chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 88.0
Sex: F
Vaccine: COVID19-2
Symptoms: Blood potassium increased, Blood urea increased, Brain natriuretic peptide increased, COVID-19, Cardiac failure acute
Clinical narrative: Discharge Provider: MD Primary Care Physician at Discharge: FNP Admission Date: 3/16/2023  PRESENTING PROBLEM: Acute on chronic respiratory failure with hypoxia and hypercapnia (HCC) [J96.21, J96.22]   HOSPITAL COURSE: Patient is a 88 y.o. female, patient of FNP who presented with increasing SHOB and cough the past few weeks with more sleepiness the past few days. She is chronically ill with diastolic heart failure, diabetes mellitus controlled, idiopathic pulmonary fibrosis/on 2L continuous, chronic lower leg lymphedema with recurrent wounds, chronic kidney disease stage IV-V (follows with Nephrology). She was diagnosed with UTI on Mar 10 and started on ciprofloxacin, cultures confirmed it is susceptible.   In the ED, she was severely dyspneic. She was placed on BiPap. CXR showing pulmonary vascular congestion and bilateral pleural effusions. Labs revealing pH 7.20, pCO2 70, with worsening renal function, creatinine 3.15 (usuaally 2.30 - 2.70) and BUN 115, along with lactate 4.1, potassium 5.4. BNP quite elevated at 46,000. She was given breathing treatments, Lasix, Solumedrol and Bipap. Unfortunately, she did test (+) for Covid. She requires admission for a/c heart failure, a/c renal failure.    Daughter at bedside, very involved in care, visits her mom at facility daily and is often caring for her wounds. She explains that her mom recently had code discussion and wished to be DNR. She also would not want dialysis. Palliative care/hospice care also broached with PCP, however daughter didn't feel her mom was ready for that stage of care, as she doesn't have any chronic pain.    The patient was treated with oxygen which needed to be progressed to BiPAP for her respiratory failure, and she also developed hypotension requiring norepinephrine.  She had progressive confusion and decreasing urine output and worsening renal failure, and after discussion in regards to very poor prognosis decision was made to transition her to comfort care measures.  She was treated with norepinephrine while her daughter was trying to arrived to see her from another state, but was otherwise treated with comfort care measures beginning on 03/19/2020.  On 03/20/2020 her norepinephrine was discontinued and her oxygen was also removed.  She was treated with IV Ativan and morphine for distress, and passed away with family at bedside at 11:10 a.m..
Age: 88.0
Sex: F
Vaccine: COVID19-2
Symptoms: Chest X-ray abnormal, Confusional state, Cough, Culture urine positive, Death
Clinical narrative: Discharge Provider: MD Primary Care Physician at Discharge: FNP Admission Date: 3/16/2023  PRESENTING PROBLEM: Acute on chronic respiratory failure with hypoxia and hypercapnia (HCC) [J96.21, J96.22]   HOSPITAL COURSE: Patient is a 88 y.o. female, patient of FNP who presented with increasing SHOB and cough the past few weeks with more sleepiness the past few days. She is chronically ill with diastolic heart failure, diabetes mellitus controlled, idiopathic pulmonary fibrosis/on 2L continuous, chronic lower leg lymphedema with recurrent wounds, chronic kidney disease stage IV-V (follows with Nephrology). She was diagnosed with UTI on Mar 10 and started on ciprofloxacin, cultures confirmed it is susceptible.   In the ED, she was severely dyspneic. She was placed on BiPap. CXR showing pulmonary vascular congestion and bilateral pleural effusions. Labs revealing pH 7.20, pCO2 70, with worsening renal function, creatinine 3.15 (usuaally 2.30 - 2.70) and BUN 115, along with lactate 4.1, potassium 5.4. BNP quite elevated at 46,000. She was given breathing treatments, Lasix, Solumedrol and Bipap. Unfortunately, she did test (+) for Covid. She requires admission for a/c heart failure, a/c renal failure.    Daughter at bedside, very involved in care, visits her mom at facility daily and is often caring for her wounds. She explains that her mom recently had code discussion and wished to be DNR. She also would not want dialysis. Palliative care/hospice care also broached with PCP, however daughter didn't feel her mom was ready for that stage of care, as she doesn't have any chronic pain.    The patient was treated with oxygen which needed to be progressed to BiPAP for her respiratory failure, and she also developed hypotension requiring norepinephrine.  She had progressive confusion and decreasing urine output and worsening renal failure, and after discussion in regards to very poor prognosis decision was made to transition her to comfort care measures.  She was treated with norepinephrine while her daughter was trying to arrived to see her from another state, but was otherwise treated with comfort care measures beginning on 03/19/2020.  On 03/20/2020 her norepinephrine was discontinued and her oxygen was also removed.  She was treated with IV Ativan and morphine for distress, and passed away with family at bedside at 11:10 a.m..
Age: 88.0
Sex: F
Vaccine: COVID19-2
Symptoms: Dyspnoea, Emotional distress, Hypotension, Laboratory test abnormal, PCO2 increased
Clinical narrative: Discharge Provider: MD Primary Care Physician at Discharge: FNP Admission Date: 3/16/2023  PRESENTING PROBLEM: Acute on chronic respiratory failure with hypoxia and hypercapnia (HCC) [J96.21, J96.22]   HOSPITAL COURSE: Patient is a 88 y.o. female, patient of FNP who presented with increasing SHOB and cough the past few weeks with more sleepiness the past few days. She is chronically ill with diastolic heart failure, diabetes mellitus controlled, idiopathic pulmonary fibrosis/on 2L continuous, chronic lower leg lymphedema with recurrent wounds, chronic kidney disease stage IV-V (follows with Nephrology). She was diagnosed with UTI on Mar 10 and started on ciprofloxacin, cultures confirmed it is susceptible.   In the ED, she was severely dyspneic. She was placed on BiPap. CXR showing pulmonary vascular congestion and bilateral pleural effusions. Labs revealing pH 7.20, pCO2 70, with worsening renal function, creatinine 3.15 (usuaally 2.30 - 2.70) and BUN 115, along with lactate 4.1, potassium 5.4. BNP quite elevated at 46,000. She was given breathing treatments, Lasix, Solumedrol and Bipap. Unfortunately, she did test (+) for Covid. She requires admission for a/c heart failure, a/c renal failure.    Daughter at bedside, very involved in care, visits her mom at facility daily and is often caring for her wounds. She explains that her mom recently had code discussion and wished to be DNR. She also would not want dialysis. Palliative care/hospice care also broached with PCP, however daughter didn't feel her mom was ready for that stage of care, as she doesn't have any chronic pain.    The patient was treated with oxygen which needed to be progressed to BiPAP for her respiratory failure, and she also developed hypotension requiring norepinephrine.  She had progressive confusion and decreasing urine output and worsening renal failure, and after discussion in regards to very poor prognosis decision was made to transition her to comfort care measures.  She was treated with norepinephrine while her daughter was trying to arrived to see her from another state, but was otherwise treated with comfort care measures beginning on 03/19/2020.  On 03/20/2020 her norepinephrine was discontinued and her oxygen was also removed.  She was treated with IV Ativan and morphine for distress, and passed away with family at bedside at 11:10 a.m..
Age: 88.0
Sex: F
Vaccine: COVID19-2
Symptoms: Pleural effusion, Positive airway pressure therapy, Pulmonary congestion, Renal impairment, Respiratory failure
Clinical narrative: Discharge Provider: MD Primary Care Physician at Discharge: FNP Admission Date: 3/16/2023  PRESENTING PROBLEM: Acute on chronic respiratory failure with hypoxia and hypercapnia (HCC) [J96.21, J96.22]   HOSPITAL COURSE: Patient is a 88 y.o. female, patient of FNP who presented with increasing SHOB and cough the past few weeks with more sleepiness the past few days. She is chronically ill with diastolic heart failure, diabetes mellitus controlled, idiopathic pulmonary fibrosis/on 2L continuous, chronic lower leg lymphedema with recurrent wounds, chronic kidney disease stage IV-V (follows with Nephrology). She was diagnosed with UTI on Mar 10 and started on ciprofloxacin, cultures confirmed it is susceptible.   In the ED, she was severely dyspneic. She was placed on BiPap. CXR showing pulmonary vascular congestion and bilateral pleural effusions. Labs revealing pH 7.20, pCO2 70, with worsening renal function, creatinine 3.15 (usuaally 2.30 - 2.70) and BUN 115, along with lactate 4.1, potassium 5.4. BNP quite elevated at 46,000. She was given breathing treatments, Lasix, Solumedrol and Bipap. Unfortunately, she did test (+) for Covid. She requires admission for a/c heart failure, a/c renal failure.    Daughter at bedside, very involved in care, visits her mom at facility daily and is often caring for her wounds. She explains that her mom recently had code discussion and wished to be DNR. She also would not want dialysis. Palliative care/hospice care also broached with PCP, however daughter didn't feel her mom was ready for that stage of care, as she doesn't have any chronic pain.    The patient was treated with oxygen which needed to be progressed to BiPAP for her respiratory failure, and she also developed hypotension requiring norepinephrine.  She had progressive confusion and decreasing urine output and worsening renal failure, and after discussion in regards to very poor prognosis decision was made to transition her to comfort care measures.  She was treated with norepinephrine while her daughter was trying to arrived to see her from another state, but was otherwise treated with comfort care measures beginning on 03/19/2020.  On 03/20/2020 her norepinephrine was discontinued and her oxygen was also removed.  She was treated with IV Ativan and morphine for distress, and passed away with family at bedside at 11:10 a.m..
Age: 88.0
Sex: F
Vaccine: COVID19-2
Symptoms: SARS-CoV-2 test positive, Somnolence, Urinary tract infection, Urine output decreased, Wound
Clinical narrative: Discharge Provider: MD Primary Care Physician at Discharge: FNP Admission Date: 3/16/2023  PRESENTING PROBLEM: Acute on chronic respiratory failure with hypoxia and hypercapnia (HCC) [J96.21, J96.22]   HOSPITAL COURSE: Patient is a 88 y.o. female, patient of FNP who presented with increasing SHOB and cough the past few weeks with more sleepiness the past few days. She is chronically ill with diastolic heart failure, diabetes mellitus controlled, idiopathic pulmonary fibrosis/on 2L continuous, chronic lower leg lymphedema with recurrent wounds, chronic kidney disease stage IV-V (follows with Nephrology). She was diagnosed with UTI on Mar 10 and started on ciprofloxacin, cultures confirmed it is susceptible.   In the ED, she was severely dyspneic. She was placed on BiPap. CXR showing pulmonary vascular congestion and bilateral pleural effusions. Labs revealing pH 7.20, pCO2 70, with worsening renal function, creatinine 3.15 (usuaally 2.30 - 2.70) and BUN 115, along with lactate 4.1, potassium 5.4. BNP quite elevated at 46,000. She was given breathing treatments, Lasix, Solumedrol and Bipap. Unfortunately, she did test (+) for Covid. She requires admission for a/c heart failure, a/c renal failure.    Daughter at bedside, very involved in care, visits her mom at facility daily and is often caring for her wounds. She explains that her mom recently had code discussion and wished to be DNR. She also would not want dialysis. Palliative care/hospice care also broached with PCP, however daughter didn't feel her mom was ready for that stage of care, as she doesn't have any chronic pain.    The patient was treated with oxygen which needed to be progressed to BiPAP for her respiratory failure, and she also developed hypotension requiring norepinephrine.  She had progressive confusion and decreasing urine output and worsening renal failure, and after discussion in regards to very poor prognosis decision was made to transition her to comfort care measures.  She was treated with norepinephrine while her daughter was trying to arrived to see her from another state, but was otherwise treated with comfort care measures beginning on 03/19/2020.  On 03/20/2020 her norepinephrine was discontinued and her oxygen was also removed.  She was treated with IV Ativan and morphine for distress, and passed away with family at bedside at 11:10 a.m..
Age: 45.0
Sex: F
Vaccine: COVID19-2
Symptoms: Cough, Headache, Nasopharyngitis, Oropharyngeal pain, Pharyngeal inflammation
Clinical narrative: I had a runny nose, congestion, scratchy throat, headache, sore throat, and a cough. I thought I had a minor cold, but after the eighth day I decided to go to the doctor because it just wasn't going away. I went to Urgent Care, and they told me too much time had passed to test for COVID-19 and Flu. They prescribed Benzonatate and Azithromycin. I also took Zinc and Vitamin C. I still feel a little inflammation in my throat when I am talking to people wile at work, but other than that I am feeling better.
Age: 45.0
Sex: F
Vaccine: COVID19-2
Symptoms: Respiratory tract congestion, Rhinorrhoea, Throat irritation
Clinical narrative: I had a runny nose, congestion, scratchy throat, headache, sore throat, and a cough. I thought I had a minor cold, but after the eighth day I decided to go to the doctor because it just wasn't going away. I went to Urgent Care, and they told me too much time had passed to test for COVID-19 and Flu. They prescribed Benzonatate and Azithromycin. I also took Zinc and Vitamin C. I still feel a little inflammation in my throat when I am talking to people wile at work, but other than that I am feeling better.
Age: 18.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered, No adverse event
Clinical narrative: NO adverse reaction - vaccine was used beyond expiration
Age: 92.0
Sex: F
Vaccine: COVID19
Symptoms: Aggression, Behaviour disorder, Breath sounds absent, Condition aggravated, Death
Clinical narrative: Discharge Provider: DO Primary Care Physician at Discharge: MD Admission Date: 3/4/2023  PRESENTING PROBLEM: Dementia with behavioral disturbance   HOSPITAL COURSE: Patient is a 93 y.o. female with PMHx of vascular dementia, CKD stage 3, hypertension and depression who presented with dementia and aggressive behavior, paranoia, delusions, and behavior disturbances to the ER.    She was being cared for by her family, but has been having outbursts and paranoid delusions. Family no longer able to care for her. They were working on placement in assisted living, but did not feel this was proper care for her dementia, and therefore brought her to the ER for evaluation. No obvious cause for delusions and attributed to progressive dementia. She was admitted to medicine for further management.    While hospitalized she had intermittent outbursts at staff. Psychiatry was consulted to assist with behavioral disturbance. Patient with limited po intake. Informational meeting with hospice and family decided to look for options with plan to sign on with Hospice.Family agreed to remove all medications not focused on comfort. Patient was continued on comfort care and patient's condition ultimately deteriorated before she passed on 3/18/23.   Death Pronouncement: Called to patient?s bedside to pronounce that patient has died. Patient was comfort care. On bedside exam no spontaneous movements were present. There was not response to verbal or tactile stimuli. Pupils were mid-dilated and fixed. No breath sounds were appreciated over either lung field. No carotid pulses were palpable. No heart sounds appreciated.   Patient pronounced deceased 3/18/2023 at 1:35 AM   Family notified over phone grieving appropriately.  Hospice notified.  Funeral Home:  Death certificate to be completed by attending in am.
Age: 92.0
Sex: F
Vaccine: COVID19
Symptoms: Delusion, Dementia, General physical health deterioration, Heart sounds abnormal, Hypophagia
Clinical narrative: Discharge Provider: DO Primary Care Physician at Discharge: MD Admission Date: 3/4/2023  PRESENTING PROBLEM: Dementia with behavioral disturbance   HOSPITAL COURSE: Patient is a 93 y.o. female with PMHx of vascular dementia, CKD stage 3, hypertension and depression who presented with dementia and aggressive behavior, paranoia, delusions, and behavior disturbances to the ER.    She was being cared for by her family, but has been having outbursts and paranoid delusions. Family no longer able to care for her. They were working on placement in assisted living, but did not feel this was proper care for her dementia, and therefore brought her to the ER for evaluation. No obvious cause for delusions and attributed to progressive dementia. She was admitted to medicine for further management.    While hospitalized she had intermittent outbursts at staff. Psychiatry was consulted to assist with behavioral disturbance. Patient with limited po intake. Informational meeting with hospice and family decided to look for options with plan to sign on with Hospice.Family agreed to remove all medications not focused on comfort. Patient was continued on comfort care and patient's condition ultimately deteriorated before she passed on 3/18/23.   Death Pronouncement: Called to patient?s bedside to pronounce that patient has died. Patient was comfort care. On bedside exam no spontaneous movements were present. There was not response to verbal or tactile stimuli. Pupils were mid-dilated and fixed. No breath sounds were appreciated over either lung field. No carotid pulses were palpable. No heart sounds appreciated.   Patient pronounced deceased 3/18/2023 at 1:35 AM   Family notified over phone grieving appropriately.  Hospice notified.  Funeral Home:  Death certificate to be completed by attending in am.
Age: 92.0
Sex: F
Vaccine: COVID19
Symptoms: Mydriasis, Paranoia, Pulse absent, Pupil fixed, Unresponsive to stimuli
Clinical narrative: Discharge Provider: DO Primary Care Physician at Discharge: MD Admission Date: 3/4/2023  PRESENTING PROBLEM: Dementia with behavioral disturbance   HOSPITAL COURSE: Patient is a 93 y.o. female with PMHx of vascular dementia, CKD stage 3, hypertension and depression who presented with dementia and aggressive behavior, paranoia, delusions, and behavior disturbances to the ER.    She was being cared for by her family, but has been having outbursts and paranoid delusions. Family no longer able to care for her. They were working on placement in assisted living, but did not feel this was proper care for her dementia, and therefore brought her to the ER for evaluation. No obvious cause for delusions and attributed to progressive dementia. She was admitted to medicine for further management.    While hospitalized she had intermittent outbursts at staff. Psychiatry was consulted to assist with behavioral disturbance. Patient with limited po intake. Informational meeting with hospice and family decided to look for options with plan to sign on with Hospice.Family agreed to remove all medications not focused on comfort. Patient was continued on comfort care and patient's condition ultimately deteriorated before she passed on 3/18/23.   Death Pronouncement: Called to patient?s bedside to pronounce that patient has died. Patient was comfort care. On bedside exam no spontaneous movements were present. There was not response to verbal or tactile stimuli. Pupils were mid-dilated and fixed. No breath sounds were appreciated over either lung field. No carotid pulses were palpable. No heart sounds appreciated.   Patient pronounced deceased 3/18/2023 at 1:35 AM   Family notified over phone grieving appropriately.  Hospice notified.  Funeral Home:  Death certificate to be completed by attending in am.
Age: 67.0
Sex: F
Vaccine: COVID19-2
Symptoms: COVID-19, Vaccine breakthrough infection
Clinical narrative: I had a breakthrough case of Covid-19, No symptoms..
Age: 81.0
Sex: M
Vaccine: COVID19-2, FLU4
Symptoms: COVID-19, Malaise, Pyrexia, Rhinorrhoea, SARS-CoV-2 test positive
Clinical narrative: 6 months after receiving my 5th dose. I contracted COVID-19 infection the symptoms started on 10/10/2022 in the morning. I had fever, runny nose and feeing unwell. I used a home test on 10/12/2022 which was positive. I called my  doctor's office and they called me back saying the you tested positive we can't do anything about it. They also said to call back if my symptoms worsened. It was a very mild case.  My symptoms subsided slowly  so I didn't need to call back.   I probably took Tylenol. I took  a COVID-19  test on 10/20/2022 which was negative.
Age: 4.0
Sex: F
Vaccine: COVID19
Symptoms: Anxiety, Chest X-ray normal, Decreased appetite, Dyspnoea, Insomnia
Clinical narrative: Patient received the COVID-19 vaccine 1st dose on April 7, 2023. Following 19 hours, she manifested contraindications with the vaccine. She encountered difficulty breathing lasted 5 minutes which was the first time it was encountered by my child even prior and post open heart surgery. It is beyond normal.  She threw-up 3 times, had fever and her sleep overnight only lasted like 4 hours. We went to Hospital ER to monitor her and report the shortness of breath. During ER stay, she also experienced severe pain reactions reactions described comparable with post surgery when pain reliever wore-off. She was given Tylenol for pain medications.  Following day,  it was also observed she was catching her breath again for few minutes. Other side effects for few days observed were fever, uneasiness, irritability, difficulty sleeping and loss of appetite.
Age: 4.0
Sex: F
Vaccine: COVID19
Symptoms: Irritability, Pain, Pyrexia, Vomiting
Clinical narrative: Patient received the COVID-19 vaccine 1st dose on April 7, 2023. Following 19 hours, she manifested contraindications with the vaccine. She encountered difficulty breathing lasted 5 minutes which was the first time it was encountered by my child even prior and post open heart surgery. It is beyond normal.  She threw-up 3 times, had fever and her sleep overnight only lasted like 4 hours. We went to Hospital ER to monitor her and report the shortness of breath. During ER stay, she also experienced severe pain reactions reactions described comparable with post surgery when pain reliever wore-off. She was given Tylenol for pain medications.  Following day,  it was also observed she was catching her breath again for few minutes. Other side effects for few days observed were fever, uneasiness, irritability, difficulty sleeping and loss of appetite.
Age: 22.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered, No adverse event
Clinical narrative: no adverse reaction - expired vaccine
Age: 84.0
Sex: F
Vaccine: COVID19
Symptoms: Acute respiratory failure, Blood culture negative, Blood lactic acid, COVID-19, Chest X-ray abnormal
Clinical narrative: Discharge Provider: MD Primary Care Provider: MD Admission Date: 3/15/2023 Discharge Date: Mar 17, 2023  PRESENTING PROBLEM: Hypoxia [R09.02] Acute hypoxemic respiratory failure [J96.01] Community acquired pneumonia of right middle lobe of lung [J18.9] Sepsis without acute organ dysfunction, due to unspecified organism [A41.9] COVID-19 [U07.1]   HOSPITAL COURSE: Pt is a 85 yr old F with PMHx of Insomnia, Dyslipidemia, OA presented to ED on 3/15 with concerns for confusion, shortness of breath and hypoxia. On ED admission - patient found to be febrile, hypoxic requiring 2L NC, WBC of 10k, procalcitonin of 1.6, and initial lactic acid of 2.1.   COVID PCR positive, CXR confirmed Right lower lobe pneumonia - she was started on IV Rocephin/Azithromycin and admitted for further workup.   For her COVID pneumonia - she was started on Decadron and Remdesivir. For her Community Acquired Pneumonia- Urine Strept came back positive so she was continued on IV Rocephin. Her blood cultures were negative. She was weaned off oxygen.   She was transitioned to oral abx and discharged home in stable conditions.   She will need repeat Chest X ray in 4-6 weeks outpatient to ensure resolution of pneumonia.
Age: 84.0
Sex: F
Vaccine: COVID19
Symptoms: Hypoxia, Pneumonia, Procalcitonin, Pyrexia, SARS-CoV-2 test positive
Clinical narrative: Discharge Provider: MD Primary Care Provider: MD Admission Date: 3/15/2023 Discharge Date: Mar 17, 2023  PRESENTING PROBLEM: Hypoxia [R09.02] Acute hypoxemic respiratory failure [J96.01] Community acquired pneumonia of right middle lobe of lung [J18.9] Sepsis without acute organ dysfunction, due to unspecified organism [A41.9] COVID-19 [U07.1]   HOSPITAL COURSE: Pt is a 85 yr old F with PMHx of Insomnia, Dyslipidemia, OA presented to ED on 3/15 with concerns for confusion, shortness of breath and hypoxia. On ED admission - patient found to be febrile, hypoxic requiring 2L NC, WBC of 10k, procalcitonin of 1.6, and initial lactic acid of 2.1.   COVID PCR positive, CXR confirmed Right lower lobe pneumonia - she was started on IV Rocephin/Azithromycin and admitted for further workup.   For her COVID pneumonia - she was started on Decadron and Remdesivir. For her Community Acquired Pneumonia- Urine Strept came back positive so she was continued on IV Rocephin. Her blood cultures were negative. She was weaned off oxygen.   She was transitioned to oral abx and discharged home in stable conditions.   She will need repeat Chest X ray in 4-6 weeks outpatient to ensure resolution of pneumonia.
Age: 84.0
Sex: F
Vaccine: COVID19
Symptoms: Sepsis, Streptococcus test positive, White blood cell count normal
Clinical narrative: Discharge Provider: MD Primary Care Provider: MD Admission Date: 3/15/2023 Discharge Date: Mar 17, 2023  PRESENTING PROBLEM: Hypoxia [R09.02] Acute hypoxemic respiratory failure [J96.01] Community acquired pneumonia of right middle lobe of lung [J18.9] Sepsis without acute organ dysfunction, due to unspecified organism [A41.9] COVID-19 [U07.1]   HOSPITAL COURSE: Pt is a 85 yr old F with PMHx of Insomnia, Dyslipidemia, OA presented to ED on 3/15 with concerns for confusion, shortness of breath and hypoxia. On ED admission - patient found to be febrile, hypoxic requiring 2L NC, WBC of 10k, procalcitonin of 1.6, and initial lactic acid of 2.1.   COVID PCR positive, CXR confirmed Right lower lobe pneumonia - she was started on IV Rocephin/Azithromycin and admitted for further workup.   For her COVID pneumonia - she was started on Decadron and Remdesivir. For her Community Acquired Pneumonia- Urine Strept came back positive so she was continued on IV Rocephin. Her blood cultures were negative. She was weaned off oxygen.   She was transitioned to oral abx and discharged home in stable conditions.   She will need repeat Chest X ray in 4-6 weeks outpatient to ensure resolution of pneumonia.
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: Anticoagulant therapy, Chest pain, Computerised tomogram thorax abnormal, Hypertension, Subclavian artery dissection
Clinical narrative: On September 29, 2022, I had chest pains. I went to the emergency room on October 2, 2022. I was admitted. My blood pressure was about 200/112. They treated me for Hypertension. They got my pressure down and sent me home. They gave me medication. All the symptoms returned. I went to my regular doctor on October 7, 2022. They ordered a CT scan. It showed something wrong with the left Subclavian Artery. On October 10, 2022, I went to a Vascular Surgeon. I was diagnosed with a Subclavian Artery Dissection. I take a bunch of blood pressure medications now and PLAVIX.
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: Subclavian artery stenosis, Symptom recurrence
Clinical narrative: On September 29, 2022, I had chest pains. I went to the emergency room on October 2, 2022. I was admitted. My blood pressure was about 200/112. They treated me for Hypertension. They got my pressure down and sent me home. They gave me medication. All the symptoms returned. I went to my regular doctor on October 7, 2022. They ordered a CT scan. It showed something wrong with the left Subclavian Artery. On October 10, 2022, I went to a Vascular Surgeon. I was diagnosed with a Subclavian Artery Dissection. I take a bunch of blood pressure medications now and PLAVIX.
Age: 73.0
Sex: F
Vaccine: COVID19-2
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Tested positive for COVID on January 23, 2023
Age: 21.0
Sex: F
Vaccine: HPV9, TDAP
Symptoms: Product administered to patient of inappropriate age, Wrong product administered
Clinical narrative: The patient was to receive the HPV vaccine but the provider gave them the TDAP vaccine.  When the error was identified, they also received the HPV vaccine during the visit.
Age: 38.0
Sex: F
Vaccine: COVID19
Symptoms: Back pain, Electromyogram, Fibromyalgia, Hypoaesthesia, Magnetic resonance imaging
Clinical narrative: right arm pain and numbness, right ulnar neuropathy, blood clot in the eye, fibromyalgia, low back pain
Age: 38.0
Sex: F
Vaccine: COVID19
Symptoms: Neuropathy peripheral, Ophthalmic vascular thrombosis, Pain in extremity, X-ray
Clinical narrative: right arm pain and numbness, right ulnar neuropathy, blood clot in the eye, fibromyalgia, low back pain
Age: 53.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive, Vaccine breakthrough infection
Clinical narrative: Breakthrough case admission after 2 vaccines Moderna 4/13/21 Lot# 043B21A; Moderna 5/10/21 Lot# 005C21A
Age: 83.0
Sex: F
Vaccine: COVID19-2, FLU4
Symptoms: Acute kidney injury, COVID-19, Cardiac septal hypertrophy, Computerised tomogram thorax abnormal, Condition aggravated
Clinical narrative: Discharge Provider: MD Primary Care Provider: DO Admission Date: 3/10/2023 Discharge Date: Mar 23, 2023  PRESENTING PROBLEM: Sepsis (HCC)  Severe sepsis (HCC) Septic shock (HCC)    HOSPITAL COURSE:  83 y.o. who has a past medical history significant for CKD, schizophrenia, bipolar disorder, previous CVA with residual weakness who presented on 3/10 with an acute onset of altered mentation, fever, hypoxemia and hypotension. Per family, she is slow to respond to questions at baseline and sleeps up to 20 hours per day. CT chest showed bilateral multifocal pneumonia. Labs were significant for AKI, mild lactic acidosis, transaminitis, elevated troponins and leukocytosis. UA with mild pyuria. She was given 4L IV fluids then started on vasopressors due to persistent hypotension. US of RUQ c/w fatty liver. Echo showed moderate concentric hypertrophy with assymetric severe septal hypertrophy (1.5 cm). No LV outflow obstruction at time of study. LVEF 66%. 1 of 2 blood cultures (+) for coag neg Staph - contaminant   Zosyn deescalated to Augmentin and completed 7 day course. In addition to pneumonia, found to be COVID+, She was started on remdesivir to complete 5 days with CMP monitoring.  Decadron 6 mg daily for 10 days.  Patient's acute kidney injury had resolved.   For her hypertrophic cardiomyopathy cardiology consulted and recommended non urgent outpatient visit in the next 1-2 months for re-evaluation and consideration of further testing such as cardiac MRI for her prior history of amyloidosis.   PTOT evaluation recommended skilled nursing facility placement. Doctor consulted and recommended dysphagia diet and outpatient ENT follow up. Psychiatry consulted and did deem patient mentally compensated and appropriate and no need for inpatient psychiatry.
Age: 83.0
Sex: F
Vaccine: COVID19-2, FLU4
Symptoms: Dysphagia, Echocardiogram abnormal, Ejection fraction, Hepatic steatosis, Hypersomnia
Clinical narrative: Discharge Provider: MD Primary Care Provider: DO Admission Date: 3/10/2023 Discharge Date: Mar 23, 2023  PRESENTING PROBLEM: Sepsis (HCC)  Severe sepsis (HCC) Septic shock (HCC)    HOSPITAL COURSE:  83 y.o. who has a past medical history significant for CKD, schizophrenia, bipolar disorder, previous CVA with residual weakness who presented on 3/10 with an acute onset of altered mentation, fever, hypoxemia and hypotension. Per family, she is slow to respond to questions at baseline and sleeps up to 20 hours per day. CT chest showed bilateral multifocal pneumonia. Labs were significant for AKI, mild lactic acidosis, transaminitis, elevated troponins and leukocytosis. UA with mild pyuria. She was given 4L IV fluids then started on vasopressors due to persistent hypotension. US of RUQ c/w fatty liver. Echo showed moderate concentric hypertrophy with assymetric severe septal hypertrophy (1.5 cm). No LV outflow obstruction at time of study. LVEF 66%. 1 of 2 blood cultures (+) for coag neg Staph - contaminant   Zosyn deescalated to Augmentin and completed 7 day course. In addition to pneumonia, found to be COVID+, She was started on remdesivir to complete 5 days with CMP monitoring.  Decadron 6 mg daily for 10 days.  Patient's acute kidney injury had resolved.   For her hypertrophic cardiomyopathy cardiology consulted and recommended non urgent outpatient visit in the next 1-2 months for re-evaluation and consideration of further testing such as cardiac MRI for her prior history of amyloidosis.   PTOT evaluation recommended skilled nursing facility placement. Doctor consulted and recommended dysphagia diet and outpatient ENT follow up. Psychiatry consulted and did deem patient mentally compensated and appropriate and no need for inpatient psychiatry.
Age: 83.0
Sex: F
Vaccine: COVID19-2, FLU4
Symptoms: Hypertransaminasaemia, Hyporesponsive to stimuli, Hypotension, Hypoxia, Laboratory test abnormal
Clinical narrative: Discharge Provider: MD Primary Care Provider: DO Admission Date: 3/10/2023 Discharge Date: Mar 23, 2023  PRESENTING PROBLEM: Sepsis (HCC)  Severe sepsis (HCC) Septic shock (HCC)    HOSPITAL COURSE:  83 y.o. who has a past medical history significant for CKD, schizophrenia, bipolar disorder, previous CVA with residual weakness who presented on 3/10 with an acute onset of altered mentation, fever, hypoxemia and hypotension. Per family, she is slow to respond to questions at baseline and sleeps up to 20 hours per day. CT chest showed bilateral multifocal pneumonia. Labs were significant for AKI, mild lactic acidosis, transaminitis, elevated troponins and leukocytosis. UA with mild pyuria. She was given 4L IV fluids then started on vasopressors due to persistent hypotension. US of RUQ c/w fatty liver. Echo showed moderate concentric hypertrophy with assymetric severe septal hypertrophy (1.5 cm). No LV outflow obstruction at time of study. LVEF 66%. 1 of 2 blood cultures (+) for coag neg Staph - contaminant   Zosyn deescalated to Augmentin and completed 7 day course. In addition to pneumonia, found to be COVID+, She was started on remdesivir to complete 5 days with CMP monitoring.  Decadron 6 mg daily for 10 days.  Patient's acute kidney injury had resolved.   For her hypertrophic cardiomyopathy cardiology consulted and recommended non urgent outpatient visit in the next 1-2 months for re-evaluation and consideration of further testing such as cardiac MRI for her prior history of amyloidosis.   PTOT evaluation recommended skilled nursing facility placement. Doctor consulted and recommended dysphagia diet and outpatient ENT follow up. Psychiatry consulted and did deem patient mentally compensated and appropriate and no need for inpatient psychiatry.
Age: 83.0
Sex: F
Vaccine: COVID19-2, FLU4
Symptoms: Lactic acidosis, Leukocytosis, Mental status changes, Pneumonia, Pyrexia
Clinical narrative: Discharge Provider: MD Primary Care Provider: DO Admission Date: 3/10/2023 Discharge Date: Mar 23, 2023  PRESENTING PROBLEM: Sepsis (HCC)  Severe sepsis (HCC) Septic shock (HCC)    HOSPITAL COURSE:  83 y.o. who has a past medical history significant for CKD, schizophrenia, bipolar disorder, previous CVA with residual weakness who presented on 3/10 with an acute onset of altered mentation, fever, hypoxemia and hypotension. Per family, she is slow to respond to questions at baseline and sleeps up to 20 hours per day. CT chest showed bilateral multifocal pneumonia. Labs were significant for AKI, mild lactic acidosis, transaminitis, elevated troponins and leukocytosis. UA with mild pyuria. She was given 4L IV fluids then started on vasopressors due to persistent hypotension. US of RUQ c/w fatty liver. Echo showed moderate concentric hypertrophy with assymetric severe septal hypertrophy (1.5 cm). No LV outflow obstruction at time of study. LVEF 66%. 1 of 2 blood cultures (+) for coag neg Staph - contaminant   Zosyn deescalated to Augmentin and completed 7 day course. In addition to pneumonia, found to be COVID+, She was started on remdesivir to complete 5 days with CMP monitoring.  Decadron 6 mg daily for 10 days.  Patient's acute kidney injury had resolved.   For her hypertrophic cardiomyopathy cardiology consulted and recommended non urgent outpatient visit in the next 1-2 months for re-evaluation and consideration of further testing such as cardiac MRI for her prior history of amyloidosis.   PTOT evaluation recommended skilled nursing facility placement. Doctor consulted and recommended dysphagia diet and outpatient ENT follow up. Psychiatry consulted and did deem patient mentally compensated and appropriate and no need for inpatient psychiatry.
Age: 83.0
Sex: F
Vaccine: COVID19-2, FLU4
Symptoms: Pyuria, SARS-CoV-2 test positive, Sepsis, Septic shock, Staphylococcus test positive
Clinical narrative: Discharge Provider: MD Primary Care Provider: DO Admission Date: 3/10/2023 Discharge Date: Mar 23, 2023  PRESENTING PROBLEM: Sepsis (HCC)  Severe sepsis (HCC) Septic shock (HCC)    HOSPITAL COURSE:  83 y.o. who has a past medical history significant for CKD, schizophrenia, bipolar disorder, previous CVA with residual weakness who presented on 3/10 with an acute onset of altered mentation, fever, hypoxemia and hypotension. Per family, she is slow to respond to questions at baseline and sleeps up to 20 hours per day. CT chest showed bilateral multifocal pneumonia. Labs were significant for AKI, mild lactic acidosis, transaminitis, elevated troponins and leukocytosis. UA with mild pyuria. She was given 4L IV fluids then started on vasopressors due to persistent hypotension. US of RUQ c/w fatty liver. Echo showed moderate concentric hypertrophy with assymetric severe septal hypertrophy (1.5 cm). No LV outflow obstruction at time of study. LVEF 66%. 1 of 2 blood cultures (+) for coag neg Staph - contaminant   Zosyn deescalated to Augmentin and completed 7 day course. In addition to pneumonia, found to be COVID+, She was started on remdesivir to complete 5 days with CMP monitoring.  Decadron 6 mg daily for 10 days.  Patient's acute kidney injury had resolved.   For her hypertrophic cardiomyopathy cardiology consulted and recommended non urgent outpatient visit in the next 1-2 months for re-evaluation and consideration of further testing such as cardiac MRI for her prior history of amyloidosis.   PTOT evaluation recommended skilled nursing facility placement. Doctor consulted and recommended dysphagia diet and outpatient ENT follow up. Psychiatry consulted and did deem patient mentally compensated and appropriate and no need for inpatient psychiatry.
Age: 83.0
Sex: F
Vaccine: COVID19-2, FLU4
Symptoms: Troponin increased, Ultrasound abdomen abnormal, Urine analysis abnormal, Ventricular hypertrophy
Clinical narrative: Discharge Provider: MD Primary Care Provider: DO Admission Date: 3/10/2023 Discharge Date: Mar 23, 2023  PRESENTING PROBLEM: Sepsis (HCC)  Severe sepsis (HCC) Septic shock (HCC)    HOSPITAL COURSE:  83 y.o. who has a past medical history significant for CKD, schizophrenia, bipolar disorder, previous CVA with residual weakness who presented on 3/10 with an acute onset of altered mentation, fever, hypoxemia and hypotension. Per family, she is slow to respond to questions at baseline and sleeps up to 20 hours per day. CT chest showed bilateral multifocal pneumonia. Labs were significant for AKI, mild lactic acidosis, transaminitis, elevated troponins and leukocytosis. UA with mild pyuria. She was given 4L IV fluids then started on vasopressors due to persistent hypotension. US of RUQ c/w fatty liver. Echo showed moderate concentric hypertrophy with assymetric severe septal hypertrophy (1.5 cm). No LV outflow obstruction at time of study. LVEF 66%. 1 of 2 blood cultures (+) for coag neg Staph - contaminant   Zosyn deescalated to Augmentin and completed 7 day course. In addition to pneumonia, found to be COVID+, She was started on remdesivir to complete 5 days with CMP monitoring.  Decadron 6 mg daily for 10 days.  Patient's acute kidney injury had resolved.   For her hypertrophic cardiomyopathy cardiology consulted and recommended non urgent outpatient visit in the next 1-2 months for re-evaluation and consideration of further testing such as cardiac MRI for her prior history of amyloidosis.   PTOT evaluation recommended skilled nursing facility placement. Doctor consulted and recommended dysphagia diet and outpatient ENT follow up. Psychiatry consulted and did deem patient mentally compensated and appropriate and no need for inpatient psychiatry.
Age: 61.0
Sex: F
Vaccine: COVID19-2, FLU4
Symptoms: Computerised tomogram head normal, Dizziness, Gait inability, Hypoaesthesia, Magnetic resonance imaging head normal
Clinical narrative: I was extremely dizzy, I could not walk, I was unable to feel anything on my left side. My daughter drove me to the emergency room, I was uncertain of knowing if I was having a stroke or something with my heart. Once I got into the emergency room, they did a complete blood panel to check for a heart attack, they did a CT scan to check for stroke. I was kept overnight for observation and to have an MRI to also check for a stroke. All tests came back negative. I have a follow up MRI coming up on May 13, 2023.
Age: 61.0
Sex: F
Vaccine: COVID19-2, FLU4
Symptoms: Myocardial necrosis marker normal
Clinical narrative: I was extremely dizzy, I could not walk, I was unable to feel anything on my left side. My daughter drove me to the emergency room, I was uncertain of knowing if I was having a stroke or something with my heart. Once I got into the emergency room, they did a complete blood panel to check for a heart attack, they did a CT scan to check for stroke. I was kept overnight for observation and to have an MRI to also check for a stroke. All tests came back negative. I have a follow up MRI coming up on May 13, 2023.
Age: 97.0
Sex: F
Vaccine: COVID19
Symptoms: Acute kidney injury, Computerised tomogram thorax abnormal, Hypersensitivity, Hypoxia, Mental status changes
Clinical narrative: HYPOXEMIA 5/14/2022 ALTERED MENTAL STATUS, UNSPECIFIED ALLERGIC REACTION, INIT 5/14/2022 ALTERED MENTAL STATUS, UNSPECIFIED ALLERGIC REACTION, SUBSEQ 5/14/2022 ALTERED MENTAL STATUS, UNSPECIFIED HYPOXEMIA 5/14/2022 ABNL CHEST CT SCAN ALLERGIC REACTION, INIT 5/14/2022 ABNL CHEST CT SCAN ALLERGIC REACTION, SUBSEQ 5/14/2022 ABNL CHEST CT SCAN HYPOXEMIA 5/14/2022 NONTRAUMATIC ACUTE KIDNEY INJURY ALLERGIC REACTION, INIT 5/14/2022 NONTRAUMATIC ACUTE KIDNEY INJURY ALLERGIC REACTION, SUBSEQ 5/14/2022 NONTRAUMATIC ACUTE KIDNEY INJURY
Age: 71.0
Sex: M
Vaccine: COVID19
Symptoms: Abdominal pain, Acute kidney injury, Alcohol abuse, Asthenia, Blood culture negative
Clinical narrative: Discharge Provider: MD Primary Care Provider: MD Admission Date: 2/27/2023 Discharge Date: Mar 23, 2023 PRESENTING PROBLEM: Hypomagnesemia Debility  Alcohol abuse Weakness COVID-19   HOSPITAL COURSE: 72M with past medical history significant for alcohol use disorder, presented with overall body pain, generalized weakness and fall. He has been seen 4 x in the E.D. in the past few weeks mostly for etoh. He was planning to go to a rehab but sent to the E.D. for medical clearance. He was unable to ambulate in the E.D. so admission was requested for PT / OT and potentially SAR .He had a CT scan head showing mild soft tissue swelling on the right frontal scalp no intracranial hemorrhage midline shift or mass effect.  Left knee x-ray showing sclerotic changes in the proximal tibia concerning for metastatic disease.  PSA within normal limits.   Due to the patient's abdominal pain and CT abdomen and pelvis done showed fatty liver and questionable cirrhosis.    He was given multivitamin thiamine folic acid and Ativan p.r.n. for alcohol withdrawal.   PT and OT recommended skilled nursing facility, neurology patient was awaiting placement he spiked fevers greater than and 39 C. A chest x-ray was negative for any acute processes..  Patient was initiated on vancomycin and cefepime. Work up was positive for COVID on 3/10/23. He was titrated off antibiotics. He developed AKI 2/2 uncontrolled fever and this resolved with IVF as well as fever suppression with tylenol. He developed TME and this improved with fever suppression and correction of AKI. Blood cultures were negative. He remained on room air during his acute COVID episode.    He completed 10 days of COVID isolation on 03/21 and was discharged In stable condition.
Age: 71.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Chest X-ray normal, Computerised tomogram abdomen abnormal, Computerised tomogram head abnormal, Fall
Clinical narrative: Discharge Provider: MD Primary Care Provider: MD Admission Date: 2/27/2023 Discharge Date: Mar 23, 2023 PRESENTING PROBLEM: Hypomagnesemia Debility  Alcohol abuse Weakness COVID-19   HOSPITAL COURSE: 72M with past medical history significant for alcohol use disorder, presented with overall body pain, generalized weakness and fall. He has been seen 4 x in the E.D. in the past few weeks mostly for etoh. He was planning to go to a rehab but sent to the E.D. for medical clearance. He was unable to ambulate in the E.D. so admission was requested for PT / OT and potentially SAR .He had a CT scan head showing mild soft tissue swelling on the right frontal scalp no intracranial hemorrhage midline shift or mass effect.  Left knee x-ray showing sclerotic changes in the proximal tibia concerning for metastatic disease.  PSA within normal limits.   Due to the patient's abdominal pain and CT abdomen and pelvis done showed fatty liver and questionable cirrhosis.    He was given multivitamin thiamine folic acid and Ativan p.r.n. for alcohol withdrawal.   PT and OT recommended skilled nursing facility, neurology patient was awaiting placement he spiked fevers greater than and 39 C. A chest x-ray was negative for any acute processes..  Patient was initiated on vancomycin and cefepime. Work up was positive for COVID on 3/10/23. He was titrated off antibiotics. He developed AKI 2/2 uncontrolled fever and this resolved with IVF as well as fever suppression with tylenol. He developed TME and this improved with fever suppression and correction of AKI. Blood cultures were negative. He remained on room air during his acute COVID episode.    He completed 10 days of COVID isolation on 03/21 and was discharged In stable condition.
Age: 71.0
Sex: M
Vaccine: COVID19
Symptoms: Hepatic steatosis, Hypomagnesaemia, Pain, Prostatic specific antigen normal, Pyrexia
Clinical narrative: Discharge Provider: MD Primary Care Provider: MD Admission Date: 2/27/2023 Discharge Date: Mar 23, 2023 PRESENTING PROBLEM: Hypomagnesemia Debility  Alcohol abuse Weakness COVID-19   HOSPITAL COURSE: 72M with past medical history significant for alcohol use disorder, presented with overall body pain, generalized weakness and fall. He has been seen 4 x in the E.D. in the past few weeks mostly for etoh. He was planning to go to a rehab but sent to the E.D. for medical clearance. He was unable to ambulate in the E.D. so admission was requested for PT / OT and potentially SAR .He had a CT scan head showing mild soft tissue swelling on the right frontal scalp no intracranial hemorrhage midline shift or mass effect.  Left knee x-ray showing sclerotic changes in the proximal tibia concerning for metastatic disease.  PSA within normal limits.   Due to the patient's abdominal pain and CT abdomen and pelvis done showed fatty liver and questionable cirrhosis.    He was given multivitamin thiamine folic acid and Ativan p.r.n. for alcohol withdrawal.   PT and OT recommended skilled nursing facility, neurology patient was awaiting placement he spiked fevers greater than and 39 C. A chest x-ray was negative for any acute processes..  Patient was initiated on vancomycin and cefepime. Work up was positive for COVID on 3/10/23. He was titrated off antibiotics. He developed AKI 2/2 uncontrolled fever and this resolved with IVF as well as fever suppression with tylenol. He developed TME and this improved with fever suppression and correction of AKI. Blood cultures were negative. He remained on room air during his acute COVID episode.    He completed 10 days of COVID isolation on 03/21 and was discharged In stable condition.