chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 90.0
Sex: F
Vaccine: COVID19
Symptoms: Bundle branch block left, COVID-19, Cardiomegaly, Chest pain, Chills
Clinical narrative: Patient is a 91 y.o. female patient of MD with history of hypertension, hyperlipidemia, ovarian cancer presented to Doctors Hospital with generalized body aches, chills, cough.   Covid-19 virus infection - Improved  Date of onset of symptoms: 11/06 Symptoms present on admission: Yes Date of covid positive test: 11/08 per patient at her Doctor's office.  Unable to view results. Vaccination status: vaccinated Imaging: CTPA: No evidence of PE.  Linear bibasilar opacities are most consistent with atelectasis.  Superimposed infection is not entirely excluded in the appropriate clinical setting. Cardiomegaly without pulmonary edema.  And age-indeterminate compression deformity of T8 5 vertebral body which is new in comparison to February 2019 CT. Oxygen requirements on admission: 2 L nasal cannula Current oxygen requirements: RA  Medical therapy: remdesivir and steroids Consultants following: None Anticipated special isolation end date: 11/18  antitussives, IS   Out of Special isolation    Back pain Compression fracture T5 Today, patient complains of both upper and lower back pain Received IV Toradol as patient does have multiple medication allergies Lidocaine patch added Added ultram  Continues to have pain  MRI thoracic spine Acute compression fracture at T5 with 75% loss of vertebral body height.  Vertebral body height loss at this level is worse than on the CT of the chest from 11/13/2022. mild retropulsion of the posterior aspect of T5 into the canal with mild effacement of the thecal sac.  No significant spinal stenosis.  No compression of the thoracic spinal cord. Neurosurgery consulted - recommended CTO brace and f/u outpatient in 2 weeks   Hyponatremia  Euvolemic 127-- >129-- >130->130-- >128 S/b Nephrology, suspected SIADH physiology  Recommended 1.5 L fluid restriction  Patient to have repeat BMP in 1 week with PCP  Hypertension Resume amlodipine as per home regimen. Low blood pressure this morning after receiving hydralazine.  Dropped blood pressure in the 70s received fluid boluses much improved Continue to monitor   Hyperlipidemia Resume statin    Hypokalemia K replaced Monitor   Elevated troponin Chest pain  Troponin 17-- >18 Patient denies any chest pain.  She has bilateral rib pain with coughing. EKG: Sinus rhythm with nonspecific ST-T changes. EKG shows Left anterior fasicular block seen on previous EKG  Troponin 22-- >21  Pain likely musculoskeletal    Elevated BNP NT proBNP 696 She appears euvolemic on exam Monitor   Constipation Continue MiraLAX and senna/docusate added home milk of mag Monitor
Age: 90.0
Sex: F
Vaccine: COVID19
Symptoms: Computerised tomogram thorax abnormal, Constipation, Cough, Electrocardiogram ST-T change, Fluid intake restriction
Clinical narrative: Patient is a 91 y.o. female patient of MD with history of hypertension, hyperlipidemia, ovarian cancer presented to Doctors Hospital with generalized body aches, chills, cough.   Covid-19 virus infection - Improved  Date of onset of symptoms: 11/06 Symptoms present on admission: Yes Date of covid positive test: 11/08 per patient at her Doctor's office.  Unable to view results. Vaccination status: vaccinated Imaging: CTPA: No evidence of PE.  Linear bibasilar opacities are most consistent with atelectasis.  Superimposed infection is not entirely excluded in the appropriate clinical setting. Cardiomegaly without pulmonary edema.  And age-indeterminate compression deformity of T8 5 vertebral body which is new in comparison to February 2019 CT. Oxygen requirements on admission: 2 L nasal cannula Current oxygen requirements: RA  Medical therapy: remdesivir and steroids Consultants following: None Anticipated special isolation end date: 11/18  antitussives, IS   Out of Special isolation    Back pain Compression fracture T5 Today, patient complains of both upper and lower back pain Received IV Toradol as patient does have multiple medication allergies Lidocaine patch added Added ultram  Continues to have pain  MRI thoracic spine Acute compression fracture at T5 with 75% loss of vertebral body height.  Vertebral body height loss at this level is worse than on the CT of the chest from 11/13/2022. mild retropulsion of the posterior aspect of T5 into the canal with mild effacement of the thecal sac.  No significant spinal stenosis.  No compression of the thoracic spinal cord. Neurosurgery consulted - recommended CTO brace and f/u outpatient in 2 weeks   Hyponatremia  Euvolemic 127-- >129-- >130->130-- >128 S/b Nephrology, suspected SIADH physiology  Recommended 1.5 L fluid restriction  Patient to have repeat BMP in 1 week with PCP  Hypertension Resume amlodipine as per home regimen. Low blood pressure this morning after receiving hydralazine.  Dropped blood pressure in the 70s received fluid boluses much improved Continue to monitor   Hyperlipidemia Resume statin    Hypokalemia K replaced Monitor   Elevated troponin Chest pain  Troponin 17-- >18 Patient denies any chest pain.  She has bilateral rib pain with coughing. EKG: Sinus rhythm with nonspecific ST-T changes. EKG shows Left anterior fasicular block seen on previous EKG  Troponin 22-- >21  Pain likely musculoskeletal    Elevated BNP NT proBNP 696 She appears euvolemic on exam Monitor   Constipation Continue MiraLAX and senna/docusate added home milk of mag Monitor
Age: 90.0
Sex: F
Vaccine: COVID19
Symptoms: Fracture displacement, Hypokalaemia, Hyponatraemia, Hypotension, Inappropriate antidiuretic hormone secretion
Clinical narrative: Patient is a 91 y.o. female patient of MD with history of hypertension, hyperlipidemia, ovarian cancer presented to Doctors Hospital with generalized body aches, chills, cough.   Covid-19 virus infection - Improved  Date of onset of symptoms: 11/06 Symptoms present on admission: Yes Date of covid positive test: 11/08 per patient at her Doctor's office.  Unable to view results. Vaccination status: vaccinated Imaging: CTPA: No evidence of PE.  Linear bibasilar opacities are most consistent with atelectasis.  Superimposed infection is not entirely excluded in the appropriate clinical setting. Cardiomegaly without pulmonary edema.  And age-indeterminate compression deformity of T8 5 vertebral body which is new in comparison to February 2019 CT. Oxygen requirements on admission: 2 L nasal cannula Current oxygen requirements: RA  Medical therapy: remdesivir and steroids Consultants following: None Anticipated special isolation end date: 11/18  antitussives, IS   Out of Special isolation    Back pain Compression fracture T5 Today, patient complains of both upper and lower back pain Received IV Toradol as patient does have multiple medication allergies Lidocaine patch added Added ultram  Continues to have pain  MRI thoracic spine Acute compression fracture at T5 with 75% loss of vertebral body height.  Vertebral body height loss at this level is worse than on the CT of the chest from 11/13/2022. mild retropulsion of the posterior aspect of T5 into the canal with mild effacement of the thecal sac.  No significant spinal stenosis.  No compression of the thoracic spinal cord. Neurosurgery consulted - recommended CTO brace and f/u outpatient in 2 weeks   Hyponatremia  Euvolemic 127-- >129-- >130->130-- >128 S/b Nephrology, suspected SIADH physiology  Recommended 1.5 L fluid restriction  Patient to have repeat BMP in 1 week with PCP  Hypertension Resume amlodipine as per home regimen. Low blood pressure this morning after receiving hydralazine.  Dropped blood pressure in the 70s received fluid boluses much improved Continue to monitor   Hyperlipidemia Resume statin    Hypokalemia K replaced Monitor   Elevated troponin Chest pain  Troponin 17-- >18 Patient denies any chest pain.  She has bilateral rib pain with coughing. EKG: Sinus rhythm with nonspecific ST-T changes. EKG shows Left anterior fasicular block seen on previous EKG  Troponin 22-- >21  Pain likely musculoskeletal    Elevated BNP NT proBNP 696 She appears euvolemic on exam Monitor   Constipation Continue MiraLAX and senna/docusate added home milk of mag Monitor
Age: 90.0
Sex: F
Vaccine: COVID19
Symptoms: Lung opacity, Magnetic resonance imaging spinal abnormal, Malaise, Musculoskeletal chest pain, Musculoskeletal pain
Clinical narrative: Patient is a 91 y.o. female patient of MD with history of hypertension, hyperlipidemia, ovarian cancer presented to Doctors Hospital with generalized body aches, chills, cough.   Covid-19 virus infection - Improved  Date of onset of symptoms: 11/06 Symptoms present on admission: Yes Date of covid positive test: 11/08 per patient at her Doctor's office.  Unable to view results. Vaccination status: vaccinated Imaging: CTPA: No evidence of PE.  Linear bibasilar opacities are most consistent with atelectasis.  Superimposed infection is not entirely excluded in the appropriate clinical setting. Cardiomegaly without pulmonary edema.  And age-indeterminate compression deformity of T8 5 vertebral body which is new in comparison to February 2019 CT. Oxygen requirements on admission: 2 L nasal cannula Current oxygen requirements: RA  Medical therapy: remdesivir and steroids Consultants following: None Anticipated special isolation end date: 11/18  antitussives, IS   Out of Special isolation    Back pain Compression fracture T5 Today, patient complains of both upper and lower back pain Received IV Toradol as patient does have multiple medication allergies Lidocaine patch added Added ultram  Continues to have pain  MRI thoracic spine Acute compression fracture at T5 with 75% loss of vertebral body height.  Vertebral body height loss at this level is worse than on the CT of the chest from 11/13/2022. mild retropulsion of the posterior aspect of T5 into the canal with mild effacement of the thecal sac.  No significant spinal stenosis.  No compression of the thoracic spinal cord. Neurosurgery consulted - recommended CTO brace and f/u outpatient in 2 weeks   Hyponatremia  Euvolemic 127-- >129-- >130->130-- >128 S/b Nephrology, suspected SIADH physiology  Recommended 1.5 L fluid restriction  Patient to have repeat BMP in 1 week with PCP  Hypertension Resume amlodipine as per home regimen. Low blood pressure this morning after receiving hydralazine.  Dropped blood pressure in the 70s received fluid boluses much improved Continue to monitor   Hyperlipidemia Resume statin    Hypokalemia K replaced Monitor   Elevated troponin Chest pain  Troponin 17-- >18 Patient denies any chest pain.  She has bilateral rib pain with coughing. EKG: Sinus rhythm with nonspecific ST-T changes. EKG shows Left anterior fasicular block seen on previous EKG  Troponin 22-- >21  Pain likely musculoskeletal    Elevated BNP NT proBNP 696 She appears euvolemic on exam Monitor   Constipation Continue MiraLAX and senna/docusate added home milk of mag Monitor
Age: 90.0
Sex: F
Vaccine: COVID19
Symptoms: N-terminal prohormone brain natriuretic peptide increased, Pain, SARS-CoV-2 test positive, Sinus rhythm, Spinal compression fracture
Clinical narrative: Patient is a 91 y.o. female patient of MD with history of hypertension, hyperlipidemia, ovarian cancer presented to Doctors Hospital with generalized body aches, chills, cough.   Covid-19 virus infection - Improved  Date of onset of symptoms: 11/06 Symptoms present on admission: Yes Date of covid positive test: 11/08 per patient at her Doctor's office.  Unable to view results. Vaccination status: vaccinated Imaging: CTPA: No evidence of PE.  Linear bibasilar opacities are most consistent with atelectasis.  Superimposed infection is not entirely excluded in the appropriate clinical setting. Cardiomegaly without pulmonary edema.  And age-indeterminate compression deformity of T8 5 vertebral body which is new in comparison to February 2019 CT. Oxygen requirements on admission: 2 L nasal cannula Current oxygen requirements: RA  Medical therapy: remdesivir and steroids Consultants following: None Anticipated special isolation end date: 11/18  antitussives, IS   Out of Special isolation    Back pain Compression fracture T5 Today, patient complains of both upper and lower back pain Received IV Toradol as patient does have multiple medication allergies Lidocaine patch added Added ultram  Continues to have pain  MRI thoracic spine Acute compression fracture at T5 with 75% loss of vertebral body height.  Vertebral body height loss at this level is worse than on the CT of the chest from 11/13/2022. mild retropulsion of the posterior aspect of T5 into the canal with mild effacement of the thecal sac.  No significant spinal stenosis.  No compression of the thoracic spinal cord. Neurosurgery consulted - recommended CTO brace and f/u outpatient in 2 weeks   Hyponatremia  Euvolemic 127-- >129-- >130->130-- >128 S/b Nephrology, suspected SIADH physiology  Recommended 1.5 L fluid restriction  Patient to have repeat BMP in 1 week with PCP  Hypertension Resume amlodipine as per home regimen. Low blood pressure this morning after receiving hydralazine.  Dropped blood pressure in the 70s received fluid boluses much improved Continue to monitor   Hyperlipidemia Resume statin    Hypokalemia K replaced Monitor   Elevated troponin Chest pain  Troponin 17-- >18 Patient denies any chest pain.  She has bilateral rib pain with coughing. EKG: Sinus rhythm with nonspecific ST-T changes. EKG shows Left anterior fasicular block seen on previous EKG  Troponin 22-- >21  Pain likely musculoskeletal    Elevated BNP NT proBNP 696 She appears euvolemic on exam Monitor   Constipation Continue MiraLAX and senna/docusate added home milk of mag Monitor
Age: 90.0
Sex: F
Vaccine: COVID19
Symptoms: Spinal cord compression, Spinal deformity, Superinfection, Thecal sac compression, Thoracic vertebral fracture
Clinical narrative: Patient is a 91 y.o. female patient of MD with history of hypertension, hyperlipidemia, ovarian cancer presented to Doctors Hospital with generalized body aches, chills, cough.   Covid-19 virus infection - Improved  Date of onset of symptoms: 11/06 Symptoms present on admission: Yes Date of covid positive test: 11/08 per patient at her Doctor's office.  Unable to view results. Vaccination status: vaccinated Imaging: CTPA: No evidence of PE.  Linear bibasilar opacities are most consistent with atelectasis.  Superimposed infection is not entirely excluded in the appropriate clinical setting. Cardiomegaly without pulmonary edema.  And age-indeterminate compression deformity of T8 5 vertebral body which is new in comparison to February 2019 CT. Oxygen requirements on admission: 2 L nasal cannula Current oxygen requirements: RA  Medical therapy: remdesivir and steroids Consultants following: None Anticipated special isolation end date: 11/18  antitussives, IS   Out of Special isolation    Back pain Compression fracture T5 Today, patient complains of both upper and lower back pain Received IV Toradol as patient does have multiple medication allergies Lidocaine patch added Added ultram  Continues to have pain  MRI thoracic spine Acute compression fracture at T5 with 75% loss of vertebral body height.  Vertebral body height loss at this level is worse than on the CT of the chest from 11/13/2022. mild retropulsion of the posterior aspect of T5 into the canal with mild effacement of the thecal sac.  No significant spinal stenosis.  No compression of the thoracic spinal cord. Neurosurgery consulted - recommended CTO brace and f/u outpatient in 2 weeks   Hyponatremia  Euvolemic 127-- >129-- >130->130-- >128 S/b Nephrology, suspected SIADH physiology  Recommended 1.5 L fluid restriction  Patient to have repeat BMP in 1 week with PCP  Hypertension Resume amlodipine as per home regimen. Low blood pressure this morning after receiving hydralazine.  Dropped blood pressure in the 70s received fluid boluses much improved Continue to monitor   Hyperlipidemia Resume statin    Hypokalemia K replaced Monitor   Elevated troponin Chest pain  Troponin 17-- >18 Patient denies any chest pain.  She has bilateral rib pain with coughing. EKG: Sinus rhythm with nonspecific ST-T changes. EKG shows Left anterior fasicular block seen on previous EKG  Troponin 22-- >21  Pain likely musculoskeletal    Elevated BNP NT proBNP 696 She appears euvolemic on exam Monitor   Constipation Continue MiraLAX and senna/docusate added home milk of mag Monitor
Age: 90.0
Sex: F
Vaccine: COVID19
Symptoms: Troponin increased
Clinical narrative: Patient is a 91 y.o. female patient of MD with history of hypertension, hyperlipidemia, ovarian cancer presented to Doctors Hospital with generalized body aches, chills, cough.   Covid-19 virus infection - Improved  Date of onset of symptoms: 11/06 Symptoms present on admission: Yes Date of covid positive test: 11/08 per patient at her Doctor's office.  Unable to view results. Vaccination status: vaccinated Imaging: CTPA: No evidence of PE.  Linear bibasilar opacities are most consistent with atelectasis.  Superimposed infection is not entirely excluded in the appropriate clinical setting. Cardiomegaly without pulmonary edema.  And age-indeterminate compression deformity of T8 5 vertebral body which is new in comparison to February 2019 CT. Oxygen requirements on admission: 2 L nasal cannula Current oxygen requirements: RA  Medical therapy: remdesivir and steroids Consultants following: None Anticipated special isolation end date: 11/18  antitussives, IS   Out of Special isolation    Back pain Compression fracture T5 Today, patient complains of both upper and lower back pain Received IV Toradol as patient does have multiple medication allergies Lidocaine patch added Added ultram  Continues to have pain  MRI thoracic spine Acute compression fracture at T5 with 75% loss of vertebral body height.  Vertebral body height loss at this level is worse than on the CT of the chest from 11/13/2022. mild retropulsion of the posterior aspect of T5 into the canal with mild effacement of the thecal sac.  No significant spinal stenosis.  No compression of the thoracic spinal cord. Neurosurgery consulted - recommended CTO brace and f/u outpatient in 2 weeks   Hyponatremia  Euvolemic 127-- >129-- >130->130-- >128 S/b Nephrology, suspected SIADH physiology  Recommended 1.5 L fluid restriction  Patient to have repeat BMP in 1 week with PCP  Hypertension Resume amlodipine as per home regimen. Low blood pressure this morning after receiving hydralazine.  Dropped blood pressure in the 70s received fluid boluses much improved Continue to monitor   Hyperlipidemia Resume statin    Hypokalemia K replaced Monitor   Elevated troponin Chest pain  Troponin 17-- >18 Patient denies any chest pain.  She has bilateral rib pain with coughing. EKG: Sinus rhythm with nonspecific ST-T changes. EKG shows Left anterior fasicular block seen on previous EKG  Troponin 22-- >21  Pain likely musculoskeletal    Elevated BNP NT proBNP 696 She appears euvolemic on exam Monitor   Constipation Continue MiraLAX and senna/docusate added home milk of mag Monitor
Age: 53.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Chills, Fatigue, Feeling hot, Headache
Clinical narrative: 11/19/2022 In the morning Sore and scratchy throat.  Nasal Congestion got worse through the day.  Chills and felt hot, temperature regulation issue and headache.  11/20, symptoms continued, and I got a fever, peaking at 100, with fatigue.  11/21 Symptoms continued through 11/22 when I developed a wheeze with tightness in the throat.  Consulted with MD, who prescribed a steroid.  Got a PCR test on 11/21, positive.  11/22 MD consulted, prescribed Albuterol and Prednisone.   Advised to treat symptomatically.  Felt Better 11/26.  Returned to work on 11/28, only had lingering congestion through 11/29.  Symptoms cleared up on 11/30.
Age: 53.0
Sex: F
Vaccine: COVID19
Symptoms: Impaired work ability, Nasal congestion, Oropharyngeal pain, SARS-CoV-2 test positive, Temperature regulation disorder
Clinical narrative: 11/19/2022 In the morning Sore and scratchy throat.  Nasal Congestion got worse through the day.  Chills and felt hot, temperature regulation issue and headache.  11/20, symptoms continued, and I got a fever, peaking at 100, with fatigue.  11/21 Symptoms continued through 11/22 when I developed a wheeze with tightness in the throat.  Consulted with MD, who prescribed a steroid.  Got a PCR test on 11/21, positive.  11/22 MD consulted, prescribed Albuterol and Prednisone.   Advised to treat symptomatically.  Felt Better 11/26.  Returned to work on 11/28, only had lingering congestion through 11/29.  Symptoms cleared up on 11/30.
Age: 53.0
Sex: F
Vaccine: COVID19
Symptoms: Throat irritation, Throat tightness, Wheezing
Clinical narrative: 11/19/2022 In the morning Sore and scratchy throat.  Nasal Congestion got worse through the day.  Chills and felt hot, temperature regulation issue and headache.  11/20, symptoms continued, and I got a fever, peaking at 100, with fatigue.  11/21 Symptoms continued through 11/22 when I developed a wheeze with tightness in the throat.  Consulted with MD, who prescribed a steroid.  Got a PCR test on 11/21, positive.  11/22 MD consulted, prescribed Albuterol and Prednisone.   Advised to treat symptomatically.  Felt Better 11/26.  Returned to work on 11/28, only had lingering congestion through 11/29.  Symptoms cleared up on 11/30.
Age: 85.0
Sex: F
Vaccine: PPV
Symptoms: Erythema
Clinical narrative: Patient came 12/19/22 in and said they had arm redness from the shoulder to the elbow. She said she went to the doctor and he said it was possibly infected. I asked her what they did for her. She said they put her on an antibiotic.  I asked her how it was now and she said it was better
Age: 54.0
Sex: F
Vaccine: COVID19-2
Symptoms: Dizziness
Clinical narrative: On 12/06/2022 client presented to the vaccination site and was vaccinated with a Covid Pfizer Bivalent Booster Lot# GJ6738 on left arm by vaccinator. At approximately 1728 while sitting in the observation area, client notified nurse that she was feeling ?Dizzy?. Nurse proceeded to take her vital signs; BP:122/78, HR:67, O2:98%, RR:13. Client was able to move to the gravity chair without assistance. Client denied itchiness on any part of the body, denied difficulty breathing, and denied pain. Client reported a history of high blood pressure (medication unknown) and no known allergies. Client stated she experienced dizziness about six months ago due to being stressed. She also denied dizziness or any adverse reaction with the previous Covid Vaccines; Janssen primary series (04/10/2021) and Janssen booster (11/23/2021). Client reported she ate lunch around 1500, ?Sandwich and french-fries with coffee and soda.? At approximately 1741 PHN offered client to have EMS activated for a follow up assessment, client declined. Client reported dizziness had subsided. Client was offered a water bottle. 1740 vital signs; BP: 122/68, HR:68, O2:98%, RR:14. Client rested for a few minutes. 1750 vital signs; BP: 118/76, HR:68, O2:98%, RR:16. Client denied itchiness, difficulty breathing and dizziness. Husband reported he would be driving back home.  PHN educated on possible side effects after vaccine, to seek emergency care if symptoms worsened and to follow up with her primary care provider. Client verbalized understanding. 1756 vital signs: BP:120/78, HR:73, O2:99%. Client denied dizziness and that she was feeling ?Fine.? Client was able to stand up without assistance from gravity chair. Client left the facility accompanied by husband with a steady gait at 1759.
Age: 74.0
Sex: F
Vaccine: COVID19
Symptoms: Acute respiratory failure, Ageusia, Anosmia, Anticoagulant therapy, Atrial fibrillation
Clinical narrative: Patient is a 76 y.o. female patient of MD with a history of COPD, Chronic respiratory failure on 2 L oxygen, Paroxysmal atrial fibrillation, HFpEF, Diverticulitis, Renal cancer s/p partial nephrectomy, Chronic pain, admitted with diverticulitis.Hospital course complicated with respiratory failure    Acute on chronic respiratory failure...resolved Covid-19 Virus Infection COPD exacerbation Possible Fluid overload with history of HFpEF Date of onset of symptoms: 11/13/2022 Symptoms present on admission: Cough, loss of taste/smell, subjective fever/chills, nausea Date of covid positive test: 11/10/2022 Vaccination status: vaccinated Imaging: CXR revealed possible residual airspace disease (hospitalized for pneumonia 9/2022), repeat CXR on 11/17 with Increased reticular opacities in both lungs could represent edema or infection Oxygen requirements on admission: Chronic 2 L Current oxygen requirements: transitioned off of BIPAP, on 2 L NC Medical therapy: decadron,  IV lasix X 2 doses followed by PO lasix, not a candidate for remdesivir Consultants following: Pulmonary Anticipated special isolation end date: 11/21/2022 On 2 L NC currently   Acute diverticulitis CT abdomen/pelvis with IV contrast revealed colonic diverticulosis with pericolonic inflammatory changes involving sigmoid colon, bladder wall thickening (reactive versus cystitis-denies UTI symptoms) On omnicef and flagyl currently Complete total 12-14 days course   Atrial fibrillation with RVR Initial troponin 17 EKG atrial fibrillation with RVR, no acute ST/T changes appreciated TSH Unremarkable,  serial troponin w flat trend IV metoprolol PRN Continue Cardizem and Eliquis HR remains stable     COPD Substitute Symbicort and Spiriva for Trelegy Continue PRN albuterol Continue chronic 2 L oxygen, currently on BIPAP  Chronic HFpEF EF 65% on echocardiogram 4/11/2022 Clinically compensated Continue metoprolol Monitor volume status  Resume PO lasix 20 mg 11/18
Age: 74.0
Sex: F
Vaccine: COVID19
Symptoms: Bladder hypertrophy, Blood thyroid stimulating hormone normal, COVID-19, Chest X-ray abnormal, Chills
Clinical narrative: Patient is a 76 y.o. female patient of MD with a history of COPD, Chronic respiratory failure on 2 L oxygen, Paroxysmal atrial fibrillation, HFpEF, Diverticulitis, Renal cancer s/p partial nephrectomy, Chronic pain, admitted with diverticulitis.Hospital course complicated with respiratory failure    Acute on chronic respiratory failure...resolved Covid-19 Virus Infection COPD exacerbation Possible Fluid overload with history of HFpEF Date of onset of symptoms: 11/13/2022 Symptoms present on admission: Cough, loss of taste/smell, subjective fever/chills, nausea Date of covid positive test: 11/10/2022 Vaccination status: vaccinated Imaging: CXR revealed possible residual airspace disease (hospitalized for pneumonia 9/2022), repeat CXR on 11/17 with Increased reticular opacities in both lungs could represent edema or infection Oxygen requirements on admission: Chronic 2 L Current oxygen requirements: transitioned off of BIPAP, on 2 L NC Medical therapy: decadron,  IV lasix X 2 doses followed by PO lasix, not a candidate for remdesivir Consultants following: Pulmonary Anticipated special isolation end date: 11/21/2022 On 2 L NC currently   Acute diverticulitis CT abdomen/pelvis with IV contrast revealed colonic diverticulosis with pericolonic inflammatory changes involving sigmoid colon, bladder wall thickening (reactive versus cystitis-denies UTI symptoms) On omnicef and flagyl currently Complete total 12-14 days course   Atrial fibrillation with RVR Initial troponin 17 EKG atrial fibrillation with RVR, no acute ST/T changes appreciated TSH Unremarkable,  serial troponin w flat trend IV metoprolol PRN Continue Cardizem and Eliquis HR remains stable     COPD Substitute Symbicort and Spiriva for Trelegy Continue PRN albuterol Continue chronic 2 L oxygen, currently on BIPAP  Chronic HFpEF EF 65% on echocardiogram 4/11/2022 Clinically compensated Continue metoprolol Monitor volume status  Resume PO lasix 20 mg 11/18
Age: 74.0
Sex: F
Vaccine: COVID19
Symptoms: Chronic obstructive pulmonary disease, Colitis, Computerised tomogram abdomen abnormal, Condition aggravated, Cough
Clinical narrative: Patient is a 76 y.o. female patient of MD with a history of COPD, Chronic respiratory failure on 2 L oxygen, Paroxysmal atrial fibrillation, HFpEF, Diverticulitis, Renal cancer s/p partial nephrectomy, Chronic pain, admitted with diverticulitis.Hospital course complicated with respiratory failure    Acute on chronic respiratory failure...resolved Covid-19 Virus Infection COPD exacerbation Possible Fluid overload with history of HFpEF Date of onset of symptoms: 11/13/2022 Symptoms present on admission: Cough, loss of taste/smell, subjective fever/chills, nausea Date of covid positive test: 11/10/2022 Vaccination status: vaccinated Imaging: CXR revealed possible residual airspace disease (hospitalized for pneumonia 9/2022), repeat CXR on 11/17 with Increased reticular opacities in both lungs could represent edema or infection Oxygen requirements on admission: Chronic 2 L Current oxygen requirements: transitioned off of BIPAP, on 2 L NC Medical therapy: decadron,  IV lasix X 2 doses followed by PO lasix, not a candidate for remdesivir Consultants following: Pulmonary Anticipated special isolation end date: 11/21/2022 On 2 L NC currently   Acute diverticulitis CT abdomen/pelvis with IV contrast revealed colonic diverticulosis with pericolonic inflammatory changes involving sigmoid colon, bladder wall thickening (reactive versus cystitis-denies UTI symptoms) On omnicef and flagyl currently Complete total 12-14 days course   Atrial fibrillation with RVR Initial troponin 17 EKG atrial fibrillation with RVR, no acute ST/T changes appreciated TSH Unremarkable,  serial troponin w flat trend IV metoprolol PRN Continue Cardizem and Eliquis HR remains stable     COPD Substitute Symbicort and Spiriva for Trelegy Continue PRN albuterol Continue chronic 2 L oxygen, currently on BIPAP  Chronic HFpEF EF 65% on echocardiogram 4/11/2022 Clinically compensated Continue metoprolol Monitor volume status  Resume PO lasix 20 mg 11/18
Age: 74.0
Sex: F
Vaccine: COVID19
Symptoms: Cystitis, Diverticulitis, Diverticulum intestinal, Echocardiogram normal, Ejection fraction normal
Clinical narrative: Patient is a 76 y.o. female patient of MD with a history of COPD, Chronic respiratory failure on 2 L oxygen, Paroxysmal atrial fibrillation, HFpEF, Diverticulitis, Renal cancer s/p partial nephrectomy, Chronic pain, admitted with diverticulitis.Hospital course complicated with respiratory failure    Acute on chronic respiratory failure...resolved Covid-19 Virus Infection COPD exacerbation Possible Fluid overload with history of HFpEF Date of onset of symptoms: 11/13/2022 Symptoms present on admission: Cough, loss of taste/smell, subjective fever/chills, nausea Date of covid positive test: 11/10/2022 Vaccination status: vaccinated Imaging: CXR revealed possible residual airspace disease (hospitalized for pneumonia 9/2022), repeat CXR on 11/17 with Increased reticular opacities in both lungs could represent edema or infection Oxygen requirements on admission: Chronic 2 L Current oxygen requirements: transitioned off of BIPAP, on 2 L NC Medical therapy: decadron,  IV lasix X 2 doses followed by PO lasix, not a candidate for remdesivir Consultants following: Pulmonary Anticipated special isolation end date: 11/21/2022 On 2 L NC currently   Acute diverticulitis CT abdomen/pelvis with IV contrast revealed colonic diverticulosis with pericolonic inflammatory changes involving sigmoid colon, bladder wall thickening (reactive versus cystitis-denies UTI symptoms) On omnicef and flagyl currently Complete total 12-14 days course   Atrial fibrillation with RVR Initial troponin 17 EKG atrial fibrillation with RVR, no acute ST/T changes appreciated TSH Unremarkable,  serial troponin w flat trend IV metoprolol PRN Continue Cardizem and Eliquis HR remains stable     COPD Substitute Symbicort and Spiriva for Trelegy Continue PRN albuterol Continue chronic 2 L oxygen, currently on BIPAP  Chronic HFpEF EF 65% on echocardiogram 4/11/2022 Clinically compensated Continue metoprolol Monitor volume status  Resume PO lasix 20 mg 11/18
Age: 74.0
Sex: F
Vaccine: COVID19
Symptoms: Electrocardiogram abnormal, Lung opacity, Nausea, Pneumonia, Positive airway pressure therapy
Clinical narrative: Patient is a 76 y.o. female patient of MD with a history of COPD, Chronic respiratory failure on 2 L oxygen, Paroxysmal atrial fibrillation, HFpEF, Diverticulitis, Renal cancer s/p partial nephrectomy, Chronic pain, admitted with diverticulitis.Hospital course complicated with respiratory failure    Acute on chronic respiratory failure...resolved Covid-19 Virus Infection COPD exacerbation Possible Fluid overload with history of HFpEF Date of onset of symptoms: 11/13/2022 Symptoms present on admission: Cough, loss of taste/smell, subjective fever/chills, nausea Date of covid positive test: 11/10/2022 Vaccination status: vaccinated Imaging: CXR revealed possible residual airspace disease (hospitalized for pneumonia 9/2022), repeat CXR on 11/17 with Increased reticular opacities in both lungs could represent edema or infection Oxygen requirements on admission: Chronic 2 L Current oxygen requirements: transitioned off of BIPAP, on 2 L NC Medical therapy: decadron,  IV lasix X 2 doses followed by PO lasix, not a candidate for remdesivir Consultants following: Pulmonary Anticipated special isolation end date: 11/21/2022 On 2 L NC currently   Acute diverticulitis CT abdomen/pelvis with IV contrast revealed colonic diverticulosis with pericolonic inflammatory changes involving sigmoid colon, bladder wall thickening (reactive versus cystitis-denies UTI symptoms) On omnicef and flagyl currently Complete total 12-14 days course   Atrial fibrillation with RVR Initial troponin 17 EKG atrial fibrillation with RVR, no acute ST/T changes appreciated TSH Unremarkable,  serial troponin w flat trend IV metoprolol PRN Continue Cardizem and Eliquis HR remains stable     COPD Substitute Symbicort and Spiriva for Trelegy Continue PRN albuterol Continue chronic 2 L oxygen, currently on BIPAP  Chronic HFpEF EF 65% on echocardiogram 4/11/2022 Clinically compensated Continue metoprolol Monitor volume status  Resume PO lasix 20 mg 11/18
Age: 74.0
Sex: F
Vaccine: COVID19
Symptoms: Pyrexia, SARS-CoV-2 test positive, Scan with contrast abnormal, Troponin
Clinical narrative: Patient is a 76 y.o. female patient of MD with a history of COPD, Chronic respiratory failure on 2 L oxygen, Paroxysmal atrial fibrillation, HFpEF, Diverticulitis, Renal cancer s/p partial nephrectomy, Chronic pain, admitted with diverticulitis.Hospital course complicated with respiratory failure    Acute on chronic respiratory failure...resolved Covid-19 Virus Infection COPD exacerbation Possible Fluid overload with history of HFpEF Date of onset of symptoms: 11/13/2022 Symptoms present on admission: Cough, loss of taste/smell, subjective fever/chills, nausea Date of covid positive test: 11/10/2022 Vaccination status: vaccinated Imaging: CXR revealed possible residual airspace disease (hospitalized for pneumonia 9/2022), repeat CXR on 11/17 with Increased reticular opacities in both lungs could represent edema or infection Oxygen requirements on admission: Chronic 2 L Current oxygen requirements: transitioned off of BIPAP, on 2 L NC Medical therapy: decadron,  IV lasix X 2 doses followed by PO lasix, not a candidate for remdesivir Consultants following: Pulmonary Anticipated special isolation end date: 11/21/2022 On 2 L NC currently   Acute diverticulitis CT abdomen/pelvis with IV contrast revealed colonic diverticulosis with pericolonic inflammatory changes involving sigmoid colon, bladder wall thickening (reactive versus cystitis-denies UTI symptoms) On omnicef and flagyl currently Complete total 12-14 days course   Atrial fibrillation with RVR Initial troponin 17 EKG atrial fibrillation with RVR, no acute ST/T changes appreciated TSH Unremarkable,  serial troponin w flat trend IV metoprolol PRN Continue Cardizem and Eliquis HR remains stable     COPD Substitute Symbicort and Spiriva for Trelegy Continue PRN albuterol Continue chronic 2 L oxygen, currently on BIPAP  Chronic HFpEF EF 65% on echocardiogram 4/11/2022 Clinically compensated Continue metoprolol Monitor volume status  Resume PO lasix 20 mg 11/18
Sex: U
Vaccine: COVID19-2, COVID19-2
Symptoms: No adverse event, Underdose
Clinical narrative: No adverse effects. Staff at our clinic continued to give 0.25 mL for booster dose to Adults when we switched to giving booster doses from Moderna to Moderna Bivalent. This affected 52 patients. All have been informed and many have come back to receive their full doses. All staff are now educated on the correct dose of Moderna Bivalent to give to an Adult being 0.5 mL not 0.25 mL.
Age: 45.0
Sex: F
Vaccine: FLU4
Symptoms: Arthralgia, Injection site pain, Injection site swelling, Insomnia, Pain
Clinical narrative: Site: Pain at Injection Site-Severe, Site: Swelling at Injection Site-Severe, Systemic: Joint Pain-Severe, Systemic: Unable to Sleep-Severe, Additional Details: Arm hurts with any type of movement.
Age: 45.0
Sex: F
Vaccine: FLU4
Symptoms: Pain in extremity
Clinical narrative: Site: Pain at Injection Site-Severe, Site: Swelling at Injection Site-Severe, Systemic: Joint Pain-Severe, Systemic: Unable to Sleep-Severe, Additional Details: Arm hurts with any type of movement.
Age: 62.0
Sex: F
Vaccine: COVID19-2
Symptoms: Wrong product administered
Clinical narrative: Error: Wrong Vaccine/Product Administered-
Age: 63.0
Sex: M
Vaccine: COVID19
Symptoms: Dehydration, Diarrhoea, Dyspnoea, Hypoxia, Pneumonia
Clinical narrative: No MICR. Pfizer per chart Hospitalized 1/9/22-1/21/22 SOB, fever, diarrhea, PNA, hypoxia, dehydration, respiratory failure
Age: 63.0
Sex: M
Vaccine: COVID19
Symptoms: Pyrexia, Respiratory failure
Clinical narrative: No MICR. Pfizer per chart Hospitalized 1/9/22-1/21/22 SOB, fever, diarrhea, PNA, hypoxia, dehydration, respiratory failure
Age: 75.0
Sex: F
Vaccine: COVID19-2
Symptoms: Arthralgia, Back pain, Joint range of motion decreased, Mobility decreased, Muscle tightness
Clinical narrative: Booster caused tightness and soreness in arm at first, then spread up to shoulder, then to front of shoulder then across back of shoulder. Now, 2 months later, I have lost range of motion in that arm. I can use that arm but with limited movement.
Age: 75.0
Sex: F
Vaccine: COVID19-2
Symptoms: Pain in extremity
Clinical narrative: Booster caused tightness and soreness in arm at first, then spread up to shoulder, then to front of shoulder then across back of shoulder. Now, 2 months later, I have lost range of motion in that arm. I can use that arm but with limited movement.
Age: 78.0
Sex: M
Vaccine: COVID19
Symptoms: Acute kidney injury, Acute respiratory failure, Blood creatinine increased, COVID-19, Chest X-ray normal
Clinical narrative: Patient is a 78 y.o. male admitted to the hospital on 11/17/2022 for shortness of breath, lethargic and hypoxia after recent diagnosis of covid at his long term facility   Discharge Diagnosis and Associated Hospital Course   COVID-19 with acute hypoxic respiratory failure resolved  -Suspect the main etiology shortness of breath and cough -currently 93% RA -Reported is not on any O2 at the rehab center -will stop decadron due to dm2   -Not a candidate for remdesivir due to elevated creatinine -ID recommended continue paxlovid to complete course -cxr with no consolidation -patient has cough and congestion, symptoms    Type I IDDM w CKD 3 -Blood glucose is currently stable - continue his Lantus dose at 30 units -continue ssi -glucose elevated due to steroid   Acute kidney injury on CKD 3 Acute urinary retention -Baseline creatinine 1.2 increased to 1.6 now down  -Suspect combination from COVID and probably diuretic and if certain news -aki resolved, start flomax when off paxlovid for now will need straight cathed q8 hours   Right heel ulcer -Chronic for him -warm to touch and erythematous will -We will continue wound care to see   History of seizures -Continue Keppra   Essential hypertension -Continue metoprolol Peripheral artery disease -Has had amputations of his toes in the past -Has had multiple interventions in the past -Continue aspirin Plavix and statin therapy  Dementia without behavioral disturbance -Patient currently calm and collected -We will continue his Aricept for now
Age: 78.0
Sex: M
Vaccine: COVID19
Symptoms: Cough, Dyspnoea, Erythema, Hypoxia, Lethargy
Clinical narrative: Patient is a 78 y.o. male admitted to the hospital on 11/17/2022 for shortness of breath, lethargic and hypoxia after recent diagnosis of covid at his long term facility   Discharge Diagnosis and Associated Hospital Course   COVID-19 with acute hypoxic respiratory failure resolved  -Suspect the main etiology shortness of breath and cough -currently 93% RA -Reported is not on any O2 at the rehab center -will stop decadron due to dm2   -Not a candidate for remdesivir due to elevated creatinine -ID recommended continue paxlovid to complete course -cxr with no consolidation -patient has cough and congestion, symptoms    Type I IDDM w CKD 3 -Blood glucose is currently stable - continue his Lantus dose at 30 units -continue ssi -glucose elevated due to steroid   Acute kidney injury on CKD 3 Acute urinary retention -Baseline creatinine 1.2 increased to 1.6 now down  -Suspect combination from COVID and probably diuretic and if certain news -aki resolved, start flomax when off paxlovid for now will need straight cathed q8 hours   Right heel ulcer -Chronic for him -warm to touch and erythematous will -We will continue wound care to see   History of seizures -Continue Keppra   Essential hypertension -Continue metoprolol Peripheral artery disease -Has had amputations of his toes in the past -Has had multiple interventions in the past -Continue aspirin Plavix and statin therapy  Dementia without behavioral disturbance -Patient currently calm and collected -We will continue his Aricept for now
Age: 78.0
Sex: M
Vaccine: COVID19
Symptoms: Respiratory tract congestion, Skin ulcer, Skin warm, Urinary retention
Clinical narrative: Patient is a 78 y.o. male admitted to the hospital on 11/17/2022 for shortness of breath, lethargic and hypoxia after recent diagnosis of covid at his long term facility   Discharge Diagnosis and Associated Hospital Course   COVID-19 with acute hypoxic respiratory failure resolved  -Suspect the main etiology shortness of breath and cough -currently 93% RA -Reported is not on any O2 at the rehab center -will stop decadron due to dm2   -Not a candidate for remdesivir due to elevated creatinine -ID recommended continue paxlovid to complete course -cxr with no consolidation -patient has cough and congestion, symptoms    Type I IDDM w CKD 3 -Blood glucose is currently stable - continue his Lantus dose at 30 units -continue ssi -glucose elevated due to steroid   Acute kidney injury on CKD 3 Acute urinary retention -Baseline creatinine 1.2 increased to 1.6 now down  -Suspect combination from COVID and probably diuretic and if certain news -aki resolved, start flomax when off paxlovid for now will need straight cathed q8 hours   Right heel ulcer -Chronic for him -warm to touch and erythematous will -We will continue wound care to see   History of seizures -Continue Keppra   Essential hypertension -Continue metoprolol Peripheral artery disease -Has had amputations of his toes in the past -Has had multiple interventions in the past -Continue aspirin Plavix and statin therapy  Dementia without behavioral disturbance -Patient currently calm and collected -We will continue his Aricept for now
Age: 61.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Cough, Oropharyngeal pain, Pyrexia, Respiratory tract congestion
Clinical narrative: In September 2022 my breakthrough COVID-19 infection started with sore throat then a cough that was painful. I had a fever for about 48 hours that remained low-grade as well as chest congestion.   At Urgent Care I was prescribed Paxlovid and took that for 5 days.  The cough remained for two weeks.
Age: 61.0
Sex: M
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive, Vaccine breakthrough infection
Clinical narrative: In September 2022 my breakthrough COVID-19 infection started with sore throat then a cough that was painful. I had a fever for about 48 hours that remained low-grade as well as chest congestion.   At Urgent Care I was prescribed Paxlovid and took that for 5 days.  The cough remained for two weeks.
Age: 11.0
Sex: F
Vaccine: MNQ, TDAP
Symptoms: Dizziness, Immediate post-injection reaction, Malaise, Visual impairment, Vomiting
Clinical narrative: Immediately after receiving MenQuadfi patient stated, she felt sick and dizzy.  Afterwards she stated she felt her eyes "go black" for a couple of seconds. She did not faint but did vomit. After recovering she did receive Tdap in lying position. She had no issues directly after vaccine and rested for 10 minutes. While out at the desk she started feeling dizzy and had another feeling of her eyes "going black". She did not faint. She rested for about 15 minutes and was able to leave the clinic with no issue.
Age: 79.0
Sex: M
Vaccine: COVID19-2
Symptoms: Product storage error
Clinical narrative: Error: Improper Storage (ex. temp./location)-
Age: 62.0
Sex: M
Vaccine: COVID19-2, FLU4
Symptoms: COVID-19, Cough, Exposure to SARS-CoV-2, Malaise, Nasopharyngitis
Clinical narrative: My COVID-19 started on 12/11/2022 I wasn't feeling well. My wife tested positive few days earlier. On 12/12/2022 in the morning at around 08:00AM I tested positive for COVID-19 infection.  I had a sore throat, runny nose, and fever.  I did a telehealth with my doctor who prescribed me with Paxlovid  for 5 days. After 1 week of my medication I came down  with a head cold. I had runny nose, sneezing,  and cough. My doctor told me told wait and see how things ago and also to contact him if it gets worse.
Age: 62.0
Sex: M
Vaccine: COVID19-2, FLU4
Symptoms: Oropharyngeal pain, Pyrexia, Rhinorrhoea, SARS-CoV-2 test positive, Sneezing
Clinical narrative: My COVID-19 started on 12/11/2022 I wasn't feeling well. My wife tested positive few days earlier. On 12/12/2022 in the morning at around 08:00AM I tested positive for COVID-19 infection.  I had a sore throat, runny nose, and fever.  I did a telehealth with my doctor who prescribed me with Paxlovid  for 5 days. After 1 week of my medication I came down  with a head cold. I had runny nose, sneezing,  and cough. My doctor told me told wait and see how things ago and also to contact him if it gets worse.
Age: 69.0
Sex: M
Vaccine: COVID19, COVID19-2
Symptoms: Chills, Headache, Muscle fatigue, Myalgia, Tremor
Clinical narrative: Headache; muscle soreness: convulsive chills comparable to hypothermia lasting four hours with muscle fatigue lasting another day.
Age: 79.0
Sex: M
Vaccine: COVID19-2
Symptoms: Atrial fibrillation, Blood culture negative, Brain natriuretic peptide, COVID-19, Cardiac telemetry abnormal
Clinical narrative: Patient is a 79 y.o. male patient with history of CAD, GERD, HLD, obesity, OSA, A-fib, anxiety, depression presented to local Hospital with shortness of breath.    Community-acquired bacterial pneumonia  Covid 19 infection Increased in shortness of breath No leukocytosis CXR: right pleural effusion and sm right lung base infiltrate can't be excluded Check flu and Ur antigens neg IV fluids completed Aspiration precautions.   Cough and deep breathing exercises.  Incentive spirometry and pep Continue Levaquin started in the ED. Hemodynamically stable, does not appear septic at this time. Blood Cx NGTD At Baseline 2L NC Covid pos Dexamethasone 6mg PO daily for 10 days total    Atrial fibrillation with RVR History of left ventricular thrombus as above S/p ablation 2004, S/P cardioversion 2019, 2020, 2021 Amiodarone recent, 09/13/22, stopped due to dyspnea Continue home metoprolol, diltiazem, and warfarin. Given 5 mg Cardizem IV and restarted metoprolol BID 11/14/22 Telemetry afib with RVR VR 140s. Unable to increase metoprolol or cardizem secondary to low BP. Start digoxin  11/16/22 VR well controlled. Plan to increase his metoprolol to his home dose and stop digoxin for discharge. SBP low 100s    HFpEF  Hypertension Hyperlipidemia He was given IV Lasix at the outside hospital emergency room, but with patient's BNP being relatively stable, and chest x-ray without any edema, will hold off on further IV diuresis for the moment, and continue home oral loop diuretic.   ECHO 7/2022: EF 50%, filling defect in the apex of LV in images suggesting intra-cavitary thrombus Continue metoprolol and atorvastatin    Thrombocytopenia Likely DITP from levaquin use  PLT 137   Anxiety and depression Continue home Celexa, and quetiapine.  Morbid Obesity Outpatient diet and exercise regimen.   Evaluation for OSA and/or continuation of home CPAP.   BMI: 44.76   OSA Stopped wearing CPAP because didn't think it did anything Continue CPAP while here