with instructions to follow-up with her primary care physician as well as a Cardiology electrophysiology team.
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Troponin increased, Ultrasound biliary tract
Clinical narrative: Admission Date: 9/24/2022 Discharge Date: Sep 27, 2022 PRESENTING PROBLEM: Hepatitis [K75.9] Elevated troponin [R77.8] Allergic reaction, initial encounter [T78.40XA] Drug reaction, initial encounter [T50.905A]   HOSPITAL COURSE: Patient is 71-year-old female with past medical history of prior asbestos exposure and sinus bradycardia who is vaccinated x4 and diagnosis COVID-19 on 09/22 (symptoms started same day).  She was started on Paxlovid 9/23 and upon taking her 2nd dose 9/24 she broke out in hives diffusely, had wheezing, nausea, and abdominal pain so she presented to the emergency department.  LFTs were significantly elevated and BNP was mildly elevated. AST 1447 and ALT 948, BNP 978 on admission.  Gallbladder ultrasound negative.  Patient was given IV Solu-Medrol and then transitioned to oral prednisone 40 mg daily.  LFTs trended down and symptoms were improving but not resolved on 2nd hospital day.  That night her heart rate decreased into the 30s with EKG obtained 9/26 AM showing sinus bradycardia with HR of 36. She was feeling more lightheaded/dizzy especially with exertion.  Heart rate only increased to 50s with activity. Patient had mild electrolyte abnormalities which were corrected, TSH normal.  Cardiology consulted and recommended watching more night.  On 09/27/2022 with labs and vitals stable condition, having recovered from COVID infection, and recommendation from the electrophysiology team for ZIO patch placement the patient was discharged home with instructions to follow-up with her primary care physician as well as a Cardiology electrophysiology team.
Age: 30.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect dose administered
Clinical narrative: DOSE #1 WAS GIVEN OUTSIDE OUR FACILITY UNKNOWN TO US.  DOSE #2 WAS GIVEN AS DOSE #1, #3 WAS GIVEN AS DOSE #2.
Age: 34.0
Sex: M
Vaccine: SMALLMNK
Symptoms: Immediate post-injection reaction, Syncope
Clinical narrative: Immediately after vaccine administration patient experienced syncopal episode lasting 10 seconds. Patient reports history in vasovagal.
Age: 90.0
Sex: F
Vaccine: UNK
Symptoms: Incorrect product formulation administered, No adverse event
Clinical narrative: Patient had NOT had a previous primary series of Pfizer for COVID and was given a bivalent dose of Pfizer. No adverse reaction- this is an administration error.
Age: 48.0
Sex: F
Vaccine: COVID19-2
Symptoms: Asthenia, Fatigue, Feeding disorder, Fluid intake reduced, Headache
Clinical narrative: Intense nausea, vomiting, weakness/fatigue, for over 3 days (minor headache, low grade fever, some chills, some sweats).  Stayed in bed for 3 days, unable to eat or drink due to extreme nausea, unable to hold food, vomiting.  Called my primary doctor who prescribed me anti-nausea/vomiting drug.  Had my monovalent mRNA COVID-19 Pfizer vaccine last year fine, but the Bivalent booster side effects were intense.  I have never felt so sick.  This is day 4 as I'm typing this, slightly feeling better, but weak and shaky inside, queasy feeling.
Age: 48.0
Sex: F
Vaccine: COVID19-2
Symptoms: Hyperhidrosis, Malaise, Mobility decreased, Nausea, Nervousness
Clinical narrative: Intense nausea, vomiting, weakness/fatigue, for over 3 days (minor headache, low grade fever, some chills, some sweats).  Stayed in bed for 3 days, unable to eat or drink due to extreme nausea, unable to hold food, vomiting.  Called my primary doctor who prescribed me anti-nausea/vomiting drug.  Had my monovalent mRNA COVID-19 Pfizer vaccine last year fine, but the Bivalent booster side effects were intense.  I have never felt so sick.  This is day 4 as I'm typing this, slightly feeling better, but weak and shaky inside, queasy feeling.
Age: 48.0
Sex: F
Vaccine: COVID19-2
Symptoms: Pyrexia, Vomiting
Clinical narrative: Intense nausea, vomiting, weakness/fatigue, for over 3 days (minor headache, low grade fever, some chills, some sweats).  Stayed in bed for 3 days, unable to eat or drink due to extreme nausea, unable to hold food, vomiting.  Called my primary doctor who prescribed me anti-nausea/vomiting drug.  Had my monovalent mRNA COVID-19 Pfizer vaccine last year fine, but the Bivalent booster side effects were intense.  I have never felt so sick.  This is day 4 as I'm typing this, slightly feeling better, but weak and shaky inside, queasy feeling.
Age: 72.0
Sex: M
Vaccine: COVID19
Symptoms: Acute kidney injury, Acute respiratory failure, COVID-19, Chest X-ray abnormal, Diarrhoea
Clinical narrative: Discharge Physician: MPH Primary Care Physician: MD  Date of Admission: 9/22/2022 Discharge Date: 9/24/2022  PRESENTING PROBLEM: Near syncope [R55] Acute kidney injury (HCC) [N17.9] Nausea vomiting and diarrhea [R11.2, R19.7] Acute hypoxemic respiratory failure due to COVID-19 (HCC) [U07.1, J96.01] COVID-19 [U07.1]   HOSPITAL COURSE: Patient is a 73-year-old male who presented for evaluation of nausea, vomiting, diarrhea and near syncope. In the ER the patient was found to be COVID positive. He was hypotensive and found to have AKI. CXR showed bilateral perihilar airspace opacities. The patient was hypoxic on room air requiring supplemental oxygen. The hospitalist team was contacted for admission and further management. The patient was started on IVF and decadron. His renal function improved with fluids and his nausea, vomiting and diarrhea resolved. He was weaned off of supplemental oxygen. PT/OT advised no additional needs identified. Electrolytes were monitored and repleted throughout the admission. Patient clinically improved and hemodynamically stable for discharge.  Discussed plan of care discharge with patient including outpatient follow-up PCP within 7 days.  He will complete 2 additional days of dexamethasone then return to home prednisone dose. Patient voiced understanding was agreeable with plan of care discharge.
Age: 72.0
Sex: M
Vaccine: COVID19
Symptoms: Hypotension, Lung opacity, Nausea, Presyncope, SARS-CoV-2 test positive
Clinical narrative: Discharge Physician: MPH Primary Care Physician: MD  Date of Admission: 9/22/2022 Discharge Date: 9/24/2022  PRESENTING PROBLEM: Near syncope [R55] Acute kidney injury (HCC) [N17.9] Nausea vomiting and diarrhea [R11.2, R19.7] Acute hypoxemic respiratory failure due to COVID-19 (HCC) [U07.1, J96.01] COVID-19 [U07.1]   HOSPITAL COURSE: Patient is a 73-year-old male who presented for evaluation of nausea, vomiting, diarrhea and near syncope. In the ER the patient was found to be COVID positive. He was hypotensive and found to have AKI. CXR showed bilateral perihilar airspace opacities. The patient was hypoxic on room air requiring supplemental oxygen. The hospitalist team was contacted for admission and further management. The patient was started on IVF and decadron. His renal function improved with fluids and his nausea, vomiting and diarrhea resolved. He was weaned off of supplemental oxygen. PT/OT advised no additional needs identified. Electrolytes were monitored and repleted throughout the admission. Patient clinically improved and hemodynamically stable for discharge.  Discussed plan of care discharge with patient including outpatient follow-up PCP within 7 days.  He will complete 2 additional days of dexamethasone then return to home prednisone dose. Patient voiced understanding was agreeable with plan of care discharge.