chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 67.0
Sex: M
Vaccine: COVID19
Symptoms: Chest pain, Dyspnoea, Unresponsive to stimuli
Clinical narrative: Severe shortness of breath; chest pain for several days. Patient coded non-responsive. 911 called.
Age: 84.0
Sex: M
Vaccine: COVID19
Symptoms: Cough, Fatigue, Headache, Pyrexia, Respiratory tract congestion
Clinical narrative: fatigue, fever, congestion, cough, headaches
Age: 58.0
Sex: F
Vaccine: COVID19
Symptoms: Blister, Coma, Condition aggravated, Confusional state, Dehydration
Clinical narrative: Provider d/c note:  "59yr old female with a history of T1DM, GERD, COPD, Hypothyroidism, who was brought here after she was found unconscious at home. Initially thought to suffer from pump failure but later it was discovered that her pump's battery died and she had actually ignored 2 warnings about line obstruction and low battery. It is plausible that she had suffered covid encephalopathy and due to the confusion was not able to manage her insulin pump and so it powered down causing her to go into DKA and coma. She was initially managed in ICU and is now stable on the floors. I agree with the students assessment and plan including: DKA - Resolved Rhabdomyolysis - improved with IV fluid hydration. Encourage continued hydration T1DM - Patient is confident she is capable of managing her insulin pump. She was managed here with basal and prandial insulin. Plan is to go home and set up her pump. Home care ordered to check on her tomorrow to make sure her insulin is set up with her pump. She has an appointment with endocrinology on Sept 1st. COVID - no sign of respiratory distress. No indication for covid directed therapy. Continue with supportive care. Superficial Blisters on back and right butt cheek, blister on head - local wound care   Elevate LFT's - unclear etiology, may be due to shock liver from dehydration. Hepatitis panel ordered - PCP to follow up. Plan is for repeat CMP on Monday and patient to follow up with PCP and consider liver imaging outpatient as indicated."
Age: 58.0
Sex: F
Vaccine: COVID19
Symptoms: Device infusion issue, Diabetic ketoacidosis, Intensive care, Ischaemic hepatitis, Liver function test increased
Clinical narrative: Provider d/c note:  "59yr old female with a history of T1DM, GERD, COPD, Hypothyroidism, who was brought here after she was found unconscious at home. Initially thought to suffer from pump failure but later it was discovered that her pump's battery died and she had actually ignored 2 warnings about line obstruction and low battery. It is plausible that she had suffered covid encephalopathy and due to the confusion was not able to manage her insulin pump and so it powered down causing her to go into DKA and coma. She was initially managed in ICU and is now stable on the floors. I agree with the students assessment and plan including: DKA - Resolved Rhabdomyolysis - improved with IV fluid hydration. Encourage continued hydration T1DM - Patient is confident she is capable of managing her insulin pump. She was managed here with basal and prandial insulin. Plan is to go home and set up her pump. Home care ordered to check on her tomorrow to make sure her insulin is set up with her pump. She has an appointment with endocrinology on Sept 1st. COVID - no sign of respiratory distress. No indication for covid directed therapy. Continue with supportive care. Superficial Blisters on back and right butt cheek, blister on head - local wound care   Elevate LFT's - unclear etiology, may be due to shock liver from dehydration. Hepatitis panel ordered - PCP to follow up. Plan is for repeat CMP on Monday and patient to follow up with PCP and consider liver imaging outpatient as indicated."
Age: 58.0
Sex: F
Vaccine: COVID19
Symptoms: Loss of consciousness, Rhabdomyolysis, SARS-CoV-2 test positive, Type 1 diabetes mellitus
Clinical narrative: Provider d/c note:  "59yr old female with a history of T1DM, GERD, COPD, Hypothyroidism, who was brought here after she was found unconscious at home. Initially thought to suffer from pump failure but later it was discovered that her pump's battery died and she had actually ignored 2 warnings about line obstruction and low battery. It is plausible that she had suffered covid encephalopathy and due to the confusion was not able to manage her insulin pump and so it powered down causing her to go into DKA and coma. She was initially managed in ICU and is now stable on the floors. I agree with the students assessment and plan including: DKA - Resolved Rhabdomyolysis - improved with IV fluid hydration. Encourage continued hydration T1DM - Patient is confident she is capable of managing her insulin pump. She was managed here with basal and prandial insulin. Plan is to go home and set up her pump. Home care ordered to check on her tomorrow to make sure her insulin is set up with her pump. She has an appointment with endocrinology on Sept 1st. COVID - no sign of respiratory distress. No indication for covid directed therapy. Continue with supportive care. Superficial Blisters on back and right butt cheek, blister on head - local wound care   Elevate LFT's - unclear etiology, may be due to shock liver from dehydration. Hepatitis panel ordered - PCP to follow up. Plan is for repeat CMP on Monday and patient to follow up with PCP and consider liver imaging outpatient as indicated."
Age: 50.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Patient received a vaccine stored beyond 30 days recommended in the refrigerated state. Event reported to the manufacturer. The manufacturer tested the lot number in question. Data revealed the vaccine administered did not maintain activity necessary to protect against the SARS-CoV-2 (COVID-19) virus at time of administration. It was recommended repeating this dose. Patient sent a letter to inform them of the need to repeat the dose. We are working on a compliance improvement plan. Reinstated vaccination privileges.
Age: 46.0
Sex: M
Vaccine: COVID19
Symptoms: Cardiac imaging procedure abnormal, Electrocardiogram abnormal, Pericarditis
Clinical narrative: Pericarditis
Age: 87.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal pain, Dyspnoea, Nausea, Vomiting
Clinical narrative: SOB, abdominal pain, nausea, vomiting
Age: 65.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Pt tested positive for COVID on 08/18/2022
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Asthenia, Cough
Clinical narrative: Cough and weakness.
Age: 40.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: COVID-19, Chronic gastritis, Diabetic hyperosmolar coma, Duodenitis, Dysphagia
Clinical narrative: Provider d/c note:  "41 yo female who presented for nausea and vomiting that was bloody today. She was diagnosed with Covid 8 days ago. She complains of fatigue and nausea during these recent days. Since she wasn't able to keep things down, she has not been taking her medications including insulin.  (HPI per Dr)   Hospital Course: No notes on file patient is a 41yr old female with a history of HTN, DM, Asthma, Depression, Hyperthyroidism who presented with HONK, intractable N and V, oropharyngeal thrush. Today she is seen sitting in chair, says pain in throat is horrible.   Intractable N/V/ hematemesis - resolved.   Oropharyngeal thrush  Dysphagia/Odynophagia secondary to Esophagitis, Gastritis and Duodenitis - on diflucan. EGD done 8/24/22 revealed esophagitis, gastritis, duodenitis but no candida like plaques appreciated. Patient is tolerating soft diet.  Biopsy revealed Inactive mild chronic gastritis and Acute ulcerative esophagitis. GI recommends PPI BID x 6 wks. Continue PPI q12hrs x 6 weeks followed by once daily dosing, continue fluconazole to complete a two weeks course of treatment, f/up pathology, f/up in GI office to discuss repeat EGD to evaluate for healing of esophagitis. GI signed off. "
Age: 40.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Fatigue, Gastrointestinal tract biopsy, Haematemesis, Nausea, Odynophagia
Clinical narrative: Provider d/c note:  "41 yo female who presented for nausea and vomiting that was bloody today. She was diagnosed with Covid 8 days ago. She complains of fatigue and nausea during these recent days. Since she wasn't able to keep things down, she has not been taking her medications including insulin.  (HPI per Dr)   Hospital Course: No notes on file patient is a 41yr old female with a history of HTN, DM, Asthma, Depression, Hyperthyroidism who presented with HONK, intractable N and V, oropharyngeal thrush. Today she is seen sitting in chair, says pain in throat is horrible.   Intractable N/V/ hematemesis - resolved.   Oropharyngeal thrush  Dysphagia/Odynophagia secondary to Esophagitis, Gastritis and Duodenitis - on diflucan. EGD done 8/24/22 revealed esophagitis, gastritis, duodenitis but no candida like plaques appreciated. Patient is tolerating soft diet.  Biopsy revealed Inactive mild chronic gastritis and Acute ulcerative esophagitis. GI recommends PPI BID x 6 wks. Continue PPI q12hrs x 6 weeks followed by once daily dosing, continue fluconazole to complete a two weeks course of treatment, f/up pathology, f/up in GI office to discuss repeat EGD to evaluate for healing of esophagitis. GI signed off. "
Age: 40.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Oesophagitis, Oesophagitis ulcerative, Oesophagogastroduodenoscopy abnormal, Oral candidiasis, Oropharyngeal pain
Clinical narrative: Provider d/c note:  "41 yo female who presented for nausea and vomiting that was bloody today. She was diagnosed with Covid 8 days ago. She complains of fatigue and nausea during these recent days. Since she wasn't able to keep things down, she has not been taking her medications including insulin.  (HPI per Dr)   Hospital Course: No notes on file patient is a 41yr old female with a history of HTN, DM, Asthma, Depression, Hyperthyroidism who presented with HONK, intractable N and V, oropharyngeal thrush. Today she is seen sitting in chair, says pain in throat is horrible.   Intractable N/V/ hematemesis - resolved.   Oropharyngeal thrush  Dysphagia/Odynophagia secondary to Esophagitis, Gastritis and Duodenitis - on diflucan. EGD done 8/24/22 revealed esophagitis, gastritis, duodenitis but no candida like plaques appreciated. Patient is tolerating soft diet.  Biopsy revealed Inactive mild chronic gastritis and Acute ulcerative esophagitis. GI recommends PPI BID x 6 wks. Continue PPI q12hrs x 6 weeks followed by once daily dosing, continue fluconazole to complete a two weeks course of treatment, f/up pathology, f/up in GI office to discuss repeat EGD to evaluate for healing of esophagitis. GI signed off. "
Age: 40.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: SARS-CoV-2 test positive, Vomiting
Clinical narrative: Provider d/c note:  "41 yo female who presented for nausea and vomiting that was bloody today. She was diagnosed with Covid 8 days ago. She complains of fatigue and nausea during these recent days. Since she wasn't able to keep things down, she has not been taking her medications including insulin.  (HPI per Dr)   Hospital Course: No notes on file patient is a 41yr old female with a history of HTN, DM, Asthma, Depression, Hyperthyroidism who presented with HONK, intractable N and V, oropharyngeal thrush. Today she is seen sitting in chair, says pain in throat is horrible.   Intractable N/V/ hematemesis - resolved.   Oropharyngeal thrush  Dysphagia/Odynophagia secondary to Esophagitis, Gastritis and Duodenitis - on diflucan. EGD done 8/24/22 revealed esophagitis, gastritis, duodenitis but no candida like plaques appreciated. Patient is tolerating soft diet.  Biopsy revealed Inactive mild chronic gastritis and Acute ulcerative esophagitis. GI recommends PPI BID x 6 wks. Continue PPI q12hrs x 6 weeks followed by once daily dosing, continue fluconazole to complete a two weeks course of treatment, f/up pathology, f/up in GI office to discuss repeat EGD to evaluate for healing of esophagitis. GI signed off. "
Age: 32.0
Sex: M
Vaccine: SMALLMNK
Symptoms: Incorrect route of product administration
Clinical narrative: On first try, wheal was not formed from injection. Had to repeat dose in Right Forearm. Another nurse did the repeat dose, RN.
Age: 51.0
Sex: M
Vaccine: COVID19
Symptoms: Confusional state, Headache, Hypoaesthesia
Clinical narrative: numbness, headaches, confusion
Age: 56.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Pt tested positive for COVID on 08/17/2022
Age: 39.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: COVID-19, Constipation, Haemoglobin decreased, Pain, Rash
Clinical narrative: Provider d/c note:  "Presented to the Emergency Department complaining of generalized pain for a week which was similar in nature to previous sickle cell pain.  Only other complaint per admission history and physical was chronic constipation. Initial hemoglobin was 5.9.    Hospital Course:   ? Was found to be Covid positive but had no indication for prednisone or remdesivir. ? Received 2 units of PRBCs during hospitalization; did not complete first unit initiated in the ED because she developed a rash and urticaria.  ? Pain was treated with IV Dilaudid and Benadryl.   ? At time of discharge patient indicated her pain was well controlled and she was ready to go home. ? Hemoglobin at time of discharge was 7.1."
Age: 39.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Red blood cell transfusion, SARS-CoV-2 test positive, Urticaria
Clinical narrative: Provider d/c note:  "Presented to the Emergency Department complaining of generalized pain for a week which was similar in nature to previous sickle cell pain.  Only other complaint per admission history and physical was chronic constipation. Initial hemoglobin was 5.9.    Hospital Course:   ? Was found to be Covid positive but had no indication for prednisone or remdesivir. ? Received 2 units of PRBCs during hospitalization; did not complete first unit initiated in the ED because she developed a rash and urticaria.  ? Pain was treated with IV Dilaudid and Benadryl.   ? At time of discharge patient indicated her pain was well controlled and she was ready to go home. ? Hemoglobin at time of discharge was 7.1."
Age: 19.0
Sex: F
Vaccine: MENB
Symptoms: Cellulitis, Erythema, Immunisation reaction, Injection site pain, Injection site swelling
Clinical narrative: Patient reported she developed left arm redness, swelling and tenderness at deltoid injection site approximately 1-2 hrs after her vaccination (8/17/22).  Patient reported redness growing, tactile temp and area of discoloration so went to Urgent Care 2 days later (8/19/22). Diagnosed with cellulitis vs. adverse reaction.  She was prescribed Benadryl and betamethasone cream 0.05%. She was also given a prescription for Doxycycline to take if the redness/swelling did not improve. Pt reported that the symptoms improved and did not need to take oral antibiotic after 24 hours on Benadryl/cream.
Age: 19.0
Sex: F
Vaccine: MENB
Symptoms: Skin discolouration
Clinical narrative: Patient reported she developed left arm redness, swelling and tenderness at deltoid injection site approximately 1-2 hrs after her vaccination (8/17/22).  Patient reported redness growing, tactile temp and area of discoloration so went to Urgent Care 2 days later (8/19/22). Diagnosed with cellulitis vs. adverse reaction.  She was prescribed Benadryl and betamethasone cream 0.05%. She was also given a prescription for Doxycycline to take if the redness/swelling did not improve. Pt reported that the symptoms improved and did not need to take oral antibiotic after 24 hours on Benadryl/cream.
Age: 42.0
Sex: F
Vaccine: COVID19
Symptoms: Blood test, Cough, Face and mouth X-ray abnormal, Face injury, Facial bones fracture
Clinical narrative: Patient received the vaccine on 05/12/2022 at 5 pm. Felt fine until the following day when she woke up and stood out of bed around 11 am. At that time, patient lost consciousness and fell forward. She hit her face on the ground resulting in a facial fracture. She was taken by ambulance to a hospital where they triaged her. She was told she had a fracture on her upper jaw between front teeth. They could not find a specific reason as to why the she fainted. She  also experienced a slight fever, which lasted a few days after the vaccine, as well as, a cough that lingered up to 35 days after the vaccine. Patient still has a lingering cough.
Age: 42.0
Sex: F
Vaccine: COVID19
Symptoms: Fall, Jaw fracture, Loss of consciousness, Pyrexia, Syncope
Clinical narrative: Patient received the vaccine on 05/12/2022 at 5 pm. Felt fine until the following day when she woke up and stood out of bed around 11 am. At that time, patient lost consciousness and fell forward. She hit her face on the ground resulting in a facial fracture. She was taken by ambulance to a hospital where they triaged her. She was told she had a fracture on her upper jaw between front teeth. They could not find a specific reason as to why the she fainted. She  also experienced a slight fever, which lasted a few days after the vaccine, as well as, a cough that lingered up to 35 days after the vaccine. Patient still has a lingering cough.
Age: 17.0
Sex: M
Vaccine: COVID19, HEP
Symptoms: Interchange of vaccine products
Clinical narrative: Patient received Pfizer-BioNTech COVID-19 vaccine dose 1 on 9/20/2021 and dose 2 on 10/11/2021. Received Moderna COVID-19 vaccine booster dose (0.25ml) on 8/12/2022.
Age: 73.0
Sex: F
Vaccine: COVID19
Symptoms: Blood test abnormal, Cardiac function test, Electrocardiogram, Hyperthyroidism, Palpitations
Clinical narrative: Patient went to the ER 8 hours after receiving her second booster of Moderna with heart palpitations. She received tests and monitoring and was sent home. She's doing much better today.
Age: 49.0
Sex: M
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Patient received a vaccine stored beyond 30 days recommended in the refrigerated state. Event reported to the manufacturer. The manufacturer tested the lot number in question. Data revealed the vaccine administered did not maintain activity necessary to protect against the SARS-CoV-2 (COVID-19) virus at time of administration. It was recommended repeating this dose. Patient sent a letter to inform them of the need to repeat the dose. We are working on a compliance improvement plan. Reinstated vaccination privileges.
Age: 68.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Colitis microscopic, Colonoscopy, Diarrhoea, Laboratory test
Clinical narrative: Starting 11/01/2021, I started having a lot of diarrhea and I started to take over the counter medication to alleviate the symptoms. After a while of it not working, I saw my gastroenterologist and they suggested I take PEPTO-BISMOL which didn't help. I had lab work done to check for infections of the GI tract and then had to do a Colonoscopy. I was diagnosed with Lymphocytic Colitis. We tried PEPTO-BISMOL which still didn't work. So, I was given a steroid (budesonide) to help and that alleviated the symptoms. I am still taking it to this day and will continue taking it for the foreseeable future. It is not a cheap medicine. Between the stool sample and the colonoscopy, I contracted COVID-19.
Age: 68.0
Sex: M
Vaccine: COVID19
Symptoms: Stool analysis normal
Clinical narrative: Starting 11/01/2021, I started having a lot of diarrhea and I started to take over the counter medication to alleviate the symptoms. After a while of it not working, I saw my gastroenterologist and they suggested I take PEPTO-BISMOL which didn't help. I had lab work done to check for infections of the GI tract and then had to do a Colonoscopy. I was diagnosed with Lymphocytic Colitis. We tried PEPTO-BISMOL which still didn't work. So, I was given a steroid (budesonide) to help and that alleviated the symptoms. I am still taking it to this day and will continue taking it for the foreseeable future. It is not a cheap medicine. Between the stool sample and the colonoscopy, I contracted COVID-19.
Age: 33.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Chills, Cough, Fatigue, Oropharyngeal pain
Clinical narrative: On Monday 08/22/2022 I had a sore throat. I thought I had a scratchy throat from talking a lot. On 08/23/2022 I did COVID-19 test which was negative. On 08/24/2022 I did another COVID-19 test which was positive. On Tuesday night I had chills; runny nose; chest congestions; fever; fatigue; cough and tiredness. I was hoping that the symptoms would go down especially fever but it didn't so, I called my doctor on 08/25/2022. My doctor prescribed me PAXLOVID for 5 days. I also took MUCINEX for chest congestions and TYLENOL along with PAXLOVID. I still have lingering cough.
Age: 33.0
Sex: M
Vaccine: COVID19
Symptoms: Pyrexia, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test positive, Throat irritation
Clinical narrative: On Monday 08/22/2022 I had a sore throat. I thought I had a scratchy throat from talking a lot. On 08/23/2022 I did COVID-19 test which was negative. On 08/24/2022 I did another COVID-19 test which was positive. On Tuesday night I had chills; runny nose; chest congestions; fever; fatigue; cough and tiredness. I was hoping that the symptoms would go down especially fever but it didn't so, I called my doctor on 08/25/2022. My doctor prescribed me PAXLOVID for 5 days. I also took MUCINEX for chest congestions and TYLENOL along with PAXLOVID. I still have lingering cough.
Age: 78.0
Sex: M
Vaccine: COVID19
Symptoms: Asthenia, Constipation, Oropharyngeal pain, Pyrexia, Respiratory tract congestion
Clinical narrative: Fever, congestion, sore throat, cough, constipation and weakness.
Age: 63.0
Sex: M
Vaccine: COVID19
Symptoms: Deep vein thrombosis, Inappropriate schedule of product administration, Ultrasound Doppler abnormal
Clinical narrative: Patient suffered a deep vein thrombosis in right lower extremity on 8/5/22, about 1 month after the vaccine administration. This may have been provoked given a recent long car ride while traveling.
Age: 83.0
Sex: F
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Arthralgia, Asymptomatic COVID-19, Computerised tomogram head normal, Ecchymosis, Fall
Clinical narrative: Provider d/c note:  "84-year-old home resident who presented to the ED for the second time in 10 days after a ground level fall at her assisted-living facility.  Also COVID positive.   Injuries included: 1. Left subdural hematoma, 5 mm.  Met BIG 2 critieria. **Repeat head CT stable on 8/25/22 2. Non-displaced right skull fracture 3. Posterior right 3-4 rib fx, likely an old injury   Other medical issues: 1. Frequent falls, spanning back several years according to chart review.  Has had extensive work-up by outpatient neurology. 2. COVID positive, asymptomatic  3. Hypokalemia, replaced 4. Right shoulder pain, with evidence of previous injury (ecchymosis, painful ROM)     PT/OT evaluated the patient and SNF advised.  PT and the surgical team both spoke with the patient's son. He prefers for his mother to return to her assisted-living facility.     Issues Requiring Follow Up:  Neurosurgery follow-up 9/7/22 with Dr.  Repeat head CT.             **Hold ASA and NSAIDs per BIG guidelines, until cleared to resume by neurosurgery Neurology follow-up with Dr., as arranged May follow up with trauma surgery as needed"
Age: 83.0
Sex: F
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Hypokalaemia, Pain, Rib fracture, SARS-CoV-2 test positive, Skull fracture
Clinical narrative: Provider d/c note:  "84-year-old home resident who presented to the ED for the second time in 10 days after a ground level fall at her assisted-living facility.  Also COVID positive.   Injuries included: 1. Left subdural hematoma, 5 mm.  Met BIG 2 critieria. **Repeat head CT stable on 8/25/22 2. Non-displaced right skull fracture 3. Posterior right 3-4 rib fx, likely an old injury   Other medical issues: 1. Frequent falls, spanning back several years according to chart review.  Has had extensive work-up by outpatient neurology. 2. COVID positive, asymptomatic  3. Hypokalemia, replaced 4. Right shoulder pain, with evidence of previous injury (ecchymosis, painful ROM)     PT/OT evaluated the patient and SNF advised.  PT and the surgical team both spoke with the patient's son. He prefers for his mother to return to her assisted-living facility.     Issues Requiring Follow Up:  Neurosurgery follow-up 9/7/22 with Dr.  Repeat head CT.             **Hold ASA and NSAIDs per BIG guidelines, until cleared to resume by neurosurgery Neurology follow-up with Dr., as arranged May follow up with trauma surgery as needed"
Age: 83.0
Sex: F
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Subdural haematoma
Clinical narrative: Provider d/c note:  "84-year-old home resident who presented to the ED for the second time in 10 days after a ground level fall at her assisted-living facility.  Also COVID positive.   Injuries included: 1. Left subdural hematoma, 5 mm.  Met BIG 2 critieria. **Repeat head CT stable on 8/25/22 2. Non-displaced right skull fracture 3. Posterior right 3-4 rib fx, likely an old injury   Other medical issues: 1. Frequent falls, spanning back several years according to chart review.  Has had extensive work-up by outpatient neurology. 2. COVID positive, asymptomatic  3. Hypokalemia, replaced 4. Right shoulder pain, with evidence of previous injury (ecchymosis, painful ROM)     PT/OT evaluated the patient and SNF advised.  PT and the surgical team both spoke with the patient's son. He prefers for his mother to return to her assisted-living facility.     Issues Requiring Follow Up:  Neurosurgery follow-up 9/7/22 with Dr.  Repeat head CT.             **Hold ASA and NSAIDs per BIG guidelines, until cleared to resume by neurosurgery Neurology follow-up with Dr., as arranged May follow up with trauma surgery as needed"
Age: 33.0
Sex: F
Vaccine: COVID19
Symptoms: Headache, Myalgia, Nausea, Vomiting
Clinical narrative: nausea, vomiting, myalgias, headaches
Age: 5.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect dose administered, No adverse event, Product administered to patient of inappropriate age
Clinical narrative: Patient was under-dosed by age.  There were not any adverse side effects noted.  Plans to get correct dose in the very near future.
Age: 25.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal pain, Chills, Nausea, Vomiting
Clinical narrative: chills, abdominal pain, nausea, vomiting
Age: 6.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: given outside of recommended exp date
Age: 56.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Pt tested positive for COVID on 08/23/2022
Age: 39.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Fatigue, Pyrexia, Respiratory tract congestion
Clinical narrative: fatigue, fever, congestion, cough, arthralgias
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Arthritis, Condition aggravated
Clinical narrative: I had a first time flare up of arthritis in left knee three days after second booster
Age: 37.0
Sex: M
Vaccine: HEPA
Symptoms: Pruritus, Rash macular, Skin discolouration
Clinical narrative: Client reported 24 hours after immunization left arm down to hand was itchy, purple, and splotchy for 24 hours. After 24 hours the symptoms went away.
Age: 49.0
Sex: F
Vaccine: COVID19
Symptoms: Dizziness, Fatigue
Clinical narrative: fatigue, light-headedness
Age: 8.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: given outside of recommended exp date
Age: 77.0
Sex: F
Vaccine: VARZOS
Symptoms: Injection site erythema, Injection site pain
Clinical narrative: Site: Pain at Injection Site-Mild, Site: Redness at Injection Site-Mild
Age: 53.0
Sex: F
Vaccine: COVID19
Symptoms: Chest pain, Cough
Clinical narrative: cough, chest pain
Age: 57.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Pt tested positive for COVID on  08/22/2022
Age: 47.0
Sex: F
Vaccine: TDAP
Symptoms: No adverse event
Clinical narrative: patient did not have adverse event. However, she does have allergy to latex, which vaccine would be contraindicated.  pt did not have a reaction after receiving vaccine on 8/29/22.
Age: 63.0
Sex: F
Vaccine: SMALLMNK
Symptoms: No adverse event
Clinical narrative: Vaccine was given at 21 days.  Patient had no complications.
Age: 97.0
Sex: M
Vaccine: COVID19
Symptoms: Asthenia, Cough, Fatigue
Clinical narrative: fatigue, cough, weakness
Age: 63.0
Sex: M
Vaccine: COVID19
Symptoms: Blood test normal, Electrocardiogram normal, Extrasystoles, Palpitations
Clinical narrative: I seemed to be having intermittent heart palpitations mostly at night and sometimes during the day. Also my heart skips a beat dozens of time during the day. My PCP sent me to a Cardiologist. I'm now scheduled for a monitor to be placed on the 23rd.
Age: 87.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Death, SARS-CoV-2 test positive, Vaccine breakthrough infection
Clinical narrative: Breakthrough case admission after three vaccines; patient expired Moderna 1/16/21 Lot# 026L20A; Moderna 2/13/21 Lot# 007M2;  Moderna 10/27/21 Lot# 041C21A
Age: 66.0
Sex: M
Vaccine: COVID19
Symptoms: Fatigue
Clinical narrative: fatigue
Age: 89.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Asthenia, COVID-19, Condition aggravated, Debridement, Decubitus ulcer
Clinical narrative: Provider d/c note:  "89 YO female with history of sacral decubitus ulcer stage IV, dementia, dm 2, recent prolonged hospitalization due to septic shock from infected sacral decubitus ulcer presented from a residential facility due to concern for weakness.  She was found to be COVID positive as well.  She was subsequently admitted for management of failure to thrive and sepsis due to sacral wound ulcer and action.   During her hospitalization stay, patient started on vancomycin and Zosyn.  Surgical team consulted and perform bedside debridement of sacral wound ulcer.  It was noted that the sacral wound is extensive.  Surgeon who performed debridement shared that prognosis is likely grave.  Her hospitalization is further complicated by vancomycin resistant Enterococcus faecium and Staphylococcus epidermis bacteremia with likely sources in her urine and sacral ulcer.  Antibiotics transition to ampicillin, cefepime and Flagyl.  Due to poor overall prognosis, patient was transitioned to hospice after discussion with patient's son who is also POA. He chose for his mother to go back to the residential facility under hospice care.  Abx disccontinued and patient transfer back to residential facility. "
Age: 89.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Enterococcal infection, Failure to thrive, Infected skin ulcer, Pathogen resistance, SARS-CoV-2 test positive
Clinical narrative: Provider d/c note:  "89 YO female with history of sacral decubitus ulcer stage IV, dementia, dm 2, recent prolonged hospitalization due to septic shock from infected sacral decubitus ulcer presented from a residential facility due to concern for weakness.  She was found to be COVID positive as well.  She was subsequently admitted for management of failure to thrive and sepsis due to sacral wound ulcer and action.   During her hospitalization stay, patient started on vancomycin and Zosyn.  Surgical team consulted and perform bedside debridement of sacral wound ulcer.  It was noted that the sacral wound is extensive.  Surgeon who performed debridement shared that prognosis is likely grave.  Her hospitalization is further complicated by vancomycin resistant Enterococcus faecium and Staphylococcus epidermis bacteremia with likely sources in her urine and sacral ulcer.  Antibiotics transition to ampicillin, cefepime and Flagyl.  Due to poor overall prognosis, patient was transitioned to hospice after discussion with patient's son who is also POA. He chose for his mother to go back to the residential facility under hospice care.  Abx disccontinued and patient transfer back to residential facility. "
Age: 89.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Sepsis, Septic shock, Staphylococcal bacteraemia, Staphylococcal infection, Wound
Clinical narrative: Provider d/c note:  "89 YO female with history of sacral decubitus ulcer stage IV, dementia, dm 2, recent prolonged hospitalization due to septic shock from infected sacral decubitus ulcer presented from a residential facility due to concern for weakness.  She was found to be COVID positive as well.  She was subsequently admitted for management of failure to thrive and sepsis due to sacral wound ulcer and action.   During her hospitalization stay, patient started on vancomycin and Zosyn.  Surgical team consulted and perform bedside debridement of sacral wound ulcer.  It was noted that the sacral wound is extensive.  Surgeon who performed debridement shared that prognosis is likely grave.  Her hospitalization is further complicated by vancomycin resistant Enterococcus faecium and Staphylococcus epidermis bacteremia with likely sources in her urine and sacral ulcer.  Antibiotics transition to ampicillin, cefepime and Flagyl.  Due to poor overall prognosis, patient was transitioned to hospice after discussion with patient's son who is also POA. He chose for his mother to go back to the residential facility under hospice care.  Abx disccontinued and patient transfer back to residential facility. "
Age: 11.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: given outside of recommended exp date
Age: 89.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive, Vaccine breakthrough infection
Clinical narrative: Breakthrough case admission after 2 vaccines Pfizer 2/25/21 Lot# EN6202;  Pfizer 3/18/21 Lot# EN6207
Age: 63.0
Sex: F
Vaccine: COVID19
Symptoms: Chest pain, Chills, Cough, Pyrexia
Clinical narrative: chills, fever, cough, chest pain
Age: 91.0
Sex: F
Vaccine: FLUA4, VARZOS
Symptoms: Injection site erythema, Injection site swelling
Clinical narrative: Patient has red area from lower deltoid muscle down to about half way to elbow (palm sized).  Solid red, some swelling
Age: 9.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Given outside of recommended exp. date
Age: 60.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Pt tested positive for COVID on 08/22/2022
Age: 78.0
Sex: M
Vaccine: SMALLMNK
Symptoms: No adverse event
Clinical narrative: Vaccine #2 given at 21 days. Patient had no complications.
Age: 8.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: given outside of recommended exp date.
Age: 11.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Given outside of recommended exp. date
Age: 50.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Feeling cold, Headache, Mobility decreased
Clinical narrative: Disabling headache incapacitated me (for both COVID-19 vaccines and both boosters); severe chills/cold.
Age: 5.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: given outside of recommended exp date
Age: 76.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive, Vaccine breakthrough infection
Clinical narrative: Breakthrough case admission after 4 vaccines Moderna 3/4/21 Lot# 030A21A;  Moderna 4/1/21 Lot# 025B21A;  Moderna 11/3/21 Lot# 077C21B;  Moderna 5/16/22 Lot# 059M21A
Age: 60.0
Sex: M
Vaccine: COVID19
Symptoms: Cough, Fatigue, Headache, Myalgia, Pyrexia
Clinical narrative: fatigue, fever, cough, myalgias, headaches
Age: 8.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Given outside of recommended vaccination date.
Age: 81.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive, Vaccine breakthrough infection
Clinical narrative: Breakthrough case admission after 4 vaccines Moderna 3/3/21 Lot# 030A21A;  Moderna 3/31/21 Lot# 017B21A;  Moderna 12/2/21 Lot# 077C21A;  Moderna 4/28/22 Lot# 005M21A
Age: 81.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Pt tested positive for COVID on 08/18/2022
Age: 5.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Given outside of recommended exp. date
Age: 67.0
Sex: F
Vaccine: PNC20
Symptoms: Contusion, Erythema, Peripheral swelling, Tenderness
Clinical narrative: Pt also notes redness/ swelling of left arm after application of PSV 20 vaccine during last visit. States swelling improved, however, redness turned into a bruise. Pt notes improvement in size of bruise over the past couple of days. Mildly tender
Age: 74.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive, Vaccine breakthrough infection
Clinical narrative: Breakthrough case admission after 4 vaccines Moderna 1/28/21 Lot# 026L20A;  Moderna 2/25/21 Lot# 031L20A;  Moderna 11/19/21 Lot# 067F21A;  Moderna 7/6/22 Lot# 037A22B
Age: 7.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Given outside of recommended exp. date
Age: 72.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: pt tested positive for COVID on 08/22/2022
Age: 10.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Given outside of recommended exp. date
Age: 2.0
Sex: F
Vaccine: COVID19
Symptoms: Fatigue, Injection site erythema, Injection site papule, Injection site pustule, Injection site rash
Clinical narrative: No issues at time of injection or that night.  Woke up and had rash on the back of thigh and calf only on leg received injection in.  Rash has worsened over the past week but stayed in the same area.  Not itchy or painful to toddler.  No change in ability to run and climb.  Rash is raised, small papules/pustules on erythematous background that gets darker with heat.  Toddler was more tired than usual for a few days and took naps alone when she usually only contact naps.
Age: 2.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site swelling, Rash papular
Clinical narrative: No issues at time of injection or that night.  Woke up and had rash on the back of thigh and calf only on leg received injection in.  Rash has worsened over the past week but stayed in the same area.  Not itchy or painful to toddler.  No change in ability to run and climb.  Rash is raised, small papules/pustules on erythematous background that gets darker with heat.  Toddler was more tired than usual for a few days and took naps alone when she usually only contact naps.
Age: 65.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Pt tested positive for COVID on 08/22/2022
Age: 20.0
Sex: M
Vaccine: HEP
Symptoms: Unevaluable event
Clinical narrative: none
Age: 1.83
Sex: M
Vaccine: COVID19
Symptoms: Interchange of vaccine products, No adverse event
Clinical narrative: Patient was given first COVID vaccine on 07/13/2022 and received Pfizer. However, in the computer, it was documented as Moderna.  Patient was then booked for his next COVID vaccine in a Moderna Clinic and received Moderna. Patients COVID card stated he received Pfizer, which prompted us to investigate which vaccine was given initially. Patient was scheduled in 07/13/2022 during our clinic where Pfizer was the only vaccine available.  Parents were informed that patient received mix-matched primary series and that a third dose is indicated. Parents reported NO side effects or adverse reactions or events because of this error.
Age: 8.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Given outside of recommended exp. date
Age: 29.0
Sex: M
Vaccine: SMALLMNK
Symptoms: Syncope
Clinical narrative: Patient had episode of syncope
Age: 68.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Pt tested positive for COVID on 08/25/2022
Age: 76.0
Sex: M
Vaccine: COVID19
Symptoms: Asthenia, Blood magnesium normal, COVID-19, Condition aggravated, Loss of personal independence in daily activities
Clinical narrative: Hospitalist Discharge Summary    76 y.o.    Admit Date:  7/14/2022   Discharge Date:  7/25/2022    Principal Dx/ Final Dx: COVID-19 virus infection   Relevant Inpt Dx: Principal Problem:   COVID-19 virus infection Active Problems:   Generalized weakness   Parkinson disease       Follow-up Recommendations: #1 please take medication as prescribed #2 please keep follow-up appointments   HPI: As per Dr's Note:  "Patient is a 76 y.o. male with Parkinson's who came to the ER due to worsening generalized weakness. He usually moves around with a walker but now feels weaker than usual. He required full assistance in the ER. UA (-) for infection. Mg and BMP are normal. He tested (+) for Covid-19 infection, He had received the Covid-19 vaccine. He has been admitted."   Hospital Course:   Patient presented with generalized weakness. He was found to have COVID-19 infection. He was started on Remdecivir and he completed the full treatment. He was also evaluated by neurology for weakness due to underlying history of Parkinson disease. He was seen by physical therapy and they recommended placement which was arranged with the help of social services. Patient was recommended to follow-up with the neurology as an outpatient.     Unresolved issues requiring follow up (w/ labs or studies): None      @HOSPDCED@   Consults:   IP CONSULT TO NEUROLOGY IP CONSULT TO SOCIAL WORK IP CONSULT TO WOUND CARE   Significant Diagnostic Studies:    Positive COVID-19 test   Operations:  None    Wound care recs: None    Disposition:  SNF   Discharge Condition:  good
Age: 76.0
Sex: M
Vaccine: COVID19
Symptoms: Metabolic function test normal, SARS-CoV-2 test positive, Urine analysis normal
Clinical narrative: Hospitalist Discharge Summary    76 y.o.    Admit Date:  7/14/2022   Discharge Date:  7/25/2022    Principal Dx/ Final Dx: COVID-19 virus infection   Relevant Inpt Dx: Principal Problem:   COVID-19 virus infection Active Problems:   Generalized weakness   Parkinson disease       Follow-up Recommendations: #1 please take medication as prescribed #2 please keep follow-up appointments   HPI: As per Dr's Note:  "Patient is a 76 y.o. male with Parkinson's who came to the ER due to worsening generalized weakness. He usually moves around with a walker but now feels weaker than usual. He required full assistance in the ER. UA (-) for infection. Mg and BMP are normal. He tested (+) for Covid-19 infection, He had received the Covid-19 vaccine. He has been admitted."   Hospital Course:   Patient presented with generalized weakness. He was found to have COVID-19 infection. He was started on Remdecivir and he completed the full treatment. He was also evaluated by neurology for weakness due to underlying history of Parkinson disease. He was seen by physical therapy and they recommended placement which was arranged with the help of social services. Patient was recommended to follow-up with the neurology as an outpatient.     Unresolved issues requiring follow up (w/ labs or studies): None      @HOSPDCED@   Consults:   IP CONSULT TO NEUROLOGY IP CONSULT TO SOCIAL WORK IP CONSULT TO WOUND CARE   Significant Diagnostic Studies:    Positive COVID-19 test   Operations:  None    Wound care recs: None    Disposition:  SNF   Discharge Condition:  good
Age: 78.0
Sex: M
Vaccine: COVID19
Symptoms: Death
Clinical narrative: Resident expired.
Age: 37.0
Sex: F
Vaccine: COVID19
Symptoms: Dizziness, Echocardiogram abnormal, Electrocardiogram, Electrocardiogram ambulatory abnormal, Extrasystoles
Clinical narrative: Two weeks after my my vaccine I started feeling my heart skipping beats and I felt faint. Was referred to Cardiologist and was tested Holter Monitor, EKG, Echocardiogram. Holter monitor found something abnormal. Echocardiogram is what found the Pulmonary Hypertension. Scheduled me to have an Echocardiogram every 6 months, first appointment is in October. Dr. doesn't want to prescribe anything yet, not until all testing is done.
Age: 37.0
Sex: F
Vaccine: COVID19
Symptoms: Pulmonary hypertension
Clinical narrative: Two weeks after my my vaccine I started feeling my heart skipping beats and I felt faint. Was referred to Cardiologist and was tested Holter Monitor, EKG, Echocardiogram. Holter monitor found something abnormal. Echocardiogram is what found the Pulmonary Hypertension. Scheduled me to have an Echocardiogram every 6 months, first appointment is in October. Dr. doesn't want to prescribe anything yet, not until all testing is done.
Age: 11.0
Sex: F
Vaccine: HPV9, MNQ, TDAP
Symptoms: No adverse event, Product preparation error
Clinical narrative: n August 26th at 0949 a RN went to obtain a Menveo vaccination. She noted one bottle of diluent without a powder to go with the diluent.  Staff interviewed involving the 5 previous patient administrations.  They all confirm they did not drop or break an orange vial of powder.  Unable to determine which patient received the incorrect diluent for the Menveo powder.  No adverse events.  All 5 patients are being contacted for re-vaccination of Menveo vaccine.
Age: 49.0
Sex: F
Vaccine: COVID19
Symptoms: Acute kidney injury, Acute respiratory failure, Anticoagulant therapy, Asthenia, Blood creatinine increased
Clinical narrative: Physician Discharge Summary   Patient ID: Age: 50 y.o. Admit Date: 7/14/2022  2:57 AM Discharge Date:  7/17/2022 Unit: 4A109/4A109A   Discharge Diagnosis: Principal Problem:   Pneumonia due to COVID-19 virus Active Problems:   Hypernatremia   Elevated troponin   Hyperlipidemia   AKI (acute kidney injury)   Hypothyroidism   Chronic respiratory failure with hypoxia     Hospital Course: 50yo female presented to ED from home with respiratory distress r/t COVID 19. Has significant past medical history, including L sided paralysis due to previous CVA. She has PEG tube and is on 4L NC PTA. Was also hypotensive and in renal failure w/hypernatremia  Continue to decompensate, was intubated and admitted to COVID ICU. Nephrology and Pulm/CCM consulted. Despite full care, she continue to have hemodynamic instability and decompensation. Also developed R UE and LLE loss of pulses and was started on Heparin gtt. Multiple discussions regarding goals of care initiated. Given her overall poor health/debility, family chose to purse comfort/withdrawal of care. This was initiated per protocol and patient expired at 06:42 today.      Consults:   IP CONSULT TO PULMONOLOGY IP CONSULT TO NEPHROLOGY IP CONSULT TO SOCIAL WORK IP CONSULT TO SEPSIS NURSE NAVIGATOR IP CONSULT TO DIETARY IP CONSULT TO DIETARY IP CONSULT TO SOCIAL WORK IP CONSULT TO WOUND CARE IP CONSULT TO SOCIAL WORK IP CONSULT TO VASCULAR SURGERY   Significant Diagnostic Studies:    COVID +, Na 156, Cr 2.1 at admission    Disposition:  Funeral home of family's choice   Discharge Condition:  deceased
Age: 49.0
Sex: F
Vaccine: COVID19
Symptoms: Blood sodium increased, COVID-19, COVID-19 pneumonia, Death, Endotracheal intubation
Clinical narrative: Physician Discharge Summary   Patient ID: Age: 50 y.o. Admit Date: 7/14/2022  2:57 AM Discharge Date:  7/17/2022 Unit: 4A109/4A109A   Discharge Diagnosis: Principal Problem:   Pneumonia due to COVID-19 virus Active Problems:   Hypernatremia   Elevated troponin   Hyperlipidemia   AKI (acute kidney injury)   Hypothyroidism   Chronic respiratory failure with hypoxia     Hospital Course: 50yo female presented to ED from home with respiratory distress r/t COVID 19. Has significant past medical history, including L sided paralysis due to previous CVA. She has PEG tube and is on 4L NC PTA. Was also hypotensive and in renal failure w/hypernatremia  Continue to decompensate, was intubated and admitted to COVID ICU. Nephrology and Pulm/CCM consulted. Despite full care, she continue to have hemodynamic instability and decompensation. Also developed R UE and LLE loss of pulses and was started on Heparin gtt. Multiple discussions regarding goals of care initiated. Given her overall poor health/debility, family chose to purse comfort/withdrawal of care. This was initiated per protocol and patient expired at 06:42 today.      Consults:   IP CONSULT TO PULMONOLOGY IP CONSULT TO NEPHROLOGY IP CONSULT TO SOCIAL WORK IP CONSULT TO SEPSIS NURSE NAVIGATOR IP CONSULT TO DIETARY IP CONSULT TO DIETARY IP CONSULT TO SOCIAL WORK IP CONSULT TO WOUND CARE IP CONSULT TO SOCIAL WORK IP CONSULT TO VASCULAR SURGERY   Significant Diagnostic Studies:    COVID +, Na 156, Cr 2.1 at admission    Disposition:  Funeral home of family's choice   Discharge Condition:  deceased