chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 86.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Diarrhoea, Dyspnoea exertional, Electrocardiogram abnormal, Endotracheal intubation, Fall
Clinical narrative: 11/22/2021:  Patient tested positive for COVID in outpatient/community setting 11/23/2021:  given Casirivimab-Imdevimab dose in outpatient/community setting 11/24/21 @0100:  Presented to ER post fall with head laceration.  Noted to have SBP 80's, MAP <50, RR 30-40, HR 130-140, sat 73% on RA with respiratory distress on movement and accessory muscle use at rest.  Rapidly declining status required intubation in the ER.  BUN Crt 29/1.4, EGFR 51, WBC 15.7, CRP 8.3, troponin 0.210, glucose 304, ABG 7.331/35/143/18.5/BE -6.7 sat 100% on Bilevel vent settings 30/10 PS 20 FiO2 100%.  EKG shows new depression in inferiolateral leads.  CXR diffuse interstitial opacities consistent with COVID 19 PNA.  Admitted with acute hypox hypoxemic respiratory failure in the setting of bilateral COVID 19 PNA, septic shock, AKI, and NSTEMI with troponin peak of 0.483.  Started on IV Rocephin, IV doxycycline, methylprednisolone, baricitinip, levophed, IVF, ASA, and heparin gtt. 11/26/21:  Heparin gtt changed to Lovenox.  Bilevel 14 20/8 Fio2 80% WBC 24.2.  FMS placed for diarrhea c.diff negative.  Levophed weaned down to maintain MAP >65 SBP >100.   11/30/21:  Started PSV weaning trials in am.  Extubated in PM to 4LNC.  After a few hours post extubation required 8L via NC to maintain sat >90%. RR 20's  12/1/21:  Increase to 10L via HFNC RR 30's HR 120's.  Patient wished to have code status changed from full code to DNR/DNI with trial BiPaP. 12/2/21:  15L via HFNC with intermittent BiPap 14/8 FiO2 70% to rest.  RR 30-40 HR 110-120 anxious and dyspnic with any activity or movement 12/3/21:  Requiring BiPap at all times 100% FiO2.  Increased  respiratory distress and anxiety.  Family meeting with patient held.  Decided on comfort care measures only.  Placed on 4L NC, morphine and ativan gtt for comfort. 12/6/21 @2330 patient expired on comfort measures.
Age: 86.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Glomerular filtration rate decreased, Lung opacity, Mechanical ventilation, Positive airway pressure therapy, Respiratory distress
Clinical narrative: 11/22/2021:  Patient tested positive for COVID in outpatient/community setting 11/23/2021:  given Casirivimab-Imdevimab dose in outpatient/community setting 11/24/21 @0100:  Presented to ER post fall with head laceration.  Noted to have SBP 80's, MAP <50, RR 30-40, HR 130-140, sat 73% on RA with respiratory distress on movement and accessory muscle use at rest.  Rapidly declining status required intubation in the ER.  BUN Crt 29/1.4, EGFR 51, WBC 15.7, CRP 8.3, troponin 0.210, glucose 304, ABG 7.331/35/143/18.5/BE -6.7 sat 100% on Bilevel vent settings 30/10 PS 20 FiO2 100%.  EKG shows new depression in inferiolateral leads.  CXR diffuse interstitial opacities consistent with COVID 19 PNA.  Admitted with acute hypox hypoxemic respiratory failure in the setting of bilateral COVID 19 PNA, septic shock, AKI, and NSTEMI with troponin peak of 0.483.  Started on IV Rocephin, IV doxycycline, methylprednisolone, baricitinip, levophed, IVF, ASA, and heparin gtt. 11/26/21:  Heparin gtt changed to Lovenox.  Bilevel 14 20/8 Fio2 80% WBC 24.2.  FMS placed for diarrhea c.diff negative.  Levophed weaned down to maintain MAP >65 SBP >100.   11/30/21:  Started PSV weaning trials in am.  Extubated in PM to 4LNC.  After a few hours post extubation required 8L via NC to maintain sat >90%. RR 20's  12/1/21:  Increase to 10L via HFNC RR 30's HR 120's.  Patient wished to have code status changed from full code to DNR/DNI with trial BiPaP. 12/2/21:  15L via HFNC with intermittent BiPap 14/8 FiO2 70% to rest.  RR 30-40 HR 110-120 anxious and dyspnic with any activity or movement 12/3/21:  Requiring BiPap at all times 100% FiO2.  Increased  respiratory distress and anxiety.  Family meeting with patient held.  Decided on comfort care measures only.  Placed on 4L NC, morphine and ativan gtt for comfort. 12/6/21 @2330 patient expired on comfort measures.
Age: 86.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: SARS-CoV-2 test positive, Septic shock, Skin laceration, Spontaneous bacterial peritonitis, Troponin increased
Clinical narrative: 11/22/2021:  Patient tested positive for COVID in outpatient/community setting 11/23/2021:  given Casirivimab-Imdevimab dose in outpatient/community setting 11/24/21 @0100:  Presented to ER post fall with head laceration.  Noted to have SBP 80's, MAP <50, RR 30-40, HR 130-140, sat 73% on RA with respiratory distress on movement and accessory muscle use at rest.  Rapidly declining status required intubation in the ER.  BUN Crt 29/1.4, EGFR 51, WBC 15.7, CRP 8.3, troponin 0.210, glucose 304, ABG 7.331/35/143/18.5/BE -6.7 sat 100% on Bilevel vent settings 30/10 PS 20 FiO2 100%.  EKG shows new depression in inferiolateral leads.  CXR diffuse interstitial opacities consistent with COVID 19 PNA.  Admitted with acute hypox hypoxemic respiratory failure in the setting of bilateral COVID 19 PNA, septic shock, AKI, and NSTEMI with troponin peak of 0.483.  Started on IV Rocephin, IV doxycycline, methylprednisolone, baricitinip, levophed, IVF, ASA, and heparin gtt. 11/26/21:  Heparin gtt changed to Lovenox.  Bilevel 14 20/8 Fio2 80% WBC 24.2.  FMS placed for diarrhea c.diff negative.  Levophed weaned down to maintain MAP >65 SBP >100.   11/30/21:  Started PSV weaning trials in am.  Extubated in PM to 4LNC.  After a few hours post extubation required 8L via NC to maintain sat >90%. RR 20's  12/1/21:  Increase to 10L via HFNC RR 30's HR 120's.  Patient wished to have code status changed from full code to DNR/DNI with trial BiPaP. 12/2/21:  15L via HFNC with intermittent BiPap 14/8 FiO2 70% to rest.  RR 30-40 HR 110-120 anxious and dyspnic with any activity or movement 12/3/21:  Requiring BiPap at all times 100% FiO2.  Increased  respiratory distress and anxiety.  Family meeting with patient held.  Decided on comfort care measures only.  Placed on 4L NC, morphine and ativan gtt for comfort. 12/6/21 @2330 patient expired on comfort measures.
Age: 86.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Use of accessory respiratory muscles, White blood cell count increased
Clinical narrative: 11/22/2021:  Patient tested positive for COVID in outpatient/community setting 11/23/2021:  given Casirivimab-Imdevimab dose in outpatient/community setting 11/24/21 @0100:  Presented to ER post fall with head laceration.  Noted to have SBP 80's, MAP <50, RR 30-40, HR 130-140, sat 73% on RA with respiratory distress on movement and accessory muscle use at rest.  Rapidly declining status required intubation in the ER.  BUN Crt 29/1.4, EGFR 51, WBC 15.7, CRP 8.3, troponin 0.210, glucose 304, ABG 7.331/35/143/18.5/BE -6.7 sat 100% on Bilevel vent settings 30/10 PS 20 FiO2 100%.  EKG shows new depression in inferiolateral leads.  CXR diffuse interstitial opacities consistent with COVID 19 PNA.  Admitted with acute hypox hypoxemic respiratory failure in the setting of bilateral COVID 19 PNA, septic shock, AKI, and NSTEMI with troponin peak of 0.483.  Started on IV Rocephin, IV doxycycline, methylprednisolone, baricitinip, levophed, IVF, ASA, and heparin gtt. 11/26/21:  Heparin gtt changed to Lovenox.  Bilevel 14 20/8 Fio2 80% WBC 24.2.  FMS placed for diarrhea c.diff negative.  Levophed weaned down to maintain MAP >65 SBP >100.   11/30/21:  Started PSV weaning trials in am.  Extubated in PM to 4LNC.  After a few hours post extubation required 8L via NC to maintain sat >90%. RR 20's  12/1/21:  Increase to 10L via HFNC RR 30's HR 120's.  Patient wished to have code status changed from full code to DNR/DNI with trial BiPaP. 12/2/21:  15L via HFNC with intermittent BiPap 14/8 FiO2 70% to rest.  RR 30-40 HR 110-120 anxious and dyspnic with any activity or movement 12/3/21:  Requiring BiPap at all times 100% FiO2.  Increased  respiratory distress and anxiety.  Family meeting with patient held.  Decided on comfort care measures only.  Placed on 4L NC, morphine and ativan gtt for comfort. 12/6/21 @2330 patient expired on comfort measures.
Age: 35.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Anticoagulant therapy, Blood potassium decreased, Blood sodium decreased, C-reactive protein increased, COVID-19
Clinical narrative: 11/25/21:  Arrived to ER with complaints of nausea, vomiting, diarrhea, fever, chills X3 days.  NA 130, K 3.2, HR 140, Temp 102.0, CRP 17.8 requiring 2L NC to sat 94%.  Admitted for COVID + enterocolitis.  Started on IV decadron, IV remdesivir, IV cefepime, IV Flagyl, IV NS, and Lovenox.   11/29/21:  Discharged home after uncomplicated admission.  Requiring no oxygen on discharge.  Discharged to home with daily telemedicine follow up.
Age: 35.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Chills, Diarrhoea, Enterocolitis, Nausea, Pyrexia
Clinical narrative: 11/25/21:  Arrived to ER with complaints of nausea, vomiting, diarrhea, fever, chills X3 days.  NA 130, K 3.2, HR 140, Temp 102.0, CRP 17.8 requiring 2L NC to sat 94%.  Admitted for COVID + enterocolitis.  Started on IV decadron, IV remdesivir, IV cefepime, IV Flagyl, IV NS, and Lovenox.   11/29/21:  Discharged home after uncomplicated admission.  Requiring no oxygen on discharge.  Discharged to home with daily telemedicine follow up.
Age: 35.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: SARS-CoV-2 test positive, Vomiting
Clinical narrative: 11/25/21:  Arrived to ER with complaints of nausea, vomiting, diarrhea, fever, chills X3 days.  NA 130, K 3.2, HR 140, Temp 102.0, CRP 17.8 requiring 2L NC to sat 94%.  Admitted for COVID + enterocolitis.  Started on IV decadron, IV remdesivir, IV cefepime, IV Flagyl, IV NS, and Lovenox.   11/29/21:  Discharged home after uncomplicated admission.  Requiring no oxygen on discharge.  Discharged to home with daily telemedicine follow up.
Age: 37.0
Sex: M
Vaccine: COVID19, FLU4
Symptoms: Body temperature increased, Erythema, Headache, Myalgia, Nausea
Clinical narrative: Headache and general pain across skin and throughout muscles, as well as nausea on the first day after injection. Elevated body temperature. Beginning on the 13th, 4 days after injection, there was slight swelling on the right side of the lower back, with redness surrounding the area by about 2 inches. On the morning of the following day, hives covered the entire body, primarily on the upper torso and arms. Treatment began in the afternoon on the 14th with diphenhydramine hydrochloride, 25mg. Hives persist.
Age: 37.0
Sex: M
Vaccine: COVID19, FLU4
Symptoms: Pain of skin, Swelling, Urticaria
Clinical narrative: Headache and general pain across skin and throughout muscles, as well as nausea on the first day after injection. Elevated body temperature. Beginning on the 13th, 4 days after injection, there was slight swelling on the right side of the lower back, with redness surrounding the area by about 2 inches. On the morning of the following day, hives covered the entire body, primarily on the upper torso and arms. Treatment began in the afternoon on the 14th with diphenhydramine hydrochloride, 25mg. Hives persist.
Age: 37.0
Sex: F
Vaccine: COVID19
Symptoms: Extra dose administered, No adverse event
Clinical narrative: No adverse events reported. 3rd dose of Moderna accidentally administered as booster before Moderna was approved for use as a booster.
Age: 35.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Fatigue, Feeling cold, Mobility decreased, Musculoskeletal pain
Clinical narrative: Symptoms: extreme chills to the point where I could not sleep and could not get warm.  Fever 101-102.  Body aches and extreme exhaustion to the point I could barely move.  Symptoms were much worse than the second Moderna vaccine.  It finally started to get better about 48 hours after injection.  I still have some lingering musculoskeletal aches.
Age: 35.0
Sex: F
Vaccine: COVID19
Symptoms: Pain, Pyrexia, Sleep disorder
Clinical narrative: Symptoms: extreme chills to the point where I could not sleep and could not get warm.  Fever 101-102.  Body aches and extreme exhaustion to the point I could barely move.  Symptoms were much worse than the second Moderna vaccine.  It finally started to get better about 48 hours after injection.  I still have some lingering musculoskeletal aches.
Age: 70.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Anticoagulant therapy, Atelectasis, Blood gases, C-reactive protein increased, COVID-19
Clinical narrative: 11/27/21 @0350:  Arrived to ER with c/o severe SOB sat 67% on home pulse ox.  Denies fever, chills, N/V, or any other S/Sx.  RR 30-40, HR 100-120, sat 80% on RA with noticeable respiratory difficulty at rest, BP 193/87, 36.9 degrees C.  CRP 5.2, EGFR 47, INR 1.62, WBC 16.1, ABG 7.40/42/26/25.6/BE 1.2 sat 98% on 6L NC.  CT shows no new PE, new multilobular atelectasis with RUL consolidation and small bilateral pulmonary effusions with mildly enlarged mediastinal lymph nodes.  Started on dexamethasone, vitamin cocktail, baricitinib, changed home Eliquis to Lovenox, and admitted to telemetry unit. 11/28/21 @ 0830:  weaned off oxygen to 95% on RA.  Mild SOB with activity.  Discharged home in late afternoon with COVID Hospital Care at Home program from other provider in patient's local area.
Age: 70.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Cardiac telemetry, Computerised tomogram thorax abnormal, Dyspnoea, Dyspnoea at rest, Dyspnoea exertional
Clinical narrative: 11/27/21 @0350:  Arrived to ER with c/o severe SOB sat 67% on home pulse ox.  Denies fever, chills, N/V, or any other S/Sx.  RR 30-40, HR 100-120, sat 80% on RA with noticeable respiratory difficulty at rest, BP 193/87, 36.9 degrees C.  CRP 5.2, EGFR 47, INR 1.62, WBC 16.1, ABG 7.40/42/26/25.6/BE 1.2 sat 98% on 6L NC.  CT shows no new PE, new multilobular atelectasis with RUL consolidation and small bilateral pulmonary effusions with mildly enlarged mediastinal lymph nodes.  Started on dexamethasone, vitamin cocktail, baricitinib, changed home Eliquis to Lovenox, and admitted to telemetry unit. 11/28/21 @ 0830:  weaned off oxygen to 95% on RA.  Mild SOB with activity.  Discharged home in late afternoon with COVID Hospital Care at Home program from other provider in patient's local area.
Age: 70.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Glomerular filtration rate decreased, International normalised ratio increased, Lung consolidation, Lymphadenopathy mediastinal, Pleural effusion
Clinical narrative: 11/27/21 @0350:  Arrived to ER with c/o severe SOB sat 67% on home pulse ox.  Denies fever, chills, N/V, or any other S/Sx.  RR 30-40, HR 100-120, sat 80% on RA with noticeable respiratory difficulty at rest, BP 193/87, 36.9 degrees C.  CRP 5.2, EGFR 47, INR 1.62, WBC 16.1, ABG 7.40/42/26/25.6/BE 1.2 sat 98% on 6L NC.  CT shows no new PE, new multilobular atelectasis with RUL consolidation and small bilateral pulmonary effusions with mildly enlarged mediastinal lymph nodes.  Started on dexamethasone, vitamin cocktail, baricitinib, changed home Eliquis to Lovenox, and admitted to telemetry unit. 11/28/21 @ 0830:  weaned off oxygen to 95% on RA.  Mild SOB with activity.  Discharged home in late afternoon with COVID Hospital Care at Home program from other provider in patient's local area.
Age: 70.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: White blood cell count increased
Clinical narrative: 11/27/21 @0350:  Arrived to ER with c/o severe SOB sat 67% on home pulse ox.  Denies fever, chills, N/V, or any other S/Sx.  RR 30-40, HR 100-120, sat 80% on RA with noticeable respiratory difficulty at rest, BP 193/87, 36.9 degrees C.  CRP 5.2, EGFR 47, INR 1.62, WBC 16.1, ABG 7.40/42/26/25.6/BE 1.2 sat 98% on 6L NC.  CT shows no new PE, new multilobular atelectasis with RUL consolidation and small bilateral pulmonary effusions with mildly enlarged mediastinal lymph nodes.  Started on dexamethasone, vitamin cocktail, baricitinib, changed home Eliquis to Lovenox, and admitted to telemetry unit. 11/28/21 @ 0830:  weaned off oxygen to 95% on RA.  Mild SOB with activity.  Discharged home in late afternoon with COVID Hospital Care at Home program from other provider in patient's local area.
Age: 17.0
Sex: M
Vaccine: MENB
Symptoms: Urticaria
Clinical narrative: Urticaria, no wheezing, facial swelling or sob.  Resolved with Benadryl .
Age: 42.0
Sex: M
Vaccine: COVID19
Symptoms: Lymphadenopathy
Clinical narrative: The patient developed  significant axillary swelling 2 days post booster in the right arm which is the same arm as the booster administered in. No erythema. No lymphadenopathy. No fluctuance. No fevers
Age: 41.0
Sex: F
Vaccine: FLUA4
Symptoms: No adverse event, Product administered to patient of inappropriate age
Clinical narrative: Patient was given FLUAD versus intended FLUZONE VACCINE, patient did not experience any side effects, protentional side effects were discussed with patient by doctor. Patient advice to call office with any concerns or symptoms.
Age: 64.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Acute respiratory failure, Atelectasis, Blood lactate dehydrogenase increased, C-reactive protein increased, COVID-19 pneumonia
Clinical narrative: 11/27/21:  Complaints of feeling unwell with productive cough and nausea X 2 weeks.  Head ache for last three days.  Had increased SOB and chest pain with deep inspiration so went to PCP who then sent patient to the ER for evaluation.  In ER noted CRP 3.1, d-dimer 274, ferritin 203, LD 522, CXR shows bibasilar atelectasis and/or infiltrates.  Temp 37.3 C, Sat 89% on 3L NC, RR 20's with moist cough.  Auscultate bilateral scattered rales in bases.  Admitted with acute hypoxic respiratory failure secondary to COVID 19 PNA.  Started on IV ceftriaxone, IV doxycyline, IV decadron, remdesivir, and baricitinib. 12/2/21:  Hospitalization uneventful.  Arrangements made for resumption of home oxygen upon discharge.
Age: 64.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Chest X-ray abnormal, Chest pain, Dyspnoea, Fibrin D dimer increased, Headache
Clinical narrative: 11/27/21:  Complaints of feeling unwell with productive cough and nausea X 2 weeks.  Head ache for last three days.  Had increased SOB and chest pain with deep inspiration so went to PCP who then sent patient to the ER for evaluation.  In ER noted CRP 3.1, d-dimer 274, ferritin 203, LD 522, CXR shows bibasilar atelectasis and/or infiltrates.  Temp 37.3 C, Sat 89% on 3L NC, RR 20's with moist cough.  Auscultate bilateral scattered rales in bases.  Admitted with acute hypoxic respiratory failure secondary to COVID 19 PNA.  Started on IV ceftriaxone, IV doxycyline, IV decadron, remdesivir, and baricitinib. 12/2/21:  Hospitalization uneventful.  Arrangements made for resumption of home oxygen upon discharge.
Age: 64.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Lung infiltration, Malaise, Nausea, Painful respiration, Productive cough
Clinical narrative: 11/27/21:  Complaints of feeling unwell with productive cough and nausea X 2 weeks.  Head ache for last three days.  Had increased SOB and chest pain with deep inspiration so went to PCP who then sent patient to the ER for evaluation.  In ER noted CRP 3.1, d-dimer 274, ferritin 203, LD 522, CXR shows bibasilar atelectasis and/or infiltrates.  Temp 37.3 C, Sat 89% on 3L NC, RR 20's with moist cough.  Auscultate bilateral scattered rales in bases.  Admitted with acute hypoxic respiratory failure secondary to COVID 19 PNA.  Started on IV ceftriaxone, IV doxycyline, IV decadron, remdesivir, and baricitinib. 12/2/21:  Hospitalization uneventful.  Arrangements made for resumption of home oxygen upon discharge.
Age: 64.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Rales, Serum ferritin normal
Clinical narrative: 11/27/21:  Complaints of feeling unwell with productive cough and nausea X 2 weeks.  Head ache for last three days.  Had increased SOB and chest pain with deep inspiration so went to PCP who then sent patient to the ER for evaluation.  In ER noted CRP 3.1, d-dimer 274, ferritin 203, LD 522, CXR shows bibasilar atelectasis and/or infiltrates.  Temp 37.3 C, Sat 89% on 3L NC, RR 20's with moist cough.  Auscultate bilateral scattered rales in bases.  Admitted with acute hypoxic respiratory failure secondary to COVID 19 PNA.  Started on IV ceftriaxone, IV doxycyline, IV decadron, remdesivir, and baricitinib. 12/2/21:  Hospitalization uneventful.  Arrangements made for resumption of home oxygen upon discharge.
Age: 71.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Abdominal pain, Acute kidney injury, Acute myocardial infarction, Alanine aminotransferase increased, Aspartate aminotransferase increased
Clinical narrative: 11/28/21:  presented to ER with complaints of cough, wheezing, increased shortness of breath, abdominal pain, nausea, and tarry stools.  Findings in ER BUN Crt 37/2.4 with eGFR 28, AST 75, ALT 62, WBC 7.1, HH 11.8/39.3.  HR 70s, temp 97.9 F, RR 27, SBP labile 80-100, sat 94% on 4L NC (baseline O2 needs).  CXR bibasilar infiltrates.  COVID positive.  Admitted with COVID PNA, AKI due to dehydration, suspected lower GI bleed.  Given IVF bolus 2000 ml, levophed started at 5mcg and titrated, remdesivir, multivitamin cocktail, IV Cefepime, IV doxycycline, steroids, anticoags on hold d/t possible GI bleed. 11/29/21:  Levophed off.  SBP 95-110.  RR 20s sat 95% on 4L NC remains afebrile.  SOB at rest.  Loose green liquid BMX2 negative for c.diff.   12/1/21:  Hospitalization uneventful.  Discharged to another facility on baseline home O2 4LNC sat 96% SOB with activity back to patient baseline.  HH stable throughout stay with no blood transfusion needed.
Age: 71.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Blood creatinine increased, Blood urea increased, COVID-19, COVID-19 pneumonia, Chest X-ray abnormal
Clinical narrative: 11/28/21:  presented to ER with complaints of cough, wheezing, increased shortness of breath, abdominal pain, nausea, and tarry stools.  Findings in ER BUN Crt 37/2.4 with eGFR 28, AST 75, ALT 62, WBC 7.1, HH 11.8/39.3.  HR 70s, temp 97.9 F, RR 27, SBP labile 80-100, sat 94% on 4L NC (baseline O2 needs).  CXR bibasilar infiltrates.  COVID positive.  Admitted with COVID PNA, AKI due to dehydration, suspected lower GI bleed.  Given IVF bolus 2000 ml, levophed started at 5mcg and titrated, remdesivir, multivitamin cocktail, IV Cefepime, IV doxycycline, steroids, anticoags on hold d/t possible GI bleed. 11/29/21:  Levophed off.  SBP 95-110.  RR 20s sat 95% on 4L NC remains afebrile.  SOB at rest.  Loose green liquid BMX2 negative for c.diff.   12/1/21:  Hospitalization uneventful.  Discharged to another facility on baseline home O2 4LNC sat 96% SOB with activity back to patient baseline.  HH stable throughout stay with no blood transfusion needed.
Age: 71.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Clostridium test negative, Cough, Dehydration, Diarrhoea, Dyspnoea
Clinical narrative: 11/28/21:  presented to ER with complaints of cough, wheezing, increased shortness of breath, abdominal pain, nausea, and tarry stools.  Findings in ER BUN Crt 37/2.4 with eGFR 28, AST 75, ALT 62, WBC 7.1, HH 11.8/39.3.  HR 70s, temp 97.9 F, RR 27, SBP labile 80-100, sat 94% on 4L NC (baseline O2 needs).  CXR bibasilar infiltrates.  COVID positive.  Admitted with COVID PNA, AKI due to dehydration, suspected lower GI bleed.  Given IVF bolus 2000 ml, levophed started at 5mcg and titrated, remdesivir, multivitamin cocktail, IV Cefepime, IV doxycycline, steroids, anticoags on hold d/t possible GI bleed. 11/29/21:  Levophed off.  SBP 95-110.  RR 20s sat 95% on 4L NC remains afebrile.  SOB at rest.  Loose green liquid BMX2 negative for c.diff.   12/1/21:  Hospitalization uneventful.  Discharged to another facility on baseline home O2 4LNC sat 96% SOB with activity back to patient baseline.  HH stable throughout stay with no blood transfusion needed.
Age: 71.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Dyspnoea at rest, Faeces discoloured, Glomerular filtration rate, Haematocrit decreased, Haemoglobin decreased
Clinical narrative: 11/28/21:  presented to ER with complaints of cough, wheezing, increased shortness of breath, abdominal pain, nausea, and tarry stools.  Findings in ER BUN Crt 37/2.4 with eGFR 28, AST 75, ALT 62, WBC 7.1, HH 11.8/39.3.  HR 70s, temp 97.9 F, RR 27, SBP labile 80-100, sat 94% on 4L NC (baseline O2 needs).  CXR bibasilar infiltrates.  COVID positive.  Admitted with COVID PNA, AKI due to dehydration, suspected lower GI bleed.  Given IVF bolus 2000 ml, levophed started at 5mcg and titrated, remdesivir, multivitamin cocktail, IV Cefepime, IV doxycycline, steroids, anticoags on hold d/t possible GI bleed. 11/29/21:  Levophed off.  SBP 95-110.  RR 20s sat 95% on 4L NC remains afebrile.  SOB at rest.  Loose green liquid BMX2 negative for c.diff.   12/1/21:  Hospitalization uneventful.  Discharged to another facility on baseline home O2 4LNC sat 96% SOB with activity back to patient baseline.  HH stable throughout stay with no blood transfusion needed.
Age: 71.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Labile blood pressure, Lower gastrointestinal haemorrhage, Lung infiltration, Melaena, Nausea
Clinical narrative: 11/28/21:  presented to ER with complaints of cough, wheezing, increased shortness of breath, abdominal pain, nausea, and tarry stools.  Findings in ER BUN Crt 37/2.4 with eGFR 28, AST 75, ALT 62, WBC 7.1, HH 11.8/39.3.  HR 70s, temp 97.9 F, RR 27, SBP labile 80-100, sat 94% on 4L NC (baseline O2 needs).  CXR bibasilar infiltrates.  COVID positive.  Admitted with COVID PNA, AKI due to dehydration, suspected lower GI bleed.  Given IVF bolus 2000 ml, levophed started at 5mcg and titrated, remdesivir, multivitamin cocktail, IV Cefepime, IV doxycycline, steroids, anticoags on hold d/t possible GI bleed. 11/29/21:  Levophed off.  SBP 95-110.  RR 20s sat 95% on 4L NC remains afebrile.  SOB at rest.  Loose green liquid BMX2 negative for c.diff.   12/1/21:  Hospitalization uneventful.  Discharged to another facility on baseline home O2 4LNC sat 96% SOB with activity back to patient baseline.  HH stable throughout stay with no blood transfusion needed.
Age: 71.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: SARS-CoV-2 test positive, Wheezing, White blood cell count normal
Clinical narrative: 11/28/21:  presented to ER with complaints of cough, wheezing, increased shortness of breath, abdominal pain, nausea, and tarry stools.  Findings in ER BUN Crt 37/2.4 with eGFR 28, AST 75, ALT 62, WBC 7.1, HH 11.8/39.3.  HR 70s, temp 97.9 F, RR 27, SBP labile 80-100, sat 94% on 4L NC (baseline O2 needs).  CXR bibasilar infiltrates.  COVID positive.  Admitted with COVID PNA, AKI due to dehydration, suspected lower GI bleed.  Given IVF bolus 2000 ml, levophed started at 5mcg and titrated, remdesivir, multivitamin cocktail, IV Cefepime, IV doxycycline, steroids, anticoags on hold d/t possible GI bleed. 11/29/21:  Levophed off.  SBP 95-110.  RR 20s sat 95% on 4L NC remains afebrile.  SOB at rest.  Loose green liquid BMX2 negative for c.diff.   12/1/21:  Hospitalization uneventful.  Discharged to another facility on baseline home O2 4LNC sat 96% SOB with activity back to patient baseline.  HH stable throughout stay with no blood transfusion needed.
Age: 14.0
Sex: F
Vaccine: COVID19
Symptoms: Underdose
Clinical narrative: Error: Wrong Dose of Vaccine - Too Low-
Age: 77.0
Sex: F
Vaccine: COVID19
Symptoms: Dizziness, Fall
Clinical narrative: DIZZINESS LASTING FOR FEW DAYS, PATIENT TOOK A FALL AND ENDED UP IN EMERGENCY ROOM.
Age: 39.0
Sex: F
Vaccine: COVID19
Symptoms: Inappropriate schedule of product administration
Clinical narrative: Booster given too early (4 months instead of 6 months)
Age: 9.0
Sex: F
Vaccine: COVID19
Symptoms: Inappropriate schedule of product administration, No adverse event
Clinical narrative: Patient received 2nd dose of Pfizer vaccine at 14 day interval instead of 21 day interval. Patient mother notified of error. Pediatrician notified and consulted. Mother advised no need to repeat dose. No adverse reaction occurred.
Age: 6.0
Sex: M
Vaccine: COVID19
Symptoms: Rash
Clinical narrative: pt broke out with a small rash on his back
Age: 21.0
Sex: F
Vaccine: COVID19
Symptoms: Paraesthesia, Throat irritation
Clinical narrative: After speaking to patient about reactions to allergies listed, it was advised that patient wait in Covid-19 seating area, after about 15 minutes patient informed pharmacist of tingling along the jaw line, had patient wait a little longer she then reported having a scratchy throat-no swelling and no trouble breathing. She said she has a scratchy throat with peanut allergy in the past and nothing else(no use of EpiPen ever needed). Pharmacist gave one dose of 50mg Benadryl and patient continued to wait (total wait for observation 1 hr) no additional reaction or intervention required
Age: 66.0
Sex: F
Vaccine: COVID19
Symptoms: Alopecia, Aphonia, Dry skin, Pruritus
Clinical narrative: Patient stated she has an itchy and dry scalp and is now losing her hair. She's also losing her voice. Her PCP referred her to a dermatologist but she has not yet been seen.
Age: 12.0
Sex: F
Vaccine: COVID19
Symptoms: Product administered to patient of inappropriate age
Clinical narrative: ADMINISTRATION ERROR: 12 YEAR OLD FEMALE PATIENT IS VACCINATED WITH THE BOOSTER DOSE OF THE PFIZER VACCINE. THE BOOSTER DOSE OF THE PFIZER VACCINE IS AUTHORIZED FOR PATIENTS AGED 16 AND OLDER ONCE THE 6 MONTHS OF THEIR SECOND DOSE.
Age: 13.0
Sex: M
Vaccine: COVID19
Symptoms: Dizziness, Fall, Head injury, Syncope, Unresponsive to stimuli
Clinical narrative: Systemic: Dizziness / Lightheadness-Medium, Systemic: Fainting / Unresponsive-Medium, Additional Details: Individual received vaccination, after sitting (for unknown amount of time), patient was standing and fell and hit head.
Age: 56.0
Sex: F
Vaccine: COVID19
Symptoms: Blood test, Injection site nerve damage, Injection site pain, Magnetic resonance imaging spinal, Muscular weakness
Clinical narrative: I am writing to learn whether or not symptoms that I am experiencing post my Pfizer Covid-19 vaccines, which were both given to me on my left arm have been reported.  Post my second vaccine I had experienced some tenderness in my left arm which lasted more than 3 days.  They eventually left.  However, in early July, 2021.  I began to experience during my workouts some weakness on my left arm from shoulder, down my arm.  I continued to work out assuming that it would strengthen itself at some point.  I went to see my primary care doctor, on or about 11/04/ 21 and informed her of my concern.  She recommended an x-ray of my shoulder.  On 11/5/21, I went to Orthopedics and met with PA who did the shoulder x-ray, and referred me for a Stat MRI of my spine, which I had done on 11/5/21.  I was referred by PA  to a spine surgeon at the Orthopedic Office.  Dr. performed some reflex tests, went over my MRI and informed me that he would be referring me to a neurologist from Neurology Office.   I met with Dr. 2 weeks ago and yesterday we had a follow up.  I have nerve damage in my left arm, and am now being referred to Hospital.
Age: 56.0
Sex: F
Vaccine: COVID19
Symptoms: Reflex test, X-ray limb
Clinical narrative: I am writing to learn whether or not symptoms that I am experiencing post my Pfizer Covid-19 vaccines, which were both given to me on my left arm have been reported.  Post my second vaccine I had experienced some tenderness in my left arm which lasted more than 3 days.  They eventually left.  However, in early July, 2021.  I began to experience during my workouts some weakness on my left arm from shoulder, down my arm.  I continued to work out assuming that it would strengthen itself at some point.  I went to see my primary care doctor, on or about 11/04/ 21 and informed her of my concern.  She recommended an x-ray of my shoulder.  On 11/5/21, I went to Orthopedics and met with PA who did the shoulder x-ray, and referred me for a Stat MRI of my spine, which I had done on 11/5/21.  I was referred by PA  to a spine surgeon at the Orthopedic Office.  Dr. performed some reflex tests, went over my MRI and informed me that he would be referring me to a neurologist from Neurology Office.   I met with Dr. 2 weeks ago and yesterday we had a follow up.  I have nerve damage in my left arm, and am now being referred to Hospital.
Age: 30.0
Sex: F
Vaccine: COVID19
Symptoms: Extra dose administered, Underdose
Clinical narrative: CLIENT SIGNED CONSENT FOR BOOSTER AND RECEIVED PEDIATRIC LOT# FK5127 AND DOSE 0.2ML INSTEAD.
Age: 90.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Vaccine breakthrough infection
Clinical narrative: HOSPITALIZATION - BREAKTHROUGH COVID-19 CASE: 11/29/21 TO 12/2/21
Age: 49.0
Sex: F
Vaccine: COVID19
Symptoms: Blood test, Chest X-ray, Chills, Gait disturbance, Headache
Clinical narrative: After receiving the vaccine, I had a fever. The fever didn't go away after 3 days. The fever was high.  I was shaking and my fever went up to 103.5 degrees. On Sunday I couldn't even move. I didn't have a cough. I just had a fever, headache, body ache, chills, and nausea. On the first day I couldn't hardly walk. It was in the middle of the day, and I was shaking. My fever was so high, so I took 1000mg of Tylenol. My fever went down to 99 degrees then after a couple hours it went back up. I went to the urgent care on Friday night on 12/10/2021. They prescribed me Ibuprofen 800mg and Zofran 4mg. On 12/13/2021 I went to the ER. I was diagnosed with a UTI. I was prescribed an antibiotic for it which was cephalexin 500mg.
Age: 49.0
Sex: F
Vaccine: COVID19
Symptoms: Influenza virus test negative, Movement disorder, Nausea, Pain, Pyrexia
Clinical narrative: After receiving the vaccine, I had a fever. The fever didn't go away after 3 days. The fever was high.  I was shaking and my fever went up to 103.5 degrees. On Sunday I couldn't even move. I didn't have a cough. I just had a fever, headache, body ache, chills, and nausea. On the first day I couldn't hardly walk. It was in the middle of the day, and I was shaking. My fever was so high, so I took 1000mg of Tylenol. My fever went down to 99 degrees then after a couple hours it went back up. I went to the urgent care on Friday night on 12/10/2021. They prescribed me Ibuprofen 800mg and Zofran 4mg. On 12/13/2021 I went to the ER. I was diagnosed with a UTI. I was prescribed an antibiotic for it which was cephalexin 500mg.
Age: 49.0
Sex: F
Vaccine: COVID19
Symptoms: SARS-CoV-2 test negative, Tremor, Urinary tract infection, Urine analysis
Clinical narrative: After receiving the vaccine, I had a fever. The fever didn't go away after 3 days. The fever was high.  I was shaking and my fever went up to 103.5 degrees. On Sunday I couldn't even move. I didn't have a cough. I just had a fever, headache, body ache, chills, and nausea. On the first day I couldn't hardly walk. It was in the middle of the day, and I was shaking. My fever was so high, so I took 1000mg of Tylenol. My fever went down to 99 degrees then after a couple hours it went back up. I went to the urgent care on Friday night on 12/10/2021. They prescribed me Ibuprofen 800mg and Zofran 4mg. On 12/13/2021 I went to the ER. I was diagnosed with a UTI. I was prescribed an antibiotic for it which was cephalexin 500mg.
Age: 55.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Rash, Urticaria
Clinical narrative: Site: Pain at Injection Site-Medium, Site: Redness at Injection Site-Medium, Site: Swelling at Injection Site-Mild, Systemic: Allergic: Rash Generalized-Mild, Additional Details: Pt reported hives 2 days after vaccine
Age: 75.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: COVID-19, Vaccine breakthrough infection
Clinical narrative: Fully vaccinated with COVID breakthrough infection and inpatient hospital stay
Age: 16.0
Sex: M
Vaccine: COVID19
Symptoms: Product substitution issue
Clinical narrative: NURSE INSTRUCTED TO ADMINSTER PFIZER COVID 19 VACCINE. PARENT OF PATIENT LATER REQUESTED TO ADMINSTER MODERNA
Age: 46.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Adenovirus test positive, Blood creatinine increased, Blood culture, COVID-19, COVID-19 pneumonia
Clinical narrative: Patient reports onset of cough and shortness of breath on Tuesday, 11/30; she reports she came into contact known Covid positive patient on the bus.  Reports she went that same day, on 11/30 and received a positive Covid test.  She presents to the ED 12/2 after the onset of worsening shortness of breath and fever and chills.  She was vaccinated in March/April.  Denies loss of smell, taste, diarrhea.  12/14: 47-year-old female with PMH significant for CKD stage IV secondary to lupus nephritis, history of CVA with residual right-sided weakness and expressive aphasia 2012, history of lupus(on hydroxychloroquine, prednisone), HTN, seizure disorder, previously vaccinated for Covid was transferred from family medicine service to MICU for worsening hypoxic respiratory failure in the setting of Covid pneumonia. Symptom onset date 11/30.  Admitted to family medicine for worsening hypoxic respiratory failure requiring supplemental oxygenation, and was transferred to MICU for BiPAP initiation. Patient is s/p dexamethasone and tocilizumab. Remdesivir stopped early on 12/2 due to GFR <30. Holding hydroxychloroquine and CellCept. On 12/06 patient had increased resp fatigue and was intubated. Proning started 12/07. 12/09 patient was transfused 1 unit of RBC , Cr also increased so nephro consulted to place dialysis line on 12/09. Patient started on SLED for poor UOP and rapidly rising Cr. Worsening oxygen saturation prompted infectious workup on 12/11 with blood/urine cultures, QTL cultures, giemsa stain, PNA panel. Vanc and mero initiated on 12/11, stopped 12/13. RPP positive for adenovirus. On 40 iNO. Patient desaturated this AM after unproning and saturation dropped to 70%; increased slightly with change in ventilator settings to EPRV and repeat proning. Hgb this AM dropped to 7.0; FOBT positive; suspected internal bleeding. 1u PRBCs given with repeat H&H 1 hour afterwards. Comfort care conference today with family; patient's aunt, and both of patient's daughters opted to pursue comfort care. They understand that comfort care means stopping all life saving measures with the intention of keeping patient comfortable. They would like to begin that process soon; one of the family members would like to organize a zoom call before ETT tube is removed. She had no further questions. Will stop nimbex now and slowly wean sedation with ultimate removal of ET tube. Suspect patient will pass immediately with removal of tube considering the amount of ventilator support. Will call patient's aunt after patient passes.
Age: 46.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Chills, Cough, Culture, Culture urine, Dialysis device insertion
Clinical narrative: Patient reports onset of cough and shortness of breath on Tuesday, 11/30; she reports she came into contact known Covid positive patient on the bus.  Reports she went that same day, on 11/30 and received a positive Covid test.  She presents to the ED 12/2 after the onset of worsening shortness of breath and fever and chills.  She was vaccinated in March/April.  Denies loss of smell, taste, diarrhea.  12/14: 47-year-old female with PMH significant for CKD stage IV secondary to lupus nephritis, history of CVA with residual right-sided weakness and expressive aphasia 2012, history of lupus(on hydroxychloroquine, prednisone), HTN, seizure disorder, previously vaccinated for Covid was transferred from family medicine service to MICU for worsening hypoxic respiratory failure in the setting of Covid pneumonia. Symptom onset date 11/30.  Admitted to family medicine for worsening hypoxic respiratory failure requiring supplemental oxygenation, and was transferred to MICU for BiPAP initiation. Patient is s/p dexamethasone and tocilizumab. Remdesivir stopped early on 12/2 due to GFR <30. Holding hydroxychloroquine and CellCept. On 12/06 patient had increased resp fatigue and was intubated. Proning started 12/07. 12/09 patient was transfused 1 unit of RBC , Cr also increased so nephro consulted to place dialysis line on 12/09. Patient started on SLED for poor UOP and rapidly rising Cr. Worsening oxygen saturation prompted infectious workup on 12/11 with blood/urine cultures, QTL cultures, giemsa stain, PNA panel. Vanc and mero initiated on 12/11, stopped 12/13. RPP positive for adenovirus. On 40 iNO. Patient desaturated this AM after unproning and saturation dropped to 70%; increased slightly with change in ventilator settings to EPRV and repeat proning. Hgb this AM dropped to 7.0; FOBT positive; suspected internal bleeding. 1u PRBCs given with repeat H&H 1 hour afterwards. Comfort care conference today with family; patient's aunt, and both of patient's daughters opted to pursue comfort care. They understand that comfort care means stopping all life saving measures with the intention of keeping patient comfortable. They would like to begin that process soon; one of the family members would like to organize a zoom call before ETT tube is removed. She had no further questions. Will stop nimbex now and slowly wean sedation with ultimate removal of ET tube. Suspect patient will pass immediately with removal of tube considering the amount of ventilator support. Will call patient's aunt after patient passes.
Age: 46.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Dyspnoea, Endotracheal intubation, Exposure to SARS-CoV-2, Glomerular filtration rate decreased, Haematocrit
Clinical narrative: Patient reports onset of cough and shortness of breath on Tuesday, 11/30; she reports she came into contact known Covid positive patient on the bus.  Reports she went that same day, on 11/30 and received a positive Covid test.  She presents to the ED 12/2 after the onset of worsening shortness of breath and fever and chills.  She was vaccinated in March/April.  Denies loss of smell, taste, diarrhea.  12/14: 47-year-old female with PMH significant for CKD stage IV secondary to lupus nephritis, history of CVA with residual right-sided weakness and expressive aphasia 2012, history of lupus(on hydroxychloroquine, prednisone), HTN, seizure disorder, previously vaccinated for Covid was transferred from family medicine service to MICU for worsening hypoxic respiratory failure in the setting of Covid pneumonia. Symptom onset date 11/30.  Admitted to family medicine for worsening hypoxic respiratory failure requiring supplemental oxygenation, and was transferred to MICU for BiPAP initiation. Patient is s/p dexamethasone and tocilizumab. Remdesivir stopped early on 12/2 due to GFR <30. Holding hydroxychloroquine and CellCept. On 12/06 patient had increased resp fatigue and was intubated. Proning started 12/07. 12/09 patient was transfused 1 unit of RBC , Cr also increased so nephro consulted to place dialysis line on 12/09. Patient started on SLED for poor UOP and rapidly rising Cr. Worsening oxygen saturation prompted infectious workup on 12/11 with blood/urine cultures, QTL cultures, giemsa stain, PNA panel. Vanc and mero initiated on 12/11, stopped 12/13. RPP positive for adenovirus. On 40 iNO. Patient desaturated this AM after unproning and saturation dropped to 70%; increased slightly with change in ventilator settings to EPRV and repeat proning. Hgb this AM dropped to 7.0; FOBT positive; suspected internal bleeding. 1u PRBCs given with repeat H&H 1 hour afterwards. Comfort care conference today with family; patient's aunt, and both of patient's daughters opted to pursue comfort care. They understand that comfort care means stopping all life saving measures with the intention of keeping patient comfortable. They would like to begin that process soon; one of the family members would like to organize a zoom call before ETT tube is removed. She had no further questions. Will stop nimbex now and slowly wean sedation with ultimate removal of ET tube. Suspect patient will pass immediately with removal of tube considering the amount of ventilator support. Will call patient's aunt after patient passes.
Age: 46.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Haemofiltration, Haemoglobin decreased, Intensive care, Internal haemorrhage, Laboratory test
Clinical narrative: Patient reports onset of cough and shortness of breath on Tuesday, 11/30; she reports she came into contact known Covid positive patient on the bus.  Reports she went that same day, on 11/30 and received a positive Covid test.  She presents to the ED 12/2 after the onset of worsening shortness of breath and fever and chills.  She was vaccinated in March/April.  Denies loss of smell, taste, diarrhea.  12/14: 47-year-old female with PMH significant for CKD stage IV secondary to lupus nephritis, history of CVA with residual right-sided weakness and expressive aphasia 2012, history of lupus(on hydroxychloroquine, prednisone), HTN, seizure disorder, previously vaccinated for Covid was transferred from family medicine service to MICU for worsening hypoxic respiratory failure in the setting of Covid pneumonia. Symptom onset date 11/30.  Admitted to family medicine for worsening hypoxic respiratory failure requiring supplemental oxygenation, and was transferred to MICU for BiPAP initiation. Patient is s/p dexamethasone and tocilizumab. Remdesivir stopped early on 12/2 due to GFR <30. Holding hydroxychloroquine and CellCept. On 12/06 patient had increased resp fatigue and was intubated. Proning started 12/07. 12/09 patient was transfused 1 unit of RBC , Cr also increased so nephro consulted to place dialysis line on 12/09. Patient started on SLED for poor UOP and rapidly rising Cr. Worsening oxygen saturation prompted infectious workup on 12/11 with blood/urine cultures, QTL cultures, giemsa stain, PNA panel. Vanc and mero initiated on 12/11, stopped 12/13. RPP positive for adenovirus. On 40 iNO. Patient desaturated this AM after unproning and saturation dropped to 70%; increased slightly with change in ventilator settings to EPRV and repeat proning. Hgb this AM dropped to 7.0; FOBT positive; suspected internal bleeding. 1u PRBCs given with repeat H&H 1 hour afterwards. Comfort care conference today with family; patient's aunt, and both of patient's daughters opted to pursue comfort care. They understand that comfort care means stopping all life saving measures with the intention of keeping patient comfortable. They would like to begin that process soon; one of the family members would like to organize a zoom call before ETT tube is removed. She had no further questions. Will stop nimbex now and slowly wean sedation with ultimate removal of ET tube. Suspect patient will pass immediately with removal of tube considering the amount of ventilator support. Will call patient's aunt after patient passes.