chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 61.0
Sex: M
Vaccine: COVID19
Symptoms: Cellulitis, Nephropathy, Pain in extremity
Clinical narrative: Within two weeks of vaccination out break of cellulitis occurred in lower leg along with issues of nephropathy.  Exact same events occurred after first shot, but I am more educated on all the unadvertised side effects of the Covid vaccine.
Age: 2.0
Sex: M
Vaccine: MMRV, MNQ
Symptoms: Product administered to patient of inappropriate age, Vaccination error
Clinical narrative: PT was given this vaccine on accident by another employee in our office. Pt is only 2 yrs of age and vaccines not for children his age.
Age: 70.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Death, Vaccine breakthrough infection
Clinical narrative: breakthrough COVID-related death
Age: 43.0
Sex: U
Vaccine: COVID19
Symptoms: Chest pain, Chills, Cough, Nausea, Pyrexia
Clinical narrative: chills, fever, cough, CP N&V
Age: 43.0
Sex: U
Vaccine: COVID19
Symptoms: Vomiting
Clinical narrative: chills, fever, cough, CP N&V
Age: 32.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Blood test abnormal, Diabetes mellitus, Glycosylated haemoglobin increased
Clinical narrative: Diabetes diagnosis based on bloodwork, very high A1C about 2 years after having a normal A1C, do not have lab work from 2020, but unusual to see such extreme change so suddenly, no COVID infection
Age: 17.0
Sex: F
Vaccine: MENB, TD
Symptoms: Anxiety, Tachycardia, Tremor
Clinical narrative: patient presented with parent back to office approximately 20 minutes after leaving office- she was given a trumenba vaccine and tubersol PPD implanted.  Pt. was visibly shaking and tachycardic -BP- 118/76 Pulse 126 Oxygen 98% denies heart palpitations, SOB, throat swelling or difficultly swallowing. pt. administered 10ml of Benadryl in office.  pt. was monitored by this provider and Pulse went down to 108 - pt. appeared less anxious and less trembling. Parent defers to take patient home and will monitor - parent to take pt. to ER or call EMS if pt.s pulse elevates over 120 (parent states he knows how to take a pulse) or any further baseline changes. Parent is agreeable to plan. Provider to make a VAERS report.
Age: 75.0
Sex: F
Vaccine: VARZOS
Symptoms: Back pain
Clinical narrative: PATIENT HAD SEVERE LOW BACK PAIN FOR BOTH DOSES OF SHINGLES VACCINE, "IT WAS LIKE GOING THROUGH LABOR". SELF LIMITING, RESOLVED IN A FEW DAYS. HAPPENED ABOUT 24 HOURS AFTER VACCINE  AND RESOLVED WITHIN 4 DAYS.
Age: 62.0
Sex: M
Vaccine: COVID19
Symptoms: Bell's palsy, Ear pain, Facial paralysis, Glossitis, Glossodynia
Clinical narrative: Diagnosed with Ramsay Hunt Syndrome.    5 days after booster - noted inflammation and pain on tongue. 8 days after booster - experienced pain in ear/jaw. 9 days after booster - sought urgent medical care for facial paralysis on right side. Bell's palsy triggered by shingles suspected. 12 days after booster - Neurologist confirms Ramsay Hunt Syndrome.
Age: 62.0
Sex: M
Vaccine: COVID19
Symptoms: Herpes zoster, Herpes zoster oticus, Neurological examination, Pain in jaw
Clinical narrative: Diagnosed with Ramsay Hunt Syndrome.    5 days after booster - noted inflammation and pain on tongue. 8 days after booster - experienced pain in ear/jaw. 9 days after booster - sought urgent medical care for facial paralysis on right side. Bell's palsy triggered by shingles suspected. 12 days after booster - Neurologist confirms Ramsay Hunt Syndrome.
Age: 16.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Unevaluable event
Clinical narrative: Hospitalization
Age: 56.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: COVID positive, ED visit,  Hospital admission pending transfer
Age: 53.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Arthralgia, Balance disorder, Dizziness, Dyspnoea, Fatigue
Clinical narrative: Periodic dizzyness, unbalanced, easy exhaustion, sporadic high and low heart rate, easily short of breath, extremity weakness, near blackouts if I overexert of move quick, muscle aches, joint aches.  All symptoms have been experienced since the second vaccine.
Age: 53.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Heart rate irregular, Muscular weakness, Myalgia, Presyncope
Clinical narrative: Periodic dizzyness, unbalanced, easy exhaustion, sporadic high and low heart rate, easily short of breath, extremity weakness, near blackouts if I overexert of move quick, muscle aches, joint aches.  All symptoms have been experienced since the second vaccine.
Age: 21.0
Sex: F
Vaccine: HEPA
Symptoms: Expired product administered
Clinical narrative: Patient was given an expired vaccine the date of  6/15/22 and vaccine had expired 5/24/22. Patient has not reported any symptoms therefore no treatment has been given.
Age: 51.0
Sex: M
Vaccine: COVID19
Symptoms: Condition aggravated, Deafness, Tinnitus
Clinical narrative: I have had tinnitus and an an amount hearing loss since my early 40's. Ocassional hearing tests yielded: This was at a level deemed "not unusual for my age", but not optimal. Over the course of years, the tinnitus has slowly increased little by little.  Within a month after the vaccine, the tinnitus (and some associated hearing loss) became NOTICIBLY worse in a short time. After 6 months, it has not subsided.
Age: 67.0
Sex: F
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Abdominal pain, Anion gap, Blood bicarbonate, Blood glucose increased, Blood ketone body
Clinical narrative: Patient presented to hospital emergency department with slightly altered mentation and a 4-day history of nausea, vomiting, abdominal pain, and myalgias. Patient was found to be in diabetic ketoacidosis. Likely precipitating factors included minimal food and fluid intake, failure to administer routine insulin detemir, and continuation of daily dapagliflozin associated with severe malaise and dehydration  following COVID-19 booster. Patient was given IV fluids and insulin with subsequent resolution of metabolic abnormalities and symptoms. Patient was discharged with comprehensive follow-up care plan in place.
Age: 67.0
Sex: F
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Blood lactic acid increased, Blood pH decreased, Dehydration, Diabetic ketoacidosis, Fluid intake reduced
Clinical narrative: Patient presented to hospital emergency department with slightly altered mentation and a 4-day history of nausea, vomiting, abdominal pain, and myalgias. Patient was found to be in diabetic ketoacidosis. Likely precipitating factors included minimal food and fluid intake, failure to administer routine insulin detemir, and continuation of daily dapagliflozin associated with severe malaise and dehydration  following COVID-19 booster. Patient was given IV fluids and insulin with subsequent resolution of metabolic abnormalities and symptoms. Patient was discharged with comprehensive follow-up care plan in place.
Age: 67.0
Sex: F
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Hypophagia, Malaise, Mental status changes, Metabolic abnormality management, Myalgia
Clinical narrative: Patient presented to hospital emergency department with slightly altered mentation and a 4-day history of nausea, vomiting, abdominal pain, and myalgias. Patient was found to be in diabetic ketoacidosis. Likely precipitating factors included minimal food and fluid intake, failure to administer routine insulin detemir, and continuation of daily dapagliflozin associated with severe malaise and dehydration  following COVID-19 booster. Patient was given IV fluids and insulin with subsequent resolution of metabolic abnormalities and symptoms. Patient was discharged with comprehensive follow-up care plan in place.
Age: 67.0
Sex: F
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Nausea, Treatment noncompliance, Urine ketone body present, Vomiting
Clinical narrative: Patient presented to hospital emergency department with slightly altered mentation and a 4-day history of nausea, vomiting, abdominal pain, and myalgias. Patient was found to be in diabetic ketoacidosis. Likely precipitating factors included minimal food and fluid intake, failure to administer routine insulin detemir, and continuation of daily dapagliflozin associated with severe malaise and dehydration  following COVID-19 booster. Patient was given IV fluids and insulin with subsequent resolution of metabolic abnormalities and symptoms. Patient was discharged with comprehensive follow-up care plan in place.
Age: 57.0
Sex: F
Vaccine: COVID19
Symptoms: Borrelia test negative, Facial paralysis, Full blood count normal, Laboratory test normal, Magnetic resonance imaging head normal
Clinical narrative: Patient received her covid booster on 12/6/21 at pharmacy, reported on Christmas she cannot smile correctly, lift forehead or wink on left side of face. No motor weakness, numbness. No skin lesions, tick bites, etc. Patient was started on prednisone, famicyclovir and valacyclovir at telephone visit 1/3/22 by PCP. Patient then had in-office visit on 3/7/22 reporting symptoms did not resolve though did improve following the above medications.  Provider noted "this facial palsy is MUCH more consistent with a Central 7th and NOT a peripheral 7th as she can wrinkle her forehead on the left side that is not consistent with Bell's Palsy". CBC and Brain MRI were ordered, no acute abnormality noted on imaging or labwork. Patient seen 6/14- continues with symptoms but reports 99% improved.  Lyme reflex ordered which was also negative.
Age: 83.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Unevaluable event
Clinical narrative: patient hospitalized
Age: 68.0
Sex: M
Vaccine: HEPA
Symptoms: Expired product administered
Clinical narrative: Patient was given an expired vaccine the date of  6/13/22 and vaccine expired 5/24/22.
Age: 62.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Acute respiratory failure, Anaemia, Aspiration, Asymptomatic COVID-19, Cerebrovascular accident
Clinical narrative: 64 yo gentleman with ESRD from fibrillary GN on HD at clinic was admitted at hospital at the beginning of this month with a stroke and was found to have incidental COVID 19 + (asymptomatic) had been transferred, but while there aspirated a piece of broccoli with resultant respiratory distress and transferred to the medical center. He had been on BiPAP, but now on O2 per NC.     Discharged 06/13/2022 Discharge Dx:  1. Acute hypoxic respiratory failure secondary to acute food aspiration with     bacterial aspiration pneumonia. 2. COVID-19 positive. 3. History of recent cerebrovascular accident. 4. End-stage renal disease, on hemodialysis. 5. Chronic anemia, likely due to chronic kidney disease. 6. Chronic hypertension
Age: 62.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Hypertension, Pneumonia aspiration, Pneumonia bacterial, Positive airway pressure therapy, Respiratory distress
Clinical narrative: 64 yo gentleman with ESRD from fibrillary GN on HD at clinic was admitted at hospital at the beginning of this month with a stroke and was found to have incidental COVID 19 + (asymptomatic) had been transferred, but while there aspirated a piece of broccoli with resultant respiratory distress and transferred to the medical center. He had been on BiPAP, but now on O2 per NC.     Discharged 06/13/2022 Discharge Dx:  1. Acute hypoxic respiratory failure secondary to acute food aspiration with     bacterial aspiration pneumonia. 2. COVID-19 positive. 3. History of recent cerebrovascular accident. 4. End-stage renal disease, on hemodialysis. 5. Chronic anemia, likely due to chronic kidney disease. 6. Chronic hypertension
Age: 62.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: SARS-CoV-2 test positive
Clinical narrative: 64 yo gentleman with ESRD from fibrillary GN on HD at clinic was admitted at hospital at the beginning of this month with a stroke and was found to have incidental COVID 19 + (asymptomatic) had been transferred, but while there aspirated a piece of broccoli with resultant respiratory distress and transferred to the medical center. He had been on BiPAP, but now on O2 per NC.     Discharged 06/13/2022 Discharge Dx:  1. Acute hypoxic respiratory failure secondary to acute food aspiration with     bacterial aspiration pneumonia. 2. COVID-19 positive. 3. History of recent cerebrovascular accident. 4. End-stage renal disease, on hemodialysis. 5. Chronic anemia, likely due to chronic kidney disease. 6. Chronic hypertension
Age: 18.0
Sex: F
Vaccine: MENB
Symptoms: Injected limb mobility decreased, Joint range of motion decreased, Pain in extremity
Clinical narrative: LEFT ARM PAINX2 WEEKS, DECREASED LEFT ARM ROM.  ICE WAS USED AND  TYLENOL.  PAIN  AND DECREASED ROM REMAIN.  WILL BEGIN 600MG IBUPROFEN TID WITH FOOD BEGINNING TODAY.
Age: 58.0
Sex: F
Vaccine: HEPA
Symptoms: Expired product administered
Clinical narrative: Patient was given an expired vaccine the date of 6/10/22 and the vaccine expired 5/24/22. Patient has not yet reported any symptoms therefore no treatment was given.
Age: 88.0
Sex: F
Vaccine: COVID19
Symptoms: Death
Clinical narrative: Death
Age: 73.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Abdominal distension, Abdominal pain upper, COVID-19, Cough, Infrequent bowel movements
Clinical narrative: 2 nights ago tested positive for covid on a home test. Saturday morning started vomiting. Cough and sinus. vaxxed and boosted.Tested at home and positive for COVID 6/11. Began having nausea and vomiting yesterday into this am, no diarrhea, no BM for a few days  Today, his upper abdomen became more swollen and painful so presented to the ED  States had bowel obstruction due to colon cancer, had "18 inches" of colon removed  Had followup colonoscopy 4.5 years ago and told needs repeat in December of this year.  Discharged on 06/16/2022
Age: 73.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Intestinal obstruction, Nausea, SARS-CoV-2 test positive, Sinus disorder, Vomiting
Clinical narrative: 2 nights ago tested positive for covid on a home test. Saturday morning started vomiting. Cough and sinus. vaxxed and boosted.Tested at home and positive for COVID 6/11. Began having nausea and vomiting yesterday into this am, no diarrhea, no BM for a few days  Today, his upper abdomen became more swollen and painful so presented to the ED  States had bowel obstruction due to colon cancer, had "18 inches" of colon removed  Had followup colonoscopy 4.5 years ago and told needs repeat in December of this year.  Discharged on 06/16/2022
Age: 78.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Anticoagulant therapy, Atrial fibrillation, Blood magnesium normal, Blood potassium normal, Brain natriuretic peptide increased
Clinical narrative: 2 weeks ago she was diagnosed with covid. She was started on medication but had n/v and could not keep her medication down. She was then diagnosed with pneumonia and started on azithromycin. She started to have chest pain over the last couple of days. She presented to the ER today and was found to be in a-fib with rates in the 140s. She states she has been very fatigued lately. Her PPM was interrogated and she has been in a-fib for about 50% of the time. She continues on eliquis and has not missed any doses. Her ER workup was positive for elevated WBC, BNP of 5659, potassium and magnesium WNL, troponins flat. She was started on a diltiazem drip. She will be admitted to cardiology for further treatment.    Currently in the hospital (not in ICU on 06/20/2022).
Age: 78.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: COVID-19, Cardiac pacemaker insertion, Chest pain, Fatigue, Nausea
Clinical narrative: 2 weeks ago she was diagnosed with covid. She was started on medication but had n/v and could not keep her medication down. She was then diagnosed with pneumonia and started on azithromycin. She started to have chest pain over the last couple of days. She presented to the ER today and was found to be in a-fib with rates in the 140s. She states she has been very fatigued lately. Her PPM was interrogated and she has been in a-fib for about 50% of the time. She continues on eliquis and has not missed any doses. Her ER workup was positive for elevated WBC, BNP of 5659, potassium and magnesium WNL, troponins flat. She was started on a diltiazem drip. She will be admitted to cardiology for further treatment.    Currently in the hospital (not in ICU on 06/20/2022).
Age: 78.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Pneumonia, Troponin normal, Vomiting, White blood cell count increased
Clinical narrative: 2 weeks ago she was diagnosed with covid. She was started on medication but had n/v and could not keep her medication down. She was then diagnosed with pneumonia and started on azithromycin. She started to have chest pain over the last couple of days. She presented to the ER today and was found to be in a-fib with rates in the 140s. She states she has been very fatigued lately. Her PPM was interrogated and she has been in a-fib for about 50% of the time. She continues on eliquis and has not missed any doses. Her ER workup was positive for elevated WBC, BNP of 5659, potassium and magnesium WNL, troponins flat. She was started on a diltiazem drip. She will be admitted to cardiology for further treatment.    Currently in the hospital (not in ICU on 06/20/2022).
Age: 26.0
Sex: F
Vaccine: MNQ
Symptoms: Injection site pain, Wrong product administered
Clinical narrative: Site: Pain at Injection Site-Mild, Additional Details: Patient came in stated she wanted a mennicoccal injection but meant Varicella
Age: 48.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Injection site pain
Clinical narrative: Site: Pain at Injection Site-Mild, Systemic: shoulder pain-Mild
Age: 25.0
Sex: M
Vaccine: COVID19, PPV, TDAP
Symptoms: Incorrect dose administered, Product administered to patient of inappropriate age
Clinical narrative: Pt was given pediatric dose of the Covid-19 booster instead of the full adult dose as requested by provider by one of our RN's. I was notified of the error and notified Dr. The patient was notified and due to the CDC recommendations, Patient has been scheduled to receive the booster shot in 8 weeks to avoid any potential risks to due to his age.
Age: 66.0
Sex: F
Vaccine: COVID19
Symptoms: Dizziness, Palpitations
Clinical narrative: Systemic: Dizziness / Lightheadness-Medium, Additional Details: 10 minutes after vaccine administered, patient reported feeling dizzy and that her heart was racing. VSS at the time. Patient placed in supine position. After 10 minutes, stated she felt better, drank some water and gatorade. She left in stable ambulatory condition with her husband after 30 minutes of monitoring. VSS throughout.
Age: 80.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Acute respiratory failure, COVID-19, COVID-19 pneumonia, Chest X-ray abnormal, Dyspnoea
Clinical narrative: Presented to ED on 6/5/22 with COVID pneumonia and symptoms for 5 days.  At that time, he was saturating well on room air with normal effort.  Chest for-ray showed right middle lobe pneumonia and he was treated with doxycycline for CAP. Paxlovid was intended but unable to be used due to renal function.  Presented to ED on 6/15/22 81y.o. M with PMH of Chronic mesenteric ischemia, hypertension, CAD status post CABG, PAD with  SMA stenosis, chronic mesenteric ischemia status post iliac artery stent bilaterally, type 2 diabetes, CKD 3 and secondary hyperparathyroidism, normocytic anemia, and HLD who presents to the ED with complaint of shortness of breath.   Admitted with acute respiratory failure 2/2 Covid
Age: 80.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Malaise, Pneumonia, Renal impairment
Clinical narrative: Presented to ED on 6/5/22 with COVID pneumonia and symptoms for 5 days.  At that time, he was saturating well on room air with normal effort.  Chest for-ray showed right middle lobe pneumonia and he was treated with doxycycline for CAP. Paxlovid was intended but unable to be used due to renal function.  Presented to ED on 6/15/22 81y.o. M with PMH of Chronic mesenteric ischemia, hypertension, CAD status post CABG, PAD with  SMA stenosis, chronic mesenteric ischemia status post iliac artery stent bilaterally, type 2 diabetes, CKD 3 and secondary hyperparathyroidism, normocytic anemia, and HLD who presents to the ED with complaint of shortness of breath.   Admitted with acute respiratory failure 2/2 Covid
Age: 58.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Acute kidney injury, Asthenia, Blood creatinine normal, Blood glucose abnormal, Blood glucose decreased
Clinical narrative: She went shopping with an unvaccinated friend who also got sick around the same time as her, but otherwise has no clear exposure history.  Since her illness started she reports labile blood sugars, generalized weakness, orthostasis and very poor appetite in addition to above symptoms.  She's felt too unwell to take her medications for about two days last week but has otherwise taking her tacrolimus, mycophenolic acid, and prednisone 5mg daily as prescribed.  She's on chronic suppressive cephalexin for recurrent UTIs.  She actually called EMS last Saturday due to not feeling well and low blood sugar, but opted not to be brought in at that time.  Admitted 06/18/2022 and currently hospitalized.MPRESSION AND PLAN: 1. Acute kidney injury on chronic kidney disease.  Currently, the patient with     renal function, which is worse than previous baseline with a creatinine of     2.3, her baseline is usually 1.8-1.9.  The patient may have hyperabsorbed the     Prograf and may have a high tacrolimus level, although she does not     demonstrate symptoms of toxicity.  We will check levels obviously.  The     patient may also have some soft hemodynamics, acute tubular necrosis.  We have     seen COVID related renal impairment many times.  Once again, I think this is     volume contraction in the setting of a complex drug regimen.  We will hydrate     and monitor. 2. COVID-19 infection.  Main manifestations at this time would include cough,     fever, and diarrhea.  We will continue to monitor intake and output, hydrate     as described.  The patient has about 10 days out, so not really a candidate     for Paxlovid or monoclonal antibody therapy. 3. Diabetes mellitus.  Continues on a sliding scale insulin regimen. 4. Hypertension, well controlled on current medical regimen. 5. Distant seizure disorder, stable on current medical regimen.  Other problems     not as active.
Age: 58.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: COVID-19, Chronic kidney disease, Cough, Decreased appetite, Diabetes mellitus
Clinical narrative: She went shopping with an unvaccinated friend who also got sick around the same time as her, but otherwise has no clear exposure history.  Since her illness started she reports labile blood sugars, generalized weakness, orthostasis and very poor appetite in addition to above symptoms.  She's felt too unwell to take her medications for about two days last week but has otherwise taking her tacrolimus, mycophenolic acid, and prednisone 5mg daily as prescribed.  She's on chronic suppressive cephalexin for recurrent UTIs.  She actually called EMS last Saturday due to not feeling well and low blood sugar, but opted not to be brought in at that time.  Admitted 06/18/2022 and currently hospitalized.MPRESSION AND PLAN: 1. Acute kidney injury on chronic kidney disease.  Currently, the patient with     renal function, which is worse than previous baseline with a creatinine of     2.3, her baseline is usually 1.8-1.9.  The patient may have hyperabsorbed the     Prograf and may have a high tacrolimus level, although she does not     demonstrate symptoms of toxicity.  We will check levels obviously.  The     patient may also have some soft hemodynamics, acute tubular necrosis.  We have     seen COVID related renal impairment many times.  Once again, I think this is     volume contraction in the setting of a complex drug regimen.  We will hydrate     and monitor. 2. COVID-19 infection.  Main manifestations at this time would include cough,     fever, and diarrhea.  We will continue to monitor intake and output, hydrate     as described.  The patient has about 10 days out, so not really a candidate     for Paxlovid or monoclonal antibody therapy. 3. Diabetes mellitus.  Continues on a sliding scale insulin regimen. 4. Hypertension, well controlled on current medical regimen. 5. Distant seizure disorder, stable on current medical regimen.  Other problems     not as active.
Age: 58.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Diarrhoea, Hypertension, Illness, Malaise, Osteoarthritis
Clinical narrative: She went shopping with an unvaccinated friend who also got sick around the same time as her, but otherwise has no clear exposure history.  Since her illness started she reports labile blood sugars, generalized weakness, orthostasis and very poor appetite in addition to above symptoms.  She's felt too unwell to take her medications for about two days last week but has otherwise taking her tacrolimus, mycophenolic acid, and prednisone 5mg daily as prescribed.  She's on chronic suppressive cephalexin for recurrent UTIs.  She actually called EMS last Saturday due to not feeling well and low blood sugar, but opted not to be brought in at that time.  Admitted 06/18/2022 and currently hospitalized.MPRESSION AND PLAN: 1. Acute kidney injury on chronic kidney disease.  Currently, the patient with     renal function, which is worse than previous baseline with a creatinine of     2.3, her baseline is usually 1.8-1.9.  The patient may have hyperabsorbed the     Prograf and may have a high tacrolimus level, although she does not     demonstrate symptoms of toxicity.  We will check levels obviously.  The     patient may also have some soft hemodynamics, acute tubular necrosis.  We have     seen COVID related renal impairment many times.  Once again, I think this is     volume contraction in the setting of a complex drug regimen.  We will hydrate     and monitor. 2. COVID-19 infection.  Main manifestations at this time would include cough,     fever, and diarrhea.  We will continue to monitor intake and output, hydrate     as described.  The patient has about 10 days out, so not really a candidate     for Paxlovid or monoclonal antibody therapy. 3. Diabetes mellitus.  Continues on a sliding scale insulin regimen. 4. Hypertension, well controlled on current medical regimen. 5. Distant seizure disorder, stable on current medical regimen.  Other problems     not as active.
Age: 58.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Pyrexia, Renal impairment, SARS-CoV-2 test positive, Seizure, Urinary tract infection
Clinical narrative: She went shopping with an unvaccinated friend who also got sick around the same time as her, but otherwise has no clear exposure history.  Since her illness started she reports labile blood sugars, generalized weakness, orthostasis and very poor appetite in addition to above symptoms.  She's felt too unwell to take her medications for about two days last week but has otherwise taking her tacrolimus, mycophenolic acid, and prednisone 5mg daily as prescribed.  She's on chronic suppressive cephalexin for recurrent UTIs.  She actually called EMS last Saturday due to not feeling well and low blood sugar, but opted not to be brought in at that time.  Admitted 06/18/2022 and currently hospitalized.MPRESSION AND PLAN: 1. Acute kidney injury on chronic kidney disease.  Currently, the patient with     renal function, which is worse than previous baseline with a creatinine of     2.3, her baseline is usually 1.8-1.9.  The patient may have hyperabsorbed the     Prograf and may have a high tacrolimus level, although she does not     demonstrate symptoms of toxicity.  We will check levels obviously.  The     patient may also have some soft hemodynamics, acute tubular necrosis.  We have     seen COVID related renal impairment many times.  Once again, I think this is     volume contraction in the setting of a complex drug regimen.  We will hydrate     and monitor. 2. COVID-19 infection.  Main manifestations at this time would include cough,     fever, and diarrhea.  We will continue to monitor intake and output, hydrate     as described.  The patient has about 10 days out, so not really a candidate     for Paxlovid or monoclonal antibody therapy. 3. Diabetes mellitus.  Continues on a sliding scale insulin regimen. 4. Hypertension, well controlled on current medical regimen. 5. Distant seizure disorder, stable on current medical regimen.  Other problems     not as active.
Age: 11.0
Sex: M
Vaccine: COVID19
Symptoms: Product preparation error
Clinical narrative: The pediatric Pfizer 5-11yo 0.2mL vaccine was administered to the patient on Saturday morning, after which he left the pharmacy premises with his brother (who got same vaccine)  and father. About 45 minutes to an hour later, it was realized that he received an undiluted dose. The parents were immediately notified. The only report of side effects came during my follow-up call at 5:30pm that same day. The father reported that one of his sons (did not specify) was feeling sleepy. The parent was told to contact the pharmacy if any concerning ADRs were to arise. As of the time of this report, we have not been contacted.
Age: 29.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered, No adverse event
Clinical narrative: She had no reactions. The vial was expired due to error of invalid expiration date on packing
Age: 72.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: hospitalized with covid; fully vaccinated
Age: 91.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: hospitalized with covid; fully vaccinated with 2 boosters
Age: 94.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Blood culture, COVID-19, Chills, Pyrexia, Rectal prolapse repair
Clinical narrative: Patient is a 95y/o female followed at Oncology by Dr. for evaluation and management of her breast cancer, now treating with Fulvestrant/ Ogivar, last received on 6/3/22.  The patient was undergoing workup for a transaortic valve repair and had CT angiography of chest, abdomen, and pelvis done at hospital on May 28, 2020. She was found, incidentally, to have an asymmetric left breast density, and enlarged left axillary lymph node, which were indeterminate for malignancy. She underwent mammogram on 6/10/2020 and was found to have a hypoechoic solid mass measuring 25 mm in the left axilla along with a focal asymmetry measuring 4.4 cm in the left breast at the 7 o'clock position. Biopsy was done on 6/11/2020 and the biopsy confirmed an infiltrating ductal carcinoma, grade II, in the primary breast mass, as well as a positive left axillary node. The tumor was ER positive at 66%, PR weakly positive at 2%, Ki­67 was 36%, and HER2 was positive at 3+.  The patient was evaluated by Dr. (breast surgeon). Because she is so close to her valve replacement and is on Plavix, it was not recommended that she undergo surgery upfront.  Diagnosed in 20 She had a rectal prolapse repair by Dr. on 5/2/22 and has recovered from that well.   She presented to clinic today with fever, chills and a septic looking picture.  Blood cultures/ UA were obtained and plans for admission made.  She was incidentally found to be COVID positive. Case discussed with Dr.  OK to go to the floor, negative pressure room  Hold antivirals at this time as we are unsure when she became positive.  Admitted to hospital on 06/17/2022, currently (6/22/22) in hospital.
Age: 94.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: SARS-CoV-2 test positive, Sepsis, Urine analysis
Clinical narrative: Patient is a 95y/o female followed at Oncology by Dr. for evaluation and management of her breast cancer, now treating with Fulvestrant/ Ogivar, last received on 6/3/22.  The patient was undergoing workup for a transaortic valve repair and had CT angiography of chest, abdomen, and pelvis done at hospital on May 28, 2020. She was found, incidentally, to have an asymmetric left breast density, and enlarged left axillary lymph node, which were indeterminate for malignancy. She underwent mammogram on 6/10/2020 and was found to have a hypoechoic solid mass measuring 25 mm in the left axilla along with a focal asymmetry measuring 4.4 cm in the left breast at the 7 o'clock position. Biopsy was done on 6/11/2020 and the biopsy confirmed an infiltrating ductal carcinoma, grade II, in the primary breast mass, as well as a positive left axillary node. The tumor was ER positive at 66%, PR weakly positive at 2%, Ki­67 was 36%, and HER2 was positive at 3+.  The patient was evaluated by Dr. (breast surgeon). Because she is so close to her valve replacement and is on Plavix, it was not recommended that she undergo surgery upfront.  Diagnosed in 20 She had a rectal prolapse repair by Dr. on 5/2/22 and has recovered from that well.   She presented to clinic today with fever, chills and a septic looking picture.  Blood cultures/ UA were obtained and plans for admission made.  She was incidentally found to be COVID positive. Case discussed with Dr.  OK to go to the floor, negative pressure room  Hold antivirals at this time as we are unsure when she became positive.  Admitted to hospital on 06/17/2022, currently (6/22/22) in hospital.
Age: 36.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered, No adverse event, Product expiration date issue, Product packaging issue
Clinical narrative: He had no reactions. The vial was expired due to error of invalid expiration date on packing
Age: 57.0
Sex: F
Vaccine: COVID19
Symptoms: Condition aggravated, Cough, Dyspnoea, Flushing, Hyperhidrosis
Clinical narrative: Since day after vaccine pt has had hives (significantly improved now), cough/sob, more easily having MCAS reactions, +flushing, +diaphoresis, steroids have been helpful
Age: 57.0
Sex: F
Vaccine: COVID19
Symptoms: Mast cell activation syndrome, Urticaria
Clinical narrative: Since day after vaccine pt has had hives (significantly improved now), cough/sob, more easily having MCAS reactions, +flushing, +diaphoresis, steroids have been helpful
Age: 40.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered, No adverse event
Clinical narrative: She had no reactions. The vial was expired due to error of invalid expiration date on packing
Age: 17.0
Sex: F
Vaccine: HEPA
Symptoms: Incorrect dose administered
Clinical narrative: PHYSICIAN ORDERED HAVRIX .5ML FOR A 17 YEAR OLD PATIENT. RN USED BARCODE SCANNER TO CHECK VACCINE AND GOT A GREEN CHECK MARK TO GO AHEAD. AFTER ADMINISTERING THE VACCINE SHE SCANNED IT AGAIN AND THIS TIME GOT AN ERROR MESSAGE. SHE REALIZED THAT THE DOCTOR ORDERED .5ML BUT SHE ADMINISTERED 1ML.
Age: 9.0
Sex: M
Vaccine: COVID19
Symptoms: Product preparation issue
Clinical narrative: The pediatric Pfizer 5-11yo 0.2mL vaccine was administered to the patient on Saturday morning, after which he left the pharmacy premises with his brother (who got same vaccine) and father. About 45 minutes to an hour later, it was realized that he received an undiluted dose. The parents were immediately notified. The only report of side effects came during my follow-up call at 5:30pm that same day. The father reported that one of his sons (did not specify) was feeling sleepy. The parent was told to contact the pharmacy if any concerns were to arise. As of the time of this report, we have not been contacted.
Age: 38.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered, No adverse event
Clinical narrative: He had no reactions. The vial was expired due to error of invalid expiration date on packing
Age: 76.0
Sex: M
Vaccine: COVID19
Symptoms: Inappropriate schedule of product administration
Clinical narrative: Patient had #3 dose on 04/28/2022 and received #4 dose on 06/15/2022, less than 4 months required between doses.
Age: 49.0
Sex: F
Vaccine: PPV
Symptoms: Guillain-Barre syndrome, Hypoaesthesia, Muscular weakness, Plasmapheresis
Clinical narrative: Patient developed guillian bare syndrome, with lower extremity weakness and numbness 15 days after vaccination. Improved after plasma exchange therapy and inpatient rehabilitation.
Age: 82.0
Sex: F
Vaccine: COVID19
Symptoms: Arrhythmia, Asymptomatic COVID-19, Death, Nausea, SARS-CoV-2 test positive
Clinical narrative: 1/19/22 pt admitted from a residential facility to a local Medical Center for periumbilical hernia with vomiting and nausea; no surgery needed per consult; pt tolerating oral intake and ready to be dc'd to a residential facility; 1/20/22 pt had a positive COVID test; asymptomatic; dc'd to another Health Care Center where she passed away of cardiac arrhythmia and COVID  19.
Age: 82.0
Sex: F
Vaccine: COVID19
Symptoms: Umbilical hernia, Vomiting
Clinical narrative: 1/19/22 pt admitted from a residential facility to a local Medical Center for periumbilical hernia with vomiting and nausea; no surgery needed per consult; pt tolerating oral intake and ready to be dc'd to a residential facility; 1/20/22 pt had a positive COVID test; asymptomatic; dc'd to another Health Care Center where she passed away of cardiac arrhythmia and COVID  19.
Age: 57.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: She had no reactions. The vial was expired due to error of invalid expiration date on packing
Age: 37.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: He had no reactions. The vial was expired due to error of invalid expiration date on packing
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Asthenia, Asymptomatic COVID-19, Blood creatinine normal, Blood electrolytes normal, Cardiac failure
Clinical narrative: Discharge Physician: MD Primary Care Clinician at Discharge:  Admission Date: 6/9/2022 Discharge Date: 6/11/2022  PRESENTING PROBLEM: Orthostatic hypotension Generalized weakness COVID-19 virus infection   HOSPITAL COURSE: 69-year-old woman with chronic systolic heart failure (EF 23%), ischemic cardiomyopathy, coronary artery disease with ICD, mitral regurgitation (severe) and CKD stage 4 presented to the hospital with generalized weakness.  She is found to be orthostatic we positive and was given judicious fluid boluses in the emergency department given her heart failure.  She remained orthostatic and symptomatic and thus was admitted to the medical service.  COVID-19 testing was positive though she was asymptomatic and without hypoxemia on ambient air.  Review of medical records revealed that she was on hydrochlorothiazide/spironolactone/torsemide as well as lisinopril as prescribed by a Heart Clinic.  These medications were held and the patient was provided very judicious IV fluid hydration overnight.  Cardiac monitoring revealed no acute malignant arrhythmias.  Electrolytes were within normal limits and creatinine was at baseline.  Her symptoms did resolve.  Measured orthostatic vital signs did reveal resolution of orthostatic hypotension.  She was discharged on 06/11/2022.  She was instructed to hold hydrochlorothiazide until her next visit with a Heart Clinic.  She was discharged in good condition.
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Cardiac monitoring normal, Orthostatic hypotension, SARS-CoV-2 test positive
Clinical narrative: Discharge Physician: MD Primary Care Clinician at Discharge:  Admission Date: 6/9/2022 Discharge Date: 6/11/2022  PRESENTING PROBLEM: Orthostatic hypotension Generalized weakness COVID-19 virus infection   HOSPITAL COURSE: 69-year-old woman with chronic systolic heart failure (EF 23%), ischemic cardiomyopathy, coronary artery disease with ICD, mitral regurgitation (severe) and CKD stage 4 presented to the hospital with generalized weakness.  She is found to be orthostatic we positive and was given judicious fluid boluses in the emergency department given her heart failure.  She remained orthostatic and symptomatic and thus was admitted to the medical service.  COVID-19 testing was positive though she was asymptomatic and without hypoxemia on ambient air.  Review of medical records revealed that she was on hydrochlorothiazide/spironolactone/torsemide as well as lisinopril as prescribed by a Heart Clinic.  These medications were held and the patient was provided very judicious IV fluid hydration overnight.  Cardiac monitoring revealed no acute malignant arrhythmias.  Electrolytes were within normal limits and creatinine was at baseline.  Her symptoms did resolve.  Measured orthostatic vital signs did reveal resolution of orthostatic hypotension.  She was discharged on 06/11/2022.  She was instructed to hold hydrochlorothiazide until her next visit with a Heart Clinic.  She was discharged in good condition.
Age: 48.0
Sex: F
Vaccine: COVID19
Symptoms: Arrhythmia, Blood pressure increased, Dizziness, Dyspnoea, Feeding disorder
Clinical narrative: 45 minutes after getting vaccine, starting sweating with increased BP and heart rate, very light headed and body aches all over body.  Unable to take 20 step without having difficulty breathing or feeling very dizzy.  Nausea unable to eat, blurry vision
Age: 48.0
Sex: F
Vaccine: COVID19
Symptoms: Gait disturbance, Hyperhidrosis, Nausea, Pain, Tachycardia
Clinical narrative: 45 minutes after getting vaccine, starting sweating with increased BP and heart rate, very light headed and body aches all over body.  Unable to take 20 step without having difficulty breathing or feeling very dizzy.  Nausea unable to eat, blurry vision
Age: 48.0
Sex: F
Vaccine: COVID19
Symptoms: Vision blurred
Clinical narrative: 45 minutes after getting vaccine, starting sweating with increased BP and heart rate, very light headed and body aches all over body.  Unable to take 20 step without having difficulty breathing or feeling very dizzy.  Nausea unable to eat, blurry vision
Age: 61.0
Sex: F
Vaccine: VARZOS
Symptoms: Adverse event, Burning sensation, Lymphadenopathy, Pain
Clinical narrative: Patient called to report adverse event after receiving first dose Shingrix vaccine on 6/17/22. Patient complaining of swelling of lymph nodes under Right arm (same arm where vaccine was administered) starting 6/18/22.  She stated it became swollen and also has a burning feeling under the arm.  She has used Tylenol for pain relief.
Age: 63.0
Sex: M
Vaccine: COVID19
Symptoms: Acute kidney injury, COVID-19, Cardiac failure acute, Cardiac failure congestive, Chest X-ray abnormal
Clinical narrative: Discharge Provider: MD Primary Care Provider: MD Admission Date: 6/11/2022 Discharge Date: Jun 14, 2022  PRESENTING PROBLEM: Acute on chronic heart failure, unspecified heart failure type (HCC) [I50.9] Systolic congestive heart failure, unspecified HF chronicity (HCC) [I50.20] COVID-19 [U07.1]   HOSPITAL COURSE: 64 y.o. male with a history of of NICM s/p ICD, HFrEF, sardoidosis of heart and lung who presented with shortness of breath. He had exposure to a family friend who tested positive for COVID. HE then developed dyspnea on exertion of less than 15 feet. Admits not adhering to recommended 2 gram and 2L diet and had gained about 3 pounds in the past day. On arrival he had normal and stable vitals, mild AKI with hyperkalemia, proBNP >10,000 and CXR concerning for fluid overload. One dose of IV lasix improved his symptoms, and COVID testing was positive. He was admitted to internal medicine team for further evaluation treatment.  Entresto was held due to AKI. Cardiology was consulted on admission.   AKI improved with diuretic holiday and his shortness of breath resolved by day 2 admission.  He never developed hypoxia.  He was able to ambulate for more than 50 ft without assistance without developing any dyspnea or hypoxia.  Echocardiogram was updated which showed global hypokinesis and ejection fraction of 11%.   On 06/14/2022 he was discharged in stable condition with instruction to follow up with Cardiology on June 22. Torsemide was held on discharge, as well as Entresto.
Age: 63.0
Sex: M
Vaccine: COVID19
Symptoms: Diuretic therapy, Dyspnoea, Dyspnoea exertional, Echocardiogram abnormal, Ejection fraction
Clinical narrative: Discharge Provider: MD Primary Care Provider: MD Admission Date: 6/11/2022 Discharge Date: Jun 14, 2022  PRESENTING PROBLEM: Acute on chronic heart failure, unspecified heart failure type (HCC) [I50.9] Systolic congestive heart failure, unspecified HF chronicity (HCC) [I50.20] COVID-19 [U07.1]   HOSPITAL COURSE: 64 y.o. male with a history of of NICM s/p ICD, HFrEF, sardoidosis of heart and lung who presented with shortness of breath. He had exposure to a family friend who tested positive for COVID. HE then developed dyspnea on exertion of less than 15 feet. Admits not adhering to recommended 2 gram and 2L diet and had gained about 3 pounds in the past day. On arrival he had normal and stable vitals, mild AKI with hyperkalemia, proBNP >10,000 and CXR concerning for fluid overload. One dose of IV lasix improved his symptoms, and COVID testing was positive. He was admitted to internal medicine team for further evaluation treatment.  Entresto was held due to AKI. Cardiology was consulted on admission.   AKI improved with diuretic holiday and his shortness of breath resolved by day 2 admission.  He never developed hypoxia.  He was able to ambulate for more than 50 ft without assistance without developing any dyspnea or hypoxia.  Echocardiogram was updated which showed global hypokinesis and ejection fraction of 11%.   On 06/14/2022 he was discharged in stable condition with instruction to follow up with Cardiology on June 22. Torsemide was held on discharge, as well as Entresto.
Age: 63.0
Sex: M
Vaccine: COVID19
Symptoms: Exposure to SARS-CoV-2, Hyperkalaemia, Hypokinesia, Left ventricular failure, Prohormone brain natriuretic peptide increased
Clinical narrative: Discharge Provider: MD Primary Care Provider: MD Admission Date: 6/11/2022 Discharge Date: Jun 14, 2022  PRESENTING PROBLEM: Acute on chronic heart failure, unspecified heart failure type (HCC) [I50.9] Systolic congestive heart failure, unspecified HF chronicity (HCC) [I50.20] COVID-19 [U07.1]   HOSPITAL COURSE: 64 y.o. male with a history of of NICM s/p ICD, HFrEF, sardoidosis of heart and lung who presented with shortness of breath. He had exposure to a family friend who tested positive for COVID. HE then developed dyspnea on exertion of less than 15 feet. Admits not adhering to recommended 2 gram and 2L diet and had gained about 3 pounds in the past day. On arrival he had normal and stable vitals, mild AKI with hyperkalemia, proBNP >10,000 and CXR concerning for fluid overload. One dose of IV lasix improved his symptoms, and COVID testing was positive. He was admitted to internal medicine team for further evaluation treatment.  Entresto was held due to AKI. Cardiology was consulted on admission.   AKI improved with diuretic holiday and his shortness of breath resolved by day 2 admission.  He never developed hypoxia.  He was able to ambulate for more than 50 ft without assistance without developing any dyspnea or hypoxia.  Echocardiogram was updated which showed global hypokinesis and ejection fraction of 11%.   On 06/14/2022 he was discharged in stable condition with instruction to follow up with Cardiology on June 22. Torsemide was held on discharge, as well as Entresto.
Age: 63.0
Sex: M
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive, Weight increased
Clinical narrative: Discharge Provider: MD Primary Care Provider: MD Admission Date: 6/11/2022 Discharge Date: Jun 14, 2022  PRESENTING PROBLEM: Acute on chronic heart failure, unspecified heart failure type (HCC) [I50.9] Systolic congestive heart failure, unspecified HF chronicity (HCC) [I50.20] COVID-19 [U07.1]   HOSPITAL COURSE: 64 y.o. male with a history of of NICM s/p ICD, HFrEF, sardoidosis of heart and lung who presented with shortness of breath. He had exposure to a family friend who tested positive for COVID. HE then developed dyspnea on exertion of less than 15 feet. Admits not adhering to recommended 2 gram and 2L diet and had gained about 3 pounds in the past day. On arrival he had normal and stable vitals, mild AKI with hyperkalemia, proBNP >10,000 and CXR concerning for fluid overload. One dose of IV lasix improved his symptoms, and COVID testing was positive. He was admitted to internal medicine team for further evaluation treatment.  Entresto was held due to AKI. Cardiology was consulted on admission.   AKI improved with diuretic holiday and his shortness of breath resolved by day 2 admission.  He never developed hypoxia.  He was able to ambulate for more than 50 ft without assistance without developing any dyspnea or hypoxia.  Echocardiogram was updated which showed global hypokinesis and ejection fraction of 11%.   On 06/14/2022 he was discharged in stable condition with instruction to follow up with Cardiology on June 22. Torsemide was held on discharge, as well as Entresto.