chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Cerebral infarction, Cerebral small vessel ischaemic disease, Chest X-ray normal, Computerised tomogram head abnormal, Confusional state
Clinical narrative: Patient is a 78 y.o. male patient of CNP with history of stroke, epilepsy, coronary artery disease, hyperlipidemia, and hypothyroidism who presented to Hospital with weakness and confusion.   Generalized weakness Acute Metabolic Encephalopathy, resolved Lives alone, unable to walk due to bilateral lower extremity weakness CT brain with no acute intracranial abnormality; extensive multifocal encephalomalacia with large zone of infarction and encephalomalacia within the right frontal lobe; chronic small vessel ischemic disease, clear sinuses Suspect secondary to COVID-19 infection PT and OT evaluated, patient able to ambulate, recommended 2 to 3days/week of therapy   Covid-19 us Infection Acute respiratory failure Date of onset of symptoms: 8/20/2023 Symptoms present on admission: weakness, confusion, dry cough Date of covid positive test: 8/20/2023 Vaccination status: vaccinated Imaging: CXR nonacute Oxygen requirements on admission: room air Current oxygen requirements: With exertion O2 sats dropped to 82% Medical therapy: Started on Decadron 6 mg oral daily, and continued at discharge to complete a short course Anticipated special isolation end date: 8/30/2023 Checked O2 requirement prior to discharge.  Did not qualify for oxygen   Acute kidney injury Chronic urinary incontinence Cr 1.64 (baseline 1.3) Suspect secondary to poor intake due to COVID-19 infection Received IV fluids in the ER but with COVID IV fluids discontinued.   Repeat BMP with creatinine 1.69.  Advised patient to stay another night.  Patient is very upset and reports that he is walking out.  Explained to the patient about possible complications of worsening kidney function.  Patient still wants to leave.  Discussed with daughter. Daughter agreed that she will make sure that he gets his BMP on 8/28/2023   Elevated troponin Initial troponin 53, repeat 52 Denies chest pain EKG without acute ischemic findings Suspect secondary to demand ischemia from COVID infection   Pancytopenia WBC 3.83> 7.62, Hgb 12.7> 12.9, Plt 114> 108 Most likely due to viral infection Has chronic anemia, at baseline
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Cough, Electrocardiogram normal, Emotional distress, Encephalomalacia, Gait inability
Clinical narrative: Patient is a 78 y.o. male patient of CNP with history of stroke, epilepsy, coronary artery disease, hyperlipidemia, and hypothyroidism who presented to Hospital with weakness and confusion.   Generalized weakness Acute Metabolic Encephalopathy, resolved Lives alone, unable to walk due to bilateral lower extremity weakness CT brain with no acute intracranial abnormality; extensive multifocal encephalomalacia with large zone of infarction and encephalomalacia within the right frontal lobe; chronic small vessel ischemic disease, clear sinuses Suspect secondary to COVID-19 infection PT and OT evaluated, patient able to ambulate, recommended 2 to 3days/week of therapy   Covid-19 us Infection Acute respiratory failure Date of onset of symptoms: 8/20/2023 Symptoms present on admission: weakness, confusion, dry cough Date of covid positive test: 8/20/2023 Vaccination status: vaccinated Imaging: CXR nonacute Oxygen requirements on admission: room air Current oxygen requirements: With exertion O2 sats dropped to 82% Medical therapy: Started on Decadron 6 mg oral daily, and continued at discharge to complete a short course Anticipated special isolation end date: 8/30/2023 Checked O2 requirement prior to discharge.  Did not qualify for oxygen   Acute kidney injury Chronic urinary incontinence Cr 1.64 (baseline 1.3) Suspect secondary to poor intake due to COVID-19 infection Received IV fluids in the ER but with COVID IV fluids discontinued.   Repeat BMP with creatinine 1.69.  Advised patient to stay another night.  Patient is very upset and reports that he is walking out.  Explained to the patient about possible complications of worsening kidney function.  Patient still wants to leave.  Discussed with daughter. Daughter agreed that she will make sure that he gets his BMP on 8/28/2023   Elevated troponin Initial troponin 53, repeat 52 Denies chest pain EKG without acute ischemic findings Suspect secondary to demand ischemia from COVID infection   Pancytopenia WBC 3.83> 7.62, Hgb 12.7> 12.9, Plt 114> 108 Most likely due to viral infection Has chronic anemia, at baseline
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Haemoglobin, Hypophagia, Malaise, Metabolic encephalopathy, Metabolic function test
Clinical narrative: Patient is a 78 y.o. male patient of CNP with history of stroke, epilepsy, coronary artery disease, hyperlipidemia, and hypothyroidism who presented to Hospital with weakness and confusion.   Generalized weakness Acute Metabolic Encephalopathy, resolved Lives alone, unable to walk due to bilateral lower extremity weakness CT brain with no acute intracranial abnormality; extensive multifocal encephalomalacia with large zone of infarction and encephalomalacia within the right frontal lobe; chronic small vessel ischemic disease, clear sinuses Suspect secondary to COVID-19 infection PT and OT evaluated, patient able to ambulate, recommended 2 to 3days/week of therapy   Covid-19 us Infection Acute respiratory failure Date of onset of symptoms: 8/20/2023 Symptoms present on admission: weakness, confusion, dry cough Date of covid positive test: 8/20/2023 Vaccination status: vaccinated Imaging: CXR nonacute Oxygen requirements on admission: room air Current oxygen requirements: With exertion O2 sats dropped to 82% Medical therapy: Started on Decadron 6 mg oral daily, and continued at discharge to complete a short course Anticipated special isolation end date: 8/30/2023 Checked O2 requirement prior to discharge.  Did not qualify for oxygen   Acute kidney injury Chronic urinary incontinence Cr 1.64 (baseline 1.3) Suspect secondary to poor intake due to COVID-19 infection Received IV fluids in the ER but with COVID IV fluids discontinued.   Repeat BMP with creatinine 1.69.  Advised patient to stay another night.  Patient is very upset and reports that he is walking out.  Explained to the patient about possible complications of worsening kidney function.  Patient still wants to leave.  Discussed with daughter. Daughter agreed that she will make sure that he gets his BMP on 8/28/2023   Elevated troponin Initial troponin 53, repeat 52 Denies chest pain EKG without acute ischemic findings Suspect secondary to demand ischemia from COVID infection   Pancytopenia WBC 3.83> 7.62, Hgb 12.7> 12.9, Plt 114> 108 Most likely due to viral infection Has chronic anemia, at baseline
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Muscular weakness, Myocardial ischaemia, Oxygen saturation decreased, Pancytopenia, Platelet count decreased
Clinical narrative: Patient is a 78 y.o. male patient of CNP with history of stroke, epilepsy, coronary artery disease, hyperlipidemia, and hypothyroidism who presented to Hospital with weakness and confusion.   Generalized weakness Acute Metabolic Encephalopathy, resolved Lives alone, unable to walk due to bilateral lower extremity weakness CT brain with no acute intracranial abnormality; extensive multifocal encephalomalacia with large zone of infarction and encephalomalacia within the right frontal lobe; chronic small vessel ischemic disease, clear sinuses Suspect secondary to COVID-19 infection PT and OT evaluated, patient able to ambulate, recommended 2 to 3days/week of therapy   Covid-19 us Infection Acute respiratory failure Date of onset of symptoms: 8/20/2023 Symptoms present on admission: weakness, confusion, dry cough Date of covid positive test: 8/20/2023 Vaccination status: vaccinated Imaging: CXR nonacute Oxygen requirements on admission: room air Current oxygen requirements: With exertion O2 sats dropped to 82% Medical therapy: Started on Decadron 6 mg oral daily, and continued at discharge to complete a short course Anticipated special isolation end date: 8/30/2023 Checked O2 requirement prior to discharge.  Did not qualify for oxygen   Acute kidney injury Chronic urinary incontinence Cr 1.64 (baseline 1.3) Suspect secondary to poor intake due to COVID-19 infection Received IV fluids in the ER but with COVID IV fluids discontinued.   Repeat BMP with creatinine 1.69.  Advised patient to stay another night.  Patient is very upset and reports that he is walking out.  Explained to the patient about possible complications of worsening kidney function.  Patient still wants to leave.  Discussed with daughter. Daughter agreed that she will make sure that he gets his BMP on 8/28/2023   Elevated troponin Initial troponin 53, repeat 52 Denies chest pain EKG without acute ischemic findings Suspect secondary to demand ischemia from COVID infection   Pancytopenia WBC 3.83> 7.62, Hgb 12.7> 12.9, Plt 114> 108 Most likely due to viral infection Has chronic anemia, at baseline
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive, Troponin increased, Urinary incontinence, Viral infection, White blood cell count decreased
Clinical narrative: Patient is a 78 y.o. male patient of CNP with history of stroke, epilepsy, coronary artery disease, hyperlipidemia, and hypothyroidism who presented to Hospital with weakness and confusion.   Generalized weakness Acute Metabolic Encephalopathy, resolved Lives alone, unable to walk due to bilateral lower extremity weakness CT brain with no acute intracranial abnormality; extensive multifocal encephalomalacia with large zone of infarction and encephalomalacia within the right frontal lobe; chronic small vessel ischemic disease, clear sinuses Suspect secondary to COVID-19 infection PT and OT evaluated, patient able to ambulate, recommended 2 to 3days/week of therapy   Covid-19 us Infection Acute respiratory failure Date of onset of symptoms: 8/20/2023 Symptoms present on admission: weakness, confusion, dry cough Date of covid positive test: 8/20/2023 Vaccination status: vaccinated Imaging: CXR nonacute Oxygen requirements on admission: room air Current oxygen requirements: With exertion O2 sats dropped to 82% Medical therapy: Started on Decadron 6 mg oral daily, and continued at discharge to complete a short course Anticipated special isolation end date: 8/30/2023 Checked O2 requirement prior to discharge.  Did not qualify for oxygen   Acute kidney injury Chronic urinary incontinence Cr 1.64 (baseline 1.3) Suspect secondary to poor intake due to COVID-19 infection Received IV fluids in the ER but with COVID IV fluids discontinued.   Repeat BMP with creatinine 1.69.  Advised patient to stay another night.  Patient is very upset and reports that he is walking out.  Explained to the patient about possible complications of worsening kidney function.  Patient still wants to leave.  Discussed with daughter. Daughter agreed that she will make sure that he gets his BMP on 8/28/2023   Elevated troponin Initial troponin 53, repeat 52 Denies chest pain EKG without acute ischemic findings Suspect secondary to demand ischemia from COVID infection   Pancytopenia WBC 3.83> 7.62, Hgb 12.7> 12.9, Plt 114> 108 Most likely due to viral infection Has chronic anemia, at baseline
Age: 65.0
Sex: M
Vaccine: SMALLMNK
Symptoms: Injection site erythema, Injection site swelling
Clinical narrative: Client reports another vaccine 10/25/22, but this was not at our facility. Client reports that after receiving vaccine the site on right forearm has been red with a white center. It gets redder sometimes and some times is raised. He has sought advice from PCP but no interventions. Hoping to have someone contact him about whether his reaction is normal or something to worry about.
Age: 16.0
Sex: F
Vaccine: FLU4, IPV, MENB, MMR, MNQ, TDAP, VARCEL
Symptoms: Decorticate posture, Eye movement disorder, Malaise, Seizure
Clinical narrative: Patient was present with dad while vaccine administration, after receiving 7 out of the 9 vaccines, patient reports not feeling well, and experienced seizure with decorticate posturing manifested by eyes rolling upward, legs becoming straight and and arms flexing upward with clenched fists holding close to chest.   I had the patient lay down flat on the exam table with head turned to the side. Seizure lasted approximately 5 seconds, and afterwards patient became alert and responsive. Father was at patient's side. V/S were checked. BP 122/73, HR 94, RR 20, Temp 98.1. Patient recovered right away as soon as she lay down on the exam table. Patient was due to also get Hep B and HPV vaccines, which was held d/t this event. Father was advised to F/U with patient's PCP for further vaccine administration.
Age: 5.0
Sex: F
Vaccine: TDAP
Symptoms: Product administered to patient of inappropriate age, Wrong product administered
Clinical narrative: Pt came in for 5yr wellness check. Pt needed vaccines (Proquad (MMR, Varicella) and Dtap) Proquad was given but instead of Dtap the MA gave an Adacel. The LPN pulled the vaccine, and the MA administered the vaccine.
Age: 83.0
Sex: F
Vaccine: COVID19-2
Symptoms: Acute respiratory failure, Asthenia, Atelectasis, Back pain, COVID-19
Clinical narrative: Patient is a 84 y.o. female patient of MD with history of HTN, CVA, HLD, permanent atrial fibrillation, OSA not on CPAP and vertigo who presented with fevers and weakness after testing positive for COVID on a home test 8/14.    Discharge Diagnoses:   Covid-19 Virus Infection Acute Respiratory Failure with Hypoxemia Date of onset of symptoms: 8/11/2023 Symptoms present on admission: Weakness, nausea, malaise, body aches and fever Date of covid positive test: 8/14/2023 on home testing Vaccination status: vaccinated x3 Imaging: chest xray with mild cardiomegaly and atelectasis Oxygen requirements on admission: 2 L O2 Current oxygen requirements: 2 L O2 Medical therapy: Decadron 6 mg,  Remdesivir. Albuterol PRN with pulmonary toilet.  Antitussive as needed. Encourage self proning, use of incentive spirometer Weaned off to room air prior to discharge Will continue Decadron for several more days as outpatient   Debility with Impaired Ambulation Normally utilizes Rollator for ambulation, now unable to stand PT/OT, fall risk and delirium precautions Home health care to follow on discharge   Permanent Atrial Fibrillation Follows with Dr., continue home Eliquis 5 mg BID   Chronic Back Pain NARx with Gabapentin 300 mg TID, will continue  HTN Antihypertensives initially held on admission due to low normal blood pressures BP improved and will resume outpatient antihypertensives on discharge   HLD Per history, continue home Lipitor 40 mg daily
Age: 83.0
Sex: F
Vaccine: COVID19-2
Symptoms: Cardiomegaly, Chest X-ray abnormal, Dysstasia, Gait disturbance, Hypotension
Clinical narrative: Patient is a 84 y.o. female patient of MD with history of HTN, CVA, HLD, permanent atrial fibrillation, OSA not on CPAP and vertigo who presented with fevers and weakness after testing positive for COVID on a home test 8/14.    Discharge Diagnoses:   Covid-19 Virus Infection Acute Respiratory Failure with Hypoxemia Date of onset of symptoms: 8/11/2023 Symptoms present on admission: Weakness, nausea, malaise, body aches and fever Date of covid positive test: 8/14/2023 on home testing Vaccination status: vaccinated x3 Imaging: chest xray with mild cardiomegaly and atelectasis Oxygen requirements on admission: 2 L O2 Current oxygen requirements: 2 L O2 Medical therapy: Decadron 6 mg,  Remdesivir. Albuterol PRN with pulmonary toilet.  Antitussive as needed. Encourage self proning, use of incentive spirometer Weaned off to room air prior to discharge Will continue Decadron for several more days as outpatient   Debility with Impaired Ambulation Normally utilizes Rollator for ambulation, now unable to stand PT/OT, fall risk and delirium precautions Home health care to follow on discharge   Permanent Atrial Fibrillation Follows with Dr., continue home Eliquis 5 mg BID   Chronic Back Pain NARx with Gabapentin 300 mg TID, will continue  HTN Antihypertensives initially held on admission due to low normal blood pressures BP improved and will resume outpatient antihypertensives on discharge   HLD Per history, continue home Lipitor 40 mg daily
Age: 83.0
Sex: F
Vaccine: COVID19-2
Symptoms: Malaise, Nausea, Pain, Pyrexia, SARS-CoV-2 test positive
Clinical narrative: Patient is a 84 y.o. female patient of MD with history of HTN, CVA, HLD, permanent atrial fibrillation, OSA not on CPAP and vertigo who presented with fevers and weakness after testing positive for COVID on a home test 8/14.    Discharge Diagnoses:   Covid-19 Virus Infection Acute Respiratory Failure with Hypoxemia Date of onset of symptoms: 8/11/2023 Symptoms present on admission: Weakness, nausea, malaise, body aches and fever Date of covid positive test: 8/14/2023 on home testing Vaccination status: vaccinated x3 Imaging: chest xray with mild cardiomegaly and atelectasis Oxygen requirements on admission: 2 L O2 Current oxygen requirements: 2 L O2 Medical therapy: Decadron 6 mg,  Remdesivir. Albuterol PRN with pulmonary toilet.  Antitussive as needed. Encourage self proning, use of incentive spirometer Weaned off to room air prior to discharge Will continue Decadron for several more days as outpatient   Debility with Impaired Ambulation Normally utilizes Rollator for ambulation, now unable to stand PT/OT, fall risk and delirium precautions Home health care to follow on discharge   Permanent Atrial Fibrillation Follows with Dr., continue home Eliquis 5 mg BID   Chronic Back Pain NARx with Gabapentin 300 mg TID, will continue  HTN Antihypertensives initially held on admission due to low normal blood pressures BP improved and will resume outpatient antihypertensives on discharge   HLD Per history, continue home Lipitor 40 mg daily
Age: 3.0
Sex: F
Vaccine: UNK
Symptoms: Incorrect dose administered, Patient uncooperative
Clinical narrative: Patient is a 3 year old female who was being held by her mother to received the flu vaccine. As the vaccine was being administered by the technician, the patient's mother let go of her child which then caused the patient to move her arm away, which left half of the vaccine in the vial without being administered.
Age: 50.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: VACCINE WAS STORED IN AS UNAPPROVED STORAGE UNIT
Age: 75.0
Sex: F
Vaccine: COVID19
Symptoms: Acute respiratory failure, Blood potassium decreased, COVID-19, Chest X-ray normal, Cough
Clinical narrative: Patient is a 76 y.o. female patient of MD with a PMHx of PE on warfarin, HTN, HLD, T2DM, CAD, MDD presenting with URTI sxs.   Acute hypoxic respiratory failure d/t COVID-19 infection P/w cough, congestion, nausea, diarrhea, HA x5d. Vaccinated x2. Husband/son +COVID Afebrile on arrival, HDS. Dropped to 88% on RA, now on 2L NC (no home O2) Initial CBC with mild leukopenia (WBC 4.08). Trop 7. D-dimer neg. +COVID-19 CXR (my read): No vascular congestion or consolidation Cont supplemental O2 to maintain goal SpO2 > 88-90% Decadron 6mg PO daily for 10 days. Hold off on Remdesivir Obtain baseline inflammatory markers Albuterol, robitussin-DM, tylenol PRN. Scheduled Mucinex Encourage IS/PEP Contact precautions PT/OT/SW Daily labs   T2DM, fair control Last A1c 7.6% in 4/2023, will repeat Home regimen: Basaglar 46 units qHS, Glyburide Start Lantus 40u qHS, accuchecks w qAC/HS SSI Hypoglycemic protocol. Hold home oral meds Consider diabetic educator consult   Hypokalemia K+ 3.4 40 mEq of KCl  Additional repletion for goal K > 4, Mg > 2 Daily RFPs to monitor   PE on Warfarin INR 1.5 on admission Consult pharmacy for dosing   Stable chronic comorbid conditions  ? HTN ? HLD ? MDD  After 1 day the pateitn was mainting sats on RA and was discharged to home
Age: 75.0
Sex: F
Vaccine: COVID19
Symptoms: Diarrhoea, Fibrin D dimer normal, Full blood count abnormal, Headache, Hypokalaemia
Clinical narrative: Patient is a 76 y.o. female patient of MD with a PMHx of PE on warfarin, HTN, HLD, T2DM, CAD, MDD presenting with URTI sxs.   Acute hypoxic respiratory failure d/t COVID-19 infection P/w cough, congestion, nausea, diarrhea, HA x5d. Vaccinated x2. Husband/son +COVID Afebrile on arrival, HDS. Dropped to 88% on RA, now on 2L NC (no home O2) Initial CBC with mild leukopenia (WBC 4.08). Trop 7. D-dimer neg. +COVID-19 CXR (my read): No vascular congestion or consolidation Cont supplemental O2 to maintain goal SpO2 > 88-90% Decadron 6mg PO daily for 10 days. Hold off on Remdesivir Obtain baseline inflammatory markers Albuterol, robitussin-DM, tylenol PRN. Scheduled Mucinex Encourage IS/PEP Contact precautions PT/OT/SW Daily labs   T2DM, fair control Last A1c 7.6% in 4/2023, will repeat Home regimen: Basaglar 46 units qHS, Glyburide Start Lantus 40u qHS, accuchecks w qAC/HS SSI Hypoglycemic protocol. Hold home oral meds Consider diabetic educator consult   Hypokalemia K+ 3.4 40 mEq of KCl  Additional repletion for goal K > 4, Mg > 2 Daily RFPs to monitor   PE on Warfarin INR 1.5 on admission Consult pharmacy for dosing   Stable chronic comorbid conditions  ? HTN ? HLD ? MDD  After 1 day the pateitn was mainting sats on RA and was discharged to home
Age: 75.0
Sex: F
Vaccine: COVID19
Symptoms: International normalised ratio increased, Leukopenia, Nausea, Respiratory symptom, Respiratory tract congestion
Clinical narrative: Patient is a 76 y.o. female patient of MD with a PMHx of PE on warfarin, HTN, HLD, T2DM, CAD, MDD presenting with URTI sxs.   Acute hypoxic respiratory failure d/t COVID-19 infection P/w cough, congestion, nausea, diarrhea, HA x5d. Vaccinated x2. Husband/son +COVID Afebrile on arrival, HDS. Dropped to 88% on RA, now on 2L NC (no home O2) Initial CBC with mild leukopenia (WBC 4.08). Trop 7. D-dimer neg. +COVID-19 CXR (my read): No vascular congestion or consolidation Cont supplemental O2 to maintain goal SpO2 > 88-90% Decadron 6mg PO daily for 10 days. Hold off on Remdesivir Obtain baseline inflammatory markers Albuterol, robitussin-DM, tylenol PRN. Scheduled Mucinex Encourage IS/PEP Contact precautions PT/OT/SW Daily labs   T2DM, fair control Last A1c 7.6% in 4/2023, will repeat Home regimen: Basaglar 46 units qHS, Glyburide Start Lantus 40u qHS, accuchecks w qAC/HS SSI Hypoglycemic protocol. Hold home oral meds Consider diabetic educator consult   Hypokalemia K+ 3.4 40 mEq of KCl  Additional repletion for goal K > 4, Mg > 2 Daily RFPs to monitor   PE on Warfarin INR 1.5 on admission Consult pharmacy for dosing   Stable chronic comorbid conditions  ? HTN ? HLD ? MDD  After 1 day the pateitn was mainting sats on RA and was discharged to home
Age: 75.0
Sex: F
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive, Troponin increased, White blood cell count decreased
Clinical narrative: Patient is a 76 y.o. female patient of MD with a PMHx of PE on warfarin, HTN, HLD, T2DM, CAD, MDD presenting with URTI sxs.   Acute hypoxic respiratory failure d/t COVID-19 infection P/w cough, congestion, nausea, diarrhea, HA x5d. Vaccinated x2. Husband/son +COVID Afebrile on arrival, HDS. Dropped to 88% on RA, now on 2L NC (no home O2) Initial CBC with mild leukopenia (WBC 4.08). Trop 7. D-dimer neg. +COVID-19 CXR (my read): No vascular congestion or consolidation Cont supplemental O2 to maintain goal SpO2 > 88-90% Decadron 6mg PO daily for 10 days. Hold off on Remdesivir Obtain baseline inflammatory markers Albuterol, robitussin-DM, tylenol PRN. Scheduled Mucinex Encourage IS/PEP Contact precautions PT/OT/SW Daily labs   T2DM, fair control Last A1c 7.6% in 4/2023, will repeat Home regimen: Basaglar 46 units qHS, Glyburide Start Lantus 40u qHS, accuchecks w qAC/HS SSI Hypoglycemic protocol. Hold home oral meds Consider diabetic educator consult   Hypokalemia K+ 3.4 40 mEq of KCl  Additional repletion for goal K > 4, Mg > 2 Daily RFPs to monitor   PE on Warfarin INR 1.5 on admission Consult pharmacy for dosing   Stable chronic comorbid conditions  ? HTN ? HLD ? MDD  After 1 day the pateitn was mainting sats on RA and was discharged to home
Age: 3.0
Sex: F
Vaccine: FLU4
Symptoms: Circumstance or information capable of leading to medication error, No adverse event, Underdose
Clinical narrative: Unable to hold patient firmly during point of vaccination, needle went in arm but only half of the vaccine was administered but the other half squirted out due to the abrupt patient movement. Staff was able to fully revaccinate patient after with no adverse affects.
Age: 12.0
Sex: M
Vaccine: MENB
Symptoms: Wrong product administered
Clinical narrative: Vaccine given in error instead of Menveo dose #1
Age: 61.0
Sex: F
Vaccine: RSV
Symptoms: Headache, Injection site rash, Lethargy, Nausea, Pain in extremity
Clinical narrative: Red rash, pain, and swelling on left arm beginning two days after injection and continuing. It is now fourth day from injection with rash extending several inches from injection site, with nausea and headache, and lethargy included.
Age: 61.0
Sex: F
Vaccine: RSV
Symptoms: Peripheral swelling, Rash, Rash erythematous
Clinical narrative: Red rash, pain, and swelling on left arm beginning two days after injection and continuing. It is now fourth day from injection with rash extending several inches from injection site, with nausea and headache, and lethargy included.
Age: 56.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Aspiration pleural cavity, Computerised tomogram thorax abnormal, EGFR gene mutation, Laboratory test, Lung adenocarcinoma
Clinical narrative: Non Small Cell adenocarcinoma lung, EGFR exon 20 +, MSS, TMB low, PD-L1 negative, veristrat good Stage IV, treated initially with 4 cycles carboplatin + pemetrexed + pembrolizumab Current treatment with amivantimab
Age: 56.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Non-small cell lung cancer, PD-L1 test negative, Pleural effusion
Clinical narrative: Non Small Cell adenocarcinoma lung, EGFR exon 20 +, MSS, TMB low, PD-L1 negative, veristrat good Stage IV, treated initially with 4 cycles carboplatin + pemetrexed + pembrolizumab Current treatment with amivantimab
Age: 77.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect dose administered
Clinical narrative: VACCINE WAS STORED IN AS UNAPPROVED STORAGE UNIT
Age: 56.0
Sex: M
Vaccine: VARZOS, UNK
Symptoms: Arthralgia, Fatigue, Injected limb mobility decreased, Injection site pain, Pain
Clinical narrative: 2ND DAY TYPICAL FATIGUE AND ACHES, AFTER RECURRENING SHOULDER PAINS- DESCRIBED AS SHOOTING PAINS- FROM INJECTION SITE THAT  EXTEND DOWN ARM TO ELBOW. AT TIME OF REPORT TO PHARMACY 9/21/2023 PT STATED THE SHOOTING PAIN CONTINUES TO HAPPEN WHEN PATIENT RAISES HIS ARM AT A CERTAIN ANGLE, THE SHOOTING PAIN IS LIMITING FULL MOBILITY OF LEFT SHOULDER
Age: 56.0
Sex: M
Vaccine: VARZOS, UNK
Symptoms: Injection site pain, Pain
Clinical narrative: 2ND DAY TYPICAL FATIGUE AND ACHES, AFTER RECURRENING SHOULDER PAINS- DESCRIBED AS SHOOTING PAINS- FROM INJECTION SITE THAT  EXTEND DOWN ARM TO ELBOW. AT TIME OF REPORT TO PHARMACY 9/21/2023 PT STATED THE SHOOTING PAIN CONTINUES TO HAPPEN WHEN PATIENT RAISES HIS ARM AT A CERTAIN ANGLE, THE SHOOTING PAIN IS LIMITING FULL MOBILITY OF LEFT SHOULDER
Age: 56.0
Sex: M
Vaccine: VARZOS, UNK
Symptoms: Arthralgia, Fatigue, Injected limb mobility decreased, Injection site pain, Pain
Clinical narrative: Pain lifting left arm above shoulder height.  Severe shooting pain at certain point lifting arm from injection point down the arm just past the elbow.  General pain when reaching out to pick up an object.
Age: 56.0
Sex: M
Vaccine: VARZOS, UNK
Symptoms: Injection site pain, Pain
Clinical narrative: Pain lifting left arm above shoulder height.  Severe shooting pain at certain point lifting arm from injection point down the arm just past the elbow.  General pain when reaching out to pick up an object.
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Acute respiratory failure, COVID-19, COVID-19 pneumonia, Chronic obstructive pulmonary disease, Computerised tomogram thorax abnormal
Clinical narrative: Patient is a 76 y.o. male patient of  PA-C with history of HTN, sarcoidosis, COPD presented to Hospital with SOB.   Acute respiratory failure with hypoxia COVID19 pneumonia COPD w exacerbation Dx with pneumonia (neg covid) on 8/4 at another facility; improved with doxy Now w/ SOB, cough, fatigue x 3 days (+) covid test and hypoxia at rest at urgent care today  Currently on 2L NC; only on home O2 at bedtime CT chest (8/23) RLL patchy airspace opacity w/ consolidations  Afebrile, WBC normal, procal < .06 Started on IV dexamethasone at  hospital Continue home inhalers, spiriva, singular, add albuterol Does not qualify for Remdesivir, hypoxia resolved, breathing at baseline Stable for discharge, on home inhalers, Continue home inhalers, spiriva, singular, add albuterol Does not qualify for Remdesivir, hypoxia resolved, breathing at baseline Stable for discharge, on home inhalers, and chronic prednisone dose   HTN Stable, continue home lisinopril   Sarcoidosis Stable Home regimen: Prednisone 20mg every other day Cont dexamethasone for now
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Condition aggravated, Cough, Dyspnoea, Fatigue, Hypoxia
Clinical narrative: Patient is a 76 y.o. male patient of  PA-C with history of HTN, sarcoidosis, COPD presented to Hospital with SOB.   Acute respiratory failure with hypoxia COVID19 pneumonia COPD w exacerbation Dx with pneumonia (neg covid) on 8/4 at another facility; improved with doxy Now w/ SOB, cough, fatigue x 3 days (+) covid test and hypoxia at rest at urgent care today  Currently on 2L NC; only on home O2 at bedtime CT chest (8/23) RLL patchy airspace opacity w/ consolidations  Afebrile, WBC normal, procal < .06 Started on IV dexamethasone at  hospital Continue home inhalers, spiriva, singular, add albuterol Does not qualify for Remdesivir, hypoxia resolved, breathing at baseline Stable for discharge, on home inhalers, Continue home inhalers, spiriva, singular, add albuterol Does not qualify for Remdesivir, hypoxia resolved, breathing at baseline Stable for discharge, on home inhalers, and chronic prednisone dose   HTN Stable, continue home lisinopril   Sarcoidosis Stable Home regimen: Prednisone 20mg every other day Cont dexamethasone for now
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Lung consolidation, Lung opacity, Pneumonia, Procalcitonin, SARS-CoV-2 test positive
Clinical narrative: Patient is a 76 y.o. male patient of  PA-C with history of HTN, sarcoidosis, COPD presented to Hospital with SOB.   Acute respiratory failure with hypoxia COVID19 pneumonia COPD w exacerbation Dx with pneumonia (neg covid) on 8/4 at another facility; improved with doxy Now w/ SOB, cough, fatigue x 3 days (+) covid test and hypoxia at rest at urgent care today  Currently on 2L NC; only on home O2 at bedtime CT chest (8/23) RLL patchy airspace opacity w/ consolidations  Afebrile, WBC normal, procal < .06 Started on IV dexamethasone at  hospital Continue home inhalers, spiriva, singular, add albuterol Does not qualify for Remdesivir, hypoxia resolved, breathing at baseline Stable for discharge, on home inhalers, Continue home inhalers, spiriva, singular, add albuterol Does not qualify for Remdesivir, hypoxia resolved, breathing at baseline Stable for discharge, on home inhalers, and chronic prednisone dose   HTN Stable, continue home lisinopril   Sarcoidosis Stable Home regimen: Prednisone 20mg every other day Cont dexamethasone for now
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: White blood cell count normal
Clinical narrative: Patient is a 76 y.o. male patient of  PA-C with history of HTN, sarcoidosis, COPD presented to Hospital with SOB.   Acute respiratory failure with hypoxia COVID19 pneumonia COPD w exacerbation Dx with pneumonia (neg covid) on 8/4 at another facility; improved with doxy Now w/ SOB, cough, fatigue x 3 days (+) covid test and hypoxia at rest at urgent care today  Currently on 2L NC; only on home O2 at bedtime CT chest (8/23) RLL patchy airspace opacity w/ consolidations  Afebrile, WBC normal, procal < .06 Started on IV dexamethasone at  hospital Continue home inhalers, spiriva, singular, add albuterol Does not qualify for Remdesivir, hypoxia resolved, breathing at baseline Stable for discharge, on home inhalers, Continue home inhalers, spiriva, singular, add albuterol Does not qualify for Remdesivir, hypoxia resolved, breathing at baseline Stable for discharge, on home inhalers, and chronic prednisone dose   HTN Stable, continue home lisinopril   Sarcoidosis Stable Home regimen: Prednisone 20mg every other day Cont dexamethasone for now
Age: 4.0
Sex: F
Vaccine: COVID19-2
Symptoms: Discontinued product administered
Clinical narrative: Vaccine was administered before receiving notice to discard all bivalent covid vaccines
Age: 87.0
Sex: F
Vaccine: RSV
Symptoms: Injection site mass, Injection site rash, Tenderness
Clinical narrative: Localized lump and rash at injection site. Mildly tender one week after injection.
Age: 64.0
Sex: F
Vaccine: COVID19-2
Symptoms: Acute respiratory failure, Blood glucose normal, COVID-19, Carotid artery stenosis, Chest X-ray normal
Clinical narrative: Patient is a 65 y.o. female patient of MD with history of DMT2, HLD, HTN, CAD S/P stent 2011, COPD (not dependent on supplemental oxygen) presented to Doctors Hospital with shortness of breath and positive COVID test (8/16/23).   Covid-19 Virus detected Acute respiratory failure with hypoxia Date of onset of symptoms: 8/16 Symptoms POA: Shortness of breath Date of covid positive test: 8/16/2023 Vaccination status: vaccinated  Imaging: CXR (8/17/2023) no acute cardiopulmonary abnormality On admission: 4 LNC (baseline: Not Oxygen Dependent) Currently: 2-4 LNC, SPO2 goals: 90-95% On remdesivir and Decadron 6 mg daily  Pt has been breathing on RA last pm and this am Stable for discharge, on Stable for discharge, on prednisone   Suspected sleep apnea Pt becomes hypoxic in early am hours during sleep Pt should get sleep study as out pt   Essential HTN Resuming amlodipine 10 mg daily, Carvedilol 12.5 mg daily, lisinopril 40 mg daily   NIDDM Type 2 Adm serum Glucose: 146, A1c 7.0 PTA med list: Metformin 1000 mg twice daily, glipizide 10 mg daily Pt advised that corticosteroids may temporarily increase glucose Cont current home regiment   COPD Tobacco use disorder Baseline: RA; On admission:  2-4 LNC liters nasal cannula Home regimen: Albuterol and fluticasone Ordered as needed albuterol Advised tobacco cessation Would offer NRT by request   HLD  Bilateral carotid stenosis (50-69% stenoses CUS 5/9/23) Peripheral artery disease Follows with OSU H&V  Moderate L-SFA stenosis Resuming Zetia 10 mg daily and atorvastatin 80 mg daily   Anxiety/depression Sertraline 50 mg daily   GERD Resuming pepcid daily, especially while on steroid Tx for COVID Pt elected to stop omeprazole d/t feeling like it caused her diarrhea
Age: 64.0
Sex: F
Vaccine: COVID19-2
Symptoms: Dyspnoea, Glycosylated haemoglobin increased, Hypoxia, Peripheral artery stenosis, SARS-CoV-2 test positive
Clinical narrative: Patient is a 65 y.o. female patient of MD with history of DMT2, HLD, HTN, CAD S/P stent 2011, COPD (not dependent on supplemental oxygen) presented to Doctors Hospital with shortness of breath and positive COVID test (8/16/23).   Covid-19 Virus detected Acute respiratory failure with hypoxia Date of onset of symptoms: 8/16 Symptoms POA: Shortness of breath Date of covid positive test: 8/16/2023 Vaccination status: vaccinated  Imaging: CXR (8/17/2023) no acute cardiopulmonary abnormality On admission: 4 LNC (baseline: Not Oxygen Dependent) Currently: 2-4 LNC, SPO2 goals: 90-95% On remdesivir and Decadron 6 mg daily  Pt has been breathing on RA last pm and this am Stable for discharge, on Stable for discharge, on prednisone   Suspected sleep apnea Pt becomes hypoxic in early am hours during sleep Pt should get sleep study as out pt   Essential HTN Resuming amlodipine 10 mg daily, Carvedilol 12.5 mg daily, lisinopril 40 mg daily   NIDDM Type 2 Adm serum Glucose: 146, A1c 7.0 PTA med list: Metformin 1000 mg twice daily, glipizide 10 mg daily Pt advised that corticosteroids may temporarily increase glucose Cont current home regiment   COPD Tobacco use disorder Baseline: RA; On admission:  2-4 LNC liters nasal cannula Home regimen: Albuterol and fluticasone Ordered as needed albuterol Advised tobacco cessation Would offer NRT by request   HLD  Bilateral carotid stenosis (50-69% stenoses CUS 5/9/23) Peripheral artery disease Follows with OSU H&V  Moderate L-SFA stenosis Resuming Zetia 10 mg daily and atorvastatin 80 mg daily   Anxiety/depression Sertraline 50 mg daily   GERD Resuming pepcid daily, especially while on steroid Tx for COVID Pt elected to stop omeprazole d/t feeling like it caused her diarrhea
Age: 64.0
Sex: F
Vaccine: COVID19-2
Symptoms: Sleep apnoea syndrome, Ultrasound Doppler
Clinical narrative: Patient is a 65 y.o. female patient of MD with history of DMT2, HLD, HTN, CAD S/P stent 2011, COPD (not dependent on supplemental oxygen) presented to Doctors Hospital with shortness of breath and positive COVID test (8/16/23).   Covid-19 Virus detected Acute respiratory failure with hypoxia Date of onset of symptoms: 8/16 Symptoms POA: Shortness of breath Date of covid positive test: 8/16/2023 Vaccination status: vaccinated  Imaging: CXR (8/17/2023) no acute cardiopulmonary abnormality On admission: 4 LNC (baseline: Not Oxygen Dependent) Currently: 2-4 LNC, SPO2 goals: 90-95% On remdesivir and Decadron 6 mg daily  Pt has been breathing on RA last pm and this am Stable for discharge, on Stable for discharge, on prednisone   Suspected sleep apnea Pt becomes hypoxic in early am hours during sleep Pt should get sleep study as out pt   Essential HTN Resuming amlodipine 10 mg daily, Carvedilol 12.5 mg daily, lisinopril 40 mg daily   NIDDM Type 2 Adm serum Glucose: 146, A1c 7.0 PTA med list: Metformin 1000 mg twice daily, glipizide 10 mg daily Pt advised that corticosteroids may temporarily increase glucose Cont current home regiment   COPD Tobacco use disorder Baseline: RA; On admission:  2-4 LNC liters nasal cannula Home regimen: Albuterol and fluticasone Ordered as needed albuterol Advised tobacco cessation Would offer NRT by request   HLD  Bilateral carotid stenosis (50-69% stenoses CUS 5/9/23) Peripheral artery disease Follows with OSU H&V  Moderate L-SFA stenosis Resuming Zetia 10 mg daily and atorvastatin 80 mg daily   Anxiety/depression Sertraline 50 mg daily   GERD Resuming pepcid daily, especially while on steroid Tx for COVID Pt elected to stop omeprazole d/t feeling like it caused her diarrhea
Age: 4.0
Sex: F
Vaccine: COVID19-2, FLU4
Symptoms: Discontinued product administered
Clinical narrative: Covid vaccine was administered before receiving notice to discard all bivalent covid vaccines
Age: 63.0
Sex: F
Vaccine: FLUR4, RSV
Symptoms: Unevaluable event
Clinical narrative: None stated.
Age: 13.0
Sex: F
Vaccine: COVID19-2, FLU4, HPV9
Symptoms: Discontinued product administered
Clinical narrative: Covid vaccine was administered before receiving notice to discard all bivalent covid vaccines
Age: 65.0
Sex: F
Vaccine: COVID19, FLU4, RSV
Symptoms: Erythema, Pruritus, Rash
Clinical narrative: Red, itchy rash on left upper arm.
Age: 72.0
Sex: F
Vaccine: COVID19, FLUA4, FLUA4
Symptoms: Extra dose administered, No adverse event
Clinical narrative: Patient received two Fluad vaccinations on same day. No adverse reactions at time of vaccination. Called for follow-up but have not received call back from patient at this time.
Age: 0.5
Sex: M
Vaccine: COVID19-2, DTAP, FLU4, HEP, HIBV, PNC13
Symptoms: Discontinued product administered
Clinical narrative: Covid vaccine was administered before receiving notice to discard all bivalent covid vaccines
Age: 67.0
Sex: M
Vaccine: COVID19
Symptoms: Chest X-ray, Cough, Dyspnoea, SARS-CoV-2 test
Clinical narrative: Presented to ED on 9/18/23 with SOB and cough that started 3 days prior. Patient discharged on 9/21/23 to a swingbed facility.
Age: 73.0
Sex: F
Vaccine: COVID19, FLU4
Symptoms: Diarrhoea, Headache
Clinical narrative: Headache the next morning after injection, lasted 24hrs.  Took Tylenol orally. Diarrhea the next morning aafter injection and has continued from Tuesday morning through mid-day Thursday and still continues . Took PeptoBismol tablets and Loperamide HCL anti-diarrheal tablets orally but has not seemed to lessen diarrhea.
Age: 97.0
Sex: M
Vaccine: COVID19-2
Symptoms: Acute respiratory failure, Anaemia of chronic disease, Angiogram abnormal, Asthenia, Blood iron decreased
Clinical narrative: Patient is a 98 y.o. male patient of MD with history of HTN, CAD, COPD presented on 8/23/2023 with generalized weakness and fall, found to have COVID-19 infection. consulted by Hospitalists, Generic for continuation of care out of ICU.   Acute hypoxic respiratory failure Bilateral pleural effusions COVID-19 Sepsis Secondary to COVID-19 infection versus superimposed bacterial pneumonia Patient presented to the ED hypoxic and tachycardic He said there were 2 sick contacts in his home that were positive for COVID Chest CT 8/23 with evidence of bilateral pleural effusions Chest x-ray 8/23 showed volume overload with interstitial prominence and small bilateral pleural effusions IV fluid IV fluid resuscitation initiated as well as steroids given in the ED Urine antigens negative Ferritin/Pro-Cal ratio 9,560, likely COVID pneumonia rather than bacterial.   Decadron started on 8/23, given course while inpatient Remdesivir started on 8/25, completed 5-day course Currently remains stable on room air Case management consulted for disposition arrangements in anticipation of discharge 8/29 Currently medically stable for discharge   Pancytopenia, resolved Anemia of chronic illness Secondary to infection vs chronic pancytopenia vs lab error vs malignancy CBC on admission: WBCs 3.97, RBCs 2.17, hemoglobin 6.3, hematocrit 20.5, platelets 109 S/p 2 units PRBC.   Iron study showed low Fe (16), high ferritin (1434), and low TIBC (178), not conclusive, but possibly due to both iron deficiency and chronic illness.   Monitor CBC.  Hb stable at 10.3   Hyponatremia Patient presented with generalized weakness Sodium on admission 121, likely global cord deficiency versus SIADH versus reset Osmostat Has had a history of hyponatremia Urine osmolality elevated at 575, urine sodium 140 FENa 1.5% Rehydration with normal saline and P.O., goal sodium correction rate of 6 in 24 hours, goal sodium is 127 by 10:00 am 8/24 Legionella urine antigen negative Sodium currently 131   Intrathoracic stomach Hiatal hernia.   Patient has a history of reflux and is on omeprazole CTA 8/23 noted an intrathoracic stomach Continue PPI.
Age: 97.0
Sex: M
Vaccine: COVID19-2
Symptoms: Blood osmolarity abnormal, Blood sodium decreased, COVID-19, COVID-19 pneumonia, Chest X-ray abnormal
Clinical narrative: Patient is a 98 y.o. male patient of MD with history of HTN, CAD, COPD presented on 8/23/2023 with generalized weakness and fall, found to have COVID-19 infection. consulted by Hospitalists, Generic for continuation of care out of ICU.   Acute hypoxic respiratory failure Bilateral pleural effusions COVID-19 Sepsis Secondary to COVID-19 infection versus superimposed bacterial pneumonia Patient presented to the ED hypoxic and tachycardic He said there were 2 sick contacts in his home that were positive for COVID Chest CT 8/23 with evidence of bilateral pleural effusions Chest x-ray 8/23 showed volume overload with interstitial prominence and small bilateral pleural effusions IV fluid IV fluid resuscitation initiated as well as steroids given in the ED Urine antigens negative Ferritin/Pro-Cal ratio 9,560, likely COVID pneumonia rather than bacterial.   Decadron started on 8/23, given course while inpatient Remdesivir started on 8/25, completed 5-day course Currently remains stable on room air Case management consulted for disposition arrangements in anticipation of discharge 8/29 Currently medically stable for discharge   Pancytopenia, resolved Anemia of chronic illness Secondary to infection vs chronic pancytopenia vs lab error vs malignancy CBC on admission: WBCs 3.97, RBCs 2.17, hemoglobin 6.3, hematocrit 20.5, platelets 109 S/p 2 units PRBC.   Iron study showed low Fe (16), high ferritin (1434), and low TIBC (178), not conclusive, but possibly due to both iron deficiency and chronic illness.   Monitor CBC.  Hb stable at 10.3   Hyponatremia Patient presented with generalized weakness Sodium on admission 121, likely global cord deficiency versus SIADH versus reset Osmostat Has had a history of hyponatremia Urine osmolality elevated at 575, urine sodium 140 FENa 1.5% Rehydration with normal saline and P.O., goal sodium correction rate of 6 in 24 hours, goal sodium is 127 by 10:00 am 8/24 Legionella urine antigen negative Sodium currently 131   Intrathoracic stomach Hiatal hernia.   Patient has a history of reflux and is on omeprazole CTA 8/23 noted an intrathoracic stomach Continue PPI.
Age: 97.0
Sex: M
Vaccine: COVID19-2
Symptoms: Computerised tomogram thorax abnormal, Condition aggravated, Exposure to SARS-CoV-2, Fall, Fractional excretion of sodium
Clinical narrative: Patient is a 98 y.o. male patient of MD with history of HTN, CAD, COPD presented on 8/23/2023 with generalized weakness and fall, found to have COVID-19 infection. consulted by Hospitalists, Generic for continuation of care out of ICU.   Acute hypoxic respiratory failure Bilateral pleural effusions COVID-19 Sepsis Secondary to COVID-19 infection versus superimposed bacterial pneumonia Patient presented to the ED hypoxic and tachycardic He said there were 2 sick contacts in his home that were positive for COVID Chest CT 8/23 with evidence of bilateral pleural effusions Chest x-ray 8/23 showed volume overload with interstitial prominence and small bilateral pleural effusions IV fluid IV fluid resuscitation initiated as well as steroids given in the ED Urine antigens negative Ferritin/Pro-Cal ratio 9,560, likely COVID pneumonia rather than bacterial.   Decadron started on 8/23, given course while inpatient Remdesivir started on 8/25, completed 5-day course Currently remains stable on room air Case management consulted for disposition arrangements in anticipation of discharge 8/29 Currently medically stable for discharge   Pancytopenia, resolved Anemia of chronic illness Secondary to infection vs chronic pancytopenia vs lab error vs malignancy CBC on admission: WBCs 3.97, RBCs 2.17, hemoglobin 6.3, hematocrit 20.5, platelets 109 S/p 2 units PRBC.   Iron study showed low Fe (16), high ferritin (1434), and low TIBC (178), not conclusive, but possibly due to both iron deficiency and chronic illness.   Monitor CBC.  Hb stable at 10.3   Hyponatremia Patient presented with generalized weakness Sodium on admission 121, likely global cord deficiency versus SIADH versus reset Osmostat Has had a history of hyponatremia Urine osmolality elevated at 575, urine sodium 140 FENa 1.5% Rehydration with normal saline and P.O., goal sodium correction rate of 6 in 24 hours, goal sodium is 127 by 10:00 am 8/24 Legionella urine antigen negative Sodium currently 131   Intrathoracic stomach Hiatal hernia.   Patient has a history of reflux and is on omeprazole CTA 8/23 noted an intrathoracic stomach Continue PPI.