chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 62.0
Sex: F
Vaccine: COVID19-2
Symptoms: Asthenia, Bacteraemia, COVID-19, Clostridium difficile colitis, Clostridium test positive
Clinical narrative: COVID+ 12/14/22.  Vaccination Status - Moderna x2 + Pfizer BIVALENT BRIEF OVERVIEW: Discharge Provider: MD Primary Care Provider: DO Admission Date: 12/14/2022 Discharge Date: Dec 16, 2022   Active Hospital Problems   Diagnosis Date Noted POA ? COVID-19 12/15/2022 Unknown ? C. difficile colitis 12/15/2022 Unknown ? Unspecified severe protein-calorie malnutrition  10/03/2022 Yes ? History of deep venous thrombosis (DVT) of distal vein of left lower extremity 09/05/2022 Yes ? Bilateral pulmonary infiltrates on chest imaging 03/29/2021 Yes ? Mild persistent asthma without complication    DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Sepsis [A41.9] Sepsis, due to unspecified organism, unspecified whether acute organ dysfunction present  [A41.9] COVID-19 virus infection [U07.1]   HOSPITAL COURSE: Pt. is a 62 y.o. female with a complicated medical history including cirrhosis, hypothyroidism, hypertension, alpha-1 antitrypsin deficiency. She was recently admitted 11/03 to 12/02/2022 during which time she was found to have respiratory failure, hypotension, pneumonia as well as bacteremia with Klebsiella and Morganella.  She completed a course of cefepime and metronidazole during that admission and was discharged on prednisone.  She went to subacute rehab and was recently discharged from SAR. Pt. now presented back to the ED with generalized weakness, SOB, and diarrhea. She was now found to have COVID and readmitted to the hospital. Pulm was consulted and felt her symptoms were likely related her recent bacterial pneumonia and not COVID as she was sating well on her baseline 2L supplemental O2. Recommended continue home prednisone taper. Due to her new onset diarrhea and recent abx use c-diff studies were obtained and found to be positive. She was started on oral vanco and her diarrhea quickly improved. PT/OT recommended to continue with her previously arranged home PT. She will follow up with her PCP and pulm outpatient. Patient is discharging in improved and stable condition.
Age: 62.0
Sex: F
Vaccine: COVID19-2
Symptoms: Diarrhoea, Dyspnoea, Hypotension, Klebsiella infection, Morganella infection
Clinical narrative: COVID+ 12/14/22.  Vaccination Status - Moderna x2 + Pfizer BIVALENT BRIEF OVERVIEW: Discharge Provider: MD Primary Care Provider: DO Admission Date: 12/14/2022 Discharge Date: Dec 16, 2022   Active Hospital Problems   Diagnosis Date Noted POA ? COVID-19 12/15/2022 Unknown ? C. difficile colitis 12/15/2022 Unknown ? Unspecified severe protein-calorie malnutrition  10/03/2022 Yes ? History of deep venous thrombosis (DVT) of distal vein of left lower extremity 09/05/2022 Yes ? Bilateral pulmonary infiltrates on chest imaging 03/29/2021 Yes ? Mild persistent asthma without complication    DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Sepsis [A41.9] Sepsis, due to unspecified organism, unspecified whether acute organ dysfunction present  [A41.9] COVID-19 virus infection [U07.1]   HOSPITAL COURSE: Pt. is a 62 y.o. female with a complicated medical history including cirrhosis, hypothyroidism, hypertension, alpha-1 antitrypsin deficiency. She was recently admitted 11/03 to 12/02/2022 during which time she was found to have respiratory failure, hypotension, pneumonia as well as bacteremia with Klebsiella and Morganella.  She completed a course of cefepime and metronidazole during that admission and was discharged on prednisone.  She went to subacute rehab and was recently discharged from SAR. Pt. now presented back to the ED with generalized weakness, SOB, and diarrhea. She was now found to have COVID and readmitted to the hospital. Pulm was consulted and felt her symptoms were likely related her recent bacterial pneumonia and not COVID as she was sating well on her baseline 2L supplemental O2. Recommended continue home prednisone taper. Due to her new onset diarrhea and recent abx use c-diff studies were obtained and found to be positive. She was started on oral vanco and her diarrhea quickly improved. PT/OT recommended to continue with her previously arranged home PT. She will follow up with her PCP and pulm outpatient. Patient is discharging in improved and stable condition.
Age: 62.0
Sex: F
Vaccine: COVID19-2
Symptoms: Pneumonia, Pneumonia bacterial, Respiratory failure, SARS-CoV-2 test positive, Sepsis
Clinical narrative: COVID+ 12/14/22.  Vaccination Status - Moderna x2 + Pfizer BIVALENT BRIEF OVERVIEW: Discharge Provider: MD Primary Care Provider: DO Admission Date: 12/14/2022 Discharge Date: Dec 16, 2022   Active Hospital Problems   Diagnosis Date Noted POA ? COVID-19 12/15/2022 Unknown ? C. difficile colitis 12/15/2022 Unknown ? Unspecified severe protein-calorie malnutrition  10/03/2022 Yes ? History of deep venous thrombosis (DVT) of distal vein of left lower extremity 09/05/2022 Yes ? Bilateral pulmonary infiltrates on chest imaging 03/29/2021 Yes ? Mild persistent asthma without complication    DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Sepsis [A41.9] Sepsis, due to unspecified organism, unspecified whether acute organ dysfunction present  [A41.9] COVID-19 virus infection [U07.1]   HOSPITAL COURSE: Pt. is a 62 y.o. female with a complicated medical history including cirrhosis, hypothyroidism, hypertension, alpha-1 antitrypsin deficiency. She was recently admitted 11/03 to 12/02/2022 during which time she was found to have respiratory failure, hypotension, pneumonia as well as bacteremia with Klebsiella and Morganella.  She completed a course of cefepime and metronidazole during that admission and was discharged on prednisone.  She went to subacute rehab and was recently discharged from SAR. Pt. now presented back to the ED with generalized weakness, SOB, and diarrhea. She was now found to have COVID and readmitted to the hospital. Pulm was consulted and felt her symptoms were likely related her recent bacterial pneumonia and not COVID as she was sating well on her baseline 2L supplemental O2. Recommended continue home prednisone taper. Due to her new onset diarrhea and recent abx use c-diff studies were obtained and found to be positive. She was started on oral vanco and her diarrhea quickly improved. PT/OT recommended to continue with her previously arranged home PT. She will follow up with her PCP and pulm outpatient. Patient is discharging in improved and stable condition.
Age: 61.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect product formulation administered, No adverse event
Clinical narrative: No adverse reaction. Patient given Moderna Monovalent booster instead of Moderna bivalent booster. Patient notified.
Age: 63.0
Sex: M
Vaccine: COVID19-2, UNK
Symptoms: COVID-19, Chest discomfort, Cough, Respiratory tract congestion, SARS-CoV-2 test positive
Clinical narrative: I had a scratchy throat, congestion, and tightness in the chest. I also had a mild cough. I completed an at home COVID-19 Test on November 21, 2022. I called the doctor who prescribed Paxlovid which I began to take on the 22nd.  The symptoms gradually improved over a weeks' time to completely feel better.
Age: 63.0
Sex: M
Vaccine: COVID19-2, UNK
Symptoms: Throat irritation
Clinical narrative: I had a scratchy throat, congestion, and tightness in the chest. I also had a mild cough. I completed an at home COVID-19 Test on November 21, 2022. I called the doctor who prescribed Paxlovid which I began to take on the 22nd.  The symptoms gradually improved over a weeks' time to completely feel better.
Age: 17.0
Sex: F
Vaccine: HEP, IPV, MMR, MNQ, VARCEL
Symptoms: Exposure during pregnancy
Clinical narrative: Pt presented to clinic 11/23/22. Reported LMP as 10/28/22.  No report of pregnancy. No visual signs of pregnancy. Above Vaccines administered without problems. Pt presents to clinic 12/8/22 for Reproductive Health Services/UPT. UPT positive 12/8/22. Reports Last period as 4/13/22 and was aware of pregnancy, but did not want pregnancy and was afraid to tell her parent. Has not had prenatal care.   Pt was referred to OBGYN who reported labs and Ultrasound WNL. Immunization record from 11/23/22 visit , sent to Dr. per patient request.  No problems at present. Date of Expected Delivery 1/16/23.
Age: 54.0
Sex: F
Vaccine: COVID19-2
Symptoms: Pain in extremity
Clinical narrative: very slight arm soreness
Age: 58.0
Sex: F
Vaccine: COVID19
Symptoms: Blood sodium decreased, Bundle branch block right, COVID-19, Chest X-ray, Cough
Clinical narrative: PRESENTING PROBLEM: Pulmonary aspergillosis Anemia, unspecified type Chronic pulmonary aspergillosis COVID-19   HOSPITAL COURSE: 58 y.o. female with past medical history significant for severe chronic obstructive pulmonary disease, history of recurrent pneumothorax, history of pulmonary embolism, hypertension, chronic pulmonary aspergillosis, recent MRSA pneumonia, anemia who presented emergency department complaints of worsening shortness of breath and cough.     Upon arrival to emergency department, patient was tachypneic other vitals were stable.  Baseline blood work was obtained and independently reviewed.  Blood work was remarkable for sodium 131, stable chronic thrombocytosis and chronic anemia.  Troponin WNL.  Viral PCR was positive for COVID-19.  UA was negative for acute infection.  EKG was obtained showing normal sinus rhythm with sinus arrhythmia and incomplete RBBB.  CXR showing extensive chronic findings which are not substantially changes from 11/20. No new focal consolidations.  Patient was given a dose of her antifungal and a dose of Zofran for nausea. Patient was then admitted for further evaluation and management.   Patient stayed in hospital for approximately 3 days.   During stay patient has been monitored and had remained to be in room air throughout stay.  Infectious Disease consulted and evaluated patient during the 1st 24 hours of stay.  Her voriconazole resumed with course to be determined.  A prescription has been sent to her pharmacy.  She is to follow-up with them in 3-4 weeks.  Plan to have a repeat voriconazole level in 1 week.  Patient was also given medication for her herpes labialis with valacyclovir.   Also patient has been evaluated by LMSW for initially made suicidal comments on admission.  Patient better main to be not at risk for suicide and that she was given resources for support in the community.   Patient was discharged home stable on 12/19/2022 when medications are ensured available at her pharmacy.
Age: 58.0
Sex: F
Vaccine: COVID19
Symptoms: Dyspnoea, Electrocardiogram abnormal, Nausea, Oral herpes, SARS-CoV-2 test positive
Clinical narrative: PRESENTING PROBLEM: Pulmonary aspergillosis Anemia, unspecified type Chronic pulmonary aspergillosis COVID-19   HOSPITAL COURSE: 58 y.o. female with past medical history significant for severe chronic obstructive pulmonary disease, history of recurrent pneumothorax, history of pulmonary embolism, hypertension, chronic pulmonary aspergillosis, recent MRSA pneumonia, anemia who presented emergency department complaints of worsening shortness of breath and cough.     Upon arrival to emergency department, patient was tachypneic other vitals were stable.  Baseline blood work was obtained and independently reviewed.  Blood work was remarkable for sodium 131, stable chronic thrombocytosis and chronic anemia.  Troponin WNL.  Viral PCR was positive for COVID-19.  UA was negative for acute infection.  EKG was obtained showing normal sinus rhythm with sinus arrhythmia and incomplete RBBB.  CXR showing extensive chronic findings which are not substantially changes from 11/20. No new focal consolidations.  Patient was given a dose of her antifungal and a dose of Zofran for nausea. Patient was then admitted for further evaluation and management.   Patient stayed in hospital for approximately 3 days.   During stay patient has been monitored and had remained to be in room air throughout stay.  Infectious Disease consulted and evaluated patient during the 1st 24 hours of stay.  Her voriconazole resumed with course to be determined.  A prescription has been sent to her pharmacy.  She is to follow-up with them in 3-4 weeks.  Plan to have a repeat voriconazole level in 1 week.  Patient was also given medication for her herpes labialis with valacyclovir.   Also patient has been evaluated by LMSW for initially made suicidal comments on admission.  Patient better main to be not at risk for suicide and that she was given resources for support in the community.   Patient was discharged home stable on 12/19/2022 when medications are ensured available at her pharmacy.
Age: 58.0
Sex: F
Vaccine: COVID19
Symptoms: Sinus arrhythmia, Suicidal ideation, Tachypnoea, Troponin normal, Urine analysis normal
Clinical narrative: PRESENTING PROBLEM: Pulmonary aspergillosis Anemia, unspecified type Chronic pulmonary aspergillosis COVID-19   HOSPITAL COURSE: 58 y.o. female with past medical history significant for severe chronic obstructive pulmonary disease, history of recurrent pneumothorax, history of pulmonary embolism, hypertension, chronic pulmonary aspergillosis, recent MRSA pneumonia, anemia who presented emergency department complaints of worsening shortness of breath and cough.     Upon arrival to emergency department, patient was tachypneic other vitals were stable.  Baseline blood work was obtained and independently reviewed.  Blood work was remarkable for sodium 131, stable chronic thrombocytosis and chronic anemia.  Troponin WNL.  Viral PCR was positive for COVID-19.  UA was negative for acute infection.  EKG was obtained showing normal sinus rhythm with sinus arrhythmia and incomplete RBBB.  CXR showing extensive chronic findings which are not substantially changes from 11/20. No new focal consolidations.  Patient was given a dose of her antifungal and a dose of Zofran for nausea. Patient was then admitted for further evaluation and management.   Patient stayed in hospital for approximately 3 days.   During stay patient has been monitored and had remained to be in room air throughout stay.  Infectious Disease consulted and evaluated patient during the 1st 24 hours of stay.  Her voriconazole resumed with course to be determined.  A prescription has been sent to her pharmacy.  She is to follow-up with them in 3-4 weeks.  Plan to have a repeat voriconazole level in 1 week.  Patient was also given medication for her herpes labialis with valacyclovir.   Also patient has been evaluated by LMSW for initially made suicidal comments on admission.  Patient better main to be not at risk for suicide and that she was given resources for support in the community.   Patient was discharged home stable on 12/19/2022 when medications are ensured available at her pharmacy.
Age: 52.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: COVID-19, Chest pain, SARS-CoV-2 test positive
Clinical narrative: Hospitalization: 12/12/2022 - 12/13/2022 (23 hours) Presentation to the ED: Chest Pain COVID + date: 12/12/2022 Treatment: Zithromax (prescribed by PCP).  Discharge to: home  Moderna 031B21A 4/22/2021 Moderna 039B21A 5/20/2021
Age: 50.0
Sex: M
Vaccine: VARZOS
Symptoms: Rash
Clinical narrative: Pt had a diffuse pox-like rash on abdomen, arms, and legs. Pt presented to office 2 days after second vaccine, symptoms present several hours.
Age: 50.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect product formulation administered, No adverse event
Clinical narrative: No adverse reaction. Patient given Moderna Monovalent booster instead of Moderna bivalent booster. Patient notified.
Age: 37.0
Sex: M
Vaccine: COVID19-2
Symptoms: No adverse event, Underdose
Clinical narrative: Patient who is an adult was given 0.25mL of the Moderna Bivalent COVID booster vaccine, which is less than the authorized dose of 0.50mL.  No adverse events were noted at the time of the administration.
Age: 72.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: Patient requested Moderna Bivalent and received Moderna Primary.
Age: 69.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Asthenia, Asymptomatic COVID-19, Hyperglycaemia, SARS-CoV-2 test positive
Clinical narrative: Hospitalization: 12/7/2022 - 12/15/2022 (8 days) Presentation to the ED: generalized weakness, and hyperglycemia  COVID + date: 12/15/2022 Treatment: NONE, PATIENT WAS ASYMPOMATIC AND TESTED POSITIVE ON A TRANSFER SCREEN.  Discharge to: SNF.    RESIDENT.  MODERNA 003C21A 5/15/2021 MODERNA 053E21A 8/20/2021
Age: 76.0
Sex: F
Vaccine: COVID19-2
Symptoms: Asthenia, COVID-19, Confusional state, Cough, Malaise
Clinical narrative: I had no reaction to vaccine. On 11/27/2022, I began not feeling well with a fever and cough. On 12/01/2022, I went to a clinic to be tested for COVID-19 and it was positive. I did not receive a prescription but advised to take guaifenesin. I finally tested COVID-19 negative on 12/15/2022. As of today, I am very confused and very weak. I rarely get sick and when I do, I get very sick.
Age: 76.0
Sex: F
Vaccine: COVID19-2
Symptoms: Pyrexia, SARS-CoV-2 test positive
Clinical narrative: I had no reaction to vaccine. On 11/27/2022, I began not feeling well with a fever and cough. On 12/01/2022, I went to a clinic to be tested for COVID-19 and it was positive. I did not receive a prescription but advised to take guaifenesin. I finally tested COVID-19 negative on 12/15/2022. As of today, I am very confused and very weak. I rarely get sick and when I do, I get very sick.
Age: 76.0
Sex: F
Vaccine: COVID19-2
Symptoms: Asthenia, Blood chloride decreased, Blood sodium decreased, COVID-19, Chest X-ray normal
Clinical narrative: Discharge Provider: DO Primary Care Provider at Discharge: MD  Admission Date: 12/17/2022 Discharge Date: 12/19/2022 COVID positive 12/17/2022 HOSPITAL COURSE: Patient is a 76-year-old female with history of moderate persistent asthma, GERD, OSA, anxiety and recent TIA who presented with increased weakness, congestion, cough and sneezing.  In the ED, she tested positive for COVID-19.  She was tachycardic, but otherwise hemodynamically stable.  Chest x-ray was negative for pneumonia.  Labs showed sodium 129, chloride 95.  She was placed on observation for generalized weakness and hyponatremia related to COVID-19.   Upon admission, she was placed on IV fluids.  With hydration, her sodium and chloride normalized.  Remainder of labs and vital signs remained stable.  She was seen by PT and OT, who felt that she was safe to return home.  Her respiratory status remained stable on room air, and she did not qualify for advanced therapies for COVID-19, including Decadron or Remdesivir.   She was felt stable for discharge home on 12/19/22.  She should follow-up with her PCP in 1 week.  She will be followed by the COVID-at-home program at discharge.
Age: 76.0
Sex: F
Vaccine: COVID19-2
Symptoms: Cough, Hyponatraemia, Respiratory tract congestion, SARS-CoV-2 test positive, Sneezing
Clinical narrative: Discharge Provider: DO Primary Care Provider at Discharge: MD  Admission Date: 12/17/2022 Discharge Date: 12/19/2022 COVID positive 12/17/2022 HOSPITAL COURSE: Patient is a 76-year-old female with history of moderate persistent asthma, GERD, OSA, anxiety and recent TIA who presented with increased weakness, congestion, cough and sneezing.  In the ED, she tested positive for COVID-19.  She was tachycardic, but otherwise hemodynamically stable.  Chest x-ray was negative for pneumonia.  Labs showed sodium 129, chloride 95.  She was placed on observation for generalized weakness and hyponatremia related to COVID-19.   Upon admission, she was placed on IV fluids.  With hydration, her sodium and chloride normalized.  Remainder of labs and vital signs remained stable.  She was seen by PT and OT, who felt that she was safe to return home.  Her respiratory status remained stable on room air, and she did not qualify for advanced therapies for COVID-19, including Decadron or Remdesivir.   She was felt stable for discharge home on 12/19/22.  She should follow-up with her PCP in 1 week.  She will be followed by the COVID-at-home program at discharge.
Age: 76.0
Sex: F
Vaccine: COVID19-2
Symptoms: Tachycardia
Clinical narrative: Discharge Provider: DO Primary Care Provider at Discharge: MD  Admission Date: 12/17/2022 Discharge Date: 12/19/2022 COVID positive 12/17/2022 HOSPITAL COURSE: Patient is a 76-year-old female with history of moderate persistent asthma, GERD, OSA, anxiety and recent TIA who presented with increased weakness, congestion, cough and sneezing.  In the ED, she tested positive for COVID-19.  She was tachycardic, but otherwise hemodynamically stable.  Chest x-ray was negative for pneumonia.  Labs showed sodium 129, chloride 95.  She was placed on observation for generalized weakness and hyponatremia related to COVID-19.   Upon admission, she was placed on IV fluids.  With hydration, her sodium and chloride normalized.  Remainder of labs and vital signs remained stable.  She was seen by PT and OT, who felt that she was safe to return home.  Her respiratory status remained stable on room air, and she did not qualify for advanced therapies for COVID-19, including Decadron or Remdesivir.   She was felt stable for discharge home on 12/19/22.  She should follow-up with her PCP in 1 week.  She will be followed by the COVID-at-home program at discharge.
Age: 14.0
Sex: M
Vaccine: COVID19
Symptoms: Acute respiratory distress syndrome, COVID-19, Hypotonia
Clinical narrative: DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Acute respiratory disease due to COVID-19 virus [U07.1, J06.9]   HOSPITAL COURSE: Patient is a 15 year old male with a history of Duchenne muscular dystrophy who was admitted after being diagnosed with COVID as well as influenza.  He required close monitoring due to his chronic conditions that carry increased risk of morbidity including acute respiratory failure.  Patient was started on both remdesivir as well as Tamiflu.  He did not require supplemental O2 or pressure support while admitted.  Of note, he is supposed to be on CPAP with sleep but does not tolerate it and so never wears it, and it was decided to not put him on while here.  Because patient also has adrenal insufficiency, he was placed on stress dose steroids on admission until day prior to discharge.     Nurse care manager worked with mom to help set up home nursing, physical therapy, and occupational therapy.  His mom is also going to set up virtual learning because she is nervous having him exposed to germs at school.     CONSULTS/RECOMMENDATIONS: None   Physical Examination:  GENERAL ASSESSMENT: active, alert, no acute distress, well hydrated, well nourished MOUTH: mucous membranes moist LUNGS: Respiratory effort normal, clear to auscultation, normal breath sounds bilaterally HEART: Regular rate and rhythm, normal S1/S2, no murmurs, normal pulses and capillary fill ABDOMEN: Normal bowel sounds, soft, nondistended, no mass, no organomegaly. NEURO: hypotonia   35 minutes were spent coordinating patient's discharge.  More than 50% of this time was counseling family on the need for close follow-up with patient's primary care physician, review of medication risks and benefits as indicated, signs of worsening illness, and reasons to return to the primary care physician or Emergency Department for reevaluation.   Patient's primary care physician's office was updated of discharge via message.
Age: 33.0
Sex: M
Vaccine: COVID19-2
Symptoms: Extra dose administered
Clinical narrative: None stated.
Age: 60.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: Patient requested Moderna Bivalent and received Moderna Primary
Age: 61.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect product formulation administered, No adverse event
Clinical narrative: No adverse reaction. Patient was given Moderna Monovalent Booster dose instead of the Moderna Bivalent Booster. Patient notified.
Age: 63.0
Sex: M
Vaccine: COVID19
Symptoms: Acute respiratory failure, Anticoagulant therapy, Blood alkaline phosphatase increased, Blood calcium decreased, Blood creatinine increased
Clinical narrative: PRESENTING PROBLEM: RSV (acute bronchiolitis due to respiratory syncytial virus) [J21.0] Hypoxia [R09.02] Acute on chronic congestive heart failure, unspecified heart failure type (HCC) [I50.9] COVID-19 [U07.1] Acute respiratory failure with hypoxia (HCC) [J96.01]   HOSPITAL COURSE: Patient is a 64 y.o. male with past medical history significant for combined heart failure, essential hypertension, diabetes type 2, dyslipidemia, coronary artery disease, carotid stenosis bilaterally status post left carotid stent in October presented with progressive shortness of breath.  Patient takes Lasix 40 mg as needed . Does not follow a fluid and sodium restriction although recommended to follow 2 L fluid restriction by cardiologist.  States he drinks a lot of fluids throughout the day.  Was following a strict diabetic diet and monitoring sugars closely in anticipation his left carotid stent back in October.  Since the stent he has not been taking medications and following his sugars closely.  Plan for right carotid stent 12/27.      In the emergency department hypoxic to 79, respiratory rate 35.  Labs notable for potassium 5.4, creatinine 1.53, glucose 176, calcium 8.5, alk-phos 132, BNP 2400, VBG pH 7.3, pCO2 57. COVID and RSV positive.  Patient was started on BiPAP.  Given 10 mg IV dexamethasone, total of 80 mg IV Lasix.  Patient transitioned to high-flow nasal cannula.  I-STAT VBG without improvement placed back on BiPAP.  Patient admitted to the Internal Medicine Service has a CC2 further management of hypoxia.    He was quickly weaned off of Bipap and weaned down to 2L. He was started on dexamethasone daily for COVID 19 infection. Received Duonebs and guafenesin. Oral lasix 40 mg BID for diuresis was ordered with good response and patient down to room air quickly. Patient was started on heparin gtt for elevated troponins on admission. Cardiology consulted. Heparin gtt discontinued as troponin elevation was likely 2/2 to hypoxia and viral illness. 2D ECHO showed decreased EF to 35% compared to 49% previously. Cardiology recommending repeat echo in 3 months when removed from acute illness, they will call to schedule follow up. Patient feeling nearly back to baseline and ambulated maintaining oxygen saturation > 90%. Patient discharged in stable condition with no new complaints.
Age: 63.0
Sex: M
Vaccine: COVID19
Symptoms: Blood glucose normal, Blood pH decreased, Blood potassium increased, Brain natriuretic peptide increased, COVID-19
Clinical narrative: PRESENTING PROBLEM: RSV (acute bronchiolitis due to respiratory syncytial virus) [J21.0] Hypoxia [R09.02] Acute on chronic congestive heart failure, unspecified heart failure type (HCC) [I50.9] COVID-19 [U07.1] Acute respiratory failure with hypoxia (HCC) [J96.01]   HOSPITAL COURSE: Patient is a 64 y.o. male with past medical history significant for combined heart failure, essential hypertension, diabetes type 2, dyslipidemia, coronary artery disease, carotid stenosis bilaterally status post left carotid stent in October presented with progressive shortness of breath.  Patient takes Lasix 40 mg as needed . Does not follow a fluid and sodium restriction although recommended to follow 2 L fluid restriction by cardiologist.  States he drinks a lot of fluids throughout the day.  Was following a strict diabetic diet and monitoring sugars closely in anticipation his left carotid stent back in October.  Since the stent he has not been taking medications and following his sugars closely.  Plan for right carotid stent 12/27.      In the emergency department hypoxic to 79, respiratory rate 35.  Labs notable for potassium 5.4, creatinine 1.53, glucose 176, calcium 8.5, alk-phos 132, BNP 2400, VBG pH 7.3, pCO2 57. COVID and RSV positive.  Patient was started on BiPAP.  Given 10 mg IV dexamethasone, total of 80 mg IV Lasix.  Patient transitioned to high-flow nasal cannula.  I-STAT VBG without improvement placed back on BiPAP.  Patient admitted to the Internal Medicine Service has a CC2 further management of hypoxia.    He was quickly weaned off of Bipap and weaned down to 2L. He was started on dexamethasone daily for COVID 19 infection. Received Duonebs and guafenesin. Oral lasix 40 mg BID for diuresis was ordered with good response and patient down to room air quickly. Patient was started on heparin gtt for elevated troponins on admission. Cardiology consulted. Heparin gtt discontinued as troponin elevation was likely 2/2 to hypoxia and viral illness. 2D ECHO showed decreased EF to 35% compared to 49% previously. Cardiology recommending repeat echo in 3 months when removed from acute illness, they will call to schedule follow up. Patient feeling nearly back to baseline and ambulated maintaining oxygen saturation > 90%. Patient discharged in stable condition with no new complaints.
Age: 63.0
Sex: M
Vaccine: COVID19
Symptoms: Cardiac failure acute, Cardiac failure congestive, Condition aggravated, Dyspnoea, Echocardiogram abnormal
Clinical narrative: PRESENTING PROBLEM: RSV (acute bronchiolitis due to respiratory syncytial virus) [J21.0] Hypoxia [R09.02] Acute on chronic congestive heart failure, unspecified heart failure type (HCC) [I50.9] COVID-19 [U07.1] Acute respiratory failure with hypoxia (HCC) [J96.01]   HOSPITAL COURSE: Patient is a 64 y.o. male with past medical history significant for combined heart failure, essential hypertension, diabetes type 2, dyslipidemia, coronary artery disease, carotid stenosis bilaterally status post left carotid stent in October presented with progressive shortness of breath.  Patient takes Lasix 40 mg as needed . Does not follow a fluid and sodium restriction although recommended to follow 2 L fluid restriction by cardiologist.  States he drinks a lot of fluids throughout the day.  Was following a strict diabetic diet and monitoring sugars closely in anticipation his left carotid stent back in October.  Since the stent he has not been taking medications and following his sugars closely.  Plan for right carotid stent 12/27.      In the emergency department hypoxic to 79, respiratory rate 35.  Labs notable for potassium 5.4, creatinine 1.53, glucose 176, calcium 8.5, alk-phos 132, BNP 2400, VBG pH 7.3, pCO2 57. COVID and RSV positive.  Patient was started on BiPAP.  Given 10 mg IV dexamethasone, total of 80 mg IV Lasix.  Patient transitioned to high-flow nasal cannula.  I-STAT VBG without improvement placed back on BiPAP.  Patient admitted to the Internal Medicine Service has a CC2 further management of hypoxia.    He was quickly weaned off of Bipap and weaned down to 2L. He was started on dexamethasone daily for COVID 19 infection. Received Duonebs and guafenesin. Oral lasix 40 mg BID for diuresis was ordered with good response and patient down to room air quickly. Patient was started on heparin gtt for elevated troponins on admission. Cardiology consulted. Heparin gtt discontinued as troponin elevation was likely 2/2 to hypoxia and viral illness. 2D ECHO showed decreased EF to 35% compared to 49% previously. Cardiology recommending repeat echo in 3 months when removed from acute illness, they will call to schedule follow up. Patient feeling nearly back to baseline and ambulated maintaining oxygen saturation > 90%. Patient discharged in stable condition with no new complaints.
Age: 63.0
Sex: M
Vaccine: COVID19
Symptoms: Ejection fraction decreased, Hypoxia, PCO2 increased, Polyuria, Positive airway pressure therapy
Clinical narrative: PRESENTING PROBLEM: RSV (acute bronchiolitis due to respiratory syncytial virus) [J21.0] Hypoxia [R09.02] Acute on chronic congestive heart failure, unspecified heart failure type (HCC) [I50.9] COVID-19 [U07.1] Acute respiratory failure with hypoxia (HCC) [J96.01]   HOSPITAL COURSE: Patient is a 64 y.o. male with past medical history significant for combined heart failure, essential hypertension, diabetes type 2, dyslipidemia, coronary artery disease, carotid stenosis bilaterally status post left carotid stent in October presented with progressive shortness of breath.  Patient takes Lasix 40 mg as needed . Does not follow a fluid and sodium restriction although recommended to follow 2 L fluid restriction by cardiologist.  States he drinks a lot of fluids throughout the day.  Was following a strict diabetic diet and monitoring sugars closely in anticipation his left carotid stent back in October.  Since the stent he has not been taking medications and following his sugars closely.  Plan for right carotid stent 12/27.      In the emergency department hypoxic to 79, respiratory rate 35.  Labs notable for potassium 5.4, creatinine 1.53, glucose 176, calcium 8.5, alk-phos 132, BNP 2400, VBG pH 7.3, pCO2 57. COVID and RSV positive.  Patient was started on BiPAP.  Given 10 mg IV dexamethasone, total of 80 mg IV Lasix.  Patient transitioned to high-flow nasal cannula.  I-STAT VBG without improvement placed back on BiPAP.  Patient admitted to the Internal Medicine Service has a CC2 further management of hypoxia.    He was quickly weaned off of Bipap and weaned down to 2L. He was started on dexamethasone daily for COVID 19 infection. Received Duonebs and guafenesin. Oral lasix 40 mg BID for diuresis was ordered with good response and patient down to room air quickly. Patient was started on heparin gtt for elevated troponins on admission. Cardiology consulted. Heparin gtt discontinued as troponin elevation was likely 2/2 to hypoxia and viral illness. 2D ECHO showed decreased EF to 35% compared to 49% previously. Cardiology recommending repeat echo in 3 months when removed from acute illness, they will call to schedule follow up. Patient feeling nearly back to baseline and ambulated maintaining oxygen saturation > 90%. Patient discharged in stable condition with no new complaints.
Age: 63.0
Sex: M
Vaccine: COVID19
Symptoms: Respiratory syncytial virus bronchiolitis, Respiratory syncytial virus test positive, SARS-CoV-2 test positive, Troponin increased
Clinical narrative: PRESENTING PROBLEM: RSV (acute bronchiolitis due to respiratory syncytial virus) [J21.0] Hypoxia [R09.02] Acute on chronic congestive heart failure, unspecified heart failure type (HCC) [I50.9] COVID-19 [U07.1] Acute respiratory failure with hypoxia (HCC) [J96.01]   HOSPITAL COURSE: Patient is a 64 y.o. male with past medical history significant for combined heart failure, essential hypertension, diabetes type 2, dyslipidemia, coronary artery disease, carotid stenosis bilaterally status post left carotid stent in October presented with progressive shortness of breath.  Patient takes Lasix 40 mg as needed . Does not follow a fluid and sodium restriction although recommended to follow 2 L fluid restriction by cardiologist.  States he drinks a lot of fluids throughout the day.  Was following a strict diabetic diet and monitoring sugars closely in anticipation his left carotid stent back in October.  Since the stent he has not been taking medications and following his sugars closely.  Plan for right carotid stent 12/27.      In the emergency department hypoxic to 79, respiratory rate 35.  Labs notable for potassium 5.4, creatinine 1.53, glucose 176, calcium 8.5, alk-phos 132, BNP 2400, VBG pH 7.3, pCO2 57. COVID and RSV positive.  Patient was started on BiPAP.  Given 10 mg IV dexamethasone, total of 80 mg IV Lasix.  Patient transitioned to high-flow nasal cannula.  I-STAT VBG without improvement placed back on BiPAP.  Patient admitted to the Internal Medicine Service has a CC2 further management of hypoxia.    He was quickly weaned off of Bipap and weaned down to 2L. He was started on dexamethasone daily for COVID 19 infection. Received Duonebs and guafenesin. Oral lasix 40 mg BID for diuresis was ordered with good response and patient down to room air quickly. Patient was started on heparin gtt for elevated troponins on admission. Cardiology consulted. Heparin gtt discontinued as troponin elevation was likely 2/2 to hypoxia and viral illness. 2D ECHO showed decreased EF to 35% compared to 49% previously. Cardiology recommending repeat echo in 3 months when removed from acute illness, they will call to schedule follow up. Patient feeling nearly back to baseline and ambulated maintaining oxygen saturation > 90%. Patient discharged in stable condition with no new complaints.
Age: 32.0
Sex: F
Vaccine: COVID19-2
Symptoms: No adverse event, Underdose
Clinical narrative: Patient who is an adult was given 0.25mL of the Moderna Bivalent COVID booster vaccine, which is less than the authorized dose of 0.50mL.  No adverse events were noted at the time of the administration.
Age: 52.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect product formulation administered, No adverse event
Clinical narrative: No adverse reaction. Patient was given Moderna Monovalent Booster dose instead of the Moderna Bivalent Booster. Patient notified.
Age: 78.0
Sex: F
Vaccine: COVID19-2
Symptoms: Adult failure to thrive, Atrial fibrillation, Blood creatinine increased, Chest X-ray abnormal, Dyspnoea
Clinical narrative: COVID+ 12/14/22.  Vaccination status - pfizer x3 + Pfizer BIVALENT BRIEF OVERVIEW: Admission Date: 12/14/2022 Discharge Date:  12/15/2022   Active Hospital Problems   Diagnosis Date Noted POA ? Paroxysmal atrial fibrillation 10/01/2015 Yes ? Diabetes mellitus type 2 with complications 10/01/2015 Yes ? Acute kidney injury superimposed on chronic kidney disease 09/28/2022 Yes ? Lab test positive for detection of COVID-19 virus 12/14/2022 Yes ? Failure to thrive in adult 12/14/2022 Yes ? Chronic obstructive pulmonary disease 11/22/2022 Yes ? Diastolic heart failure   Yes ? Iron deficiency anemia   DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Failure to thrive in adult   HOSPITAL COURSE: 78 yo female with COPD on 4 liters 02 recently hospitalized with CHF, Afib with RVR, and discharged to care facility. Returned to ED last eveniong after testing Covid = in the facility, and having symptoms of head congestion and shortness of breath. Labs showed worse renal function compared to baseline (Creat 1.8 c/t 1.5) and findings of mild CHF on CXR. She received 10 mg Dexamethasone IV in ED last night and 10 mg of po torsemide additional. Today she says she feels much better. She is breathing comfortably on her usual 4 liters 02 per NC and her lungs sound clear on exam. She is anxious to discharge home and with be discharged there with home health care. The only me change is a medrol dose pack over 6 days, beginng tomorrow afeter receiving 32 mg of Medrol po in the hospital today before discharge.
Age: 78.0
Sex: F
Vaccine: COVID19-2
Symptoms: Renal impairment, Respiratory tract congestion, SARS-CoV-2 test
Clinical narrative: COVID+ 12/14/22.  Vaccination status - pfizer x3 + Pfizer BIVALENT BRIEF OVERVIEW: Admission Date: 12/14/2022 Discharge Date:  12/15/2022   Active Hospital Problems   Diagnosis Date Noted POA ? Paroxysmal atrial fibrillation 10/01/2015 Yes ? Diabetes mellitus type 2 with complications 10/01/2015 Yes ? Acute kidney injury superimposed on chronic kidney disease 09/28/2022 Yes ? Lab test positive for detection of COVID-19 virus 12/14/2022 Yes ? Failure to thrive in adult 12/14/2022 Yes ? Chronic obstructive pulmonary disease 11/22/2022 Yes ? Diastolic heart failure   Yes ? Iron deficiency anemia   DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Failure to thrive in adult   HOSPITAL COURSE: 78 yo female with COPD on 4 liters 02 recently hospitalized with CHF, Afib with RVR, and discharged to care facility. Returned to ED last eveniong after testing Covid = in the facility, and having symptoms of head congestion and shortness of breath. Labs showed worse renal function compared to baseline (Creat 1.8 c/t 1.5) and findings of mild CHF on CXR. She received 10 mg Dexamethasone IV in ED last night and 10 mg of po torsemide additional. Today she says she feels much better. She is breathing comfortably on her usual 4 liters 02 per NC and her lungs sound clear on exam. She is anxious to discharge home and with be discharged there with home health care. The only me change is a medrol dose pack over 6 days, beginng tomorrow afeter receiving 32 mg of Medrol po in the hospital today before discharge.
Age: 60.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: Patient requested Moderna Bivalent and received the Moderna primary
Age: 89.0
Sex: F
Vaccine: FLU4
Symptoms: Ataxia
Clinical narrative: Ataxia
Age: 61.0
Sex: F
Vaccine: COVID19, FLU4
Symptoms: Incorrect product formulation administered, No adverse event
Clinical narrative: No adverse reaction. Patient was given Moderna Monovalent Booster dose instead of the Moderna Bivalent Booster. Patient notified.
Age: 71.0
Sex: F
Vaccine: COVID19-2
Symptoms: Tinnitus, Vitreous floaters
Clinical narrative: Tinnitus both ears. Still present. No Rx  Floater in R eye. Still present.  No Rx
Age: 34.0
Sex: F
Vaccine: COVID19
Symptoms: Dizziness
Clinical narrative: Pt came in to receive her second Monovalent Pfizer Covid vaccine. Shortly after getting vaccinated, pt started to complain of dizziness. PT was attended to by the clinician and 911 was contacted however, the pt refused 911. AMA form signed by the patient. Pt stayed at the facility until she states her dizziness was getting better
Age: 42.0
Sex: F
Vaccine: COVID19-2
Symptoms: No adverse event, Underdose
Clinical narrative: Patient who is an adult was given 0.25mL of the Moderna Bivalent COVID booster vaccine, which is less than the authorized dose of 0.50mL.  No adverse events were noted at the time of the administration.
Age: 54.0
Sex: M
Vaccine: COVID19-2
Symptoms: Mechanical urticaria
Clinical narrative: Patient describing Dermatographism reactions three days after his last COVID booster.  He states it happens two to three times a day.  They come on and off and may last 30 minutes or so.   He states they come on when it is warm or under stress.  He describes them as appearing to be like scratch marks but go away after 30 minutes or so.
Age: 25.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: hospitalized with covid; fully vaccinated
Age: 56.0
Sex: M
Vaccine: COVID19-2
Symptoms: Underdose
Clinical narrative: Given 0.25mL bivalent booster.  No apparent injury.
Age: 81.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: DOSE #3 OF PFIZER (COMIRNATY) COVID VACCINE GIVEN 2/19/22, LOT #FK9896; pt had a positive  COVID test on 6/29/22 at Hospital; another positive COVID test on 7/6/22 from Hospital; the only medical records sent was the discharge disposition and a statement that the pt was in hospice and not in the hospital; name of hospice not given
Age: 56.0
Sex: F
Vaccine: COVID19, FLU4
Symptoms: Incorrect product formulation administered, No adverse event
Clinical narrative: No adverse reaction. Patient was given Moderna Monovalent Booster dose instead of the Moderna Bivalent Booster. Patient notified.
Age: 43.0
Sex: M
Vaccine: COVID19-2
Symptoms: Underdose
Clinical narrative: Given 0.25mL bivalent booster.  No apparent injury.
Age: 1.58
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Cough, Rhinorrhoea, SARS-CoV-2 test positive
Clinical narrative: He tested positive for COVID-19 on 7/14/22. He had a cough and runny nose. His symptoms lasted for about 6 days. We contacted his doctor, but he did not prescribe medications. We treated him with over-the-counter medications and a humidifier.
Age: 16.0
Sex: F
Vaccine: COVID19-2
Symptoms: Incorrect product formulation administered
Clinical narrative: Bivalent Pfizer booster given as dose 1 in primary series
Age: 30.0
Sex: M
Vaccine: COVID19-2
Symptoms: Underdose
Clinical narrative: Given 0.25mL bivalent booster.  No apparent injury.
Age: 46.0
Sex: F
Vaccine: COVID19, FLU4
Symptoms: Incorrect product formulation administered, No adverse event
Clinical narrative: No adverse reaction. Patient was given Moderna Monovalent Booster dose instead of the Moderna Bivalent Booster. Patient notified.
Age: 44.0
Sex: M
Vaccine: COVID19-2
Symptoms: Underdose
Clinical narrative: Given 0.25mL bivalent booster.  No apparent injury.
Age: 45.0
Sex: M
Vaccine: COVID19-2
Symptoms: Underdose
Clinical narrative: Given 0.25mL bivalent booster.  No apparent injury.
Age: 64.0
Sex: F
Vaccine: COVID19-2
Symptoms: COVID-19, Cough, Ear discomfort, Headache, Nasal congestion
Clinical narrative: I started with a sick throat, mild headache, cough, cranial pressure in my ears. A couple of days after, the sore throat got worse, felt like a razor blade was in my throat. My sister and brother are nurses so they advised me to take an at-home COVID-19 test which came back positive. The next day, I contacted my physician and informed them who later prescribed Paxlovid. As of today, I've taken my third dose and only have a minor sore throat, a slight cough, and minor nasal congestion; I'm not completely at 100% but making my way there.
Age: 64.0
Sex: F
Vaccine: COVID19-2
Symptoms: Oropharyngeal pain, SARS-CoV-2 test positive
Clinical narrative: I started with a sick throat, mild headache, cough, cranial pressure in my ears. A couple of days after, the sore throat got worse, felt like a razor blade was in my throat. My sister and brother are nurses so they advised me to take an at-home COVID-19 test which came back positive. The next day, I contacted my physician and informed them who later prescribed Paxlovid. As of today, I've taken my third dose and only have a minor sore throat, a slight cough, and minor nasal congestion; I'm not completely at 100% but making my way there.
Age: 70.0
Sex: M
Vaccine: COVID19-2
Symptoms: COVID-19, Fatigue, Malaise, SARS-CoV-2 test negative, SARS-CoV-2 test positive
Clinical narrative: After receiving the vaccine, I felt tired and needed to rest. On 12/11/2022, I began not feeling well with a scratchy throat. On 12/12/2022, the scratchy throat was getting worse, so I tested for COVID-19, and it was negative.  On 12/13/2022, I felt worse and decided to test for COVID-19 again and it was positive. I contacted my doctor and declined a prescription for Paxlovid. I took guaifenesin to help with my symptoms.
Age: 70.0
Sex: M
Vaccine: COVID19-2
Symptoms: Throat irritation
Clinical narrative: After receiving the vaccine, I felt tired and needed to rest. On 12/11/2022, I began not feeling well with a scratchy throat. On 12/12/2022, the scratchy throat was getting worse, so I tested for COVID-19, and it was negative.  On 12/13/2022, I felt worse and decided to test for COVID-19 again and it was positive. I contacted my doctor and declined a prescription for Paxlovid. I took guaifenesin to help with my symptoms.
Age: 53.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect product formulation administered, No adverse event
Clinical narrative: No adverse reaction. Patient was given Moderna Monovalent Booster dose instead of the Moderna Bivalent Booster. Patient notified.
Age: 89.0
Sex: M
Vaccine: COVID19
Symptoms: Asthenia, Asymptomatic bacteriuria, COVID-19, Computerised tomogram head abnormal, Cystitis
Clinical narrative: Discharge Provider: MD Primary Care Provider:  MD Admission Date: 12/15/2022 Discharge Date: Dec 17, 2022 COVID positive date: 12/15/2022 PRESENTING PROBLEM: Generalized weakness  Acute cystitis without hematuria  COVID-19    HOSPITAL COURSE: Patient is an 89M  with past medical history significant for asymptomatic bacteriuria, hypertension, lower extremity edema, dementia.  He presented to the emergency department after he was found lying on the ground in his home.  He lives alone, daughter came in the morning to check on him and he was found  lying on the ground unable to get up.  EMS was called.  He was found with a gas stove on without flame.  He states he was cooking dinner, sentence trailed off states he couldnt find a blanket. In the emergency department, vital signs were unremarkable. CT head negative for acute abnormality, volume loss and chronic microvascular ischemic changes. He was found to have asymptomatic bacteriuria which is a known chronic issue.  He was admitted for further observation.    On the floor, he has no symptoms or complaints. He was found to have COVID-19 positive without hypoxemia or infiltrates to necessitate pharmacologic therapy. PT/OT evaluated the patient and recommended home with home therapy and 24/7 support which family is willing to provide. They are not interested in home PT/OT or outpatient therapy services. Family opted for home with family support. He is at baseline mental status per his son who is at bedside. He was discharged in stable condition on 12/17/22