chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 73.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Drain placement, Dyspnoea, Dyspnoea exertional, Echocardiogram abnormal, Ejection fraction
Clinical narrative: 74y.o. female with PMHx of kidney stones who presented with shortness of breath. She stated that she is being worked up for possible lung cancer and had a biopsy done of a mediastinal mass at the end of June that was concerning for lung cancer. She states that she has been experiencing some exertional dyspnea. She had imaging done on 7/20 which revealed a moderate pericardial effusion and pt was sent in for eval. In EC, ECG shows sinus tachycardia. Imaging revealed a large pericardial effusion with possible early signs of tamponade. Pt was admitted to ICU for further management. Pt is s/p pericardiocentesis with drain. Repeat Echo demonstrated minimal pericardial effusion. Drain was removed. Developed fever and Urine culture with GNB and was treated with IV ceftriaxone and transitioned to Augmentin until 8/7. Pt started on radiation therapy for her lung cancer. Pt on radiation therapy until August 11th. Pt originally to stay IP until radiation completed but transportation was able to be arranged and patient wishes to go home. Pt to follow up with hematology and pulmonology as OP. Cleared for discharge home on 8/5. She returned on 8/6/2022 for shortness of breath that started earlier that day.  In EC, Bedside echocardiogram showed small pericardial effusion w/ no signs of tamponade.  Labs indicated a positive COVID-19 swab and CXR concerning for L sided pleural effusion. She was admitted for further workup. CT of chest showing significant enlargement of patient's anterior mediastinal mass with severe compression narrowing of the main pulmonary artery. There is also relative compression of the left atrium due to the increased size of the mass. There is increased pericardial effusion and there is new moderate left pleural effusion. She had episodes of NSVT improving, continue lopressor BID. repeat ECHO with EF 50%, small pericardial effusion. She  compelted remdesevir and sats stable on RA. hematology following  And completed 10 radiation treatments. Pt is stable for d/c home with close Op follow up
Age: 73.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Electrocardiogram abnormal, Imaging procedure abnormal, Intensive care, Lung neoplasm malignant, Mediastinal biopsy abnormal
Clinical narrative: 74y.o. female with PMHx of kidney stones who presented with shortness of breath. She stated that she is being worked up for possible lung cancer and had a biopsy done of a mediastinal mass at the end of June that was concerning for lung cancer. She states that she has been experiencing some exertional dyspnea. She had imaging done on 7/20 which revealed a moderate pericardial effusion and pt was sent in for eval. In EC, ECG shows sinus tachycardia. Imaging revealed a large pericardial effusion with possible early signs of tamponade. Pt was admitted to ICU for further management. Pt is s/p pericardiocentesis with drain. Repeat Echo demonstrated minimal pericardial effusion. Drain was removed. Developed fever and Urine culture with GNB and was treated with IV ceftriaxone and transitioned to Augmentin until 8/7. Pt started on radiation therapy for her lung cancer. Pt on radiation therapy until August 11th. Pt originally to stay IP until radiation completed but transportation was able to be arranged and patient wishes to go home. Pt to follow up with hematology and pulmonology as OP. Cleared for discharge home on 8/5. She returned on 8/6/2022 for shortness of breath that started earlier that day.  In EC, Bedside echocardiogram showed small pericardial effusion w/ no signs of tamponade.  Labs indicated a positive COVID-19 swab and CXR concerning for L sided pleural effusion. She was admitted for further workup. CT of chest showing significant enlargement of patient's anterior mediastinal mass with severe compression narrowing of the main pulmonary artery. There is also relative compression of the left atrium due to the increased size of the mass. There is increased pericardial effusion and there is new moderate left pleural effusion. She had episodes of NSVT improving, continue lopressor BID. repeat ECHO with EF 50%, small pericardial effusion. She  compelted remdesevir and sats stable on RA. hematology following  And completed 10 radiation treatments. Pt is stable for d/c home with close Op follow up
Age: 73.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Mediastinal mass, Pericardial drainage, Pericardial effusion, Pleural effusion, Pulmonary artery compression
Clinical narrative: 74y.o. female with PMHx of kidney stones who presented with shortness of breath. She stated that she is being worked up for possible lung cancer and had a biopsy done of a mediastinal mass at the end of June that was concerning for lung cancer. She states that she has been experiencing some exertional dyspnea. She had imaging done on 7/20 which revealed a moderate pericardial effusion and pt was sent in for eval. In EC, ECG shows sinus tachycardia. Imaging revealed a large pericardial effusion with possible early signs of tamponade. Pt was admitted to ICU for further management. Pt is s/p pericardiocentesis with drain. Repeat Echo demonstrated minimal pericardial effusion. Drain was removed. Developed fever and Urine culture with GNB and was treated with IV ceftriaxone and transitioned to Augmentin until 8/7. Pt started on radiation therapy for her lung cancer. Pt on radiation therapy until August 11th. Pt originally to stay IP until radiation completed but transportation was able to be arranged and patient wishes to go home. Pt to follow up with hematology and pulmonology as OP. Cleared for discharge home on 8/5. She returned on 8/6/2022 for shortness of breath that started earlier that day.  In EC, Bedside echocardiogram showed small pericardial effusion w/ no signs of tamponade.  Labs indicated a positive COVID-19 swab and CXR concerning for L sided pleural effusion. She was admitted for further workup. CT of chest showing significant enlargement of patient's anterior mediastinal mass with severe compression narrowing of the main pulmonary artery. There is also relative compression of the left atrium due to the increased size of the mass. There is increased pericardial effusion and there is new moderate left pleural effusion. She had episodes of NSVT improving, continue lopressor BID. repeat ECHO with EF 50%, small pericardial effusion. She  compelted remdesevir and sats stable on RA. hematology following  And completed 10 radiation treatments. Pt is stable for d/c home with close Op follow up
Age: 73.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Pyrexia, Radiotherapy, SARS-CoV-2 test positive, Sinus tachycardia, Ventricular tachycardia
Clinical narrative: 74y.o. female with PMHx of kidney stones who presented with shortness of breath. She stated that she is being worked up for possible lung cancer and had a biopsy done of a mediastinal mass at the end of June that was concerning for lung cancer. She states that she has been experiencing some exertional dyspnea. She had imaging done on 7/20 which revealed a moderate pericardial effusion and pt was sent in for eval. In EC, ECG shows sinus tachycardia. Imaging revealed a large pericardial effusion with possible early signs of tamponade. Pt was admitted to ICU for further management. Pt is s/p pericardiocentesis with drain. Repeat Echo demonstrated minimal pericardial effusion. Drain was removed. Developed fever and Urine culture with GNB and was treated with IV ceftriaxone and transitioned to Augmentin until 8/7. Pt started on radiation therapy for her lung cancer. Pt on radiation therapy until August 11th. Pt originally to stay IP until radiation completed but transportation was able to be arranged and patient wishes to go home. Pt to follow up with hematology and pulmonology as OP. Cleared for discharge home on 8/5. She returned on 8/6/2022 for shortness of breath that started earlier that day.  In EC, Bedside echocardiogram showed small pericardial effusion w/ no signs of tamponade.  Labs indicated a positive COVID-19 swab and CXR concerning for L sided pleural effusion. She was admitted for further workup. CT of chest showing significant enlargement of patient's anterior mediastinal mass with severe compression narrowing of the main pulmonary artery. There is also relative compression of the left atrium due to the increased size of the mass. There is increased pericardial effusion and there is new moderate left pleural effusion. She had episodes of NSVT improving, continue lopressor BID. repeat ECHO with EF 50%, small pericardial effusion. She  compelted remdesevir and sats stable on RA. hematology following  And completed 10 radiation treatments. Pt is stable for d/c home with close Op follow up
Age: 31.0
Sex: M
Vaccine: HEP
Symptoms: Expired product administered
Clinical narrative: Expired dose given
Age: 26.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Aggression, COVID-19, Hallucination, Homicidal ideation, Paranoia
Clinical narrative: 27-year-old male with history of hypertension and mood disorder was brought to the hospital by the cops since he was noted to have paranoid thoughts, hallucinations, homicidal ideations and aggressive behavior.  The police found him yelling on the streets and fighting.  Per notes, patient told that someone stole his father's car business and he wanted to kill him.  He also endorsed suicidal thoughts per notes.  He denies any history of suicidal attempts.  He has had 2 previous inpatient psychiatric admissions.  He drinks alcohol socially.  He denies drug use.  He uses cannabis recreationally.  He is currently homeless and collecting SSI.  He was seen in the emergency room.  His home medications were restarted. Additional information for Item 18: He was kept on Ativan, Haldol and Thorazine for agitation.  He was certified by the psychiatrist.  Currently awaiting placement.  Incidentally, patient was noted to have swabbed positive for COVID-19.  He is currently admitted as psych facility will not take him till he is off COVID precautions.  He does not have any upper respiratory symptoms at this time.  No fevers or chills.  No chest pain or shortness of breath.  He mentions to have received 2 doses of the vaccine in 2021.  When I examined the patient, he did not want to go into details of why he was having homicidal and suicidal ideations. Pt medically cleared for discharged to Inpt Psych with Behavioral Center, with EMS transportation. Healtchare coordinated and arranged by Inpt psych. No other needs.
Age: 26.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: SARS-CoV-2 test positive, Screaming, Suicidal ideation
Clinical narrative: 27-year-old male with history of hypertension and mood disorder was brought to the hospital by the cops since he was noted to have paranoid thoughts, hallucinations, homicidal ideations and aggressive behavior.  The police found him yelling on the streets and fighting.  Per notes, patient told that someone stole his father's car business and he wanted to kill him.  He also endorsed suicidal thoughts per notes.  He denies any history of suicidal attempts.  He has had 2 previous inpatient psychiatric admissions.  He drinks alcohol socially.  He denies drug use.  He uses cannabis recreationally.  He is currently homeless and collecting SSI.  He was seen in the emergency room.  His home medications were restarted. Additional information for Item 18: He was kept on Ativan, Haldol and Thorazine for agitation.  He was certified by the psychiatrist.  Currently awaiting placement.  Incidentally, patient was noted to have swabbed positive for COVID-19.  He is currently admitted as psych facility will not take him till he is off COVID precautions.  He does not have any upper respiratory symptoms at this time.  No fevers or chills.  No chest pain or shortness of breath.  He mentions to have received 2 doses of the vaccine in 2021.  When I examined the patient, he did not want to go into details of why he was having homicidal and suicidal ideations. Pt medically cleared for discharged to Inpt Psych with Behavioral Center, with EMS transportation. Healtchare coordinated and arranged by Inpt psych. No other needs.
Age: 62.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Agitation, COVID-19, Device issue, Ear pain, Homicidal ideation
Clinical narrative: This 63-year-old gentleman was admitted on 08/07/2022.  He has been noted to have a left upper lobe lung mass which is suspicious for carcinoma.  Evaluation is ongoing.  The patient describes a 2-week history of otalgia.  Initially, this involved the left ear, but later involved the right ear as well.  Pain is intermittent, moderate intensity, and may be triggered by opening his mouth wide.  He denies any  habit of clenching of teeth, but he has a lower denture which fits poorly.  He has had no otorrhea. He was kept on Ativan, Haldol and Thorazine for agitation.  He was certified by the psychiatrist.  Currently awaiting placement.  Incidentally, patient was noted to have swabbed positive for COVID-19.  He is currently admitted as psych facility will not take him till he is off COVID precautions.  He does not have any upper respiratory symptoms at this time.  No fevers or chills.  No chest pain or shortness of breath.  He mentions to have received 2 doses of the vaccine in 2021.  When I examined the patient, he did not want to go into details of why he was having homicidal and suicidal ideations. Pt medically cleared for discharged to Inpt Psych with Behavioral Center, with EMS transportation. Coordinated and arranged by Inpt psych. No other needs.
Age: 62.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Pain, Pulmonary mass, SARS-CoV-2 test positive, Suicidal ideation
Clinical narrative: This 63-year-old gentleman was admitted on 08/07/2022.  He has been noted to have a left upper lobe lung mass which is suspicious for carcinoma.  Evaluation is ongoing.  The patient describes a 2-week history of otalgia.  Initially, this involved the left ear, but later involved the right ear as well.  Pain is intermittent, moderate intensity, and may be triggered by opening his mouth wide.  He denies any  habit of clenching of teeth, but he has a lower denture which fits poorly.  He has had no otorrhea. He was kept on Ativan, Haldol and Thorazine for agitation.  He was certified by the psychiatrist.  Currently awaiting placement.  Incidentally, patient was noted to have swabbed positive for COVID-19.  He is currently admitted as psych facility will not take him till he is off COVID precautions.  He does not have any upper respiratory symptoms at this time.  No fevers or chills.  No chest pain or shortness of breath.  He mentions to have received 2 doses of the vaccine in 2021.  When I examined the patient, he did not want to go into details of why he was having homicidal and suicidal ideations. Pt medically cleared for discharged to Inpt Psych with Behavioral Center, with EMS transportation. Coordinated and arranged by Inpt psych. No other needs.
Age: 80.0
Sex: M
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Acute kidney injury, Agitation, Arthralgia, Asymptomatic COVID-19, Bone deformity
Clinical narrative: Patient is a 81-year-old male was admitted with complaints of ankle pain.  Patient was attempting to move from 1 chair to the other he hit his ankle he did not lose consciousness.  Because of the pain he brought to the ER when he came to the ER patient vitals have been stable. Trauma work-up done including left foot x-ray no acute process. Right foot x-ray diffuse soft tissue edema chronic deformity of mid right fibula compatible with healed fracture left ankle x-ray diffuse soft tissue edema. He was found to have AKI, rhabdo. Asymptomatic Covid 19 on routine screening for discharge at the request for SAR. He was kept on Ativan, Haldol and Thorazine for agitation.  He was certified by the psychiatrist.  Currently awaiting placement.  Incidentally, patient was noted to have swabbed positive for COVID-19.  He is currently admitted as psych facility will not take him till he is off COVID precautions.  He does not have any upper respiratory symptoms at this time.  No fevers or chills.  No chest pain or shortness of breath.  He mentions to have received 2 doses of the vaccine in 2021.  When I examined the patient, he did not want to go into details of why he was having homicidal and suicidal ideations. Pt medically cleared for discharged via EMS transportation. DCP coordinated and arranged by psych. No other needs.
Age: 80.0
Sex: M
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Fibula fracture, Homicidal ideation, Joint injury, Rhabdomyolysis, SARS-CoV-2 test positive
Clinical narrative: Patient is a 81-year-old male was admitted with complaints of ankle pain.  Patient was attempting to move from 1 chair to the other he hit his ankle he did not lose consciousness.  Because of the pain he brought to the ER when he came to the ER patient vitals have been stable. Trauma work-up done including left foot x-ray no acute process. Right foot x-ray diffuse soft tissue edema chronic deformity of mid right fibula compatible with healed fracture left ankle x-ray diffuse soft tissue edema. He was found to have AKI, rhabdo. Asymptomatic Covid 19 on routine screening for discharge at the request for SAR. He was kept on Ativan, Haldol and Thorazine for agitation.  He was certified by the psychiatrist.  Currently awaiting placement.  Incidentally, patient was noted to have swabbed positive for COVID-19.  He is currently admitted as psych facility will not take him till he is off COVID precautions.  He does not have any upper respiratory symptoms at this time.  No fevers or chills.  No chest pain or shortness of breath.  He mentions to have received 2 doses of the vaccine in 2021.  When I examined the patient, he did not want to go into details of why he was having homicidal and suicidal ideations. Pt medically cleared for discharged via EMS transportation. DCP coordinated and arranged by psych. No other needs.
Age: 80.0
Sex: M
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Soft tissue swelling, Suicidal ideation, X-ray limb abnormal
Clinical narrative: Patient is a 81-year-old male was admitted with complaints of ankle pain.  Patient was attempting to move from 1 chair to the other he hit his ankle he did not lose consciousness.  Because of the pain he brought to the ER when he came to the ER patient vitals have been stable. Trauma work-up done including left foot x-ray no acute process. Right foot x-ray diffuse soft tissue edema chronic deformity of mid right fibula compatible with healed fracture left ankle x-ray diffuse soft tissue edema. He was found to have AKI, rhabdo. Asymptomatic Covid 19 on routine screening for discharge at the request for SAR. He was kept on Ativan, Haldol and Thorazine for agitation.  He was certified by the psychiatrist.  Currently awaiting placement.  Incidentally, patient was noted to have swabbed positive for COVID-19.  He is currently admitted as psych facility will not take him till he is off COVID precautions.  He does not have any upper respiratory symptoms at this time.  No fevers or chills.  No chest pain or shortness of breath.  He mentions to have received 2 doses of the vaccine in 2021.  When I examined the patient, he did not want to go into details of why he was having homicidal and suicidal ideations. Pt medically cleared for discharged via EMS transportation. DCP coordinated and arranged by psych. No other needs.
Age: 69.0
Sex: F
Vaccine: UNK
Symptoms: Injected limb mobility decreased, Injection site pain, Pain
Clinical narrative: Patient had pain at the injection site and it hurt to lift her arm, she was unable to life her arm due to the pain
Age: 83.0
Sex: F
Vaccine: COVID19
Symptoms: Acute respiratory failure, Angiogram cerebral abnormal, Blood glucose decreased, COVID-19, Cerebral artery occlusion
Clinical narrative: 84y.o. female with PMH of A fib ( not on ACs , DM, HTN, CHF, GERD, OA, Hyperthyroidism  and others  , who presented to the hospital due to altered mental status . Patient unable to provide any history , so most of the history was obtained from available medical records, per EMR , Patient was first noted to have altered mental status around 11 PM on 8/6.  Patient's last known well time being around 7 PM on 8/6.  The patient's grandson states that he fed the patient at 7 PM, and around 11 PM he found the patient altered.  Grandson reported that she was not speaking with him, and was twitching.  The patient was noted to have blood sugars in the 40s and 50s with EMS. She was brought here, in ER , head CT showed no acute hemorrhage , CTA showed occlusion of the right middle cerebral artery in the mid M1 segment, amenable to mechanical thrombectomy.  Patient was not a candidate for tPA.  IR was consulted and evaluated the patient.  They recommended cerebral angiogram with thrombectomy and she underwent  thrombectomy of the M1 segment of right MCA thrombus and was admitted in the ICU for further care . She also had acute hypoxic resp failure,  her COVID swab was positive . She was seen by   neurology , ID ,neurosurgery , cardiology and pulmonary and endocrinology  here . Her stroke was worsening , neurosurgery evaluated the patient and started on Keppra , she remained unresponsive , resp status got worse, she was given remdesivir and IV steroids here , overall very poor prognosis , no sings of neurological recovery. D/w family, they agreed to comfort care, hospice and palliative care was consulted. She was appropriate  for inpatient hospice care  And she was expired on 8/16/2022 at 3:30 am
Age: 83.0
Sex: F
Vaccine: COVID19
Symptoms: Cerebral artery thrombosis, Cerebrovascular accident, Communication disorder, Computerised tomogram head normal, Death
Clinical narrative: 84y.o. female with PMH of A fib ( not on ACs , DM, HTN, CHF, GERD, OA, Hyperthyroidism  and others  , who presented to the hospital due to altered mental status . Patient unable to provide any history , so most of the history was obtained from available medical records, per EMR , Patient was first noted to have altered mental status around 11 PM on 8/6.  Patient's last known well time being around 7 PM on 8/6.  The patient's grandson states that he fed the patient at 7 PM, and around 11 PM he found the patient altered.  Grandson reported that she was not speaking with him, and was twitching.  The patient was noted to have blood sugars in the 40s and 50s with EMS. She was brought here, in ER , head CT showed no acute hemorrhage , CTA showed occlusion of the right middle cerebral artery in the mid M1 segment, amenable to mechanical thrombectomy.  Patient was not a candidate for tPA.  IR was consulted and evaluated the patient.  They recommended cerebral angiogram with thrombectomy and she underwent  thrombectomy of the M1 segment of right MCA thrombus and was admitted in the ICU for further care . She also had acute hypoxic resp failure,  her COVID swab was positive . She was seen by   neurology , ID ,neurosurgery , cardiology and pulmonary and endocrinology  here . Her stroke was worsening , neurosurgery evaluated the patient and started on Keppra , she remained unresponsive , resp status got worse, she was given remdesivir and IV steroids here , overall very poor prognosis , no sings of neurological recovery. D/w family, they agreed to comfort care, hospice and palliative care was consulted. She was appropriate  for inpatient hospice care  And she was expired on 8/16/2022 at 3:30 am
Age: 83.0
Sex: F
Vaccine: COVID19
Symptoms: Intensive care, Mental status changes, Muscle twitching, Respiratory disorder, SARS-CoV-2 test positive
Clinical narrative: 84y.o. female with PMH of A fib ( not on ACs , DM, HTN, CHF, GERD, OA, Hyperthyroidism  and others  , who presented to the hospital due to altered mental status . Patient unable to provide any history , so most of the history was obtained from available medical records, per EMR , Patient was first noted to have altered mental status around 11 PM on 8/6.  Patient's last known well time being around 7 PM on 8/6.  The patient's grandson states that he fed the patient at 7 PM, and around 11 PM he found the patient altered.  Grandson reported that she was not speaking with him, and was twitching.  The patient was noted to have blood sugars in the 40s and 50s with EMS. She was brought here, in ER , head CT showed no acute hemorrhage , CTA showed occlusion of the right middle cerebral artery in the mid M1 segment, amenable to mechanical thrombectomy.  Patient was not a candidate for tPA.  IR was consulted and evaluated the patient.  They recommended cerebral angiogram with thrombectomy and she underwent  thrombectomy of the M1 segment of right MCA thrombus and was admitted in the ICU for further care . She also had acute hypoxic resp failure,  her COVID swab was positive . She was seen by   neurology , ID ,neurosurgery , cardiology and pulmonary and endocrinology  here . Her stroke was worsening , neurosurgery evaluated the patient and started on Keppra , she remained unresponsive , resp status got worse, she was given remdesivir and IV steroids here , overall very poor prognosis , no sings of neurological recovery. D/w family, they agreed to comfort care, hospice and palliative care was consulted. She was appropriate  for inpatient hospice care  And she was expired on 8/16/2022 at 3:30 am
Age: 83.0
Sex: F
Vaccine: COVID19
Symptoms: Thrombectomy, Unresponsive to stimuli
Clinical narrative: 84y.o. female with PMH of A fib ( not on ACs , DM, HTN, CHF, GERD, OA, Hyperthyroidism  and others  , who presented to the hospital due to altered mental status . Patient unable to provide any history , so most of the history was obtained from available medical records, per EMR , Patient was first noted to have altered mental status around 11 PM on 8/6.  Patient's last known well time being around 7 PM on 8/6.  The patient's grandson states that he fed the patient at 7 PM, and around 11 PM he found the patient altered.  Grandson reported that she was not speaking with him, and was twitching.  The patient was noted to have blood sugars in the 40s and 50s with EMS. She was brought here, in ER , head CT showed no acute hemorrhage , CTA showed occlusion of the right middle cerebral artery in the mid M1 segment, amenable to mechanical thrombectomy.  Patient was not a candidate for tPA.  IR was consulted and evaluated the patient.  They recommended cerebral angiogram with thrombectomy and she underwent  thrombectomy of the M1 segment of right MCA thrombus and was admitted in the ICU for further care . She also had acute hypoxic resp failure,  her COVID swab was positive . She was seen by   neurology , ID ,neurosurgery , cardiology and pulmonary and endocrinology  here . Her stroke was worsening , neurosurgery evaluated the patient and started on Keppra , she remained unresponsive , resp status got worse, she was given remdesivir and IV steroids here , overall very poor prognosis , no sings of neurological recovery. D/w family, they agreed to comfort care, hospice and palliative care was consulted. She was appropriate  for inpatient hospice care  And she was expired on 8/16/2022 at 3:30 am
Age: 73.0
Sex: M
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: COVID-19, Decubitus ulcer, Facetectomy, Perineal ulceration, Procedural site reaction
Clinical narrative: 75y.o. male w/ complex medical hx including AFIB (on Xeralto), COPD, CAD, PAD s/p R BKA, DM, HLD, HTN, cervical stenosis(C3,C7 laminectomy with C4-6 laminoplasty with Dr on 11/10/2020), and lumbar stenosis with neurogenic claudication who presented to hospital as a transfer from facility on 7/3/2022 with surgical site leakage at the incision from his recent open L2/3 and L3/4 laminectomies and medial facetectomies (6/27/22). Patient was recovering well and had been in IPR until today when he was noted to be COVID positive.  General Surgery consulted today for small perineal pressure ulcer that was reportedly bleeding.  Patient states he feels fantastic and is frustrated he was transferred out of IPR for COVID.  He has a hx of multiple pressure ulcers, one on R hip, sacrum, and perineal region.  He states that he has seen bleeding before from his perineal wound, but not in a while.  No active bleeding now.  Denies any fevers/chills, CP, or SOB.  8/29 Medically stable for discharged to SAR. Facility is able to accommodate. Spoke with the facility and confirmed bed availability today.  Patient and his daughter aware and both are in agreement of the discharge plans.  Daughter to transport.
Age: 73.0
Sex: M
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: SARS-CoV-2 test positive, Spinal laminectomy, Ulcer haemorrhage
Clinical narrative: 75y.o. male w/ complex medical hx including AFIB (on Xeralto), COPD, CAD, PAD s/p R BKA, DM, HLD, HTN, cervical stenosis(C3,C7 laminectomy with C4-6 laminoplasty with Dr on 11/10/2020), and lumbar stenosis with neurogenic claudication who presented to hospital as a transfer from facility on 7/3/2022 with surgical site leakage at the incision from his recent open L2/3 and L3/4 laminectomies and medial facetectomies (6/27/22). Patient was recovering well and had been in IPR until today when he was noted to be COVID positive.  General Surgery consulted today for small perineal pressure ulcer that was reportedly bleeding.  Patient states he feels fantastic and is frustrated he was transferred out of IPR for COVID.  He has a hx of multiple pressure ulcers, one on R hip, sacrum, and perineal region.  He states that he has seen bleeding before from his perineal wound, but not in a while.  No active bleeding now.  Denies any fevers/chills, CP, or SOB.  8/29 Medically stable for discharged to SAR. Facility is able to accommodate. Spoke with the facility and confirmed bed availability today.  Patient and his daughter aware and both are in agreement of the discharge plans.  Daughter to transport.
Age: 85.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Acute kidney injury, Blood creatinine increased, COVID-19, Chest X-ray normal, Chest pain
Clinical narrative: Patient is 86y.o. female who was admitted to the hospital with AKI on CKD. Medical problems treated during this admission are detailed below: Acute kidney injury on CKD stage 5 - Likely prerenal due to poor PO intake. Continues to make urine. Baseline Cr around 4, Cr 5.08 on admission, with improvement with IVF. Cr stable after stopping IVF. PO intake improved. Recommendations - Outpt follow-up with nephrology  - Stop spironolactone - Continue home calcitriol, sodium bicarbonate  COVID-19 infection - Vaccinated x3, but overdue for second booster. On room air throughout admission. Procalcitonin minimally elevated but no evidence of pneumonia on CXR. ID consulted and no specific treatment recommended for COVID  given renal insufficiency and no oxygen need.   Mild hyponatremia - Suspect due to poor PO intake. Resolved.   Chest pain - Resolved. Troponin trend flat. CXR without acute process.  Essential hypertension - Stop spironolactone. Resume amlodipine. Continue other home medications.   Evaluation on Day of Discharge: Condition on discharge - Improved No acute events overnight. This morning, reports mild nausea but was able to eat yesterday. No other new complaints, eager for discharge home.
Age: 85.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: End stage renal disease, Essential hypertension, Hyponatraemia, Hypophagia, Nausea
Clinical narrative: Patient is 86y.o. female who was admitted to the hospital with AKI on CKD. Medical problems treated during this admission are detailed below: Acute kidney injury on CKD stage 5 - Likely prerenal due to poor PO intake. Continues to make urine. Baseline Cr around 4, Cr 5.08 on admission, with improvement with IVF. Cr stable after stopping IVF. PO intake improved. Recommendations - Outpt follow-up with nephrology  - Stop spironolactone - Continue home calcitriol, sodium bicarbonate  COVID-19 infection - Vaccinated x3, but overdue for second booster. On room air throughout admission. Procalcitonin minimally elevated but no evidence of pneumonia on CXR. ID consulted and no specific treatment recommended for COVID  given renal insufficiency and no oxygen need.   Mild hyponatremia - Suspect due to poor PO intake. Resolved.   Chest pain - Resolved. Troponin trend flat. CXR without acute process.  Essential hypertension - Stop spironolactone. Resume amlodipine. Continue other home medications.   Evaluation on Day of Discharge: Condition on discharge - Improved No acute events overnight. This morning, reports mild nausea but was able to eat yesterday. No other new complaints, eager for discharge home.
Age: 85.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Procalcitonin increased, Renal failure, SARS-CoV-2 test positive, Troponin
Clinical narrative: Patient is 86y.o. female who was admitted to the hospital with AKI on CKD. Medical problems treated during this admission are detailed below: Acute kidney injury on CKD stage 5 - Likely prerenal due to poor PO intake. Continues to make urine. Baseline Cr around 4, Cr 5.08 on admission, with improvement with IVF. Cr stable after stopping IVF. PO intake improved. Recommendations - Outpt follow-up with nephrology  - Stop spironolactone - Continue home calcitriol, sodium bicarbonate  COVID-19 infection - Vaccinated x3, but overdue for second booster. On room air throughout admission. Procalcitonin minimally elevated but no evidence of pneumonia on CXR. ID consulted and no specific treatment recommended for COVID  given renal insufficiency and no oxygen need.   Mild hyponatremia - Suspect due to poor PO intake. Resolved.   Chest pain - Resolved. Troponin trend flat. CXR without acute process.  Essential hypertension - Stop spironolactone. Resume amlodipine. Continue other home medications.   Evaluation on Day of Discharge: Condition on discharge - Improved No acute events overnight. This morning, reports mild nausea but was able to eat yesterday. No other new complaints, eager for discharge home.
Age: 48.0
Sex: F
Vaccine: HEP
Symptoms: Expired product administered
Clinical narrative: Expired dose given
Age: 70.0
Sex: M
Vaccine: COVID19
Symptoms: Anxiety, COVID-19, Chest pain, Dizziness, Dyspnoea
Clinical narrative: 72-year-old male, with a PMHx of cirrhosis, hepatic encephalopathy and pericarditis, presented with CC of SOB x 2.5 weeks. Patient stated he was diagnosed with COVID-19 on 7/22/2022 at hospital. He admits to productive cough, intermittent SOB, intermittent lightheadedness upon standing and chest pain after coughing. His breathing feels better when he leans forward. He has a history of pericarditis and he is worried he might have pericarditis again. He also has a history of bradycardia with HR in the 50-60's at baseline. Patient deemed medically stable for discharge to home per physician. Patient and family agreeable.
Age: 70.0
Sex: M
Vaccine: COVID19
Symptoms: Productive cough, SARS-CoV-2 test positive
Clinical narrative: 72-year-old male, with a PMHx of cirrhosis, hepatic encephalopathy and pericarditis, presented with CC of SOB x 2.5 weeks. Patient stated he was diagnosed with COVID-19 on 7/22/2022 at hospital. He admits to productive cough, intermittent SOB, intermittent lightheadedness upon standing and chest pain after coughing. His breathing feels better when he leans forward. He has a history of pericarditis and he is worried he might have pericarditis again. He also has a history of bradycardia with HR in the 50-60's at baseline. Patient deemed medically stable for discharge to home per physician. Patient and family agreeable.
Age: 4.0
Sex: F
Vaccine: MMRV
Symptoms: Expired product administered
Clinical narrative: Patient was given the vaccine that expired 9/4/2022
Age: 6.0
Sex: M
Vaccine: COVID19
Symptoms: Urticaria
Clinical narrative: Patient was administered Covid Vaccine and went home and one hour later broke out in Hives/ Mom gave benedryl, the hives went away. He was fine.
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Blood test, Platelet count decreased
Clinical narrative: Platelets crashed to 4,000 requiring hospitalization.
Age: 1.0
Sex: F
Vaccine: FLU4, HEPA, HIBV, MMR, PNC13, VARCEL
Symptoms: Syringe issue
Clinical narrative: Syringe had crack down the side when giving the Varicella a small bit squirt out the side.
Age: 86.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Asthenia, COVID-19, Chills, Malaise, Pain
Clinical narrative: weakness, body aches, chills, fever, and ,malaise
Age: 86.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Pyrexia, SARS-CoV-2 test positive
Clinical narrative: weakness, body aches, chills, fever, and ,malaise
Age: 12.0
Sex: M
Vaccine: MNQ
Symptoms: Abdominal discomfort, Decreased appetite, Malaise, Myalgia, Pain in extremity
Clinical narrative: Got shots on 8-18-22 for MCV4 and Tdap and is now covered with a full body rash.     Complained of legs aching 2 weeks after his shots, on 9/1/22.  That is not unusual for him, since he is rapidly growing taller.   But  then on 9/2/22 he woke up with myalgias in the arms and legs.   Mom encouraged him to drink water and go to school.  Didn't feel well.   He came home mid morning and slept all afternoon.  Subjective fever.  Stomach upset without vomiting.  Anorexia.    Then on 9/3/22 he woke up with spots.   Started on his chest.  After the rash appeared, the other symptoms went away.  He now feels pretty good.  No more muscle aching or fatigue.  He hasn't required any medications to treat these symptoms.  Rash progressed over a few days, worst on 9/6/22.   Came in to clinic for evaluation on 9/7/22.  The rash eventually spread to his arms and legs and became bright red.  It's itchy only when he scratches it.
Age: 12.0
Sex: M
Vaccine: MNQ
Symptoms: Pyrexia, Rash, Rash erythematous, Rash pruritic
Clinical narrative: Got shots on 8-18-22 for MCV4 and Tdap and is now covered with a full body rash.     Complained of legs aching 2 weeks after his shots, on 9/1/22.  That is not unusual for him, since he is rapidly growing taller.   But  then on 9/2/22 he woke up with myalgias in the arms and legs.   Mom encouraged him to drink water and go to school.  Didn't feel well.   He came home mid morning and slept all afternoon.  Subjective fever.  Stomach upset without vomiting.  Anorexia.    Then on 9/3/22 he woke up with spots.   Started on his chest.  After the rash appeared, the other symptoms went away.  He now feels pretty good.  No more muscle aching or fatigue.  He hasn't required any medications to treat these symptoms.  Rash progressed over a few days, worst on 9/6/22.   Came in to clinic for evaluation on 9/7/22.  The rash eventually spread to his arms and legs and became bright red.  It's itchy only when he scratches it.
Age: 25.0
Sex: M
Vaccine: COVID19, COVID19-2
Symptoms: Cardiac stress test, Chest pain, Echocardiogram, Electrocardiogram abnormal, Pericarditis
Clinical narrative: Diagnosed with pericarditis.  Intermittent chest pain and a change in my EKG morphology led me to go get seen by a cardiologist.
Age: 20.0
Sex: M
Vaccine: COVID19, FLU4, TDAP
Symptoms: Pain, Pyrexia
Clinical narrative: body pain / fever 101.9
Age: 55.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal pain, Blood test normal, Dizziness, Headache, Pyrexia
Clinical narrative: Client states she began to develop symptoms the night of vaccination. Symptoms included low grade fever, headache, dizziness, and ABD pain. States she had similar symptoms with last dose of Moderna but they did not last as long. Symptoms have been occurring for over a week now.
Age: 74.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Patient vaccinated x3 (Pfizer: 2/5/21, 2/26/21, 10/26/21)  Patient hospitalized and tested COVID positive on 9/6/22
Age: 88.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Vaccine breakthrough infection
Clinical narrative: Breakthrough COVID
Age: 4.0
Sex: M
Vaccine: COVID19
Symptoms: No adverse event, Product storage error
Clinical narrative: No harm to patient, vaccine was given one day past thaw date.
Age: 26.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: Incident Details: Per an email sent out on 9/1/22 from a Clinic provider-"the monovalent mRNA COVID-19 vaccines are not authorized as booster doses for individuals 12 years of age and older. Any patients that are currently scheduled to receive a booster should wait until we have the bivalent booster on hand." The patient, was seen in office on 9/2/22 and received a booster dose of the monovalent mRNA COVID-19 vaccine (pfizer) by staff in error as patients are now only supposed to receive the bivalent booster per Dr. email. Pt was due for booster at the time they received it, however the bivlalent booster was not yet stocked at clinic.  Possible Cause: Possible cause of the incident is that an email was sent out regarding the discontinuation  of monovalent covid boosters until clinic receives the bivalent booster doses. This was overlooked by management and staff, as previous changes to clinic processes is usually discussed in a meeting. Also ?monovalent? and ?bivalent? are new terms that have not previously been used when discussing booster vaccines.
Age: 52.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Hypoglycaemia
Clinical narrative: hypoglycemia
Age: 86.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Vaccine breakthrough infection
Clinical narrative: Breakthrough COVID
Age: 26.0
Sex: F
Vaccine: COVID19
Symptoms: Syncope
Clinical narrative: PD informed vaccination staff that patient called stating she fainted. No episodes of syncope/fainting were observed by vaccinator staff when patient was at the vaccination site.  Pt received 1st booster Pfizer dose at 1617. Pt did not wait full 30 minutes in observation as advised by vaccination staff. Pt left premises and was walking down the street when she called. RN called patient to check in. Pt reports that she is unsure if she fainted or not but she might have because she is sitting down. PD were notified by vaccination site staff and will go find patient.
Age: 27.0
Sex: M
Vaccine: SMALLMNK
Symptoms: Acne, Fatigue, Injection site erythema, Injection site nodule, Injection site swelling
Clinical narrative: 9/2/2022  - stated that on the first day he felt very tired after receiving the vaccine, on the second day he had a big red swollen knot on the area were he had received the MPX1. And now a week later 09/02/2022, he stated that he is experiencing on the same arm, the MPX1 was given their are a lot of pimples on his arm. And some on the other arm, and on his left upper thigh pimples/rashes that are also on his back area as well as on his biceps rashes. 9/3/2022 - 9/6/2022 had been unable to reach by clinician. Clinician was able to reach client 9/7/2022 - is being advised by his medical provider for the next steps and any care and treatment.
Age: 27.0
Sex: M
Vaccine: SMALLMNK
Symptoms: Rash
Clinical narrative: 9/2/2022  - stated that on the first day he felt very tired after receiving the vaccine, on the second day he had a big red swollen knot on the area were he had received the MPX1. And now a week later 09/02/2022, he stated that he is experiencing on the same arm, the MPX1 was given their are a lot of pimples on his arm. And some on the other arm, and on his left upper thigh pimples/rashes that are also on his back area as well as on his biceps rashes. 9/3/2022 - 9/6/2022 had been unable to reach by clinician. Clinician was able to reach client 9/7/2022 - is being advised by his medical provider for the next steps and any care and treatment.
Age: 35.0
Sex: M
Vaccine: SMALLMNK
Symptoms: Urticaria
Clinical narrative: No wheal formed with 1st attempt so 2nd dose given; wheal formed on 2nd attempt
Age: 41.0
Sex: M
Vaccine: UNK
Symptoms: Cough, Diarrhoea, Dyspnoea, Fatigue, Hypoaesthesia
Clinical narrative: FULL COVID SYMPTOMS INCLUDING: SHORTNESS OF BREATH, CHEST & SINUS CONGESTION, COUGHING, FEVER, BODY ACHES & FATIGUE; PARTIAL NUMBNESS TO RIGHT SIDE OF FACE, DIARRHEA X 2 DAYS, NAUSEA W/ VOMITING X 3,
Age: 41.0
Sex: M
Vaccine: UNK
Symptoms: Malaise, Nausea, Pain, Pyrexia, Respiratory tract congestion
Clinical narrative: FULL COVID SYMPTOMS INCLUDING: SHORTNESS OF BREATH, CHEST & SINUS CONGESTION, COUGHING, FEVER, BODY ACHES & FATIGUE; PARTIAL NUMBNESS TO RIGHT SIDE OF FACE, DIARRHEA X 2 DAYS, NAUSEA W/ VOMITING X 3,
Age: 41.0
Sex: M
Vaccine: UNK
Symptoms: Sinus congestion, Vomiting
Clinical narrative: FULL COVID SYMPTOMS INCLUDING: SHORTNESS OF BREATH, CHEST & SINUS CONGESTION, COUGHING, FEVER, BODY ACHES & FATIGUE; PARTIAL NUMBNESS TO RIGHT SIDE OF FACE, DIARRHEA X 2 DAYS, NAUSEA W/ VOMITING X 3,
Age: 16.0
Sex: M
Vaccine: MENB
Symptoms: Diarrhoea, Imaging procedure, Laboratory test, Nausea, Pain
Clinical narrative: Fever, vomiting, nausea, achiness and diarrhea beginning evening of 08/29/2022.  Symptoms continued and worsened over the next 24 -36 hours.  Patient presented in ER on 08/31/2022 and was admitted to hospital.  Patient discharged on 09/03/2022.
Age: 16.0
Sex: M
Vaccine: MENB
Symptoms: Pyrexia, Vomiting
Clinical narrative: Fever, vomiting, nausea, achiness and diarrhea beginning evening of 08/29/2022.  Symptoms continued and worsened over the next 24 -36 hours.  Patient presented in ER on 08/31/2022 and was admitted to hospital.  Patient discharged on 09/03/2022.
Age: 73.0
Sex: M
Vaccine: COVID19
Symptoms: Asthenia, COVID-19, SARS-CoV-2 test positive
Clinical narrative: Admitted for Weakness on 9/7/22. Per note, symptoms likely started 1-2 days prior.
Age: 48.0
Sex: M
Vaccine: SMALLMNK
Symptoms: Hypersensitivity
Clinical narrative: Client had a localized allergic reaction to vaccine
Age: 11.0
Sex: F
Vaccine: MNQ
Symptoms: Inappropriate schedule of product administration
Clinical narrative: Menquadfi administered too soon.  Last meningococcal vaccine administered 3/22/2022, Menquadfi administered 8/5/2022
Age: 60.0
Sex: M
Vaccine: COVID19
Symptoms: Asthenia, COVID-19, Pain, SARS-CoV-2 test positive
Clinical narrative: Weakness, severe, diffuse body pains at all times.
Age: 56.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: Per a clinic provider's email sent on 9/1/2022: "The monovalent mRNA COVID-19 vaccines are not authorized as booster doses for individuals 12 years of age and older. Any patients currently scheduled to receive a booster should wait until we have the bivalent booster on hand." The patient, seen in office on 9/2/2022, received a booster dose of the monovalent mRNA COVID-19 vaccine (Pfizer). This was in error as patients are now only supposed to receive the bivalent booster per email. Patient due for booster at the time they received it, however the bivalent booster was not yet stocked. Possible cause of the incident is that an email was sent out regarding the discontinuation of monovalent COVID-19 boosters until receipt of the bivalent booster doses. This was overlooked, as previous changes to clinic processes is usually discussed in a meeting. Also 'monovalent' and 'bivalent' are new terms that have not previously been used when discussing booster vaccines.
Age: 67.0
Sex: M
Vaccine: SMALLMNK
Symptoms: Urticaria
Clinical narrative: No wheal formed on 1st dose; 2nd doses given; wheal formed on 2nd attempt.
Age: 53.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: Incident Details: Per a clinic provider's email sent out on 9/1/22- "the monovalent mRNA COVID-19 vaccines are not authorized as booster doses for individuals 12 years of age and older. Any patients that are currently scheduled to receive a booster should wait until we have the bivalent booster on hand." The patient was seen in office on 9/2/22 and received a booster dose of the monovalent mRNA COVID-19 vaccine (Pfizer) by *** in error as patients are now only supposed to receive the bivalent booster per Drs. email. Patient was due for booster at the time they received it, however the bivalent booster was not yet stocked. Possible Cause: Possible cause of the incident is that an email was sent out regarding the discontinuation of monovalent Covid boosters until Private receives the bivalent booster doses. This was overlooked by management and staff, as previous changes to clinic processes is usually discussed in a meeting. Also "monovalent" and "bivalent" are new terms that have not previously been used when discussing booster vaccines.