chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 24.0
Sex: M
Vaccine: HEP, HEPA
Symptoms: Face injury, Facial bones fracture, Fall, Loss of consciousness
Clinical narrative: Patient passed out and hit the floor with his face after second vaccine was given.  He was speaking with the nurse when she turned around to get a paper off the counter and she heard him fall.
Age: 1.25
Sex: M
Vaccine: MMR
Symptoms: Inappropriate schedule of product administration
Clinical narrative: The adverse event was administering MMR too soon at 15 months old. Treatment is not necessary as this is still considered "valid dose" according to CDC guidelines.
Age: 89.0
Sex: F
Vaccine: COVID19-2
Symptoms: Acute respiratory failure, Atelectasis, COVID-19, COVID-19 pneumonia, Chest X-ray abnormal
Clinical narrative: Patient is a 90 y.o. female with known history of HTN, GERD, Parkinson's who presented from assisted living on 3/24/2023 with shortness of breath that began earlier that morning. Found to have Covid with mild respiratory failure. Treated with steroids and paxlovid. Weaned to RA before discharge. Hospital course complicated by delirium - steroid induced with baseline opioid and benzo on board .        Assessment and Plan   COVID-19 pneumonia Acute respiratory failure with hypoxia - Presented with: Shortness of breath the morning of admission - Positive COVID-19: Tested positive on 3/24 at ER - Vaccination status: Vaccinated with Pfizer most recently 10/27/2022 - CXR on admission with mild atelectasis - Oxygen status: Currently on room air with normal wob - stop Decadron, s/p 5-day course of Paxlovid   Toxic metabolic encephalopathy - related to hospital stay, steroids, infection  - noted 3/28 upon waking, mild and waxing and waning, improved 3/29 and 3/30 but still not sleeping well - noted worsening on multiple occasions after benzo administration  - stop steroids, stop IVF , safe for d/c today, d/c home ativan I discussed with daughter via telephone and recommended we explore other  medications with pcp. From my perspective she should not be on tramadol + ativan at 90 years old with fall risk , memory risk , and confusion. They will discuss with dr.    Hyponatremia - suspect related to poor intake / illness - remains slightly low but stable, stop fluids,  follow up pcp   Anxiety and depression - on Prozac, Remeron - continued, Ativan prn at home discontinued , likely needs additional agent (atarax and benzo not good options)   Parkinson's disease - known chronic issue - continue home Sinemet  Essential hypertension - high in the hospital, she is convinced I added coreg / she doesn't take at home, she states its making her feel "crummy" - pharmacist confirms she fills at home but we decided to reduce to 3.125 to see if her sx improve , follow up with pcp   History of multinodular goiter - known issue  - continue home methimazole   Chronic constipation -Continue home miralax once daily   Chronic back pain, scoliosis - Continue home
Age: 89.0
Sex: F
Vaccine: COVID19-2
Symptoms: Confusional state, Delirium, Dyspnoea, Hyponatraemia, Hypophagia
Clinical narrative: Patient is a 90 y.o. female with known history of HTN, GERD, Parkinson's who presented from assisted living on 3/24/2023 with shortness of breath that began earlier that morning. Found to have Covid with mild respiratory failure. Treated with steroids and paxlovid. Weaned to RA before discharge. Hospital course complicated by delirium - steroid induced with baseline opioid and benzo on board .        Assessment and Plan   COVID-19 pneumonia Acute respiratory failure with hypoxia - Presented with: Shortness of breath the morning of admission - Positive COVID-19: Tested positive on 3/24 at ER - Vaccination status: Vaccinated with Pfizer most recently 10/27/2022 - CXR on admission with mild atelectasis - Oxygen status: Currently on room air with normal wob - stop Decadron, s/p 5-day course of Paxlovid   Toxic metabolic encephalopathy - related to hospital stay, steroids, infection  - noted 3/28 upon waking, mild and waxing and waning, improved 3/29 and 3/30 but still not sleeping well - noted worsening on multiple occasions after benzo administration  - stop steroids, stop IVF , safe for d/c today, d/c home ativan I discussed with daughter via telephone and recommended we explore other  medications with pcp. From my perspective she should not be on tramadol + ativan at 90 years old with fall risk , memory risk , and confusion. They will discuss with dr.    Hyponatremia - suspect related to poor intake / illness - remains slightly low but stable, stop fluids,  follow up pcp   Anxiety and depression - on Prozac, Remeron - continued, Ativan prn at home discontinued , likely needs additional agent (atarax and benzo not good options)   Parkinson's disease - known chronic issue - continue home Sinemet  Essential hypertension - high in the hospital, she is convinced I added coreg / she doesn't take at home, she states its making her feel "crummy" - pharmacist confirms she fills at home but we decided to reduce to 3.125 to see if her sx improve , follow up with pcp   History of multinodular goiter - known issue  - continue home methimazole   Chronic constipation -Continue home miralax once daily   Chronic back pain, scoliosis - Continue home
Age: 89.0
Sex: F
Vaccine: COVID19-2
Symptoms: Illness, Metabolic encephalopathy, Poor quality sleep, Respiratory failure, SARS-CoV-2 test positive
Clinical narrative: Patient is a 90 y.o. female with known history of HTN, GERD, Parkinson's who presented from assisted living on 3/24/2023 with shortness of breath that began earlier that morning. Found to have Covid with mild respiratory failure. Treated with steroids and paxlovid. Weaned to RA before discharge. Hospital course complicated by delirium - steroid induced with baseline opioid and benzo on board .        Assessment and Plan   COVID-19 pneumonia Acute respiratory failure with hypoxia - Presented with: Shortness of breath the morning of admission - Positive COVID-19: Tested positive on 3/24 at ER - Vaccination status: Vaccinated with Pfizer most recently 10/27/2022 - CXR on admission with mild atelectasis - Oxygen status: Currently on room air with normal wob - stop Decadron, s/p 5-day course of Paxlovid   Toxic metabolic encephalopathy - related to hospital stay, steroids, infection  - noted 3/28 upon waking, mild and waxing and waning, improved 3/29 and 3/30 but still not sleeping well - noted worsening on multiple occasions after benzo administration  - stop steroids, stop IVF , safe for d/c today, d/c home ativan I discussed with daughter via telephone and recommended we explore other  medications with pcp. From my perspective she should not be on tramadol + ativan at 90 years old with fall risk , memory risk , and confusion. They will discuss with dr.    Hyponatremia - suspect related to poor intake / illness - remains slightly low but stable, stop fluids,  follow up pcp   Anxiety and depression - on Prozac, Remeron - continued, Ativan prn at home discontinued , likely needs additional agent (atarax and benzo not good options)   Parkinson's disease - known chronic issue - continue home Sinemet  Essential hypertension - high in the hospital, she is convinced I added coreg / she doesn't take at home, she states its making her feel "crummy" - pharmacist confirms she fills at home but we decided to reduce to 3.125 to see if her sx improve , follow up with pcp   History of multinodular goiter - known issue  - continue home methimazole   Chronic constipation -Continue home miralax once daily   Chronic back pain, scoliosis - Continue home
Age: 79.0
Sex: F
Vaccine: COVID19-2
Symptoms: Abdominal pain, Anticoagulant therapy, Asthma, Atrial fibrillation, CHA2DS2-VASc annual stroke risk high
Clinical narrative: Patient is a 80 y.o. female patient of, MD with a history of    Discharge Diagnoses:   1. COVID pneumonia              - vaccinated and finished antiviral (recommended by econsult to ID)              - finished paxlovid  2. Asthma exacerbation 3. Symptomatic bradycardia       Coumadin due to high CHADS2 score            4.Anemia of chronic disease   5. Hypothyroidism   6. Hx of ileus and gastritis   7. Hx of thoracic aortic aneurysm   8. Deaf status             - Used Martti for ASL and writing    9. Strep pneumo + urine 1. Continue Rocephin (day 5) 10. Abdominal pain  11. Shoulder pain              - xray with moderate AC joint OA  12. Back pain              - osteoporosis with moderate T4 compression fracture; chronic      Patient was admitted through the emergency department with a cough and a chest x-ray concerning with perihilar bronchitis versus a multifocal pneumonia and effusion.  Did appear somewhat similar to her previous chest x-ray in January.  Patient was not requiring any oxygen.  She was found to be COVID-positive.  E consult was placed I discussed with the infectious disease who states patient would qualify for Paxlovid.  Patient is agreeable to taking this.  She should hold her simvastatin as well as risperidone while taking this.  Patient is currently on room air.  She feels comfortable with discharge to home.  Was initiated on Rocephin- completed course.  Due to her significant asthma history and significant wheezing yesterday we will also place on steroids to help with asthmatic flare. Episode of a.fib with RVR and elevated CHADS2 score; cardiology recommended initiation of Coumadin therapy.  Patient will be started on 5 mg of Coumadin daily.  Is to have a recheck of her INR in 2 to 3 days.  Outpatient follow-up with primary care.   While hospitalized patient did develop abdominal pain.  Due to his CT scan was concerning for potential partial small bowel obstruction.  Patient was evaluated by general surgery and had a repeat KUB today that did not show any evidence of obstruction.  Patient was able to have bowel movement today.  Endorses no abdominal pain and feels comfortable being discharged home.  Outpatient follow-up with primary care.
Age: 79.0
Sex: F
Vaccine: COVID19-2
Symptoms: COVID-19, Chest X-ray abnormal, Computerised tomogram abdomen abnormal, Condition aggravated, Cough
Clinical narrative: Patient is a 80 y.o. female patient of, MD with a history of    Discharge Diagnoses:   1. COVID pneumonia              - vaccinated and finished antiviral (recommended by econsult to ID)              - finished paxlovid  2. Asthma exacerbation 3. Symptomatic bradycardia       Coumadin due to high CHADS2 score            4.Anemia of chronic disease   5. Hypothyroidism   6. Hx of ileus and gastritis   7. Hx of thoracic aortic aneurysm   8. Deaf status             - Used Martti for ASL and writing    9. Strep pneumo + urine 1. Continue Rocephin (day 5) 10. Abdominal pain  11. Shoulder pain              - xray with moderate AC joint OA  12. Back pain              - osteoporosis with moderate T4 compression fracture; chronic      Patient was admitted through the emergency department with a cough and a chest x-ray concerning with perihilar bronchitis versus a multifocal pneumonia and effusion.  Did appear somewhat similar to her previous chest x-ray in January.  Patient was not requiring any oxygen.  She was found to be COVID-positive.  E consult was placed I discussed with the infectious disease who states patient would qualify for Paxlovid.  Patient is agreeable to taking this.  She should hold her simvastatin as well as risperidone while taking this.  Patient is currently on room air.  She feels comfortable with discharge to home.  Was initiated on Rocephin- completed course.  Due to her significant asthma history and significant wheezing yesterday we will also place on steroids to help with asthmatic flare. Episode of a.fib with RVR and elevated CHADS2 score; cardiology recommended initiation of Coumadin therapy.  Patient will be started on 5 mg of Coumadin daily.  Is to have a recheck of her INR in 2 to 3 days.  Outpatient follow-up with primary care.   While hospitalized patient did develop abdominal pain.  Due to his CT scan was concerning for potential partial small bowel obstruction.  Patient was evaluated by general surgery and had a repeat KUB today that did not show any evidence of obstruction.  Patient was able to have bowel movement today.  Endorses no abdominal pain and feels comfortable being discharged home.  Outpatient follow-up with primary care.
Age: 79.0
Sex: F
Vaccine: COVID19-2
Symptoms: International normalised ratio, SARS-CoV-2 test positive, Urinary system X-ray, Wheezing
Clinical narrative: Patient is a 80 y.o. female patient of, MD with a history of    Discharge Diagnoses:   1. COVID pneumonia              - vaccinated and finished antiviral (recommended by econsult to ID)              - finished paxlovid  2. Asthma exacerbation 3. Symptomatic bradycardia       Coumadin due to high CHADS2 score            4.Anemia of chronic disease   5. Hypothyroidism   6. Hx of ileus and gastritis   7. Hx of thoracic aortic aneurysm   8. Deaf status             - Used Martti for ASL and writing    9. Strep pneumo + urine 1. Continue Rocephin (day 5) 10. Abdominal pain  11. Shoulder pain              - xray with moderate AC joint OA  12. Back pain              - osteoporosis with moderate T4 compression fracture; chronic      Patient was admitted through the emergency department with a cough and a chest x-ray concerning with perihilar bronchitis versus a multifocal pneumonia and effusion.  Did appear somewhat similar to her previous chest x-ray in January.  Patient was not requiring any oxygen.  She was found to be COVID-positive.  E consult was placed I discussed with the infectious disease who states patient would qualify for Paxlovid.  Patient is agreeable to taking this.  She should hold her simvastatin as well as risperidone while taking this.  Patient is currently on room air.  She feels comfortable with discharge to home.  Was initiated on Rocephin- completed course.  Due to her significant asthma history and significant wheezing yesterday we will also place on steroids to help with asthmatic flare. Episode of a.fib with RVR and elevated CHADS2 score; cardiology recommended initiation of Coumadin therapy.  Patient will be started on 5 mg of Coumadin daily.  Is to have a recheck of her INR in 2 to 3 days.  Outpatient follow-up with primary care.   While hospitalized patient did develop abdominal pain.  Due to his CT scan was concerning for potential partial small bowel obstruction.  Patient was evaluated by general surgery and had a repeat KUB today that did not show any evidence of obstruction.  Patient was able to have bowel movement today.  Endorses no abdominal pain and feels comfortable being discharged home.  Outpatient follow-up with primary care.
Age: 75.0
Sex: F
Vaccine: COVID19
Symptoms: Acute respiratory failure, Asthenia, COVID-19, COVID-19 pneumonia, Cough
Clinical narrative: Patient is a 76 y.o. female patient of MD with history of vertigo, sleep apnea, hyperlipidemia, obesity, hypertension, depression, GERD presented to Hospital with chief complaint of headache and weakness   Acute on chronic respiratory failure with hypoxia  Covid-19 PNA Date of onset of symptoms: 3/21/23 Symptoms present on admission: Fever, shortness of breath, fatigue, cough Date of covid positive test: 3/23/2023 Oxygen requirements on admission: 3 L Current oxygen requirements: RA Medical therapy: remdesivir, steroids, Anticipated special isolation end date: 4/1  Home oxygen eval was done on discharge. Patient did not qualify for one    Ecoli UTI Macrobid for 3 days     Essential hypertension Continue amlodipine   Tobacco abuse 62-pack-year history Advised cessation   Obesity  BMI 31   OSA cpap
Age: 75.0
Sex: F
Vaccine: COVID19
Symptoms: Dyspnoea, Fatigue, Headache, Pyrexia, Respiratory failure
Clinical narrative: Patient is a 76 y.o. female patient of MD with history of vertigo, sleep apnea, hyperlipidemia, obesity, hypertension, depression, GERD presented to Hospital with chief complaint of headache and weakness   Acute on chronic respiratory failure with hypoxia  Covid-19 PNA Date of onset of symptoms: 3/21/23 Symptoms present on admission: Fever, shortness of breath, fatigue, cough Date of covid positive test: 3/23/2023 Oxygen requirements on admission: 3 L Current oxygen requirements: RA Medical therapy: remdesivir, steroids, Anticipated special isolation end date: 4/1  Home oxygen eval was done on discharge. Patient did not qualify for one    Ecoli UTI Macrobid for 3 days     Essential hypertension Continue amlodipine   Tobacco abuse 62-pack-year history Advised cessation   Obesity  BMI 31   OSA cpap
Age: 75.0
Sex: F
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive
Clinical narrative: Patient is a 76 y.o. female patient of MD with history of vertigo, sleep apnea, hyperlipidemia, obesity, hypertension, depression, GERD presented to Hospital with chief complaint of headache and weakness   Acute on chronic respiratory failure with hypoxia  Covid-19 PNA Date of onset of symptoms: 3/21/23 Symptoms present on admission: Fever, shortness of breath, fatigue, cough Date of covid positive test: 3/23/2023 Oxygen requirements on admission: 3 L Current oxygen requirements: RA Medical therapy: remdesivir, steroids, Anticipated special isolation end date: 4/1  Home oxygen eval was done on discharge. Patient did not qualify for one    Ecoli UTI Macrobid for 3 days     Essential hypertension Continue amlodipine   Tobacco abuse 62-pack-year history Advised cessation   Obesity  BMI 31   OSA cpap
Age: 67.0
Sex: M
Vaccine: COVID19
Symptoms: Acute kidney injury, Acute respiratory failure, Anaemia, Angiogram pulmonary abnormal, Bladder outlet obstruction
Clinical narrative: Patient is a 68 y.o. male patient of Physician No with history of CLL, COPD and tobacco abuse who presented to the ED on 3/16 who presented with shortness of breath and malaise for the past week.  On arrival to the hospital, patient was hypoxic at 82% requiring 6 L nasal cannula.  Other vital signs include temperature 100.1, heart rate 113 and respiratory rate of 22.  Lab work was significant for sodium of 130, potassium 3.2, creatinine 2.33, CRP 110, BNP 1400, lactic acid 2.3, white blood cell count of 30, hemoglobin 11.2, platelets 50 and positive COVID test.  CTA of the chest was performed and negative for pulmonary embolism.  Also showed prominent patchy areas of groundglass and alveolar opacities in the lower lobes bilaterally.  Background changes of COPD are also present.  Patient was admitted to the hospital for hypoxia and suspected COVID/bacterial pneumonia. He received judicious fluids in the setting of COVID with progressive improvement in his renal function to baseline. Oncology was consulted and hydroxyurea continued during his stay. Broad spectrum abx started on admission with reduction to ceftriaxone due to neg mrsa swab and positive strep antigen. Also, sputum came back positive for H. Influ which was also sensitive to rocephin.  Oxygen require was de-escalated to 2L NC but could not be titrated further. Ultimately, he was hemodynamically stable and discharged home on 2L NC on 3/10. Six minute walk test was performed demonstrating need for home oxygen due to COPD and COVID pneumonia. A script for Omnicef was sent to his pharmacy to complete a 10 day treatment. A script for decadron 6 mg daily for 5 days and albuterol was also sent to his pharmacy. He was instructed to wear his oxygen until re-evaluation by a PCP for which info was provided to establish.    Discharge diagnosis   Sepsis (tachypnea, tachycardia and pna) Acute hypoxic respiratory failure COVID Pneumonia H. Influenza Pneumonia Acute COPD exacerbation Concern for Pulm HTN, on CTA Acute Kidney Injury, resolved Chronic Bladder Outlet Obstruction, per note Hypokalemia Hyponatremia Elevated Lactic Acid MPD Anemia and thrombocytopenia, due to above Chronic Splenomegaly Hx of Gout Severe Protein Calorie Malnutrition
Age: 67.0
Sex: M
Vaccine: COVID19
Symptoms: Blood creatinine decreased, Blood lactic acid increased, Blood potassium decreased, Blood sodium decreased, Brain natriuretic peptide increased
Clinical narrative: Patient is a 68 y.o. male patient of Physician No with history of CLL, COPD and tobacco abuse who presented to the ED on 3/16 who presented with shortness of breath and malaise for the past week.  On arrival to the hospital, patient was hypoxic at 82% requiring 6 L nasal cannula.  Other vital signs include temperature 100.1, heart rate 113 and respiratory rate of 22.  Lab work was significant for sodium of 130, potassium 3.2, creatinine 2.33, CRP 110, BNP 1400, lactic acid 2.3, white blood cell count of 30, hemoglobin 11.2, platelets 50 and positive COVID test.  CTA of the chest was performed and negative for pulmonary embolism.  Also showed prominent patchy areas of groundglass and alveolar opacities in the lower lobes bilaterally.  Background changes of COPD are also present.  Patient was admitted to the hospital for hypoxia and suspected COVID/bacterial pneumonia. He received judicious fluids in the setting of COVID with progressive improvement in his renal function to baseline. Oncology was consulted and hydroxyurea continued during his stay. Broad spectrum abx started on admission with reduction to ceftriaxone due to neg mrsa swab and positive strep antigen. Also, sputum came back positive for H. Influ which was also sensitive to rocephin.  Oxygen require was de-escalated to 2L NC but could not be titrated further. Ultimately, he was hemodynamically stable and discharged home on 2L NC on 3/10. Six minute walk test was performed demonstrating need for home oxygen due to COPD and COVID pneumonia. A script for Omnicef was sent to his pharmacy to complete a 10 day treatment. A script for decadron 6 mg daily for 5 days and albuterol was also sent to his pharmacy. He was instructed to wear his oxygen until re-evaluation by a PCP for which info was provided to establish.    Discharge diagnosis   Sepsis (tachypnea, tachycardia and pna) Acute hypoxic respiratory failure COVID Pneumonia H. Influenza Pneumonia Acute COPD exacerbation Concern for Pulm HTN, on CTA Acute Kidney Injury, resolved Chronic Bladder Outlet Obstruction, per note Hypokalemia Hyponatremia Elevated Lactic Acid MPD Anemia and thrombocytopenia, due to above Chronic Splenomegaly Hx of Gout Severe Protein Calorie Malnutrition
Age: 67.0
Sex: M
Vaccine: COVID19
Symptoms: C-reactive protein increased, COVID-19, COVID-19 pneumonia, Cardiopulmonary exercise test abnormal, Chronic obstructive pulmonary disease
Clinical narrative: Patient is a 68 y.o. male patient of Physician No with history of CLL, COPD and tobacco abuse who presented to the ED on 3/16 who presented with shortness of breath and malaise for the past week.  On arrival to the hospital, patient was hypoxic at 82% requiring 6 L nasal cannula.  Other vital signs include temperature 100.1, heart rate 113 and respiratory rate of 22.  Lab work was significant for sodium of 130, potassium 3.2, creatinine 2.33, CRP 110, BNP 1400, lactic acid 2.3, white blood cell count of 30, hemoglobin 11.2, platelets 50 and positive COVID test.  CTA of the chest was performed and negative for pulmonary embolism.  Also showed prominent patchy areas of groundglass and alveolar opacities in the lower lobes bilaterally.  Background changes of COPD are also present.  Patient was admitted to the hospital for hypoxia and suspected COVID/bacterial pneumonia. He received judicious fluids in the setting of COVID with progressive improvement in his renal function to baseline. Oncology was consulted and hydroxyurea continued during his stay. Broad spectrum abx started on admission with reduction to ceftriaxone due to neg mrsa swab and positive strep antigen. Also, sputum came back positive for H. Influ which was also sensitive to rocephin.  Oxygen require was de-escalated to 2L NC but could not be titrated further. Ultimately, he was hemodynamically stable and discharged home on 2L NC on 3/10. Six minute walk test was performed demonstrating need for home oxygen due to COPD and COVID pneumonia. A script for Omnicef was sent to his pharmacy to complete a 10 day treatment. A script for decadron 6 mg daily for 5 days and albuterol was also sent to his pharmacy. He was instructed to wear his oxygen until re-evaluation by a PCP for which info was provided to establish.    Discharge diagnosis   Sepsis (tachypnea, tachycardia and pna) Acute hypoxic respiratory failure COVID Pneumonia H. Influenza Pneumonia Acute COPD exacerbation Concern for Pulm HTN, on CTA Acute Kidney Injury, resolved Chronic Bladder Outlet Obstruction, per note Hypokalemia Hyponatremia Elevated Lactic Acid MPD Anemia and thrombocytopenia, due to above Chronic Splenomegaly Hx of Gout Severe Protein Calorie Malnutrition
Age: 67.0
Sex: M
Vaccine: COVID19
Symptoms: Condition aggravated, Haemoglobin decreased, Haemophilus infection, Haemophilus test positive, Hypokalaemia
Clinical narrative: Patient is a 68 y.o. male patient of Physician No with history of CLL, COPD and tobacco abuse who presented to the ED on 3/16 who presented with shortness of breath and malaise for the past week.  On arrival to the hospital, patient was hypoxic at 82% requiring 6 L nasal cannula.  Other vital signs include temperature 100.1, heart rate 113 and respiratory rate of 22.  Lab work was significant for sodium of 130, potassium 3.2, creatinine 2.33, CRP 110, BNP 1400, lactic acid 2.3, white blood cell count of 30, hemoglobin 11.2, platelets 50 and positive COVID test.  CTA of the chest was performed and negative for pulmonary embolism.  Also showed prominent patchy areas of groundglass and alveolar opacities in the lower lobes bilaterally.  Background changes of COPD are also present.  Patient was admitted to the hospital for hypoxia and suspected COVID/bacterial pneumonia. He received judicious fluids in the setting of COVID with progressive improvement in his renal function to baseline. Oncology was consulted and hydroxyurea continued during his stay. Broad spectrum abx started on admission with reduction to ceftriaxone due to neg mrsa swab and positive strep antigen. Also, sputum came back positive for H. Influ which was also sensitive to rocephin.  Oxygen require was de-escalated to 2L NC but could not be titrated further. Ultimately, he was hemodynamically stable and discharged home on 2L NC on 3/10. Six minute walk test was performed demonstrating need for home oxygen due to COPD and COVID pneumonia. A script for Omnicef was sent to his pharmacy to complete a 10 day treatment. A script for decadron 6 mg daily for 5 days and albuterol was also sent to his pharmacy. He was instructed to wear his oxygen until re-evaluation by a PCP for which info was provided to establish.    Discharge diagnosis   Sepsis (tachypnea, tachycardia and pna) Acute hypoxic respiratory failure COVID Pneumonia H. Influenza Pneumonia Acute COPD exacerbation Concern for Pulm HTN, on CTA Acute Kidney Injury, resolved Chronic Bladder Outlet Obstruction, per note Hypokalemia Hyponatremia Elevated Lactic Acid MPD Anemia and thrombocytopenia, due to above Chronic Splenomegaly Hx of Gout Severe Protein Calorie Malnutrition
Age: 67.0
Sex: M
Vaccine: COVID19
Symptoms: Hyponatraemia, Lung opacity, Myeloproliferative neoplasm, Platelet count decreased, Pneumonia
Clinical narrative: Patient is a 68 y.o. male patient of Physician No with history of CLL, COPD and tobacco abuse who presented to the ED on 3/16 who presented with shortness of breath and malaise for the past week.  On arrival to the hospital, patient was hypoxic at 82% requiring 6 L nasal cannula.  Other vital signs include temperature 100.1, heart rate 113 and respiratory rate of 22.  Lab work was significant for sodium of 130, potassium 3.2, creatinine 2.33, CRP 110, BNP 1400, lactic acid 2.3, white blood cell count of 30, hemoglobin 11.2, platelets 50 and positive COVID test.  CTA of the chest was performed and negative for pulmonary embolism.  Also showed prominent patchy areas of groundglass and alveolar opacities in the lower lobes bilaterally.  Background changes of COPD are also present.  Patient was admitted to the hospital for hypoxia and suspected COVID/bacterial pneumonia. He received judicious fluids in the setting of COVID with progressive improvement in his renal function to baseline. Oncology was consulted and hydroxyurea continued during his stay. Broad spectrum abx started on admission with reduction to ceftriaxone due to neg mrsa swab and positive strep antigen. Also, sputum came back positive for H. Influ which was also sensitive to rocephin.  Oxygen require was de-escalated to 2L NC but could not be titrated further. Ultimately, he was hemodynamically stable and discharged home on 2L NC on 3/10. Six minute walk test was performed demonstrating need for home oxygen due to COPD and COVID pneumonia. A script for Omnicef was sent to his pharmacy to complete a 10 day treatment. A script for decadron 6 mg daily for 5 days and albuterol was also sent to his pharmacy. He was instructed to wear his oxygen until re-evaluation by a PCP for which info was provided to establish.    Discharge diagnosis   Sepsis (tachypnea, tachycardia and pna) Acute hypoxic respiratory failure COVID Pneumonia H. Influenza Pneumonia Acute COPD exacerbation Concern for Pulm HTN, on CTA Acute Kidney Injury, resolved Chronic Bladder Outlet Obstruction, per note Hypokalemia Hyponatremia Elevated Lactic Acid MPD Anemia and thrombocytopenia, due to above Chronic Splenomegaly Hx of Gout Severe Protein Calorie Malnutrition
Age: 67.0
Sex: M
Vaccine: COVID19
Symptoms: Pneumonia bacterial, Renal impairment, SARS-CoV-2 test positive, Sepsis, Splenomegaly
Clinical narrative: Patient is a 68 y.o. male patient of Physician No with history of CLL, COPD and tobacco abuse who presented to the ED on 3/16 who presented with shortness of breath and malaise for the past week.  On arrival to the hospital, patient was hypoxic at 82% requiring 6 L nasal cannula.  Other vital signs include temperature 100.1, heart rate 113 and respiratory rate of 22.  Lab work was significant for sodium of 130, potassium 3.2, creatinine 2.33, CRP 110, BNP 1400, lactic acid 2.3, white blood cell count of 30, hemoglobin 11.2, platelets 50 and positive COVID test.  CTA of the chest was performed and negative for pulmonary embolism.  Also showed prominent patchy areas of groundglass and alveolar opacities in the lower lobes bilaterally.  Background changes of COPD are also present.  Patient was admitted to the hospital for hypoxia and suspected COVID/bacterial pneumonia. He received judicious fluids in the setting of COVID with progressive improvement in his renal function to baseline. Oncology was consulted and hydroxyurea continued during his stay. Broad spectrum abx started on admission with reduction to ceftriaxone due to neg mrsa swab and positive strep antigen. Also, sputum came back positive for H. Influ which was also sensitive to rocephin.  Oxygen require was de-escalated to 2L NC but could not be titrated further. Ultimately, he was hemodynamically stable and discharged home on 2L NC on 3/10. Six minute walk test was performed demonstrating need for home oxygen due to COPD and COVID pneumonia. A script for Omnicef was sent to his pharmacy to complete a 10 day treatment. A script for decadron 6 mg daily for 5 days and albuterol was also sent to his pharmacy. He was instructed to wear his oxygen until re-evaluation by a PCP for which info was provided to establish.    Discharge diagnosis   Sepsis (tachypnea, tachycardia and pna) Acute hypoxic respiratory failure COVID Pneumonia H. Influenza Pneumonia Acute COPD exacerbation Concern for Pulm HTN, on CTA Acute Kidney Injury, resolved Chronic Bladder Outlet Obstruction, per note Hypokalemia Hyponatremia Elevated Lactic Acid MPD Anemia and thrombocytopenia, due to above Chronic Splenomegaly Hx of Gout Severe Protein Calorie Malnutrition
Age: 67.0
Sex: M
Vaccine: COVID19
Symptoms: Sputum test, Staphylococcus test negative, Streptococcus test positive, Tachycardia, Tachypnoea
Clinical narrative: Patient is a 68 y.o. male patient of Physician No with history of CLL, COPD and tobacco abuse who presented to the ED on 3/16 who presented with shortness of breath and malaise for the past week.  On arrival to the hospital, patient was hypoxic at 82% requiring 6 L nasal cannula.  Other vital signs include temperature 100.1, heart rate 113 and respiratory rate of 22.  Lab work was significant for sodium of 130, potassium 3.2, creatinine 2.33, CRP 110, BNP 1400, lactic acid 2.3, white blood cell count of 30, hemoglobin 11.2, platelets 50 and positive COVID test.  CTA of the chest was performed and negative for pulmonary embolism.  Also showed prominent patchy areas of groundglass and alveolar opacities in the lower lobes bilaterally.  Background changes of COPD are also present.  Patient was admitted to the hospital for hypoxia and suspected COVID/bacterial pneumonia. He received judicious fluids in the setting of COVID with progressive improvement in his renal function to baseline. Oncology was consulted and hydroxyurea continued during his stay. Broad spectrum abx started on admission with reduction to ceftriaxone due to neg mrsa swab and positive strep antigen. Also, sputum came back positive for H. Influ which was also sensitive to rocephin.  Oxygen require was de-escalated to 2L NC but could not be titrated further. Ultimately, he was hemodynamically stable and discharged home on 2L NC on 3/10. Six minute walk test was performed demonstrating need for home oxygen due to COPD and COVID pneumonia. A script for Omnicef was sent to his pharmacy to complete a 10 day treatment. A script for decadron 6 mg daily for 5 days and albuterol was also sent to his pharmacy. He was instructed to wear his oxygen until re-evaluation by a PCP for which info was provided to establish.    Discharge diagnosis   Sepsis (tachypnea, tachycardia and pna) Acute hypoxic respiratory failure COVID Pneumonia H. Influenza Pneumonia Acute COPD exacerbation Concern for Pulm HTN, on CTA Acute Kidney Injury, resolved Chronic Bladder Outlet Obstruction, per note Hypokalemia Hyponatremia Elevated Lactic Acid MPD Anemia and thrombocytopenia, due to above Chronic Splenomegaly Hx of Gout Severe Protein Calorie Malnutrition
Age: 67.0
Sex: M
Vaccine: COVID19
Symptoms: Thrombocytopenia, White blood cell count increased
Clinical narrative: Patient is a 68 y.o. male patient of Physician No with history of CLL, COPD and tobacco abuse who presented to the ED on 3/16 who presented with shortness of breath and malaise for the past week.  On arrival to the hospital, patient was hypoxic at 82% requiring 6 L nasal cannula.  Other vital signs include temperature 100.1, heart rate 113 and respiratory rate of 22.  Lab work was significant for sodium of 130, potassium 3.2, creatinine 2.33, CRP 110, BNP 1400, lactic acid 2.3, white blood cell count of 30, hemoglobin 11.2, platelets 50 and positive COVID test.  CTA of the chest was performed and negative for pulmonary embolism.  Also showed prominent patchy areas of groundglass and alveolar opacities in the lower lobes bilaterally.  Background changes of COPD are also present.  Patient was admitted to the hospital for hypoxia and suspected COVID/bacterial pneumonia. He received judicious fluids in the setting of COVID with progressive improvement in his renal function to baseline. Oncology was consulted and hydroxyurea continued during his stay. Broad spectrum abx started on admission with reduction to ceftriaxone due to neg mrsa swab and positive strep antigen. Also, sputum came back positive for H. Influ which was also sensitive to rocephin.  Oxygen require was de-escalated to 2L NC but could not be titrated further. Ultimately, he was hemodynamically stable and discharged home on 2L NC on 3/10. Six minute walk test was performed demonstrating need for home oxygen due to COPD and COVID pneumonia. A script for Omnicef was sent to his pharmacy to complete a 10 day treatment. A script for decadron 6 mg daily for 5 days and albuterol was also sent to his pharmacy. He was instructed to wear his oxygen until re-evaluation by a PCP for which info was provided to establish.    Discharge diagnosis   Sepsis (tachypnea, tachycardia and pna) Acute hypoxic respiratory failure COVID Pneumonia H. Influenza Pneumonia Acute COPD exacerbation Concern for Pulm HTN, on CTA Acute Kidney Injury, resolved Chronic Bladder Outlet Obstruction, per note Hypokalemia Hyponatremia Elevated Lactic Acid MPD Anemia and thrombocytopenia, due to above Chronic Splenomegaly Hx of Gout Severe Protein Calorie Malnutrition
Age: 41.0
Sex: F
Vaccine: COVID19
Symptoms: Brain fog, Headache, Nervous system disorder, Psychiatric evaluation abnormal, Psychotic disorder
Clinical narrative: Neurologic impairment; brain fog, headaches, fever, severe psychotic symptoms eventual psychotic break requiring hospitalization.
Age: 41.0
Sex: F
Vaccine: COVID19
Symptoms: Psychotic symptom, Pyrexia
Clinical narrative: Neurologic impairment; brain fog, headaches, fever, severe psychotic symptoms eventual psychotic break requiring hospitalization.
Age: 0.17
Sex: M
Vaccine: DTAPHEPBIP, HIBV, PNC13, RV1
Symptoms: Pyrexia
Clinical narrative: Fever with temp 98.8-101.3. Mom denies irritability or changes in rash.  Advised Tylenol per weight dosage, tepid bath, hydration, continue to monitor symptoms and inform clinic of changes.  Notified provider per message and will f/u with mom with further recommendations.
Age: 5.0
Sex: F
Vaccine: IPV
Symptoms: Extra dose administered, No adverse event
Clinical narrative: No adverse reaction. Doing inventory count today and realized count was off. Child was given extra dose of IPV.  Spoke with parent and she not had any adverse reactions.
Age: 59.0
Sex: F
Vaccine: COVID19, COVID19, COVID19, COVID19, COVID19
Symptoms: Blood test abnormal, Cardiac stress test abnormal, Echocardiogram abnormal, Electrocardiogram abnormal, Electrocardiogram ambulatory abnormal
Clinical narrative: Severe premature ventricular contractions after dose 5 which was a bivalent Pfizer vaccine that your system would not let me select. Extensive testing including blood work, EKGs, echocardiogram, 24 hour Holter and stress testing. Treatment with combination calcium channel blockers was not successful. Adding beta blockers was not successful. Currently taking 50 mg twice daily of Toprol with some small margin of relief. Six months post vaccination premature ventricular contractions burden has been reduced by approximately 50% but is still present.
Age: 59.0
Sex: F
Vaccine: COVID19, COVID19, COVID19, COVID19, COVID19
Symptoms: Ventricular extrasystoles
Clinical narrative: Severe premature ventricular contractions after dose 5 which was a bivalent Pfizer vaccine that your system would not let me select. Extensive testing including blood work, EKGs, echocardiogram, 24 hour Holter and stress testing. Treatment with combination calcium channel blockers was not successful. Adding beta blockers was not successful. Currently taking 50 mg twice daily of Toprol with some small margin of relief. Six months post vaccination premature ventricular contractions burden has been reduced by approximately 50% but is still present.
Age: 79.0
Sex: F
Vaccine: VARZOS
Symptoms: Extra dose administered, No adverse event
Clinical narrative: NO ADVERSE EVENT WAS REPORTED, BUT THIS IS AN INVALID DOSE AS THE CUSTOMER HAD 2 DOSES IN NOVEMBER 2018
Age: 41.0
Sex: M
Vaccine: COVID19
Symptoms: Aortic aneurysm, Aortic dissection, Aortic surgery, Asthenia, Blood cholesterol normal
Clinical narrative: March 23, 2023 I suffered a near-fatal Thoracic Ascending Aneurysm due to interior surface dissection / damage to the aorta.  I required an ambulance.  This damage is present in CT scans down to the height of my kidneys.  I required emergency open-heart surgery on my Ascending Aorta.  The damaged section required it be replaced with rubber tubing, as indicated in the medical report for the surgery.  I am currently undergoing periodic monitoring for the damage done to my Lower / Descending Aorta.  It is highly expected that I will need a stent (another surgery).  Additionally, as a result of the emergency surgery, my right brachial plexus nerve was damage, as shown on an electromyogram, causing significant and likely permanent weakness in my right bicep and chest.     All blood samples indicated that I was not obese (BMI >40%), did NOT have high blood sugar, did NOT drink or use drugs, I was NOT under the effects of any prescription, did NOT have high cholesterol and, was of good physical strength and endurance.  The only thing I did medically different was take that injection because of "No Jab No Job" mandate, which should be as illegal as any male boss telling a subordinate, "No Head No Bread"!
Age: 41.0
Sex: M
Vaccine: COVID19
Symptoms: Blood glucose normal, Blood test abnormal, Cardiac operation, Computerised tomogram thorax abnormal, Electromyogram abnormal
Clinical narrative: March 23, 2023 I suffered a near-fatal Thoracic Ascending Aneurysm due to interior surface dissection / damage to the aorta.  I required an ambulance.  This damage is present in CT scans down to the height of my kidneys.  I required emergency open-heart surgery on my Ascending Aorta.  The damaged section required it be replaced with rubber tubing, as indicated in the medical report for the surgery.  I am currently undergoing periodic monitoring for the damage done to my Lower / Descending Aorta.  It is highly expected that I will need a stent (another surgery).  Additionally, as a result of the emergency surgery, my right brachial plexus nerve was damage, as shown on an electromyogram, causing significant and likely permanent weakness in my right bicep and chest.     All blood samples indicated that I was not obese (BMI >40%), did NOT have high blood sugar, did NOT drink or use drugs, I was NOT under the effects of any prescription, did NOT have high cholesterol and, was of good physical strength and endurance.  The only thing I did medically different was take that injection because of "No Jab No Job" mandate, which should be as illegal as any male boss telling a subordinate, "No Head No Bread"!
Age: 41.0
Sex: M
Vaccine: COVID19
Symptoms: Muscular weakness, Nerve injury, Obesity
Clinical narrative: March 23, 2023 I suffered a near-fatal Thoracic Ascending Aneurysm due to interior surface dissection / damage to the aorta.  I required an ambulance.  This damage is present in CT scans down to the height of my kidneys.  I required emergency open-heart surgery on my Ascending Aorta.  The damaged section required it be replaced with rubber tubing, as indicated in the medical report for the surgery.  I am currently undergoing periodic monitoring for the damage done to my Lower / Descending Aorta.  It is highly expected that I will need a stent (another surgery).  Additionally, as a result of the emergency surgery, my right brachial plexus nerve was damage, as shown on an electromyogram, causing significant and likely permanent weakness in my right bicep and chest.     All blood samples indicated that I was not obese (BMI >40%), did NOT have high blood sugar, did NOT drink or use drugs, I was NOT under the effects of any prescription, did NOT have high cholesterol and, was of good physical strength and endurance.  The only thing I did medically different was take that injection because of "No Jab No Job" mandate, which should be as illegal as any male boss telling a subordinate, "No Head No Bread"!
Age: 18.0
Sex: F
Vaccine: MNQ
Symptoms: Contusion, Fall, Head injury, Syncope
Clinical narrative: Patient experienced syncope,possibly seizure,Patient fell and bumped her head.Helped patient upright into a chair, applied ice pack to bruise on forehead.Patient was alert,answered all my questions.Observed patient for the next 30-40 minutes.Patient was driven home by her mother.
Age: 56.0
Sex: M
Vaccine: COVID19-2
Symptoms: Biopsy skin, Pityriasis rubra pilaris, Rash
Clinical narrative: Developed rash all over my body.  Eventually diagnoses as Pityriasis rubra pilaris (PRP) in Jan 2023
Age: 0.58
Sex: F
Vaccine: COVID19-2, DTPPVHBHPB, FLU4, PNC15, DTPPVHBHPB
Symptoms: Crying, Hypophagia, Incorrect product formulation administered, Injection site induration, Pyrexia
Clinical narrative: WRONG MODERNA FORMULATION GIVEN.  SHOULD HAVE BEEN 0.25 MG/ug BUT GAVE 0.2 MG/ug FORMULATION.  PATIENT HAD HISTORY OF ONE DOSE MODERNA BIVALENT GIVEN ON  5/4/23  STARTED HAVING DIFFUSE RED RASH ON BACK.  MOM STATES THAT IT APPEARS TO BE LIKE "HEAT RASH" & IS NOT RAISED OR BUMPY.  MOM DENIES RASH ANYWHERE ELSE.  SHE CRIED & WAS "INCONSOLABLE" FOR THE ENTIRE NIGHT.  THIS STARTED ABOUT 4-5 HOURS POST VACCINATION.  MOM STATES THAT THEY HAD TO TAKE SHOWERS WITH THE CHILD ALL NIGHT INTERMITTENTLY.  SHE THINKS SHE WAS FEBRILE BUT DID NOT TAKE HER TEMPERATURE.  SHE STATES THAT HER FOOD INTAKE HAS BEEN "MINIMAL" FOR 24-HOURS.  SHE STATES THAT HER URINARY OUTPUT IS "THE SAME AS USUAL... SHE'S BEEN HAVING NORMAL WET DIAPERS."   MOM STATES THE CHILD'S LEFT LEG IS HARD TO THE TOUCH BUT DOES NOT APPEAR READ OR SWOLLEN.  THE CHILD IS ALLOWING HER TO RUB ON THE SITE & SHE IS "DOING SO TO TRY & HELP SOFTEN IT".  SHE &  HER HUSBAND HAVE BEEN ADMINISTERING CHILDREN'S TYLENOL Q  HOURS SINCE YESTERDAY.  MOM DENIES THE NEED TO CALL HER PEDIATRICIAN, AS SHE FEELS THE CHILD IS IMPROVING SOME TODAY. .
Age: 0.58
Sex: F
Vaccine: COVID19-2, DTPPVHBHPB, FLU4, PNC15, DTPPVHBHPB
Symptoms: Rash, Rash erythematous, Rash macular, Underdose
Clinical narrative: WRONG MODERNA FORMULATION GIVEN.  SHOULD HAVE BEEN 0.25 MG/ug BUT GAVE 0.2 MG/ug FORMULATION.  PATIENT HAD HISTORY OF ONE DOSE MODERNA BIVALENT GIVEN ON  5/4/23  STARTED HAVING DIFFUSE RED RASH ON BACK.  MOM STATES THAT IT APPEARS TO BE LIKE "HEAT RASH" & IS NOT RAISED OR BUMPY.  MOM DENIES RASH ANYWHERE ELSE.  SHE CRIED & WAS "INCONSOLABLE" FOR THE ENTIRE NIGHT.  THIS STARTED ABOUT 4-5 HOURS POST VACCINATION.  MOM STATES THAT THEY HAD TO TAKE SHOWERS WITH THE CHILD ALL NIGHT INTERMITTENTLY.  SHE THINKS SHE WAS FEBRILE BUT DID NOT TAKE HER TEMPERATURE.  SHE STATES THAT HER FOOD INTAKE HAS BEEN "MINIMAL" FOR 24-HOURS.  SHE STATES THAT HER URINARY OUTPUT IS "THE SAME AS USUAL... SHE'S BEEN HAVING NORMAL WET DIAPERS."   MOM STATES THE CHILD'S LEFT LEG IS HARD TO THE TOUCH BUT DOES NOT APPEAR READ OR SWOLLEN.  THE CHILD IS ALLOWING HER TO RUB ON THE SITE & SHE IS "DOING SO TO TRY & HELP SOFTEN IT".  SHE &  HER HUSBAND HAVE BEEN ADMINISTERING CHILDREN'S TYLENOL Q  HOURS SINCE YESTERDAY.  MOM DENIES THE NEED TO CALL HER PEDIATRICIAN, AS SHE FEELS THE CHILD IS IMPROVING SOME TODAY. .
Age: 0.58
Sex: F
Vaccine: COVID19-2, DTPPVHBHPB, FLU4, PNC15, DTPPVHBHPB
Symptoms: Crying, Hypophagia, Incorrect product formulation administered, Injection site induration, Miliaria
Clinical narrative: WRONG MODERNA FORMULATION GIVEN.  SHOULD HAVE BEEN 0.25 MG/ug BUT GAVE 0.2 MG/ug FORMULATION.  PATIENT HAD HISTORY OF ONE DOSE MODERNA BIVALENT GIVEN ON  5/4/23  STARTED HAVING DIFFUSE RED RASH ON BACK.  MOM STATES THAT IT APPEARS TO BE LIKE "HEAT RASH" & IS NOT RAISED OR BUMPY.  MOM DENIES RASH ANYWHERE ELSE.  SHE CRIED & WAS "INCONSOLABLE" FOR THE ENTIRE NIGHT.  THIS STARTED ABOUT 4-5 HOURS POST VACCINATION.  MOM STATES THAT THEY HAD TO TAKE SHOWERS WITH THE CHILD ALL NIGHT INTERMITTENTLY.  SHE THINKS SHE WAS FEBRILE BUT DID NOT TAKE HER TEMPERATURE.  SHE STATES THAT HER FOOD INTAKE HAS BEEN "MINIMAL" FOR 24-HOURS.  SHE STATES THAT HER URINARY OUTPUT IS "THE SAME AS USUAL... SHE'S BEEN HAVING NORMAL WET DIAPERS."   MOM STATES THE CHILD'S LEFT LEG IS HARD TO THE TOUCH BUT DOES NOT APPEAR READ OR SWOLLEN.  THE CHILD IS ALLOWING HER TO RUB ON THE SITE & SHE IS "DOING SO TO TRY & HELP SOFTEN IT".  SHE &  HER HUSBAND HAVE BEEN ADMINISTERING CHILDREN'S TYLENOL Q  HOURS SINCE YESTERDAY.  MOM DENIES THE NEED TO CALL HER PEDIATRICIAN, AS SHE FEELS THE CHILD IS IMPROVING SOME TODAY. .