chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 33.0
Sex: F
Vaccine: COVID19
Symptoms: Swelling face, Throat tightness
Clinical narrative: Pt came in. said she had no  reaction  until 1 week after her first shot, but wanted to get her second shot. She said she had swelling under arm, but said positive it was not lymph nodes, and some tightness around chin  for very short time,  and nausea for 1 month.  She said sister had same rxn but on 2nd shot had no rxn whatever, so wanted to get it. We discussed it, and I told her at least make sure you have benadryl and someone around you at all times since it was so much later rxn time if at all, than the shot, not sure if it even came from the shot except possibly the swelling under arm.  She said she understood.  5 minutes after getting the shot, during her 15 minute waiting period, she said she felt tightening in her larynx and was having trouble breathing. Gave her 50mg benadryl and called 911. While waiting for rescue squad, she said she was feeling dizzy, but she was also getting more agitated and breathing fast and deep. I told her to slow down, breath slowly and calmly. When rescue squad arrived they took over. Talked to her but she got more agitated again and they started oxygen, but only used it for about 5 minutes. They took it off, she was conscious the entire time, and they told her they wanted to transport her to ER for observation only. She stood up and got onto the gurney herself.  Tried to call her at 6pm but no answer.
Age: 83.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: No adverse event
Clinical narrative: There was no adverse event.
Age: 44.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Dehydration, Diarrhoea, Fatigue, Feeding disorder
Clinical narrative: It started off with a few days of intense fatigued, then I had acute diarrhea made me dehydrated and nausea and could not eat. I had a fever between 99 to 100. I had four days of feeling relatively well then I started having respiratory symptoms, very sore throat, high fever, lots of mucus and sinus pressure. Those symptoms last about a week the clinic gave me Molnupiravir. I'm still suffering from post nasal drip and bad fatigue.
Age: 44.0
Sex: F
Vaccine: COVID19
Symptoms: Nausea, Oropharyngeal pain, Paranasal sinus discomfort, Pyrexia, Respiratory disorder
Clinical narrative: It started off with a few days of intense fatigued, then I had acute diarrhea made me dehydrated and nausea and could not eat. I had a fever between 99 to 100. I had four days of feeling relatively well then I started having respiratory symptoms, very sore throat, high fever, lots of mucus and sinus pressure. Those symptoms last about a week the clinic gave me Molnupiravir. I'm still suffering from post nasal drip and bad fatigue.
Age: 44.0
Sex: F
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive, Secretion discharge, Upper-airway cough syndrome
Clinical narrative: It started off with a few days of intense fatigued, then I had acute diarrhea made me dehydrated and nausea and could not eat. I had a fever between 99 to 100. I had four days of feeling relatively well then I started having respiratory symptoms, very sore throat, high fever, lots of mucus and sinus pressure. Those symptoms last about a week the clinic gave me Molnupiravir. I'm still suffering from post nasal drip and bad fatigue.
Age: 32.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Dizziness, Fatigue, Headache, Injection site pain
Clinical narrative: Fever, chills. Arm very sore at injection site. Severe hradache, body aches and pains, fatigue, dizziness
Age: 32.0
Sex: F
Vaccine: COVID19
Symptoms: Pain, Pyrexia
Clinical narrative: Fever, chills. Arm very sore at injection site. Severe hradache, body aches and pains, fatigue, dizziness
Age: 94.0
Sex: M
Vaccine: COVID19
Symptoms: Wrong product administered
Clinical narrative: 1/22/2022 a Moderna dose was administered by mistake to a patient with a JANSSEN vaccine and a Moderna booster previously administered on November 24, 2021. He was monitored for 1 hour and there was no reaction.
Age: 57.0
Sex: F
Vaccine: VARZOS
Symptoms: Arthralgia, Asthenia, Fatigue, Headache, Myalgia
Clinical narrative: joint and muscle aching all over, headache, weakness and fatigue.
Age: 89.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Asymptomatic COVID-19, Bladder catheterisation, Cerebral mass effect, Chromaturia, Condition aggravated
Clinical narrative: Patient is DECEASED;  hospitalized (1.16.22);  COVID-19 positive (1.13.22);  Fully vaccinated (no booster) Admission Date: 1/16/2022 Discharge Date: 01/18/2022  Discharge Disposition: Deceased DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Subdural hematoma. HOSPITAL COURSE: Patient is a 90 y.o. female with pertinent past medical history for Alzheimer's dementia and PE on Xarelto who presented to the ED primarily with altered mental status.  She was brought in from her facility with worsening mental status over the past week after a reported fall at her facility 1-2 weeks prior.  In the ED, she was found to have subdural hematomas, largest measuring 24 mm overlying the left cerebral hemisphere with midline shift.  The patient was also found to be COVID-19 positive however was asymptomatic in this regard.  The patient was evaluated by neurosurgery who felt subdural hematoma was associated with significant morbidity/mortality and patient not likely to benefit from surgery and achieve a good outcome.  This was discussed with the patient's guardian and decision was made to change code status to comfort care.  The patient was admitted and full comfort measures were initiated.  Hospice was consulted who assisted in symptom management.The patient expired at 2303 on 1/18/2022.  The medical examiner was contacted at time of death and requests to complete the death certificate but does not request autopsy.
Age: 89.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Cystitis, Death, Disorientation, Fall, Laboratory test abnormal
Clinical narrative: Patient is DECEASED;  hospitalized (1.16.22);  COVID-19 positive (1.13.22);  Fully vaccinated (no booster) Admission Date: 1/16/2022 Discharge Date: 01/18/2022  Discharge Disposition: Deceased DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Subdural hematoma. HOSPITAL COURSE: Patient is a 90 y.o. female with pertinent past medical history for Alzheimer's dementia and PE on Xarelto who presented to the ED primarily with altered mental status.  She was brought in from her facility with worsening mental status over the past week after a reported fall at her facility 1-2 weeks prior.  In the ED, she was found to have subdural hematomas, largest measuring 24 mm overlying the left cerebral hemisphere with midline shift.  The patient was also found to be COVID-19 positive however was asymptomatic in this regard.  The patient was evaluated by neurosurgery who felt subdural hematoma was associated with significant morbidity/mortality and patient not likely to benefit from surgery and achieve a good outcome.  This was discussed with the patient's guardian and decision was made to change code status to comfort care.  The patient was admitted and full comfort measures were initiated.  Hospice was consulted who assisted in symptom management.The patient expired at 2303 on 1/18/2022.  The medical examiner was contacted at time of death and requests to complete the death certificate but does not request autopsy.
Age: 89.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Mental status changes, SARS-CoV-2 test positive, Sepsis, Subdural haematoma, Tachycardia
Clinical narrative: Patient is DECEASED;  hospitalized (1.16.22);  COVID-19 positive (1.13.22);  Fully vaccinated (no booster) Admission Date: 1/16/2022 Discharge Date: 01/18/2022  Discharge Disposition: Deceased DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Subdural hematoma. HOSPITAL COURSE: Patient is a 90 y.o. female with pertinent past medical history for Alzheimer's dementia and PE on Xarelto who presented to the ED primarily with altered mental status.  She was brought in from her facility with worsening mental status over the past week after a reported fall at her facility 1-2 weeks prior.  In the ED, she was found to have subdural hematomas, largest measuring 24 mm overlying the left cerebral hemisphere with midline shift.  The patient was also found to be COVID-19 positive however was asymptomatic in this regard.  The patient was evaluated by neurosurgery who felt subdural hematoma was associated with significant morbidity/mortality and patient not likely to benefit from surgery and achieve a good outcome.  This was discussed with the patient's guardian and decision was made to change code status to comfort care.  The patient was admitted and full comfort measures were initiated.  Hospice was consulted who assisted in symptom management.The patient expired at 2303 on 1/18/2022.  The medical examiner was contacted at time of death and requests to complete the death certificate but does not request autopsy.
Age: 89.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Urinary tract infection, Urine abnormality
Clinical narrative: Patient is DECEASED;  hospitalized (1.16.22);  COVID-19 positive (1.13.22);  Fully vaccinated (no booster) Admission Date: 1/16/2022 Discharge Date: 01/18/2022  Discharge Disposition: Deceased DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Subdural hematoma. HOSPITAL COURSE: Patient is a 90 y.o. female with pertinent past medical history for Alzheimer's dementia and PE on Xarelto who presented to the ED primarily with altered mental status.  She was brought in from her facility with worsening mental status over the past week after a reported fall at her facility 1-2 weeks prior.  In the ED, she was found to have subdural hematomas, largest measuring 24 mm overlying the left cerebral hemisphere with midline shift.  The patient was also found to be COVID-19 positive however was asymptomatic in this regard.  The patient was evaluated by neurosurgery who felt subdural hematoma was associated with significant morbidity/mortality and patient not likely to benefit from surgery and achieve a good outcome.  This was discussed with the patient's guardian and decision was made to change code status to comfort care.  The patient was admitted and full comfort measures were initiated.  Hospice was consulted who assisted in symptom management.The patient expired at 2303 on 1/18/2022.  The medical examiner was contacted at time of death and requests to complete the death certificate but does not request autopsy.
Age: 77.0
Sex: F
Vaccine: COVID19
Symptoms: Audiogram, Deafness, Ear, nose and throat examination, Tinnitus
Clinical narrative: Hearing loss and tinnitus
Age: 56.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal discomfort, Asthenia, Dizziness, Hypoaesthesia, Hypoaesthesia oral
Clinical narrative: I ran a 101 degree fever from about 4:00 a.m. into the next day. I was so light-headed and weak that I could barely make it out of bee. The tips of my fingers went numb along with part of my bottom lip. I had an upset GI for several hours and had an accompanied migraine. The next day a gland was so swollen in my armpit that I could barely raise my arm. It was on the same side as the injection.
Age: 56.0
Sex: F
Vaccine: COVID19
Symptoms: Lymphadenopathy, Migraine, Mobility decreased, Pyrexia
Clinical narrative: I ran a 101 degree fever from about 4:00 a.m. into the next day. I was so light-headed and weak that I could barely make it out of bee. The tips of my fingers went numb along with part of my bottom lip. I had an upset GI for several hours and had an accompanied migraine. The next day a gland was so swollen in my armpit that I could barely raise my arm. It was on the same side as the injection.
Age: 38.0
Sex: F
Vaccine: COVID19
Symptoms: Mechanical urticaria, Rash, Swelling, Swelling face, Urticaria
Clinical narrative: Rash/hives started on neck and chest. It spread over full body including palms, soles of feet, ears and scalp. After 3 days of rash and hives and when face and neck started swelling, went to ER. Hives responded to oral steroids and antihistamines. Rash diminished over 10 days, but I still have very pronounced dermatographia on thighs and trunk, especially at night.
Age: 18.0
Sex: F
Vaccine: COVID19
Symptoms: Lip blister, Mouth ulceration, Oral disorder, Oral mucosal blistering, Tongue ulceration
Clinical narrative: Lesions, blisters, and ulcers throughout mouth, lips, and tongue.   2 weeks duration and continuing.   Prescribed Valaciclovir on 1/23/22.
Age: 69.0
Sex: M
Vaccine: COVID19
Symptoms: Angiogram pulmonary abnormal, Deep vein thrombosis, Pulmonary embolism, Ultrasound Doppler abnormal
Clinical narrative: Patient developed a right lower extremity DVT and a large saddle pulmonary embolus 1 month after his Moderna booster shot.
Age: 32.0
Sex: F
Vaccine: COVID19
Symptoms: Headache
Clinical narrative: Headaches for mostly left side of the head and the same intensity for 5 days straight mostly comes back at night when the effect of the tylenol is gone
Age: 63.0
Sex: F
Vaccine: COVID19
Symptoms: Acidosis, Altered state of consciousness, Angiogram cerebral, Angiogram pulmonary abnormal, Anticoagulant therapy
Clinical narrative: Patient is DECEASED;  hospitalized (1.11.2022);  COVID-19 positive (1.5.22);  fully vaccinated (no booster)  Admission Date: 1/11/2022  Date of Death: 1/16/22 Time of Death:  4:37 AM Preliminary Cause of Death: Shock  DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Atrial fibrillation with RVR  [I48.91] Hypervolemia, unspecified hypervolemia type [E87.70] Shock  [R57.9] HOSPITAL COURSE: Patient is a 63 y.o. female with a past medical history of ESRD on HD, COPD on 3L at baseline, OSA on BiPAP, tob use disorder, BiFV HF with diastolic dysfunction, T2DM, HTN and obesity who initially presented after missing two days of HD and was admitted with afib with RVR now with worsening lactic acidosis and requiring CRRT.    Patient was transferred to ICU service after found to be more altered and the unresponsive even to noxious stimuli. Patient intubated. Vancomycin, flagyl, cefepime started empirically. Nephrology consulted for CRRT and this was started the morning of 1/14. Patient had increasing pressor needs up to 3 pressors. Bedside echo was done by the ICU fellow and showed a largely dilated RV and possible clot present in RV and RA. An official echo was ordered stat and did not show evidence of clot but did see a vegetation on pulmonic valve. PERT was activated in case of need for systemic tPA or thrombectomy was needed. IR recommended CTA of the thorax and head first to assess for clot burden. Cardiology did not see signs of a clot either and recommended further imaging. Heparin was started for possible PE and rising Ddimer. Blood cultures grew E. Coli. Bilateral upper and lower extremity ultrasounds showed no signs of DVT. CTA of head and thorax were done emergently. CT head showed no signs of infarction. CTA thorax showed a small segmental PE in the right lower lobe. IR was contacted and they did not recommend systemic tPA or thrombectomy. General surgery consulted to assess for bowel ischemia, but based on CT A/P findings and physical exam, they did not have any intervention to benefit the patient at that time. Patient improved with increase in Epinephrine infusion. CRRT was started by nephrology and fluid removal was set to 25ml/hr in the afternoon of 1/14. Bedside echo and bubble study was performed and showed no signs of VSD but there was very poor forward flow. Veletri, duonebs were started. Peep was reduced to 5 in order to reduce RV stress. Evening of 1/15 she developed worsening acidosis and increasing pressor requirements eventually being placed on angiotensin II. She had worsening acidosis as well. She did have cardiac arrest in the early morning with ROSC after 2 rounds of compressions. At that point further discussion was had with family who were present at bedside who decided to change code status to DNR. Shortly thereafter she passed away with family around her at bedside. Official TOD 4:37am.
Age: 63.0
Sex: F
Vaccine: COVID19
Symptoms: Atrial fibrillation, Blood culture positive, Bronchitis chronic, COVID-19, Cardiac arrest
Clinical narrative: Patient is DECEASED;  hospitalized (1.11.2022);  COVID-19 positive (1.5.22);  fully vaccinated (no booster)  Admission Date: 1/11/2022  Date of Death: 1/16/22 Time of Death:  4:37 AM Preliminary Cause of Death: Shock  DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Atrial fibrillation with RVR  [I48.91] Hypervolemia, unspecified hypervolemia type [E87.70] Shock  [R57.9] HOSPITAL COURSE: Patient is a 63 y.o. female with a past medical history of ESRD on HD, COPD on 3L at baseline, OSA on BiPAP, tob use disorder, BiFV HF with diastolic dysfunction, T2DM, HTN and obesity who initially presented after missing two days of HD and was admitted with afib with RVR now with worsening lactic acidosis and requiring CRRT.    Patient was transferred to ICU service after found to be more altered and the unresponsive even to noxious stimuli. Patient intubated. Vancomycin, flagyl, cefepime started empirically. Nephrology consulted for CRRT and this was started the morning of 1/14. Patient had increasing pressor needs up to 3 pressors. Bedside echo was done by the ICU fellow and showed a largely dilated RV and possible clot present in RV and RA. An official echo was ordered stat and did not show evidence of clot but did see a vegetation on pulmonic valve. PERT was activated in case of need for systemic tPA or thrombectomy was needed. IR recommended CTA of the thorax and head first to assess for clot burden. Cardiology did not see signs of a clot either and recommended further imaging. Heparin was started for possible PE and rising Ddimer. Blood cultures grew E. Coli. Bilateral upper and lower extremity ultrasounds showed no signs of DVT. CTA of head and thorax were done emergently. CT head showed no signs of infarction. CTA thorax showed a small segmental PE in the right lower lobe. IR was contacted and they did not recommend systemic tPA or thrombectomy. General surgery consulted to assess for bowel ischemia, but based on CT A/P findings and physical exam, they did not have any intervention to benefit the patient at that time. Patient improved with increase in Epinephrine infusion. CRRT was started by nephrology and fluid removal was set to 25ml/hr in the afternoon of 1/14. Bedside echo and bubble study was performed and showed no signs of VSD but there was very poor forward flow. Veletri, duonebs were started. Peep was reduced to 5 in order to reduce RV stress. Evening of 1/15 she developed worsening acidosis and increasing pressor requirements eventually being placed on angiotensin II. She had worsening acidosis as well. She did have cardiac arrest in the early morning with ROSC after 2 rounds of compressions. At that point further discussion was had with family who were present at bedside who decided to change code status to DNR. Shortly thereafter she passed away with family around her at bedside. Official TOD 4:37am.
Age: 63.0
Sex: F
Vaccine: COVID19
Symptoms: Cardiac valve vegetation, Computerised tomogram abdomen, Computerised tomogram head normal, Condition aggravated, Cough
Clinical narrative: Patient is DECEASED;  hospitalized (1.11.2022);  COVID-19 positive (1.5.22);  fully vaccinated (no booster)  Admission Date: 1/11/2022  Date of Death: 1/16/22 Time of Death:  4:37 AM Preliminary Cause of Death: Shock  DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Atrial fibrillation with RVR  [I48.91] Hypervolemia, unspecified hypervolemia type [E87.70] Shock  [R57.9] HOSPITAL COURSE: Patient is a 63 y.o. female with a past medical history of ESRD on HD, COPD on 3L at baseline, OSA on BiPAP, tob use disorder, BiFV HF with diastolic dysfunction, T2DM, HTN and obesity who initially presented after missing two days of HD and was admitted with afib with RVR now with worsening lactic acidosis and requiring CRRT.    Patient was transferred to ICU service after found to be more altered and the unresponsive even to noxious stimuli. Patient intubated. Vancomycin, flagyl, cefepime started empirically. Nephrology consulted for CRRT and this was started the morning of 1/14. Patient had increasing pressor needs up to 3 pressors. Bedside echo was done by the ICU fellow and showed a largely dilated RV and possible clot present in RV and RA. An official echo was ordered stat and did not show evidence of clot but did see a vegetation on pulmonic valve. PERT was activated in case of need for systemic tPA or thrombectomy was needed. IR recommended CTA of the thorax and head first to assess for clot burden. Cardiology did not see signs of a clot either and recommended further imaging. Heparin was started for possible PE and rising Ddimer. Blood cultures grew E. Coli. Bilateral upper and lower extremity ultrasounds showed no signs of DVT. CTA of head and thorax were done emergently. CT head showed no signs of infarction. CTA thorax showed a small segmental PE in the right lower lobe. IR was contacted and they did not recommend systemic tPA or thrombectomy. General surgery consulted to assess for bowel ischemia, but based on CT A/P findings and physical exam, they did not have any intervention to benefit the patient at that time. Patient improved with increase in Epinephrine infusion. CRRT was started by nephrology and fluid removal was set to 25ml/hr in the afternoon of 1/14. Bedside echo and bubble study was performed and showed no signs of VSD but there was very poor forward flow. Veletri, duonebs were started. Peep was reduced to 5 in order to reduce RV stress. Evening of 1/15 she developed worsening acidosis and increasing pressor requirements eventually being placed on angiotensin II. She had worsening acidosis as well. She did have cardiac arrest in the early morning with ROSC after 2 rounds of compressions. At that point further discussion was had with family who were present at bedside who decided to change code status to DNR. Shortly thereafter she passed away with family around her at bedside. Official TOD 4:37am.
Age: 63.0
Sex: F
Vaccine: COVID19
Symptoms: Death, Dialysis, Echocardiogram abnormal, Endotracheal intubation, Escherichia test positive
Clinical narrative: Patient is DECEASED;  hospitalized (1.11.2022);  COVID-19 positive (1.5.22);  fully vaccinated (no booster)  Admission Date: 1/11/2022  Date of Death: 1/16/22 Time of Death:  4:37 AM Preliminary Cause of Death: Shock  DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Atrial fibrillation with RVR  [I48.91] Hypervolemia, unspecified hypervolemia type [E87.70] Shock  [R57.9] HOSPITAL COURSE: Patient is a 63 y.o. female with a past medical history of ESRD on HD, COPD on 3L at baseline, OSA on BiPAP, tob use disorder, BiFV HF with diastolic dysfunction, T2DM, HTN and obesity who initially presented after missing two days of HD and was admitted with afib with RVR now with worsening lactic acidosis and requiring CRRT.    Patient was transferred to ICU service after found to be more altered and the unresponsive even to noxious stimuli. Patient intubated. Vancomycin, flagyl, cefepime started empirically. Nephrology consulted for CRRT and this was started the morning of 1/14. Patient had increasing pressor needs up to 3 pressors. Bedside echo was done by the ICU fellow and showed a largely dilated RV and possible clot present in RV and RA. An official echo was ordered stat and did not show evidence of clot but did see a vegetation on pulmonic valve. PERT was activated in case of need for systemic tPA or thrombectomy was needed. IR recommended CTA of the thorax and head first to assess for clot burden. Cardiology did not see signs of a clot either and recommended further imaging. Heparin was started for possible PE and rising Ddimer. Blood cultures grew E. Coli. Bilateral upper and lower extremity ultrasounds showed no signs of DVT. CTA of head and thorax were done emergently. CT head showed no signs of infarction. CTA thorax showed a small segmental PE in the right lower lobe. IR was contacted and they did not recommend systemic tPA or thrombectomy. General surgery consulted to assess for bowel ischemia, but based on CT A/P findings and physical exam, they did not have any intervention to benefit the patient at that time. Patient improved with increase in Epinephrine infusion. CRRT was started by nephrology and fluid removal was set to 25ml/hr in the afternoon of 1/14. Bedside echo and bubble study was performed and showed no signs of VSD but there was very poor forward flow. Veletri, duonebs were started. Peep was reduced to 5 in order to reduce RV stress. Evening of 1/15 she developed worsening acidosis and increasing pressor requirements eventually being placed on angiotensin II. She had worsening acidosis as well. She did have cardiac arrest in the early morning with ROSC after 2 rounds of compressions. At that point further discussion was had with family who were present at bedside who decided to change code status to DNR. Shortly thereafter she passed away with family around her at bedside. Official TOD 4:37am.
Age: 63.0
Sex: F
Vaccine: COVID19
Symptoms: Fatigue, Fibrin D dimer increased, General physical health deterioration, Haemofiltration, Hypervolaemia
Clinical narrative: Patient is DECEASED;  hospitalized (1.11.2022);  COVID-19 positive (1.5.22);  fully vaccinated (no booster)  Admission Date: 1/11/2022  Date of Death: 1/16/22 Time of Death:  4:37 AM Preliminary Cause of Death: Shock  DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Atrial fibrillation with RVR  [I48.91] Hypervolemia, unspecified hypervolemia type [E87.70] Shock  [R57.9] HOSPITAL COURSE: Patient is a 63 y.o. female with a past medical history of ESRD on HD, COPD on 3L at baseline, OSA on BiPAP, tob use disorder, BiFV HF with diastolic dysfunction, T2DM, HTN and obesity who initially presented after missing two days of HD and was admitted with afib with RVR now with worsening lactic acidosis and requiring CRRT.    Patient was transferred to ICU service after found to be more altered and the unresponsive even to noxious stimuli. Patient intubated. Vancomycin, flagyl, cefepime started empirically. Nephrology consulted for CRRT and this was started the morning of 1/14. Patient had increasing pressor needs up to 3 pressors. Bedside echo was done by the ICU fellow and showed a largely dilated RV and possible clot present in RV and RA. An official echo was ordered stat and did not show evidence of clot but did see a vegetation on pulmonic valve. PERT was activated in case of need for systemic tPA or thrombectomy was needed. IR recommended CTA of the thorax and head first to assess for clot burden. Cardiology did not see signs of a clot either and recommended further imaging. Heparin was started for possible PE and rising Ddimer. Blood cultures grew E. Coli. Bilateral upper and lower extremity ultrasounds showed no signs of DVT. CTA of head and thorax were done emergently. CT head showed no signs of infarction. CTA thorax showed a small segmental PE in the right lower lobe. IR was contacted and they did not recommend systemic tPA or thrombectomy. General surgery consulted to assess for bowel ischemia, but based on CT A/P findings and physical exam, they did not have any intervention to benefit the patient at that time. Patient improved with increase in Epinephrine infusion. CRRT was started by nephrology and fluid removal was set to 25ml/hr in the afternoon of 1/14. Bedside echo and bubble study was performed and showed no signs of VSD but there was very poor forward flow. Veletri, duonebs were started. Peep was reduced to 5 in order to reduce RV stress. Evening of 1/15 she developed worsening acidosis and increasing pressor requirements eventually being placed on angiotensin II. She had worsening acidosis as well. She did have cardiac arrest in the early morning with ROSC after 2 rounds of compressions. At that point further discussion was had with family who were present at bedside who decided to change code status to DNR. Shortly thereafter she passed away with family around her at bedside. Official TOD 4:37am.
Age: 63.0
Sex: F
Vaccine: COVID19
Symptoms: Illness, Intensive care, Lactic acidosis, Myalgia, Pneumonia bacterial
Clinical narrative: Patient is DECEASED;  hospitalized (1.11.2022);  COVID-19 positive (1.5.22);  fully vaccinated (no booster)  Admission Date: 1/11/2022  Date of Death: 1/16/22 Time of Death:  4:37 AM Preliminary Cause of Death: Shock  DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Atrial fibrillation with RVR  [I48.91] Hypervolemia, unspecified hypervolemia type [E87.70] Shock  [R57.9] HOSPITAL COURSE: Patient is a 63 y.o. female with a past medical history of ESRD on HD, COPD on 3L at baseline, OSA on BiPAP, tob use disorder, BiFV HF with diastolic dysfunction, T2DM, HTN and obesity who initially presented after missing two days of HD and was admitted with afib with RVR now with worsening lactic acidosis and requiring CRRT.    Patient was transferred to ICU service after found to be more altered and the unresponsive even to noxious stimuli. Patient intubated. Vancomycin, flagyl, cefepime started empirically. Nephrology consulted for CRRT and this was started the morning of 1/14. Patient had increasing pressor needs up to 3 pressors. Bedside echo was done by the ICU fellow and showed a largely dilated RV and possible clot present in RV and RA. An official echo was ordered stat and did not show evidence of clot but did see a vegetation on pulmonic valve. PERT was activated in case of need for systemic tPA or thrombectomy was needed. IR recommended CTA of the thorax and head first to assess for clot burden. Cardiology did not see signs of a clot either and recommended further imaging. Heparin was started for possible PE and rising Ddimer. Blood cultures grew E. Coli. Bilateral upper and lower extremity ultrasounds showed no signs of DVT. CTA of head and thorax were done emergently. CT head showed no signs of infarction. CTA thorax showed a small segmental PE in the right lower lobe. IR was contacted and they did not recommend systemic tPA or thrombectomy. General surgery consulted to assess for bowel ischemia, but based on CT A/P findings and physical exam, they did not have any intervention to benefit the patient at that time. Patient improved with increase in Epinephrine infusion. CRRT was started by nephrology and fluid removal was set to 25ml/hr in the afternoon of 1/14. Bedside echo and bubble study was performed and showed no signs of VSD but there was very poor forward flow. Veletri, duonebs were started. Peep was reduced to 5 in order to reduce RV stress. Evening of 1/15 she developed worsening acidosis and increasing pressor requirements eventually being placed on angiotensin II. She had worsening acidosis as well. She did have cardiac arrest in the early morning with ROSC after 2 rounds of compressions. At that point further discussion was had with family who were present at bedside who decided to change code status to DNR. Shortly thereafter she passed away with family around her at bedside. Official TOD 4:37am.
Age: 63.0
Sex: F
Vaccine: COVID19
Symptoms: Positive end-expiratory pressure, Productive cough, Pulmonary embolism, Pyrexia, Respiratory failure
Clinical narrative: Patient is DECEASED;  hospitalized (1.11.2022);  COVID-19 positive (1.5.22);  fully vaccinated (no booster)  Admission Date: 1/11/2022  Date of Death: 1/16/22 Time of Death:  4:37 AM Preliminary Cause of Death: Shock  DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Atrial fibrillation with RVR  [I48.91] Hypervolemia, unspecified hypervolemia type [E87.70] Shock  [R57.9] HOSPITAL COURSE: Patient is a 63 y.o. female with a past medical history of ESRD on HD, COPD on 3L at baseline, OSA on BiPAP, tob use disorder, BiFV HF with diastolic dysfunction, T2DM, HTN and obesity who initially presented after missing two days of HD and was admitted with afib with RVR now with worsening lactic acidosis and requiring CRRT.    Patient was transferred to ICU service after found to be more altered and the unresponsive even to noxious stimuli. Patient intubated. Vancomycin, flagyl, cefepime started empirically. Nephrology consulted for CRRT and this was started the morning of 1/14. Patient had increasing pressor needs up to 3 pressors. Bedside echo was done by the ICU fellow and showed a largely dilated RV and possible clot present in RV and RA. An official echo was ordered stat and did not show evidence of clot but did see a vegetation on pulmonic valve. PERT was activated in case of need for systemic tPA or thrombectomy was needed. IR recommended CTA of the thorax and head first to assess for clot burden. Cardiology did not see signs of a clot either and recommended further imaging. Heparin was started for possible PE and rising Ddimer. Blood cultures grew E. Coli. Bilateral upper and lower extremity ultrasounds showed no signs of DVT. CTA of head and thorax were done emergently. CT head showed no signs of infarction. CTA thorax showed a small segmental PE in the right lower lobe. IR was contacted and they did not recommend systemic tPA or thrombectomy. General surgery consulted to assess for bowel ischemia, but based on CT A/P findings and physical exam, they did not have any intervention to benefit the patient at that time. Patient improved with increase in Epinephrine infusion. CRRT was started by nephrology and fluid removal was set to 25ml/hr in the afternoon of 1/14. Bedside echo and bubble study was performed and showed no signs of VSD but there was very poor forward flow. Veletri, duonebs were started. Peep was reduced to 5 in order to reduce RV stress. Evening of 1/15 she developed worsening acidosis and increasing pressor requirements eventually being placed on angiotensin II. She had worsening acidosis as well. She did have cardiac arrest in the early morning with ROSC after 2 rounds of compressions. At that point further discussion was had with family who were present at bedside who decided to change code status to DNR. Shortly thereafter she passed away with family around her at bedside. Official TOD 4:37am.
Age: 63.0
Sex: F
Vaccine: COVID19
Symptoms: Resuscitation, Right ventricular dilatation, SARS-CoV-2 test positive, Shock, Ultrasound Doppler normal
Clinical narrative: Patient is DECEASED;  hospitalized (1.11.2022);  COVID-19 positive (1.5.22);  fully vaccinated (no booster)  Admission Date: 1/11/2022  Date of Death: 1/16/22 Time of Death:  4:37 AM Preliminary Cause of Death: Shock  DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Atrial fibrillation with RVR  [I48.91] Hypervolemia, unspecified hypervolemia type [E87.70] Shock  [R57.9] HOSPITAL COURSE: Patient is a 63 y.o. female with a past medical history of ESRD on HD, COPD on 3L at baseline, OSA on BiPAP, tob use disorder, BiFV HF with diastolic dysfunction, T2DM, HTN and obesity who initially presented after missing two days of HD and was admitted with afib with RVR now with worsening lactic acidosis and requiring CRRT.    Patient was transferred to ICU service after found to be more altered and the unresponsive even to noxious stimuli. Patient intubated. Vancomycin, flagyl, cefepime started empirically. Nephrology consulted for CRRT and this was started the morning of 1/14. Patient had increasing pressor needs up to 3 pressors. Bedside echo was done by the ICU fellow and showed a largely dilated RV and possible clot present in RV and RA. An official echo was ordered stat and did not show evidence of clot but did see a vegetation on pulmonic valve. PERT was activated in case of need for systemic tPA or thrombectomy was needed. IR recommended CTA of the thorax and head first to assess for clot burden. Cardiology did not see signs of a clot either and recommended further imaging. Heparin was started for possible PE and rising Ddimer. Blood cultures grew E. Coli. Bilateral upper and lower extremity ultrasounds showed no signs of DVT. CTA of head and thorax were done emergently. CT head showed no signs of infarction. CTA thorax showed a small segmental PE in the right lower lobe. IR was contacted and they did not recommend systemic tPA or thrombectomy. General surgery consulted to assess for bowel ischemia, but based on CT A/P findings and physical exam, they did not have any intervention to benefit the patient at that time. Patient improved with increase in Epinephrine infusion. CRRT was started by nephrology and fluid removal was set to 25ml/hr in the afternoon of 1/14. Bedside echo and bubble study was performed and showed no signs of VSD but there was very poor forward flow. Veletri, duonebs were started. Peep was reduced to 5 in order to reduce RV stress. Evening of 1/15 she developed worsening acidosis and increasing pressor requirements eventually being placed on angiotensin II. She had worsening acidosis as well. She did have cardiac arrest in the early morning with ROSC after 2 rounds of compressions. At that point further discussion was had with family who were present at bedside who decided to change code status to DNR. Shortly thereafter she passed away with family around her at bedside. Official TOD 4:37am.
Age: 63.0
Sex: F
Vaccine: COVID19
Symptoms: Unresponsive to stimuli
Clinical narrative: Patient is DECEASED;  hospitalized (1.11.2022);  COVID-19 positive (1.5.22);  fully vaccinated (no booster)  Admission Date: 1/11/2022  Date of Death: 1/16/22 Time of Death:  4:37 AM Preliminary Cause of Death: Shock  DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Atrial fibrillation with RVR  [I48.91] Hypervolemia, unspecified hypervolemia type [E87.70] Shock  [R57.9] HOSPITAL COURSE: Patient is a 63 y.o. female with a past medical history of ESRD on HD, COPD on 3L at baseline, OSA on BiPAP, tob use disorder, BiFV HF with diastolic dysfunction, T2DM, HTN and obesity who initially presented after missing two days of HD and was admitted with afib with RVR now with worsening lactic acidosis and requiring CRRT.    Patient was transferred to ICU service after found to be more altered and the unresponsive even to noxious stimuli. Patient intubated. Vancomycin, flagyl, cefepime started empirically. Nephrology consulted for CRRT and this was started the morning of 1/14. Patient had increasing pressor needs up to 3 pressors. Bedside echo was done by the ICU fellow and showed a largely dilated RV and possible clot present in RV and RA. An official echo was ordered stat and did not show evidence of clot but did see a vegetation on pulmonic valve. PERT was activated in case of need for systemic tPA or thrombectomy was needed. IR recommended CTA of the thorax and head first to assess for clot burden. Cardiology did not see signs of a clot either and recommended further imaging. Heparin was started for possible PE and rising Ddimer. Blood cultures grew E. Coli. Bilateral upper and lower extremity ultrasounds showed no signs of DVT. CTA of head and thorax were done emergently. CT head showed no signs of infarction. CTA thorax showed a small segmental PE in the right lower lobe. IR was contacted and they did not recommend systemic tPA or thrombectomy. General surgery consulted to assess for bowel ischemia, but based on CT A/P findings and physical exam, they did not have any intervention to benefit the patient at that time. Patient improved with increase in Epinephrine infusion. CRRT was started by nephrology and fluid removal was set to 25ml/hr in the afternoon of 1/14. Bedside echo and bubble study was performed and showed no signs of VSD but there was very poor forward flow. Veletri, duonebs were started. Peep was reduced to 5 in order to reduce RV stress. Evening of 1/15 she developed worsening acidosis and increasing pressor requirements eventually being placed on angiotensin II. She had worsening acidosis as well. She did have cardiac arrest in the early morning with ROSC after 2 rounds of compressions. At that point further discussion was had with family who were present at bedside who decided to change code status to DNR. Shortly thereafter she passed away with family around her at bedside. Official TOD 4:37am.
Age: 28.0
Sex: F
Vaccine: COVID19
Symptoms: Dizziness, Erythema, Hyperhidrosis, Pallor, Pruritus
Clinical narrative: Client reported feeling dizzy to RN. Client ambulated and sat down in the anti-gravity chair. RN adjusted the anti-gravity chair to a low fowler's position. RN responded. The following was obtained with RN translating between Spanish and English. RN  noted pallor of the client's face and diaphoresis on the client's face. The client reported seeing white spots and dizziness. Vitals obtained at 02:56PM were as follows: automatic BP 97/46, HR 68, O2 97%. The client state she last ate at 2:00 PM. The client denied any chronic conditions or known allergies. The client reported a history of fainting twice before once when she exercised too hard and another after seeing blood. The client stated she experienced vision changes with the two previous episodes of syncope. The client received the first dose of COVID vaccine Janssen on 06/22/21 and denied any adverse reaction. Vitals obtained at 02:59PM were as follows: manual BP 94/50, HR 71, O2 99%. The client denied any other s/s of anaphylaxis. The anti-gravity chair was adjusted to a high-fowler's position. The client reported mild persistent dizziness. RN noted decrease in pallor on the client's face. Vitals obtained at 03:04PM were as follows: manual BP 102/56, HR 87, O2 99%. The client denied any current symptoms. The client began drinking a juice and eating animal crackers. Vitals obtained at 03:09PM were as follows: manual BP 102/58, HR 72, O2 99%. The client denied any current symptoms. The client's boyfriend joined the client next to the anti-gravity chair. Vitals obtained at 03:19PM were as follows: manual BP 114/68, HR 68, O2 98%. The client reported itchiness on the left side of her neck and on the right side of her scalp. RN  noted a red spot about one inch in diameter on the left side of the client's neck. The client stated she had scratched the spot. RN noted no visible redness on the client's scalp where the client pointed the itchiness was located. RN  noted no redness around the vaccination site or the client's right arm. Mild pink discoloration was located on the client's forearm. The client denied any itching on her arm. RN  offered the client Benadryl and educated on the possible adverse effects. The client declined the Benadryl stating that she was riding a motorcycle home. The client then stated the itching resolved. RN  noted a decrease in size and discoloration of the redness of the spot on the client's neck. RN provided education regarding possible adverse events and when to seek care. The client voiced understanding of this education. Repeat vitals obtained at 3:27PM were as follows: BP 110/62, HR 98%, O2 98%. The client denied any current symptoms. The client ambulated unassisted with a steady gait out of the vaccination site at 3:34PM.
Age: 28.0
Sex: F
Vaccine: COVID19
Symptoms: Visual impairment
Clinical narrative: Client reported feeling dizzy to RN. Client ambulated and sat down in the anti-gravity chair. RN adjusted the anti-gravity chair to a low fowler's position. RN responded. The following was obtained with RN translating between Spanish and English. RN  noted pallor of the client's face and diaphoresis on the client's face. The client reported seeing white spots and dizziness. Vitals obtained at 02:56PM were as follows: automatic BP 97/46, HR 68, O2 97%. The client state she last ate at 2:00 PM. The client denied any chronic conditions or known allergies. The client reported a history of fainting twice before once when she exercised too hard and another after seeing blood. The client stated she experienced vision changes with the two previous episodes of syncope. The client received the first dose of COVID vaccine Janssen on 06/22/21 and denied any adverse reaction. Vitals obtained at 02:59PM were as follows: manual BP 94/50, HR 71, O2 99%. The client denied any other s/s of anaphylaxis. The anti-gravity chair was adjusted to a high-fowler's position. The client reported mild persistent dizziness. RN noted decrease in pallor on the client's face. Vitals obtained at 03:04PM were as follows: manual BP 102/56, HR 87, O2 99%. The client denied any current symptoms. The client began drinking a juice and eating animal crackers. Vitals obtained at 03:09PM were as follows: manual BP 102/58, HR 72, O2 99%. The client denied any current symptoms. The client's boyfriend joined the client next to the anti-gravity chair. Vitals obtained at 03:19PM were as follows: manual BP 114/68, HR 68, O2 98%. The client reported itchiness on the left side of her neck and on the right side of her scalp. RN  noted a red spot about one inch in diameter on the left side of the client's neck. The client stated she had scratched the spot. RN noted no visible redness on the client's scalp where the client pointed the itchiness was located. RN  noted no redness around the vaccination site or the client's right arm. Mild pink discoloration was located on the client's forearm. The client denied any itching on her arm. RN  offered the client Benadryl and educated on the possible adverse effects. The client declined the Benadryl stating that she was riding a motorcycle home. The client then stated the itching resolved. RN  noted a decrease in size and discoloration of the redness of the spot on the client's neck. RN provided education regarding possible adverse events and when to seek care. The client voiced understanding of this education. Repeat vitals obtained at 3:27PM were as follows: BP 110/62, HR 98%, O2 98%. The client denied any current symptoms. The client ambulated unassisted with a steady gait out of the vaccination site at 3:34PM.
Age: 80.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: COVID-19, Death
Clinical narrative: Death secondary  to COVID 19 infection
Age: 51.0
Sex: F
Vaccine: COVID19
Symptoms: Dysphonia, Ear discomfort, Feeling hot, Gait disturbance, Muscular weakness
Clinical narrative: Severe hives all over body. The worst day was January 20th, Thursday, I woke up at 2 am and then 4 am. I had large welts on my legs, near groin area and under arms. I was about to take myself to the hospital, but I took 2 pills of Benadryl and I was able to go back to sleep. The hives are on both arms, front and back legs, feet, lower abdomen, hands and back of neck. Feeling of wearing a very tight ring/tightness in middle finger of right hand and ring finger of left hand. Swelling outside of right arm; and swelling on top of right foot. Day after, I saw a doctor. Then next day at around 5 pm, I got swelling on the base of my left foot. I couldn't walk. It was painful. Today, my left ear feels hot and uncomfortable. My voice sounds differently and right arm feels weak and painful right now. I hope I don't get anymore signs or symptoms. I never had allergies to anything at all. I hope this goes away permanently. My right arm is aching as I'm writing this. In process of making appointment with allergist but they are difficult to make appointment.
Age: 51.0
Sex: F
Vaccine: COVID19
Symptoms: Pain in extremity, Peripheral swelling, Sleep disorder, Urticaria
Clinical narrative: Severe hives all over body. The worst day was January 20th, Thursday, I woke up at 2 am and then 4 am. I had large welts on my legs, near groin area and under arms. I was about to take myself to the hospital, but I took 2 pills of Benadryl and I was able to go back to sleep. The hives are on both arms, front and back legs, feet, lower abdomen, hands and back of neck. Feeling of wearing a very tight ring/tightness in middle finger of right hand and ring finger of left hand. Swelling outside of right arm; and swelling on top of right foot. Day after, I saw a doctor. Then next day at around 5 pm, I got swelling on the base of my left foot. I couldn't walk. It was painful. Today, my left ear feels hot and uncomfortable. My voice sounds differently and right arm feels weak and painful right now. I hope I don't get anymore signs or symptoms. I never had allergies to anything at all. I hope this goes away permanently. My right arm is aching as I'm writing this. In process of making appointment with allergist but they are difficult to make appointment.
Age: 40.0
Sex: F
Vaccine: COVID19
Symptoms: Lip swelling, Rash
Clinical narrative: Round rash on left shoulder and swelling lips 1 week after they wont  stop swelling
Age: 68.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: not reported by nurse supervisor
Age: 8.0
Sex: M
Vaccine: COVID19
Symptoms: Product preparation issue
Clinical narrative: The dose was given undiluted
Age: 73.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Death
Clinical narrative: Death related to COVID 19
Age: 7.0
Sex: M
Vaccine: COVID19
Symptoms: Product preparation issue
Clinical narrative: The dose was administered undiluted