chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 70.0
Sex: F
Vaccine: VARZOS
Symptoms: Musculoskeletal stiffness, Myalgia, Nausea, Peripheral swelling, Pruritus
Clinical narrative: Headache then migraine Stiff very sore arm around injection site, Arm swollen, pink in color Chills, nausea, Sore muscles - legs, body Itchy face, specially right side of cheek & above & around right eye-brow. After 20 hrs, itchiness all over; face, neck, arms, sides of torso, legs, toes (yep), inside ears, scalp, fingers (!), eyes, nose (all night), back. The nausea was so strong, worked to stay relaxed & calm so not to vomit. Possibly ran fever. I wasn't connecting the physical reactions to the vaccine until day 3
Age: 45.0
Sex: M
Vaccine: COVID19
Symptoms: Genital herpes, Oral herpes
Clinical narrative: Cold sores on my lips and herepes sores on my genital area
Age: 1.5
Sex: M
Vaccine: DTAPIPVHIB, HEPA, MMRV, PNC20
Symptoms: Expired product administered
Clinical narrative: Expired hepatitis A vaccine administered to patient. Plan to have patient return in 6 months.
Sex: U
Vaccine: HPV9
Symptoms: Expired product administered, No adverse event
Clinical narrative: No additional AE reported; expired GARDASIL 9 was administered to a patient.; This spontaneous report was received from a medical assistant referring to a patient of unknown age and gender. The patient's medical history, historical drugs, concurrent conditions, and concomitant drugs were not reported.   On 20-DEC-2023, the patient was vaccinated with HPV rL1 6 11 16 18 31 33 45 52 58 VLP vaccine (yeast) (GARDASIL 9) injection (lot#: U019412, expiration date: 30-OCT-2023; strength, dose, and route of administration were not reported) for prophylaxis (expired product administered). The administered vaccine did not have any temperature excursions before. No additional adverse events (AE) were reported (no adverse event).
Sex: F
Vaccine: VARZOS
Symptoms: Incorrect dose administered
Clinical narrative: received two doses of shingrix yesterday; This non-serious case was reported by a pharmacist via call center representative and described the occurrence of accidental overdose in a female patient who received Herpes zoster (Shingrix) for prophylaxis.   Previously administered products included Shingrix. Concomitant products included Varicella zoster vaccine rgE (CHO) (Shingrix).   On 11-DEC-2023, the patient received the 2nd dose of Shingrix. On 11-DEC-2023, an unknown time after receiving Shingrix, the patient experienced accidental overdose (Verbatim: received two doses of shingrix yesterday). The outcome of the accidental overdose was unknown.   Additional Information: GSK Receipt Date: 12-DEC-2023 The pharmacist reported that a patient accidently received two doses of shingrix yesterday on 11 December 2023. They accidentally administered 2 doses of shingrix to one patient on same day which led to accidental overdose. The reported that patient received her first dose of shingrix on a previous date. The reporter consent to follow up.
Sex: F
Vaccine: MENB, MNQ
Symptoms: Injection site pain
Clinical narrative: muscle pain at the injections site; This non-serious case was reported by a other health professional via call center representative and described the occurrence of injection site muscle pain in a female patient who received Men ACWY-CRM NVS (Menveo) for prophylaxis.   Co-suspect products included Men B NVS (Bexsero) for prophylaxis.   On an unknown date, the patient received Menveo and Bexsero. On an unknown date, an unknown time after receiving Menveo and Bexsero, the patient experienced injection site muscle pain (Verbatim: muscle pain at the injections site). The outcome of the injection site muscle pain was unknown.   It was unknown if the reporter considered the injection site muscle pain to be related to Menveo, Bexsero and Bexsero Pre-Filled Syringe Device.     It was unknown if the company considered the injection site muscle pain to be related to Menveo, Bexsero and Bexsero Pre-Filled Syringe Device.   This report is made by GSK without prejudice and does not imply any admission or liability for the incident or its consequences.   Additional Information: GSK Receipt Date: 12-DEC-2023 The pharmacist reported a couple of weeks ago patient administered Menveo and Bexsero together. The patient had muscle pain at the injections site. The sales representative (caller) did not have any further information about the vaccines or patient. The reporter consented to follow up.
Sex: U
Vaccine: VARZOS
Symptoms: Incomplete course of vaccination
Clinical narrative: not yet received 2nd dose; This non-serious case was reported by a consumer via call center representative and described the occurrence of incomplete course of vaccination in a patient who received Herpes zoster (Shingrix) for prophylaxis.   Previously administered products included Shingrix (received 1st dose in September 2020).   On an unknown date, the patient did not received the 2nd dose of Shingrix. On an unknown date, an unknown time after receiving Shingrix, the patient experienced incomplete course of vaccination (Verbatim: not yet received 2nd dose). The outcome of the incomplete course of vaccination was unknown.   Additional Information: GSK Receipt date: 12-DEC-2023 The patient was self-reported.  The patient asked that need to get the 2nd dose, but given the length of time since the first, did he/she need to start over. The pharmacy was not certain and recommended contacting GSK to find out.  His/her thought it was still ok to get the second vaccine but was not 100 percent. Till the time of reporting the patient had not received the second dose of Shingrix, which led to incomplete course of vaccination.
Sex: M
Vaccine: TDAP
Symptoms: Product administered to patient of inappropriate age, Wrong product administered
Clinical narrative: underage administration; patient received Boostrix instead of Infanrix. Patient was up to date with the Dtap vaccination schedule.; This non-serious case was reported by a pharmacist via call center representative and described the occurrence of inappropriate age at vaccine administration in a 18-month-old male patient who received DTPa (Reduced antigen) (Boostrix) for prophylaxis.   On 11-DEC-2023, the patient received Boostrix. On 11-DEC-2023, an unknown time after receiving Boostrix, the patient experienced inappropriate age at vaccine administration (Verbatim: underage administration) and wrong vaccine administered (Verbatim: patient received Boostrix instead of Infanrix. Patient was up to date with the Dtap vaccination schedule.). The outcome of the inappropriate age at vaccine administration and wrong vaccine administered were unknown.   This report is made by GSK without prejudice and does not imply any admission or liability for the incident or its consequences.   Additional Information: GSK Receipt Date: 12-DEC-2023 The pharmacist reported that an underage patient received Boostrix instead of Infanrix which led to wrong vaccine administered and inappropriate age at vaccine administration. The patient was up to date with the Dtap vaccination schedule. The vaccine administration facility was the same as primary reporter. The reporter did not consent to follow up.
Age: 79.0
Sex: M
Vaccine: COVID19
Symptoms: Fatigue, Paraesthesia
Clinical narrative: I became much more fatigued; I now have a burning pins and needles like feeling that radiates through my torso and arms 24/7; This spontaneous case was reported by a consumer and describes the occurrence of FATIGUE (I became much more fatigued) and PARAESTHESIA (I now have a burning pins and needles like feeling that radiates through my torso and arms 24/7) in a 79-year-old male patient who received mRNA-1273.815 (SPIKEVAX 2023-2024) for COVID-19 prophylaxis.     No Medical History information was reported.    On 06-Nov-2023, the patient received dose of mRNA-1273.815 (SPIKEVAX 2023-2024) (Intramuscular use) 1 dosage form. On 11-Nov-2023, the patient experienced FATIGUE (I became much more fatigued) and PARAESTHESIA (I now have a burning pins and needles like feeling that radiates through my torso and arms 24/7). At the time of the report, FATIGUE (I became much more fatigued) and PARAESTHESIA (I now have a burning pins and needles like feeling that radiates through my torso and arms 24/7) had not resolved.        The action taken with mRNA-1273.815 (SPIKEVAX 2023-2024) (Intramuscular use) was unknown.   For mRNA-1273.815 (SPIKEVAX 2023-2024) (Intramuscular use), the reporter did not provide any causality assessments.   No concomitant and treatment medication were reported.  The patient was not sure if vaccine caused this, but one week after she took the vaccine at pharmacy on 06-NOV-2023, two things happened. She became much more fatigued and now have a burning pins and needles like feeling that radiates through her torso and arms 24/7. It was not stopped now for almost two months. It lasts all day and night every day. Patient visited the doctors about this with no answers so far. It was unknown if the patient experienced any additional symptoms or events.
Sex: M
Vaccine: FLUN4
Symptoms: Full blood count, Imaging procedure, Laboratory test, Stevens-Johnson syndrome
Clinical narrative: STEVENS JOHNSON REACTION; A spontaneous report has been received from the regulatory authority in (RA) concerning a male patient of Unknown ethnic origin (age 10 years, weight 39 kg).    No medical history was reported. The following demography was reported for the patient's parent:   Sex: Unknown    Concomitant medication included ibuprofen for adverse drug reaction nos, loratadine for antihistamine therapy and paracetamol for adverse drug reaction nos.     The patient received Fluenz Tetra (influenza vaccine live reassort 4v) (batch number not known), via nasal route, for adverse drug reaction nos on 22-NOV-2023.     No malfunction has been reported for FLUENZ TETRA.    On 10-DEC-2023, the patient experienced stevens johnson reaction (preferred term: Stevens-Johnson syndrome).     At the time of reporting, the event was ongoing.    It was not applicable if any action taken with fluenz tetra.    The reporter was assessed the event of  stevens johnson reaction as serious due to seriousness criterion of important medical event.    Device Information:     Combination Product Report: Yes    Product As Reported: FLUENZ TETRA  Common Device Name: Nasal Spray  Procode: CCQ  Product Role: Suspect    Minor correction on 22-Dec-2023: Added valid null flavors to the State field for all Reporters. Added Hospitalization Required in association with each event with serious criteria hospitalization. Added Treatment Facility from reporter tab. Narrative updated.; Sender's Comments: Stevens-Johnson syndrome is not listed in the company core data sheet of Q/LAIV.  Concomitant use of paracetamol and ibuprofen could be contributory for the event.  Due to limited information on details of indication of the suspect, relevant medical history, concurrent conditions, treatment details, etiological and diagnostic work up(complete blood count, infectious work up and imaging studies), the evaluation did not find evidence to suggest a causal relationship between event and suspect drug.
Age: 39.0
Sex: M
Vaccine: VARZOS
Symptoms: Arthralgia, Headache, Pain in extremity, Pyrexia
Clinical narrative: Fever, pain in arm, pain in joints, headache.
Age: 34.0
Sex: F
Vaccine: COVID19, FLU4
Symptoms: Abdominal pain, Abortion spontaneous, COVID-19, Exposure during pregnancy, Vaginal haemorrhage
Clinical narrative: Presented to emergency department (ED) with 16week 2 day pregnancy, increased vaginal bleeding with clots and lower abdominal cramping. Started with vaginal spotting and bleeding at 14 weeks.  LMP 11/9/2021.  Had COVID-19 infection during first trimester.   In ED BP 152/80, HR 96, afebrile.  White blood cell count was elevated - 18,300.   Pelvic examination revealed blood in the vault and fetal tissue at the cervical os consistent with a spontaneous abortion.  Final diagnosis was spontaneous second trimester abortion.
Age: 34.0
Sex: F
Vaccine: COVID19, FLU4
Symptoms: White blood cell count increased
Clinical narrative: Presented to emergency department (ED) with 16week 2 day pregnancy, increased vaginal bleeding with clots and lower abdominal cramping. Started with vaginal spotting and bleeding at 14 weeks.  LMP 11/9/2021.  Had COVID-19 infection during first trimester.   In ED BP 152/80, HR 96, afebrile.  White blood cell count was elevated - 18,300.   Pelvic examination revealed blood in the vault and fetal tissue at the cervical os consistent with a spontaneous abortion.  Final diagnosis was spontaneous second trimester abortion.
Age: 17.0
Sex: M
Vaccine: FLUC4
Symptoms: No adverse event
Clinical narrative: Patient recieved a flu vaccine on 10/21/2023. No symptoms reported during or after vaccination.
Age: 73.0
Sex: M
Vaccine: COVID19
Symptoms: Chills, Death, Feeling abnormal
Clinical narrative: 8 hours after shot started to feel bad. 24 hours  temperature chills admitted to hospital 2 days late. Patient died 4 days after the vaccine given.
Age: 83.0
Sex: M
Vaccine: COVID19
Symptoms: Acute respiratory failure, Bladder catheterisation, COVID-19, Catheter site discharge, Chest X-ray abnormal
Clinical narrative: Patient is a 85 y.o. male patient of MD with history of empymea, hypothryroid, mood, BPH, HLD, HTN presented to Hospital with worsenign shortness of breath .   Acute on chronic respiratory failure with hypoxemia and hypercapnia Malignant neoplasm of unspecified part of unspecified bronchus or lung Recurrent pleural effusion COPD COVID-19 infection Follows with CCF oncology Baseline of 2 liters, currently on 2 L NC Chest xray with opacifcation of left hemi thorax Chest ct reviewed showing left hydropneumothorax with new areas of loculated gas within the pleural space Consulted IR, small bore chest tube placed 9/29 ID following -recommendations-continue Decadron for COVID-19.  Continue Zosyn for empyema.  Cultures negative. Pulmonary following-not a candidate for VATS per CCF CTS.  Continue IV lasix daily Chest tube removed 10/6 Discharge pending PT/OT evaluation and disposition-follow-up with CCF The patient is likely from the chest tube site.  Discussed with pulmonology and they put a suture and leakage has stopped. Discontinue steroids on discharge The patient is on chronic ciprofloxacin at home due to history of Pseudomonas infection.  Continue home Cipro   Dysphagia Pt reportedly having difficulty swallowing SLP consulted MBS on10/2 showed no evidence of laryngeal penetration or aspiration Continue current diet   Diabetes mellitus, type 2 Ha1c 6.3 on 6/30/23 Not on home medication Continue to monitor   HTN Tachycardia CAD Chronic diastolic CHF Hx of CABG Hx of TAVR Last echo 8/4/23 showing EF 57%, mild LV hypertrophy, well-seated TAVR with minimal leaflet thickening Follows with Dr.  Home amlodpipine and metoprolol PO Prn metoprolol IV Lasix as above Continue aspirin, statin   Chronic kidney disease, stage III Baseline creat around 1.3-1.6 Avoid nephrotoxic agents as able Continue diuresis, monitor renal function   BPH Home proscar and flomax Foley placed d/t increased work of breathing with activity, including urinal use
Age: 83.0
Sex: M
Vaccine: COVID19
Symptoms: Chest tube insertion, Chronic obstructive pulmonary disease, Computerised tomogram thorax abnormal, Culture negative, Dysphagia
Clinical narrative: Patient is a 85 y.o. male patient of MD with history of empymea, hypothryroid, mood, BPH, HLD, HTN presented to Hospital with worsenign shortness of breath .   Acute on chronic respiratory failure with hypoxemia and hypercapnia Malignant neoplasm of unspecified part of unspecified bronchus or lung Recurrent pleural effusion COPD COVID-19 infection Follows with CCF oncology Baseline of 2 liters, currently on 2 L NC Chest xray with opacifcation of left hemi thorax Chest ct reviewed showing left hydropneumothorax with new areas of loculated gas within the pleural space Consulted IR, small bore chest tube placed 9/29 ID following -recommendations-continue Decadron for COVID-19.  Continue Zosyn for empyema.  Cultures negative. Pulmonary following-not a candidate for VATS per CCF CTS.  Continue IV lasix daily Chest tube removed 10/6 Discharge pending PT/OT evaluation and disposition-follow-up with CCF The patient is likely from the chest tube site.  Discussed with pulmonology and they put a suture and leakage has stopped. Discontinue steroids on discharge The patient is on chronic ciprofloxacin at home due to history of Pseudomonas infection.  Continue home Cipro   Dysphagia Pt reportedly having difficulty swallowing SLP consulted MBS on10/2 showed no evidence of laryngeal penetration or aspiration Continue current diet   Diabetes mellitus, type 2 Ha1c 6.3 on 6/30/23 Not on home medication Continue to monitor   HTN Tachycardia CAD Chronic diastolic CHF Hx of CABG Hx of TAVR Last echo 8/4/23 showing EF 57%, mild LV hypertrophy, well-seated TAVR with minimal leaflet thickening Follows with Dr.  Home amlodpipine and metoprolol PO Prn metoprolol IV Lasix as above Continue aspirin, statin   Chronic kidney disease, stage III Baseline creat around 1.3-1.6 Avoid nephrotoxic agents as able Continue diuresis, monitor renal function   BPH Home proscar and flomax Foley placed d/t increased work of breathing with activity, including urinal use
Age: 83.0
Sex: M
Vaccine: COVID19
Symptoms: Dyspnoea, Dyspnoea exertional, Echocardiogram abnormal, Ejection fraction normal, Glycosylated haemoglobin
Clinical narrative: Patient is a 85 y.o. male patient of MD with history of empymea, hypothryroid, mood, BPH, HLD, HTN presented to Hospital with worsenign shortness of breath .   Acute on chronic respiratory failure with hypoxemia and hypercapnia Malignant neoplasm of unspecified part of unspecified bronchus or lung Recurrent pleural effusion COPD COVID-19 infection Follows with CCF oncology Baseline of 2 liters, currently on 2 L NC Chest xray with opacifcation of left hemi thorax Chest ct reviewed showing left hydropneumothorax with new areas of loculated gas within the pleural space Consulted IR, small bore chest tube placed 9/29 ID following -recommendations-continue Decadron for COVID-19.  Continue Zosyn for empyema.  Cultures negative. Pulmonary following-not a candidate for VATS per CCF CTS.  Continue IV lasix daily Chest tube removed 10/6 Discharge pending PT/OT evaluation and disposition-follow-up with CCF The patient is likely from the chest tube site.  Discussed with pulmonology and they put a suture and leakage has stopped. Discontinue steroids on discharge The patient is on chronic ciprofloxacin at home due to history of Pseudomonas infection.  Continue home Cipro   Dysphagia Pt reportedly having difficulty swallowing SLP consulted MBS on10/2 showed no evidence of laryngeal penetration or aspiration Continue current diet   Diabetes mellitus, type 2 Ha1c 6.3 on 6/30/23 Not on home medication Continue to monitor   HTN Tachycardia CAD Chronic diastolic CHF Hx of CABG Hx of TAVR Last echo 8/4/23 showing EF 57%, mild LV hypertrophy, well-seated TAVR with minimal leaflet thickening Follows with Dr.  Home amlodpipine and metoprolol PO Prn metoprolol IV Lasix as above Continue aspirin, statin   Chronic kidney disease, stage III Baseline creat around 1.3-1.6 Avoid nephrotoxic agents as able Continue diuresis, monitor renal function   BPH Home proscar and flomax Foley placed d/t increased work of breathing with activity, including urinal use
Age: 83.0
Sex: M
Vaccine: COVID19
Symptoms: Hypercapnia, Hypoxia, Left ventricular hypertrophy, Lung neoplasm malignant, Lung opacity
Clinical narrative: Patient is a 85 y.o. male patient of MD with history of empymea, hypothryroid, mood, BPH, HLD, HTN presented to Hospital with worsenign shortness of breath .   Acute on chronic respiratory failure with hypoxemia and hypercapnia Malignant neoplasm of unspecified part of unspecified bronchus or lung Recurrent pleural effusion COPD COVID-19 infection Follows with CCF oncology Baseline of 2 liters, currently on 2 L NC Chest xray with opacifcation of left hemi thorax Chest ct reviewed showing left hydropneumothorax with new areas of loculated gas within the pleural space Consulted IR, small bore chest tube placed 9/29 ID following -recommendations-continue Decadron for COVID-19.  Continue Zosyn for empyema.  Cultures negative. Pulmonary following-not a candidate for VATS per CCF CTS.  Continue IV lasix daily Chest tube removed 10/6 Discharge pending PT/OT evaluation and disposition-follow-up with CCF The patient is likely from the chest tube site.  Discussed with pulmonology and they put a suture and leakage has stopped. Discontinue steroids on discharge The patient is on chronic ciprofloxacin at home due to history of Pseudomonas infection.  Continue home Cipro   Dysphagia Pt reportedly having difficulty swallowing SLP consulted MBS on10/2 showed no evidence of laryngeal penetration or aspiration Continue current diet   Diabetes mellitus, type 2 Ha1c 6.3 on 6/30/23 Not on home medication Continue to monitor   HTN Tachycardia CAD Chronic diastolic CHF Hx of CABG Hx of TAVR Last echo 8/4/23 showing EF 57%, mild LV hypertrophy, well-seated TAVR with minimal leaflet thickening Follows with Dr.  Home amlodpipine and metoprolol PO Prn metoprolol IV Lasix as above Continue aspirin, statin   Chronic kidney disease, stage III Baseline creat around 1.3-1.6 Avoid nephrotoxic agents as able Continue diuresis, monitor renal function   BPH Home proscar and flomax Foley placed d/t increased work of breathing with activity, including urinal use
Age: 83.0
Sex: M
Vaccine: COVID19
Symptoms: Pleural effusion, Pneumothorax, Polyuria, Prosthetic cardiac valve malfunction, Suture insertion
Clinical narrative: Patient is a 85 y.o. male patient of MD with history of empymea, hypothryroid, mood, BPH, HLD, HTN presented to Hospital with worsenign shortness of breath .   Acute on chronic respiratory failure with hypoxemia and hypercapnia Malignant neoplasm of unspecified part of unspecified bronchus or lung Recurrent pleural effusion COPD COVID-19 infection Follows with CCF oncology Baseline of 2 liters, currently on 2 L NC Chest xray with opacifcation of left hemi thorax Chest ct reviewed showing left hydropneumothorax with new areas of loculated gas within the pleural space Consulted IR, small bore chest tube placed 9/29 ID following -recommendations-continue Decadron for COVID-19.  Continue Zosyn for empyema.  Cultures negative. Pulmonary following-not a candidate for VATS per CCF CTS.  Continue IV lasix daily Chest tube removed 10/6 Discharge pending PT/OT evaluation and disposition-follow-up with CCF The patient is likely from the chest tube site.  Discussed with pulmonology and they put a suture and leakage has stopped. Discontinue steroids on discharge The patient is on chronic ciprofloxacin at home due to history of Pseudomonas infection.  Continue home Cipro   Dysphagia Pt reportedly having difficulty swallowing SLP consulted MBS on10/2 showed no evidence of laryngeal penetration or aspiration Continue current diet   Diabetes mellitus, type 2 Ha1c 6.3 on 6/30/23 Not on home medication Continue to monitor   HTN Tachycardia CAD Chronic diastolic CHF Hx of CABG Hx of TAVR Last echo 8/4/23 showing EF 57%, mild LV hypertrophy, well-seated TAVR with minimal leaflet thickening Follows with Dr.  Home amlodpipine and metoprolol PO Prn metoprolol IV Lasix as above Continue aspirin, statin   Chronic kidney disease, stage III Baseline creat around 1.3-1.6 Avoid nephrotoxic agents as able Continue diuresis, monitor renal function   BPH Home proscar and flomax Foley placed d/t increased work of breathing with activity, including urinal use
Age: 83.0
Sex: M
Vaccine: COVID19
Symptoms: Tachycardia
Clinical narrative: Patient is a 85 y.o. male patient of MD with history of empymea, hypothryroid, mood, BPH, HLD, HTN presented to Hospital with worsenign shortness of breath .   Acute on chronic respiratory failure with hypoxemia and hypercapnia Malignant neoplasm of unspecified part of unspecified bronchus or lung Recurrent pleural effusion COPD COVID-19 infection Follows with CCF oncology Baseline of 2 liters, currently on 2 L NC Chest xray with opacifcation of left hemi thorax Chest ct reviewed showing left hydropneumothorax with new areas of loculated gas within the pleural space Consulted IR, small bore chest tube placed 9/29 ID following -recommendations-continue Decadron for COVID-19.  Continue Zosyn for empyema.  Cultures negative. Pulmonary following-not a candidate for VATS per CCF CTS.  Continue IV lasix daily Chest tube removed 10/6 Discharge pending PT/OT evaluation and disposition-follow-up with CCF The patient is likely from the chest tube site.  Discussed with pulmonology and they put a suture and leakage has stopped. Discontinue steroids on discharge The patient is on chronic ciprofloxacin at home due to history of Pseudomonas infection.  Continue home Cipro   Dysphagia Pt reportedly having difficulty swallowing SLP consulted MBS on10/2 showed no evidence of laryngeal penetration or aspiration Continue current diet   Diabetes mellitus, type 2 Ha1c 6.3 on 6/30/23 Not on home medication Continue to monitor   HTN Tachycardia CAD Chronic diastolic CHF Hx of CABG Hx of TAVR Last echo 8/4/23 showing EF 57%, mild LV hypertrophy, well-seated TAVR with minimal leaflet thickening Follows with Dr.  Home amlodpipine and metoprolol PO Prn metoprolol IV Lasix as above Continue aspirin, statin   Chronic kidney disease, stage III Baseline creat around 1.3-1.6 Avoid nephrotoxic agents as able Continue diuresis, monitor renal function   BPH Home proscar and flomax Foley placed d/t increased work of breathing with activity, including urinal use
Age: 78.0
Sex: F
Vaccine: COVID19
Symptoms: Acute respiratory failure, Asthenia, Bronchiectasis, COVID-19, Chest X-ray abnormal
Clinical narrative: Acute on chronic hypoxemic respiratory failure with hypercapnia Chronic obstructive pulmonary disease Bronchiectasis, uncomplicated Obstructive sleep apnea Acute metabolic encephalopathy Presented with confusion in the context of SARS-CoV-2 infection, hypoxemia, and hypercapnia she is established with Dr. (outpatient pulmonary medicine) -Assessed this admission by pulmonary medicine 10/9/2023 with lower suspicion noted for SARS-CoV-2 related pneumonia -Recommendations include continuation of empiric antibiotics x7 days and dexamethasone x10 days -Continue with process to obtain home PAP therapy already initiated by her pulmonologist/sleep specialist   Non-insulin-dependent diabetes mellitus type 2 Outpatient regimen includes oral glipizide she required insulin coverage while hospitalized off glipizide -Resume home glipizide at discharge avoiding simple sugars and high carbohydrate meals   SARS-CoV-2 infection -Presented with: weakness and encephalopathy - Symptom onset: 10/5/2023 - Positive COVID-19: 10/7/23 at home - Vaccination status: Vaccinated with Moderna with last dose 2022 - CXR on admission showed patchy airspace disease similar to prior exams. - Oxygen status: 3 L (she is on home oxygen 2 L at night)  - Decadron: Yes. - Remdesir: E consult placed to ID on admission, pending - DVT prophylaxis: Currently on full anticoagulation - Serial COVID labs ordered: No - Case Management/Social Services consulted: Yes    Paroxysmal atrial fibrillation Continue carvedilol and apixaban   Rheumatoid arthritis Chronic therapy includes hydroxychloroquine 200 mg twice daily and prednisone 5 mg daily -Resume home hydroxychloroquine at discharge History of lower gastrointestinal bleeding (7/2023) Hospitalized 7/24/2023-8/11/2023 with acute bleeding secondary to colon polyps with further complication of post polypectomy bleeding -Remains stable with reinstatement of apixaban therapy following that admission   History of bilateral LE distal DVT  First lifetime episode identified during her July-August 2023 hospitalization related to immobility/prolonged hospital stay -Continue apixaban therapy   Hypothyroidism Continue levothyroxine
Age: 78.0
Sex: F
Vaccine: COVID19
Symptoms: Chronic obstructive pulmonary disease, Confusional state, Deep vein thrombosis, Hypercapnia, Hypoxia
Clinical narrative: Acute on chronic hypoxemic respiratory failure with hypercapnia Chronic obstructive pulmonary disease Bronchiectasis, uncomplicated Obstructive sleep apnea Acute metabolic encephalopathy Presented with confusion in the context of SARS-CoV-2 infection, hypoxemia, and hypercapnia she is established with Dr. (outpatient pulmonary medicine) -Assessed this admission by pulmonary medicine 10/9/2023 with lower suspicion noted for SARS-CoV-2 related pneumonia -Recommendations include continuation of empiric antibiotics x7 days and dexamethasone x10 days -Continue with process to obtain home PAP therapy already initiated by her pulmonologist/sleep specialist   Non-insulin-dependent diabetes mellitus type 2 Outpatient regimen includes oral glipizide she required insulin coverage while hospitalized off glipizide -Resume home glipizide at discharge avoiding simple sugars and high carbohydrate meals   SARS-CoV-2 infection -Presented with: weakness and encephalopathy - Symptom onset: 10/5/2023 - Positive COVID-19: 10/7/23 at home - Vaccination status: Vaccinated with Moderna with last dose 2022 - CXR on admission showed patchy airspace disease similar to prior exams. - Oxygen status: 3 L (she is on home oxygen 2 L at night)  - Decadron: Yes. - Remdesir: E consult placed to ID on admission, pending - DVT prophylaxis: Currently on full anticoagulation - Serial COVID labs ordered: No - Case Management/Social Services consulted: Yes    Paroxysmal atrial fibrillation Continue carvedilol and apixaban   Rheumatoid arthritis Chronic therapy includes hydroxychloroquine 200 mg twice daily and prednisone 5 mg daily -Resume home hydroxychloroquine at discharge History of lower gastrointestinal bleeding (7/2023) Hospitalized 7/24/2023-8/11/2023 with acute bleeding secondary to colon polyps with further complication of post polypectomy bleeding -Remains stable with reinstatement of apixaban therapy following that admission   History of bilateral LE distal DVT  First lifetime episode identified during her July-August 2023 hospitalization related to immobility/prolonged hospital stay -Continue apixaban therapy   Hypothyroidism Continue levothyroxine
Age: 78.0
Sex: F
Vaccine: COVID19
Symptoms: Immobile, Large intestine polyp, Lower gastrointestinal haemorrhage, Lung disorder, Metabolic encephalopathy
Clinical narrative: Acute on chronic hypoxemic respiratory failure with hypercapnia Chronic obstructive pulmonary disease Bronchiectasis, uncomplicated Obstructive sleep apnea Acute metabolic encephalopathy Presented with confusion in the context of SARS-CoV-2 infection, hypoxemia, and hypercapnia she is established with Dr. (outpatient pulmonary medicine) -Assessed this admission by pulmonary medicine 10/9/2023 with lower suspicion noted for SARS-CoV-2 related pneumonia -Recommendations include continuation of empiric antibiotics x7 days and dexamethasone x10 days -Continue with process to obtain home PAP therapy already initiated by her pulmonologist/sleep specialist   Non-insulin-dependent diabetes mellitus type 2 Outpatient regimen includes oral glipizide she required insulin coverage while hospitalized off glipizide -Resume home glipizide at discharge avoiding simple sugars and high carbohydrate meals   SARS-CoV-2 infection -Presented with: weakness and encephalopathy - Symptom onset: 10/5/2023 - Positive COVID-19: 10/7/23 at home - Vaccination status: Vaccinated with Moderna with last dose 2022 - CXR on admission showed patchy airspace disease similar to prior exams. - Oxygen status: 3 L (she is on home oxygen 2 L at night)  - Decadron: Yes. - Remdesir: E consult placed to ID on admission, pending - DVT prophylaxis: Currently on full anticoagulation - Serial COVID labs ordered: No - Case Management/Social Services consulted: Yes    Paroxysmal atrial fibrillation Continue carvedilol and apixaban   Rheumatoid arthritis Chronic therapy includes hydroxychloroquine 200 mg twice daily and prednisone 5 mg daily -Resume home hydroxychloroquine at discharge History of lower gastrointestinal bleeding (7/2023) Hospitalized 7/24/2023-8/11/2023 with acute bleeding secondary to colon polyps with further complication of post polypectomy bleeding -Remains stable with reinstatement of apixaban therapy following that admission   History of bilateral LE distal DVT  First lifetime episode identified during her July-August 2023 hospitalization related to immobility/prolonged hospital stay -Continue apixaban therapy   Hypothyroidism Continue levothyroxine
Age: 78.0
Sex: F
Vaccine: COVID19
Symptoms: Obstructive sleep apnoea syndrome, Polypectomy, Post procedural haemorrhage, Respiratory failure, SARS-CoV-2 test positive
Clinical narrative: Acute on chronic hypoxemic respiratory failure with hypercapnia Chronic obstructive pulmonary disease Bronchiectasis, uncomplicated Obstructive sleep apnea Acute metabolic encephalopathy Presented with confusion in the context of SARS-CoV-2 infection, hypoxemia, and hypercapnia she is established with Dr. (outpatient pulmonary medicine) -Assessed this admission by pulmonary medicine 10/9/2023 with lower suspicion noted for SARS-CoV-2 related pneumonia -Recommendations include continuation of empiric antibiotics x7 days and dexamethasone x10 days -Continue with process to obtain home PAP therapy already initiated by her pulmonologist/sleep specialist   Non-insulin-dependent diabetes mellitus type 2 Outpatient regimen includes oral glipizide she required insulin coverage while hospitalized off glipizide -Resume home glipizide at discharge avoiding simple sugars and high carbohydrate meals   SARS-CoV-2 infection -Presented with: weakness and encephalopathy - Symptom onset: 10/5/2023 - Positive COVID-19: 10/7/23 at home - Vaccination status: Vaccinated with Moderna with last dose 2022 - CXR on admission showed patchy airspace disease similar to prior exams. - Oxygen status: 3 L (she is on home oxygen 2 L at night)  - Decadron: Yes. - Remdesir: E consult placed to ID on admission, pending - DVT prophylaxis: Currently on full anticoagulation - Serial COVID labs ordered: No - Case Management/Social Services consulted: Yes    Paroxysmal atrial fibrillation Continue carvedilol and apixaban   Rheumatoid arthritis Chronic therapy includes hydroxychloroquine 200 mg twice daily and prednisone 5 mg daily -Resume home hydroxychloroquine at discharge History of lower gastrointestinal bleeding (7/2023) Hospitalized 7/24/2023-8/11/2023 with acute bleeding secondary to colon polyps with further complication of post polypectomy bleeding -Remains stable with reinstatement of apixaban therapy following that admission   History of bilateral LE distal DVT  First lifetime episode identified during her July-August 2023 hospitalization related to immobility/prolonged hospital stay -Continue apixaban therapy   Hypothyroidism Continue levothyroxine
Age: 73.0
Sex: F
Vaccine: RSV
Symptoms: Erythema, Pruritus
Clinical narrative: patient was fine for a few weeks but then a red spot and itching starting to occur after that.  no pain just itching some times.  Advised patient to draw around red spot and watch to see if it got bigger than the draw mark.  If it did, to contact prescriber to take a look at it.  Advised hydrocortistone for itching or a good lotion.
Age: 57.0
Sex: M
Vaccine: VARZOS
Symptoms: Differential white blood cell count abnormal, Immune thrombocytopenia, Increased tendency to bruise, Platelet count decreased
Clinical narrative: Pt had easy bruising, Pt was diagnosed with Acute ITP(D69.3), Pt was hospitalized from 6/23/23 to 6/25/23
Age: 0.33
Sex: F
Vaccine: DTAPIPV
Symptoms: Product administered to patient of inappropriate age, Wrong product administered
Clinical narrative: patient was given Kinrix vaccine instead of pediarix and a separate dose of Hib had to be given so child received 4 injections instead of 3.
Age: 86.0
Sex: M
Vaccine: UNK
Symptoms: Chest discomfort, Chest pain, Electrocardiogram, Laboratory test
Clinical narrative: Patient called clinic at 12:45 today on 12/21/2023. States he started to experience left sided chest pain, described as "near defibrillator", intermittently. Described quality of pain as "discomfort". States he took Tylenol 12/20/2023 and slept through the night. States on 12/21/2023 he started to experience these intermittent left sided chest pains again. Patient states he has not felt his defibrillator activate since experiencing theses pains. Advised patient to seek care at the ER since he is experiencing pain in his left chest area, concerning for cardiac origin. Per verbal account from patient on 12/22, he sought care at ER on 12/21/2023. He states he had two EKGs, x-ray, lab work a and sent home from the ER on 12/21/23. He states his pain his since resolved and denies being diagnosed with any type of acute cardiac event during ER visit.
Age: 85.0
Sex: F
Vaccine: COVID19
Symptoms: Acute respiratory failure, Angiogram pulmonary, Asthenia, C-reactive protein increased, COVID-19
Clinical narrative: Acute hypoxic respiratory failure - resolved  COVID-19 infection Generalized weakness  On room air Incentive spirometer Albuterol inhaler remdesivir  Lasix for dry lung strategy  Procal 0.10  D-dimer 2.10, CRP 60,  Ferritin 288  10/05/23 Start decadron x 10 days  CTA pulm prior to discharge     Hypertension Continue with her home carvedilol,  hold the lisinopril given that her blood pressures have been a little soft with out patient reassessment    Hyperlipidemia  continue with the statins
Age: 85.0
Sex: F
Vaccine: COVID19
Symptoms: Fibrin D dimer, Hyperlipidaemia, Hypertension, Procalcitonin, Serum ferritin increased
Clinical narrative: Acute hypoxic respiratory failure - resolved  COVID-19 infection Generalized weakness  On room air Incentive spirometer Albuterol inhaler remdesivir  Lasix for dry lung strategy  Procal 0.10  D-dimer 2.10, CRP 60,  Ferritin 288  10/05/23 Start decadron x 10 days  CTA pulm prior to discharge     Hypertension Continue with her home carvedilol,  hold the lisinopril given that her blood pressures have been a little soft with out patient reassessment    Hyperlipidemia  continue with the statins
Age: 3.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Patient was administered expired vaccine; expiration date sticker 12/18/2023, given 12/18/2023
Age: 0.08
Sex: M
Vaccine: DTPPVHBHPB, PNC20, RV5
Symptoms: Electrocardiogram, Hypotonia, Pallor
Clinical narrative: Baby went pale and limp twice, 10 minutes apart, starting at 5pm and was brought to ED by parents.
Age: 73.0
Sex: F
Vaccine: COVID19
Symptoms: Asthenia, COVID-19, Dehydration, Dizziness, Fall
Clinical narrative: Pt presents with illness syndrome. Reports weakness, fatigue, difficulty with ambulation that has been progressively worsening. States she's had a fever as high as 102 at home. Boyfriend at home sick with similar symptoms as well. Today, pt states she was walking from her bathroom to her kitchen when she passed out. She does not recall what happened, only reports waking up on the floor several minutes later. Does remember feeling somewhat dizzy prior to this episode. Fall was not witnessed but her boyfriend was there shortly afterwards and states she regained consciousness within less than a minute. Pt currently denies focal neurologic deficits or other symptoms.      Clinical Summary Patient was admitted to MedSurg unit for further evaluation of syncope.  She received IV fluid bolus and her lightheadedness completely resolved.  Orthostatics were checked and were negative however this was after patient received IV fluids.  Patient was seen by cardiology, felt to have near syncopal episode in the setting of COVID-19/dehydration, no further work-up was recommended.  On 10/11 patient was feeling significantly improved compared to admission.  She was able to ambulate without orthostatic symptoms.  She has no shortness of breath, cough, body aches or any other symptoms of COVID at the time of discharge.  She is discharged home in stable condition.  She is instructed to call her primary care physician within the next 1 week for a follow-up appointment.   Discharge diagnosis Syncope - suspect orthostasis, asymptomatic on DC after IVF COVID 19 - no hypoxia, symptoms nearly resolved on DC  Clinical dehydration - resolved Hyperlipidemia History of ILD History of depression
Age: 73.0
Sex: F
Vaccine: COVID19
Symptoms: Fatigue, Gait disturbance, Hyperlipidaemia, Loss of consciousness, Presyncope
Clinical narrative: Pt presents with illness syndrome. Reports weakness, fatigue, difficulty with ambulation that has been progressively worsening. States she's had a fever as high as 102 at home. Boyfriend at home sick with similar symptoms as well. Today, pt states she was walking from her bathroom to her kitchen when she passed out. She does not recall what happened, only reports waking up on the floor several minutes later. Does remember feeling somewhat dizzy prior to this episode. Fall was not witnessed but her boyfriend was there shortly afterwards and states she regained consciousness within less than a minute. Pt currently denies focal neurologic deficits or other symptoms.      Clinical Summary Patient was admitted to MedSurg unit for further evaluation of syncope.  She received IV fluid bolus and her lightheadedness completely resolved.  Orthostatics were checked and were negative however this was after patient received IV fluids.  Patient was seen by cardiology, felt to have near syncopal episode in the setting of COVID-19/dehydration, no further work-up was recommended.  On 10/11 patient was feeling significantly improved compared to admission.  She was able to ambulate without orthostatic symptoms.  She has no shortness of breath, cough, body aches or any other symptoms of COVID at the time of discharge.  She is discharged home in stable condition.  She is instructed to call her primary care physician within the next 1 week for a follow-up appointment.   Discharge diagnosis Syncope - suspect orthostasis, asymptomatic on DC after IVF COVID 19 - no hypoxia, symptoms nearly resolved on DC  Clinical dehydration - resolved Hyperlipidemia History of ILD History of depression
Age: 73.0
Sex: F
Vaccine: COVID19
Symptoms: Pyrexia, Syncope
Clinical narrative: Pt presents with illness syndrome. Reports weakness, fatigue, difficulty with ambulation that has been progressively worsening. States she's had a fever as high as 102 at home. Boyfriend at home sick with similar symptoms as well. Today, pt states she was walking from her bathroom to her kitchen when she passed out. She does not recall what happened, only reports waking up on the floor several minutes later. Does remember feeling somewhat dizzy prior to this episode. Fall was not witnessed but her boyfriend was there shortly afterwards and states she regained consciousness within less than a minute. Pt currently denies focal neurologic deficits or other symptoms.      Clinical Summary Patient was admitted to MedSurg unit for further evaluation of syncope.  She received IV fluid bolus and her lightheadedness completely resolved.  Orthostatics were checked and were negative however this was after patient received IV fluids.  Patient was seen by cardiology, felt to have near syncopal episode in the setting of COVID-19/dehydration, no further work-up was recommended.  On 10/11 patient was feeling significantly improved compared to admission.  She was able to ambulate without orthostatic symptoms.  She has no shortness of breath, cough, body aches or any other symptoms of COVID at the time of discharge.  She is discharged home in stable condition.  She is instructed to call her primary care physician within the next 1 week for a follow-up appointment.   Discharge diagnosis Syncope - suspect orthostasis, asymptomatic on DC after IVF COVID 19 - no hypoxia, symptoms nearly resolved on DC  Clinical dehydration - resolved Hyperlipidemia History of ILD History of depression
Age: 12.0
Sex: M
Vaccine: COVID19
Symptoms: Alanine aminotransferase increased, Anti-thyroid antibody, Antinuclear antibody negative, Aspartate aminotransferase increased, Blood creatine phosphokinase increased
Clinical narrative: Rhabdomyolysis, with CK 75,000. Was discharged from the hospital after hydration and symptomatic care but continues to have muscle pain and slightly elevated muscle enzymes a couple years later. Neuromuscular workup was negative.
Age: 12.0
Sex: M
Vaccine: COVID19
Symptoms: Blood lactic acid, Blood thyroid stimulating hormone decreased, Borrelia test negative, C-reactive protein, Chest X-ray normal
Clinical narrative: Rhabdomyolysis, with CK 75,000. Was discharged from the hospital after hydration and symptomatic care but continues to have muscle pain and slightly elevated muscle enzymes a couple years later. Neuromuscular workup was negative.
Age: 12.0
Sex: M
Vaccine: COVID19
Symptoms: Epstein-Barr virus test negative, Fibrin D dimer normal, Mononucleosis heterophile test negative, Muscle enzyme increased, Myalgia
Clinical narrative: Rhabdomyolysis, with CK 75,000. Was discharged from the hospital after hydration and symptomatic care but continues to have muscle pain and slightly elevated muscle enzymes a couple years later. Neuromuscular workup was negative.
Age: 12.0
Sex: M
Vaccine: COVID19
Symptoms: Myoglobin urine absent, Neurological examination normal, Protein urine present, Red blood cell sedimentation rate normal, Rhabdomyolysis
Clinical narrative: Rhabdomyolysis, with CK 75,000. Was discharged from the hospital after hydration and symptomatic care but continues to have muscle pain and slightly elevated muscle enzymes a couple years later. Neuromuscular workup was negative.
Age: 12.0
Sex: M
Vaccine: COVID19
Symptoms: SARS-CoV-2 test negative, Thyroxine free normal, Treponema test negative, Tri-iodothyronine free, Troponin T normal
Clinical narrative: Rhabdomyolysis, with CK 75,000. Was discharged from the hospital after hydration and symptomatic care but continues to have muscle pain and slightly elevated muscle enzymes a couple years later. Neuromuscular workup was negative.
Age: 12.0
Sex: M
Vaccine: COVID19
Symptoms: Troponin normal, Urine ketone body present, Vitamin D
Clinical narrative: Rhabdomyolysis, with CK 75,000. Was discharged from the hospital after hydration and symptomatic care but continues to have muscle pain and slightly elevated muscle enzymes a couple years later. Neuromuscular workup was negative.
Age: 2.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Patient was administered expired vaccine; expiration date sticker 12/18/2023, given 12/18/2023
Age: 62.0
Sex: F
Vaccine: COVID19
Symptoms: Acute respiratory failure, Aspiration pleural cavity, Atrial fibrillation, Atrial flutter, Blood bicarbonate decreased
Clinical narrative: Patient is a 64 y.o. female with a PMHx of NASH cirrhosis, asthma, recently diagnosed ampulla of vater adenocarcinoma, hx of renal cell carcinoma s/p partial right nephrectomy presented to DH with complaints of trouble breathing, ongoing for the past few weeks and had been progressive, with increased oxygen requirements. Patient hypoxemic on arrival, fond to have COVID pneumonia and bilateral pleural and transferred to ICU on BiPAP for closer monitoring of respiratory status. Thoracentesis was performed on 10/10 after increasing FiO2 requirements on bipap. Respiratory status continued to decline and patient was intubated and placed on mechanical ventilation 10/11. Increasing vasopressor requirements on 10/11 secondary to medical conditions and new aflutter with RVR, cardioverted to normal sinus rhythm. Pressors continued to increase later that evening and went back into a-fib with RVR, this time is was not amendable to cardioversion overnight. Patient continued to decline despite aggressive medical intervention. Patients husband was updated on her overall prognosis and after multiple conversations, patients husband made the decision to make her comfort care. Patient was compassionately extubated and passed at 2:26 pm, husband at bedside.    Discharge Diagnoses:   Acute hypoxic respiratory failure COVID + pneumonia Septic Shock Lactic Acidosis, worsening Low bicarb, worsening A-fib Elevated troponins NASH cirrhosis Recently diagnosed Ampulla of Vater adenocarcinoma Hx of Renal Cell Carcinoma