chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 31.0
Sex: F
Vaccine: COVID19
Symptoms: Varicella zoster virus infection
Clinical narrative: Note - patient was vaccinated for chickenpox in childhood with attenuated live vaccine and never infected with chickenpox previously.  On Oct 29, 2021, patient received Moderna COVID booster vaccine. On Oct 30, 2021, patient began experiencing neuropathic pain in R gluteus. On Oct 31, 2021, blistering rash appeared on patient's R gluteal dermatome, and several lesions appears on patient's torso, scalp, and face, accompanied by pain. Lesions continued to appear on patient's torso and extremities (arms, legs) over the next several days (>20 lesions on various, non-gluteal sites). Patient began taking oral valacyclovir treatment on Nov 2, 2021 and was instructed to quarantine beginning on those dates. On Nov 4, 2021, VZV PCR testing on facial and gluteal lesion was positive for VZV, confirming disseminated zoster. As of reporting date (Nov 9, 2021), patient has not recovered
Age: 33.0
Sex: M
Vaccine: COVID19
Symptoms: Chest pain, Cold sweat, Muscle spasms
Clinical narrative: Cold sweats, leg spasms, chest pains
Age: 65.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Acute kidney injury, Acute respiratory failure, Alanine aminotransferase increased, Anticoagulant therapy, Aspartate aminotransferase increased
Clinical narrative: Hospitalized 11/1/2021; COVID-19 positive 10/27/2021; fully vaccinated  CHIEF COMPLAINT Dyspnea, cough, sent from monoclonal antibody infusion clinic   HISTORY OF PRESENT ILLNESS Patient is a 66 y.o. male with past medical history significant for coronary artery disease, history of anterior wall infarct with cardiac arrest in 2016, paroxysmal atrial fibrillation, on Eliquis, obesity, hypertension, who presented to the ER today after being sent from the monoclonal antibody clinic for evaluation. The patient woke up on the morning of 10/23 with a dry cough and funny feeling in his throat, developed high fevers, severe fatigue and worsening cough for over the next couple days. He tested positive for covid 19 PLAN   Acute hypoxemic respiratory failure COVID 19 pneumonia - Symptom onset 10/23  - Received pfizer vaccines in March, April - Currently requiring 15 L nonrebreather, transition to high flow - Lungs with diffuse wheezing bilaterally, add albuterol inhaler  - CXR independently reviewed, with bibasilar changes of covid 19 pneumonia - Start Decadron 6mg daily x 10 days (start 11/1) - Out of window for remdesivir, also not recommended due to GFR 24 and AKI  - IS q 1hr while awake, prone positioning prn - Check d-dimer - Bilateral lower extremity doppler ordered. No missed doses of eliquis other than this morning due to being in the ED. Regardless, has right lower extremity tenderness to palpation and palpable cord, raising concern for DVT  11/3/2021 note: ASSESSMENT / PLAN: Acute hypoxemic respiratory failure Breakthrough COVID 19 pneumonia - CXR: Worsening in the appearance of the chest as discussed. While elements of this may be on the basis of the patient's Covid pneumonia, cannot exclude the possibility of elements of superimposed CHF and pulmonary edema as well.  - Symptom onset 10/23, COVID-19 + 10/27, s/p Pfizer vaccines in March, April '21 - Currently on HFNC 100%, 55 l/min, with NRB mask over, Pox 90-94% - on albuterol inhaler  - Decadron 6mg daily day # 3/10 days, remdesivir day # 2/5   - IS q 1hr while awake, prone positioning prn - D-dimer 640-- > 640-- >740, on Eliquis  - CRP 135-- > 127.6-- > 130.3 - AST 164--. 405 - ALT 101-- > 285 - Doppler US of legs: No deep vein thrombus is seen in the right or left lower extremity - will give Lasix 40 mg IV this am, may need transfer to ICU - discussed with pulmonologist who will see patient today
Age: 65.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Atrial fibrillation, C-reactive protein increased, COVID-19, COVID-19 pneumonia, Cardiac arrest
Clinical narrative: Hospitalized 11/1/2021; COVID-19 positive 10/27/2021; fully vaccinated  CHIEF COMPLAINT Dyspnea, cough, sent from monoclonal antibody infusion clinic   HISTORY OF PRESENT ILLNESS Patient is a 66 y.o. male with past medical history significant for coronary artery disease, history of anterior wall infarct with cardiac arrest in 2016, paroxysmal atrial fibrillation, on Eliquis, obesity, hypertension, who presented to the ER today after being sent from the monoclonal antibody clinic for evaluation. The patient woke up on the morning of 10/23 with a dry cough and funny feeling in his throat, developed high fevers, severe fatigue and worsening cough for over the next couple days. He tested positive for covid 19 PLAN   Acute hypoxemic respiratory failure COVID 19 pneumonia - Symptom onset 10/23  - Received pfizer vaccines in March, April - Currently requiring 15 L nonrebreather, transition to high flow - Lungs with diffuse wheezing bilaterally, add albuterol inhaler  - CXR independently reviewed, with bibasilar changes of covid 19 pneumonia - Start Decadron 6mg daily x 10 days (start 11/1) - Out of window for remdesivir, also not recommended due to GFR 24 and AKI  - IS q 1hr while awake, prone positioning prn - Check d-dimer - Bilateral lower extremity doppler ordered. No missed doses of eliquis other than this morning due to being in the ED. Regardless, has right lower extremity tenderness to palpation and palpable cord, raising concern for DVT  11/3/2021 note: ASSESSMENT / PLAN: Acute hypoxemic respiratory failure Breakthrough COVID 19 pneumonia - CXR: Worsening in the appearance of the chest as discussed. While elements of this may be on the basis of the patient's Covid pneumonia, cannot exclude the possibility of elements of superimposed CHF and pulmonary edema as well.  - Symptom onset 10/23, COVID-19 + 10/27, s/p Pfizer vaccines in March, April '21 - Currently on HFNC 100%, 55 l/min, with NRB mask over, Pox 90-94% - on albuterol inhaler  - Decadron 6mg daily day # 3/10 days, remdesivir day # 2/5   - IS q 1hr while awake, prone positioning prn - D-dimer 640-- > 640-- >740, on Eliquis  - CRP 135-- > 127.6-- > 130.3 - AST 164--. 405 - ALT 101-- > 285 - Doppler US of legs: No deep vein thrombus is seen in the right or left lower extremity - will give Lasix 40 mg IV this am, may need transfer to ICU - discussed with pulmonologist who will see patient today
Age: 65.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Chest X-ray abnormal, Cough, Endotracheal intubation, Fatigue, Fibrin D dimer increased
Clinical narrative: Hospitalized 11/1/2021; COVID-19 positive 10/27/2021; fully vaccinated  CHIEF COMPLAINT Dyspnea, cough, sent from monoclonal antibody infusion clinic   HISTORY OF PRESENT ILLNESS Patient is a 66 y.o. male with past medical history significant for coronary artery disease, history of anterior wall infarct with cardiac arrest in 2016, paroxysmal atrial fibrillation, on Eliquis, obesity, hypertension, who presented to the ER today after being sent from the monoclonal antibody clinic for evaluation. The patient woke up on the morning of 10/23 with a dry cough and funny feeling in his throat, developed high fevers, severe fatigue and worsening cough for over the next couple days. He tested positive for covid 19 PLAN   Acute hypoxemic respiratory failure COVID 19 pneumonia - Symptom onset 10/23  - Received pfizer vaccines in March, April - Currently requiring 15 L nonrebreather, transition to high flow - Lungs with diffuse wheezing bilaterally, add albuterol inhaler  - CXR independently reviewed, with bibasilar changes of covid 19 pneumonia - Start Decadron 6mg daily x 10 days (start 11/1) - Out of window for remdesivir, also not recommended due to GFR 24 and AKI  - IS q 1hr while awake, prone positioning prn - Check d-dimer - Bilateral lower extremity doppler ordered. No missed doses of eliquis other than this morning due to being in the ED. Regardless, has right lower extremity tenderness to palpation and palpable cord, raising concern for DVT  11/3/2021 note: ASSESSMENT / PLAN: Acute hypoxemic respiratory failure Breakthrough COVID 19 pneumonia - CXR: Worsening in the appearance of the chest as discussed. While elements of this may be on the basis of the patient's Covid pneumonia, cannot exclude the possibility of elements of superimposed CHF and pulmonary edema as well.  - Symptom onset 10/23, COVID-19 + 10/27, s/p Pfizer vaccines in March, April '21 - Currently on HFNC 100%, 55 l/min, with NRB mask over, Pox 90-94% - on albuterol inhaler  - Decadron 6mg daily day # 3/10 days, remdesivir day # 2/5   - IS q 1hr while awake, prone positioning prn - D-dimer 640-- > 640-- >740, on Eliquis  - CRP 135-- > 127.6-- > 130.3 - AST 164--. 405 - ALT 101-- > 285 - Doppler US of legs: No deep vein thrombus is seen in the right or left lower extremity - will give Lasix 40 mg IV this am, may need transfer to ICU - discussed with pulmonologist who will see patient today
Age: 65.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Glomerular filtration rate decreased, Hypoxia, Intensive care, Lung infiltration, Oxygen saturation decreased
Clinical narrative: Hospitalized 11/1/2021; COVID-19 positive 10/27/2021; fully vaccinated  CHIEF COMPLAINT Dyspnea, cough, sent from monoclonal antibody infusion clinic   HISTORY OF PRESENT ILLNESS Patient is a 66 y.o. male with past medical history significant for coronary artery disease, history of anterior wall infarct with cardiac arrest in 2016, paroxysmal atrial fibrillation, on Eliquis, obesity, hypertension, who presented to the ER today after being sent from the monoclonal antibody clinic for evaluation. The patient woke up on the morning of 10/23 with a dry cough and funny feeling in his throat, developed high fevers, severe fatigue and worsening cough for over the next couple days. He tested positive for covid 19 PLAN   Acute hypoxemic respiratory failure COVID 19 pneumonia - Symptom onset 10/23  - Received pfizer vaccines in March, April - Currently requiring 15 L nonrebreather, transition to high flow - Lungs with diffuse wheezing bilaterally, add albuterol inhaler  - CXR independently reviewed, with bibasilar changes of covid 19 pneumonia - Start Decadron 6mg daily x 10 days (start 11/1) - Out of window for remdesivir, also not recommended due to GFR 24 and AKI  - IS q 1hr while awake, prone positioning prn - Check d-dimer - Bilateral lower extremity doppler ordered. No missed doses of eliquis other than this morning due to being in the ED. Regardless, has right lower extremity tenderness to palpation and palpable cord, raising concern for DVT  11/3/2021 note: ASSESSMENT / PLAN: Acute hypoxemic respiratory failure Breakthrough COVID 19 pneumonia - CXR: Worsening in the appearance of the chest as discussed. While elements of this may be on the basis of the patient's Covid pneumonia, cannot exclude the possibility of elements of superimposed CHF and pulmonary edema as well.  - Symptom onset 10/23, COVID-19 + 10/27, s/p Pfizer vaccines in March, April '21 - Currently on HFNC 100%, 55 l/min, with NRB mask over, Pox 90-94% - on albuterol inhaler  - Decadron 6mg daily day # 3/10 days, remdesivir day # 2/5   - IS q 1hr while awake, prone positioning prn - D-dimer 640-- > 640-- >740, on Eliquis  - CRP 135-- > 127.6-- > 130.3 - AST 164--. 405 - ALT 101-- > 285 - Doppler US of legs: No deep vein thrombus is seen in the right or left lower extremity - will give Lasix 40 mg IV this am, may need transfer to ICU - discussed with pulmonologist who will see patient today
Age: 65.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Paralytic disability, Pyrexia, SARS-CoV-2 test positive, Tenderness, Throat irritation
Clinical narrative: Hospitalized 11/1/2021; COVID-19 positive 10/27/2021; fully vaccinated  CHIEF COMPLAINT Dyspnea, cough, sent from monoclonal antibody infusion clinic   HISTORY OF PRESENT ILLNESS Patient is a 66 y.o. male with past medical history significant for coronary artery disease, history of anterior wall infarct with cardiac arrest in 2016, paroxysmal atrial fibrillation, on Eliquis, obesity, hypertension, who presented to the ER today after being sent from the monoclonal antibody clinic for evaluation. The patient woke up on the morning of 10/23 with a dry cough and funny feeling in his throat, developed high fevers, severe fatigue and worsening cough for over the next couple days. He tested positive for covid 19 PLAN   Acute hypoxemic respiratory failure COVID 19 pneumonia - Symptom onset 10/23  - Received pfizer vaccines in March, April - Currently requiring 15 L nonrebreather, transition to high flow - Lungs with diffuse wheezing bilaterally, add albuterol inhaler  - CXR independently reviewed, with bibasilar changes of covid 19 pneumonia - Start Decadron 6mg daily x 10 days (start 11/1) - Out of window for remdesivir, also not recommended due to GFR 24 and AKI  - IS q 1hr while awake, prone positioning prn - Check d-dimer - Bilateral lower extremity doppler ordered. No missed doses of eliquis other than this morning due to being in the ED. Regardless, has right lower extremity tenderness to palpation and palpable cord, raising concern for DVT  11/3/2021 note: ASSESSMENT / PLAN: Acute hypoxemic respiratory failure Breakthrough COVID 19 pneumonia - CXR: Worsening in the appearance of the chest as discussed. While elements of this may be on the basis of the patient's Covid pneumonia, cannot exclude the possibility of elements of superimposed CHF and pulmonary edema as well.  - Symptom onset 10/23, COVID-19 + 10/27, s/p Pfizer vaccines in March, April '21 - Currently on HFNC 100%, 55 l/min, with NRB mask over, Pox 90-94% - on albuterol inhaler  - Decadron 6mg daily day # 3/10 days, remdesivir day # 2/5   - IS q 1hr while awake, prone positioning prn - D-dimer 640-- > 640-- >740, on Eliquis  - CRP 135-- > 127.6-- > 130.3 - AST 164--. 405 - ALT 101-- > 285 - Doppler US of legs: No deep vein thrombus is seen in the right or left lower extremity - will give Lasix 40 mg IV this am, may need transfer to ICU - discussed with pulmonologist who will see patient today
Age: 65.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Ultrasound Doppler normal, Vaccine breakthrough infection, Wheezing
Clinical narrative: Hospitalized 11/1/2021; COVID-19 positive 10/27/2021; fully vaccinated  CHIEF COMPLAINT Dyspnea, cough, sent from monoclonal antibody infusion clinic   HISTORY OF PRESENT ILLNESS Patient is a 66 y.o. male with past medical history significant for coronary artery disease, history of anterior wall infarct with cardiac arrest in 2016, paroxysmal atrial fibrillation, on Eliquis, obesity, hypertension, who presented to the ER today after being sent from the monoclonal antibody clinic for evaluation. The patient woke up on the morning of 10/23 with a dry cough and funny feeling in his throat, developed high fevers, severe fatigue and worsening cough for over the next couple days. He tested positive for covid 19 PLAN   Acute hypoxemic respiratory failure COVID 19 pneumonia - Symptom onset 10/23  - Received pfizer vaccines in March, April - Currently requiring 15 L nonrebreather, transition to high flow - Lungs with diffuse wheezing bilaterally, add albuterol inhaler  - CXR independently reviewed, with bibasilar changes of covid 19 pneumonia - Start Decadron 6mg daily x 10 days (start 11/1) - Out of window for remdesivir, also not recommended due to GFR 24 and AKI  - IS q 1hr while awake, prone positioning prn - Check d-dimer - Bilateral lower extremity doppler ordered. No missed doses of eliquis other than this morning due to being in the ED. Regardless, has right lower extremity tenderness to palpation and palpable cord, raising concern for DVT  11/3/2021 note: ASSESSMENT / PLAN: Acute hypoxemic respiratory failure Breakthrough COVID 19 pneumonia - CXR: Worsening in the appearance of the chest as discussed. While elements of this may be on the basis of the patient's Covid pneumonia, cannot exclude the possibility of elements of superimposed CHF and pulmonary edema as well.  - Symptom onset 10/23, COVID-19 + 10/27, s/p Pfizer vaccines in March, April '21 - Currently on HFNC 100%, 55 l/min, with NRB mask over, Pox 90-94% - on albuterol inhaler  - Decadron 6mg daily day # 3/10 days, remdesivir day # 2/5   - IS q 1hr while awake, prone positioning prn - D-dimer 640-- > 640-- >740, on Eliquis  - CRP 135-- > 127.6-- > 130.3 - AST 164--. 405 - ALT 101-- > 285 - Doppler US of legs: No deep vein thrombus is seen in the right or left lower extremity - will give Lasix 40 mg IV this am, may need transfer to ICU - discussed with pulmonologist who will see patient today
Age: 55.0
Sex: M
Vaccine: COVID19
Symptoms: Heart rate increased, Pruritus, Scab, Urticaria
Clinical narrative: Accelerated heart rate through the first day. Unbearable itching from ankles through to scalp.  Legs, core, back, shoulders, neck were the worst areas.  The itching caused welts and scabs. Started over the counter Benadryl  both oral and topical on 10/30 in the am.  Called doctor office and started other medication on Monday 11/1 in the am to be taken for 5 days.  At the end of 5 days the symptoms were slightly better, but itching persisted.  Contacted doctor again 11/5 and currently under another dose of 3 different drugs.  Symptoms are starting to improve, welts / scabs are still present in a few areas.
Age: 61.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: positive COVID
Age: 87.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, C-reactive protein increased, Computerised tomogram thorax, Dyspnoea, Echocardiogram
Clinical narrative: SOB, heart racing, neck and shoulder pain starting with 24 hours of Pfizer "Booster" She was found to have d-Dimer >4000, elevated sed rate and CRP. Sent to emergency room. Found to have significant pericarditis and transfered to higher level care hospital for emergency care.
Age: 87.0
Sex: F
Vaccine: COVID19
Symptoms: Fibrin D dimer, Laboratory test, Neck pain, Palpitations, Pericarditis
Clinical narrative: SOB, heart racing, neck and shoulder pain starting with 24 hours of Pfizer "Booster" She was found to have d-Dimer >4000, elevated sed rate and CRP. Sent to emergency room. Found to have significant pericarditis and transfered to higher level care hospital for emergency care.
Age: 87.0
Sex: F
Vaccine: COVID19
Symptoms: Red blood cell sedimentation rate increased
Clinical narrative: SOB, heart racing, neck and shoulder pain starting with 24 hours of Pfizer "Booster" She was found to have d-Dimer >4000, elevated sed rate and CRP. Sent to emergency room. Found to have significant pericarditis and transfered to higher level care hospital for emergency care.
Age: 30.0
Sex: M
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: STORAGE IN REGRIGERATOS (2-8 C) UP TO 30 DAYS. VACCINE USED AFTER 10/16/2021
Age: 57.0
Sex: M
Vaccine: COVID19
Symptoms: Chest pain, Electrocardiogram abnormal, Fibrin D dimer, Full blood count, Metabolic function test
Clinical narrative: Patient is a 57-year-old whom had his booster shot (Moderna) October 30.  He reports beginning the night of November 5 he developed constant sharp substernal chest pain.  This peaked in intensity overnight and he presented to the ER November 6 with constant pleuritic chest pain worse when lying on his back.  EKG suggested pericarditis.  The pain has gradually subsided and is almost gone today.  He has no known history of CAD.
Age: 57.0
Sex: M
Vaccine: COVID19
Symptoms: Pain, Pericarditis, Pleuritic pain, Troponin normal
Clinical narrative: Patient is a 57-year-old whom had his booster shot (Moderna) October 30.  He reports beginning the night of November 5 he developed constant sharp substernal chest pain.  This peaked in intensity overnight and he presented to the ER November 6 with constant pleuritic chest pain worse when lying on his back.  EKG suggested pericarditis.  The pain has gradually subsided and is almost gone today.  He has no known history of CAD.
Age: 73.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: positive COVID
Age: 38.0
Sex: F
Vaccine: COVID19
Symptoms: Electrocardiogram normal, Hypoaesthesia, Paraesthesia
Clinical narrative: Tingling and numbness - pins and needles sensation upper body, limbs and mouth approximately one hour after first dose administered. Cleared approximately 15 minutes later. Sensation appeared once again 30 minutes after clearing. Urgent care visit-advised to monitor symptoms at home
Age: 71.0
Sex: M
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: STORAGE IN REFRIGERATOR (2C- 8C) UP TO 30 DAYS. (VACCINE USED AFTER 10/16/2021).
Age: 35.0
Sex: F
Vaccine: COVID19
Symptoms: Abortion spontaneous, Extra dose administered, Foetal heart rate abnormal, Uterine dilation and curettage, Vaginal haemorrhage
Clinical narrative: Post 3rd vaccination, I began bleeding vaginally on 10/10. The bleeding continued for 12 days then subsided for several days and returned. Ultrasound revealed a low fetal heart rate on 10/25. On 11/2 there was no longer a fetal heartbeat showing miscarriage. A D&C followed on 11/6.
Age: 99.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: positive COVID
Age: 89.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Error: Improper storage (temperature).
Age: 55.0
Sex: M
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: STORAGE IN REFRIGERATOR (2C- 8C) UP TO 30 DAYS (VACCINE USED AFTER 10/16/2021
Age: 60.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Acute kidney injury, Acute respiratory distress syndrome, Atrial fibrillation, COVID-19, COVID-19 pneumonia
Clinical narrative: Hospitalized 10/26/2021; COVID-19 positive 10/27/2021, fully vaccinated  BRIEF OVERVIEW: Discharge Provider: DOCTOR Primary Care Physician at Discharge: DOCTOR Admission Date: 10/26/2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Septic shock   HOSPITAL COURSE: Patient is a 60 year old male with PMH of HTN, HLD, DMII, super morbid obesity who initially presented to outside hospital with a 2-3 day history of right groin rash and found to have necrotizing fascitis. Patient underwent his initial debridement at outside hospital prior to transferring to Butterworth SICU. Of note, patient was hypoxic prior to intubation and found to have COVID-19 pneumonia which was treated with steroids and Remdesivir. Patient was intubated and sedated upon transfer and had pressor requirements due to septic shock from the necrotizing fascitis. Patient underwent IV abx therapy, resuscitation with fluids and pressors, and ventilator support. Patient underwent a second debridement for source control the following day. Patient's ICU course was also complicated by Diabetic ketoacidosis for which he was on endotool with DGMS following, AKI, and SVT with RVR. During his ICU course, source control was obtained from his infection, however patient's respiratory status continued to decline with ARDS. Patient on high ventilator requirements of 90-100% Fi02 with hypercarbia due to large body habitus with chest wall restrction, COVID-19, and volume overload due to resuscitation for septic shock. Patient was paralyzed during his course to assist with ventilation however this did not improve his respiratory status. Pulmonary critical care was consulted however patient not a candidate for ECMO given his BMI. Discussion was held with family (sister) on 10/31/21 given poor prognosis even with aggressive therapy. Comfort care was ultimately decided upon per family. Paralyzation was stopped and patient was subsequently extubated and expired on 10/31/2021 at 1354
Age: 60.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Condition aggravated, Death, Debridement, Diabetic ketoacidosis, Endotracheal intubation
Clinical narrative: Hospitalized 10/26/2021; COVID-19 positive 10/27/2021, fully vaccinated  BRIEF OVERVIEW: Discharge Provider: DOCTOR Primary Care Physician at Discharge: DOCTOR Admission Date: 10/26/2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Septic shock   HOSPITAL COURSE: Patient is a 60 year old male with PMH of HTN, HLD, DMII, super morbid obesity who initially presented to outside hospital with a 2-3 day history of right groin rash and found to have necrotizing fascitis. Patient underwent his initial debridement at outside hospital prior to transferring to Butterworth SICU. Of note, patient was hypoxic prior to intubation and found to have COVID-19 pneumonia which was treated with steroids and Remdesivir. Patient was intubated and sedated upon transfer and had pressor requirements due to septic shock from the necrotizing fascitis. Patient underwent IV abx therapy, resuscitation with fluids and pressors, and ventilator support. Patient underwent a second debridement for source control the following day. Patient's ICU course was also complicated by Diabetic ketoacidosis for which he was on endotool with DGMS following, AKI, and SVT with RVR. During his ICU course, source control was obtained from his infection, however patient's respiratory status continued to decline with ARDS. Patient on high ventilator requirements of 90-100% Fi02 with hypercarbia due to large body habitus with chest wall restrction, COVID-19, and volume overload due to resuscitation for septic shock. Patient was paralyzed during his course to assist with ventilation however this did not improve his respiratory status. Pulmonary critical care was consulted however patient not a candidate for ECMO given his BMI. Discussion was held with family (sister) on 10/31/21 given poor prognosis even with aggressive therapy. Comfort care was ultimately decided upon per family. Paralyzation was stopped and patient was subsequently extubated and expired on 10/31/2021 at 1354
Age: 60.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Extubation, General physical health deterioration, Hypercapnia, Hypervolaemia, Hypoxia
Clinical narrative: Hospitalized 10/26/2021; COVID-19 positive 10/27/2021, fully vaccinated  BRIEF OVERVIEW: Discharge Provider: DOCTOR Primary Care Physician at Discharge: DOCTOR Admission Date: 10/26/2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Septic shock   HOSPITAL COURSE: Patient is a 60 year old male with PMH of HTN, HLD, DMII, super morbid obesity who initially presented to outside hospital with a 2-3 day history of right groin rash and found to have necrotizing fascitis. Patient underwent his initial debridement at outside hospital prior to transferring to Butterworth SICU. Of note, patient was hypoxic prior to intubation and found to have COVID-19 pneumonia which was treated with steroids and Remdesivir. Patient was intubated and sedated upon transfer and had pressor requirements due to septic shock from the necrotizing fascitis. Patient underwent IV abx therapy, resuscitation with fluids and pressors, and ventilator support. Patient underwent a second debridement for source control the following day. Patient's ICU course was also complicated by Diabetic ketoacidosis for which he was on endotool with DGMS following, AKI, and SVT with RVR. During his ICU course, source control was obtained from his infection, however patient's respiratory status continued to decline with ARDS. Patient on high ventilator requirements of 90-100% Fi02 with hypercarbia due to large body habitus with chest wall restrction, COVID-19, and volume overload due to resuscitation for septic shock. Patient was paralyzed during his course to assist with ventilation however this did not improve his respiratory status. Pulmonary critical care was consulted however patient not a candidate for ECMO given his BMI. Discussion was held with family (sister) on 10/31/21 given poor prognosis even with aggressive therapy. Comfort care was ultimately decided upon per family. Paralyzation was stopped and patient was subsequently extubated and expired on 10/31/2021 at 1354
Age: 60.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Infection, Intensive care, Mechanical ventilation, Necrotising fasciitis, Paralysis
Clinical narrative: Hospitalized 10/26/2021; COVID-19 positive 10/27/2021, fully vaccinated  BRIEF OVERVIEW: Discharge Provider: DOCTOR Primary Care Physician at Discharge: DOCTOR Admission Date: 10/26/2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Septic shock   HOSPITAL COURSE: Patient is a 60 year old male with PMH of HTN, HLD, DMII, super morbid obesity who initially presented to outside hospital with a 2-3 day history of right groin rash and found to have necrotizing fascitis. Patient underwent his initial debridement at outside hospital prior to transferring to Butterworth SICU. Of note, patient was hypoxic prior to intubation and found to have COVID-19 pneumonia which was treated with steroids and Remdesivir. Patient was intubated and sedated upon transfer and had pressor requirements due to septic shock from the necrotizing fascitis. Patient underwent IV abx therapy, resuscitation with fluids and pressors, and ventilator support. Patient underwent a second debridement for source control the following day. Patient's ICU course was also complicated by Diabetic ketoacidosis for which he was on endotool with DGMS following, AKI, and SVT with RVR. During his ICU course, source control was obtained from his infection, however patient's respiratory status continued to decline with ARDS. Patient on high ventilator requirements of 90-100% Fi02 with hypercarbia due to large body habitus with chest wall restrction, COVID-19, and volume overload due to resuscitation for septic shock. Patient was paralyzed during his course to assist with ventilation however this did not improve his respiratory status. Pulmonary critical care was consulted however patient not a candidate for ECMO given his BMI. Discussion was held with family (sister) on 10/31/21 given poor prognosis even with aggressive therapy. Comfort care was ultimately decided upon per family. Paralyzation was stopped and patient was subsequently extubated and expired on 10/31/2021 at 1354
Age: 60.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Rash, Resuscitation, SARS-CoV-2 test positive, Septic shock, Supraventricular tachycardia
Clinical narrative: Hospitalized 10/26/2021; COVID-19 positive 10/27/2021, fully vaccinated  BRIEF OVERVIEW: Discharge Provider: DOCTOR Primary Care Physician at Discharge: DOCTOR Admission Date: 10/26/2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Septic shock   HOSPITAL COURSE: Patient is a 60 year old male with PMH of HTN, HLD, DMII, super morbid obesity who initially presented to outside hospital with a 2-3 day history of right groin rash and found to have necrotizing fascitis. Patient underwent his initial debridement at outside hospital prior to transferring to Butterworth SICU. Of note, patient was hypoxic prior to intubation and found to have COVID-19 pneumonia which was treated with steroids and Remdesivir. Patient was intubated and sedated upon transfer and had pressor requirements due to septic shock from the necrotizing fascitis. Patient underwent IV abx therapy, resuscitation with fluids and pressors, and ventilator support. Patient underwent a second debridement for source control the following day. Patient's ICU course was also complicated by Diabetic ketoacidosis for which he was on endotool with DGMS following, AKI, and SVT with RVR. During his ICU course, source control was obtained from his infection, however patient's respiratory status continued to decline with ARDS. Patient on high ventilator requirements of 90-100% Fi02 with hypercarbia due to large body habitus with chest wall restrction, COVID-19, and volume overload due to resuscitation for septic shock. Patient was paralyzed during his course to assist with ventilation however this did not improve his respiratory status. Pulmonary critical care was consulted however patient not a candidate for ECMO given his BMI. Discussion was held with family (sister) on 10/31/21 given poor prognosis even with aggressive therapy. Comfort care was ultimately decided upon per family. Paralyzation was stopped and patient was subsequently extubated and expired on 10/31/2021 at 1354
Age: 52.0
Sex: M
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: STORAGE IN REFRIGERATOR (2C-8C) UP TO 30 DAYS. (VACCINE USED AFTER 10-16-2021).
Age: 50.0
Sex: M
Vaccine: COVID19
Symptoms: C-reactive protein, Chest pain, Echocardiogram normal, Electrocardiogram normal, Fibrin D dimer
Clinical narrative: Pleuritic chest pain , moderate to severe. Treated with NSAIDS and colchicine.
Age: 50.0
Sex: M
Vaccine: COVID19
Symptoms: Pleuritic pain, Respiratory viral panel, Troponin I normal
Clinical narrative: Pleuritic chest pain , moderate to severe. Treated with NSAIDS and colchicine.
Age: 34.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site swelling
Clinical narrative: Site: Swelling at Injection Site-Medium
Age: 48.0
Sex: M
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: STORAGE IN REFRIGERATOR (2C-8C) UP TO 320 DAYS. (VACCINE USED AFTER 10/16/2021)
Age: 78.0
Sex: M
Vaccine: COVID19
Symptoms: Blood test, Electrocardiogram, Extra dose administered, Heart rate increased, Tachycardia
Clinical narrative: Received vaccine Nov 2. Early next morning Nov 3 I noticed my pulse was racing. Measured at 95 beats per minute. Around 7 am Nov 4 measured pulse again at 108.  Contacted urgent care and made appointment that morning. Doctor did EKG and took blood. He thought the tachycardia was due to my being dehydrated and ordered fluid intravenously. Heartbeat did slow down a bit after this, but he still described it as "fast." By the next day, Nov 4, heartbeat was lower, in the 90's. By Nov 5, heartbeat was normal, around 70. Was my problem truly dehydration (I've never had this problem before) or was it due to the effect of the vaccine?
Age: 8.0
Sex: M
Vaccine: COVID19
Symptoms: Cough, Injection site pain, Respiratory tract congestion
Clinical narrative: Pain to site of injection.  Increased cough.  Congestion.
Age: 55.0
Sex: F
Vaccine: COVID19
Symptoms: Tinnitus
Clinical narrative: tinnitus.  started the day after the vaccine in both ears. it is worse on the left. but present in both ears.  it is consistent ringing all day allnight..    I dont notice it if I am busy and active or in a noisy place.
Age: 70.0
Sex: M
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: STORAGE IN REFRIGERATOR (2C-8C) UP TO 30 DAYS. (VACCINE USED AFTER 10-16-2021)
Age: 66.0
Sex: M
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: STORAGE IN REFRIGERATOR (2C-8C) UP TP 30 DAYS. ( VACCINE USED AFTER 10/16/2021)
Age: 59.0
Sex: M
Vaccine: COVID19
Symptoms: Adverse reaction, Arthralgia, Cough, Headache, Malaise
Clinical narrative: The adverse reaction started on November7th, They started with Muscle weakness and joint pain, Slight fever, Slight cough, Headache And general malaise. It is now November 9, 2021, And I believe all of these symptoms are at there apex.
Age: 59.0
Sex: M
Vaccine: COVID19
Symptoms: Muscular weakness, Pyrexia
Clinical narrative: The adverse reaction started on November7th, They started with Muscle weakness and joint pain, Slight fever, Slight cough, Headache And general malaise. It is now November 9, 2021, And I believe all of these symptoms are at there apex.
Age: 79.0
Sex: M
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: STORAGE IN REFRIGERATOR (2C- 8C) UP TO 30 DAYS (VACCINE USED AFTER 10/16/2021
Age: 83.0
Sex: F
Vaccine: COVID19
Symptoms: Balance disorder, Dizziness
Clinical narrative: Patient experienced 1 week of dizziness and poor balance.
Age: 81.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: COVID-19, COVID-19 pneumonia, Chest X-ray abnormal, Condition aggravated, Confusional state
Clinical narrative: Hospitalized 10/27/2021; COVID-19 positive 10/27/2021; fully vaccinated  BRIEF OVERVIEW:  Admission Date: 10/27/2021 Discharge Date: 11/5/21 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Hypoxia [R09.02] Pneumonia due to COVID-19 virus [U07.1, J12.82] COVID-19 [U07.1] HOSPITAL COURSE Patient s a 81 y.o. female with past medical history of coronary artery disease, EF 55%, COPD who presented with hypoxia and altered mental status due to COVID encephelopathy in the setting of COVID infection. Husband reported 2 weeks of cough, diarrhea and confusion. Husband also reported mild dementia before this however pt was more altered than baseline dementia. CXR showed bilateral opacities. Treated with decadron. Was outside the window for remdesivir. Pt was diuresed during the admission.  Pt had mitts, restraints, seroquel was given due to encephelopathy and removing oxygen which cause her to desat to the 70's on multiple occasions.   Over multiple days patient began to become less encephalopathic and required less oxygen.  On 11/04 patient was fully awake and oriented on exam is, was conversing with her husband in the afternoon, was able to eat by herself and create linear conversations.  We observed her for 1 more day and to complete her steroid treatment.  Patient was discharged on 11/05 in stable condition for home with assist.
Age: 81.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Cough, Dementia, Diarrhoea, Encephalopathy, Hypoxia
Clinical narrative: Hospitalized 10/27/2021; COVID-19 positive 10/27/2021; fully vaccinated  BRIEF OVERVIEW:  Admission Date: 10/27/2021 Discharge Date: 11/5/21 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Hypoxia [R09.02] Pneumonia due to COVID-19 virus [U07.1, J12.82] COVID-19 [U07.1] HOSPITAL COURSE Patient s a 81 y.o. female with past medical history of coronary artery disease, EF 55%, COPD who presented with hypoxia and altered mental status due to COVID encephelopathy in the setting of COVID infection. Husband reported 2 weeks of cough, diarrhea and confusion. Husband also reported mild dementia before this however pt was more altered than baseline dementia. CXR showed bilateral opacities. Treated with decadron. Was outside the window for remdesivir. Pt was diuresed during the admission.  Pt had mitts, restraints, seroquel was given due to encephelopathy and removing oxygen which cause her to desat to the 70's on multiple occasions.   Over multiple days patient began to become less encephalopathic and required less oxygen.  On 11/04 patient was fully awake and oriented on exam is, was conversing with her husband in the afternoon, was able to eat by herself and create linear conversations.  We observed her for 1 more day and to complete her steroid treatment.  Patient was discharged on 11/05 in stable condition for home with assist.
Age: 81.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Lung opacity, Mental status changes, Oxygen saturation decreased, Patient restraint, Polyuria
Clinical narrative: Hospitalized 10/27/2021; COVID-19 positive 10/27/2021; fully vaccinated  BRIEF OVERVIEW:  Admission Date: 10/27/2021 Discharge Date: 11/5/21 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Hypoxia [R09.02] Pneumonia due to COVID-19 virus [U07.1, J12.82] COVID-19 [U07.1] HOSPITAL COURSE Patient s a 81 y.o. female with past medical history of coronary artery disease, EF 55%, COPD who presented with hypoxia and altered mental status due to COVID encephelopathy in the setting of COVID infection. Husband reported 2 weeks of cough, diarrhea and confusion. Husband also reported mild dementia before this however pt was more altered than baseline dementia. CXR showed bilateral opacities. Treated with decadron. Was outside the window for remdesivir. Pt was diuresed during the admission.  Pt had mitts, restraints, seroquel was given due to encephelopathy and removing oxygen which cause her to desat to the 70's on multiple occasions.   Over multiple days patient began to become less encephalopathic and required less oxygen.  On 11/04 patient was fully awake and oriented on exam is, was conversing with her husband in the afternoon, was able to eat by herself and create linear conversations.  We observed her for 1 more day and to complete her steroid treatment.  Patient was discharged on 11/05 in stable condition for home with assist.
Age: 81.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: SARS-CoV-2 test positive
Clinical narrative: Hospitalized 10/27/2021; COVID-19 positive 10/27/2021; fully vaccinated  BRIEF OVERVIEW:  Admission Date: 10/27/2021 Discharge Date: 11/5/21 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Hypoxia [R09.02] Pneumonia due to COVID-19 virus [U07.1, J12.82] COVID-19 [U07.1] HOSPITAL COURSE Patient s a 81 y.o. female with past medical history of coronary artery disease, EF 55%, COPD who presented with hypoxia and altered mental status due to COVID encephelopathy in the setting of COVID infection. Husband reported 2 weeks of cough, diarrhea and confusion. Husband also reported mild dementia before this however pt was more altered than baseline dementia. CXR showed bilateral opacities. Treated with decadron. Was outside the window for remdesivir. Pt was diuresed during the admission.  Pt had mitts, restraints, seroquel was given due to encephelopathy and removing oxygen which cause her to desat to the 70's on multiple occasions.   Over multiple days patient began to become less encephalopathic and required less oxygen.  On 11/04 patient was fully awake and oriented on exam is, was conversing with her husband in the afternoon, was able to eat by herself and create linear conversations.  We observed her for 1 more day and to complete her steroid treatment.  Patient was discharged on 11/05 in stable condition for home with assist.
Age: 51.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Chest pain, Cough, Disorientation, Disturbance in attention
Clinical narrative: Started to feel dizzy with ringing in my ears and trouble focusing on work around 10am around 10:45 my face started to feel numb and I felt like I was going to pass out. Laid my head down for a bit and then called my PCP's office. While talking to the nurse, my speech was slurred and my tongue and the roof of my mouth started to feel numb. she advised me to take Benadryl and call 911. I took Benadryl called 911 they sent out EMS and they advised me that I was just injected with a live virus and this was the side effect of having COVID. That made no sense to me, she then instructed me to take DayQuil for the effects of having COVID. I told the EMT that I was not feeling like I had the flu I felt out of it and numb. She checked my vitals and lungs and said everything was good and that they could transport me to the Hospital ED but they were full and I would just be sitting there and it would be best to rest in my home. That if the Benadryl wore off or if things got worse, to go to urgent care. I slept and when I woke up the facial numbness was less and my tongue and mouth no longer felt numb. I was dizzy and my ears were still ringing and disoriented the entire day. The next day I was extremely tired and started to having coughing with chest pain when I would cough and by that evening I was having joint pain everywhere. Today I feel better, still have the coughing with chest pain. Following up with my PCP at 9:20am 11/04/21.
Age: 51.0
Sex: F
Vaccine: COVID19
Symptoms: Dizziness, Dysarthria, Fatigue, Feeling abnormal, Hypoaesthesia
Clinical narrative: Started to feel dizzy with ringing in my ears and trouble focusing on work around 10am around 10:45 my face started to feel numb and I felt like I was going to pass out. Laid my head down for a bit and then called my PCP's office. While talking to the nurse, my speech was slurred and my tongue and the roof of my mouth started to feel numb. she advised me to take Benadryl and call 911. I took Benadryl called 911 they sent out EMS and they advised me that I was just injected with a live virus and this was the side effect of having COVID. That made no sense to me, she then instructed me to take DayQuil for the effects of having COVID. I told the EMT that I was not feeling like I had the flu I felt out of it and numb. She checked my vitals and lungs and said everything was good and that they could transport me to the Hospital ED but they were full and I would just be sitting there and it would be best to rest in my home. That if the Benadryl wore off or if things got worse, to go to urgent care. I slept and when I woke up the facial numbness was less and my tongue and mouth no longer felt numb. I was dizzy and my ears were still ringing and disoriented the entire day. The next day I was extremely tired and started to having coughing with chest pain when I would cough and by that evening I was having joint pain everywhere. Today I feel better, still have the coughing with chest pain. Following up with my PCP at 9:20am 11/04/21.
Age: 51.0
Sex: F
Vaccine: COVID19
Symptoms: Hypoaesthesia oral, Impaired work ability, Tinnitus
Clinical narrative: Started to feel dizzy with ringing in my ears and trouble focusing on work around 10am around 10:45 my face started to feel numb and I felt like I was going to pass out. Laid my head down for a bit and then called my PCP's office. While talking to the nurse, my speech was slurred and my tongue and the roof of my mouth started to feel numb. she advised me to take Benadryl and call 911. I took Benadryl called 911 they sent out EMS and they advised me that I was just injected with a live virus and this was the side effect of having COVID. That made no sense to me, she then instructed me to take DayQuil for the effects of having COVID. I told the EMT that I was not feeling like I had the flu I felt out of it and numb. She checked my vitals and lungs and said everything was good and that they could transport me to the Hospital ED but they were full and I would just be sitting there and it would be best to rest in my home. That if the Benadryl wore off or if things got worse, to go to urgent care. I slept and when I woke up the facial numbness was less and my tongue and mouth no longer felt numb. I was dizzy and my ears were still ringing and disoriented the entire day. The next day I was extremely tired and started to having coughing with chest pain when I would cough and by that evening I was having joint pain everywhere. Today I feel better, still have the coughing with chest pain. Following up with my PCP at 9:20am 11/04/21.
Age: 80.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered, No adverse event
Clinical narrative: Patient inadvertently received vaccine after published expiration date. Moderna Company analyzed vaccine and advised lot 007B21A maintained activity needed to protect against covid 19  on date vaccine was administered. Patient also did not call in to complain of adverse event.  This is administrative error without adverse event.
Age: 40.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site induration, Injection site warmth, Lymphadenopathy, Pyrexia, Rash erythematous
Clinical narrative: High fever (103.1 was the highest) beginning Saturday, 10/30, continuing between 101-102.7 throught the night. Hard, hot shoulder at injection site, with red rash spreading over Saturday-Monday morning when I was seen. Swelling in lymph node in armpit of arm where shot was administered. Rotated Tylenol and Ibuprofen, but it was not helping. Tried icing the arm.
Age: 85.0
Sex: F
Vaccine: COVID19
Symptoms: Dysphagia, Dyspnoea, Eye swelling, Mouth swelling, Swelling face
Clinical narrative: Systemic: Allergic: Difficulty Breathing-Severe, Systemic: Allergic: Difficulty Swallowing, Throat Tightness-Severe, Systemic: Allergic: Swelling of Face / Eyes / Mouth / Tongue-Severe, Additional Details: symptom onset after patient left pharmacy, after the 15minute observation was over
Age: 85.0
Sex: F
Vaccine: COVID19
Symptoms: Swollen tongue, Throat tightness
Clinical narrative: Systemic: Allergic: Difficulty Breathing-Severe, Systemic: Allergic: Difficulty Swallowing, Throat Tightness-Severe, Systemic: Allergic: Swelling of Face / Eyes / Mouth / Tongue-Severe, Additional Details: symptom onset after patient left pharmacy, after the 15minute observation was over
Age: 74.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: STORAGE IN REFRIGERATOR (2C-8C) UP TO 30 DAYS. (VACCINE USED AFTER 10/16/2021)
Age: 68.0
Sex: M
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: STORAGE IN REFRIGERATOR (2C-8C) UP TO 30 DAYS (VACCINE USED AFTER 10/16/2021)
Age: 48.0
Sex: M
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: STORAGE REFRIGERATOR (2C-8C) UP TO 30 DAYS. (VACCINE USED AFTER 10-16-2021)
Age: 48.0
Sex: F
Vaccine: COVID19
Symptoms: Bone pain, Chills, Dyspnoea, Fatigue, Headache
Clinical narrative: extreme chills, body and bone ache, vomiting, headache, extreme fatigue, facial tingling, breathing difficulty, shortness of breath, fever
Age: 48.0
Sex: F
Vaccine: COVID19
Symptoms: Pain, Paraesthesia, Pyrexia, Vomiting
Clinical narrative: extreme chills, body and bone ache, vomiting, headache, extreme fatigue, facial tingling, breathing difficulty, shortness of breath, fever