chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 59.0
Sex: F
Vaccine: COVID19-2
Symptoms: Superinfection, Tachycardia, Tobacco user, Vomiting
Clinical narrative: Admit date: 12/6/2023  Discharge date: 12/11/2023  Admitting Physician: DO   Attending Physician at the Time of Discharge: DO  Primary Care Physician: MD Reason for Admission: High anion gap metabolic acidosis secondary to Alcoholic ketoacidosis and starvation lactic acidosis, complicated by sepsis 2/2 COVID infection with superimposed bacterial CAP  Brief Summary of Hospital Stay:Per H&P Patient is a 60 YO female with a PMHx of alcohol abuse, alcoholic pancreatitis, anxiety, depression, COPD, GERD, HTN, Hypothyroidism, and IBS  who presents with chest pain that started 2 days ago.  She reported the pain is mid-sternal, constant pressure, rated a 7/10, exacerbated with talking and taking deep breaths; she has taken her home tramadol at home and nothing has helped. She states two days prior to admission she noticed she had a sore throat, raspy voice, dry cough, and fever up to 101.2, so initially she thought the pain was associated to her cold.  The chest pain has not improved, so she became worried and called EMS. She reports treating her cold with "hot toddys" and tylenol.  She also endorses nausea x 2 days and did not eat or drink anything yesterday due to the nausea  except 1 pint of brandy. She also reports a mild generalized abdominal pain she reports she noticed today after vomiting up "phlegm" three times in the ED and that it just feels like "muscular pain from vomiting." She endorses use of 0.5ppd of cigarettes and has a history of alcohol abuse; she usually drinks 1 pint of brandy daily with last drink being yesterday around 1 pm. She reports no seizure or DT history.   In the ED, she has been afebrile, tachycardic, and hemodynamically stable. Initial labs show hypoglycemia of 22, lactate 9.4, anion gap of 34, CO@ of 4 and alcohol level 0.210. She was treated with prednisone 40mg po x 1 dose, magnesium sulfate 2g IV x 1 dose, fentanyl 50mcg x 1 dose, LR 2L IVF, morphine 4mg IV x 1 dose, ativan 1mg IV x  dose, and Zofran 4mg IV x 1 dose. Hospitalist team admitting for high anion gap metabolic acidosis secondary to alcoholic ketoacidosis and lactic acidosis.   Hospital Course: She was admitted for HAGMA likely in setting of alcoholic ketoacidosis vs starvation ketoacidosis in setting of COVID Infection.  She was placed on electrolyte supplementation, as well as antibiotics for superimposed bacterial CAP. She improved significantly.   Upon exam this morning, patient feeling overall better. Cough persists but is improved. Chest pain resolved.  Patient was medically optimized. Vital signs were stable for discharge.  Discharged to home.
Age: 57.0
Sex: M
Vaccine: VARZOS
Symptoms: Product storage error
Clinical narrative: Vaccine frozen instead of refrigerated
Age: 61.0
Sex: M
Vaccine: COVID19-2
Symptoms: Atelectasis, Blood loss anaemia, Chest X-ray abnormal, Faeces discoloured, Gastric ulcer
Clinical narrative: Admit date: 12/5/2023  Discharge date: 12/11/2023  Admitting Physician: MD   Attending Physician at the Time of Discharge: DO  Primary Care Physician: MD Reason for Admission: Acute blood loss anemia likely secondary to GIB, likely in setting of anticoagulant   Brief Summary of Hospital Stay:As per H&P:62 y/o male with extensive PMH including but not limited to ETOH abuse (notes that he quit drinking over a year ago) reported dark tarry stools which have been " off and on" for the past couple of months.  Patient noted that the night of 12/4/23  he had "several very dark stools"  Presented to ED for evaluation the night of 12/5/23.    Chest AP notes moderate right pleural effusion with right basilar atelectasis.    Hospital Course: Patient accepted to the ICU/ PCU team. Patient received 6 U PRBC. EGD by General surgery on 12/8/23: Diffuse moderate gastritis. A 7 mm ulcer in the pyloric channel (non-bleeding). Normal duodenum (bulb, 2nd and 3rd portion).    Patient remained hemodynamically stable. The morning of discharge he stated he was feeling "great!" Patient was medically optimized. Vital signs were stable for discharge.  Discharged to home.
Age: 61.0
Sex: M
Vaccine: COVID19-2
Symptoms: Gastritis, Gastrointestinal haemorrhage, Intensive care, Melaena, Oesophagogastroduodenoscopy abnormal
Clinical narrative: Admit date: 12/5/2023  Discharge date: 12/11/2023  Admitting Physician: MD   Attending Physician at the Time of Discharge: DO  Primary Care Physician: MD Reason for Admission: Acute blood loss anemia likely secondary to GIB, likely in setting of anticoagulant   Brief Summary of Hospital Stay:As per H&P:62 y/o male with extensive PMH including but not limited to ETOH abuse (notes that he quit drinking over a year ago) reported dark tarry stools which have been " off and on" for the past couple of months.  Patient noted that the night of 12/4/23  he had "several very dark stools"  Presented to ED for evaluation the night of 12/5/23.    Chest AP notes moderate right pleural effusion with right basilar atelectasis.    Hospital Course: Patient accepted to the ICU/ PCU team. Patient received 6 U PRBC. EGD by General surgery on 12/8/23: Diffuse moderate gastritis. A 7 mm ulcer in the pyloric channel (non-bleeding). Normal duodenum (bulb, 2nd and 3rd portion).    Patient remained hemodynamically stable. The morning of discharge he stated he was feeling "great!" Patient was medically optimized. Vital signs were stable for discharge.  Discharged to home.
Age: 61.0
Sex: M
Vaccine: COVID19-2
Symptoms: Pleural effusion
Clinical narrative: Admit date: 12/5/2023  Discharge date: 12/11/2023  Admitting Physician: MD   Attending Physician at the Time of Discharge: DO  Primary Care Physician: MD Reason for Admission: Acute blood loss anemia likely secondary to GIB, likely in setting of anticoagulant   Brief Summary of Hospital Stay:As per H&P:62 y/o male with extensive PMH including but not limited to ETOH abuse (notes that he quit drinking over a year ago) reported dark tarry stools which have been " off and on" for the past couple of months.  Patient noted that the night of 12/4/23  he had "several very dark stools"  Presented to ED for evaluation the night of 12/5/23.    Chest AP notes moderate right pleural effusion with right basilar atelectasis.    Hospital Course: Patient accepted to the ICU/ PCU team. Patient received 6 U PRBC. EGD by General surgery on 12/8/23: Diffuse moderate gastritis. A 7 mm ulcer in the pyloric channel (non-bleeding). Normal duodenum (bulb, 2nd and 3rd portion).    Patient remained hemodynamically stable. The morning of discharge he stated he was feeling "great!" Patient was medically optimized. Vital signs were stable for discharge.  Discharged to home.
Age: 18.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal pain, Anion gap increased, Asymptomatic bacteriuria, Blood potassium decreased, COVID-19
Clinical narrative: Admit date: 12/10/2023  Discharge date: 12/12/2023   Admitting Physician: MD   Attending Physician at the Time of Discharge: DO  Primary Care Physician: FNP Reason for Admission: Starvation ketosis, intractable nausea and vomiting  Hospital Course: 20 year old G1P0 female at 14 weeks gestational age with a history of Type 1 diabetes mellitis presented to ED with complaints of intractable abdominal pain and nausea and vomiting.   Patient was admitted for treatment of starvation ketosis with elevated anion gap. She was managed with an insulin drip and fluids until nausea and vomiting resolved and until patient was able to tolerate oral intake. Nausea was treated originally with Zofran, compazine with no effect, but was later treated successfully with droperidol with resolution of symptoms. Nausea and vomiting suspected to be multifactorial secondary to pregnancy as well as marijuana hyperemesis syndrome.  Patient was then able to tolerate  normal diet and was converted to home insulin regimen prior to discharge, although due to recurrent hypoglycemia her home insulin glargine dose is being decreased to 8 units twice daily. She was monitored during the rest of the hospital course  without recurrence of symptoms. Patient was also started on antibiotics for asymptomatic bacteriuria however this was discontinued as urine culture grew normal flora. Additionally, patient tested positive for Covid, however did complain of any symptoms and was monitored in isolation during hospital course.   Of note, patient's potassium level was noted to be 2.9 earlier in the day of discharge. Replacement was started prior to discharge; she is being discharged with the instructions to continue potassium supplementation 40 mEq daily for the next two days. Instructed patient to have a repeat BMP obtained at PCP's office in 4-5 days to follow up on potassium level. Patient expressed understanding and is agreeable.  Discharged to home.
Age: 18.0
Sex: F
Vaccine: COVID19
Symptoms: Cannabinoid hyperemesis syndrome, Culture urine negative, Hypoglycaemia, Hypophagia, Insulin therapy
Clinical narrative: Admit date: 12/10/2023  Discharge date: 12/12/2023   Admitting Physician: MD   Attending Physician at the Time of Discharge: DO  Primary Care Physician: FNP Reason for Admission: Starvation ketosis, intractable nausea and vomiting  Hospital Course: 20 year old G1P0 female at 14 weeks gestational age with a history of Type 1 diabetes mellitis presented to ED with complaints of intractable abdominal pain and nausea and vomiting.   Patient was admitted for treatment of starvation ketosis with elevated anion gap. She was managed with an insulin drip and fluids until nausea and vomiting resolved and until patient was able to tolerate oral intake. Nausea was treated originally with Zofran, compazine with no effect, but was later treated successfully with droperidol with resolution of symptoms. Nausea and vomiting suspected to be multifactorial secondary to pregnancy as well as marijuana hyperemesis syndrome.  Patient was then able to tolerate  normal diet and was converted to home insulin regimen prior to discharge, although due to recurrent hypoglycemia her home insulin glargine dose is being decreased to 8 units twice daily. She was monitored during the rest of the hospital course  without recurrence of symptoms. Patient was also started on antibiotics for asymptomatic bacteriuria however this was discontinued as urine culture grew normal flora. Additionally, patient tested positive for Covid, however did complain of any symptoms and was monitored in isolation during hospital course.   Of note, patient's potassium level was noted to be 2.9 earlier in the day of discharge. Replacement was started prior to discharge; she is being discharged with the instructions to continue potassium supplementation 40 mEq daily for the next two days. Instructed patient to have a repeat BMP obtained at PCP's office in 4-5 days to follow up on potassium level. Patient expressed understanding and is agreeable.  Discharged to home.
Age: 18.0
Sex: F
Vaccine: COVID19
Symptoms: Ketosis, Maternal exposure before pregnancy, Nausea, SARS-CoV-2 test positive, Starvation
Clinical narrative: Admit date: 12/10/2023  Discharge date: 12/12/2023   Admitting Physician: MD   Attending Physician at the Time of Discharge: DO  Primary Care Physician: FNP Reason for Admission: Starvation ketosis, intractable nausea and vomiting  Hospital Course: 20 year old G1P0 female at 14 weeks gestational age with a history of Type 1 diabetes mellitis presented to ED with complaints of intractable abdominal pain and nausea and vomiting.   Patient was admitted for treatment of starvation ketosis with elevated anion gap. She was managed with an insulin drip and fluids until nausea and vomiting resolved and until patient was able to tolerate oral intake. Nausea was treated originally with Zofran, compazine with no effect, but was later treated successfully with droperidol with resolution of symptoms. Nausea and vomiting suspected to be multifactorial secondary to pregnancy as well as marijuana hyperemesis syndrome.  Patient was then able to tolerate  normal diet and was converted to home insulin regimen prior to discharge, although due to recurrent hypoglycemia her home insulin glargine dose is being decreased to 8 units twice daily. She was monitored during the rest of the hospital course  without recurrence of symptoms. Patient was also started on antibiotics for asymptomatic bacteriuria however this was discontinued as urine culture grew normal flora. Additionally, patient tested positive for Covid, however did complain of any symptoms and was monitored in isolation during hospital course.   Of note, patient's potassium level was noted to be 2.9 earlier in the day of discharge. Replacement was started prior to discharge; she is being discharged with the instructions to continue potassium supplementation 40 mEq daily for the next two days. Instructed patient to have a repeat BMP obtained at PCP's office in 4-5 days to follow up on potassium level. Patient expressed understanding and is agreeable.  Discharged to home.
Age: 18.0
Sex: F
Vaccine: COVID19
Symptoms: Vomiting
Clinical narrative: Admit date: 12/10/2023  Discharge date: 12/12/2023   Admitting Physician: MD   Attending Physician at the Time of Discharge: DO  Primary Care Physician: FNP Reason for Admission: Starvation ketosis, intractable nausea and vomiting  Hospital Course: 20 year old G1P0 female at 14 weeks gestational age with a history of Type 1 diabetes mellitis presented to ED with complaints of intractable abdominal pain and nausea and vomiting.   Patient was admitted for treatment of starvation ketosis with elevated anion gap. She was managed with an insulin drip and fluids until nausea and vomiting resolved and until patient was able to tolerate oral intake. Nausea was treated originally with Zofran, compazine with no effect, but was later treated successfully with droperidol with resolution of symptoms. Nausea and vomiting suspected to be multifactorial secondary to pregnancy as well as marijuana hyperemesis syndrome.  Patient was then able to tolerate  normal diet and was converted to home insulin regimen prior to discharge, although due to recurrent hypoglycemia her home insulin glargine dose is being decreased to 8 units twice daily. She was monitored during the rest of the hospital course  without recurrence of symptoms. Patient was also started on antibiotics for asymptomatic bacteriuria however this was discontinued as urine culture grew normal flora. Additionally, patient tested positive for Covid, however did complain of any symptoms and was monitored in isolation during hospital course.   Of note, patient's potassium level was noted to be 2.9 earlier in the day of discharge. Replacement was started prior to discharge; she is being discharged with the instructions to continue potassium supplementation 40 mEq daily for the next two days. Instructed patient to have a repeat BMP obtained at PCP's office in 4-5 days to follow up on potassium level. Patient expressed understanding and is agreeable.  Discharged to home.
Age: 52.0
Sex: F
Vaccine: VARZOS
Symptoms: Product storage error
Clinical narrative: VACCINES FROZEN INSTEAD OF REFRIGERATED
Age: 62.0
Sex: F
Vaccine: COVID19-2
Symptoms: Urticaria
Clinical narrative: Patient reports breaking out from hives from Comirnaty vaccination. Called MD and got on antihistamines
Age: 4.0
Sex: M
Vaccine: DTAPIPV, FLU4, HEPA, MMRV
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth
Clinical narrative: Reported by father that child came home from school on 12/13/23 with right arm swelling (3 golf balls in size) and redness at the deltoid muscle site of injection. Right arm was hot to the touch. Left arm deltoid was red at site of injection. Child was taken to the emergency room for evaluation. Emergency room provided evaluation and then sent home. Child was then taken to the Urgent Care, where patient was evaluated and father told that system was "overstimulated." Patient was provided prescription for antibiotics and steroids.
Age: 51.0
Sex: M
Vaccine: VARZOS
Symptoms: Product storage error
Clinical narrative: Vaccine was frozen instead of refrigerated.
Age: 64.0
Sex: F
Vaccine: VARZOS, VARZOS
Symptoms: Product storage error
Clinical narrative: VACCINE FROZEN INSTEAD OF REFRIGERATED
Age: 32.0
Sex: F
Vaccine: RSV
Symptoms: Cervical dilatation, Exposure during pregnancy, False labour, Premature labour
Clinical narrative: Patient received vaccine evening of 12/11. Patient was 35 months 1 day pregnant  at time of injection. Patient contractions began increasing in frequency and intensity that evening causing patient to go to hospital triage. Event was determined as false labor with no cervical progression and patient sent home 12/12 at 7am. Patient returned to hospital  (35 and 4) at 5pm after cervix ripened to 4 cm.  Patient was admitted to hospital.
Age: 30.0
Sex: F
Vaccine: COVID19-2
Symptoms: Pain, Pruritus, Pyrexia, Skin warm, Swelling
Clinical narrative: Large hives and swelling appeared about a day and a half after injection. Pain in the area as well as extreme heat and itching. My two main covid shots and first booster where Pfizer and other then standard light fever and slight aches I?ve never had this much pain and swelling.
Age: 30.0
Sex: F
Vaccine: COVID19-2
Symptoms: Urticaria
Clinical narrative: Large hives and swelling appeared about a day and a half after injection. Pain in the area as well as extreme heat and itching. My two main covid shots and first booster where Pfizer and other then standard light fever and slight aches I?ve never had this much pain and swelling.
Age: 29.0
Sex: F
Vaccine: UNK
Symptoms: Arthralgia, Contusion, Immediate post-injection reaction, Immunisation reaction, Impaired work ability
Clinical narrative: On Monday 12/04/23 I received my flu shot from the Employee Health Nurse for work. I immediately started bruising. I was still in pain 12/14/23, 10 days later. I notified my supervisor that I was still having pain & bruising in my left arm/shoulder & that I made myself a Dr Appt to be seen. On 12/14/23 around 11:30AM I was seen at the Health Center by Dr., since it happened for employee health. The doctor, stated that it was deeply bruised and to apply heat packs to help dissolve the bruise & to take ibuprofen for the pain. I then went to my appointment that afternoon and seen my doctor. His diagnosis for me was ?adverse reaction to vaccine?. I was referred to Physical therapy, put on a 2 week lifting restriction under 10lbs until 12/25/23 with a excuse note for work which I gave to my supervisor & given medication for the nerve pain at bedtime.
Age: 29.0
Sex: F
Vaccine: UNK
Symptoms: Neuralgia, Pain in extremity
Clinical narrative: On Monday 12/04/23 I received my flu shot from the Employee Health Nurse for work. I immediately started bruising. I was still in pain 12/14/23, 10 days later. I notified my supervisor that I was still having pain & bruising in my left arm/shoulder & that I made myself a Dr Appt to be seen. On 12/14/23 around 11:30AM I was seen at the Health Center by Dr., since it happened for employee health. The doctor, stated that it was deeply bruised and to apply heat packs to help dissolve the bruise & to take ibuprofen for the pain. I then went to my appointment that afternoon and seen my doctor. His diagnosis for me was ?adverse reaction to vaccine?. I was referred to Physical therapy, put on a 2 week lifting restriction under 10lbs until 12/25/23 with a excuse note for work which I gave to my supervisor & given medication for the nerve pain at bedtime.
Age: 65.0
Sex: F
Vaccine: FLU4
Symptoms: Arthralgia, Injection site pain, Injection site warmth, Mobility decreased, Pain
Clinical narrative: Arm and site tender and warm x 2 to 3 days then improved.  then arm became painful, with movement towards elbow.  then are became painful with movement towards shoulder and into shoulder.  Spoke with primary care's Nurse and she advised her to contact the local Health Department.  I spoke with her 12/15/23 and she indicated at that time that arm remains painful with movement and she has decreased movement in shoulder.  She was advised to see Primary Care as soon and can get appointment.
Age: 65.0
Sex: F
Vaccine: FLU4
Symptoms: Pain in extremity
Clinical narrative: Arm and site tender and warm x 2 to 3 days then improved.  then arm became painful, with movement towards elbow.  then are became painful with movement towards shoulder and into shoulder.  Spoke with primary care's Nurse and she advised her to contact the local Health Department.  I spoke with her 12/15/23 and she indicated at that time that arm remains painful with movement and she has decreased movement in shoulder.  She was advised to see Primary Care as soon and can get appointment.
Age: 85.0
Sex: M
Vaccine: COVID19
Symptoms: Agonal respiration, Bradycardia, COVID-19 pneumonia, Cardiac pacemaker insertion, Cerebrovascular accident
Clinical narrative: Admit date: 12/5/2023  Discharge date: 12/12/2023  Admitting Physician: MD   Discharge Physician: No att. providers found  Reason for Admission:  Patient is an 87-year-old male with history of COPD, HFpEF, hypertension, prostate cancer s/p prostatectomy 2008 who presented to the emergency department via EMS for altered mental status. He has had recent strokes and was in a rehab facility recently.  Hospital Course: No notes on file  Admitted to CCU for septic shock from COVID -19 Pneumonia and possible repeated aspirations. Stabilized while there and was transferred to PCU for further care. Patient was DNR/DNI status. He developed several episodes of bradycardia. He needed PRN doses of atropine several times. He developed severe bradycardia once again, this time associated with sinus pauses. He became hypoxic, unresponsive and with agonal breathing. Rapid response was called overhead and CCU. Floor, and cardiology teams came. Resuscitative efforts were done, but he continued to do poorly. Cardiology was consulted for emergent temporary pacemaker placement given recurrent/persistent bradycardia.  Given progressive agonal respirations and hypoxia, treatment of the bradycardia was probably not going to be successful and since patient was a DNI, family ultimately decided to discontinue resuscitative effort Resuscitative measures were withdrawn and patient passed away. No interventions were performed according to the family's wishes.
Age: 85.0
Sex: M
Vaccine: COVID19
Symptoms: Death, General physical health deterioration, Hypoxia, Intensive care, Mental status changes
Clinical narrative: Admit date: 12/5/2023  Discharge date: 12/12/2023  Admitting Physician: MD   Discharge Physician: No att. providers found  Reason for Admission:  Patient is an 87-year-old male with history of COPD, HFpEF, hypertension, prostate cancer s/p prostatectomy 2008 who presented to the emergency department via EMS for altered mental status. He has had recent strokes and was in a rehab facility recently.  Hospital Course: No notes on file  Admitted to CCU for septic shock from COVID -19 Pneumonia and possible repeated aspirations. Stabilized while there and was transferred to PCU for further care. Patient was DNR/DNI status. He developed several episodes of bradycardia. He needed PRN doses of atropine several times. He developed severe bradycardia once again, this time associated with sinus pauses. He became hypoxic, unresponsive and with agonal breathing. Rapid response was called overhead and CCU. Floor, and cardiology teams came. Resuscitative efforts were done, but he continued to do poorly. Cardiology was consulted for emergent temporary pacemaker placement given recurrent/persistent bradycardia.  Given progressive agonal respirations and hypoxia, treatment of the bradycardia was probably not going to be successful and since patient was a DNI, family ultimately decided to discontinue resuscitative effort Resuscitative measures were withdrawn and patient passed away. No interventions were performed according to the family's wishes.
Age: 85.0
Sex: M
Vaccine: COVID19
Symptoms: Resuscitation, Septic shock, Sinus arrest, Unresponsive to stimuli
Clinical narrative: Admit date: 12/5/2023  Discharge date: 12/12/2023  Admitting Physician: MD   Discharge Physician: No att. providers found  Reason for Admission:  Patient is an 87-year-old male with history of COPD, HFpEF, hypertension, prostate cancer s/p prostatectomy 2008 who presented to the emergency department via EMS for altered mental status. He has had recent strokes and was in a rehab facility recently.  Hospital Course: No notes on file  Admitted to CCU for septic shock from COVID -19 Pneumonia and possible repeated aspirations. Stabilized while there and was transferred to PCU for further care. Patient was DNR/DNI status. He developed several episodes of bradycardia. He needed PRN doses of atropine several times. He developed severe bradycardia once again, this time associated with sinus pauses. He became hypoxic, unresponsive and with agonal breathing. Rapid response was called overhead and CCU. Floor, and cardiology teams came. Resuscitative efforts were done, but he continued to do poorly. Cardiology was consulted for emergent temporary pacemaker placement given recurrent/persistent bradycardia.  Given progressive agonal respirations and hypoxia, treatment of the bradycardia was probably not going to be successful and since patient was a DNI, family ultimately decided to discontinue resuscitative effort Resuscitative measures were withdrawn and patient passed away. No interventions were performed according to the family's wishes.
Age: 70.0
Sex: M
Vaccine: VARZOS
Symptoms: Product storage error
Clinical narrative: Vaccine was frozen instead of refrigerated.
Age: 77.0
Sex: M
Vaccine: COVID19-2
Symptoms: Acute kidney injury, Anion gap, Bladder catheterisation, Blood triglycerides normal, COVID-19
Clinical narrative: Admit date: 12/10/2023  Discharge date:  12/14/2023  Admitting Physician: DO   Attending Physician at the Time of Discharge: MD  Primary Care Physician: MD Reason for Admission: Altered mental status 78yoM hx type1 DM, CVA, and HTN who presented via EMS from home for "unresponsive". I was unable to reach wife, who he lives with, nor his daughter.   Brief Summary of Hospital Stay: (Include Significant Findings and Invasive Procedures)  Course characterized by DKA, seizure-like activity, evidence of acute pancreatitis, type 2 MI, PCU stay  Improving, DKA resolved, AKI improved, acute pancreatitis is improved, neurology consultation, patient transferred to general floor  EEG, no epileptiform activity, neurology was consulted -no indication for AED at this stage DKA-78-year-old man with type 1 diabetes mellitus, was treated in PCU setting, would DKA protocol, no obvious precipitating infectious etiology, other than COVID-19 positive 12/12 anion gap closed, patient recovered from DKA  COVID positive- no respiratory concern for steroids or antiviral   Elevated procalcitonin-normal chest x-ray  Seizure-like activity Was observed in ER on presentation, loaded with Keppra, CT of the head is negative, MRI of the brain shows left frontal encephalomalacia, could be serving as the substrate for seizure  EEG, no epileptiform activity from 12/12 tele neurology consultation and follow-up is appreciated  Acute metabolic encephalopathy Improving., continues to improve  Acute pancreatitis Elevated lipase, CT of the abdomen shows pancreatic edema, consistent with acute pancreatitis, CT of the abdomen showed no gallstones, normal CBD, check triglycerides within normal limit, Diet being advanced  Elevated liver enzyme, 12/13 will be trended -nonoliguric AKI-improving, holding nephrotoxins  12/12 AKI resolved   Acute retention of urine- Patient had acute retention of urine just before being discharged, Flomax has been started and Foley catheter inserted, needs follow-up with Urology Discharged to Home.
Age: 77.0
Sex: M
Vaccine: COVID19-2
Symptoms: Chest X-ray normal, Computerised tomogram abdomen abnormal, Computerised tomogram head normal, Electroencephalogram normal, Encephalomalacia
Clinical narrative: Admit date: 12/10/2023  Discharge date:  12/14/2023  Admitting Physician: DO   Attending Physician at the Time of Discharge: MD  Primary Care Physician: MD Reason for Admission: Altered mental status 78yoM hx type1 DM, CVA, and HTN who presented via EMS from home for "unresponsive". I was unable to reach wife, who he lives with, nor his daughter.   Brief Summary of Hospital Stay: (Include Significant Findings and Invasive Procedures)  Course characterized by DKA, seizure-like activity, evidence of acute pancreatitis, type 2 MI, PCU stay  Improving, DKA resolved, AKI improved, acute pancreatitis is improved, neurology consultation, patient transferred to general floor  EEG, no epileptiform activity, neurology was consulted -no indication for AED at this stage DKA-78-year-old man with type 1 diabetes mellitus, was treated in PCU setting, would DKA protocol, no obvious precipitating infectious etiology, other than COVID-19 positive 12/12 anion gap closed, patient recovered from DKA  COVID positive- no respiratory concern for steroids or antiviral   Elevated procalcitonin-normal chest x-ray  Seizure-like activity Was observed in ER on presentation, loaded with Keppra, CT of the head is negative, MRI of the brain shows left frontal encephalomalacia, could be serving as the substrate for seizure  EEG, no epileptiform activity from 12/12 tele neurology consultation and follow-up is appreciated  Acute metabolic encephalopathy Improving., continues to improve  Acute pancreatitis Elevated lipase, CT of the abdomen shows pancreatic edema, consistent with acute pancreatitis, CT of the abdomen showed no gallstones, normal CBD, check triglycerides within normal limit, Diet being advanced  Elevated liver enzyme, 12/13 will be trended -nonoliguric AKI-improving, holding nephrotoxins  12/12 AKI resolved   Acute retention of urine- Patient had acute retention of urine just before being discharged, Flomax has been started and Foley catheter inserted, needs follow-up with Urology Discharged to Home.
Age: 77.0
Sex: M
Vaccine: COVID19-2
Symptoms: Hepatic enzyme increased, Laboratory test normal, Magnetic resonance imaging head abnormal, Metabolic encephalopathy, Oedematous pancreatitis
Clinical narrative: Admit date: 12/10/2023  Discharge date:  12/14/2023  Admitting Physician: DO   Attending Physician at the Time of Discharge: MD  Primary Care Physician: MD Reason for Admission: Altered mental status 78yoM hx type1 DM, CVA, and HTN who presented via EMS from home for "unresponsive". I was unable to reach wife, who he lives with, nor his daughter.   Brief Summary of Hospital Stay: (Include Significant Findings and Invasive Procedures)  Course characterized by DKA, seizure-like activity, evidence of acute pancreatitis, type 2 MI, PCU stay  Improving, DKA resolved, AKI improved, acute pancreatitis is improved, neurology consultation, patient transferred to general floor  EEG, no epileptiform activity, neurology was consulted -no indication for AED at this stage DKA-78-year-old man with type 1 diabetes mellitus, was treated in PCU setting, would DKA protocol, no obvious precipitating infectious etiology, other than COVID-19 positive 12/12 anion gap closed, patient recovered from DKA  COVID positive- no respiratory concern for steroids or antiviral   Elevated procalcitonin-normal chest x-ray  Seizure-like activity Was observed in ER on presentation, loaded with Keppra, CT of the head is negative, MRI of the brain shows left frontal encephalomalacia, could be serving as the substrate for seizure  EEG, no epileptiform activity from 12/12 tele neurology consultation and follow-up is appreciated  Acute metabolic encephalopathy Improving., continues to improve  Acute pancreatitis Elevated lipase, CT of the abdomen shows pancreatic edema, consistent with acute pancreatitis, CT of the abdomen showed no gallstones, normal CBD, check triglycerides within normal limit, Diet being advanced  Elevated liver enzyme, 12/13 will be trended -nonoliguric AKI-improving, holding nephrotoxins  12/12 AKI resolved   Acute retention of urine- Patient had acute retention of urine just before being discharged, Flomax has been started and Foley catheter inserted, needs follow-up with Urology Discharged to Home.
Age: 77.0
Sex: M
Vaccine: COVID19-2
Symptoms: Pancreatitis acute, Procalcitonin increased, SARS-CoV-2 test positive, Seizure like phenomena, Type 2 diabetes mellitus
Clinical narrative: Admit date: 12/10/2023  Discharge date:  12/14/2023  Admitting Physician: DO   Attending Physician at the Time of Discharge: MD  Primary Care Physician: MD Reason for Admission: Altered mental status 78yoM hx type1 DM, CVA, and HTN who presented via EMS from home for "unresponsive". I was unable to reach wife, who he lives with, nor his daughter.   Brief Summary of Hospital Stay: (Include Significant Findings and Invasive Procedures)  Course characterized by DKA, seizure-like activity, evidence of acute pancreatitis, type 2 MI, PCU stay  Improving, DKA resolved, AKI improved, acute pancreatitis is improved, neurology consultation, patient transferred to general floor  EEG, no epileptiform activity, neurology was consulted -no indication for AED at this stage DKA-78-year-old man with type 1 diabetes mellitus, was treated in PCU setting, would DKA protocol, no obvious precipitating infectious etiology, other than COVID-19 positive 12/12 anion gap closed, patient recovered from DKA  COVID positive- no respiratory concern for steroids or antiviral   Elevated procalcitonin-normal chest x-ray  Seizure-like activity Was observed in ER on presentation, loaded with Keppra, CT of the head is negative, MRI of the brain shows left frontal encephalomalacia, could be serving as the substrate for seizure  EEG, no epileptiform activity from 12/12 tele neurology consultation and follow-up is appreciated  Acute metabolic encephalopathy Improving., continues to improve  Acute pancreatitis Elevated lipase, CT of the abdomen shows pancreatic edema, consistent with acute pancreatitis, CT of the abdomen showed no gallstones, normal CBD, check triglycerides within normal limit, Diet being advanced  Elevated liver enzyme, 12/13 will be trended -nonoliguric AKI-improving, holding nephrotoxins  12/12 AKI resolved   Acute retention of urine- Patient had acute retention of urine just before being discharged, Flomax has been started and Foley catheter inserted, needs follow-up with Urology Discharged to Home.
Age: 77.0
Sex: M
Vaccine: COVID19-2
Symptoms: Unresponsive to stimuli, Urinary retention
Clinical narrative: Admit date: 12/10/2023  Discharge date:  12/14/2023  Admitting Physician: DO   Attending Physician at the Time of Discharge: MD  Primary Care Physician: MD Reason for Admission: Altered mental status 78yoM hx type1 DM, CVA, and HTN who presented via EMS from home for "unresponsive". I was unable to reach wife, who he lives with, nor his daughter.   Brief Summary of Hospital Stay: (Include Significant Findings and Invasive Procedures)  Course characterized by DKA, seizure-like activity, evidence of acute pancreatitis, type 2 MI, PCU stay  Improving, DKA resolved, AKI improved, acute pancreatitis is improved, neurology consultation, patient transferred to general floor  EEG, no epileptiform activity, neurology was consulted -no indication for AED at this stage DKA-78-year-old man with type 1 diabetes mellitus, was treated in PCU setting, would DKA protocol, no obvious precipitating infectious etiology, other than COVID-19 positive 12/12 anion gap closed, patient recovered from DKA  COVID positive- no respiratory concern for steroids or antiviral   Elevated procalcitonin-normal chest x-ray  Seizure-like activity Was observed in ER on presentation, loaded with Keppra, CT of the head is negative, MRI of the brain shows left frontal encephalomalacia, could be serving as the substrate for seizure  EEG, no epileptiform activity from 12/12 tele neurology consultation and follow-up is appreciated  Acute metabolic encephalopathy Improving., continues to improve  Acute pancreatitis Elevated lipase, CT of the abdomen shows pancreatic edema, consistent with acute pancreatitis, CT of the abdomen showed no gallstones, normal CBD, check triglycerides within normal limit, Diet being advanced  Elevated liver enzyme, 12/13 will be trended -nonoliguric AKI-improving, holding nephrotoxins  12/12 AKI resolved   Acute retention of urine- Patient had acute retention of urine just before being discharged, Flomax has been started and Foley catheter inserted, needs follow-up with Urology Discharged to Home.
Age: 76.0
Sex: F
Vaccine: RSV
Symptoms: Injection site pain, Pain
Clinical narrative: patient has been experiencing injection site pain since the date of receiving the vaccine. pain radiates down the arm, at the worst pain is a 4/10. she mostly notices it at bedtime but it is present throughout the day. there is a small mark on her upper right arm, but she is unsure if that is the injection site-patient encourage to reach out to physician about prolonged side effects
Age: 82.0
Sex: M
Vaccine: COVID19
Symptoms: Asthenia, COVID-19, Infection, Procalcitonin, Pyrexia
Clinical narrative: Admit date: 12/7/2023  Discharge date: 12/14/23  Admitting Physician: DO   Attending Physician at the Time of Discharge: DO  Primary Care Physician: NP Reason for Admission: covid  Brief Summary of Hospital Stay: (Include Significant Findings and Invasive Procedures) patient presented with profound weakness found to have covid. Treated supportively and received 3 doses remdesivir per high risk protocol. Developed fever some days into hospitalization and procalcitonin was trending up so antibiotics started for secondary infection. Strength improved though not to baseline - safe to return to AFC with outpatient therapy.  He was never hypoxic. Discharged to home.
Age: 0.5
Sex: M
Vaccine: COVID19, DTPPVHBHPB, FLU4, PNC20, RV5
Symptoms: Condition aggravated, Incorrect dose administered, Infantile spitting up, Product preparation error, Somnolence
Clinical narrative: Patient inadvertently received full vial of undiluted Covid 19. Medical assistant did not use diluent, drew up full vial of Covid vaccine and administered it to the patient. Patient was notified on 12/13 when error was identified. Mom reported that patient had increased spitting up for 1 week after he received his 6 month vaccines and he was very sleepy for 24 hours after his vaccines. He is back at baseline.
Age: 4.0
Sex: F
Vaccine: DTAPIPV
Symptoms: Injection site erythema, Injection site macule, Injection site mass, Injection site pain, Injection site pruritus
Clinical narrative: Mom called into clinic on 12/14/2023 to report that patient had developed a red, blotchy, lumpy, itchy rash over the injection site, approximately 3-4 inches across. The area over the injection site was painful to palpation and mom reported patient was complaining of itching at the injection site where the rash was present.  The rash was blanchable, not bleeding or oozing, did not look fluid filled. Parents voiced concern that the injection site was too lateral and there was concern the injection was administered into an area of the thigh that was more fatty tissue than muscle. MD phoned and spoke to mom that same day of report at 8:48pm Mom reported at that time the patient's condition was about the same as when she messaged in and talked to the RN earlier in the evening. No worse.  Redness had not exceeded the line she drew around the affected area.  Did give cetirizine 5mg and ibuprofen.  Patient was comfortable at time of communication with mother.   Mother also relayed to MD that the redness wasn't there Tuesday or Wednesday but showed up Thursday.  Tender and "lumpy" at injection site.   No streaking.  No fever.  Reviewed plan for follow up evaluation at clinic 12/15, possible antibiotics, possible antihistamines. May need repeat vaccination.  Yes, ok to split up the shot into dtap and ipv as separate shots if repeat coverage is indicated.   MD Recommend to ER overnight if fever, streaking, other concern. MD Reviewed our ofc plan for addressing proper vaccination administration with staff. Mom expressed understanding and agreement.
Age: 4.0
Sex: F
Vaccine: DTAPIPV
Symptoms: Injection site rash
Clinical narrative: Mom called into clinic on 12/14/2023 to report that patient had developed a red, blotchy, lumpy, itchy rash over the injection site, approximately 3-4 inches across. The area over the injection site was painful to palpation and mom reported patient was complaining of itching at the injection site where the rash was present.  The rash was blanchable, not bleeding or oozing, did not look fluid filled. Parents voiced concern that the injection site was too lateral and there was concern the injection was administered into an area of the thigh that was more fatty tissue than muscle. MD phoned and spoke to mom that same day of report at 8:48pm Mom reported at that time the patient's condition was about the same as when she messaged in and talked to the RN earlier in the evening. No worse.  Redness had not exceeded the line she drew around the affected area.  Did give cetirizine 5mg and ibuprofen.  Patient was comfortable at time of communication with mother.   Mother also relayed to MD that the redness wasn't there Tuesday or Wednesday but showed up Thursday.  Tender and "lumpy" at injection site.   No streaking.  No fever.  Reviewed plan for follow up evaluation at clinic 12/15, possible antibiotics, possible antihistamines. May need repeat vaccination.  Yes, ok to split up the shot into dtap and ipv as separate shots if repeat coverage is indicated.   MD Recommend to ER overnight if fever, streaking, other concern. MD Reviewed our ofc plan for addressing proper vaccination administration with staff. Mom expressed understanding and agreement.
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Respiratory tract congestion, SARS-CoV-2 test negative
Clinical narrative: Congestion.
Age: 0.5
Sex: F
Vaccine: COVID19, DTPPVHBHPB, FLU4, PNC20, RV5
Symptoms: Incorrect dose administered, No adverse event, Product preparation error
Clinical narrative: Patient inadvertently received undiluted Covid 19 vaccine. Medical assistant did not use diluent, filled syringe from vial. Mother notified on 12/13 when error was identified. Mother denies adverse effects from the vaccine.
Age: 2.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect dose administered, No adverse event, Product preparation error
Clinical narrative: Patient inadvertently received undiluted covid vaccine. The medical assistant did not use diluent. She drew up entire volume from a new vial into syringe and administered to patient. Parent was notified on 12/13 when error was identified. Mom reported that patient tolerated the vaccine without any local or systemic adverse effects.
Age: 2.0
Sex: F
Vaccine: COVID19, FLU4
Symptoms: Incorrect dose administered, No adverse event, Product preparation error
Clinical narrative: Patient inadvertently received undiluted covid vaccine. The medical assistant did not use diluent. She drew up entire volume from a new vial into syringe and administered to patient. Mother was notified on 12/13 when error was identified. Mother reported that patient did not have any adverse effects from the vaccine. No erythema or swelling at site and no systemic symptoms such as fever.
Age: 80.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Drooling, Extremity contracture, Eye movement disorder, Gaze palsy, Seizure like phenomena
Clinical narrative: Seizure like activity witnessed by nursing staff 48 hours after vaccination. Resident was vocally calling out (baseline is non-verbal), body shaking, fists clenched, drooling, and eyes rolled up and darting. Resident does have a history of seizure like activity that started in 2022 however was put on keppra and had very few further episodes. This may have just been a breakthrough seizure and unrelated to the vaccine.
Age: 80.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Tremor
Clinical narrative: Seizure like activity witnessed by nursing staff 48 hours after vaccination. Resident was vocally calling out (baseline is non-verbal), body shaking, fists clenched, drooling, and eyes rolled up and darting. Resident does have a history of seizure like activity that started in 2022 however was put on keppra and had very few further episodes. This may have just been a breakthrough seizure and unrelated to the vaccine.
Age: 80.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Seizure
Clinical narrative: Seizure like activity witnessed by nursing staff 48 hours after vaccination. Resident was vocally calling out (baseline is non-verbal), body shaking, fists clenched, drooling, and eyes rolled up and darting. Resident does have a history of seizure like activity that started in 2022 however was put on keppra and had very few further episodes. This may have just been a breakthrough seizure and unrelated to the vaccine.
Age: 3.0
Sex: F
Vaccine: COVID19, FLU4
Symptoms: Incorrect dose administered, No adverse event, Product preparation error
Clinical narrative: Patient inadvertently received undiluted covid vaccine. The medical assistant did not use diluent. She drew up entire volume from a new vial into syringe and administered to patient. Mother was notified on 12/13/2023 when error was identified.  Mom denied adverse side effects including fever, redness, swelling, or other abnormalities.
Age: 83.0
Sex: M
Vaccine: COVID19
Symptoms: Cerebral thrombosis, Cerebrovascular accident, Hypoaesthesia
Clinical narrative: Left side of body numb. Ambulance called. Blood clot left side of brain causing a stroke, hospitalized and discharged, followed by 2 months therapy
Age: 5.0
Sex: M
Vaccine: COVID19, FLU4
Symptoms: Expired product administered
Clinical narrative: Pfizer vaccine that was kept in refrigerator was given to patient 2 days after "Beyond Use" date accidentally.
Age: 18.0
Sex: M
Vaccine: HEPA
Symptoms: No adverse event, Product administered to patient of inappropriate age
Clinical narrative: No adverse events reported
Age: 1.25
Sex: M
Vaccine: DTAP, FLUN4, HEP, IPV, MMR, VARCEL
Symptoms: No adverse event, Product administered to patient of inappropriate age
Clinical narrative: FluMist administered to 15 month old client. No adverse effects.
Age: 69.0
Sex: F
Vaccine: VARZOS
Symptoms: Product storage error
Clinical narrative: Vaccine was frozen instead of refrigerated.
Age: 7.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect dose administered, Product administered to patient of inappropriate age
Clinical narrative: received adult dose of Moderna COVID vaccine
Age: 8.0
Sex: M
Vaccine: COVID19
Symptoms: No adverse event
Clinical narrative: Patient did not have any reactions or symptoms after the vaccination.
Age: 62.0
Sex: F
Vaccine: COVID19
Symptoms: Blood glucose, Differential white blood cell count, Dizziness, Full blood count, Glomerular filtration rate
Clinical narrative: 200/100 Blood Pressure, palpitations,light headed, nausea, before ER. On ER, varied blood pressure. In ER for a few hours. Gave me Lisinopril and went home.
Age: 62.0
Sex: F
Vaccine: COVID19
Symptoms: Influenza virus test, Metabolic function test, Palpitations, Platelet count, Respiratory syncytial virus test
Clinical narrative: 200/100 Blood Pressure, palpitations,light headed, nausea, before ER. On ER, varied blood pressure. In ER for a few hours. Gave me Lisinopril and went home.
Age: 62.0
Sex: F
Vaccine: COVID19
Symptoms: SARS-CoV-2 test, Thyroid function test, Troponin, Urine analysis
Clinical narrative: 200/100 Blood Pressure, palpitations,light headed, nausea, before ER. On ER, varied blood pressure. In ER for a few hours. Gave me Lisinopril and went home.
Age: 59.0
Sex: F
Vaccine: VARZOS
Symptoms: Product storage error
Clinical narrative: Vaccine was frozen instead of refrigerated.
Age: 22.0
Sex: M
Vaccine: MNQ
Symptoms: Inappropriate schedule of product administration
Clinical narrative: The meningococcal was given to patient twice within 2 weeks, once on 11/29/23 and once on 12/15/23. i asked pt several times when was the last time he got his meningitis shots, he said 2005, so i gave him the shot. After the shots, he asked me, when can he get this tetanus shot, so I look STC , I saw meningitis shot was given on the 29th of November of 2023. I told him I saw a shot on 11/29,/23 and i made him call the school and school said he did get it.  He told he did not know he already got the meningitis. I made him wait for 45 mins and he was ok. He told me " I'll be fine". so i told him i will report it because he got it twice, and we will call to check on him after 2 weeks,. I also told him to call us if he as any problem I felt very very horrible, and I will look at stc for shots every time.
Age: 60.0
Sex: F
Vaccine: VARZOS
Symptoms: Product storage error
Clinical narrative: Vaccine was frozen instead of refrigerated.