chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 62.0
Sex: F
Vaccine: COVID19-2
Symptoms: COVID-19, Full blood count normal, Magnetic resonance imaging head normal, Metabolic encephalopathy, Metabolic function test normal
Clinical narrative: Admit date: 1/13/2024  Discharge date: 1/15/2024  Admitting Physician:  MD   Attending Physician at the Time of Discharge:  DO  Primary Care Physician:  MD   Reason for Admission: Acute metabolic encephalopathy  Hospital Course: Patient is a 63-year-old female with past medical history of SCC of left upper lobe of lung Stage I, anxiety, chronic pain, fibromyalgia, hypothyroidism, cannabis use, and OSA who was admitted for acute metabolic encephalopathy.    Work-up including CBC, CMP, and MRI brain were unremarkable. Patient was found to be Covid-19 positive. Acute encephalopathy was likely 2/2 to polypharmacy as patient is on fentanyl patch 25mcg every 3 days, gabapentin, duloxetine, prn ativan, and prn norco. Patient also endorses nightly marijuana use, and did try a new resin type the evening prior to her admission, as well as muscle relaxers at home.   Upon discharge, patient is A&Ox4. She is mentating well, conversing well, and able to follow commands. Her pain was well managed without fentanyl patch, duloxetine, or norco during her hospitalization.   We will lower her fentanyl dose from 25mcg to 12.5mcg and discontinue her ativan. Patient will need to follow-up with her PCP and palliative care to further assess pain regimen requirements.    Issues Requiring Follow Up: (Who, what, when, and how communicated?)  PCP and palliative care to reassess pain regimen. Changes made: fentanyl patch dose decreased from 25mcg to 12mcg. Ativan prn discontinued.   Discharged to Home
Age: 62.0
Sex: F
Vaccine: COVID19-2
Symptoms: Multiple drug therapy, Pain management, SARS-CoV-2 test positive, Substance use, Therapy change
Clinical narrative: Admit date: 1/13/2024  Discharge date: 1/15/2024  Admitting Physician:  MD   Attending Physician at the Time of Discharge:  DO  Primary Care Physician:  MD   Reason for Admission: Acute metabolic encephalopathy  Hospital Course: Patient is a 63-year-old female with past medical history of SCC of left upper lobe of lung Stage I, anxiety, chronic pain, fibromyalgia, hypothyroidism, cannabis use, and OSA who was admitted for acute metabolic encephalopathy.    Work-up including CBC, CMP, and MRI brain were unremarkable. Patient was found to be Covid-19 positive. Acute encephalopathy was likely 2/2 to polypharmacy as patient is on fentanyl patch 25mcg every 3 days, gabapentin, duloxetine, prn ativan, and prn norco. Patient also endorses nightly marijuana use, and did try a new resin type the evening prior to her admission, as well as muscle relaxers at home.   Upon discharge, patient is A&Ox4. She is mentating well, conversing well, and able to follow commands. Her pain was well managed without fentanyl patch, duloxetine, or norco during her hospitalization.   We will lower her fentanyl dose from 25mcg to 12.5mcg and discontinue her ativan. Patient will need to follow-up with her PCP and palliative care to further assess pain regimen requirements.    Issues Requiring Follow Up: (Who, what, when, and how communicated?)  PCP and palliative care to reassess pain regimen. Changes made: fentanyl patch dose decreased from 25mcg to 12mcg. Ativan prn discontinued.   Discharged to Home
Age: 63.0
Sex: M
Vaccine: COVID19
Symptoms: Blood pressure increased, Blood pressure systolic increased, COVID-19, Catheterisation cardiac abnormal, Coronary artery disease
Clinical narrative: Hospital Admit Date: 1/15/2024 ICU Admit Date:  1/15/2024  CHIEF COMPLAINT: Presurgical admit for CABG on 1/16.  HPI:  Patient is a 66 YO male who presented to the hospital on direct admit pending CABG on 1/16 with Dr. Has relevant past medical history of CAD s/p stent placement, diabetes mellitus type II, pulmonary hypertension, peripheral vascular disease, hx of NSTEMI, hypertension, hyperlipidemia, BPH.  Patient presented to hospital under direct admit on 1/15 pending CABG scheduled for 1/16. Has again been following with CTS since December of 2023. Prior to this presented to hospital twice in December of 2023 with high blood pressure, SOB, headache. Blood pressures were consistently in systolic of >200mmHg. Symptoms typical improve with nitroglycerin per patient. Underwent cardiac cath on 12/23 indicating triple vessel disease with moderate L main stenosis, 90% LAD, and 70% RCA stenosis. Subsequently had carotid u/s with saphenous mapping. Was scheduled for CABG on 1/2, but canceled given a (+) COVID test prior to procedure.  Today patient is feeling well, but still has persistently elevated BP. Denies any changes or symptoms such as headache, dizziness, SOB, chest pressure, N/V, paresthesias. Nurse states patient has been asymptomatic but that blood pressure has been difficult to manage. Blood pressures were in 180-200mmHg systolic range. Received hydralazine once with minimal improvement in BP. Systolic continued to elevated. Dr. was called per nurse and recommended nicardipine drip. Patient was evaluated and transferred to ICU in stable condition. Admitted as an Inpatient.
Age: 63.0
Sex: M
Vaccine: COVID19
Symptoms: Coronary artery stenosis, Dyspnoea, Headache, Hypertension, Intensive care
Clinical narrative: Hospital Admit Date: 1/15/2024 ICU Admit Date:  1/15/2024  CHIEF COMPLAINT: Presurgical admit for CABG on 1/16.  HPI:  Patient is a 66 YO male who presented to the hospital on direct admit pending CABG on 1/16 with Dr. Has relevant past medical history of CAD s/p stent placement, diabetes mellitus type II, pulmonary hypertension, peripheral vascular disease, hx of NSTEMI, hypertension, hyperlipidemia, BPH.  Patient presented to hospital under direct admit on 1/15 pending CABG scheduled for 1/16. Has again been following with CTS since December of 2023. Prior to this presented to hospital twice in December of 2023 with high blood pressure, SOB, headache. Blood pressures were consistently in systolic of >200mmHg. Symptoms typical improve with nitroglycerin per patient. Underwent cardiac cath on 12/23 indicating triple vessel disease with moderate L main stenosis, 90% LAD, and 70% RCA stenosis. Subsequently had carotid u/s with saphenous mapping. Was scheduled for CABG on 1/2, but canceled given a (+) COVID test prior to procedure.  Today patient is feeling well, but still has persistently elevated BP. Denies any changes or symptoms such as headache, dizziness, SOB, chest pressure, N/V, paresthesias. Nurse states patient has been asymptomatic but that blood pressure has been difficult to manage. Blood pressures were in 180-200mmHg systolic range. Received hydralazine once with minimal improvement in BP. Systolic continued to elevated. Dr. was called per nurse and recommended nicardipine drip. Patient was evaluated and transferred to ICU in stable condition. Admitted as an Inpatient.
Age: 63.0
Sex: M
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive, Ultrasound Doppler
Clinical narrative: Hospital Admit Date: 1/15/2024 ICU Admit Date:  1/15/2024  CHIEF COMPLAINT: Presurgical admit for CABG on 1/16.  HPI:  Patient is a 66 YO male who presented to the hospital on direct admit pending CABG on 1/16 with Dr. Has relevant past medical history of CAD s/p stent placement, diabetes mellitus type II, pulmonary hypertension, peripheral vascular disease, hx of NSTEMI, hypertension, hyperlipidemia, BPH.  Patient presented to hospital under direct admit on 1/15 pending CABG scheduled for 1/16. Has again been following with CTS since December of 2023. Prior to this presented to hospital twice in December of 2023 with high blood pressure, SOB, headache. Blood pressures were consistently in systolic of >200mmHg. Symptoms typical improve with nitroglycerin per patient. Underwent cardiac cath on 12/23 indicating triple vessel disease with moderate L main stenosis, 90% LAD, and 70% RCA stenosis. Subsequently had carotid u/s with saphenous mapping. Was scheduled for CABG on 1/2, but canceled given a (+) COVID test prior to procedure.  Today patient is feeling well, but still has persistently elevated BP. Denies any changes or symptoms such as headache, dizziness, SOB, chest pressure, N/V, paresthesias. Nurse states patient has been asymptomatic but that blood pressure has been difficult to manage. Blood pressures were in 180-200mmHg systolic range. Received hydralazine once with minimal improvement in BP. Systolic continued to elevated. Dr. was called per nurse and recommended nicardipine drip. Patient was evaluated and transferred to ICU in stable condition. Admitted as an Inpatient.
Age: 63.0
Sex: F
Vaccine: COVID19
Symptoms: Breast mass, COVID-19, Confusional state, Glomerular filtration rate decreased, Imaging procedure abnormal
Clinical narrative: Admit date: 1/12/2024  Discharge date: 1/15/2024  Admitting Physician: MD   Attending Physician at the Time of Discharge: MD   Primary Care Physician: MD  Reason for Admission: increased confusion  Brief Summary of Hospital Stay: (Include Significant Findings and Invasive Procedures) Patient admitted for increased confusion.  She was found to have a positive COVID.  Did not have any respiratory symptoms at all.  No fevers or chills.  Did get a 3L of fluid that could have affected her BP.  Nephrology was consulted and medications adjusted.  Patient's ACEI was resumed.  SGLT2 inhibitors was started.  Nephrology recommend that her primary nephrologist consider a NS-MRA or a GLP1 inhibitor if BP not well controlled. There was question if tylenol could be used.  Had issues with increased LFTs at a previous hospitalization.  Likely secondary to methotrexate.  They are pretty much normal on this admission.  Recommend that she can take tylenol up to 2 grams a day without issues.  She was questioning if norco would be better.  I informed her that that had tylenol in it as well.  She was not on it at this admission.  Encouraged her to discuss pain management with her PCP or rheumatologist at her next visit. Metformin was discontinued because of kidney function.  SGLT2 inhibitor started but will likely not help much with BS as eGFR is low.  BS need to be monitored closely.  Consider a GLP1 inhibitor if more BS control is needed vs increasing insulin.  BS should be monitored closely since there has been a change in her diabetes medications.  Patient had a breast mass found on imaging. She has been referred to high risk cancer clinic for this. Discharged to Home.
Age: 63.0
Sex: F
Vaccine: COVID19
Symptoms: Liver function test normal, SARS-CoV-2 test positive
Clinical narrative: Admit date: 1/12/2024  Discharge date: 1/15/2024  Admitting Physician: MD   Attending Physician at the Time of Discharge: MD   Primary Care Physician: MD  Reason for Admission: increased confusion  Brief Summary of Hospital Stay: (Include Significant Findings and Invasive Procedures) Patient admitted for increased confusion.  She was found to have a positive COVID.  Did not have any respiratory symptoms at all.  No fevers or chills.  Did get a 3L of fluid that could have affected her BP.  Nephrology was consulted and medications adjusted.  Patient's ACEI was resumed.  SGLT2 inhibitors was started.  Nephrology recommend that her primary nephrologist consider a NS-MRA or a GLP1 inhibitor if BP not well controlled. There was question if tylenol could be used.  Had issues with increased LFTs at a previous hospitalization.  Likely secondary to methotrexate.  They are pretty much normal on this admission.  Recommend that she can take tylenol up to 2 grams a day without issues.  She was questioning if norco would be better.  I informed her that that had tylenol in it as well.  She was not on it at this admission.  Encouraged her to discuss pain management with her PCP or rheumatologist at her next visit. Metformin was discontinued because of kidney function.  SGLT2 inhibitor started but will likely not help much with BS as eGFR is low.  BS need to be monitored closely.  Consider a GLP1 inhibitor if more BS control is needed vs increasing insulin.  BS should be monitored closely since there has been a change in her diabetes medications.  Patient had a breast mass found on imaging. She has been referred to high risk cancer clinic for this. Discharged to Home.
Age: 43.0
Sex: M
Vaccine: COVID19
Symptoms: Acute myocardial infarction, Apnoea test abnormal, Areflexia, Brain death, Carbon dioxide increased
Clinical narrative: Admit date: 1/14/2024  Discharge date: 1/15/2024  Admitting Physician: DO   Discharge Physician: DO  Reason for Admission: Out of Hospital Cardiac Arrest  Hospital Course: Patient presented to the emergency department via EMS post  PEA cardiac arrest. Total down time was approximately 2 hours before he arrived at the emergency department.  Initial EKG in ED significant for ST elevation in AVR with deep reciprocal changes in V2 V3 and V4 normal QT consistent with STEMI. Follow up ED EKG with marked ST elevation in aVR, with reciprocal depressions in V3, V4, V5 and inferior leads, similar to initial. He was given rectal aspirin and started on PTD heparin gtt. Patient taken to cath lab with Dr. He was found to have normal coronary arteries without evidence of occlusive MI and transferred to the ICU intubated and sedated.  He required increasing hemodynamic support with levophed and vasopressin overnight and it was noted on the morning of 1/15 that he was no longer breathing over the ventilator. Strong suspicion was for brain death and brain death testing was initiated. Dr. and Dr. independently evaluated the patient and found that he did not have any signs of brainstem reflexes. Dr. oversaw apnea testing with positive increase of CO2 from 40 to 68 after five minutes. Brain death was declared on 1/15/2024 at 12:15 PM. Family were apprised of this and given time with the patient prior to withdrawal of care. Time of cardiac death was 17:57.
Age: 43.0
Sex: M
Vaccine: COVID19
Symptoms: Cardiac arrest, Cardiac death, Catheterisation cardiac normal, Electrocardiogram QT interval normal, Electrocardiogram ST segment elevation
Clinical narrative: Admit date: 1/14/2024  Discharge date: 1/15/2024  Admitting Physician: DO   Discharge Physician: DO  Reason for Admission: Out of Hospital Cardiac Arrest  Hospital Course: Patient presented to the emergency department via EMS post  PEA cardiac arrest. Total down time was approximately 2 hours before he arrived at the emergency department.  Initial EKG in ED significant for ST elevation in AVR with deep reciprocal changes in V2 V3 and V4 normal QT consistent with STEMI. Follow up ED EKG with marked ST elevation in aVR, with reciprocal depressions in V3, V4, V5 and inferior leads, similar to initial. He was given rectal aspirin and started on PTD heparin gtt. Patient taken to cath lab with Dr. He was found to have normal coronary arteries without evidence of occlusive MI and transferred to the ICU intubated and sedated.  He required increasing hemodynamic support with levophed and vasopressin overnight and it was noted on the morning of 1/15 that he was no longer breathing over the ventilator. Strong suspicion was for brain death and brain death testing was initiated. Dr. and Dr. independently evaluated the patient and found that he did not have any signs of brainstem reflexes. Dr. oversaw apnea testing with positive increase of CO2 from 40 to 68 after five minutes. Brain death was declared on 1/15/2024 at 12:15 PM. Family were apprised of this and given time with the patient prior to withdrawal of care. Time of cardiac death was 17:57.
Age: 43.0
Sex: M
Vaccine: COVID19
Symptoms: Electrocardiogram abnormal, Endotracheal intubation, Intensive care, Mechanical ventilation, Pulseless electrical activity
Clinical narrative: Admit date: 1/14/2024  Discharge date: 1/15/2024  Admitting Physician: DO   Discharge Physician: DO  Reason for Admission: Out of Hospital Cardiac Arrest  Hospital Course: Patient presented to the emergency department via EMS post  PEA cardiac arrest. Total down time was approximately 2 hours before he arrived at the emergency department.  Initial EKG in ED significant for ST elevation in AVR with deep reciprocal changes in V2 V3 and V4 normal QT consistent with STEMI. Follow up ED EKG with marked ST elevation in aVR, with reciprocal depressions in V3, V4, V5 and inferior leads, similar to initial. He was given rectal aspirin and started on PTD heparin gtt. Patient taken to cath lab with Dr. He was found to have normal coronary arteries without evidence of occlusive MI and transferred to the ICU intubated and sedated.  He required increasing hemodynamic support with levophed and vasopressin overnight and it was noted on the morning of 1/15 that he was no longer breathing over the ventilator. Strong suspicion was for brain death and brain death testing was initiated. Dr. and Dr. independently evaluated the patient and found that he did not have any signs of brainstem reflexes. Dr. oversaw apnea testing with positive increase of CO2 from 40 to 68 after five minutes. Brain death was declared on 1/15/2024 at 12:15 PM. Family were apprised of this and given time with the patient prior to withdrawal of care. Time of cardiac death was 17:57.
Age: 43.0
Sex: M
Vaccine: COVID19
Symptoms: Respiratory arrest
Clinical narrative: Admit date: 1/14/2024  Discharge date: 1/15/2024  Admitting Physician: DO   Discharge Physician: DO  Reason for Admission: Out of Hospital Cardiac Arrest  Hospital Course: Patient presented to the emergency department via EMS post  PEA cardiac arrest. Total down time was approximately 2 hours before he arrived at the emergency department.  Initial EKG in ED significant for ST elevation in AVR with deep reciprocal changes in V2 V3 and V4 normal QT consistent with STEMI. Follow up ED EKG with marked ST elevation in aVR, with reciprocal depressions in V3, V4, V5 and inferior leads, similar to initial. He was given rectal aspirin and started on PTD heparin gtt. Patient taken to cath lab with Dr. He was found to have normal coronary arteries without evidence of occlusive MI and transferred to the ICU intubated and sedated.  He required increasing hemodynamic support with levophed and vasopressin overnight and it was noted on the morning of 1/15 that he was no longer breathing over the ventilator. Strong suspicion was for brain death and brain death testing was initiated. Dr. and Dr. independently evaluated the patient and found that he did not have any signs of brainstem reflexes. Dr. oversaw apnea testing with positive increase of CO2 from 40 to 68 after five minutes. Brain death was declared on 1/15/2024 at 12:15 PM. Family were apprised of this and given time with the patient prior to withdrawal of care. Time of cardiac death was 17:57.
Age: 40.0
Sex: F
Vaccine: COVID19
Symptoms: Encephalitis, Lumbar puncture, Magnetic resonance imaging, Meningitis
Clinical narrative: Meningitis Encephalitis
Age: 7.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Administration Error; covid vaccine given was out of the 30 day expiration date when transferred to the fridge
Age: 4.0
Sex: F
Vaccine: DTAPIPV, MMR, VARCEL
Symptoms: Rash
Clinical narrative: Mother verbalizes that the following day after the administration of the vaccines the PT had a rash all over the body, it started with rash in a few areas of the body and then it spread, but the one that persisted was the one on the left arm. Mother verbalizes that it never took the PT to the doctor because according to him, she said it was a normal effect of vaccines.
Age: 35.0
Sex: M
Vaccine: COVID19
Symptoms: Blood test normal, Magnetic resonance imaging normal, Pain, Pain in extremity, Small fibre neuropathy
Clinical narrative: Small fiber neuropathy began 3 weeks post-vaccine. Presented as burning pain in both feet.
Age: 4.0
Sex: F
Vaccine: FLU4
Symptoms: Cyanosis, Drooling, Eye movement disorder, Increased bronchial secretion, Injection site pain
Clinical narrative: Patient was give three vaccines at the same time. within a few seconds of getting her vaccines was quiet, her muscles all stiffened, she was unresponsive with gurgling sounds, drool, eyes rolled back, and appeared cyanotic. This lasted about 10 seconds. Still having severe leg pain the following day.  Immunization(s) given: Orders Placed This Encounter Procedures ? IIV4 (FLUZONE QUADRIVALENT) influenza preservative free quadrivalent vaccine (dose 0.5 mL) ? MMRV (PROQUAD) measles, mumps, rubella, varicella live vaccine-age 1 to 12 years ? DTaP-IPV (KINRIX) diphteria, tetanus, acellular pertussis, inactivated polio combined vaccine-Peds
Age: 4.0
Sex: F
Vaccine: FLU4
Symptoms: Musculoskeletal stiffness, Unresponsive to stimuli
Clinical narrative: Patient was give three vaccines at the same time. within a few seconds of getting her vaccines was quiet, her muscles all stiffened, she was unresponsive with gurgling sounds, drool, eyes rolled back, and appeared cyanotic. This lasted about 10 seconds. Still having severe leg pain the following day.  Immunization(s) given: Orders Placed This Encounter Procedures ? IIV4 (FLUZONE QUADRIVALENT) influenza preservative free quadrivalent vaccine (dose 0.5 mL) ? MMRV (PROQUAD) measles, mumps, rubella, varicella live vaccine-age 1 to 12 years ? DTaP-IPV (KINRIX) diphteria, tetanus, acellular pertussis, inactivated polio combined vaccine-Peds
Age: 57.0
Sex: M
Vaccine: VARZOS
Symptoms: Abdominal pain upper, Headache, Injection site pain
Clinical narrative: Mild headache and stomach pains one day later.  Typical sore muscles around injection point within hours.
Age: 42.0
Sex: F
Vaccine: COVID19
Symptoms: Blood pressure increased, Loss of consciousness
Clinical narrative: Increased blood pressure  Patient reports she passed out. No other information available.
Age: 0.75
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: covid vaccine given was out of the 30 day expiration date when transferred to the fridge
Age: 69.0
Sex: M
Vaccine: COVID19
Symptoms: Dizziness, Lacrimation increased, Pruritus, Tongue discomfort
Clinical narrative: 01/17/2024 @ 1405 - Patient called clinic to report the following symptoms occurring post  COVID Spikevax vaccination: -Tongue feeling "funny" but not swollen -Dizziness -Itchy and watery eyes  This nurse did notify PCP via TEAMS and made the suggestion to advise patient to take (2) 325 mg Tylenol along with (1) 50 mg Benadryl; and to also advise  patient if symptoms persist to report to the nearest ER. PCP agreed.   @1438 - attempted to contact patient with instructions. No answer. No voicemail  available. Nurse will continue to try to reach patient via phone number provided  @1450 - Patient returns phone call to clinic. This nurse did advise patient to  take (2) 325 mg of Tylenol along with (1) 50 mg Benadryl. Patient requests order  for Tylenol and Benadryl from provider. Provider notified that emergency vaccine  side effect kit is stocked with 50 mg Benadryl but not Tylenol  @1507 - Provider orders now dose of 650 mg of Tylenol. COVID Vaccine emergency  side effect kit stocked with 50 mg Benadryl.  @1525 - Patient notified that 650 mg of Tylenol and 50 mg of Benadryl available  at vaccine clinic and to report to clinic as soon as possible to be administered  medication ( 650 mg Tylenol with 50 mg Benadryl)  @1557 - Patient reports to vaccine clinic and is administered (2) 325 mg of  Tylenol along with (1) 50 mg Benadryl. Patient able to swallow and tolerated  administration of medication well. It is also reiterated to patient that IF  SYMPTOMS DO PERSIST OR WORSEN TO REPORT TO THE NEAREST ER. Patient able to voice  understanding and states that he is able to leave facility with no problem. No  s/s voiced or observations of any pain discomfort or distress noted at this  time.
Age: 2.0
Sex: M
Vaccine: COVID19, FLU4
Symptoms: Expired product administered
Clinical narrative: Administration Error; covid vaccine given was out of the 30 day expiration date when transferred to the fridge
Age: 46.0
Sex: M
Vaccine: COVID19
Symptoms: Anterior segment ischaemia, COVID-19, Cardiac stress test abnormal, Catheterisation cardiac abnormal, Chest pain
Clinical narrative: Admit date: 1/15/2024  Discharge date:  01/18/2024  Admitting Physician: MD   Attending Physician at the Time of Discharge: No att. providers found  Primary Care Physician: DO Reason for Admission:  Patient is a 48-year-old male history of asthma presented for chief complaint of chest pain shortness for breath.  On presentation patient noted to be febrile at 102.1, normotensive satting well on room air.  Respiratory viral panel was positive for COVID labs are notable for elevated troponin positive delta.  EKGs were without ischemic changes.  Patient was started on heparin drip cardiology consultation was obtained.  Stress test was obtained showing induced anterior ischemic segment.  Patient went for left heart catheterization requiring LAD PCA stenting.  Patient was started on dual antiplatelets beta-blocker ACE inhibitor with adequate blood pressure.  Echo was obtained showing preserved EF.  Patient remained on room air throughout his stay required no treatment for COVID.  He will be discharged home.
Age: 46.0
Sex: M
Vaccine: COVID19
Symptoms: Coronary arterial stent insertion, Dyspnoea, Echocardiogram normal, Ejection fraction normal, Electrocardiogram normal
Clinical narrative: Admit date: 1/15/2024  Discharge date:  01/18/2024  Admitting Physician: MD   Attending Physician at the Time of Discharge: No att. providers found  Primary Care Physician: DO Reason for Admission:  Patient is a 48-year-old male history of asthma presented for chief complaint of chest pain shortness for breath.  On presentation patient noted to be febrile at 102.1, normotensive satting well on room air.  Respiratory viral panel was positive for COVID labs are notable for elevated troponin positive delta.  EKGs were without ischemic changes.  Patient was started on heparin drip cardiology consultation was obtained.  Stress test was obtained showing induced anterior ischemic segment.  Patient went for left heart catheterization requiring LAD PCA stenting.  Patient was started on dual antiplatelets beta-blocker ACE inhibitor with adequate blood pressure.  Echo was obtained showing preserved EF.  Patient remained on room air throughout his stay required no treatment for COVID.  He will be discharged home.
Age: 46.0
Sex: M
Vaccine: COVID19
Symptoms: Pyrexia, Respiratory viral panel, SARS-CoV-2 test positive, Troponin increased
Clinical narrative: Admit date: 1/15/2024  Discharge date:  01/18/2024  Admitting Physician: MD   Attending Physician at the Time of Discharge: No att. providers found  Primary Care Physician: DO Reason for Admission:  Patient is a 48-year-old male history of asthma presented for chief complaint of chest pain shortness for breath.  On presentation patient noted to be febrile at 102.1, normotensive satting well on room air.  Respiratory viral panel was positive for COVID labs are notable for elevated troponin positive delta.  EKGs were without ischemic changes.  Patient was started on heparin drip cardiology consultation was obtained.  Stress test was obtained showing induced anterior ischemic segment.  Patient went for left heart catheterization requiring LAD PCA stenting.  Patient was started on dual antiplatelets beta-blocker ACE inhibitor with adequate blood pressure.  Echo was obtained showing preserved EF.  Patient remained on room air throughout his stay required no treatment for COVID.  He will be discharged home.
Sex: M
Vaccine: HEP
Symptoms: Autopsy, Death, Mechanical ventilation, Resuscitation, Unresponsive to stimuli
Clinical narrative: Patient was found unresponsive in his home on 10/21/23; attempts at resuscitation were not successful; he was pronounced dead at Hospital on 10/22/23
Age: 0.75
Sex: F
Vaccine: COVID19, DTAPHEPBIP, HIBV, PNC20
Symptoms: Expired product administered
Clinical narrative: Administration Error; covid vaccine given was out of the 30 day expiration date when transferred to the fridge
Age: 51.0
Sex: F
Vaccine: FLU4
Symptoms: Loss of personal independence in daily activities, Mobility decreased, Pain in extremity
Clinical narrative: Patient complaining of left upper arm pain since she received flu vaccine on 12/22/23, unable to lift arm, unable to hold 1 gallon of milk/shovel/unable to dress.
Age: 64.0
Sex: M
Vaccine: RSV
Symptoms: Acute disseminated encephalomyelitis, CSF glucose normal, CSF protein increased, CSF red blood cell count, CSF white blood cell count increased
Clinical narrative: The patient developed a single dermatomal zoster lesion and was prescribed valacyclovir by his PCP.  He went to the pharmacy to obtain the medication.  At the pharmacy he also obtained an RSV vaccine on 1/11/24.  I am not sure whether it was Abrysvo or Arexvy as that information is not available to me at this time.  He then in the early AM 1/15/24 woke up confused.  He was admitted to the hospital later that day with concerns of VZV meningoencephalitis.  He was treated with IV acyclovir.  However based on imaging studies and labs he does not have CNS involvement of the varicella.  He was then diagnosed with ADEM and treated with IV steroids with notable improvement.
Age: 64.0
Sex: M
Vaccine: RSV
Symptoms: Confusional state, Imaging procedure, Magnetic resonance imaging head abnormal, Scan with contrast abnormal, Varicella virus test negative
Clinical narrative: The patient developed a single dermatomal zoster lesion and was prescribed valacyclovir by his PCP.  He went to the pharmacy to obtain the medication.  At the pharmacy he also obtained an RSV vaccine on 1/11/24.  I am not sure whether it was Abrysvo or Arexvy as that information is not available to me at this time.  He then in the early AM 1/15/24 woke up confused.  He was admitted to the hospital later that day with concerns of VZV meningoencephalitis.  He was treated with IV acyclovir.  However based on imaging studies and labs he does not have CNS involvement of the varicella.  He was then diagnosed with ADEM and treated with IV steroids with notable improvement.
Age: 64.0
Sex: M
Vaccine: RSV
Symptoms: White blood cell count normal
Clinical narrative: The patient developed a single dermatomal zoster lesion and was prescribed valacyclovir by his PCP.  He went to the pharmacy to obtain the medication.  At the pharmacy he also obtained an RSV vaccine on 1/11/24.  I am not sure whether it was Abrysvo or Arexvy as that information is not available to me at this time.  He then in the early AM 1/15/24 woke up confused.  He was admitted to the hospital later that day with concerns of VZV meningoencephalitis.  He was treated with IV acyclovir.  However based on imaging studies and labs he does not have CNS involvement of the varicella.  He was then diagnosed with ADEM and treated with IV steroids with notable improvement.
Age: 60.0
Sex: F
Vaccine: COVID19
Symptoms: Nausea, Pyrexia, Vomiting
Clinical narrative: Intense nausea and vomiting for a prolonged period (>8 hours). fever spiked unreported value. Referred to primary care physician for follow up and potential fluid replenishment and evaluation.
Age: 0.58
Sex: M
Vaccine: COVID19-2
Symptoms: Incorrect dose administered, Product preparation error
Clinical narrative: Dose was not mixed with diluent-thus higher dose delivered for age group.
Age: 1.33
Sex: F
Vaccine: COVID19
Symptoms: Incorrect dose administered, Product preparation error
Clinical narrative: Vaccine given without diluent.
Age: 0.5
Sex: M
Vaccine: COVID19-2, DTAPHEPBIP, FLU4, HIBV, PNC20
Symptoms: Expired product administered
Clinical narrative: Administration Error; covid vaccine given was out of the 30 day expiration date when transferred to the fridge; pt did start to run a fever on 1-16-24  but is now doing better
Age: 82.0
Sex: M
Vaccine: RSV
Symptoms: Erythema, Rash, Rash erythematous, Rash macular, Rash pruritic
Clinical narrative: Patient received cetirizine, diphenhydramine and topical hydrocortisone to treat rash. Benadryl 25 mg given stat per MD's order due to hypersensitivity reaction to recent RSV vaccine received on 1/12/2024. Resident manifesting diffused erythematous rash with pruritus noted on both upper & lower extremities. Afebrile at 98.7F. Zyrtec to be given daily for 10 days & Hydrocortisone cream to affected areas. From nursing note on 1/13/2024: Noted with redness in blotches on upper arms bilaterally and with scratches on upper thighs bilaterally. Noted with scattered red pinpoint spots on right upper thigh and lower leg. Resident denies any pain.
Age: 82.0
Sex: M
Vaccine: RSV
Symptoms: Scratch
Clinical narrative: Patient received cetirizine, diphenhydramine and topical hydrocortisone to treat rash. Benadryl 25 mg given stat per MD's order due to hypersensitivity reaction to recent RSV vaccine received on 1/12/2024. Resident manifesting diffused erythematous rash with pruritus noted on both upper & lower extremities. Afebrile at 98.7F. Zyrtec to be given daily for 10 days & Hydrocortisone cream to affected areas. From nursing note on 1/13/2024: Noted with redness in blotches on upper arms bilaterally and with scratches on upper thighs bilaterally. Noted with scattered red pinpoint spots on right upper thigh and lower leg. Resident denies any pain.
Age: 0.58
Sex: F
Vaccine: COVID19, FLU4
Symptoms: Expired product administered
Clinical narrative: Administration Error; covid vaccine given was out of the 30 day expiration date when transferred to the fridge
Age: 1.0
Sex: F
Vaccine: HEPA, MMRV, VARCEL
Symptoms: Extra dose administered, No adverse event
Clinical narrative: Patient received both MMRV and Varicella vaccines on the same day.  Physician was notified along with the parent.  Pt was monitored by patient and followed up with phone calls by physician's office.  Patient did not have any adverse reactions to the vaccines from that day.
Age: 12.0
Sex: F
Vaccine: TDAP
Symptoms: Dermal cyst
Clinical narrative: epidermal cyst near injection site, sending to dermatology for work up
Age: 91.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: patient had total of three vaccines two pfizer one moderna.
Age: 73.0
Sex: F
Vaccine: PNC20, TYP
Symptoms: Urticaria
Clinical narrative: Diffuse hives to the trunk, bilateral arms, and legs. Allergist notified and spoke to patient. Administered oral Fexofenadine 180mg in clinic. Prescription given for  Fexofenadine 180mg  to take daily until hives go away. If they do not go away patient will follow back up with the Allergist she saw in the clinic.
Age: 79.0
Sex: M
Vaccine: FLU4
Symptoms: Extra dose administered
Clinical narrative: Current immunizations were not reconciled when scheduling this appointment and missed that he received vaccine previously on 11/12/23 via outside pharmacy.   Patient received second administration today and should not have received additional dose.
Age: 55.0
Sex: F
Vaccine: UNK
Symptoms: Asthma, Blood test, Cough, Dizziness, Dyspnoea
Clinical narrative: She got her flu shot as an employee of the hospital, they did not tell her which one she got.  She was fine initially.  The next day when she got ready to get out of her car to go to work, she was having some breathing difficulty.  Went into work and worked all day, and she worked in hot conditions in decontamination area, and then she started feeling more short of breath on the next day.  She could not breath, was dizzy, light headed.  She asked her husband to take her to the ER on 9/27/23.  In the ER they thought she was having a stroke, was evaluated and felt that she did not have a stroke.  She was there 5-6 hours, had an MRI of her brain, EKG, and was tested for blood clots in her legs.  They did not find anything, and then they sent her home where she still could not breath that well.  From Wednesday 9/27/23 she went home, 9/28/23 she was getting progressively worse and she called her PCP informed them that she went to the ER and went to see him on Friday 9/27/23.  She said they did a million dollar work up and they did not give her a breathing treatment . She was sent to a respiratory treatment on Monday, 10/2/23 and that she had asthma, difficulty breathing and had a pin hole of breath left.  Her lungs were full of fluid with coughing, still having breathing, winded and only able to take little steps.  She had a pulmonary function study and was told she had asthma, her lungs were full and she had a pinhole of air left.  She was given Symbicort in the office, still goes to see her, has some issues with breathing sometimes, and still uses the Symbicort.   She did not have any issues with breathing prior to the vaccine.  Hospital sent her to a facility doctor for 2nd opinion and he said that he agreed that the asthma reaction was due to the flu shot.   She still went to work, was on restrictions as she could not wear a mask, and then she was told she was OK.  She was then put back in Decontamination department, and noticed she had a breathing problem in that area, and she has not been put back in that particular area.  She is still able to do her job and never quit working.   They told her to FU with her PCP or cardiologist, which she did and then went to respiratory therapy.
Age: 55.0
Sex: F
Vaccine: UNK
Symptoms: Electrocardiogram normal, Impaired work ability, Magnetic resonance imaging head normal, Pulmonary function test abnormal, Pulmonary oedema
Clinical narrative: She got her flu shot as an employee of the hospital, they did not tell her which one she got.  She was fine initially.  The next day when she got ready to get out of her car to go to work, she was having some breathing difficulty.  Went into work and worked all day, and she worked in hot conditions in decontamination area, and then she started feeling more short of breath on the next day.  She could not breath, was dizzy, light headed.  She asked her husband to take her to the ER on 9/27/23.  In the ER they thought she was having a stroke, was evaluated and felt that she did not have a stroke.  She was there 5-6 hours, had an MRI of her brain, EKG, and was tested for blood clots in her legs.  They did not find anything, and then they sent her home where she still could not breath that well.  From Wednesday 9/27/23 she went home, 9/28/23 she was getting progressively worse and she called her PCP informed them that she went to the ER and went to see him on Friday 9/27/23.  She said they did a million dollar work up and they did not give her a breathing treatment . She was sent to a respiratory treatment on Monday, 10/2/23 and that she had asthma, difficulty breathing and had a pin hole of breath left.  Her lungs were full of fluid with coughing, still having breathing, winded and only able to take little steps.  She had a pulmonary function study and was told she had asthma, her lungs were full and she had a pinhole of air left.  She was given Symbicort in the office, still goes to see her, has some issues with breathing sometimes, and still uses the Symbicort.   She did not have any issues with breathing prior to the vaccine.  Hospital sent her to a facility doctor for 2nd opinion and he said that he agreed that the asthma reaction was due to the flu shot.   She still went to work, was on restrictions as she could not wear a mask, and then she was told she was OK.  She was then put back in Decontamination department, and noticed she had a breathing problem in that area, and she has not been put back in that particular area.  She is still able to do her job and never quit working.   They told her to FU with her PCP or cardiologist, which she did and then went to respiratory therapy.
Age: 55.0
Sex: F
Vaccine: UNK
Symptoms: SARS-CoV-2 test, Ultrasound Doppler normal
Clinical narrative: She got her flu shot as an employee of the hospital, they did not tell her which one she got.  She was fine initially.  The next day when she got ready to get out of her car to go to work, she was having some breathing difficulty.  Went into work and worked all day, and she worked in hot conditions in decontamination area, and then she started feeling more short of breath on the next day.  She could not breath, was dizzy, light headed.  She asked her husband to take her to the ER on 9/27/23.  In the ER they thought she was having a stroke, was evaluated and felt that she did not have a stroke.  She was there 5-6 hours, had an MRI of her brain, EKG, and was tested for blood clots in her legs.  They did not find anything, and then they sent her home where she still could not breath that well.  From Wednesday 9/27/23 she went home, 9/28/23 she was getting progressively worse and she called her PCP informed them that she went to the ER and went to see him on Friday 9/27/23.  She said they did a million dollar work up and they did not give her a breathing treatment . She was sent to a respiratory treatment on Monday, 10/2/23 and that she had asthma, difficulty breathing and had a pin hole of breath left.  Her lungs were full of fluid with coughing, still having breathing, winded and only able to take little steps.  She had a pulmonary function study and was told she had asthma, her lungs were full and she had a pinhole of air left.  She was given Symbicort in the office, still goes to see her, has some issues with breathing sometimes, and still uses the Symbicort.   She did not have any issues with breathing prior to the vaccine.  Hospital sent her to a facility doctor for 2nd opinion and he said that he agreed that the asthma reaction was due to the flu shot.   She still went to work, was on restrictions as she could not wear a mask, and then she was told she was OK.  She was then put back in Decontamination department, and noticed she had a breathing problem in that area, and she has not been put back in that particular area.  She is still able to do her job and never quit working.   They told her to FU with her PCP or cardiologist, which she did and then went to respiratory therapy.
Age: 78.0
Sex: M
Vaccine: RSV
Symptoms: Anisocoria, Asthenia, Depressed level of consciousness, Hyporesponsive to stimuli, Hypotension
Clinical narrative: Resident was sent to ER via 911 at about 6:45 am due to change of mental status. Obtunded with decreased responsiveness to verbal & pain stimuli. Fixed stare with anisocoric pupils noted. Has generalized body weakness, pale looking with cold extremities noted. Tachycardic at 132, hypotensive at 99/66, O2 sat going down rapidly from 96 to 90% RA. Administered O2 inh at 2lpm/nc. Afebrile 97.8 No chest pain nor pain complaints of any etiology noted. Sent to ER per MD's order via Night supervisor. Then Resident was admitted to hospital with diagnosis of sepsis. On 1/16/2024 resident was discharged from hospital on piperacillin/tazobactam 4.5 grams tid to continue until 1/19/2024.
Age: 78.0
Sex: M
Vaccine: RSV
Symptoms: Mental status changes, Oxygen saturation decreased, Pallor, Peripheral coldness, Pupil fixed
Clinical narrative: Resident was sent to ER via 911 at about 6:45 am due to change of mental status. Obtunded with decreased responsiveness to verbal & pain stimuli. Fixed stare with anisocoric pupils noted. Has generalized body weakness, pale looking with cold extremities noted. Tachycardic at 132, hypotensive at 99/66, O2 sat going down rapidly from 96 to 90% RA. Administered O2 inh at 2lpm/nc. Afebrile 97.8 No chest pain nor pain complaints of any etiology noted. Sent to ER per MD's order via Night supervisor. Then Resident was admitted to hospital with diagnosis of sepsis. On 1/16/2024 resident was discharged from hospital on piperacillin/tazobactam 4.5 grams tid to continue until 1/19/2024.
Age: 78.0
Sex: M
Vaccine: RSV
Symptoms: Sepsis, Staring, Tachycardia
Clinical narrative: Resident was sent to ER via 911 at about 6:45 am due to change of mental status. Obtunded with decreased responsiveness to verbal & pain stimuli. Fixed stare with anisocoric pupils noted. Has generalized body weakness, pale looking with cold extremities noted. Tachycardic at 132, hypotensive at 99/66, O2 sat going down rapidly from 96 to 90% RA. Administered O2 inh at 2lpm/nc. Afebrile 97.8 No chest pain nor pain complaints of any etiology noted. Sent to ER per MD's order via Night supervisor. Then Resident was admitted to hospital with diagnosis of sepsis. On 1/16/2024 resident was discharged from hospital on piperacillin/tazobactam 4.5 grams tid to continue until 1/19/2024.
Age: 52.0
Sex: F
Vaccine: COVID19
Symptoms: C-reactive protein increased, Chills, Night sweats, Pyrexia
Clinical narrative: High c-reactive liver protein   Night sweats chills fever (at night)
Age: 1.58
Sex: M
Vaccine: COVID19
Symptoms: Incorrect dose administered, Product preparation error
Clinical narrative: Vaccine was drawn up and given without being diluted.
Age: 30.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Eye pain, Laboratory test, Magnetic resonance imaging, Optic neuritis, Vision blurred
Clinical narrative: Eye soreness began in the last few days of Februrary 2022. Soreness increased over the next week, becoming painful. Blurred vision started at about March 2 or 3. On March 3, I made an emergency visit to an optometrist, where I mainly saw Dr. at Dr.'s optometrist. The next day, my eye was not getting any better, they told me to admit myself to a hospital on March 4. Vision was mostly blurred out of my right eye, giving me only one eye to see out of. Optic Neuritis was the official diagnosis. Anti-inflammatory drugs and IV's were taken to bring me back to normal. By March 7 I was out of the hospital, with eye vision back to normal, with some soreness still left over. Right eye took some time, about 1-2 months, to feel fully normal again.
Age: 21.0
Sex: F
Vaccine: MMR, VARCEL
Symptoms: Maternal exposure before pregnancy
Clinical narrative: DENIED ILLNESS OR PREGNANCY AT THE TIME WAS ON PERIOD 1-19-24 BROUGHT IN DR NOTE WAS DX PREGNANCY 1-16-24 AT ED
Age: 37.0
Sex: M
Vaccine: COVID19
Symptoms: Cerebrovascular accident, Computerised tomogram, Intensive care, Magnetic resonance imaging
Clinical narrative: Other than horrible symptoms from initial shot for around 12 hours.  Symptoms started around 6 hours after shot.  Had stroke on 11/17/2023.  Assuming attached to this shot.
Age: 18.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal pain upper, Cough, Feeling hot, Flushing, Hypoaesthesia
Clinical narrative: Patient states that upon the needle entering her arm she immediately felt pain in her stomach, spots in her field of vision, and numbness in her vision. She felt warm and her face was flushed. The vaccine was administered by intern who immediately came to get me to assist. My first impression was seeing her coughing with a flushed face so an Epi-pen and EMS were offered. The patient stated that she seemed to be feeling better so Benadryl 50mg was administered. She was monitored for a few more minutes and seemed to be calming down and in less distress. She messaged her dad to come pick her up. Pharmacy staff stayed with her throughout this time to monitor her condition. She reported having no known medication allergies and no previous reactions to a vaccine. She was currently being treated for a sinus infection and had recently undergone allergy testing revealing only a mold allergy. When her dad arrived he was informed of the situation and advised to monitor her and alert EMS with any worsening of the condition or difficulty breathing. A follow up phone call to the patient a couple hours later (around 6pm) was not answered.
Age: 18.0
Sex: F
Vaccine: COVID19
Symptoms: Immediate post-injection reaction, Visual impairment
Clinical narrative: Patient states that upon the needle entering her arm she immediately felt pain in her stomach, spots in her field of vision, and numbness in her vision. She felt warm and her face was flushed. The vaccine was administered by intern who immediately came to get me to assist. My first impression was seeing her coughing with a flushed face so an Epi-pen and EMS were offered. The patient stated that she seemed to be feeling better so Benadryl 50mg was administered. She was monitored for a few more minutes and seemed to be calming down and in less distress. She messaged her dad to come pick her up. Pharmacy staff stayed with her throughout this time to monitor her condition. She reported having no known medication allergies and no previous reactions to a vaccine. She was currently being treated for a sinus infection and had recently undergone allergy testing revealing only a mold allergy. When her dad arrived he was informed of the situation and advised to monitor her and alert EMS with any worsening of the condition or difficulty breathing. A follow up phone call to the patient a couple hours later (around 6pm) was not answered.