chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 1.08
Sex: F
Vaccine: HEPA, MMR, PNC13, VARCEL
Symptoms: Crying, Decreased appetite, Hair colour changes, Irritability, Oral pain
Clinical narrative: Very irritable for next 48 hours- arching back, inconsolable,  hard crying. Loss of appetite for 1 week following  Sudden refusal to take a bottle (because of sore throat/mouth?) Day 9- fever (didn't check temp) Day 10- rash of red dots all over stomach and back, few on face and neck, white of eyes look gray
Age: 1.08
Sex: F
Vaccine: HEPA, MMR, PNC13, VARCEL
Symptoms: Oropharyngeal pain, Pyrexia, Rash
Clinical narrative: Very irritable for next 48 hours- arching back, inconsolable,  hard crying. Loss of appetite for 1 week following  Sudden refusal to take a bottle (because of sore throat/mouth?) Day 9- fever (didn't check temp) Day 10- rash of red dots all over stomach and back, few on face and neck, white of eyes look gray
Age: 41.0
Sex: F
Vaccine: PNC20
Symptoms: Lymph node pain, Lymphadenopathy
Clinical narrative: severe swelling/tenderness on  lymph nodes -  left axilla.
Age: 0.5
Sex: M
Vaccine: COVID19-2
Symptoms: No adverse event, Wrong product administered
Clinical narrative: No Adverse event; Patient of 6 months-5 years of age received a Moderna COVID-19, bivalent vaccine from the Pink cap vial(10 mcg) instead of blue cap vial(25 mcg), when blue cap was indicated; This spontaneous case was reported by a nurse and describes the occurrence of WRONG PRODUCT ADMINISTERED (Patient of 6 months-5 years of age received a Moderna COVID-19, bivalent vaccine from the Pink cap vial(10 mcg) instead of blue cap vial(25 mcg), when blue cap was indicated) and NO ADVERSE EVENT (No Adverse event) in a 6-month-old male patient who received mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)) (batch no. 214K22A) for COVID-19 prophylaxis.     No Medical History information was reported.    On 05-May-2023, the patient received first dose of mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)) (unknown route) 10 microgram. On 05-May-2023,  after starting mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)), the patient experienced WRONG PRODUCT ADMINISTERED (Patient of 6 months-5 years of age received a Moderna COVID-19, bivalent vaccine from the Pink cap vial(10 mcg) instead of blue cap vial(25 mcg), when blue cap was indicated). On an unknown date, the patient experienced NO ADVERSE EVENT (No Adverse event). At the time of the report, WRONG PRODUCT ADMINISTERED (Patient of 6 months-5 years of age received a Moderna COVID-19, bivalent vaccine from the Pink cap vial(10 mcg) instead of blue cap vial(25 mcg), when blue cap was indicated) and NO ADVERSE EVENT (No Adverse event) outcome was unknown.        For mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)) (Unknown), the reporter considered NO ADVERSE EVENT (No Adverse event) to be not related. No further causality assessment was provided for WRONG PRODUCT ADMINISTERED (Patient of 6 months-5 years of age received a Moderna COVID-19, bivalent vaccine from the Pink cap vial(10 mcg) instead of blue cap vial(25 mcg), when blue cap was indicated).    Concomitant medications were not reported.   The route of administration of suspect Moderna bivalent was reported as BI.  No treatment information was provided by the reporter.
Sex: F
Vaccine: COVID19-2
Symptoms: No adverse event, Wrong product administered
Clinical narrative: No adverse event; Patient of 6 months-5 years of age received a Moderna COVID-19, bivalent vaccine from the Pink cap vial(10 mcg) instead of blue cap vial(25 mcg), when blue cap was indicated; This spontaneous case was reported by a nurse and describes the occurrence of WRONG PRODUCT ADMINISTERED (Patient of 6 months-5 years of age received a Moderna COVID-19, bivalent vaccine from the Pink cap vial(10 mcg) instead of blue cap vial(25 mcg), when blue cap was indicated) and NO ADVERSE EVENT (No adverse event) in an infant female patient who received mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)) (batch nos. 216K22A and 216K22A) for COVID-19 prophylaxis.     No Medical History information was reported.   On 12-May-2023, the patient received first dose of mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)) (unknown route) 10 microgram. On 10-Jun-2023, received second dose of mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)) (unknown route) dosage was changed to 10 microgram. In 2023, the patient experienced WRONG PRODUCT ADMINISTERED (Patient of 6 months-5 years of age received a Moderna COVID-19, bivalent vaccine from the Pink cap vial(10 mcg) instead of blue cap vial(25 mcg), when blue cap was indicated). On an unknown date, the patient experienced NO ADVERSE EVENT (No adverse event). At the time of the report, WRONG PRODUCT ADMINISTERED (Patient of 6 months-5 years of age received a Moderna COVID-19, bivalent vaccine from the Pink cap vial(10 mcg) instead of blue cap vial(25 mcg), when blue cap was indicated) and NO ADVERSE EVENT (No adverse event) outcome was unknown. Not Provided      For mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)) (Unknown), the reporter considered NO ADVERSE EVENT (No adverse event) to be not related. No further causality assessment was provided for WRONG PRODUCT ADMINISTERED (Patient of 6 months-5 years of age received a Moderna COVID-19, bivalent vaccine from the Pink cap vial(10 mcg) instead of blue cap vial(25 mcg), when blue cap was indicated).    The route of administration of suspect Moderna bivalent was reported as BI. Concomitant medications were not reported.  No treatment information was provided by the reporter.   This case was linked to US-MODERNATX, INC.-MOD-2023-730780 (Linked Report).; Sender's Comments:  US-MODERNATX, INC.-MOD-2023-730780:Master case,
Age: 1.0
Sex: M
Vaccine: COVID19-2
Symptoms: No adverse event, Wrong product administered
Clinical narrative: No adverse event; Patient of 6 months-5 years of age received a Moderna COVID-19, bivalent vaccine from the Pink cap vial(10 mcg) instead of blue cap vial(25 mcg), when blue cap was indicated; This spontaneous case was reported by a nurse and describes the occurrence of WRONG PRODUCT ADMINISTERED (Patient of 6 months-5 years of age received a Moderna COVID-19, bivalent vaccine from the Pink cap vial(10 mcg) instead of blue cap vial(25 mcg), when blue cap was indicated) and NO ADVERSE EVENT (No adverse event) in a 12-month-old male patient who received mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)) (batch no. 214K22A) for COVID-19 prophylaxis.     No Medical History information was reported.    On 25-Apr-2023, the patient received first dose of mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)) (unknown route) 10 microgram. On 25-Apr-2023,  after starting mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)), the patient experienced WRONG PRODUCT ADMINISTERED (Patient of 6 months-5 years of age received a Moderna COVID-19, bivalent vaccine from the Pink cap vial(10 mcg) instead of blue cap vial(25 mcg), when blue cap was indicated). On an unknown date, the patient experienced NO ADVERSE EVENT (No adverse event). At the time of the report, WRONG PRODUCT ADMINISTERED (Patient of 6 months-5 years of age received a Moderna COVID-19, bivalent vaccine from the Pink cap vial(10 mcg) instead of blue cap vial(25 mcg), when blue cap was indicated) and NO ADVERSE EVENT (No adverse event) outcome was unknown. Not Provided      For mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)) (Unknown), the reporter considered NO ADVERSE EVENT (No adverse event) to be not related. No further causality assessment was provided for WRONG PRODUCT ADMINISTERED (Patient of 6 months-5 years of age received a Moderna COVID-19, bivalent vaccine from the Pink cap vial(10 mcg) instead of blue cap vial(25 mcg), when blue cap was indicated).    The route of administration of suspect Moderna bivalent was reported as BI. Concomitant medications were not reported.  No treatment information was provided by the reporter.   This case was linked to US-MODERNATX, INC.-MOD-2023-730780 (Linked Report).; Sender's Comments:  US-MODERNATX, INC.-MOD-2023-730780:Master case,
Age: 0.5
Sex: F
Vaccine: COVID19-2
Symptoms: No adverse event, Wrong product administered
Clinical narrative: No adverse event; Patient of 6 months-5 years of age received a Moderna COVID-19, bivalent vaccine from the Pink cap vial(10 mcg) instead of blue cap vial(25 mcg), when blue cap was indicated.; This spontaneous case was reported by a nurse and describes the occurrence of WRONG PRODUCT ADMINISTERED (Patient of 6 months-5 years of age received a Moderna COVID-19, bivalent vaccine from the Pink cap vial(10 mcg) instead of blue cap vial(25 mcg), when blue cap was indicated.) and NO ADVERSE EVENT (No adverse event) in a 6-month-old female patient who received mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)) (batch nos. 216K22A and AS7643E) for COVID-19 prophylaxis.     No Medical History information was reported.   On 30-May-2023, the patient received first dose of mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)) (unknown route) 10 microgram. On 28-Jun-2023, received second dose of mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)) (unknown route) dosage was changed to 25 microgram. On 30-May-2023, the patient experienced WRONG PRODUCT ADMINISTERED (Patient of 6 months-5 years of age received a Moderna COVID-19, bivalent vaccine from the Pink cap vial(10 mcg) instead of blue cap vial(25 mcg), when blue cap was indicated.). On an unknown date, the patient experienced NO ADVERSE EVENT (No adverse event). At the time of the report, WRONG PRODUCT ADMINISTERED (Patient of 6 months-5 years of age received a Moderna COVID-19, bivalent vaccine from the Pink cap vial(10 mcg) instead of blue cap vial(25 mcg), when blue cap was indicated.) and NO ADVERSE EVENT (No adverse event) outcome was unknown.        For mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)) (Unknown), the reporter considered NO ADVERSE EVENT (No adverse event) to be not related. No further causality assessment was provided for WRONG PRODUCT ADMINISTERED (Patient of 6 months-5 years of age received a Moderna COVID-19, bivalent vaccine from the Pink cap vial(10 mcg) instead of blue cap vial(25 mcg), when blue cap was indicated.).    Concomitant product use was not provided by the reporter.  The route of administration of suspect Moderna bivalent was reported as BI.  Treatment information was not provided.   This case was linked to US-MODERNATX, INC.-MOD-2023-730780 (E2B Linked Report).; Sender's Comments:  US-MODERNATX, INC.-MOD-2023-730780:Master case
Age: 3.0
Sex: F
Vaccine: COVID19-2
Symptoms: No adverse event, Wrong product administered
Clinical narrative: No adverse event; Patient of 6 months-5 years of age received a Moderna COVID-19, bivalent vaccine from the Pink cap vial(10 mcg) instead of blue cap vial(25 mcg), when blue cap was indicated; This spontaneous case was reported by a nurse and describes the occurrence of WRONG PRODUCT ADMINISTERED (Patient of 6 months-5 years of age received a Moderna COVID-19, bivalent vaccine from the Pink cap vial(10 mcg) instead of blue cap vial(25 mcg), when blue cap was indicated) and NO ADVERSE EVENT (No adverse event) in a 3-year-old female patient who received mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)) (batch no. 216K22A) for COVID-19 prophylaxis.     No Medical History information was reported.    On 17-May-2023, the patient received second dose of mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)) (unknown route) 10 microgram. On 17-May-2023,  after starting mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)), the patient experienced WRONG PRODUCT ADMINISTERED (Patient of 6 months-5 years of age received a Moderna COVID-19, bivalent vaccine from the Pink cap vial(10 mcg) instead of blue cap vial(25 mcg), when blue cap was indicated). On an unknown date, the patient experienced NO ADVERSE EVENT (No adverse event). At the time of the report, WRONG PRODUCT ADMINISTERED (Patient of 6 months-5 years of age received a Moderna COVID-19, bivalent vaccine from the Pink cap vial(10 mcg) instead of blue cap vial(25 mcg), when blue cap was indicated) and NO ADVERSE EVENT (No adverse event) outcome was unknown.        For mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)) (Unknown), the reporter considered NO ADVERSE EVENT (No adverse event) to be not related. No further causality assessment was provided for WRONG PRODUCT ADMINISTERED (Patient of 6 months-5 years of age received a Moderna COVID-19, bivalent vaccine from the Pink cap vial(10 mcg) instead of blue cap vial(25 mcg), when blue cap was indicated).    On 05-Nov-2022, the patient received first dose of monovalent vaccine (Batch/Lot number: AR9236B and Dose/volume: 25 micrograms).  Concomitant product use was not provided by the reporter.  The route of administration of suspect Moderna monovalent was reported as Mono and bivalent was reported as BI. No adverse effects were noted.  Treatment information was not provided.   This case was linked to US-MODERNATX, INC.-MOD-2023-730780 (Linked Report).; Sender's Comments:  US-MODERNATX, INC.-MOD-2023-730780:Master case
Age: 2.0
Sex: M
Vaccine: COVID19-2
Symptoms: No adverse event, Wrong product administered
Clinical narrative: No adverse event; Patient of 6 months-5 years of age received a Moderna COVID-19, bivalent vaccine from the Pink cap vial(10 mcg) instead of blue cap vial(25 mcg), when blue cap was indicated; This spontaneous case was reported by a nurse and describes the occurrence of WRONG PRODUCT ADMINISTERED (Patient of 6 months-5 years of age received a Moderna COVID-19, bivalent vaccine from the Pink cap vial(10 mcg) instead of blue cap vial(25 mcg), when blue cap was indicated) and NO ADVERSE EVENT (No adverse event) in a 24-month-old male patient who received mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)) (batch no. 214K22A) for COVID-19 prophylaxis.     No Medical History information was reported.    On 03-May-2023, the patient received second dose of mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)) (unknown route) 10 microgram. On 03-May-2023,  after starting mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)), the patient experienced WRONG PRODUCT ADMINISTERED (Patient of 6 months-5 years of age received a Moderna COVID-19, bivalent vaccine from the Pink cap vial(10 mcg) instead of blue cap vial(25 mcg), when blue cap was indicated). On an unknown date, the patient experienced NO ADVERSE EVENT (No adverse event). At the time of the report, WRONG PRODUCT ADMINISTERED (Patient of 6 months-5 years of age received a Moderna COVID-19, bivalent vaccine from the Pink cap vial(10 mcg) instead of blue cap vial(25 mcg), when blue cap was indicated) and NO ADVERSE EVENT (No adverse event) outcome was unknown. Not Provided      For mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)) (Unknown), the reporter considered NO ADVERSE EVENT (No adverse event) to be not related. No further causality assessment was provided for WRONG PRODUCT ADMINISTERED (Patient of 6 months-5 years of age received a Moderna COVID-19, bivalent vaccine from the Pink cap vial(10 mcg) instead of blue cap vial(25 mcg), when blue cap was indicated).    On 14-Sep-2022, the patient received first dose of Moderna monovalent vaccine (Batch/Lot number: AS1414B and Dose/volume: 25 micrograms).  Concomitant product use was not provided by the reporter.  The route of administration of suspect Moderna monovalent was reported as Mono and bivalent was reported as BI.  Treatment information was not provided.   This case was linked to US-MODERNATX, INC.-MOD-2023-730780 (E2B Linked Report).; Sender's Comments:  US-MODERNATX, INC.-MOD-2023-730780:Master case
Age: 5.0
Sex: M
Vaccine: COVID19-2
Symptoms: No adverse event, Wrong product administered
Clinical narrative: No Adverse event; Patient of 6 months-5 years of age received a Moderna COVID-19, bivalent vaccine from the Pink cap vial(10 mcg) instead of blue cap vial(25 mcg), when blue cap was indicated; This spontaneous case was reported by a nurse and describes the occurrence of WRONG PRODUCT ADMINISTERED (Patient of 6 months-5 years of age received a Moderna COVID-19, bivalent vaccine from the Pink cap vial(10 mcg) instead of blue cap vial(25 mcg), when blue cap was indicated) and NO ADVERSE EVENT (No Adverse event) in a 5-year-old male patient who received mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)) (batch no. 216K22A) for COVID-19 prophylaxis.     No Medical History information was reported.    On 25-May-2023, the patient received second dose of mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)) (unknown route) 10 microgram. On 25-May-2023, after starting mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)), the patient experienced WRONG PRODUCT ADMINISTERED (Patient of 6 months-5 years of age received a Moderna COVID-19, bivalent vaccine from the Pink cap vial(10 mcg) instead of blue cap vial(25 mcg), when blue cap was indicated). On an unknown date, the patient experienced NO ADVERSE EVENT (No Adverse event). At the time of the report, WRONG PRODUCT ADMINISTERED (Patient of 6 months-5 years of age received a Moderna COVID-19, bivalent vaccine from the Pink cap vial(10 mcg) instead of blue cap vial(25 mcg), when blue cap was indicated) and NO ADVERSE EVENT (No Adverse event) outcome was unknown.        For mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)) (Unknown), the reporter considered NO ADVERSE EVENT (No Adverse event) to be not related. No further causality assessment was provided for WRONG PRODUCT ADMINISTERED (Patient of 6 months-5 years of age received a Moderna COVID-19, bivalent vaccine from the Pink cap vial(10 mcg) instead of blue cap vial(25 mcg), when blue cap was indicated).    On 03-Dec-2022, the patient received first dose of monovalent vaccine (Batch/Lot number: AR9236B and Dose/volume: 25 micrograms).  Concomitant product use was not provided by the reporter.  The route of administration of suspect Moderna monovalent was reported as Mono and bivalent was reported. No adverse effects noted.  Treatment information was not provided.   This case was linked to US-MODERNATX, INC.-MOD-2023-730780 (E2B Linked Report).; Sender's Comments:  US-MODERNATX, INC.-MOD-2023-730780:Master case
Age: 0.58
Sex: F
Vaccine: COVID19-2
Symptoms: No adverse event, Wrong product administered
Clinical narrative: No adverse event; Patient of 6 months-5 years of age received a Moderna COVID-19, bivalent vaccine from the pink cap vial (10 mcg) instead of blue cap vial (25 mcg), when blue cap was indicated- wrong vaccine; This spontaneous case was reported by a nurse and describes the occurrence of WRONG PRODUCT ADMINISTERED (Patient of 6 months-5 years of age received a Moderna COVID-19, bivalent vaccine from the pink cap vial (10 mcg) instead of blue cap vial (25 mcg), when blue cap was indicated- wrong vaccine) and NO ADVERSE EVENT (No adverse event) in a 7-month-old female patient who received mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)) (batch no. 214K22A) for COVID-19 prophylaxis.     No Medical History information was reported.    On 06-May-2023, the patient received second dose of mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)) (unknown route) 10 microgram. On 06-May-2023,  after starting mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)), the patient experienced WRONG PRODUCT ADMINISTERED (Patient of 6 months-5 years of age received a Moderna COVID-19, bivalent vaccine from the pink cap vial (10 mcg) instead of blue cap vial (25 mcg), when blue cap was indicated- wrong vaccine). On an unknown date, the patient experienced NO ADVERSE EVENT (No adverse event). At the time of the report, WRONG PRODUCT ADMINISTERED (Patient of 6 months-5 years of age received a Moderna COVID-19, bivalent vaccine from the pink cap vial (10 mcg) instead of blue cap vial (25 mcg), when blue cap was indicated- wrong vaccine) and NO ADVERSE EVENT (No adverse event) outcome was unknown.        For mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)) (Unknown), the reporter considered NO ADVERSE EVENT (No adverse event) to be not related. No further causality assessment was provided for WRONG PRODUCT ADMINISTERED (Patient of 6 months-5 years of age received a Moderna COVID-19, bivalent vaccine from the pink cap vial (10 mcg) instead of blue cap vial (25 mcg), when blue cap was indicated- wrong vaccine).    Concomitant product use was not provided by the reporter.  On 25-Mar-2023, patient received 25 microgram dose 1 of Moderna monovalent vaccine (batch number: AS1903B).  The route of administration of suspect Moderna bivalent was reported as BI.  No adverse event was reported. Appropriate vaccine scheduled or given as indicated by the CDC.  Treatment information was not provided.   This case was linked to US-MODERNATX, INC.-MOD-2023-730780 (E2B Linked Report).; Sender's Comments:  US-MODERNATX, INC.-MOD-2023-730780:Master case
Age: 4.0
Sex: U
Vaccine: MMRV
Symptoms: No adverse event, Product storage error
Clinical narrative: No Adverse Event; Caller reported AE for improperly stored administered PROQUAD. No symptoms reported. Obtained consent to contact HCP. TE Filed (Case #02441023). AEs Filed (Cases #02441027, 02441050, 02441051, 02441052, 02441053). No additional AE/PQC.  Product Name:; This spontaneous report was received from a nurse refers to a 4-year-old patient of unknown gender.     The patient's medical history, concurrent conditions and concomitant therapies were not reported.  On 03-JUL-2023, the patient was vaccinated with improperly stored dose of measles, mumps, rubella and varicella (oka-merck) virus vaccine live, rHA (recombinant Human albumin), (PROQUAD) lot #W024551, expiration date: 31-JAN-2024, 0.5 milliliter (route of administration and anatomical location were not reported) for prophylaxis.         Administered dose of vaccine was exposed to the temperature excursion reported as 0.6 C/ -10 degrees Celsius up to 8 degrees Celsius for 6 hours and 15 minutes (product storage error). No previous temperature excursion had occurred. There were no additional adverse events reported (no adverse event).; Sender's Comments:  US-009507513-2308USA001106:
Sex: U
Vaccine: VARZOS, VARZOS
Symptoms: Herpes zoster, Vaccination failure
Clinical narrative: shingles after Shingrix / Suspected vaccination Failure; Shingles; This serious case was reported by a physician via sales rep and described the occurrence of vaccination failure in a patient who received Herpes zoster (Shingrix) for prophylaxis.   Co-suspect products included Herpes zoster (Shingrix) for prophylaxis.   Concurrent medical conditions included cystitis interstitial.   In FEB-2023, the patient received the 2nd dose of Shingrix. On an unknown date, the patient received the 1st dose of Shingrix. On an unknown date, less than 6 months after receiving Shingrix and an unknown time after receiving Shingrix, the patient experienced vaccination failure (Verbatim: shingles after Shingrix / Suspected vaccination Failure) (serious criteria medically significant) and shingles (Verbatim: Shingles). The outcome of the vaccination failure was unknown and the outcome of the shingles was not resolved.   It was unknown if the reporter considered the vaccination failure and shingles to be related to Shingrix and Shingrix.     It was unknown if the company considered the vaccination failure and shingles to be related to Shingrix and Shingrix.   Additional Information: Receipt date: 14-AUG-2023 A physician reported that he/she was inquiring regarding a patient who was vaccinated 6 months ago with Shingrix, did receive 2 dose series. The patient came in today (on reporting day) with Shingles active.  The reporter wanted to know when or if he should revaccinate with Shingrix. The vaccine administration facility was the same as primary reporter. This case was considered as suspected vaccination failure since the detail regarding laboratory confirmation of shingles was unknown at the time of reporting.
Age: 78.0
Sex: M
Vaccine: COVID19-2
Symptoms: Acute kidney injury, Acute myocardial infarction, Acute respiratory failure, Anaemia, Angiogram pulmonary abnormal
Clinical narrative: "Brief Summary of Hospital Stay: Per HPI, a 79 YO male with a PMHx of HFpEF, CAD, HTN, CKD, HLD, PVD, tobacco abuse and T2DM who presents with ongoing dyspnea at rest and with exertion.  He states the shortness of breath has been ongoing for about 3 weeks but has been progressing to where he was seen here on 8/11 for evaluation of chest pressure and shortness of breath which he was diagnosed with a CAP and started on doxycycline.  He started the doxycycline yesterday morning and has taken 3 doses.  He reports when he woke up this morning felt "just really bad." He also endorses a dry "shallow cough," weakness in his legs and body aches.  He reports history of tobacco use, unable to quantify amount and reports smoked cigarettes for about 60 years recently stopping a year and a half ago; no alcohol use, no illicit drugs. In the ED, he is afebrile and hemodynamically stable; no leukocytosis on CBC, baseline anemia noted; elevated ddimer at 1950, CMP with elevated Cr of 2.4 (baseline 1.7) and elevated transaminases.  Initial trop 407 and repeat 336.  He was briefly hypotensive into the 80s which resolved after receiving 1L IVF; he was started on heparin drip and was given 1 duoneb.  CT pulmonary Cta with left upper lobe mass, no PE, and bilateral infiltrates in lower lobes.   Hospital Course:  1. Acute respiratory insuffiencey: suspect due to COVID +/- component of bacterial PNA, possibly post obstructive PNA given newly found lung mass-like object - Switch ceftriaxone to Augmentin, continue doxycycline to complete total of 5 day course of abx therapy    2. AKI on CKD: suspect hypotension/dehydration, improved with IVF, near baseline now - Encourage oral intake  - Restarted home ARB   3. NSTEMI: suspect demand ischemia, troponin downtrending. Hx of CAD s/p stents  - Continue DAPT, BB, statin, Imdur    4. Elevated LFTs: likely related to hypotension, asymptomatic. Improving - Will defer further workup for now, though continue to monitor outpt to ensure resolution    5. HTN: pt initially hypotensive in the ED, responded to fluids  - Restarted on home antihypertensives    6. PVD - DAPT, statin   7. Hx CHB s/p PPM   8. QTC prolongation - Avoid QT prolonging meds    9. HLD - Statin   10. Lung mass: newly found, malignancy vs infectious. Will need a follow up imaging study once stable.    11. Diastolic CHF - Stable    12. Generalized weakness: suspect related to above - PT/OT   13. Hyperkalemia: mild, improved      Issues Requiring Follow Up:  - Monitor renal/hepatic function  - High risk mass referral placed for newly found mass like object in lung "
Age: 78.0
Sex: M
Vaccine: COVID19-2
Symptoms: Anticoagulant therapy, Asthenia, Blood creatinine increased, COVID-19, Cardiac failure congestive
Clinical narrative: "Brief Summary of Hospital Stay: Per HPI, a 79 YO male with a PMHx of HFpEF, CAD, HTN, CKD, HLD, PVD, tobacco abuse and T2DM who presents with ongoing dyspnea at rest and with exertion.  He states the shortness of breath has been ongoing for about 3 weeks but has been progressing to where he was seen here on 8/11 for evaluation of chest pressure and shortness of breath which he was diagnosed with a CAP and started on doxycycline.  He started the doxycycline yesterday morning and has taken 3 doses.  He reports when he woke up this morning felt "just really bad." He also endorses a dry "shallow cough," weakness in his legs and body aches.  He reports history of tobacco use, unable to quantify amount and reports smoked cigarettes for about 60 years recently stopping a year and a half ago; no alcohol use, no illicit drugs. In the ED, he is afebrile and hemodynamically stable; no leukocytosis on CBC, baseline anemia noted; elevated ddimer at 1950, CMP with elevated Cr of 2.4 (baseline 1.7) and elevated transaminases.  Initial trop 407 and repeat 336.  He was briefly hypotensive into the 80s which resolved after receiving 1L IVF; he was started on heparin drip and was given 1 duoneb.  CT pulmonary Cta with left upper lobe mass, no PE, and bilateral infiltrates in lower lobes.   Hospital Course:  1. Acute respiratory insuffiencey: suspect due to COVID +/- component of bacterial PNA, possibly post obstructive PNA given newly found lung mass-like object - Switch ceftriaxone to Augmentin, continue doxycycline to complete total of 5 day course of abx therapy    2. AKI on CKD: suspect hypotension/dehydration, improved with IVF, near baseline now - Encourage oral intake  - Restarted home ARB   3. NSTEMI: suspect demand ischemia, troponin downtrending. Hx of CAD s/p stents  - Continue DAPT, BB, statin, Imdur    4. Elevated LFTs: likely related to hypotension, asymptomatic. Improving - Will defer further workup for now, though continue to monitor outpt to ensure resolution    5. HTN: pt initially hypotensive in the ED, responded to fluids  - Restarted on home antihypertensives    6. PVD - DAPT, statin   7. Hx CHB s/p PPM   8. QTC prolongation - Avoid QT prolonging meds    9. HLD - Statin   10. Lung mass: newly found, malignancy vs infectious. Will need a follow up imaging study once stable.    11. Diastolic CHF - Stable    12. Generalized weakness: suspect related to above - PT/OT   13. Hyperkalemia: mild, improved      Issues Requiring Follow Up:  - Monitor renal/hepatic function  - High risk mass referral placed for newly found mass like object in lung "
Age: 78.0
Sex: M
Vaccine: COVID19-2
Symptoms: Chest discomfort, Chronic kidney disease, Condition aggravated, Cough, Dehydration
Clinical narrative: "Brief Summary of Hospital Stay: Per HPI, a 79 YO male with a PMHx of HFpEF, CAD, HTN, CKD, HLD, PVD, tobacco abuse and T2DM who presents with ongoing dyspnea at rest and with exertion.  He states the shortness of breath has been ongoing for about 3 weeks but has been progressing to where he was seen here on 8/11 for evaluation of chest pressure and shortness of breath which he was diagnosed with a CAP and started on doxycycline.  He started the doxycycline yesterday morning and has taken 3 doses.  He reports when he woke up this morning felt "just really bad." He also endorses a dry "shallow cough," weakness in his legs and body aches.  He reports history of tobacco use, unable to quantify amount and reports smoked cigarettes for about 60 years recently stopping a year and a half ago; no alcohol use, no illicit drugs. In the ED, he is afebrile and hemodynamically stable; no leukocytosis on CBC, baseline anemia noted; elevated ddimer at 1950, CMP with elevated Cr of 2.4 (baseline 1.7) and elevated transaminases.  Initial trop 407 and repeat 336.  He was briefly hypotensive into the 80s which resolved after receiving 1L IVF; he was started on heparin drip and was given 1 duoneb.  CT pulmonary Cta with left upper lobe mass, no PE, and bilateral infiltrates in lower lobes.   Hospital Course:  1. Acute respiratory insuffiencey: suspect due to COVID +/- component of bacterial PNA, possibly post obstructive PNA given newly found lung mass-like object - Switch ceftriaxone to Augmentin, continue doxycycline to complete total of 5 day course of abx therapy    2. AKI on CKD: suspect hypotension/dehydration, improved with IVF, near baseline now - Encourage oral intake  - Restarted home ARB   3. NSTEMI: suspect demand ischemia, troponin downtrending. Hx of CAD s/p stents  - Continue DAPT, BB, statin, Imdur    4. Elevated LFTs: likely related to hypotension, asymptomatic. Improving - Will defer further workup for now, though continue to monitor outpt to ensure resolution    5. HTN: pt initially hypotensive in the ED, responded to fluids  - Restarted on home antihypertensives    6. PVD - DAPT, statin   7. Hx CHB s/p PPM   8. QTC prolongation - Avoid QT prolonging meds    9. HLD - Statin   10. Lung mass: newly found, malignancy vs infectious. Will need a follow up imaging study once stable.    11. Diastolic CHF - Stable    12. Generalized weakness: suspect related to above - PT/OT   13. Hyperkalemia: mild, improved      Issues Requiring Follow Up:  - Monitor renal/hepatic function  - High risk mass referral placed for newly found mass like object in lung "
Age: 78.0
Sex: M
Vaccine: COVID19-2
Symptoms: Dyspnoea, Dyspnoea at rest, Dyspnoea exertional, Electrocardiogram QT prolonged, Feeling abnormal
Clinical narrative: "Brief Summary of Hospital Stay: Per HPI, a 79 YO male with a PMHx of HFpEF, CAD, HTN, CKD, HLD, PVD, tobacco abuse and T2DM who presents with ongoing dyspnea at rest and with exertion.  He states the shortness of breath has been ongoing for about 3 weeks but has been progressing to where he was seen here on 8/11 for evaluation of chest pressure and shortness of breath which he was diagnosed with a CAP and started on doxycycline.  He started the doxycycline yesterday morning and has taken 3 doses.  He reports when he woke up this morning felt "just really bad." He also endorses a dry "shallow cough," weakness in his legs and body aches.  He reports history of tobacco use, unable to quantify amount and reports smoked cigarettes for about 60 years recently stopping a year and a half ago; no alcohol use, no illicit drugs. In the ED, he is afebrile and hemodynamically stable; no leukocytosis on CBC, baseline anemia noted; elevated ddimer at 1950, CMP with elevated Cr of 2.4 (baseline 1.7) and elevated transaminases.  Initial trop 407 and repeat 336.  He was briefly hypotensive into the 80s which resolved after receiving 1L IVF; he was started on heparin drip and was given 1 duoneb.  CT pulmonary Cta with left upper lobe mass, no PE, and bilateral infiltrates in lower lobes.   Hospital Course:  1. Acute respiratory insuffiencey: suspect due to COVID +/- component of bacterial PNA, possibly post obstructive PNA given newly found lung mass-like object - Switch ceftriaxone to Augmentin, continue doxycycline to complete total of 5 day course of abx therapy    2. AKI on CKD: suspect hypotension/dehydration, improved with IVF, near baseline now - Encourage oral intake  - Restarted home ARB   3. NSTEMI: suspect demand ischemia, troponin downtrending. Hx of CAD s/p stents  - Continue DAPT, BB, statin, Imdur    4. Elevated LFTs: likely related to hypotension, asymptomatic. Improving - Will defer further workup for now, though continue to monitor outpt to ensure resolution    5. HTN: pt initially hypotensive in the ED, responded to fluids  - Restarted on home antihypertensives    6. PVD - DAPT, statin   7. Hx CHB s/p PPM   8. QTC prolongation - Avoid QT prolonging meds    9. HLD - Statin   10. Lung mass: newly found, malignancy vs infectious. Will need a follow up imaging study once stable.    11. Diastolic CHF - Stable    12. Generalized weakness: suspect related to above - PT/OT   13. Hyperkalemia: mild, improved      Issues Requiring Follow Up:  - Monitor renal/hepatic function  - High risk mass referral placed for newly found mass like object in lung "
Age: 78.0
Sex: M
Vaccine: COVID19-2
Symptoms: Fibrin D dimer increased, Full blood count abnormal, Hyperkalaemia, Hypotension, Left ventricular failure
Clinical narrative: "Brief Summary of Hospital Stay: Per HPI, a 79 YO male with a PMHx of HFpEF, CAD, HTN, CKD, HLD, PVD, tobacco abuse and T2DM who presents with ongoing dyspnea at rest and with exertion.  He states the shortness of breath has been ongoing for about 3 weeks but has been progressing to where he was seen here on 8/11 for evaluation of chest pressure and shortness of breath which he was diagnosed with a CAP and started on doxycycline.  He started the doxycycline yesterday morning and has taken 3 doses.  He reports when he woke up this morning felt "just really bad." He also endorses a dry "shallow cough," weakness in his legs and body aches.  He reports history of tobacco use, unable to quantify amount and reports smoked cigarettes for about 60 years recently stopping a year and a half ago; no alcohol use, no illicit drugs. In the ED, he is afebrile and hemodynamically stable; no leukocytosis on CBC, baseline anemia noted; elevated ddimer at 1950, CMP with elevated Cr of 2.4 (baseline 1.7) and elevated transaminases.  Initial trop 407 and repeat 336.  He was briefly hypotensive into the 80s which resolved after receiving 1L IVF; he was started on heparin drip and was given 1 duoneb.  CT pulmonary Cta with left upper lobe mass, no PE, and bilateral infiltrates in lower lobes.   Hospital Course:  1. Acute respiratory insuffiencey: suspect due to COVID +/- component of bacterial PNA, possibly post obstructive PNA given newly found lung mass-like object - Switch ceftriaxone to Augmentin, continue doxycycline to complete total of 5 day course of abx therapy    2. AKI on CKD: suspect hypotension/dehydration, improved with IVF, near baseline now - Encourage oral intake  - Restarted home ARB   3. NSTEMI: suspect demand ischemia, troponin downtrending. Hx of CAD s/p stents  - Continue DAPT, BB, statin, Imdur    4. Elevated LFTs: likely related to hypotension, asymptomatic. Improving - Will defer further workup for now, though continue to monitor outpt to ensure resolution    5. HTN: pt initially hypotensive in the ED, responded to fluids  - Restarted on home antihypertensives    6. PVD - DAPT, statin   7. Hx CHB s/p PPM   8. QTC prolongation - Avoid QT prolonging meds    9. HLD - Statin   10. Lung mass: newly found, malignancy vs infectious. Will need a follow up imaging study once stable.    11. Diastolic CHF - Stable    12. Generalized weakness: suspect related to above - PT/OT   13. Hyperkalemia: mild, improved      Issues Requiring Follow Up:  - Monitor renal/hepatic function  - High risk mass referral placed for newly found mass like object in lung "
Age: 78.0
Sex: M
Vaccine: COVID19-2
Symptoms: Liver function test increased, Lung infiltration, Metabolic function test abnormal, Muscular weakness, Myocardial ischaemia
Clinical narrative: "Brief Summary of Hospital Stay: Per HPI, a 79 YO male with a PMHx of HFpEF, CAD, HTN, CKD, HLD, PVD, tobacco abuse and T2DM who presents with ongoing dyspnea at rest and with exertion.  He states the shortness of breath has been ongoing for about 3 weeks but has been progressing to where he was seen here on 8/11 for evaluation of chest pressure and shortness of breath which he was diagnosed with a CAP and started on doxycycline.  He started the doxycycline yesterday morning and has taken 3 doses.  He reports when he woke up this morning felt "just really bad." He also endorses a dry "shallow cough," weakness in his legs and body aches.  He reports history of tobacco use, unable to quantify amount and reports smoked cigarettes for about 60 years recently stopping a year and a half ago; no alcohol use, no illicit drugs. In the ED, he is afebrile and hemodynamically stable; no leukocytosis on CBC, baseline anemia noted; elevated ddimer at 1950, CMP with elevated Cr of 2.4 (baseline 1.7) and elevated transaminases.  Initial trop 407 and repeat 336.  He was briefly hypotensive into the 80s which resolved after receiving 1L IVF; he was started on heparin drip and was given 1 duoneb.  CT pulmonary Cta with left upper lobe mass, no PE, and bilateral infiltrates in lower lobes.   Hospital Course:  1. Acute respiratory insuffiencey: suspect due to COVID +/- component of bacterial PNA, possibly post obstructive PNA given newly found lung mass-like object - Switch ceftriaxone to Augmentin, continue doxycycline to complete total of 5 day course of abx therapy    2. AKI on CKD: suspect hypotension/dehydration, improved with IVF, near baseline now - Encourage oral intake  - Restarted home ARB   3. NSTEMI: suspect demand ischemia, troponin downtrending. Hx of CAD s/p stents  - Continue DAPT, BB, statin, Imdur    4. Elevated LFTs: likely related to hypotension, asymptomatic. Improving - Will defer further workup for now, though continue to monitor outpt to ensure resolution    5. HTN: pt initially hypotensive in the ED, responded to fluids  - Restarted on home antihypertensives    6. PVD - DAPT, statin   7. Hx CHB s/p PPM   8. QTC prolongation - Avoid QT prolonging meds    9. HLD - Statin   10. Lung mass: newly found, malignancy vs infectious. Will need a follow up imaging study once stable.    11. Diastolic CHF - Stable    12. Generalized weakness: suspect related to above - PT/OT   13. Hyperkalemia: mild, improved      Issues Requiring Follow Up:  - Monitor renal/hepatic function  - High risk mass referral placed for newly found mass like object in lung "
Age: 78.0
Sex: M
Vaccine: COVID19-2
Symptoms: Pain, Pneumonia, Pulmonary mass, SARS-CoV-2 test positive, Transaminases increased
Clinical narrative: "Brief Summary of Hospital Stay: Per HPI, a 79 YO male with a PMHx of HFpEF, CAD, HTN, CKD, HLD, PVD, tobacco abuse and T2DM who presents with ongoing dyspnea at rest and with exertion.  He states the shortness of breath has been ongoing for about 3 weeks but has been progressing to where he was seen here on 8/11 for evaluation of chest pressure and shortness of breath which he was diagnosed with a CAP and started on doxycycline.  He started the doxycycline yesterday morning and has taken 3 doses.  He reports when he woke up this morning felt "just really bad." He also endorses a dry "shallow cough," weakness in his legs and body aches.  He reports history of tobacco use, unable to quantify amount and reports smoked cigarettes for about 60 years recently stopping a year and a half ago; no alcohol use, no illicit drugs. In the ED, he is afebrile and hemodynamically stable; no leukocytosis on CBC, baseline anemia noted; elevated ddimer at 1950, CMP with elevated Cr of 2.4 (baseline 1.7) and elevated transaminases.  Initial trop 407 and repeat 336.  He was briefly hypotensive into the 80s which resolved after receiving 1L IVF; he was started on heparin drip and was given 1 duoneb.  CT pulmonary Cta with left upper lobe mass, no PE, and bilateral infiltrates in lower lobes.   Hospital Course:  1. Acute respiratory insuffiencey: suspect due to COVID +/- component of bacterial PNA, possibly post obstructive PNA given newly found lung mass-like object - Switch ceftriaxone to Augmentin, continue doxycycline to complete total of 5 day course of abx therapy    2. AKI on CKD: suspect hypotension/dehydration, improved with IVF, near baseline now - Encourage oral intake  - Restarted home ARB   3. NSTEMI: suspect demand ischemia, troponin downtrending. Hx of CAD s/p stents  - Continue DAPT, BB, statin, Imdur    4. Elevated LFTs: likely related to hypotension, asymptomatic. Improving - Will defer further workup for now, though continue to monitor outpt to ensure resolution    5. HTN: pt initially hypotensive in the ED, responded to fluids  - Restarted on home antihypertensives    6. PVD - DAPT, statin   7. Hx CHB s/p PPM   8. QTC prolongation - Avoid QT prolonging meds    9. HLD - Statin   10. Lung mass: newly found, malignancy vs infectious. Will need a follow up imaging study once stable.    11. Diastolic CHF - Stable    12. Generalized weakness: suspect related to above - PT/OT   13. Hyperkalemia: mild, improved      Issues Requiring Follow Up:  - Monitor renal/hepatic function  - High risk mass referral placed for newly found mass like object in lung "
Age: 78.0
Sex: M
Vaccine: COVID19-2
Symptoms: Troponin
Clinical narrative: "Brief Summary of Hospital Stay: Per HPI, a 79 YO male with a PMHx of HFpEF, CAD, HTN, CKD, HLD, PVD, tobacco abuse and T2DM who presents with ongoing dyspnea at rest and with exertion.  He states the shortness of breath has been ongoing for about 3 weeks but has been progressing to where he was seen here on 8/11 for evaluation of chest pressure and shortness of breath which he was diagnosed with a CAP and started on doxycycline.  He started the doxycycline yesterday morning and has taken 3 doses.  He reports when he woke up this morning felt "just really bad." He also endorses a dry "shallow cough," weakness in his legs and body aches.  He reports history of tobacco use, unable to quantify amount and reports smoked cigarettes for about 60 years recently stopping a year and a half ago; no alcohol use, no illicit drugs. In the ED, he is afebrile and hemodynamically stable; no leukocytosis on CBC, baseline anemia noted; elevated ddimer at 1950, CMP with elevated Cr of 2.4 (baseline 1.7) and elevated transaminases.  Initial trop 407 and repeat 336.  He was briefly hypotensive into the 80s which resolved after receiving 1L IVF; he was started on heparin drip and was given 1 duoneb.  CT pulmonary Cta with left upper lobe mass, no PE, and bilateral infiltrates in lower lobes.   Hospital Course:  1. Acute respiratory insuffiencey: suspect due to COVID +/- component of bacterial PNA, possibly post obstructive PNA given newly found lung mass-like object - Switch ceftriaxone to Augmentin, continue doxycycline to complete total of 5 day course of abx therapy    2. AKI on CKD: suspect hypotension/dehydration, improved with IVF, near baseline now - Encourage oral intake  - Restarted home ARB   3. NSTEMI: suspect demand ischemia, troponin downtrending. Hx of CAD s/p stents  - Continue DAPT, BB, statin, Imdur    4. Elevated LFTs: likely related to hypotension, asymptomatic. Improving - Will defer further workup for now, though continue to monitor outpt to ensure resolution    5. HTN: pt initially hypotensive in the ED, responded to fluids  - Restarted on home antihypertensives    6. PVD - DAPT, statin   7. Hx CHB s/p PPM   8. QTC prolongation - Avoid QT prolonging meds    9. HLD - Statin   10. Lung mass: newly found, malignancy vs infectious. Will need a follow up imaging study once stable.    11. Diastolic CHF - Stable    12. Generalized weakness: suspect related to above - PT/OT   13. Hyperkalemia: mild, improved      Issues Requiring Follow Up:  - Monitor renal/hepatic function  - High risk mass referral placed for newly found mass like object in lung "
Age: 61.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Dyspnoea, Endotracheal intubation, Excessive cerumen production, Multiple system atrophy
Clinical narrative: "Brief Summary of Hospital Stay: (Include Significant Findings and Invasive Procedures) the patient presented with dyspnea after recent travel. Found to have covid, but due to multisystem atrophy concern for aspiration also had. She developed worsened stridor and secretions, was intubated, soon thereafter extubated to HFNC but weaned very quickly. Treated with steroids, antibiotics, returned to baseline. Husband eager to get her home, well versed in her medical care and comfortable taking care of her. Speech therapy worked with her recommending a level 3 nectar thick no straw diet. Thickener provided.   BP (!) 132/95  | Pulse 85  | Temp 36.6 °C (97.8 °F) (Axillary)  | Resp 18  | Ht 1.575 m (5' 2")  | Wt 61.2 kg (134 lb 14.7 oz)  | LMP 06/02/2015  | SpO2 99%  | BMI 24.68 kg/m²    General: in NAD, non toxic Right ear with significant ear wax cannot visualize ear drum. Respiratory: no respiratory distress. Coarse. No stridor or wheeze. CV: regular rhythm, normal rate ABD: soft, non-tender  Neuro: alert. Does not speak but can mouth-words.   Telemetry: normal sinus rhythm   The patient was discharged in stable condition with improvement of symptoms and appropriate follow up planned.     Issues Requiring Follow Up: (Who, what, when, and how communicated?) speech therapy reevaluation of swallow ability"