chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 81.0
Sex: F
Vaccine: COVID19
Symptoms: Echocardiogram, Ejection fraction, Electrocardiogram normal, Escherichia test positive, Glycosylated haemoglobin increased
Clinical narrative: The patient is a 82 y.o. female with history of cad, cardiomyopathy, dm2, ckd3 presented to the Hospital with exertional dyspnea .   Exertional dyspnea and hypoxia - resolved  Covid 19 virus infection Date of onset of symptoms: 1/3/23 Symptoms present on admission: Cough, nasal congestion, exertional dyspnea Date of covid positive test: 1/5/2023 Vaccination status: vaccinated Imaging: CTPA showed no acute PE, showed borderline aortic aneurysm and ascending aorta, stable mildly enlarged mediastinal and bilateral hilar lymph nodes.  Minimal scarring in RML.  Cholelithiasis also noted Oxygen requirements on admission: None at rest, 2 L with exertion Current oxygen requirements: Room air Medical therapy: steroids Consultants following: ID Anticipated special isolation end date: 1/13/2023   AKI on CKD 3 - resolved  Most likely due to diuresis Cr 1.9 on arrival Baseline Cr.  Around 1.4 Hold home diuretics and Entresto Avoid nephrotoxins Monitor renal function   Acute UTI UA with moderate leuk esterase, WBC 9500 bacteria Patient does endorse urinary frequency but is also on diuretic Given Keflex in ER Urine culture grew E-coli  Will discharge home with 2 more days of Keflex   Elevated troponin Troponin 27 and then 24 Likely related to CKD EKG without any acute ST changes Patient denies chest pain Continue telemetry monitoring   Chronic HFrEF Does not appear clinically fluid overloaded Hold home Lasix and Aldactone given AKI Monitor volume status BNP 509, near baseline of 500 Echo 12/12 with EF 45%  Hilar lymphadenopathy, chronic stable, likely benign.    DM type 2 with current long term insulin use and CKD 3 A1c 8.8 on 12/16/2022 Home regimen: levemir 50 units qpm and novlog 7-10 with meals Lantus 25 units nightly plus sliding scale ordered for now   Acquired hypothyroidism Continue levothroid   Depression Continue sertraline
Age: 81.0
Sex: F
Vaccine: COVID19
Symptoms: Hilar lymphadenopathy, Hypervolaemia, Hypoxia, Lymphadenopathy, Malaise
Clinical narrative: The patient is a 82 y.o. female with history of cad, cardiomyopathy, dm2, ckd3 presented to the Hospital with exertional dyspnea .   Exertional dyspnea and hypoxia - resolved  Covid 19 virus infection Date of onset of symptoms: 1/3/23 Symptoms present on admission: Cough, nasal congestion, exertional dyspnea Date of covid positive test: 1/5/2023 Vaccination status: vaccinated Imaging: CTPA showed no acute PE, showed borderline aortic aneurysm and ascending aorta, stable mildly enlarged mediastinal and bilateral hilar lymph nodes.  Minimal scarring in RML.  Cholelithiasis also noted Oxygen requirements on admission: None at rest, 2 L with exertion Current oxygen requirements: Room air Medical therapy: steroids Consultants following: ID Anticipated special isolation end date: 1/13/2023   AKI on CKD 3 - resolved  Most likely due to diuresis Cr 1.9 on arrival Baseline Cr.  Around 1.4 Hold home diuretics and Entresto Avoid nephrotoxins Monitor renal function   Acute UTI UA with moderate leuk esterase, WBC 9500 bacteria Patient does endorse urinary frequency but is also on diuretic Given Keflex in ER Urine culture grew E-coli  Will discharge home with 2 more days of Keflex   Elevated troponin Troponin 27 and then 24 Likely related to CKD EKG without any acute ST changes Patient denies chest pain Continue telemetry monitoring   Chronic HFrEF Does not appear clinically fluid overloaded Hold home Lasix and Aldactone given AKI Monitor volume status BNP 509, near baseline of 500 Echo 12/12 with EF 45%  Hilar lymphadenopathy, chronic stable, likely benign.    DM type 2 with current long term insulin use and CKD 3 A1c 8.8 on 12/16/2022 Home regimen: levemir 50 units qpm and novlog 7-10 with meals Lantus 25 units nightly plus sliding scale ordered for now   Acquired hypothyroidism Continue levothroid   Depression Continue sertraline
Age: 81.0
Sex: F
Vaccine: COVID19
Symptoms: Nasal congestion, Pollakiuria, Pulmonary fibrosis, SARS-CoV-2 test positive, Troponin increased
Clinical narrative: The patient is a 82 y.o. female with history of cad, cardiomyopathy, dm2, ckd3 presented to the Hospital with exertional dyspnea .   Exertional dyspnea and hypoxia - resolved  Covid 19 virus infection Date of onset of symptoms: 1/3/23 Symptoms present on admission: Cough, nasal congestion, exertional dyspnea Date of covid positive test: 1/5/2023 Vaccination status: vaccinated Imaging: CTPA showed no acute PE, showed borderline aortic aneurysm and ascending aorta, stable mildly enlarged mediastinal and bilateral hilar lymph nodes.  Minimal scarring in RML.  Cholelithiasis also noted Oxygen requirements on admission: None at rest, 2 L with exertion Current oxygen requirements: Room air Medical therapy: steroids Consultants following: ID Anticipated special isolation end date: 1/13/2023   AKI on CKD 3 - resolved  Most likely due to diuresis Cr 1.9 on arrival Baseline Cr.  Around 1.4 Hold home diuretics and Entresto Avoid nephrotoxins Monitor renal function   Acute UTI UA with moderate leuk esterase, WBC 9500 bacteria Patient does endorse urinary frequency but is also on diuretic Given Keflex in ER Urine culture grew E-coli  Will discharge home with 2 more days of Keflex   Elevated troponin Troponin 27 and then 24 Likely related to CKD EKG without any acute ST changes Patient denies chest pain Continue telemetry monitoring   Chronic HFrEF Does not appear clinically fluid overloaded Hold home Lasix and Aldactone given AKI Monitor volume status BNP 509, near baseline of 500 Echo 12/12 with EF 45%  Hilar lymphadenopathy, chronic stable, likely benign.    DM type 2 with current long term insulin use and CKD 3 A1c 8.8 on 12/16/2022 Home regimen: levemir 50 units qpm and novlog 7-10 with meals Lantus 25 units nightly plus sliding scale ordered for now   Acquired hypothyroidism Continue levothroid   Depression Continue sertraline
Age: 81.0
Sex: F
Vaccine: COVID19
Symptoms: Urinary tract infection, Urine analysis abnormal, Urine leukocyte esterase positive, White blood cells urine positive
Clinical narrative: The patient is a 82 y.o. female with history of cad, cardiomyopathy, dm2, ckd3 presented to the Hospital with exertional dyspnea .   Exertional dyspnea and hypoxia - resolved  Covid 19 virus infection Date of onset of symptoms: 1/3/23 Symptoms present on admission: Cough, nasal congestion, exertional dyspnea Date of covid positive test: 1/5/2023 Vaccination status: vaccinated Imaging: CTPA showed no acute PE, showed borderline aortic aneurysm and ascending aorta, stable mildly enlarged mediastinal and bilateral hilar lymph nodes.  Minimal scarring in RML.  Cholelithiasis also noted Oxygen requirements on admission: None at rest, 2 L with exertion Current oxygen requirements: Room air Medical therapy: steroids Consultants following: ID Anticipated special isolation end date: 1/13/2023   AKI on CKD 3 - resolved  Most likely due to diuresis Cr 1.9 on arrival Baseline Cr.  Around 1.4 Hold home diuretics and Entresto Avoid nephrotoxins Monitor renal function   Acute UTI UA with moderate leuk esterase, WBC 9500 bacteria Patient does endorse urinary frequency but is also on diuretic Given Keflex in ER Urine culture grew E-coli  Will discharge home with 2 more days of Keflex   Elevated troponin Troponin 27 and then 24 Likely related to CKD EKG without any acute ST changes Patient denies chest pain Continue telemetry monitoring   Chronic HFrEF Does not appear clinically fluid overloaded Hold home Lasix and Aldactone given AKI Monitor volume status BNP 509, near baseline of 500 Echo 12/12 with EF 45%  Hilar lymphadenopathy, chronic stable, likely benign.    DM type 2 with current long term insulin use and CKD 3 A1c 8.8 on 12/16/2022 Home regimen: levemir 50 units qpm and novlog 7-10 with meals Lantus 25 units nightly plus sliding scale ordered for now   Acquired hypothyroidism Continue levothroid   Depression Continue sertraline
Age: 85.0
Sex: M
Vaccine: COVID19
Symptoms: Acute kidney injury, Acute respiratory failure, Asthenia, Blood creatinine increased, COVID-19
Clinical narrative: Clinical Summary Patient is a 86 y.o. male with a history of CAD, HFpEF, CKD-4, recently dx with COVID 12/17/22, who presented to hospital 12/22/22 with progressive dyspnea, weight gain, generalized weakness and abdominal/lower extremity edema. Found to have acute CHF. Hospital course complicated by worsening CKD started on HD, pneumonia and dispo/goals of care. After GOC discussions plan was to transition to inpatient hospice.    1. Acute on Chronic HFpEF: S/p PPM, with pHTN. Follows with Dr. TTE 12/14/22 with EF 57%, pHTN. Admit ProBNP 31K. Started on IV diuresis then switched to Lasix gtt, now on dialysis. Meds completed for CC.  2. AKI on CKD-4: Follows Dr. (nephrology). Baseline Cr recently ~3 but on admission Cr >4. Nephrology began trial of CRT 12/30/22. IR placed line 12/30/22. Pt already has outpt chair set up for T-R-S, however family requested twice a week given weakness - Nephro following labs. Patient declined HD and transitioned to hospice.  3. COVID-19: Symptom onset 12/16/22. Tested positive 12/17/22. Had persistent hypoxia, so obtained CT Chest 12/24/22, showed multifocal PNA. Completed decadron and Azithromycin 1/2/22. Resolved.  4. Acute Resp Failure: used to be on O2 at baseline, but last few months has not used it. Required 3L on admit, titrate for comfort.  5. DM-2: by hx. Insulin completed.  6. CAD: Follows with Dr. (cardiology). CABG 1992 and also stent. ASA and statin completed.  7. History of Heart Block: Complete heart block s/p PPM implant with generator change during hospitalization 12/2021. Recent device interrogation almost 100% RV pacing without significant arrhythmia 8. Dysphagia: new problem noted 1/1/22- recommended regular solids, thin liquids 9. Sacral pressure injury stage 2: wound care completed.
Age: 85.0
Sex: M
Vaccine: COVID19
Symptoms: Cardiac failure congestive, Cardiac resynchronisation therapy, Chronic kidney disease, Computerised tomogram thorax abnormal, Condition aggravated
Clinical narrative: Clinical Summary Patient is a 86 y.o. male with a history of CAD, HFpEF, CKD-4, recently dx with COVID 12/17/22, who presented to hospital 12/22/22 with progressive dyspnea, weight gain, generalized weakness and abdominal/lower extremity edema. Found to have acute CHF. Hospital course complicated by worsening CKD started on HD, pneumonia and dispo/goals of care. After GOC discussions plan was to transition to inpatient hospice.    1. Acute on Chronic HFpEF: S/p PPM, with pHTN. Follows with Dr. TTE 12/14/22 with EF 57%, pHTN. Admit ProBNP 31K. Started on IV diuresis then switched to Lasix gtt, now on dialysis. Meds completed for CC.  2. AKI on CKD-4: Follows Dr. (nephrology). Baseline Cr recently ~3 but on admission Cr >4. Nephrology began trial of CRT 12/30/22. IR placed line 12/30/22. Pt already has outpt chair set up for T-R-S, however family requested twice a week given weakness - Nephro following labs. Patient declined HD and transitioned to hospice.  3. COVID-19: Symptom onset 12/16/22. Tested positive 12/17/22. Had persistent hypoxia, so obtained CT Chest 12/24/22, showed multifocal PNA. Completed decadron and Azithromycin 1/2/22. Resolved.  4. Acute Resp Failure: used to be on O2 at baseline, but last few months has not used it. Required 3L on admit, titrate for comfort.  5. DM-2: by hx. Insulin completed.  6. CAD: Follows with Dr. (cardiology). CABG 1992 and also stent. ASA and statin completed.  7. History of Heart Block: Complete heart block s/p PPM implant with generator change during hospitalization 12/2021. Recent device interrogation almost 100% RV pacing without significant arrhythmia 8. Dysphagia: new problem noted 1/1/22- recommended regular solids, thin liquids 9. Sacral pressure injury stage 2: wound care completed.
Age: 85.0
Sex: M
Vaccine: COVID19
Symptoms: Decubitus ulcer, Diuretic therapy, Dysphagia, Dyspnoea, Echocardiogram
Clinical narrative: Clinical Summary Patient is a 86 y.o. male with a history of CAD, HFpEF, CKD-4, recently dx with COVID 12/17/22, who presented to hospital 12/22/22 with progressive dyspnea, weight gain, generalized weakness and abdominal/lower extremity edema. Found to have acute CHF. Hospital course complicated by worsening CKD started on HD, pneumonia and dispo/goals of care. After GOC discussions plan was to transition to inpatient hospice.    1. Acute on Chronic HFpEF: S/p PPM, with pHTN. Follows with Dr. TTE 12/14/22 with EF 57%, pHTN. Admit ProBNP 31K. Started on IV diuresis then switched to Lasix gtt, now on dialysis. Meds completed for CC.  2. AKI on CKD-4: Follows Dr. (nephrology). Baseline Cr recently ~3 but on admission Cr >4. Nephrology began trial of CRT 12/30/22. IR placed line 12/30/22. Pt already has outpt chair set up for T-R-S, however family requested twice a week given weakness - Nephro following labs. Patient declined HD and transitioned to hospice.  3. COVID-19: Symptom onset 12/16/22. Tested positive 12/17/22. Had persistent hypoxia, so obtained CT Chest 12/24/22, showed multifocal PNA. Completed decadron and Azithromycin 1/2/22. Resolved.  4. Acute Resp Failure: used to be on O2 at baseline, but last few months has not used it. Required 3L on admit, titrate for comfort.  5. DM-2: by hx. Insulin completed.  6. CAD: Follows with Dr. (cardiology). CABG 1992 and also stent. ASA and statin completed.  7. History of Heart Block: Complete heart block s/p PPM implant with generator change during hospitalization 12/2021. Recent device interrogation almost 100% RV pacing without significant arrhythmia 8. Dysphagia: new problem noted 1/1/22- recommended regular solids, thin liquids 9. Sacral pressure injury stage 2: wound care completed.
Age: 85.0
Sex: M
Vaccine: COVID19
Symptoms: Ejection fraction normal, Haemodialysis, Hypoxia, Localised oedema, Malaise
Clinical narrative: Clinical Summary Patient is a 86 y.o. male with a history of CAD, HFpEF, CKD-4, recently dx with COVID 12/17/22, who presented to hospital 12/22/22 with progressive dyspnea, weight gain, generalized weakness and abdominal/lower extremity edema. Found to have acute CHF. Hospital course complicated by worsening CKD started on HD, pneumonia and dispo/goals of care. After GOC discussions plan was to transition to inpatient hospice.    1. Acute on Chronic HFpEF: S/p PPM, with pHTN. Follows with Dr. TTE 12/14/22 with EF 57%, pHTN. Admit ProBNP 31K. Started on IV diuresis then switched to Lasix gtt, now on dialysis. Meds completed for CC.  2. AKI on CKD-4: Follows Dr. (nephrology). Baseline Cr recently ~3 but on admission Cr >4. Nephrology began trial of CRT 12/30/22. IR placed line 12/30/22. Pt already has outpt chair set up for T-R-S, however family requested twice a week given weakness - Nephro following labs. Patient declined HD and transitioned to hospice.  3. COVID-19: Symptom onset 12/16/22. Tested positive 12/17/22. Had persistent hypoxia, so obtained CT Chest 12/24/22, showed multifocal PNA. Completed decadron and Azithromycin 1/2/22. Resolved.  4. Acute Resp Failure: used to be on O2 at baseline, but last few months has not used it. Required 3L on admit, titrate for comfort.  5. DM-2: by hx. Insulin completed.  6. CAD: Follows with Dr. (cardiology). CABG 1992 and also stent. ASA and statin completed.  7. History of Heart Block: Complete heart block s/p PPM implant with generator change during hospitalization 12/2021. Recent device interrogation almost 100% RV pacing without significant arrhythmia 8. Dysphagia: new problem noted 1/1/22- recommended regular solids, thin liquids 9. Sacral pressure injury stage 2: wound care completed.
Age: 85.0
Sex: M
Vaccine: COVID19
Symptoms: Oedema peripheral, Pneumonia, Prohormone brain natriuretic peptide increased, Pulmonary hypertension, SARS-CoV-2 test positive
Clinical narrative: Clinical Summary Patient is a 86 y.o. male with a history of CAD, HFpEF, CKD-4, recently dx with COVID 12/17/22, who presented to hospital 12/22/22 with progressive dyspnea, weight gain, generalized weakness and abdominal/lower extremity edema. Found to have acute CHF. Hospital course complicated by worsening CKD started on HD, pneumonia and dispo/goals of care. After GOC discussions plan was to transition to inpatient hospice.    1. Acute on Chronic HFpEF: S/p PPM, with pHTN. Follows with Dr. TTE 12/14/22 with EF 57%, pHTN. Admit ProBNP 31K. Started on IV diuresis then switched to Lasix gtt, now on dialysis. Meds completed for CC.  2. AKI on CKD-4: Follows Dr. (nephrology). Baseline Cr recently ~3 but on admission Cr >4. Nephrology began trial of CRT 12/30/22. IR placed line 12/30/22. Pt already has outpt chair set up for T-R-S, however family requested twice a week given weakness - Nephro following labs. Patient declined HD and transitioned to hospice.  3. COVID-19: Symptom onset 12/16/22. Tested positive 12/17/22. Had persistent hypoxia, so obtained CT Chest 12/24/22, showed multifocal PNA. Completed decadron and Azithromycin 1/2/22. Resolved.  4. Acute Resp Failure: used to be on O2 at baseline, but last few months has not used it. Required 3L on admit, titrate for comfort.  5. DM-2: by hx. Insulin completed.  6. CAD: Follows with Dr. (cardiology). CABG 1992 and also stent. ASA and statin completed.  7. History of Heart Block: Complete heart block s/p PPM implant with generator change during hospitalization 12/2021. Recent device interrogation almost 100% RV pacing without significant arrhythmia 8. Dysphagia: new problem noted 1/1/22- recommended regular solids, thin liquids 9. Sacral pressure injury stage 2: wound care completed.
Age: 85.0
Sex: M
Vaccine: COVID19
Symptoms: Weight increased, Wound treatment
Clinical narrative: Clinical Summary Patient is a 86 y.o. male with a history of CAD, HFpEF, CKD-4, recently dx with COVID 12/17/22, who presented to hospital 12/22/22 with progressive dyspnea, weight gain, generalized weakness and abdominal/lower extremity edema. Found to have acute CHF. Hospital course complicated by worsening CKD started on HD, pneumonia and dispo/goals of care. After GOC discussions plan was to transition to inpatient hospice.    1. Acute on Chronic HFpEF: S/p PPM, with pHTN. Follows with Dr. TTE 12/14/22 with EF 57%, pHTN. Admit ProBNP 31K. Started on IV diuresis then switched to Lasix gtt, now on dialysis. Meds completed for CC.  2. AKI on CKD-4: Follows Dr. (nephrology). Baseline Cr recently ~3 but on admission Cr >4. Nephrology began trial of CRT 12/30/22. IR placed line 12/30/22. Pt already has outpt chair set up for T-R-S, however family requested twice a week given weakness - Nephro following labs. Patient declined HD and transitioned to hospice.  3. COVID-19: Symptom onset 12/16/22. Tested positive 12/17/22. Had persistent hypoxia, so obtained CT Chest 12/24/22, showed multifocal PNA. Completed decadron and Azithromycin 1/2/22. Resolved.  4. Acute Resp Failure: used to be on O2 at baseline, but last few months has not used it. Required 3L on admit, titrate for comfort.  5. DM-2: by hx. Insulin completed.  6. CAD: Follows with Dr. (cardiology). CABG 1992 and also stent. ASA and statin completed.  7. History of Heart Block: Complete heart block s/p PPM implant with generator change during hospitalization 12/2021. Recent device interrogation almost 100% RV pacing without significant arrhythmia 8. Dysphagia: new problem noted 1/1/22- recommended regular solids, thin liquids 9. Sacral pressure injury stage 2: wound care completed.
Age: 38.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect product formulation administered, No adverse event
Clinical narrative: No adverse events or reactions noted. Pt given Pfizer monovalent covid vaccine instead of desired Pfizer bivalent booster. Pt already received Pfizer monovalent primary series with no adverse reactions reported by pt. Pt left in stable condition.
Age: 89.0
Sex: M
Vaccine: COVID19
Symptoms: Acute respiratory failure, Anaemia, Asthenia, Benign prostatic hyperplasia, Brain natriuretic peptide increased
Clinical narrative: Acute on chronic respiratory failure with hypoxia COVID-19 pneumonia only Sepsis present on admission due to above Patient from SNF.  Family stated patient was positive on 1/4, however unable to verify.  Swabbed on 1/8 and was positive for COVID-19.  Patient is febrile, tachycardic, has leukocytosis. Discussed goals of care at length with family yesterday and will continue to keep the patient comfortable.  Patient will be discharged home with hospice likely tomorrow.   Continue comfort measures for now Tylenol for fever Initially required 4 L O2 on admission.  Titrate supplemental O2 for comfort 4L.  Comfort measures in place including muscle relaxants, anxiety medication, pain medication.   Elevated BNP, chronic BNP 2797, previously 28550   Hyponatremia, mild Due to dehydration Refrain from IVF resuscitation due to DNR cc   Anemia, stable Hb 10.5, baseline Hb 9.1-9.9   BPH Continue flomax and proscar   GERD Continue protonix   Cachexia POA   Debility Dementia Frequent falls Pressure sores buttock stage I POA Sacral pressure ulcer stage I POA Follow-up with hospice care.
Age: 89.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, COVID-19 pneumonia, Cachexia, Decubitus ulcer, Dehydration
Clinical narrative: Acute on chronic respiratory failure with hypoxia COVID-19 pneumonia only Sepsis present on admission due to above Patient from SNF.  Family stated patient was positive on 1/4, however unable to verify.  Swabbed on 1/8 and was positive for COVID-19.  Patient is febrile, tachycardic, has leukocytosis. Discussed goals of care at length with family yesterday and will continue to keep the patient comfortable.  Patient will be discharged home with hospice likely tomorrow.   Continue comfort measures for now Tylenol for fever Initially required 4 L O2 on admission.  Titrate supplemental O2 for comfort 4L.  Comfort measures in place including muscle relaxants, anxiety medication, pain medication.   Elevated BNP, chronic BNP 2797, previously 28550   Hyponatremia, mild Due to dehydration Refrain from IVF resuscitation due to DNR cc   Anemia, stable Hb 10.5, baseline Hb 9.1-9.9   BPH Continue flomax and proscar   GERD Continue protonix   Cachexia POA   Debility Dementia Frequent falls Pressure sores buttock stage I POA Sacral pressure ulcer stage I POA Follow-up with hospice care.
Age: 89.0
Sex: M
Vaccine: COVID19
Symptoms: Dementia, Fall, Gastrooesophageal reflux disease, Haemoglobin decreased, Hyponatraemia
Clinical narrative: Acute on chronic respiratory failure with hypoxia COVID-19 pneumonia only Sepsis present on admission due to above Patient from SNF.  Family stated patient was positive on 1/4, however unable to verify.  Swabbed on 1/8 and was positive for COVID-19.  Patient is febrile, tachycardic, has leukocytosis. Discussed goals of care at length with family yesterday and will continue to keep the patient comfortable.  Patient will be discharged home with hospice likely tomorrow.   Continue comfort measures for now Tylenol for fever Initially required 4 L O2 on admission.  Titrate supplemental O2 for comfort 4L.  Comfort measures in place including muscle relaxants, anxiety medication, pain medication.   Elevated BNP, chronic BNP 2797, previously 28550   Hyponatremia, mild Due to dehydration Refrain from IVF resuscitation due to DNR cc   Anemia, stable Hb 10.5, baseline Hb 9.1-9.9   BPH Continue flomax and proscar   GERD Continue protonix   Cachexia POA   Debility Dementia Frequent falls Pressure sores buttock stage I POA Sacral pressure ulcer stage I POA Follow-up with hospice care.
Age: 89.0
Sex: M
Vaccine: COVID19
Symptoms: Leukocytosis, Pyrexia, Respiratory failure, SARS-CoV-2 test positive, Sepsis
Clinical narrative: Acute on chronic respiratory failure with hypoxia COVID-19 pneumonia only Sepsis present on admission due to above Patient from SNF.  Family stated patient was positive on 1/4, however unable to verify.  Swabbed on 1/8 and was positive for COVID-19.  Patient is febrile, tachycardic, has leukocytosis. Discussed goals of care at length with family yesterday and will continue to keep the patient comfortable.  Patient will be discharged home with hospice likely tomorrow.   Continue comfort measures for now Tylenol for fever Initially required 4 L O2 on admission.  Titrate supplemental O2 for comfort 4L.  Comfort measures in place including muscle relaxants, anxiety medication, pain medication.   Elevated BNP, chronic BNP 2797, previously 28550   Hyponatremia, mild Due to dehydration Refrain from IVF resuscitation due to DNR cc   Anemia, stable Hb 10.5, baseline Hb 9.1-9.9   BPH Continue flomax and proscar   GERD Continue protonix   Cachexia POA   Debility Dementia Frequent falls Pressure sores buttock stage I POA Sacral pressure ulcer stage I POA Follow-up with hospice care.
Age: 89.0
Sex: M
Vaccine: COVID19
Symptoms: Tachycardia
Clinical narrative: Acute on chronic respiratory failure with hypoxia COVID-19 pneumonia only Sepsis present on admission due to above Patient from SNF.  Family stated patient was positive on 1/4, however unable to verify.  Swabbed on 1/8 and was positive for COVID-19.  Patient is febrile, tachycardic, has leukocytosis. Discussed goals of care at length with family yesterday and will continue to keep the patient comfortable.  Patient will be discharged home with hospice likely tomorrow.   Continue comfort measures for now Tylenol for fever Initially required 4 L O2 on admission.  Titrate supplemental O2 for comfort 4L.  Comfort measures in place including muscle relaxants, anxiety medication, pain medication.   Elevated BNP, chronic BNP 2797, previously 28550   Hyponatremia, mild Due to dehydration Refrain from IVF resuscitation due to DNR cc   Anemia, stable Hb 10.5, baseline Hb 9.1-9.9   BPH Continue flomax and proscar   GERD Continue protonix   Cachexia POA   Debility Dementia Frequent falls Pressure sores buttock stage I POA Sacral pressure ulcer stage I POA Follow-up with hospice care.
Age: 85.0
Sex: F
Vaccine: COVID19
Symptoms: Biopsy, Laboratory test normal, Nerve conduction studies normal, Pain in extremity, Paraesthesia
Clinical narrative: Intial Covid Injection given 02012021. Leg pain and paresthesia reported to physician Feb 26, 2021, with worsening symptoms and spread through bilateral legs.  After many tests doctor of Neurology referred to other for a biopsy . Biopsy was performed 07/2022 with specimen sent to Pathology   revealing small fiber neuropathy, Pain has worsened to point of 8-10 level most days. Gabapentin dose not at 900 mg day not touching pain.
Age: 85.0
Sex: F
Vaccine: COVID19
Symptoms: Small fibre neuropathy
Clinical narrative: Intial Covid Injection given 02012021. Leg pain and paresthesia reported to physician Feb 26, 2021, with worsening symptoms and spread through bilateral legs.  After many tests doctor of Neurology referred to other for a biopsy . Biopsy was performed 07/2022 with specimen sent to Pathology   revealing small fiber neuropathy, Pain has worsened to point of 8-10 level most days. Gabapentin dose not at 900 mg day not touching pain.
Age: 16.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: I accidentally gave the monovalent Pfizer instead of bivalent Pfizer
Age: 56.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Chest X-ray normal, Diarrhoea, Dizziness, Electrolyte substitution therapy
Clinical narrative: Patient is a 58 y.o. female with history of GERD,Hyperlipidemia,Hypertension,Nephrolithiasis,DM Type 2,DVT,Chronic pain syndrome,RA,OSA,COPD,Asthma,UTI,pneumonia, hypothyroidism, essential tremor presented to Hospital with Dizziness vomiting   Hypokalemia due to intractable vomiting . etiology unknown concern for gastritis gastroparesis in the setting of poorly controlled diabetes mellitus. Patient improved with potassium replacement, IV fluids, and antiemetics.   Covid-19 Virus Infection Date of onset of symptoms: 3 days prior to admission Symptoms present on admission: Nausea vomiting Date of covid positive test: 12/29/2022 Vaccination status: vaccinated Imaging: Chest x-ray shows no acute disease Oxygen requirements on admission: Room air Current oxygen requirements: Room air Medical therapy: not indicated Anticipated special isolation end date: TBD   Intractable vomiting The patient also notes some diarrhea Stool PCR was negative Resolved with symptomatic treatment..   Hypertension Essential Continue losartan   Diabetes mellitus type 2, Blood glucose fairly controlled 95 on admission. Chronically uncontrolled given hemoglobin A1c of 9.4 1/31/22 Resume previous home diabetic regimen at discharge.   Chronic anemia. Continue to monitor and treat as needed.   DVT Continue Xarelto   Hypothyroidism Continue levothyroxine
Age: 56.0
Sex: F
Vaccine: COVID19
Symptoms: Glycosylated haemoglobin increased, Hypokalaemia, Malaise, Nausea, SARS-CoV-2 test positive
Clinical narrative: Patient is a 58 y.o. female with history of GERD,Hyperlipidemia,Hypertension,Nephrolithiasis,DM Type 2,DVT,Chronic pain syndrome,RA,OSA,COPD,Asthma,UTI,pneumonia, hypothyroidism, essential tremor presented to Hospital with Dizziness vomiting   Hypokalemia due to intractable vomiting . etiology unknown concern for gastritis gastroparesis in the setting of poorly controlled diabetes mellitus. Patient improved with potassium replacement, IV fluids, and antiemetics.   Covid-19 Virus Infection Date of onset of symptoms: 3 days prior to admission Symptoms present on admission: Nausea vomiting Date of covid positive test: 12/29/2022 Vaccination status: vaccinated Imaging: Chest x-ray shows no acute disease Oxygen requirements on admission: Room air Current oxygen requirements: Room air Medical therapy: not indicated Anticipated special isolation end date: TBD   Intractable vomiting The patient also notes some diarrhea Stool PCR was negative Resolved with symptomatic treatment..   Hypertension Essential Continue losartan   Diabetes mellitus type 2, Blood glucose fairly controlled 95 on admission. Chronically uncontrolled given hemoglobin A1c of 9.4 1/31/22 Resume previous home diabetic regimen at discharge.   Chronic anemia. Continue to monitor and treat as needed.   DVT Continue Xarelto   Hypothyroidism Continue levothyroxine
Age: 56.0
Sex: F
Vaccine: COVID19
Symptoms: Stool analysis normal, Vomiting
Clinical narrative: Patient is a 58 y.o. female with history of GERD,Hyperlipidemia,Hypertension,Nephrolithiasis,DM Type 2,DVT,Chronic pain syndrome,RA,OSA,COPD,Asthma,UTI,pneumonia, hypothyroidism, essential tremor presented to Hospital with Dizziness vomiting   Hypokalemia due to intractable vomiting . etiology unknown concern for gastritis gastroparesis in the setting of poorly controlled diabetes mellitus. Patient improved with potassium replacement, IV fluids, and antiemetics.   Covid-19 Virus Infection Date of onset of symptoms: 3 days prior to admission Symptoms present on admission: Nausea vomiting Date of covid positive test: 12/29/2022 Vaccination status: vaccinated Imaging: Chest x-ray shows no acute disease Oxygen requirements on admission: Room air Current oxygen requirements: Room air Medical therapy: not indicated Anticipated special isolation end date: TBD   Intractable vomiting The patient also notes some diarrhea Stool PCR was negative Resolved with symptomatic treatment..   Hypertension Essential Continue losartan   Diabetes mellitus type 2, Blood glucose fairly controlled 95 on admission. Chronically uncontrolled given hemoglobin A1c of 9.4 1/31/22 Resume previous home diabetic regimen at discharge.   Chronic anemia. Continue to monitor and treat as needed.   DVT Continue Xarelto   Hypothyroidism Continue levothyroxine
Age: 55.0
Sex: M
Vaccine: COVID19
Symptoms: Abdominal distension, Acute respiratory failure, Angiogram pulmonary abnormal, COVID-19, COVID-19 pneumonia
Clinical narrative: Patient is a 56 y.o. male patient of CNP with history of asthma, HTN, obesity, GERD, OSA who presented to Hospital with acute respiratory failure due to multifactorial etiology: COVID-positive, fluid overload requiring 2 L nasal cannula.   Acute respiratory failure with hypoxia Initially requiring 2 L of oxygen, now weaned to room air Likely due to COVID-19 pneumonia and acute on chronic heart failure Improved   Covid-19 Virus Infection Date of onset of symptoms: 3 days PTA (1/3/23) Symptoms present on admission: Shortness of breath Date of covid positive test: 1/6/23 Vaccination status: vaccinated and boosted Imaging: CTPA (1/6/23) extensive multifocal bilateral upper and lower lung GGO Procalcitonin negative, urine Legionella and strep pneumonia negative Oxygen requirements on admission: 2 L NC Current oxygen requirements: Room air Medical therapy: remdesivir and steroids (decadron 6 mg x 10d) Consultants following: None Anticipated special isolation end date: 1/16/23   Fluid overload Acute on chronic heart failure with reduced EF Last echo 3/28 showed EF of 40±5% and grade 2 diastolic dysfunction Presenting with abdominal distention, orthopnea and bilateral lower extremity edema Good response with 60 mg of IV Lasix( 40 mg, 20 mg) Resume home medication on discharge On hydralazine, Imdur, Toprol, Entresto, and spironolactone Follow-up with primary cardiology   Asthma Resume home inhaler  Chest discomfort Presenting with chest discomfort worse with exertion Resolved Cardiac cath 3/2022 with no significant coronary artery disease Resume beta-blocker, statin and aspirin   Diabetes Hemoglobin A1c 4.7, significantly improved from previous level 9.4 Continue home medication on discharge
Age: 55.0
Sex: M
Vaccine: COVID19
Symptoms: Cardiac failure, Cardiac failure acute, Catheterisation cardiac normal, Chest discomfort, Diastolic dysfunction
Clinical narrative: Patient is a 56 y.o. male patient of CNP with history of asthma, HTN, obesity, GERD, OSA who presented to Hospital with acute respiratory failure due to multifactorial etiology: COVID-positive, fluid overload requiring 2 L nasal cannula.   Acute respiratory failure with hypoxia Initially requiring 2 L of oxygen, now weaned to room air Likely due to COVID-19 pneumonia and acute on chronic heart failure Improved   Covid-19 Virus Infection Date of onset of symptoms: 3 days PTA (1/3/23) Symptoms present on admission: Shortness of breath Date of covid positive test: 1/6/23 Vaccination status: vaccinated and boosted Imaging: CTPA (1/6/23) extensive multifocal bilateral upper and lower lung GGO Procalcitonin negative, urine Legionella and strep pneumonia negative Oxygen requirements on admission: 2 L NC Current oxygen requirements: Room air Medical therapy: remdesivir and steroids (decadron 6 mg x 10d) Consultants following: None Anticipated special isolation end date: 1/16/23   Fluid overload Acute on chronic heart failure with reduced EF Last echo 3/28 showed EF of 40±5% and grade 2 diastolic dysfunction Presenting with abdominal distention, orthopnea and bilateral lower extremity edema Good response with 60 mg of IV Lasix( 40 mg, 20 mg) Resume home medication on discharge On hydralazine, Imdur, Toprol, Entresto, and spironolactone Follow-up with primary cardiology   Asthma Resume home inhaler  Chest discomfort Presenting with chest discomfort worse with exertion Resolved Cardiac cath 3/2022 with no significant coronary artery disease Resume beta-blocker, statin and aspirin   Diabetes Hemoglobin A1c 4.7, significantly improved from previous level 9.4 Continue home medication on discharge
Age: 55.0
Sex: M
Vaccine: COVID19
Symptoms: Dyspnoea, Echocardiogram abnormal, Ejection fraction, Glycosylated haemoglobin increased, Hypervolaemia
Clinical narrative: Patient is a 56 y.o. male patient of CNP with history of asthma, HTN, obesity, GERD, OSA who presented to Hospital with acute respiratory failure due to multifactorial etiology: COVID-positive, fluid overload requiring 2 L nasal cannula.   Acute respiratory failure with hypoxia Initially requiring 2 L of oxygen, now weaned to room air Likely due to COVID-19 pneumonia and acute on chronic heart failure Improved   Covid-19 Virus Infection Date of onset of symptoms: 3 days PTA (1/3/23) Symptoms present on admission: Shortness of breath Date of covid positive test: 1/6/23 Vaccination status: vaccinated and boosted Imaging: CTPA (1/6/23) extensive multifocal bilateral upper and lower lung GGO Procalcitonin negative, urine Legionella and strep pneumonia negative Oxygen requirements on admission: 2 L NC Current oxygen requirements: Room air Medical therapy: remdesivir and steroids (decadron 6 mg x 10d) Consultants following: None Anticipated special isolation end date: 1/16/23   Fluid overload Acute on chronic heart failure with reduced EF Last echo 3/28 showed EF of 40±5% and grade 2 diastolic dysfunction Presenting with abdominal distention, orthopnea and bilateral lower extremity edema Good response with 60 mg of IV Lasix( 40 mg, 20 mg) Resume home medication on discharge On hydralazine, Imdur, Toprol, Entresto, and spironolactone Follow-up with primary cardiology   Asthma Resume home inhaler  Chest discomfort Presenting with chest discomfort worse with exertion Resolved Cardiac cath 3/2022 with no significant coronary artery disease Resume beta-blocker, statin and aspirin   Diabetes Hemoglobin A1c 4.7, significantly improved from previous level 9.4 Continue home medication on discharge
Age: 55.0
Sex: M
Vaccine: COVID19
Symptoms: Legionella test, Lung opacity, Oedema peripheral, Orthopnoea, Procalcitonin normal
Clinical narrative: Patient is a 56 y.o. male patient of CNP with history of asthma, HTN, obesity, GERD, OSA who presented to Hospital with acute respiratory failure due to multifactorial etiology: COVID-positive, fluid overload requiring 2 L nasal cannula.   Acute respiratory failure with hypoxia Initially requiring 2 L of oxygen, now weaned to room air Likely due to COVID-19 pneumonia and acute on chronic heart failure Improved   Covid-19 Virus Infection Date of onset of symptoms: 3 days PTA (1/3/23) Symptoms present on admission: Shortness of breath Date of covid positive test: 1/6/23 Vaccination status: vaccinated and boosted Imaging: CTPA (1/6/23) extensive multifocal bilateral upper and lower lung GGO Procalcitonin negative, urine Legionella and strep pneumonia negative Oxygen requirements on admission: 2 L NC Current oxygen requirements: Room air Medical therapy: remdesivir and steroids (decadron 6 mg x 10d) Consultants following: None Anticipated special isolation end date: 1/16/23   Fluid overload Acute on chronic heart failure with reduced EF Last echo 3/28 showed EF of 40±5% and grade 2 diastolic dysfunction Presenting with abdominal distention, orthopnea and bilateral lower extremity edema Good response with 60 mg of IV Lasix( 40 mg, 20 mg) Resume home medication on discharge On hydralazine, Imdur, Toprol, Entresto, and spironolactone Follow-up with primary cardiology   Asthma Resume home inhaler  Chest discomfort Presenting with chest discomfort worse with exertion Resolved Cardiac cath 3/2022 with no significant coronary artery disease Resume beta-blocker, statin and aspirin   Diabetes Hemoglobin A1c 4.7, significantly improved from previous level 9.4 Continue home medication on discharge
Age: 55.0
Sex: M
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive, Streptococcus test negative
Clinical narrative: Patient is a 56 y.o. male patient of CNP with history of asthma, HTN, obesity, GERD, OSA who presented to Hospital with acute respiratory failure due to multifactorial etiology: COVID-positive, fluid overload requiring 2 L nasal cannula.   Acute respiratory failure with hypoxia Initially requiring 2 L of oxygen, now weaned to room air Likely due to COVID-19 pneumonia and acute on chronic heart failure Improved   Covid-19 Virus Infection Date of onset of symptoms: 3 days PTA (1/3/23) Symptoms present on admission: Shortness of breath Date of covid positive test: 1/6/23 Vaccination status: vaccinated and boosted Imaging: CTPA (1/6/23) extensive multifocal bilateral upper and lower lung GGO Procalcitonin negative, urine Legionella and strep pneumonia negative Oxygen requirements on admission: 2 L NC Current oxygen requirements: Room air Medical therapy: remdesivir and steroids (decadron 6 mg x 10d) Consultants following: None Anticipated special isolation end date: 1/16/23   Fluid overload Acute on chronic heart failure with reduced EF Last echo 3/28 showed EF of 40±5% and grade 2 diastolic dysfunction Presenting with abdominal distention, orthopnea and bilateral lower extremity edema Good response with 60 mg of IV Lasix( 40 mg, 20 mg) Resume home medication on discharge On hydralazine, Imdur, Toprol, Entresto, and spironolactone Follow-up with primary cardiology   Asthma Resume home inhaler  Chest discomfort Presenting with chest discomfort worse with exertion Resolved Cardiac cath 3/2022 with no significant coronary artery disease Resume beta-blocker, statin and aspirin   Diabetes Hemoglobin A1c 4.7, significantly improved from previous level 9.4 Continue home medication on discharge
Age: 65.0
Sex: F
Vaccine: COVID19
Symptoms: Imaging procedure, Injected limb mobility decreased, Injection site pain, Magnetic resonance imaging, Tendon disorder
Clinical narrative: Excruciating pain for several days at injection site. Unable to lift R arm over head to this day 9 months later. Spent thousands of dollars on PT, steroid injections, imaging and pill packs. Pain specialist, Walk in clinics and orthopedic surgery visit. Told I have a tendinopathy.
Age: 46.0
Sex: F
Vaccine: VARZOS
Symptoms: Asthenia, Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth
Clinical narrative: I experience pain, redness, and swelling spanning several inches from an incorrectly administered Shingrix vaccination. I had warmth and redness of the skin and weakness.  I received it on 13 JAN 2023 from Immunization Clinic. Allergy Services, Department of Medicine Emailed Medical Center on 16 JAN 2023 2 16:25 subject: Shingrix Vaccine, of this reaction with a picture attached and did not receive a reply and/ or response due to his email distribution on 27 MAY 2022 subject: Safe Patient Care I also contacted Medical Center and emailed Medical Center Patient Advocate| Customer Relations, I received an email response from to call Customer Relations office by phone. I called and left a message and returned a follow-up email. There has not been any accountability or responsibility or reassurance the error has been or will be corrected.
Age: 46.0
Sex: F
Vaccine: VARZOS
Symptoms: Product administration error
Clinical narrative: I experience pain, redness, and swelling spanning several inches from an incorrectly administered Shingrix vaccination. I had warmth and redness of the skin and weakness.  I received it on 13 JAN 2023 from Immunization Clinic. Allergy Services, Department of Medicine Emailed Medical Center on 16 JAN 2023 2 16:25 subject: Shingrix Vaccine, of this reaction with a picture attached and did not receive a reply and/ or response due to his email distribution on 27 MAY 2022 subject: Safe Patient Care I also contacted Medical Center and emailed Medical Center Patient Advocate| Customer Relations, I received an email response from to call Customer Relations office by phone. I called and left a message and returned a follow-up email. There has not been any accountability or responsibility or reassurance the error has been or will be corrected.
Age: 52.0
Sex: F
Vaccine: COVID19
Symptoms: Depression, Feeling abnormal, Memory impairment, Suicidal ideation
Clinical narrative: Worsened severe depression, suicidal, foggy headed, forgetful.  Ended up in psychiatric ward.  First time ever in psychiatric ward.  Severe for 3 weeks.  First 3 vaccines fine, only mild physical symptoms.
Age: 13.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Allergy test, Loss of personal independence in daily activities, Papule, Skin abrasion, Skin disorder
Clinical narrative: My minor child experienced a negative response to the COVID-19 vaccination. The 2nd vaccination was worse than the first. She received it at Medical Center. Department of Medicine. A  significant incapacity that caused a  substantial disruption of the ability to conduct normal life functions formation of circular patches of skin. Person in Charge of COVID-19 Immunization Clinic.
Age: 13.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Staphylococcal infection
Clinical narrative: My minor child experienced a negative response to the COVID-19 vaccination. The 2nd vaccination was worse than the first. She received it at Medical Center. Department of Medicine. A  significant incapacity that caused a  substantial disruption of the ability to conduct normal life functions formation of circular patches of skin. Person in Charge of COVID-19 Immunization Clinic.
Age: 67.0
Sex: M
Vaccine: COVID19-2
Symptoms: Angiogram cerebral abnormal, Anticoagulant therapy, Arteriogram carotid abnormal, Arteriosclerosis, Blood creatinine normal
Clinical narrative: Admitted to the hospital with symptoms consistent with an acute ischemic stroke on 1/28/23. On 1/25 or 1/26 he noticed intermittent blurry vision, primarily with near vision (did not have difficulty driving to the HCF on 1/28). On 1/27 at 8pm, he developed acute onset tongue numbness, a feeling that his L face was rubbery, and L UE/LE weakness and  numbness, primarily in his hand and leg. Noticed it was harder to lift his L leg  to walk but was still able to. Looked on the internet 1/28 and was concerned about a stroke, so he drove to the ED and walked unassisted inside. On admission on 1/28, reported that his weakness/numbness is improving but not resolved. Exam notable for tongue protrusion w/ R deviation, SILT in all extremities but decreased on L UE/LE, strength 5/5 R UE/LE and 4/5 L UE/LE, no pronator drift, FNF wnl. ASA and plavix loaded in the ED, seen by neuro and discussed with cardiology. Remains admitted undergoing stroke work-up, including ICD interrogation, TTE, and repeat CT. Unfortunately, this HCF does not do MRIs in patients with ICDs. Currently on a heparin drip and home medications except aspirin, with final plan to be decided 1/30.
Age: 67.0
Sex: M
Vaccine: COVID19-2
Symptoms: Blood fibrinogen normal, Blood thyroid stimulating hormone normal, Carotid arteriosclerosis, Coagulation test normal, Computerised tomogram
Clinical narrative: Admitted to the hospital with symptoms consistent with an acute ischemic stroke on 1/28/23. On 1/25 or 1/26 he noticed intermittent blurry vision, primarily with near vision (did not have difficulty driving to the HCF on 1/28). On 1/27 at 8pm, he developed acute onset tongue numbness, a feeling that his L face was rubbery, and L UE/LE weakness and  numbness, primarily in his hand and leg. Noticed it was harder to lift his L leg  to walk but was still able to. Looked on the internet 1/28 and was concerned about a stroke, so he drove to the ED and walked unassisted inside. On admission on 1/28, reported that his weakness/numbness is improving but not resolved. Exam notable for tongue protrusion w/ R deviation, SILT in all extremities but decreased on L UE/LE, strength 5/5 R UE/LE and 4/5 L UE/LE, no pronator drift, FNF wnl. ASA and plavix loaded in the ED, seen by neuro and discussed with cardiology. Remains admitted undergoing stroke work-up, including ICD interrogation, TTE, and repeat CT. Unfortunately, this HCF does not do MRIs in patients with ICDs. Currently on a heparin drip and home medications except aspirin, with final plan to be decided 1/30.
Age: 67.0
Sex: M
Vaccine: COVID19-2
Symptoms: Computerised tomogram head normal, Echocardiogram, Electrocardiogram normal, Electrophoresis protein normal, Gait disturbance
Clinical narrative: Admitted to the hospital with symptoms consistent with an acute ischemic stroke on 1/28/23. On 1/25 or 1/26 he noticed intermittent blurry vision, primarily with near vision (did not have difficulty driving to the HCF on 1/28). On 1/27 at 8pm, he developed acute onset tongue numbness, a feeling that his L face was rubbery, and L UE/LE weakness and  numbness, primarily in his hand and leg. Noticed it was harder to lift his L leg  to walk but was still able to. Looked on the internet 1/28 and was concerned about a stroke, so he drove to the ED and walked unassisted inside. On admission on 1/28, reported that his weakness/numbness is improving but not resolved. Exam notable for tongue protrusion w/ R deviation, SILT in all extremities but decreased on L UE/LE, strength 5/5 R UE/LE and 4/5 L UE/LE, no pronator drift, FNF wnl. ASA and plavix loaded in the ED, seen by neuro and discussed with cardiology. Remains admitted undergoing stroke work-up, including ICD interrogation, TTE, and repeat CT. Unfortunately, this HCF does not do MRIs in patients with ICDs. Currently on a heparin drip and home medications except aspirin, with final plan to be decided 1/30.