chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 53.0
Sex: M
Vaccine: COVID19
Symptoms: Blood culture negative, Blood loss anaemia, COVID-19, Cardiac arrest, Cirrhosis alcoholic
Clinical narrative: 54 y.o. male patient of Physician No with history of esophageal varices (last banding 1 year ago), decompensated alcoholic cirrhosis, hepatitis C and HTN. Transferred from Hospital where he initially presented for large volume hematemesis followed by subsequent cardiac arrest, managed in the ICU eventually transferred to the floor. He left AMA saying he had a rehab place line up. He left despite worsening liver failure and without any appropriate follow ups arranged.        Decompensated Alcoholic Cirrhosis Hepatitis C Unable to verify extent of alcohol use, was previously sober for 9 months in 2020 but unclear if still drinking Home meds: propranolol, spironolactone, Hep C quant and Ab positive 2020, unclear if treated Repeat Hep C quant 605,000 IV thiamine  Encourage cessation, consider addiction med c/s  Rising T bili 0.5-- >2.6,  rising AST 54-- >107, ALT wnl, will re-consult GI Patient wants to leave but parameters heading in the wrong direction. He eventually signed out AMA knowing the risk. He appeared to have capacity.    Cardiac Arrest Suspect 2/2 to hypovolemic shock from esophageal variceal bleeding vs profound acidosis  ROSC obtained after two rounds of CPR, Ca, Epi, and Bicarb S/p 2u pRBC EKG no ischemic changes  Wean sedation and ventilation as tolerated Post cardiac arrest protocol initiated: Target temperature management, CT head pending, EEG Cardio consulted, signed off 12/29 No further testing per cardiology  Neurology consulted, signed off 12/29   Upper GI bleed Acute blood loss on chronic anemia  Esophageal varices, secondary to alcoholic cirrhosis as below  Patient with history of varices, last banding one year ago; now presenting with large volume hematemesis prior to cardiac arrest, see above.  On admission Hgb 11.7, b/l 9.1-10.6 CTA abd/chest/pelvis with no signs of active bleeding  S/p 2U pRBC, protonix bolus On Octreotide gtt, discontinued 12/30 S/p CTX in ED for CAP, see below, will continue for SBP prophylaxis Rocephin and Protonix IV x 5 days  Gastroenterology consulted EGD 12/28 + stigmata of recent esophageal variceal bleed, s/p band x5 IF rebleeds from varices will need VIR for emergent TIPS  Okay from GI for diet  Was tolerating diet prior to discharge.  Acute Hypercapnic respiratory failure Multifocal Pneumonia COVID-19 2/2 cardiac arrest in the setting of acute COVID infection and imaging c/f CAP Currently sedated and on ventilator Continue dilaudid and propofol gtt, added precedex 12/29 as weaning off other medications  Continue Azithro/CTX for CAP coverage Steroids and remdesivir  Legionella and strep pneumo antigen negative  MRSA nares positive  Blood Cx prelim negative Extubated 12/30 on NC  PRN cough suppressants for comfort
Age: 53.0
Sex: M
Vaccine: COVID19
Symptoms: Condition aggravated, Electrocardiogram normal, Endotracheal intubation, Haematemesis, Haemoglobin decreased
Clinical narrative: 54 y.o. male patient of Physician No with history of esophageal varices (last banding 1 year ago), decompensated alcoholic cirrhosis, hepatitis C and HTN. Transferred from Hospital where he initially presented for large volume hematemesis followed by subsequent cardiac arrest, managed in the ICU eventually transferred to the floor. He left AMA saying he had a rehab place line up. He left despite worsening liver failure and without any appropriate follow ups arranged.        Decompensated Alcoholic Cirrhosis Hepatitis C Unable to verify extent of alcohol use, was previously sober for 9 months in 2020 but unclear if still drinking Home meds: propranolol, spironolactone, Hep C quant and Ab positive 2020, unclear if treated Repeat Hep C quant 605,000 IV thiamine  Encourage cessation, consider addiction med c/s  Rising T bili 0.5-- >2.6,  rising AST 54-- >107, ALT wnl, will re-consult GI Patient wants to leave but parameters heading in the wrong direction. He eventually signed out AMA knowing the risk. He appeared to have capacity.    Cardiac Arrest Suspect 2/2 to hypovolemic shock from esophageal variceal bleeding vs profound acidosis  ROSC obtained after two rounds of CPR, Ca, Epi, and Bicarb S/p 2u pRBC EKG no ischemic changes  Wean sedation and ventilation as tolerated Post cardiac arrest protocol initiated: Target temperature management, CT head pending, EEG Cardio consulted, signed off 12/29 No further testing per cardiology  Neurology consulted, signed off 12/29   Upper GI bleed Acute blood loss on chronic anemia  Esophageal varices, secondary to alcoholic cirrhosis as below  Patient with history of varices, last banding one year ago; now presenting with large volume hematemesis prior to cardiac arrest, see above.  On admission Hgb 11.7, b/l 9.1-10.6 CTA abd/chest/pelvis with no signs of active bleeding  S/p 2U pRBC, protonix bolus On Octreotide gtt, discontinued 12/30 S/p CTX in ED for CAP, see below, will continue for SBP prophylaxis Rocephin and Protonix IV x 5 days  Gastroenterology consulted EGD 12/28 + stigmata of recent esophageal variceal bleed, s/p band x5 IF rebleeds from varices will need VIR for emergent TIPS  Okay from GI for diet  Was tolerating diet prior to discharge.  Acute Hypercapnic respiratory failure Multifocal Pneumonia COVID-19 2/2 cardiac arrest in the setting of acute COVID infection and imaging c/f CAP Currently sedated and on ventilator Continue dilaudid and propofol gtt, added precedex 12/29 as weaning off other medications  Continue Azithro/CTX for CAP coverage Steroids and remdesivir  Legionella and strep pneumo antigen negative  MRSA nares positive  Blood Cx prelim negative Extubated 12/30 on NC  PRN cough suppressants for comfort
Age: 53.0
Sex: M
Vaccine: COVID19
Symptoms: Hepatic failure, Hepatitis C RNA, Hypovolaemic shock, Intensive care, Legionella test
Clinical narrative: 54 y.o. male patient of Physician No with history of esophageal varices (last banding 1 year ago), decompensated alcoholic cirrhosis, hepatitis C and HTN. Transferred from Hospital where he initially presented for large volume hematemesis followed by subsequent cardiac arrest, managed in the ICU eventually transferred to the floor. He left AMA saying he had a rehab place line up. He left despite worsening liver failure and without any appropriate follow ups arranged.        Decompensated Alcoholic Cirrhosis Hepatitis C Unable to verify extent of alcohol use, was previously sober for 9 months in 2020 but unclear if still drinking Home meds: propranolol, spironolactone, Hep C quant and Ab positive 2020, unclear if treated Repeat Hep C quant 605,000 IV thiamine  Encourage cessation, consider addiction med c/s  Rising T bili 0.5-- >2.6,  rising AST 54-- >107, ALT wnl, will re-consult GI Patient wants to leave but parameters heading in the wrong direction. He eventually signed out AMA knowing the risk. He appeared to have capacity.    Cardiac Arrest Suspect 2/2 to hypovolemic shock from esophageal variceal bleeding vs profound acidosis  ROSC obtained after two rounds of CPR, Ca, Epi, and Bicarb S/p 2u pRBC EKG no ischemic changes  Wean sedation and ventilation as tolerated Post cardiac arrest protocol initiated: Target temperature management, CT head pending, EEG Cardio consulted, signed off 12/29 No further testing per cardiology  Neurology consulted, signed off 12/29   Upper GI bleed Acute blood loss on chronic anemia  Esophageal varices, secondary to alcoholic cirrhosis as below  Patient with history of varices, last banding one year ago; now presenting with large volume hematemesis prior to cardiac arrest, see above.  On admission Hgb 11.7, b/l 9.1-10.6 CTA abd/chest/pelvis with no signs of active bleeding  S/p 2U pRBC, protonix bolus On Octreotide gtt, discontinued 12/30 S/p CTX in ED for CAP, see below, will continue for SBP prophylaxis Rocephin and Protonix IV x 5 days  Gastroenterology consulted EGD 12/28 + stigmata of recent esophageal variceal bleed, s/p band x5 IF rebleeds from varices will need VIR for emergent TIPS  Okay from GI for diet  Was tolerating diet prior to discharge.  Acute Hypercapnic respiratory failure Multifocal Pneumonia COVID-19 2/2 cardiac arrest in the setting of acute COVID infection and imaging c/f CAP Currently sedated and on ventilator Continue dilaudid and propofol gtt, added precedex 12/29 as weaning off other medications  Continue Azithro/CTX for CAP coverage Steroids and remdesivir  Legionella and strep pneumo antigen negative  MRSA nares positive  Blood Cx prelim negative Extubated 12/30 on NC  PRN cough suppressants for comfort
Age: 53.0
Sex: M
Vaccine: COVID19
Symptoms: Mechanical ventilation, Oesophageal varices haemorrhage, Oesophagogastroduodenoscopy abnormal, Pneumonia, Pulmonary imaging procedure abnormal
Clinical narrative: 54 y.o. male patient of Physician No with history of esophageal varices (last banding 1 year ago), decompensated alcoholic cirrhosis, hepatitis C and HTN. Transferred from Hospital where he initially presented for large volume hematemesis followed by subsequent cardiac arrest, managed in the ICU eventually transferred to the floor. He left AMA saying he had a rehab place line up. He left despite worsening liver failure and without any appropriate follow ups arranged.        Decompensated Alcoholic Cirrhosis Hepatitis C Unable to verify extent of alcohol use, was previously sober for 9 months in 2020 but unclear if still drinking Home meds: propranolol, spironolactone, Hep C quant and Ab positive 2020, unclear if treated Repeat Hep C quant 605,000 IV thiamine  Encourage cessation, consider addiction med c/s  Rising T bili 0.5-- >2.6,  rising AST 54-- >107, ALT wnl, will re-consult GI Patient wants to leave but parameters heading in the wrong direction. He eventually signed out AMA knowing the risk. He appeared to have capacity.    Cardiac Arrest Suspect 2/2 to hypovolemic shock from esophageal variceal bleeding vs profound acidosis  ROSC obtained after two rounds of CPR, Ca, Epi, and Bicarb S/p 2u pRBC EKG no ischemic changes  Wean sedation and ventilation as tolerated Post cardiac arrest protocol initiated: Target temperature management, CT head pending, EEG Cardio consulted, signed off 12/29 No further testing per cardiology  Neurology consulted, signed off 12/29   Upper GI bleed Acute blood loss on chronic anemia  Esophageal varices, secondary to alcoholic cirrhosis as below  Patient with history of varices, last banding one year ago; now presenting with large volume hematemesis prior to cardiac arrest, see above.  On admission Hgb 11.7, b/l 9.1-10.6 CTA abd/chest/pelvis with no signs of active bleeding  S/p 2U pRBC, protonix bolus On Octreotide gtt, discontinued 12/30 S/p CTX in ED for CAP, see below, will continue for SBP prophylaxis Rocephin and Protonix IV x 5 days  Gastroenterology consulted EGD 12/28 + stigmata of recent esophageal variceal bleed, s/p band x5 IF rebleeds from varices will need VIR for emergent TIPS  Okay from GI for diet  Was tolerating diet prior to discharge.  Acute Hypercapnic respiratory failure Multifocal Pneumonia COVID-19 2/2 cardiac arrest in the setting of acute COVID infection and imaging c/f CAP Currently sedated and on ventilator Continue dilaudid and propofol gtt, added precedex 12/29 as weaning off other medications  Continue Azithro/CTX for CAP coverage Steroids and remdesivir  Legionella and strep pneumo antigen negative  MRSA nares positive  Blood Cx prelim negative Extubated 12/30 on NC  PRN cough suppressants for comfort
Age: 53.0
Sex: M
Vaccine: COVID19
Symptoms: Red blood cell transfusion, Respiratory failure, Resuscitation, Staphylococcus test positive, Streptococcus test negative
Clinical narrative: 54 y.o. male patient of Physician No with history of esophageal varices (last banding 1 year ago), decompensated alcoholic cirrhosis, hepatitis C and HTN. Transferred from Hospital where he initially presented for large volume hematemesis followed by subsequent cardiac arrest, managed in the ICU eventually transferred to the floor. He left AMA saying he had a rehab place line up. He left despite worsening liver failure and without any appropriate follow ups arranged.        Decompensated Alcoholic Cirrhosis Hepatitis C Unable to verify extent of alcohol use, was previously sober for 9 months in 2020 but unclear if still drinking Home meds: propranolol, spironolactone, Hep C quant and Ab positive 2020, unclear if treated Repeat Hep C quant 605,000 IV thiamine  Encourage cessation, consider addiction med c/s  Rising T bili 0.5-- >2.6,  rising AST 54-- >107, ALT wnl, will re-consult GI Patient wants to leave but parameters heading in the wrong direction. He eventually signed out AMA knowing the risk. He appeared to have capacity.    Cardiac Arrest Suspect 2/2 to hypovolemic shock from esophageal variceal bleeding vs profound acidosis  ROSC obtained after two rounds of CPR, Ca, Epi, and Bicarb S/p 2u pRBC EKG no ischemic changes  Wean sedation and ventilation as tolerated Post cardiac arrest protocol initiated: Target temperature management, CT head pending, EEG Cardio consulted, signed off 12/29 No further testing per cardiology  Neurology consulted, signed off 12/29   Upper GI bleed Acute blood loss on chronic anemia  Esophageal varices, secondary to alcoholic cirrhosis as below  Patient with history of varices, last banding one year ago; now presenting with large volume hematemesis prior to cardiac arrest, see above.  On admission Hgb 11.7, b/l 9.1-10.6 CTA abd/chest/pelvis with no signs of active bleeding  S/p 2U pRBC, protonix bolus On Octreotide gtt, discontinued 12/30 S/p CTX in ED for CAP, see below, will continue for SBP prophylaxis Rocephin and Protonix IV x 5 days  Gastroenterology consulted EGD 12/28 + stigmata of recent esophageal variceal bleed, s/p band x5 IF rebleeds from varices will need VIR for emergent TIPS  Okay from GI for diet  Was tolerating diet prior to discharge.  Acute Hypercapnic respiratory failure Multifocal Pneumonia COVID-19 2/2 cardiac arrest in the setting of acute COVID infection and imaging c/f CAP Currently sedated and on ventilator Continue dilaudid and propofol gtt, added precedex 12/29 as weaning off other medications  Continue Azithro/CTX for CAP coverage Steroids and remdesivir  Legionella and strep pneumo antigen negative  MRSA nares positive  Blood Cx prelim negative Extubated 12/30 on NC  PRN cough suppressants for comfort
Age: 53.0
Sex: M
Vaccine: COVID19
Symptoms: Upper gastrointestinal haemorrhage
Clinical narrative: 54 y.o. male patient of Physician No with history of esophageal varices (last banding 1 year ago), decompensated alcoholic cirrhosis, hepatitis C and HTN. Transferred from Hospital where he initially presented for large volume hematemesis followed by subsequent cardiac arrest, managed in the ICU eventually transferred to the floor. He left AMA saying he had a rehab place line up. He left despite worsening liver failure and without any appropriate follow ups arranged.        Decompensated Alcoholic Cirrhosis Hepatitis C Unable to verify extent of alcohol use, was previously sober for 9 months in 2020 but unclear if still drinking Home meds: propranolol, spironolactone, Hep C quant and Ab positive 2020, unclear if treated Repeat Hep C quant 605,000 IV thiamine  Encourage cessation, consider addiction med c/s  Rising T bili 0.5-- >2.6,  rising AST 54-- >107, ALT wnl, will re-consult GI Patient wants to leave but parameters heading in the wrong direction. He eventually signed out AMA knowing the risk. He appeared to have capacity.    Cardiac Arrest Suspect 2/2 to hypovolemic shock from esophageal variceal bleeding vs profound acidosis  ROSC obtained after two rounds of CPR, Ca, Epi, and Bicarb S/p 2u pRBC EKG no ischemic changes  Wean sedation and ventilation as tolerated Post cardiac arrest protocol initiated: Target temperature management, CT head pending, EEG Cardio consulted, signed off 12/29 No further testing per cardiology  Neurology consulted, signed off 12/29   Upper GI bleed Acute blood loss on chronic anemia  Esophageal varices, secondary to alcoholic cirrhosis as below  Patient with history of varices, last banding one year ago; now presenting with large volume hematemesis prior to cardiac arrest, see above.  On admission Hgb 11.7, b/l 9.1-10.6 CTA abd/chest/pelvis with no signs of active bleeding  S/p 2U pRBC, protonix bolus On Octreotide gtt, discontinued 12/30 S/p CTX in ED for CAP, see below, will continue for SBP prophylaxis Rocephin and Protonix IV x 5 days  Gastroenterology consulted EGD 12/28 + stigmata of recent esophageal variceal bleed, s/p band x5 IF rebleeds from varices will need VIR for emergent TIPS  Okay from GI for diet  Was tolerating diet prior to discharge.  Acute Hypercapnic respiratory failure Multifocal Pneumonia COVID-19 2/2 cardiac arrest in the setting of acute COVID infection and imaging c/f CAP Currently sedated and on ventilator Continue dilaudid and propofol gtt, added precedex 12/29 as weaning off other medications  Continue Azithro/CTX for CAP coverage Steroids and remdesivir  Legionella and strep pneumo antigen negative  MRSA nares positive  Blood Cx prelim negative Extubated 12/30 on NC  PRN cough suppressants for comfort
Age: 89.0
Sex: M
Vaccine: COVID19-2
Symptoms: Acute respiratory failure, Asthenia, Atrial fibrillation, Blood creatinine increased, Blood lactic acid normal
Clinical narrative: Patient is a 89 y.o. male patient of local MD with history of Dementia, presented from ER for weakness, covid related anorexia, hypoxia, new onset afib.    Acute hypoxic respiratory failure, resolved Possible pneumonia vs. Pulmonary edema Sepsis, POA, now resolved Covid 12/20/22 AF, WBC 15.6-- >12.3, LA normal, EKG now with sinus tachycardia Was 87% on RA needing brief supplemental oxygenation support through nasal cannula, currently on room air, not on home O2 chronically.  Covid + this time, CXR with edema, D dimer >5, BNP 1704 (likely due to RVR) Received IVF, dexamethasone, cefepime, levaquin at HCF Consulted HCP; continued dexamethasone and Added mucinex, albuterol, covid cocktail Procalcitonin 0.68  On Azithromycin and Ceftriaxone.  Discontinue azithromycin as Legionella antigen negative. Sputum culture pending. Echo showed grade 2 diastolic dysfunction, normal LVEF. Discharging on oral cefdinir for 5 days per HCP.  No need for steroid at discharge as hypoxia was corrected   New Onset Afib with RVR Pt does not have hx of Afib but does have history of weakness and falls TSH, K normal; checking Mg and CTPA to rule out PE from covid  Needed IV cardizem gtt but self converted to NSR Given PO cardizem in ER and will continue  S/b cardiology recommended anticoagulation  D/w spouse regarding risk vs benefits  would like him to start anticoagulation  Start Eliquis, ASA discontinued  Continue cardizem 120 mg daily    Acute on chronic renal failure stage 3 Cr baseline likely 1.2; was 1.9 on 12/20 but improved to 1.3 this morning    Dementia Continued home aricept and namenda Likely at his baseline.
Age: 89.0
Sex: M
Vaccine: COVID19-2
Symptoms: Blood potassium normal, Blood thyroid stimulating hormone normal, Brain natriuretic peptide increased, COVID-19, Chest X-ray abnormal
Clinical narrative: Patient is a 89 y.o. male patient of local MD with history of Dementia, presented from ER for weakness, covid related anorexia, hypoxia, new onset afib.    Acute hypoxic respiratory failure, resolved Possible pneumonia vs. Pulmonary edema Sepsis, POA, now resolved Covid 12/20/22 AF, WBC 15.6-- >12.3, LA normal, EKG now with sinus tachycardia Was 87% on RA needing brief supplemental oxygenation support through nasal cannula, currently on room air, not on home O2 chronically.  Covid + this time, CXR with edema, D dimer >5, BNP 1704 (likely due to RVR) Received IVF, dexamethasone, cefepime, levaquin at HCF Consulted HCP; continued dexamethasone and Added mucinex, albuterol, covid cocktail Procalcitonin 0.68  On Azithromycin and Ceftriaxone.  Discontinue azithromycin as Legionella antigen negative. Sputum culture pending. Echo showed grade 2 diastolic dysfunction, normal LVEF. Discharging on oral cefdinir for 5 days per HCP.  No need for steroid at discharge as hypoxia was corrected   New Onset Afib with RVR Pt does not have hx of Afib but does have history of weakness and falls TSH, K normal; checking Mg and CTPA to rule out PE from covid  Needed IV cardizem gtt but self converted to NSR Given PO cardizem in ER and will continue  S/b cardiology recommended anticoagulation  D/w spouse regarding risk vs benefits  would like him to start anticoagulation  Start Eliquis, ASA discontinued  Continue cardizem 120 mg daily    Acute on chronic renal failure stage 3 Cr baseline likely 1.2; was 1.9 on 12/20 but improved to 1.3 this morning    Dementia Continued home aricept and namenda Likely at his baseline.
Age: 89.0
Sex: M
Vaccine: COVID19-2
Symptoms: Decreased appetite, Diastolic dysfunction, Echocardiogram abnormal, Ejection fraction, Electrocardiogram abnormal
Clinical narrative: Patient is a 89 y.o. male patient of local MD with history of Dementia, presented from ER for weakness, covid related anorexia, hypoxia, new onset afib.    Acute hypoxic respiratory failure, resolved Possible pneumonia vs. Pulmonary edema Sepsis, POA, now resolved Covid 12/20/22 AF, WBC 15.6-- >12.3, LA normal, EKG now with sinus tachycardia Was 87% on RA needing brief supplemental oxygenation support through nasal cannula, currently on room air, not on home O2 chronically.  Covid + this time, CXR with edema, D dimer >5, BNP 1704 (likely due to RVR) Received IVF, dexamethasone, cefepime, levaquin at HCF Consulted HCP; continued dexamethasone and Added mucinex, albuterol, covid cocktail Procalcitonin 0.68  On Azithromycin and Ceftriaxone.  Discontinue azithromycin as Legionella antigen negative. Sputum culture pending. Echo showed grade 2 diastolic dysfunction, normal LVEF. Discharging on oral cefdinir for 5 days per HCP.  No need for steroid at discharge as hypoxia was corrected   New Onset Afib with RVR Pt does not have hx of Afib but does have history of weakness and falls TSH, K normal; checking Mg and CTPA to rule out PE from covid  Needed IV cardizem gtt but self converted to NSR Given PO cardizem in ER and will continue  S/b cardiology recommended anticoagulation  D/w spouse regarding risk vs benefits  would like him to start anticoagulation  Start Eliquis, ASA discontinued  Continue cardizem 120 mg daily    Acute on chronic renal failure stage 3 Cr baseline likely 1.2; was 1.9 on 12/20 but improved to 1.3 this morning    Dementia Continued home aricept and namenda Likely at his baseline.
Age: 89.0
Sex: M
Vaccine: COVID19-2
Symptoms: Fibrin D dimer, Hypoxia, Legionella test, Pneumonia, Procalcitonin
Clinical narrative: Patient is a 89 y.o. male patient of local MD with history of Dementia, presented from ER for weakness, covid related anorexia, hypoxia, new onset afib.    Acute hypoxic respiratory failure, resolved Possible pneumonia vs. Pulmonary edema Sepsis, POA, now resolved Covid 12/20/22 AF, WBC 15.6-- >12.3, LA normal, EKG now with sinus tachycardia Was 87% on RA needing brief supplemental oxygenation support through nasal cannula, currently on room air, not on home O2 chronically.  Covid + this time, CXR with edema, D dimer >5, BNP 1704 (likely due to RVR) Received IVF, dexamethasone, cefepime, levaquin at HCF Consulted HCP; continued dexamethasone and Added mucinex, albuterol, covid cocktail Procalcitonin 0.68  On Azithromycin and Ceftriaxone.  Discontinue azithromycin as Legionella antigen negative. Sputum culture pending. Echo showed grade 2 diastolic dysfunction, normal LVEF. Discharging on oral cefdinir for 5 days per HCP.  No need for steroid at discharge as hypoxia was corrected   New Onset Afib with RVR Pt does not have hx of Afib but does have history of weakness and falls TSH, K normal; checking Mg and CTPA to rule out PE from covid  Needed IV cardizem gtt but self converted to NSR Given PO cardizem in ER and will continue  S/b cardiology recommended anticoagulation  D/w spouse regarding risk vs benefits  would like him to start anticoagulation  Start Eliquis, ASA discontinued  Continue cardizem 120 mg daily    Acute on chronic renal failure stage 3 Cr baseline likely 1.2; was 1.9 on 12/20 but improved to 1.3 this morning    Dementia Continued home aricept and namenda Likely at his baseline.
Age: 89.0
Sex: M
Vaccine: COVID19-2
Symptoms: Pulmonary oedema, SARS-CoV-2 test positive, Sepsis, Sinus tachycardia, Sputum culture
Clinical narrative: Patient is a 89 y.o. male patient of local MD with history of Dementia, presented from ER for weakness, covid related anorexia, hypoxia, new onset afib.    Acute hypoxic respiratory failure, resolved Possible pneumonia vs. Pulmonary edema Sepsis, POA, now resolved Covid 12/20/22 AF, WBC 15.6-- >12.3, LA normal, EKG now with sinus tachycardia Was 87% on RA needing brief supplemental oxygenation support through nasal cannula, currently on room air, not on home O2 chronically.  Covid + this time, CXR with edema, D dimer >5, BNP 1704 (likely due to RVR) Received IVF, dexamethasone, cefepime, levaquin at HCF Consulted HCP; continued dexamethasone and Added mucinex, albuterol, covid cocktail Procalcitonin 0.68  On Azithromycin and Ceftriaxone.  Discontinue azithromycin as Legionella antigen negative. Sputum culture pending. Echo showed grade 2 diastolic dysfunction, normal LVEF. Discharging on oral cefdinir for 5 days per HCP.  No need for steroid at discharge as hypoxia was corrected   New Onset Afib with RVR Pt does not have hx of Afib but does have history of weakness and falls TSH, K normal; checking Mg and CTPA to rule out PE from covid  Needed IV cardizem gtt but self converted to NSR Given PO cardizem in ER and will continue  S/b cardiology recommended anticoagulation  D/w spouse regarding risk vs benefits  would like him to start anticoagulation  Start Eliquis, ASA discontinued  Continue cardizem 120 mg daily    Acute on chronic renal failure stage 3 Cr baseline likely 1.2; was 1.9 on 12/20 but improved to 1.3 this morning    Dementia Continued home aricept and namenda Likely at his baseline.
Age: 89.0
Sex: M
Vaccine: COVID19-2
Symptoms: White blood cell count increased
Clinical narrative: Patient is a 89 y.o. male patient of local MD with history of Dementia, presented from ER for weakness, covid related anorexia, hypoxia, new onset afib.    Acute hypoxic respiratory failure, resolved Possible pneumonia vs. Pulmonary edema Sepsis, POA, now resolved Covid 12/20/22 AF, WBC 15.6-- >12.3, LA normal, EKG now with sinus tachycardia Was 87% on RA needing brief supplemental oxygenation support through nasal cannula, currently on room air, not on home O2 chronically.  Covid + this time, CXR with edema, D dimer >5, BNP 1704 (likely due to RVR) Received IVF, dexamethasone, cefepime, levaquin at HCF Consulted HCP; continued dexamethasone and Added mucinex, albuterol, covid cocktail Procalcitonin 0.68  On Azithromycin and Ceftriaxone.  Discontinue azithromycin as Legionella antigen negative. Sputum culture pending. Echo showed grade 2 diastolic dysfunction, normal LVEF. Discharging on oral cefdinir for 5 days per HCP.  No need for steroid at discharge as hypoxia was corrected   New Onset Afib with RVR Pt does not have hx of Afib but does have history of weakness and falls TSH, K normal; checking Mg and CTPA to rule out PE from covid  Needed IV cardizem gtt but self converted to NSR Given PO cardizem in ER and will continue  S/b cardiology recommended anticoagulation  D/w spouse regarding risk vs benefits  would like him to start anticoagulation  Start Eliquis, ASA discontinued  Continue cardizem 120 mg daily    Acute on chronic renal failure stage 3 Cr baseline likely 1.2; was 1.9 on 12/20 but improved to 1.3 this morning    Dementia Continued home aricept and namenda Likely at his baseline.
Age: 51.0
Sex: F
Vaccine: COVID19
Symptoms: Anticoagulant therapy, COVID-19, Cardiac dysfunction, Chest X-ray normal, Coronary arterial stent insertion
Clinical narrative: I started PAXLOVID the same day that I tested positive for COVID-19. The date was July 22, 2022. On July 28, 2022, I tested negative for COVID-19. Three days later, I tested positive for COVID-19 again. I stayed positive for two weeks. I had mild symptoms. I was tired. I had a headache. I had a little bit of congestion and a mild cough. The cough lingered the longest. Approximately two months later, I had a heart attack. My Cardiologist thinks there may be a connection to COVID-19. I have three stents and have been under a cardiologist's care. I take blood thinners and another medication to keep my arteries dilated. I've been on medical leave this whole time. I go back to work this Monday.
Age: 51.0
Sex: F
Vaccine: COVID19
Symptoms: Cough, Echocardiogram abnormal, Electrocardiogram abnormal, Fatigue, Full blood count normal
Clinical narrative: I started PAXLOVID the same day that I tested positive for COVID-19. The date was July 22, 2022. On July 28, 2022, I tested negative for COVID-19. Three days later, I tested positive for COVID-19 again. I stayed positive for two weeks. I had mild symptoms. I was tired. I had a headache. I had a little bit of congestion and a mild cough. The cough lingered the longest. Approximately two months later, I had a heart attack. My Cardiologist thinks there may be a connection to COVID-19. I have three stents and have been under a cardiologist's care. I take blood thinners and another medication to keep my arteries dilated. I've been on medical leave this whole time. I go back to work this Monday.
Age: 51.0
Sex: F
Vaccine: COVID19
Symptoms: Headache, Impaired work ability, Malaise, Metabolic function test normal, Myocardial infarction
Clinical narrative: I started PAXLOVID the same day that I tested positive for COVID-19. The date was July 22, 2022. On July 28, 2022, I tested negative for COVID-19. Three days later, I tested positive for COVID-19 again. I stayed positive for two weeks. I had mild symptoms. I was tired. I had a headache. I had a little bit of congestion and a mild cough. The cough lingered the longest. Approximately two months later, I had a heart attack. My Cardiologist thinks there may be a connection to COVID-19. I have three stents and have been under a cardiologist's care. I take blood thinners and another medication to keep my arteries dilated. I've been on medical leave this whole time. I go back to work this Monday.
Age: 51.0
Sex: F
Vaccine: COVID19
Symptoms: Respiratory tract congestion, SARS-CoV-2 test positive
Clinical narrative: I started PAXLOVID the same day that I tested positive for COVID-19. The date was July 22, 2022. On July 28, 2022, I tested negative for COVID-19. Three days later, I tested positive for COVID-19 again. I stayed positive for two weeks. I had mild symptoms. I was tired. I had a headache. I had a little bit of congestion and a mild cough. The cough lingered the longest. Approximately two months later, I had a heart attack. My Cardiologist thinks there may be a connection to COVID-19. I have three stents and have been under a cardiologist's care. I take blood thinners and another medication to keep my arteries dilated. I've been on medical leave this whole time. I go back to work this Monday.
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Anticoagulant therapy, Aortic valve replacement, COVID-19, Deep vein thrombosis, Dyspnoea
Clinical narrative: Patient is a 69 y.o. female with a past medical history that includes granulomatosis with polyangiitis w/ kidney and sinus involvement, hx of DVT 11/2021 on eliquis, meningioma, migraines, rectocele, multiple lung nodules, HTN, CKD IV on TThS dialysis, HFpEF and MVR and AVR,  who recently underwent aortic valve and mitral valve replacement and tricuspid valve repair at clinic 11/8/22.  She presented on 12/22/2022 for increasing oxygen requirements, COVID, and shortness of breath. Intubated on 12/22. Initially on iHD then CRRT for volume removal. Unable to wean off ventilatory support despite multiple therapies, volume removal, medical optimization. Patient required pressor support for hypotension, likely multifactorial in etiology. She was an an initial course of vancomycin and zosyn, then ultimately weaned off due to more viral picture. However patient while in the ICU developed a new episode of severe shock, therefore meropenem was initiated.  Patient required small volume resuscitation, however patient's respiratory status appeared to be tenuous with small amounts of fluid resuscitation for shock.  Course complicated with suspected GI bleed, GI initially requested EGD, however goals of care discussion were made and this was deferred.  Multiple ongoing goals of care discussions were made with family. Patient stated multiple times that she did not want to be on prolonged ventilator support.  Ultimately patient and family decided that patient would want to focus on comfort, especially given declining overall medical prognosis, and overall health fragility.  Therefore patient being DNR CCA, once family visited, patient transition to comfort care with compassionate extubation.
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Endotracheal intubation, Gastrointestinal haemorrhage, Haemofiltration, Hypotension, Intensive care
Clinical narrative: Patient is a 69 y.o. female with a past medical history that includes granulomatosis with polyangiitis w/ kidney and sinus involvement, hx of DVT 11/2021 on eliquis, meningioma, migraines, rectocele, multiple lung nodules, HTN, CKD IV on TThS dialysis, HFpEF and MVR and AVR,  who recently underwent aortic valve and mitral valve replacement and tricuspid valve repair at clinic 11/8/22.  She presented on 12/22/2022 for increasing oxygen requirements, COVID, and shortness of breath. Intubated on 12/22. Initially on iHD then CRRT for volume removal. Unable to wean off ventilatory support despite multiple therapies, volume removal, medical optimization. Patient required pressor support for hypotension, likely multifactorial in etiology. She was an an initial course of vancomycin and zosyn, then ultimately weaned off due to more viral picture. However patient while in the ICU developed a new episode of severe shock, therefore meropenem was initiated.  Patient required small volume resuscitation, however patient's respiratory status appeared to be tenuous with small amounts of fluid resuscitation for shock.  Course complicated with suspected GI bleed, GI initially requested EGD, however goals of care discussion were made and this was deferred.  Multiple ongoing goals of care discussions were made with family. Patient stated multiple times that she did not want to be on prolonged ventilator support.  Ultimately patient and family decided that patient would want to focus on comfort, especially given declining overall medical prognosis, and overall health fragility.  Therefore patient being DNR CCA, once family visited, patient transition to comfort care with compassionate extubation.
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Mechanical ventilation, Mitral valve replacement, Resuscitation, Shock, Tricuspid valve repair
Clinical narrative: Patient is a 69 y.o. female with a past medical history that includes granulomatosis with polyangiitis w/ kidney and sinus involvement, hx of DVT 11/2021 on eliquis, meningioma, migraines, rectocele, multiple lung nodules, HTN, CKD IV on TThS dialysis, HFpEF and MVR and AVR,  who recently underwent aortic valve and mitral valve replacement and tricuspid valve repair at clinic 11/8/22.  She presented on 12/22/2022 for increasing oxygen requirements, COVID, and shortness of breath. Intubated on 12/22. Initially on iHD then CRRT for volume removal. Unable to wean off ventilatory support despite multiple therapies, volume removal, medical optimization. Patient required pressor support for hypotension, likely multifactorial in etiology. She was an an initial course of vancomycin and zosyn, then ultimately weaned off due to more viral picture. However patient while in the ICU developed a new episode of severe shock, therefore meropenem was initiated.  Patient required small volume resuscitation, however patient's respiratory status appeared to be tenuous with small amounts of fluid resuscitation for shock.  Course complicated with suspected GI bleed, GI initially requested EGD, however goals of care discussion were made and this was deferred.  Multiple ongoing goals of care discussions were made with family. Patient stated multiple times that she did not want to be on prolonged ventilator support.  Ultimately patient and family decided that patient would want to focus on comfort, especially given declining overall medical prognosis, and overall health fragility.  Therefore patient being DNR CCA, once family visited, patient transition to comfort care with compassionate extubation.
Age: 76.0
Sex: F
Vaccine: COVID19
Symptoms: Acute kidney injury, Acute respiratory failure, Asthenia, Atrial fibrillation, Blood creatinine increased
Clinical narrative: Patient is a 78  years old female patient of PRIVATE, MD with history of CAD, afib, HTN, Renal artery stenosis, CKD 3 presented to local General Hospital with general weakness.   Paroxysmal atrial fibrillation with RVR, likely due to COVID CAD  Hypertension Heart rate controlled Continue amiodarone Increased metoprolol to 50 mg twice daily Continue Imdur, aspirin, statins Continue Coumadin and monitor INR Continue clonidine and Norvasc for BP control Monitor BP and heart rate and follow-up with PCP for medication adjustment   Weakness Deconditioning Fall due to weakness COVID infection Viral sepsis, POA; due to above; resolved Acute hypoxic respiratory failure, resolved Presented with dry nonproductive cough associated with shortness of breath  Respiratory status is stable Currently on room air Supportive care Supplemental oxygen as needed. Incentive spirometry Tessalon for cough PT OT Discharge to short-term rehab   AKI Due to p.o. poor p.o. Creatinine 1.4=> 1.2=> 1.1 S/p IVF Encourage oral hydration
Age: 76.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Condition aggravated, Cough, Dyspnoea, Fall
Clinical narrative: Patient is a 78  years old female patient of PRIVATE, MD with history of CAD, afib, HTN, Renal artery stenosis, CKD 3 presented to local General Hospital with general weakness.   Paroxysmal atrial fibrillation with RVR, likely due to COVID CAD  Hypertension Heart rate controlled Continue amiodarone Increased metoprolol to 50 mg twice daily Continue Imdur, aspirin, statins Continue Coumadin and monitor INR Continue clonidine and Norvasc for BP control Monitor BP and heart rate and follow-up with PCP for medication adjustment   Weakness Deconditioning Fall due to weakness COVID infection Viral sepsis, POA; due to above; resolved Acute hypoxic respiratory failure, resolved Presented with dry nonproductive cough associated with shortness of breath  Respiratory status is stable Currently on room air Supportive care Supplemental oxygen as needed. Incentive spirometry Tessalon for cough PT OT Discharge to short-term rehab   AKI Due to p.o. poor p.o. Creatinine 1.4=> 1.2=> 1.1 S/p IVF Encourage oral hydration
Age: 76.0
Sex: F
Vaccine: COVID19
Symptoms: Hypophagia, Incentive spirometry, Physical deconditioning, Viral sepsis
Clinical narrative: Patient is a 78  years old female patient of PRIVATE, MD with history of CAD, afib, HTN, Renal artery stenosis, CKD 3 presented to local General Hospital with general weakness.   Paroxysmal atrial fibrillation with RVR, likely due to COVID CAD  Hypertension Heart rate controlled Continue amiodarone Increased metoprolol to 50 mg twice daily Continue Imdur, aspirin, statins Continue Coumadin and monitor INR Continue clonidine and Norvasc for BP control Monitor BP and heart rate and follow-up with PCP for medication adjustment   Weakness Deconditioning Fall due to weakness COVID infection Viral sepsis, POA; due to above; resolved Acute hypoxic respiratory failure, resolved Presented with dry nonproductive cough associated with shortness of breath  Respiratory status is stable Currently on room air Supportive care Supplemental oxygen as needed. Incentive spirometry Tessalon for cough PT OT Discharge to short-term rehab   AKI Due to p.o. poor p.o. Creatinine 1.4=> 1.2=> 1.1 S/p IVF Encourage oral hydration
Age: 42.0
Sex: M
Vaccine: SMALLMNK
Symptoms: Inappropriate schedule of product administration
Clinical narrative: Patient received second dose of Jynneos before the 28 days due date. He received it 20 days after the first dose. Nurse attempted to call patient to discuss further guidelines, however patient did not answer. Voicemails were left on unidentified voicemail box.
Age: 8.0
Sex: F
Vaccine: COVID19-2
Symptoms: Incorrect product formulation administered
Clinical narrative: Pt was supposed to get the second dose of Monovalent primary dose but was administered Bivalent booster 0.5ml.
Age: 35.0
Sex: M
Vaccine: COVID19
Symptoms: Blood cholesterol increased, Blood test abnormal, Blood triglycerides increased, Electrocardiogram normal, Limb discomfort
Clinical narrative: The very next I started having tingling in my left leg and then it gave me the feeling like I slept on it. These feeling continued and then in March I started having issues feeling like my heart was tender. The feeling in my left leg continued along with the tender feeling in my heart and then I started having discomfort and tingling in my arm.  The next day I went to the doctor, and I was told I should've gone to the ER until I saw a doctor because it could've been a stroke. He did an EKG and it was fine and then he did bloodwork. The doctor said he found high cholesterol and high triglycerides range was off. The doctor told me I was too young for medication, so he gave me a nutrition's to try and fix the issue naturally. I changed my diet over 5 months and exercise on paper it looked like it fixed everything but tested me again the numbers were even high 150 and now its 173. The doctor suggested 6 more months of a strict diet and more exercise   to see if it would improve. I am set to go back to the doctor next week so I will call back to give an update.
Age: 35.0
Sex: M
Vaccine: COVID19
Symptoms: Paraesthesia, Tenderness
Clinical narrative: The very next I started having tingling in my left leg and then it gave me the feeling like I slept on it. These feeling continued and then in March I started having issues feeling like my heart was tender. The feeling in my left leg continued along with the tender feeling in my heart and then I started having discomfort and tingling in my arm.  The next day I went to the doctor, and I was told I should've gone to the ER until I saw a doctor because it could've been a stroke. He did an EKG and it was fine and then he did bloodwork. The doctor said he found high cholesterol and high triglycerides range was off. The doctor told me I was too young for medication, so he gave me a nutrition's to try and fix the issue naturally. I changed my diet over 5 months and exercise on paper it looked like it fixed everything but tested me again the numbers were even high 150 and now its 173. The doctor suggested 6 more months of a strict diet and more exercise   to see if it would improve. I am set to go back to the doctor next week so I will call back to give an update.
Age: 31.0
Sex: M
Vaccine: SMALLMNK
Symptoms: Inappropriate schedule of product administration
Clinical narrative: Patient received second dose of Jynneos before the 28 days due date. He received it 20 days after the first dose. Nurse attempted to call patient to discuss further guidelines, however patient did not answer. Voicemails were left on unidentified voicemail box.
Age: 75.0
Sex: F
Vaccine: COVID19-2, COVID19-2
Symptoms: Extra dose administered, No adverse event
Clinical narrative: pt had no Adverse reaction. patient recieved Moderna Bivalent on 11/09/23. pt then recieved a 2nd dose of the Moderna Bivalent again on 01/30/23. on the day of 1/30/23, pt realized that she may have recieved 2 doses of the bivalent.
Age: 48.0
Sex: M
Vaccine: SMALLMNK
Symptoms: Inappropriate schedule of product administration
Clinical narrative: Patient received second dose of Jynneos before the 28 days due date. He received it 21 days after the first dose. Nurse attempted to call patient to discuss further guidelines, however patient did not answer. Voicemails were left on unidentified voicemail box.
Age: 70.0
Sex: F
Vaccine: COVID19
Symptoms: Asthenia, Magnetic resonance imaging, Thrombosis
Clinical narrative: I got blood clot in the legs. I think it started with surgery I needed but I am not sure. It seems I get new blood clots every time I take the vaccines. And my back seems to be getting weaker, with every vaccine I take. It is very concerning. I had surgery on my back and was recovering when I took the 2nd dose and it hasn't gone away and getting worse with every single vaccine.
Age: 1.0
Sex: M
Vaccine: HEPA, MMR, VARCEL
Symptoms: Urticaria
Clinical narrative: Hives all over body
Age: 51.0
Sex: F
Vaccine: COVID19
Symptoms: Exercise tolerance decreased, Gait disturbance, Injection site pain, Muscular weakness, Musculoskeletal disorder
Clinical narrative: Within ten minutes of the 2nd injection, I felt as if my legs were going to give out while I was standing in the lobby. I then proceeded to go directly to the gym and discovered my legs wouldn't work anymore to walk. When I tried to bike my legs could only function approximately 10 minutes before slowing down and stopping.  It is over a year later and I cannot walk for any real distance, I can't stand very long, I can only swim as far as exercise. I also developed a rash under my arms that persisted for months before I got relief from that. My legs just do not work anymore and there is pain that tends to exist in my left leg.  My left arm where the injection was given is also achy constantly and I get little relief even when using ibuprofen.
Age: 51.0
Sex: F
Vaccine: COVID19
Symptoms: Pain in extremity, Rash
Clinical narrative: Within ten minutes of the 2nd injection, I felt as if my legs were going to give out while I was standing in the lobby. I then proceeded to go directly to the gym and discovered my legs wouldn't work anymore to walk. When I tried to bike my legs could only function approximately 10 minutes before slowing down and stopping.  It is over a year later and I cannot walk for any real distance, I can't stand very long, I can only swim as far as exercise. I also developed a rash under my arms that persisted for months before I got relief from that. My legs just do not work anymore and there is pain that tends to exist in my left leg.  My left arm where the injection was given is also achy constantly and I get little relief even when using ibuprofen.
Age: 54.0
Sex: F
Vaccine: COVID19-2, FLUA4
Symptoms: Balance disorder, Cold sweat, Feeling hot, Hyperhidrosis, Malaise
Clinical narrative: vertigo, sweating, clammy, dripping sweat, balance issues, hot, unwell feeling, nausea and vomiting
Age: 54.0
Sex: F
Vaccine: COVID19-2, FLUA4
Symptoms: Nausea, Vertigo, Vomiting
Clinical narrative: vertigo, sweating, clammy, dripping sweat, balance issues, hot, unwell feeling, nausea and vomiting
Age: 26.0
Sex: F
Vaccine: COVID19-2
Symptoms: Incorrect product formulation administered, No adverse event
Clinical narrative: Patient had initially registered for flu vaccine at the Public Health clinic and an annual flu vaccine was administered correctly IM inthe Left arm of patient.  During the flu vaccination,  patient reported receiving primary series of COVID vaccine "awhile back" and was wanting to get a COVID booster that day as well.  Patient couldn't remember when primary series was given.  RN did contact PCP to ask for an order for COVID booster vaccine to be administered to patient.  RN receive verbal order from PCP to administer COVID booster vaccine, so Moderna Bivalent COVID booster vaccine was administered that same day to patient.  After clinic was closed and vaccine record entered into register, found that patient had only received ONE primary dose of COVID vaccine on 12/25/2021 (Pfizer-Comirnaty).  Patient informed and she recalled only remembering receiving one dose of COVID vaccine. No adverse events noted or reported from patient after receiving vaccine.
Age: 72.0
Sex: F
Vaccine: COVID19
Symptoms: Asthenia, COVID-19, Chronic kidney disease, Condition aggravated, Decreased appetite
Clinical narrative: C/O generalize weakness/fatigue, loss of appetite. Hospitalized due to CKD stage 4, acute UTI, hypomagnesemia, hypercalcemia, hyperthyroidism
Age: 72.0
Sex: F
Vaccine: COVID19
Symptoms: Fatigue, Hypercalcaemia, Hyperthyroidism, Hypomagnesaemia, SARS-CoV-2 test positive
Clinical narrative: C/O generalize weakness/fatigue, loss of appetite. Hospitalized due to CKD stage 4, acute UTI, hypomagnesemia, hypercalcemia, hyperthyroidism