chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 10.0
Sex: F
Vaccine: COVID19-2
Symptoms: Incorrect dose administered, No adverse event, Product administration error, Product preparation error
Clinical narrative: "Error occurred when administering a dose of Pediatric Pfizer Bivalent vaccine. Clinic staff did not dilute vaccine vial prior to administration and so patient received concentrated vaccine. Estimated dose administered ~28 mcg rather than intended 10 mcg.  Patient/caregiver did not report any adverse event."
Age: 8.0
Sex: M
Vaccine: COVID19-2
Symptoms: Incorrect dose administered, No adverse event, Product administration error, Product preparation error
Clinical narrative: "Error occurred when administering a dose of Pediatric Pfizer Bivalent vaccine. Clinic staff did not dilute vaccine vial prior to administration and so patient received concentrated vaccine. Estimated dose administered ~28 mcg rather than intended 10 mcg.  Patient/caregiver did not report any adverse event."
Age: 9.0
Sex: M
Vaccine: COVID19-2
Symptoms: Incorrect dose administered, No adverse event, Product administration error, Product preparation error
Clinical narrative: Error occurred when administering a dose of Pediatric Pfizer Bivalent vaccine. Clinic staff did not dilute vaccine vial prior to administration and so patient received concentrated vaccine. Estimated dose administered ~28 mcg rather than intended 10 mcg.  Patient/caregiver did not report any adverse event.
Age: 60.0
Sex: F
Vaccine: FLUA4
Symptoms: No adverse event, Product administered to patient of inappropriate age
Clinical narrative: None that we are aware of, only reporting because patient is 60 and was given a Fluad 65+ shot meant for people over the age of 65.
Age: 11.0
Sex: M
Vaccine: COVID19-2
Symptoms: Incorrect product formulation administered, No adverse event
Clinical narrative: No physical adverse event.  Gave Pfizer Bivalent Pediatric dose diluted to 0.2 ml  instead of Pfizer Primary Pediatric dose diluted  to 0.2 ml for second vaccine in series.
Age: 72.0
Sex: F
Vaccine: PNC20
Symptoms: Injection site erythema, Injection site inflammation, Injection site warmth, Rash macular
Clinical narrative: Injection site inflamed, red, hot.  Back of arm behind of injection site has red splotches.  Red, hot inflammation lasting for more than 1 week.
Age: 71.0
Sex: F
Vaccine: COVID19-2
Symptoms: Fall, Mobility decreased
Clinical narrative: fell, not able to move for a couple of hours
Age: 3.0
Sex: F
Vaccine: FLU4
Symptoms: Crying, Syncope, Unresponsive to stimuli
Clinical narrative: The patient fainted for less than 10 seconds after the flu shot was administered. The patient was sitting in her mom's lap and after receiving the shot, the mom noticed she wasn't responding. Her mom shook her to wake her up while the immunizer came and got me (the pharmacist). I immediately went into our vaccine room and when I walked in, the patient had woken up and was crying. I immediately called EMS. They arrived at our pharmacy within 10 minutes.  The patient's vitals were normal, and she did not have any other signs/symptoms of an adverse reaction. Upon evaluation, the paramedics gave the parent the okay to take her child home.  The parent will be following up with the pediatrician as this has not happened in the past.
Age: 8.0
Sex: F
Vaccine: COVID19-2
Symptoms: Incorrect product formulation administered, No adverse event
Clinical narrative: No adverse event reported. Pt was given 0.2 ml Pfizer Covid Bivalent Peds 5 -11 years instead of 0.2 ml Pfizer Primary Covid Peds 5-11 years. They got the Bivalent Booster instead of the primary #2 in series.
Age: 66.0
Sex: F
Vaccine: COVID19-2
Symptoms: Dizziness, Fatigue, Headache, Influenza virus test negative, Pyrexia
Clinical narrative: Headache, dizziness, fever, congestion, and fatigue lasting four to five days.
Age: 66.0
Sex: F
Vaccine: COVID19-2
Symptoms: Respiratory tract congestion, SARS-CoV-2 test negative
Clinical narrative: Headache, dizziness, fever, congestion, and fatigue lasting four to five days.
Age: 78.0
Sex: F
Vaccine: VARZOS
Symptoms: Injection site mass, Injection site swelling, Pain in extremity
Clinical narrative: Patient returned to pharmacy today, 15 days after receiving Shingrix vaccine in her left arm.  She states she has had continued and increasing arm soreness and a large swelling/lump (size of a large lemon) on the inside of left arm above elbow fold in the bicep area.  The pain started after vaccination and the swelling was days later.
Age: 64.0
Sex: M
Vaccine: FLU4
Symptoms: Incorrect dose administered, Wrong product administered
Clinical narrative: Patient received Fluzone High Dose vaccine and he should have received the Fluzone Quadrivalent vaccine. No symptoms were reported.
Age: 31.0
Sex: F
Vaccine: COVID19-2, FLU4
Symptoms: Eye movement disorder
Clinical narrative: Nurse administered both shots and pt's eyes started twittering (involuntary eye movements).  HR was 76 and BP 125/84.  911 was activated. Pt was cognizant and husband stated that she experiences these reactions with vaccines sometimes.  They stated medical hx of neurological disorder.  Pt was assessed by 911 also. She sat for 30 to 40 minutes and was fine again.
Age: 9.0
Sex: F
Vaccine: COVID19-2
Symptoms: Product administered to patient of inappropriate age
Clinical narrative: VACCINE FOR 12 YEARS UP ADMINISTERED TO 9 YEAR OLD
Age: 26.0
Sex: M
Vaccine: COVID19-2, FLU4
Symptoms: Dizziness, Pallor
Clinical narrative: Patient felt dizzy and slide down to sit on the floor before getting to the seat for post-vaccination waiting chair.  We helped patient to lie down and put legs up.  He looked pale, but responsive and coherence.  He was laying down for about 15 minutes while talking with me. He said that this happened to him a few year back when he got a vaccine and that this happened again today because he had donated his blood prior to come in the pharmacy for the vaccines.  He sat up after feeling better and sat for few more minutes and said he's feeling ok (not looking pale any more) and ready to go home with his driver.
Age: 73.0
Sex: M
Vaccine: COVID19, COVID19-2
Symptoms: Unevaluable event
Clinical narrative: Went to emergency room on November 1 went back to emergency room on November 15
Age: 73.0
Sex: M
Vaccine: COVID19, COVID19-2
Symptoms: Cardiac function test, Chest discomfort, Chest pain, Dizziness, Heart rate irregular
Clinical narrative: Went to emergency room on November 1 went back to emergency room on November 15
Age: 73.0
Sex: M
Vaccine: COVID19, COVID19-2
Symptoms: Myocarditis, Palpitations
Clinical narrative: Went to emergency room on November 1 went back to emergency room on November 15
Age: 5.0
Sex: F
Vaccine: DTAPIPV
Symptoms: Extra dose administered
Clinical narrative: Patient received an extra dose of DTaP/IPV due to patient's vaccine record not being properly abstracted into the system. Patient had already received a dose on 02/10/2022, which was not needed.
Age: 66.0
Sex: M
Vaccine: COVID19
Symptoms: Asthenia, COVID-19, Cough, Fatigue, Headache
Clinical narrative: I received my 4th booster shot for COVID-19 on 11/01/2022 at 8:00AM. I wasn't feeling well. It started getting worse and worse. I was feeling very tired. I had a headache, lack of energy,  problems with throat( cough), and fever. I tested positive for COVID-19 on 11/03/2022.  On the following day  I contacted my doctor on 11/04/2022. My doctor prescribed me with Paxlovid for 5 days and Advil once a day.
Age: 66.0
Sex: M
Vaccine: COVID19
Symptoms: Malaise, Oropharyngeal discomfort, Pyrexia, SARS-CoV-2 test positive
Clinical narrative: I received my 4th booster shot for COVID-19 on 11/01/2022 at 8:00AM. I wasn't feeling well. It started getting worse and worse. I was feeling very tired. I had a headache, lack of energy,  problems with throat( cough), and fever. I tested positive for COVID-19 on 11/03/2022.  On the following day  I contacted my doctor on 11/04/2022. My doctor prescribed me with Paxlovid for 5 days and Advil once a day.
Age: 33.0
Sex: F
Vaccine: COVID19-2
Symptoms: Brain natriuretic peptide normal, C-reactive protein increased, Chest X-ray normal, Chest pain, Electrocardiogram abnormal
Clinical narrative: Woke up on Monday 11/14 around 7 am with severe chest pain. Pain lasted for 1 hour before arrival to ED. Pain worse with inspiration and lying down. Pain relieved by sitting upright and NSAIDs. Saw cardiologist on Tuesday (11/15) and was diagnosed with pericarditis. Started on colchicine 0.6 mg po BID and ibuprofen 600 mg po q8h
Age: 33.0
Sex: F
Vaccine: COVID19-2
Symptoms: Fibrin D dimer normal, Full blood count normal, Metabolic function test normal, Painful respiration, Pericarditis
Clinical narrative: Woke up on Monday 11/14 around 7 am with severe chest pain. Pain lasted for 1 hour before arrival to ED. Pain worse with inspiration and lying down. Pain relieved by sitting upright and NSAIDs. Saw cardiologist on Tuesday (11/15) and was diagnosed with pericarditis. Started on colchicine 0.6 mg po BID and ibuprofen 600 mg po q8h
Age: 33.0
Sex: F
Vaccine: COVID19-2
Symptoms: Red blood cell sedimentation rate increased, Sinus bradycardia, Troponin normal
Clinical narrative: Woke up on Monday 11/14 around 7 am with severe chest pain. Pain lasted for 1 hour before arrival to ED. Pain worse with inspiration and lying down. Pain relieved by sitting upright and NSAIDs. Saw cardiologist on Tuesday (11/15) and was diagnosed with pericarditis. Started on colchicine 0.6 mg po BID and ibuprofen 600 mg po q8h
Age: 73.0
Sex: F
Vaccine: COVID19
Symptoms: Acute respiratory failure, Angiogram pulmonary abnormal, Anticoagulant therapy, Blood culture negative, Blood lactic acid normal
Clinical narrative: Clinical Summary Patient is a 74 y.o. female with a history of bronchiectasis and RA who presented to hospital 10/24/2022 with cough, fever in setting of positive home COVID testing. Found to be hypoxic. Patient left against medical advice 10/26/22.   1. Sepsis: presented with fever, tachypnea. Lactate and WBC WNL in ED. Likely d/t COVID PNA. S/p Empiric IV abx coverage with cefepime and doxycycline in ED, continued on admit in setting of her bronchiectasis. Urine Ags negative. Blood Cx NGTD. Urine Cx contaminated. Sputum Cx with many gram negative bacilli. Pulm followed. 2. Acute hypoxic respiratory failure: in setting of COVID PNA on baseline bronchiectasis, requiring 2LPM per NC in ED though O2 in ED on RA initially 81%. Tx of COVID as below. Home O2 eval ordered. Consulted pulm in setting of her known bronchiectasis  3. COVID-19 pneumonia: Positive testing 10/24/22, vaccinated (x4 vaccinations total, last 4/2022 but no bivalent booster). Presented with fatigue, dry cough and fever. CTPA with multifocal infiltrates on baseline bronchiectatic changes. Decadron and Remdesivir started on admit given her O2 requirement. Baseline inflammatory markers CRP 50.2, ferritin 282. Required special isolation.  4. Bronchiectasis: known h/o. Does not follow with pulm. Not on inhalers at home. No longer on daily abx. Pulm followed. 5. Elevated troponin: denied any chest pain on admit. Trop 86 -> 90. EKG in ED trended with findings more c/w LVH on repeat. Had initially started on heparin drip given her abnormal initial EKG and elevated trop, stopped given delta flat and less concerning for NSTEMI, more likely d/t demand ischemia in setting of above. Started heparin gtt. TTE without WMA. Cardio followed 6. Elevated BNP: 3817 in ED. Without any findings c/w HF nor any h/o HF in the past, appeared somewhat hypovolemic on admit. TTE 10/25/22 with EF 62%, diastolic function indeterminate.   7. Hyponatremia: Na in ED 130. Unclear etiology, possibly d/t poor PO intake and sepsis. S/p IVF bolus in ED. Resolved.  8. Hypokalemia: K in ED 3.3. in setting of poor PO intake PTA. S/p replacement. Improved 9. Rheumatoid arthritis: denied any recent flares of RA. On chronic steroids with prednisone 10mg daily, held on admit in place of Remdesivir. Consider taper off of prednisone as O/P but defer to rheumatologist.
Age: 73.0
Sex: F
Vaccine: COVID19
Symptoms: Blood potassium decreased, Blood sodium decreased, Brain natriuretic peptide increased, Bronchiectasis, C-reactive protein increased
Clinical narrative: Clinical Summary Patient is a 74 y.o. female with a history of bronchiectasis and RA who presented to hospital 10/24/2022 with cough, fever in setting of positive home COVID testing. Found to be hypoxic. Patient left against medical advice 10/26/22.   1. Sepsis: presented with fever, tachypnea. Lactate and WBC WNL in ED. Likely d/t COVID PNA. S/p Empiric IV abx coverage with cefepime and doxycycline in ED, continued on admit in setting of her bronchiectasis. Urine Ags negative. Blood Cx NGTD. Urine Cx contaminated. Sputum Cx with many gram negative bacilli. Pulm followed. 2. Acute hypoxic respiratory failure: in setting of COVID PNA on baseline bronchiectasis, requiring 2LPM per NC in ED though O2 in ED on RA initially 81%. Tx of COVID as below. Home O2 eval ordered. Consulted pulm in setting of her known bronchiectasis  3. COVID-19 pneumonia: Positive testing 10/24/22, vaccinated (x4 vaccinations total, last 4/2022 but no bivalent booster). Presented with fatigue, dry cough and fever. CTPA with multifocal infiltrates on baseline bronchiectatic changes. Decadron and Remdesivir started on admit given her O2 requirement. Baseline inflammatory markers CRP 50.2, ferritin 282. Required special isolation.  4. Bronchiectasis: known h/o. Does not follow with pulm. Not on inhalers at home. No longer on daily abx. Pulm followed. 5. Elevated troponin: denied any chest pain on admit. Trop 86 -> 90. EKG in ED trended with findings more c/w LVH on repeat. Had initially started on heparin drip given her abnormal initial EKG and elevated trop, stopped given delta flat and less concerning for NSTEMI, more likely d/t demand ischemia in setting of above. Started heparin gtt. TTE without WMA. Cardio followed 6. Elevated BNP: 3817 in ED. Without any findings c/w HF nor any h/o HF in the past, appeared somewhat hypovolemic on admit. TTE 10/25/22 with EF 62%, diastolic function indeterminate.   7. Hyponatremia: Na in ED 130. Unclear etiology, possibly d/t poor PO intake and sepsis. S/p IVF bolus in ED. Resolved.  8. Hypokalemia: K in ED 3.3. in setting of poor PO intake PTA. S/p replacement. Improved 9. Rheumatoid arthritis: denied any recent flares of RA. On chronic steroids with prednisone 10mg daily, held on admit in place of Remdesivir. Consider taper off of prednisone as O/P but defer to rheumatologist.
Age: 73.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, COVID-19 pneumonia, Condition aggravated, Cough, Culture urine
Clinical narrative: Clinical Summary Patient is a 74 y.o. female with a history of bronchiectasis and RA who presented to hospital 10/24/2022 with cough, fever in setting of positive home COVID testing. Found to be hypoxic. Patient left against medical advice 10/26/22.   1. Sepsis: presented with fever, tachypnea. Lactate and WBC WNL in ED. Likely d/t COVID PNA. S/p Empiric IV abx coverage with cefepime and doxycycline in ED, continued on admit in setting of her bronchiectasis. Urine Ags negative. Blood Cx NGTD. Urine Cx contaminated. Sputum Cx with many gram negative bacilli. Pulm followed. 2. Acute hypoxic respiratory failure: in setting of COVID PNA on baseline bronchiectasis, requiring 2LPM per NC in ED though O2 in ED on RA initially 81%. Tx of COVID as below. Home O2 eval ordered. Consulted pulm in setting of her known bronchiectasis  3. COVID-19 pneumonia: Positive testing 10/24/22, vaccinated (x4 vaccinations total, last 4/2022 but no bivalent booster). Presented with fatigue, dry cough and fever. CTPA with multifocal infiltrates on baseline bronchiectatic changes. Decadron and Remdesivir started on admit given her O2 requirement. Baseline inflammatory markers CRP 50.2, ferritin 282. Required special isolation.  4. Bronchiectasis: known h/o. Does not follow with pulm. Not on inhalers at home. No longer on daily abx. Pulm followed. 5. Elevated troponin: denied any chest pain on admit. Trop 86 -> 90. EKG in ED trended with findings more c/w LVH on repeat. Had initially started on heparin drip given her abnormal initial EKG and elevated trop, stopped given delta flat and less concerning for NSTEMI, more likely d/t demand ischemia in setting of above. Started heparin gtt. TTE without WMA. Cardio followed 6. Elevated BNP: 3817 in ED. Without any findings c/w HF nor any h/o HF in the past, appeared somewhat hypovolemic on admit. TTE 10/25/22 with EF 62%, diastolic function indeterminate.   7. Hyponatremia: Na in ED 130. Unclear etiology, possibly d/t poor PO intake and sepsis. S/p IVF bolus in ED. Resolved.  8. Hypokalemia: K in ED 3.3. in setting of poor PO intake PTA. S/p replacement. Improved 9. Rheumatoid arthritis: denied any recent flares of RA. On chronic steroids with prednisone 10mg daily, held on admit in place of Remdesivir. Consider taper off of prednisone as O/P but defer to rheumatologist.
Age: 73.0
Sex: F
Vaccine: COVID19
Symptoms: Echocardiogram, Ejection fraction normal, Electrocardiogram abnormal, Fatigue, Hypokalaemia
Clinical narrative: Clinical Summary Patient is a 74 y.o. female with a history of bronchiectasis and RA who presented to hospital 10/24/2022 with cough, fever in setting of positive home COVID testing. Found to be hypoxic. Patient left against medical advice 10/26/22.   1. Sepsis: presented with fever, tachypnea. Lactate and WBC WNL in ED. Likely d/t COVID PNA. S/p Empiric IV abx coverage with cefepime and doxycycline in ED, continued on admit in setting of her bronchiectasis. Urine Ags negative. Blood Cx NGTD. Urine Cx contaminated. Sputum Cx with many gram negative bacilli. Pulm followed. 2. Acute hypoxic respiratory failure: in setting of COVID PNA on baseline bronchiectasis, requiring 2LPM per NC in ED though O2 in ED on RA initially 81%. Tx of COVID as below. Home O2 eval ordered. Consulted pulm in setting of her known bronchiectasis  3. COVID-19 pneumonia: Positive testing 10/24/22, vaccinated (x4 vaccinations total, last 4/2022 but no bivalent booster). Presented with fatigue, dry cough and fever. CTPA with multifocal infiltrates on baseline bronchiectatic changes. Decadron and Remdesivir started on admit given her O2 requirement. Baseline inflammatory markers CRP 50.2, ferritin 282. Required special isolation.  4. Bronchiectasis: known h/o. Does not follow with pulm. Not on inhalers at home. No longer on daily abx. Pulm followed. 5. Elevated troponin: denied any chest pain on admit. Trop 86 -> 90. EKG in ED trended with findings more c/w LVH on repeat. Had initially started on heparin drip given her abnormal initial EKG and elevated trop, stopped given delta flat and less concerning for NSTEMI, more likely d/t demand ischemia in setting of above. Started heparin gtt. TTE without WMA. Cardio followed 6. Elevated BNP: 3817 in ED. Without any findings c/w HF nor any h/o HF in the past, appeared somewhat hypovolemic on admit. TTE 10/25/22 with EF 62%, diastolic function indeterminate.   7. Hyponatremia: Na in ED 130. Unclear etiology, possibly d/t poor PO intake and sepsis. S/p IVF bolus in ED. Resolved.  8. Hypokalemia: K in ED 3.3. in setting of poor PO intake PTA. S/p replacement. Improved 9. Rheumatoid arthritis: denied any recent flares of RA. On chronic steroids with prednisone 10mg daily, held on admit in place of Remdesivir. Consider taper off of prednisone as O/P but defer to rheumatologist.
Age: 73.0
Sex: F
Vaccine: COVID19
Symptoms: Hyponatraemia, Hypophagia, Hypoxia, Inflammatory marker test, Lung infiltration
Clinical narrative: Clinical Summary Patient is a 74 y.o. female with a history of bronchiectasis and RA who presented to hospital 10/24/2022 with cough, fever in setting of positive home COVID testing. Found to be hypoxic. Patient left against medical advice 10/26/22.   1. Sepsis: presented with fever, tachypnea. Lactate and WBC WNL in ED. Likely d/t COVID PNA. S/p Empiric IV abx coverage with cefepime and doxycycline in ED, continued on admit in setting of her bronchiectasis. Urine Ags negative. Blood Cx NGTD. Urine Cx contaminated. Sputum Cx with many gram negative bacilli. Pulm followed. 2. Acute hypoxic respiratory failure: in setting of COVID PNA on baseline bronchiectasis, requiring 2LPM per NC in ED though O2 in ED on RA initially 81%. Tx of COVID as below. Home O2 eval ordered. Consulted pulm in setting of her known bronchiectasis  3. COVID-19 pneumonia: Positive testing 10/24/22, vaccinated (x4 vaccinations total, last 4/2022 but no bivalent booster). Presented with fatigue, dry cough and fever. CTPA with multifocal infiltrates on baseline bronchiectatic changes. Decadron and Remdesivir started on admit given her O2 requirement. Baseline inflammatory markers CRP 50.2, ferritin 282. Required special isolation.  4. Bronchiectasis: known h/o. Does not follow with pulm. Not on inhalers at home. No longer on daily abx. Pulm followed. 5. Elevated troponin: denied any chest pain on admit. Trop 86 -> 90. EKG in ED trended with findings more c/w LVH on repeat. Had initially started on heparin drip given her abnormal initial EKG and elevated trop, stopped given delta flat and less concerning for NSTEMI, more likely d/t demand ischemia in setting of above. Started heparin gtt. TTE without WMA. Cardio followed 6. Elevated BNP: 3817 in ED. Without any findings c/w HF nor any h/o HF in the past, appeared somewhat hypovolemic on admit. TTE 10/25/22 with EF 62%, diastolic function indeterminate.   7. Hyponatremia: Na in ED 130. Unclear etiology, possibly d/t poor PO intake and sepsis. S/p IVF bolus in ED. Resolved.  8. Hypokalemia: K in ED 3.3. in setting of poor PO intake PTA. S/p replacement. Improved 9. Rheumatoid arthritis: denied any recent flares of RA. On chronic steroids with prednisone 10mg daily, held on admit in place of Remdesivir. Consider taper off of prednisone as O/P but defer to rheumatologist.
Age: 73.0
Sex: F
Vaccine: COVID19
Symptoms: Pyrexia, SARS-CoV-2 test positive, Sepsis, Serum ferritin increased, Sputum culture positive
Clinical narrative: Clinical Summary Patient is a 74 y.o. female with a history of bronchiectasis and RA who presented to hospital 10/24/2022 with cough, fever in setting of positive home COVID testing. Found to be hypoxic. Patient left against medical advice 10/26/22.   1. Sepsis: presented with fever, tachypnea. Lactate and WBC WNL in ED. Likely d/t COVID PNA. S/p Empiric IV abx coverage with cefepime and doxycycline in ED, continued on admit in setting of her bronchiectasis. Urine Ags negative. Blood Cx NGTD. Urine Cx contaminated. Sputum Cx with many gram negative bacilli. Pulm followed. 2. Acute hypoxic respiratory failure: in setting of COVID PNA on baseline bronchiectasis, requiring 2LPM per NC in ED though O2 in ED on RA initially 81%. Tx of COVID as below. Home O2 eval ordered. Consulted pulm in setting of her known bronchiectasis  3. COVID-19 pneumonia: Positive testing 10/24/22, vaccinated (x4 vaccinations total, last 4/2022 but no bivalent booster). Presented with fatigue, dry cough and fever. CTPA with multifocal infiltrates on baseline bronchiectatic changes. Decadron and Remdesivir started on admit given her O2 requirement. Baseline inflammatory markers CRP 50.2, ferritin 282. Required special isolation.  4. Bronchiectasis: known h/o. Does not follow with pulm. Not on inhalers at home. No longer on daily abx. Pulm followed. 5. Elevated troponin: denied any chest pain on admit. Trop 86 -> 90. EKG in ED trended with findings more c/w LVH on repeat. Had initially started on heparin drip given her abnormal initial EKG and elevated trop, stopped given delta flat and less concerning for NSTEMI, more likely d/t demand ischemia in setting of above. Started heparin gtt. TTE without WMA. Cardio followed 6. Elevated BNP: 3817 in ED. Without any findings c/w HF nor any h/o HF in the past, appeared somewhat hypovolemic on admit. TTE 10/25/22 with EF 62%, diastolic function indeterminate.   7. Hyponatremia: Na in ED 130. Unclear etiology, possibly d/t poor PO intake and sepsis. S/p IVF bolus in ED. Resolved.  8. Hypokalemia: K in ED 3.3. in setting of poor PO intake PTA. S/p replacement. Improved 9. Rheumatoid arthritis: denied any recent flares of RA. On chronic steroids with prednisone 10mg daily, held on admit in place of Remdesivir. Consider taper off of prednisone as O/P but defer to rheumatologist.
Age: 73.0
Sex: F
Vaccine: COVID19
Symptoms: Tachypnoea, Troponin increased, Urine antigen test, White blood cell count normal
Clinical narrative: Clinical Summary Patient is a 74 y.o. female with a history of bronchiectasis and RA who presented to hospital 10/24/2022 with cough, fever in setting of positive home COVID testing. Found to be hypoxic. Patient left against medical advice 10/26/22.   1. Sepsis: presented with fever, tachypnea. Lactate and WBC WNL in ED. Likely d/t COVID PNA. S/p Empiric IV abx coverage with cefepime and doxycycline in ED, continued on admit in setting of her bronchiectasis. Urine Ags negative. Blood Cx NGTD. Urine Cx contaminated. Sputum Cx with many gram negative bacilli. Pulm followed. 2. Acute hypoxic respiratory failure: in setting of COVID PNA on baseline bronchiectasis, requiring 2LPM per NC in ED though O2 in ED on RA initially 81%. Tx of COVID as below. Home O2 eval ordered. Consulted pulm in setting of her known bronchiectasis  3. COVID-19 pneumonia: Positive testing 10/24/22, vaccinated (x4 vaccinations total, last 4/2022 but no bivalent booster). Presented with fatigue, dry cough and fever. CTPA with multifocal infiltrates on baseline bronchiectatic changes. Decadron and Remdesivir started on admit given her O2 requirement. Baseline inflammatory markers CRP 50.2, ferritin 282. Required special isolation.  4. Bronchiectasis: known h/o. Does not follow with pulm. Not on inhalers at home. No longer on daily abx. Pulm followed. 5. Elevated troponin: denied any chest pain on admit. Trop 86 -> 90. EKG in ED trended with findings more c/w LVH on repeat. Had initially started on heparin drip given her abnormal initial EKG and elevated trop, stopped given delta flat and less concerning for NSTEMI, more likely d/t demand ischemia in setting of above. Started heparin gtt. TTE without WMA. Cardio followed 6. Elevated BNP: 3817 in ED. Without any findings c/w HF nor any h/o HF in the past, appeared somewhat hypovolemic on admit. TTE 10/25/22 with EF 62%, diastolic function indeterminate.   7. Hyponatremia: Na in ED 130. Unclear etiology, possibly d/t poor PO intake and sepsis. S/p IVF bolus in ED. Resolved.  8. Hypokalemia: K in ED 3.3. in setting of poor PO intake PTA. S/p replacement. Improved 9. Rheumatoid arthritis: denied any recent flares of RA. On chronic steroids with prednisone 10mg daily, held on admit in place of Remdesivir. Consider taper off of prednisone as O/P but defer to rheumatologist.
Age: 63.0
Sex: F
Vaccine: COVID19-2, HEP
Symptoms: Diarrhoea, Swelling, Swelling face
Clinical narrative: Patient said the evening of the vaccines that her face started to swell including the bottom eye and her neck and she had diarrhea.  No trouble breathing. She said it lasted for 3 days and it went away
Age: 38.0
Sex: F
Vaccine: COVID19-2
Symptoms: Arthralgia, Injection site bruising, Injection site haemorrhage, Injection site pain, Injection site rash
Clinical narrative: When the shot was administered it bled a decent amount and immediately bruised. By the next day the bruise was much larger and a red rash surrounded it taking up about half of my upper arm. On day 3 the rash is spreading and my shoulder and elbow joint is achy. The rash is itchy hot and raised
Age: 38.0
Sex: F
Vaccine: COVID19-2
Symptoms: Rash papular, Rash pruritic, Skin warm
Clinical narrative: When the shot was administered it bled a decent amount and immediately bruised. By the next day the bruise was much larger and a red rash surrounded it taking up about half of my upper arm. On day 3 the rash is spreading and my shoulder and elbow joint is achy. The rash is itchy hot and raised
Age: 18.0
Sex: F
Vaccine: COVID19-2
Symptoms: Incorrect product formulation administered
Clinical narrative: Pfizer Bivalent COVID-19 vaccine given as second dose of primary series as opposed to the monovalent vaccine. No side effects reported by patient next day.
Age: 18.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: upon discovery from the administrator of the shot, and errant dose of Pfizer-BioNTech COVID-19  instead of the Bivalent Pfizer Booster
Age: 0.17
Sex: F
Vaccine: RV1
Symptoms: Haematochezia, Infant irritability
Clinical narrative: 4 days after receiving oral vaccine, started having increased fussiness and bloody stools. Self resolved after 2 days.
Age: 82.0
Sex: F
Vaccine: COVID19
Symptoms: Acute kidney injury, COVID-19, Chest X-ray abnormal, Chronic kidney disease, Computerised tomogram head
Clinical narrative: Patient is a 83 y.o. female patient of local MD.   Report on admission: 83-year-old female presents to ED with chief complaint of dizziness, which she noticed when she got out of bed yesterday morning.  She states as long as she is sitting or lying still she feels minimally dizzy, but whenever she gets up, "everything starts going around", and she has had some instability in her gait, has been having to put her arms out to steady herself.  She has a mild frontal headache.  Denies any visual changes since the dizziness began.  She has chronic tingling in both of her hands but she has no new sensory disturbance since the dizziness began.  Has not noticed any weakness in her arms or legs, any facial droop.  Daughter states the patient has some mild chronic aphasia, but she does not feel her mother speech is changed from baseline acutely today.  Since yesterday she has had some nasal congestion, reports a sore throat, has started coughing, felt warm to her daughter this morning.  Temperature was 99.4 when the daughter checked it.  She is had some diarrhea the last couple days, but this is fairly chronic.  Stools have not been tarry or bloody, no associated abdominal pain.  Has been mildly nauseated since yesterday but has not vomited.  Denies ear pain, hearing loss, tinnitus       Hospital course as below.  Patient improved with medical treatment.  Patient discharged home in stable condition with instructions to follow-up with primary care provider within a week.    1.  COVID, + 10/14, symptoms 10/13: -Chest x-ray without pneumonia, chronic findings -Remdesivir -Decadron -Heparin DVT prophylaxis  2.  Chronic hypoxic respiratory failure: -2 L nasal cannula oxygen baseline  3.  AKI on CKD: -Improved -Monitor labs  4.  Orthostatic hypotension: -Received IV fluids -Continue to monitor orthostatic vital signs  5.  Dizziness: -CT head nonacute -Continue meclizine  6.  Other chronic medical conditions: Dementia, history of hypertension, GERD, history of stroke
Age: 82.0
Sex: F
Vaccine: COVID19
Symptoms: Cough, Diarrhoea, Dizziness, Feeling hot, Gait disturbance
Clinical narrative: Patient is a 83 y.o. female patient of local MD.   Report on admission: 83-year-old female presents to ED with chief complaint of dizziness, which she noticed when she got out of bed yesterday morning.  She states as long as she is sitting or lying still she feels minimally dizzy, but whenever she gets up, "everything starts going around", and she has had some instability in her gait, has been having to put her arms out to steady herself.  She has a mild frontal headache.  Denies any visual changes since the dizziness began.  She has chronic tingling in both of her hands but she has no new sensory disturbance since the dizziness began.  Has not noticed any weakness in her arms or legs, any facial droop.  Daughter states the patient has some mild chronic aphasia, but she does not feel her mother speech is changed from baseline acutely today.  Since yesterday she has had some nasal congestion, reports a sore throat, has started coughing, felt warm to her daughter this morning.  Temperature was 99.4 when the daughter checked it.  She is had some diarrhea the last couple days, but this is fairly chronic.  Stools have not been tarry or bloody, no associated abdominal pain.  Has been mildly nauseated since yesterday but has not vomited.  Denies ear pain, hearing loss, tinnitus       Hospital course as below.  Patient improved with medical treatment.  Patient discharged home in stable condition with instructions to follow-up with primary care provider within a week.    1.  COVID, + 10/14, symptoms 10/13: -Chest x-ray without pneumonia, chronic findings -Remdesivir -Decadron -Heparin DVT prophylaxis  2.  Chronic hypoxic respiratory failure: -2 L nasal cannula oxygen baseline  3.  AKI on CKD: -Improved -Monitor labs  4.  Orthostatic hypotension: -Received IV fluids -Continue to monitor orthostatic vital signs  5.  Dizziness: -CT head nonacute -Continue meclizine  6.  Other chronic medical conditions: Dementia, history of hypertension, GERD, history of stroke
Age: 82.0
Sex: F
Vaccine: COVID19
Symptoms: Headache, Malaise, Nasal congestion, Nausea, Oropharyngeal pain
Clinical narrative: Patient is a 83 y.o. female patient of local MD.   Report on admission: 83-year-old female presents to ED with chief complaint of dizziness, which she noticed when she got out of bed yesterday morning.  She states as long as she is sitting or lying still she feels minimally dizzy, but whenever she gets up, "everything starts going around", and she has had some instability in her gait, has been having to put her arms out to steady herself.  She has a mild frontal headache.  Denies any visual changes since the dizziness began.  She has chronic tingling in both of her hands but she has no new sensory disturbance since the dizziness began.  Has not noticed any weakness in her arms or legs, any facial droop.  Daughter states the patient has some mild chronic aphasia, but she does not feel her mother speech is changed from baseline acutely today.  Since yesterday she has had some nasal congestion, reports a sore throat, has started coughing, felt warm to her daughter this morning.  Temperature was 99.4 when the daughter checked it.  She is had some diarrhea the last couple days, but this is fairly chronic.  Stools have not been tarry or bloody, no associated abdominal pain.  Has been mildly nauseated since yesterday but has not vomited.  Denies ear pain, hearing loss, tinnitus       Hospital course as below.  Patient improved with medical treatment.  Patient discharged home in stable condition with instructions to follow-up with primary care provider within a week.    1.  COVID, + 10/14, symptoms 10/13: -Chest x-ray without pneumonia, chronic findings -Remdesivir -Decadron -Heparin DVT prophylaxis  2.  Chronic hypoxic respiratory failure: -2 L nasal cannula oxygen baseline  3.  AKI on CKD: -Improved -Monitor labs  4.  Orthostatic hypotension: -Received IV fluids -Continue to monitor orthostatic vital signs  5.  Dizziness: -CT head nonacute -Continue meclizine  6.  Other chronic medical conditions: Dementia, history of hypertension, GERD, history of stroke
Age: 82.0
Sex: F
Vaccine: COVID19
Symptoms: Orthostatic hypotension, Paraesthesia, Respiratory failure, SARS-CoV-2 test positive
Clinical narrative: Patient is a 83 y.o. female patient of local MD.   Report on admission: 83-year-old female presents to ED with chief complaint of dizziness, which she noticed when she got out of bed yesterday morning.  She states as long as she is sitting or lying still she feels minimally dizzy, but whenever she gets up, "everything starts going around", and she has had some instability in her gait, has been having to put her arms out to steady herself.  She has a mild frontal headache.  Denies any visual changes since the dizziness began.  She has chronic tingling in both of her hands but she has no new sensory disturbance since the dizziness began.  Has not noticed any weakness in her arms or legs, any facial droop.  Daughter states the patient has some mild chronic aphasia, but she does not feel her mother speech is changed from baseline acutely today.  Since yesterday she has had some nasal congestion, reports a sore throat, has started coughing, felt warm to her daughter this morning.  Temperature was 99.4 when the daughter checked it.  She is had some diarrhea the last couple days, but this is fairly chronic.  Stools have not been tarry or bloody, no associated abdominal pain.  Has been mildly nauseated since yesterday but has not vomited.  Denies ear pain, hearing loss, tinnitus       Hospital course as below.  Patient improved with medical treatment.  Patient discharged home in stable condition with instructions to follow-up with primary care provider within a week.    1.  COVID, + 10/14, symptoms 10/13: -Chest x-ray without pneumonia, chronic findings -Remdesivir -Decadron -Heparin DVT prophylaxis  2.  Chronic hypoxic respiratory failure: -2 L nasal cannula oxygen baseline  3.  AKI on CKD: -Improved -Monitor labs  4.  Orthostatic hypotension: -Received IV fluids -Continue to monitor orthostatic vital signs  5.  Dizziness: -CT head nonacute -Continue meclizine  6.  Other chronic medical conditions: Dementia, history of hypertension, GERD, history of stroke
Age: 70.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: upon discovery from the administrator of the shot, and errant dose of Pfizer-BioNTech COVID-19 vaccine with a LOT of FP7137 instead of the Bivalent Pfizer Booster
Age: 46.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: upon discovery from the administrator of the shot, and errant dose of Pfizer-BioNTech COVID-19 vaccine with a LOT of FP7137 instead of the Bivalent Pfizer Booster
Age: 8.0
Sex: F
Vaccine: COVID19-2
Symptoms: Incorrect dose administered
Clinical narrative: PT RECIEVED ADULT PFIZER VACCINE INSTEAD OF PEDIATRIC PFIZER
Age: 74.0
Sex: M
Vaccine: FLUA4
Symptoms: Arthralgia, Injection site pain, Pain in extremity
Clinical narrative: Pain in Left shoulder and arm following vaccine > 3 weeks ago. Patient just reported to pharmacy today to complain that it was still very painful. Pointed to entire shoulder region through injection site and down through pt wrist.
Age: 26.0
Sex: M
Vaccine: HEPA
Symptoms: Product administration error, Wrong product administered
Clinical narrative: Patient had requested hepatitis B vaccine and was given hepatitis A vaccine in error. He has been notified.
Age: 89.0
Sex: F
Vaccine: COVID19
Symptoms: Acute respiratory failure, Ageusia, Angiogram pulmonary abnormal, Anosmia, Anticoagulant therapy
Clinical narrative: The patient is a 90 y.o. female with a history of PE/DVT 6/2022 completed 3 months of Xarelto, Hypertension, Hyperlipidemia, GERD, Ulcerative colitis, Anemia, Arthritis, admitted with COVID-19 and generalized weakness. When she progressed, she was discharged HHC in stable but guarded condition with advice for all time fall precautions and OP f/u with her physicians as instructed.   Acute respiratory failure with hypoxia-resolved Covid-19 Virus Infection Date of onset of symptoms: 10/17/2022 Symptoms present on admission: Cough, dyspnea, rhinorrhea, loss of taste/smell, nausea, fever/chills Date of covid positive test: 10/18/2022 Vaccination status: vaccinated, f/u with PCP for need for booster in near future Imaging: CTPA negative for PE, revealed bilateral bronchial wall thickening and scattered bilateral lung opacities Oxygen requirements on admission: 2 L Current oxygen requirements: RA Medical therapy: remdesivir and steroids(Day #4), resume home prednisone taper on discharge Consultants following: None Anticipated special isolation end date: 10/29/2022 Weaned to RA and did not need home o2 on discharge Cough better OP PCP f/u as instructed     SIRS criteria- improved WBC 12.31, tachycardia Likely secondary to COVID-19 Blood cultures-NGTD.  LA normal     New onset atrial fibrillation with RVR, prozsymal Converted to NSR following 10 mg IV Cardizem in ED proBNP 613.  TSH normal.  Serial troponins with a flat trend 21> 21 Echo from June 2022 with EF greater than 70% RVSP 42 mmHg, moderate TR Cardiology followed in the hospital Continue home Rx Toprol-XL 25 mg daily Cardiology started AC with Xarelto 15 mg daily OP Cardio f/u as instructed   Chronic normocytic anemia Baseline hemoglobin 9.7 to 11 g/dL H&H 9.9/31.7 OP PCP f/u    Generalized weakness Up with assistance PT/OT evaluated-recommended home therapy and qualified for HHC on discharge C/w wheeled walker and all time fall precautions  Essential hypertension ontinue Toprol and hydrochlorothiazide   Ulcerative colitis Started on prednisone taper 10/1-will held while receiving Decadron>resume on discharge Continue Entocort Pepcid for a month ordered OP PCP f/u recommended   History of recent PE Saddle PE with extensive bilateral emboli with heart strain in June 2022 Completed 3 months of Xarelto Admission CTPA with no evidence of PE
Age: 89.0
Sex: F
Vaccine: COVID19
Symptoms: Asthenia, Atrial fibrillation, Blood culture negative, Blood lactic acid normal, Blood thyroid stimulating hormone normal
Clinical narrative: The patient is a 90 y.o. female with a history of PE/DVT 6/2022 completed 3 months of Xarelto, Hypertension, Hyperlipidemia, GERD, Ulcerative colitis, Anemia, Arthritis, admitted with COVID-19 and generalized weakness. When she progressed, she was discharged HHC in stable but guarded condition with advice for all time fall precautions and OP f/u with her physicians as instructed.   Acute respiratory failure with hypoxia-resolved Covid-19 Virus Infection Date of onset of symptoms: 10/17/2022 Symptoms present on admission: Cough, dyspnea, rhinorrhea, loss of taste/smell, nausea, fever/chills Date of covid positive test: 10/18/2022 Vaccination status: vaccinated, f/u with PCP for need for booster in near future Imaging: CTPA negative for PE, revealed bilateral bronchial wall thickening and scattered bilateral lung opacities Oxygen requirements on admission: 2 L Current oxygen requirements: RA Medical therapy: remdesivir and steroids(Day #4), resume home prednisone taper on discharge Consultants following: None Anticipated special isolation end date: 10/29/2022 Weaned to RA and did not need home o2 on discharge Cough better OP PCP f/u as instructed     SIRS criteria- improved WBC 12.31, tachycardia Likely secondary to COVID-19 Blood cultures-NGTD.  LA normal     New onset atrial fibrillation with RVR, prozsymal Converted to NSR following 10 mg IV Cardizem in ED proBNP 613.  TSH normal.  Serial troponins with a flat trend 21> 21 Echo from June 2022 with EF greater than 70% RVSP 42 mmHg, moderate TR Cardiology followed in the hospital Continue home Rx Toprol-XL 25 mg daily Cardiology started AC with Xarelto 15 mg daily OP Cardio f/u as instructed   Chronic normocytic anemia Baseline hemoglobin 9.7 to 11 g/dL H&H 9.9/31.7 OP PCP f/u    Generalized weakness Up with assistance PT/OT evaluated-recommended home therapy and qualified for HHC on discharge C/w wheeled walker and all time fall precautions  Essential hypertension ontinue Toprol and hydrochlorothiazide   Ulcerative colitis Started on prednisone taper 10/1-will held while receiving Decadron>resume on discharge Continue Entocort Pepcid for a month ordered OP PCP f/u recommended   History of recent PE Saddle PE with extensive bilateral emboli with heart strain in June 2022 Completed 3 months of Xarelto Admission CTPA with no evidence of PE
Age: 89.0
Sex: F
Vaccine: COVID19
Symptoms: Bronchial wall thickening, COVID-19, Cardioversion, Chills, Cough
Clinical narrative: The patient is a 90 y.o. female with a history of PE/DVT 6/2022 completed 3 months of Xarelto, Hypertension, Hyperlipidemia, GERD, Ulcerative colitis, Anemia, Arthritis, admitted with COVID-19 and generalized weakness. When she progressed, she was discharged HHC in stable but guarded condition with advice for all time fall precautions and OP f/u with her physicians as instructed.   Acute respiratory failure with hypoxia-resolved Covid-19 Virus Infection Date of onset of symptoms: 10/17/2022 Symptoms present on admission: Cough, dyspnea, rhinorrhea, loss of taste/smell, nausea, fever/chills Date of covid positive test: 10/18/2022 Vaccination status: vaccinated, f/u with PCP for need for booster in near future Imaging: CTPA negative for PE, revealed bilateral bronchial wall thickening and scattered bilateral lung opacities Oxygen requirements on admission: 2 L Current oxygen requirements: RA Medical therapy: remdesivir and steroids(Day #4), resume home prednisone taper on discharge Consultants following: None Anticipated special isolation end date: 10/29/2022 Weaned to RA and did not need home o2 on discharge Cough better OP PCP f/u as instructed     SIRS criteria- improved WBC 12.31, tachycardia Likely secondary to COVID-19 Blood cultures-NGTD.  LA normal     New onset atrial fibrillation with RVR, prozsymal Converted to NSR following 10 mg IV Cardizem in ED proBNP 613.  TSH normal.  Serial troponins with a flat trend 21> 21 Echo from June 2022 with EF greater than 70% RVSP 42 mmHg, moderate TR Cardiology followed in the hospital Continue home Rx Toprol-XL 25 mg daily Cardiology started AC with Xarelto 15 mg daily OP Cardio f/u as instructed   Chronic normocytic anemia Baseline hemoglobin 9.7 to 11 g/dL H&H 9.9/31.7 OP PCP f/u    Generalized weakness Up with assistance PT/OT evaluated-recommended home therapy and qualified for HHC on discharge C/w wheeled walker and all time fall precautions  Essential hypertension ontinue Toprol and hydrochlorothiazide   Ulcerative colitis Started on prednisone taper 10/1-will held while receiving Decadron>resume on discharge Continue Entocort Pepcid for a month ordered OP PCP f/u recommended   History of recent PE Saddle PE with extensive bilateral emboli with heart strain in June 2022 Completed 3 months of Xarelto Admission CTPA with no evidence of PE
Age: 89.0
Sex: F
Vaccine: COVID19
Symptoms: Deep vein thrombosis, Dyspnoea, Echocardiogram normal, Ejection fraction normal, Haematocrit decreased
Clinical narrative: The patient is a 90 y.o. female with a history of PE/DVT 6/2022 completed 3 months of Xarelto, Hypertension, Hyperlipidemia, GERD, Ulcerative colitis, Anemia, Arthritis, admitted with COVID-19 and generalized weakness. When she progressed, she was discharged HHC in stable but guarded condition with advice for all time fall precautions and OP f/u with her physicians as instructed.   Acute respiratory failure with hypoxia-resolved Covid-19 Virus Infection Date of onset of symptoms: 10/17/2022 Symptoms present on admission: Cough, dyspnea, rhinorrhea, loss of taste/smell, nausea, fever/chills Date of covid positive test: 10/18/2022 Vaccination status: vaccinated, f/u with PCP for need for booster in near future Imaging: CTPA negative for PE, revealed bilateral bronchial wall thickening and scattered bilateral lung opacities Oxygen requirements on admission: 2 L Current oxygen requirements: RA Medical therapy: remdesivir and steroids(Day #4), resume home prednisone taper on discharge Consultants following: None Anticipated special isolation end date: 10/29/2022 Weaned to RA and did not need home o2 on discharge Cough better OP PCP f/u as instructed     SIRS criteria- improved WBC 12.31, tachycardia Likely secondary to COVID-19 Blood cultures-NGTD.  LA normal     New onset atrial fibrillation with RVR, prozsymal Converted to NSR following 10 mg IV Cardizem in ED proBNP 613.  TSH normal.  Serial troponins with a flat trend 21> 21 Echo from June 2022 with EF greater than 70% RVSP 42 mmHg, moderate TR Cardiology followed in the hospital Continue home Rx Toprol-XL 25 mg daily Cardiology started AC with Xarelto 15 mg daily OP Cardio f/u as instructed   Chronic normocytic anemia Baseline hemoglobin 9.7 to 11 g/dL H&H 9.9/31.7 OP PCP f/u    Generalized weakness Up with assistance PT/OT evaluated-recommended home therapy and qualified for HHC on discharge C/w wheeled walker and all time fall precautions  Essential hypertension ontinue Toprol and hydrochlorothiazide   Ulcerative colitis Started on prednisone taper 10/1-will held while receiving Decadron>resume on discharge Continue Entocort Pepcid for a month ordered OP PCP f/u recommended   History of recent PE Saddle PE with extensive bilateral emboli with heart strain in June 2022 Completed 3 months of Xarelto Admission CTPA with no evidence of PE