chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 55.0
Sex: M
Vaccine: COVID19-2
Symptoms: Acute respiratory failure, Symptom recurrence
Clinical narrative: ACUTE RESPIRATORY FAILURE 1/3/2023  &   2/4/2023  --  RECURRENCE OF HOSPITALIZATION WITH SAME SYMPTOMS
Age: 25.0
Sex: F
Vaccine: HPV9, HPV9
Symptoms: Autoimmune disorder
Clinical narrative: Autoimmune disease
Age: 0.42
Sex: F
Vaccine: UNK
Symptoms: Angioedema
Clinical narrative: angioedema of the left leg
Age: 2.0
Sex: M
Vaccine: DTAP, HEPA, HIBV
Symptoms: Erythema, Immunisation reaction, Injection site warmth, Nodule
Clinical narrative: Patient came in on June 30,2023 and received the three vaccines listed above. Patient started experiencing symptoms on July 01,2023. The symptoms displayed were fever in the area of vaccination (left thigh) and a red knot on the patients thigh which was sensitive to touch. Over the weekend the symptoms progressed. On July 03,2023 mother called to have the patient seen in the clinic. Patient was seen by PA where he diagnosed adverse effect of vaccine. Patient was prescribed Benadryl allergy liquid and Cefdinir. Mother was also educated on the vaccine reaction. Follow up was scheduled for July 06,2023.
Age: 90.0
Sex: F
Vaccine: COVID19-2
Symptoms: Hypoxia, Pulmonary embolism
Clinical narrative: ACUTE PULMONARY EMBOLISM HYPOXIA
Age: 79.0
Sex: F
Vaccine: COVID19-2
Symptoms: Myocardial ischaemia, Transient ischaemic attack
Clinical narrative: TRANSIENT CEREBRAL ISCHEMIA DEMAND ISCHEMIA
Age: 60.0
Sex: F
Vaccine: COVID19-2
Symptoms: Product storage error
Clinical narrative: Vaccine given outside recommended storage guidelines. Multi-use vial had been thawed and punctured greater than 12 hours from first dose.
Age: 71.0
Sex: F
Vaccine: COVID19-2
Symptoms: Injection site erythema, Injection site induration
Clinical narrative: Circular area of induration and erythema surrounding injection site.
Age: 55.0
Sex: F
Vaccine: VARZOS
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth
Clinical narrative: Redness, swelling, and hot to the touch surrounding the injection site. Presented 24 hours after vaccination administered.
Age: 53.0
Sex: F
Vaccine: VARZOS
Symptoms: Chills, Fatigue, Injection site erythema, Injection site pruritus, Injection site swelling
Clinical narrative: 5/31: 4-inch diameter ring of red, swollen, hot tissue around injection site plus body aches, chills, and exhaustion. 6/1 and 6/2: swollen, painful lymph nodes in the left armpit and red, swollen, hot tissue around inj site. 6/3: same symptoms as prev two days; however, the diameter of the affected area is 5 inches in diameter, and a red streak extends into the armpit. 6/4 - 6/6: area of swelling, redness, heat, and now itchiness has increased to 4 inches by 8 inches and resembles a hive.
Age: 53.0
Sex: F
Vaccine: VARZOS
Symptoms: Injection site warmth, Lymph node pain, Lymphadenopathy, Pain
Clinical narrative: 5/31: 4-inch diameter ring of red, swollen, hot tissue around injection site plus body aches, chills, and exhaustion. 6/1 and 6/2: swollen, painful lymph nodes in the left armpit and red, swollen, hot tissue around inj site. 6/3: same symptoms as prev two days; however, the diameter of the affected area is 5 inches in diameter, and a red streak extends into the armpit. 6/4 - 6/6: area of swelling, redness, heat, and now itchiness has increased to 4 inches by 8 inches and resembles a hive.
Age: 97.0
Sex: F
Vaccine: COVID19-2
Symptoms: Acute respiratory failure
Clinical narrative: ACUTE HYPOXEMIC RESPIRATORY FAILURE
Age: 1.08
Sex: M
Vaccine: DTAPIPVHIB, HEPA
Symptoms: Product preparation error
Clinical narrative: Pentacel vaccine was administered; however, the vaccine was not diluted with the diluent that was in the boxed package. When pulling the vaccine to be administered, I did not realize/see that there was a specific diluent to be used with the vaccine. RN diluted the vaccine with sterile diluent instead.
Age: 54.0
Sex: M
Vaccine: COVID19
Symptoms: Burning sensation, Gout
Clinical narrative: My left foot felt like if itwas on fire, I went to the ER and said that I have gout, they gave me some medicine.
Age: 19.0
Sex: F
Vaccine: COVID19
Symptoms: Chest pain, Echocardiogram, Electrocardiogram, Electrocardiogram ambulatory, Postural orthostatic tachycardia syndrome
Clinical narrative: Chest pain, tachycardia - resting pulse 140 -155 went to ER, EKG performed, she was given a potassium pill and told to see a cardiologist.  Cardiologist did ECHO, Holter monitor.  Diagnosed with sinus tachycardia.  Saw a neurologist who diagnosed her with POTS.
Age: 19.0
Sex: F
Vaccine: COVID19
Symptoms: Sinus tachycardia, Tachycardia
Clinical narrative: Chest pain, tachycardia - resting pulse 140 -155 went to ER, EKG performed, she was given a potassium pill and told to see a cardiologist.  Cardiologist did ECHO, Holter monitor.  Diagnosed with sinus tachycardia.  Saw a neurologist who diagnosed her with POTS.
Age: 91.0
Sex: F
Vaccine: COVID19
Symptoms: Acute respiratory failure, Brain natriuretic peptide increased, COVID-19, Cardiac failure, Cardiac failure congestive
Clinical narrative: Patient is a 93 y.o. female patient of a MD with history of hypertension, glaucoma, CHF presented to a local Hospital with SOB, low HR. Found to have covid infection.   Sinus bradycardia HR 30s to 40s initially, received 2 doses of atropine Likely 2/2 combination of long acting BB and acute covid infection Discontinued home Toprol XL permanently Echo with EF 62%, RVSP 48 mmHg Patient asymptomatic, HR improved Cardiology followed in the hospital and signed off   Acute Respiratory Failure with Hypoxia, resolved Patient has oxygen at baseline and uses PRN rarely Etiology:Thought to be secondary to COVID Pneumonia May also have CHF Exacerbation contributing See management of COVID and CHF e Initially required supplemental oxygen.  Weaned down to RA prior to discharge.  No O2 requirement at discharge  Covid-19 Virus Infection Date of onset of symptoms: 3/21/2023 Symptoms present on admission: Cough, SOB, fatigue Date of covid positive test: 3/21/2023  Vaccination status: vaccinated Imaging: Increased opacity left costophrenic angle may be atelectasis or developing pneumonia ar pleural effusion Oxygen requirements  1L>RA Medical therapy: Completed Paxlovid.  Steroids on taper Anticipated special isolation end date: 3/31/2023 Had significant cough for which Tessalon Perles as needed and breathing treatments were utilized in the hospital   Acute Exacerbation of HFpEF Etiology: May be due to underlying COVID Patient showing signs of CHF by LE Edema, Pulmonary edema, SOB, elevated BNP Echo with EF 62%, RVSP 48 mmHg Home Rx: Lasix 20 mg daily.  Started IV diuresis with 40 mg BID, transitioned to oral Lasix. Low-salt diet, daily weights, strict I's/O Cardiology followed in the hospital DC home on Lasix 40 mg daily  Elevated Troponin  Serial troponin 39> 35.  Not consistent with ACS. Echo with no wall motion abnormalities. No further work-up indicated   HTN Accelerated BP Home Rx: Norvasc, Losartan Held and discontinued Toprol XL due to bradycardia Home Rx: Norvasc 2.5 mg daily, increased to to 10 mg daily. Continued home losartan 50 mg daily Started PO hydralazine low dose and increased to 25 mg TID and DC'd on that dose  Glaucoma Continue Home: Xalatan, Cosopt   Obesity BMI 37.11   Gait weakness Patient is from independent living.  At her baseline she is able to transfer to wheelchair without difficulty. PT/OT followed with daily evaluations.  They recommended two-person assist Daughter arranged for 2 caregivers x24 hours. Daughter also arranged hospital bed. Arrangement of caregiver and hospital bed delayed discharge
Age: 91.0
Sex: F
Vaccine: COVID19
Symptoms: Condition aggravated, Cough, Diuretic therapy, Dyspnoea, Echocardiogram normal
Clinical narrative: Patient is a 93 y.o. female patient of a MD with history of hypertension, glaucoma, CHF presented to a local Hospital with SOB, low HR. Found to have covid infection.   Sinus bradycardia HR 30s to 40s initially, received 2 doses of atropine Likely 2/2 combination of long acting BB and acute covid infection Discontinued home Toprol XL permanently Echo with EF 62%, RVSP 48 mmHg Patient asymptomatic, HR improved Cardiology followed in the hospital and signed off   Acute Respiratory Failure with Hypoxia, resolved Patient has oxygen at baseline and uses PRN rarely Etiology:Thought to be secondary to COVID Pneumonia May also have CHF Exacerbation contributing See management of COVID and CHF e Initially required supplemental oxygen.  Weaned down to RA prior to discharge.  No O2 requirement at discharge  Covid-19 Virus Infection Date of onset of symptoms: 3/21/2023 Symptoms present on admission: Cough, SOB, fatigue Date of covid positive test: 3/21/2023  Vaccination status: vaccinated Imaging: Increased opacity left costophrenic angle may be atelectasis or developing pneumonia ar pleural effusion Oxygen requirements  1L>RA Medical therapy: Completed Paxlovid.  Steroids on taper Anticipated special isolation end date: 3/31/2023 Had significant cough for which Tessalon Perles as needed and breathing treatments were utilized in the hospital   Acute Exacerbation of HFpEF Etiology: May be due to underlying COVID Patient showing signs of CHF by LE Edema, Pulmonary edema, SOB, elevated BNP Echo with EF 62%, RVSP 48 mmHg Home Rx: Lasix 20 mg daily.  Started IV diuresis with 40 mg BID, transitioned to oral Lasix. Low-salt diet, daily weights, strict I's/O Cardiology followed in the hospital DC home on Lasix 40 mg daily  Elevated Troponin  Serial troponin 39> 35.  Not consistent with ACS. Echo with no wall motion abnormalities. No further work-up indicated   HTN Accelerated BP Home Rx: Norvasc, Losartan Held and discontinued Toprol XL due to bradycardia Home Rx: Norvasc 2.5 mg daily, increased to to 10 mg daily. Continued home losartan 50 mg daily Started PO hydralazine low dose and increased to 25 mg TID and DC'd on that dose  Glaucoma Continue Home: Xalatan, Cosopt   Obesity BMI 37.11   Gait weakness Patient is from independent living.  At her baseline she is able to transfer to wheelchair without difficulty. PT/OT followed with daily evaluations.  They recommended two-person assist Daughter arranged for 2 caregivers x24 hours. Daughter also arranged hospital bed. Arrangement of caregiver and hospital bed delayed discharge
Age: 91.0
Sex: F
Vaccine: COVID19
Symptoms: Ejection fraction normal, Fatigue, Heart rate decreased, Lung opacity, Malaise
Clinical narrative: Patient is a 93 y.o. female patient of a MD with history of hypertension, glaucoma, CHF presented to a local Hospital with SOB, low HR. Found to have covid infection.   Sinus bradycardia HR 30s to 40s initially, received 2 doses of atropine Likely 2/2 combination of long acting BB and acute covid infection Discontinued home Toprol XL permanently Echo with EF 62%, RVSP 48 mmHg Patient asymptomatic, HR improved Cardiology followed in the hospital and signed off   Acute Respiratory Failure with Hypoxia, resolved Patient has oxygen at baseline and uses PRN rarely Etiology:Thought to be secondary to COVID Pneumonia May also have CHF Exacerbation contributing See management of COVID and CHF e Initially required supplemental oxygen.  Weaned down to RA prior to discharge.  No O2 requirement at discharge  Covid-19 Virus Infection Date of onset of symptoms: 3/21/2023 Symptoms present on admission: Cough, SOB, fatigue Date of covid positive test: 3/21/2023  Vaccination status: vaccinated Imaging: Increased opacity left costophrenic angle may be atelectasis or developing pneumonia ar pleural effusion Oxygen requirements  1L>RA Medical therapy: Completed Paxlovid.  Steroids on taper Anticipated special isolation end date: 3/31/2023 Had significant cough for which Tessalon Perles as needed and breathing treatments were utilized in the hospital   Acute Exacerbation of HFpEF Etiology: May be due to underlying COVID Patient showing signs of CHF by LE Edema, Pulmonary edema, SOB, elevated BNP Echo with EF 62%, RVSP 48 mmHg Home Rx: Lasix 20 mg daily.  Started IV diuresis with 40 mg BID, transitioned to oral Lasix. Low-salt diet, daily weights, strict I's/O Cardiology followed in the hospital DC home on Lasix 40 mg daily  Elevated Troponin  Serial troponin 39> 35.  Not consistent with ACS. Echo with no wall motion abnormalities. No further work-up indicated   HTN Accelerated BP Home Rx: Norvasc, Losartan Held and discontinued Toprol XL due to bradycardia Home Rx: Norvasc 2.5 mg daily, increased to to 10 mg daily. Continued home losartan 50 mg daily Started PO hydralazine low dose and increased to 25 mg TID and DC'd on that dose  Glaucoma Continue Home: Xalatan, Cosopt   Obesity BMI 37.11   Gait weakness Patient is from independent living.  At her baseline she is able to transfer to wheelchair without difficulty. PT/OT followed with daily evaluations.  They recommended two-person assist Daughter arranged for 2 caregivers x24 hours. Daughter also arranged hospital bed. Arrangement of caregiver and hospital bed delayed discharge
Age: 91.0
Sex: F
Vaccine: COVID19
Symptoms: Medical diet, Oedema peripheral, Pulmonary imaging procedure abnormal, SARS-CoV-2 test positive, Sinus bradycardia
Clinical narrative: Patient is a 93 y.o. female patient of a MD with history of hypertension, glaucoma, CHF presented to a local Hospital with SOB, low HR. Found to have covid infection.   Sinus bradycardia HR 30s to 40s initially, received 2 doses of atropine Likely 2/2 combination of long acting BB and acute covid infection Discontinued home Toprol XL permanently Echo with EF 62%, RVSP 48 mmHg Patient asymptomatic, HR improved Cardiology followed in the hospital and signed off   Acute Respiratory Failure with Hypoxia, resolved Patient has oxygen at baseline and uses PRN rarely Etiology:Thought to be secondary to COVID Pneumonia May also have CHF Exacerbation contributing See management of COVID and CHF e Initially required supplemental oxygen.  Weaned down to RA prior to discharge.  No O2 requirement at discharge  Covid-19 Virus Infection Date of onset of symptoms: 3/21/2023 Symptoms present on admission: Cough, SOB, fatigue Date of covid positive test: 3/21/2023  Vaccination status: vaccinated Imaging: Increased opacity left costophrenic angle may be atelectasis or developing pneumonia ar pleural effusion Oxygen requirements  1L>RA Medical therapy: Completed Paxlovid.  Steroids on taper Anticipated special isolation end date: 3/31/2023 Had significant cough for which Tessalon Perles as needed and breathing treatments were utilized in the hospital   Acute Exacerbation of HFpEF Etiology: May be due to underlying COVID Patient showing signs of CHF by LE Edema, Pulmonary edema, SOB, elevated BNP Echo with EF 62%, RVSP 48 mmHg Home Rx: Lasix 20 mg daily.  Started IV diuresis with 40 mg BID, transitioned to oral Lasix. Low-salt diet, daily weights, strict I's/O Cardiology followed in the hospital DC home on Lasix 40 mg daily  Elevated Troponin  Serial troponin 39> 35.  Not consistent with ACS. Echo with no wall motion abnormalities. No further work-up indicated   HTN Accelerated BP Home Rx: Norvasc, Losartan Held and discontinued Toprol XL due to bradycardia Home Rx: Norvasc 2.5 mg daily, increased to to 10 mg daily. Continued home losartan 50 mg daily Started PO hydralazine low dose and increased to 25 mg TID and DC'd on that dose  Glaucoma Continue Home: Xalatan, Cosopt   Obesity BMI 37.11   Gait weakness Patient is from independent living.  At her baseline she is able to transfer to wheelchair without difficulty. PT/OT followed with daily evaluations.  They recommended two-person assist Daughter arranged for 2 caregivers x24 hours. Daughter also arranged hospital bed. Arrangement of caregiver and hospital bed delayed discharge
Age: 91.0
Sex: F
Vaccine: COVID19
Symptoms: Troponin increased, Wall motion score index normal
Clinical narrative: Patient is a 93 y.o. female patient of a MD with history of hypertension, glaucoma, CHF presented to a local Hospital with SOB, low HR. Found to have covid infection.   Sinus bradycardia HR 30s to 40s initially, received 2 doses of atropine Likely 2/2 combination of long acting BB and acute covid infection Discontinued home Toprol XL permanently Echo with EF 62%, RVSP 48 mmHg Patient asymptomatic, HR improved Cardiology followed in the hospital and signed off   Acute Respiratory Failure with Hypoxia, resolved Patient has oxygen at baseline and uses PRN rarely Etiology:Thought to be secondary to COVID Pneumonia May also have CHF Exacerbation contributing See management of COVID and CHF e Initially required supplemental oxygen.  Weaned down to RA prior to discharge.  No O2 requirement at discharge  Covid-19 Virus Infection Date of onset of symptoms: 3/21/2023 Symptoms present on admission: Cough, SOB, fatigue Date of covid positive test: 3/21/2023  Vaccination status: vaccinated Imaging: Increased opacity left costophrenic angle may be atelectasis or developing pneumonia ar pleural effusion Oxygen requirements  1L>RA Medical therapy: Completed Paxlovid.  Steroids on taper Anticipated special isolation end date: 3/31/2023 Had significant cough for which Tessalon Perles as needed and breathing treatments were utilized in the hospital   Acute Exacerbation of HFpEF Etiology: May be due to underlying COVID Patient showing signs of CHF by LE Edema, Pulmonary edema, SOB, elevated BNP Echo with EF 62%, RVSP 48 mmHg Home Rx: Lasix 20 mg daily.  Started IV diuresis with 40 mg BID, transitioned to oral Lasix. Low-salt diet, daily weights, strict I's/O Cardiology followed in the hospital DC home on Lasix 40 mg daily  Elevated Troponin  Serial troponin 39> 35.  Not consistent with ACS. Echo with no wall motion abnormalities. No further work-up indicated   HTN Accelerated BP Home Rx: Norvasc, Losartan Held and discontinued Toprol XL due to bradycardia Home Rx: Norvasc 2.5 mg daily, increased to to 10 mg daily. Continued home losartan 50 mg daily Started PO hydralazine low dose and increased to 25 mg TID and DC'd on that dose  Glaucoma Continue Home: Xalatan, Cosopt   Obesity BMI 37.11   Gait weakness Patient is from independent living.  At her baseline she is able to transfer to wheelchair without difficulty. PT/OT followed with daily evaluations.  They recommended two-person assist Daughter arranged for 2 caregivers x24 hours. Daughter also arranged hospital bed. Arrangement of caregiver and hospital bed delayed discharge
Age: 18.0
Sex: F
Vaccine: COVID19-2
Symptoms: No adverse event, Product storage error
Clinical narrative: Covid vaccine was accidently stored in the freezer instead of the fridge.  No adverse symptoms noted.
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: Acute kidney injury, Acute respiratory failure, Adenocarcinoma, Biopsy brain abnormal, COVID-19
Clinical narrative: Patient is a 61 y.o. female with history of Lung adenocarcinoma with brain metastasis, COPD, Hepatitis C, Arthritis, polysubstance abuse, Tobacco abuse, and Anxiety who presented to a local Medical Center with declining mental status and worsening brain metastasis and found to also have covid-19 infection and was subsequently intubated.   Acute respiratory failure, resolved Intubated (4/9) due to AMS from brain mets and covid/PNA Extubated (4/11) Weaned to room air (4/13) Pulm followed   Acute encephalopathy Likely due to worsening brain mets with vasogenic edema Continue decadron and keppra Oriented x 2-3 (4/13)   Stage IV lung adenocarcinoma Brain metastasis Biopsy 1/10/2023 with adenocarcinoma Patient was receiving brain radiation but noncompliant CT Head (4/9) with multiple cerebral metastasis with significant vasogenic edema  On decadron and keppra Neurosurgery, oncology and palliative care consulted Rad/onc consulted; possibly resume radiation outpt if improves but no benefit for inpt, continue steroids Neurosurgery discussing surgical intervention vs palliative care with family Family and pt wish for hospice and dc home Plan to discharge home   Severe sepsis Covid -19 infection Bacterial pneumonia CT chest with LUL consolidation and b/l GGO Covid positive 4/9, unknown vaccination status Urinary antigen positive for pneumococcal Continue Azithro, rocephin changed to omnicef Continue decadron  Remdesivir stopped due to AKI   Hyperglycemia A1c 5.6 Likely due to steroids SSI   COPD Not in acute exacerbation Continue symbicort and bronchodilators
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19 pneumonia, Computerised tomogram head abnormal, Computerised tomogram thorax abnormal, Condition aggravated, Encephalopathy
Clinical narrative: Patient is a 61 y.o. female with history of Lung adenocarcinoma with brain metastasis, COPD, Hepatitis C, Arthritis, polysubstance abuse, Tobacco abuse, and Anxiety who presented to a local Medical Center with declining mental status and worsening brain metastasis and found to also have covid-19 infection and was subsequently intubated.   Acute respiratory failure, resolved Intubated (4/9) due to AMS from brain mets and covid/PNA Extubated (4/11) Weaned to room air (4/13) Pulm followed   Acute encephalopathy Likely due to worsening brain mets with vasogenic edema Continue decadron and keppra Oriented x 2-3 (4/13)   Stage IV lung adenocarcinoma Brain metastasis Biopsy 1/10/2023 with adenocarcinoma Patient was receiving brain radiation but noncompliant CT Head (4/9) with multiple cerebral metastasis with significant vasogenic edema  On decadron and keppra Neurosurgery, oncology and palliative care consulted Rad/onc consulted; possibly resume radiation outpt if improves but no benefit for inpt, continue steroids Neurosurgery discussing surgical intervention vs palliative care with family Family and pt wish for hospice and dc home Plan to discharge home   Severe sepsis Covid -19 infection Bacterial pneumonia CT chest with LUL consolidation and b/l GGO Covid positive 4/9, unknown vaccination status Urinary antigen positive for pneumococcal Continue Azithro, rocephin changed to omnicef Continue decadron  Remdesivir stopped due to AKI   Hyperglycemia A1c 5.6 Likely due to steroids SSI   COPD Not in acute exacerbation Continue symbicort and bronchodilators
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: Endotracheal intubation, Glycosylated haemoglobin normal, Hyperglycaemia, Lung adenocarcinoma stage IV, Lung consolidation
Clinical narrative: Patient is a 61 y.o. female with history of Lung adenocarcinoma with brain metastasis, COPD, Hepatitis C, Arthritis, polysubstance abuse, Tobacco abuse, and Anxiety who presented to a local Medical Center with declining mental status and worsening brain metastasis and found to also have covid-19 infection and was subsequently intubated.   Acute respiratory failure, resolved Intubated (4/9) due to AMS from brain mets and covid/PNA Extubated (4/11) Weaned to room air (4/13) Pulm followed   Acute encephalopathy Likely due to worsening brain mets with vasogenic edema Continue decadron and keppra Oriented x 2-3 (4/13)   Stage IV lung adenocarcinoma Brain metastasis Biopsy 1/10/2023 with adenocarcinoma Patient was receiving brain radiation but noncompliant CT Head (4/9) with multiple cerebral metastasis with significant vasogenic edema  On decadron and keppra Neurosurgery, oncology and palliative care consulted Rad/onc consulted; possibly resume radiation outpt if improves but no benefit for inpt, continue steroids Neurosurgery discussing surgical intervention vs palliative care with family Family and pt wish for hospice and dc home Plan to discharge home   Severe sepsis Covid -19 infection Bacterial pneumonia CT chest with LUL consolidation and b/l GGO Covid positive 4/9, unknown vaccination status Urinary antigen positive for pneumococcal Continue Azithro, rocephin changed to omnicef Continue decadron  Remdesivir stopped due to AKI   Hyperglycemia A1c 5.6 Likely due to steroids SSI   COPD Not in acute exacerbation Continue symbicort and bronchodilators
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: Lung opacity, Mental status changes, Metastases to central nervous system, Pneumococcal infection, Pneumonia bacterial
Clinical narrative: Patient is a 61 y.o. female with history of Lung adenocarcinoma with brain metastasis, COPD, Hepatitis C, Arthritis, polysubstance abuse, Tobacco abuse, and Anxiety who presented to a local Medical Center with declining mental status and worsening brain metastasis and found to also have covid-19 infection and was subsequently intubated.   Acute respiratory failure, resolved Intubated (4/9) due to AMS from brain mets and covid/PNA Extubated (4/11) Weaned to room air (4/13) Pulm followed   Acute encephalopathy Likely due to worsening brain mets with vasogenic edema Continue decadron and keppra Oriented x 2-3 (4/13)   Stage IV lung adenocarcinoma Brain metastasis Biopsy 1/10/2023 with adenocarcinoma Patient was receiving brain radiation but noncompliant CT Head (4/9) with multiple cerebral metastasis with significant vasogenic edema  On decadron and keppra Neurosurgery, oncology and palliative care consulted Rad/onc consulted; possibly resume radiation outpt if improves but no benefit for inpt, continue steroids Neurosurgery discussing surgical intervention vs palliative care with family Family and pt wish for hospice and dc home Plan to discharge home   Severe sepsis Covid -19 infection Bacterial pneumonia CT chest with LUL consolidation and b/l GGO Covid positive 4/9, unknown vaccination status Urinary antigen positive for pneumococcal Continue Azithro, rocephin changed to omnicef Continue decadron  Remdesivir stopped due to AKI   Hyperglycemia A1c 5.6 Likely due to steroids SSI   COPD Not in acute exacerbation Continue symbicort and bronchodilators
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: Radiotherapy, Sepsis, Streptococcus test, Vasogenic cerebral oedema
Clinical narrative: Patient is a 61 y.o. female with history of Lung adenocarcinoma with brain metastasis, COPD, Hepatitis C, Arthritis, polysubstance abuse, Tobacco abuse, and Anxiety who presented to a local Medical Center with declining mental status and worsening brain metastasis and found to also have covid-19 infection and was subsequently intubated.   Acute respiratory failure, resolved Intubated (4/9) due to AMS from brain mets and covid/PNA Extubated (4/11) Weaned to room air (4/13) Pulm followed   Acute encephalopathy Likely due to worsening brain mets with vasogenic edema Continue decadron and keppra Oriented x 2-3 (4/13)   Stage IV lung adenocarcinoma Brain metastasis Biopsy 1/10/2023 with adenocarcinoma Patient was receiving brain radiation but noncompliant CT Head (4/9) with multiple cerebral metastasis with significant vasogenic edema  On decadron and keppra Neurosurgery, oncology and palliative care consulted Rad/onc consulted; possibly resume radiation outpt if improves but no benefit for inpt, continue steroids Neurosurgery discussing surgical intervention vs palliative care with family Family and pt wish for hospice and dc home Plan to discharge home   Severe sepsis Covid -19 infection Bacterial pneumonia CT chest with LUL consolidation and b/l GGO Covid positive 4/9, unknown vaccination status Urinary antigen positive for pneumococcal Continue Azithro, rocephin changed to omnicef Continue decadron  Remdesivir stopped due to AKI   Hyperglycemia A1c 5.6 Likely due to steroids SSI   COPD Not in acute exacerbation Continue symbicort and bronchodilators
Age: 15.0
Sex: M
Vaccine: COVID19-2
Symptoms: No adverse event, Product storage error
Clinical narrative: Covid vaccine was accidently stored in the freezer instead of the fridge.  No adverse symptoms noted.
Age: 31.0
Sex: M
Vaccine: COVID19-2
Symptoms: Angiogram abnormal, Ankle brachial index abnormal, Anticoagulant therapy, Antineutrophil cytoplasmic antibody negative, Antinuclear antibody negative
Clinical narrative: A 31 y.o. male with no significant past medical history who presented to RMH 4/1/2023 with complaints of right lower extremity pain.  Patient went to urgent care 3/31/2023 and was given antibiotics and steroids for arthritis.  Admitted for concerns of ischemic limb   1. Right LE vasculopathy: Presented with swelling, skin discoloration. Pulses, sensation Intact.  Duplex negative.  Right ABI abnormal.  CTA abdominal aorta with lower extremity runoff 4/1/2023 with no evidence of RLE large vessel arterial occlusion, likely small vessel occlusion , COVID vasculitis per vascular medicine. C3, C4, Hepatitis panel, ANA, ANCA mixing studies normal. Cryoglobulins pending.  Continued heparin drip- changed to eliquis 4/6/2023. Peripheral vascular cardiology advised norvasc, pletal and consideration for formal angio 4/4/23. TTE 4/2/23 with NLVEF, no vegetations. R foot MRI 4/3/23 neg for abscess, blood cultures 4/2/23 negative to date. RLE angio 4/4/23 with evidence of diffuse inflammation of the right foot as evidenced by vasodilation induced rapid flow and occlusion of digital vessels of R toe- likely related to COVID induced coagulopathy/vasculopathy. Hyperbaric Rx started 4/5/2023. To discharge on plavix, eliquis, pletal and norvasc. ID started vancomycin 4/2/23- stopped 4/5/23. Continued supportive care with IV/PO narcs. Pain team followed for optimal pain control. 2. COVID-19: Reportedly diagnosed 3/28/2023 with home test.  Had symptoms of malaise, cough, roughly a week before that.  Vaccinated and boosted.  + 4/1/2023.  No respiratory distress.  Not a candidate for remdesivir/steroids . Vascular complications as above. 3. Leukocytosis: Likely reactive due to steroid use as given by urgent care .  Afebrile.  Trended. 4. Marijuana dependence: Daily use.  Cessation advised 5. Alcohol dependence: Reports that he drinks only on weekends but drinks "a lot" reports no signs of withdrawal. 6. Nicotine dependence: Uses e-cigarettes.  Refused patch.  Cessation advised.
Age: 31.0
Sex: M
Vaccine: COVID19-2
Symptoms: Blood culture negative, COVID-19, Coagulopathy, Complement factor C3, Complement factor C4
Clinical narrative: A 31 y.o. male with no significant past medical history who presented to RMH 4/1/2023 with complaints of right lower extremity pain.  Patient went to urgent care 3/31/2023 and was given antibiotics and steroids for arthritis.  Admitted for concerns of ischemic limb   1. Right LE vasculopathy: Presented with swelling, skin discoloration. Pulses, sensation Intact.  Duplex negative.  Right ABI abnormal.  CTA abdominal aorta with lower extremity runoff 4/1/2023 with no evidence of RLE large vessel arterial occlusion, likely small vessel occlusion , COVID vasculitis per vascular medicine. C3, C4, Hepatitis panel, ANA, ANCA mixing studies normal. Cryoglobulins pending.  Continued heparin drip- changed to eliquis 4/6/2023. Peripheral vascular cardiology advised norvasc, pletal and consideration for formal angio 4/4/23. TTE 4/2/23 with NLVEF, no vegetations. R foot MRI 4/3/23 neg for abscess, blood cultures 4/2/23 negative to date. RLE angio 4/4/23 with evidence of diffuse inflammation of the right foot as evidenced by vasodilation induced rapid flow and occlusion of digital vessels of R toe- likely related to COVID induced coagulopathy/vasculopathy. Hyperbaric Rx started 4/5/2023. To discharge on plavix, eliquis, pletal and norvasc. ID started vancomycin 4/2/23- stopped 4/5/23. Continued supportive care with IV/PO narcs. Pain team followed for optimal pain control. 2. COVID-19: Reportedly diagnosed 3/28/2023 with home test.  Had symptoms of malaise, cough, roughly a week before that.  Vaccinated and boosted.  + 4/1/2023.  No respiratory distress.  Not a candidate for remdesivir/steroids . Vascular complications as above. 3. Leukocytosis: Likely reactive due to steroid use as given by urgent care .  Afebrile.  Trended. 4. Marijuana dependence: Daily use.  Cessation advised 5. Alcohol dependence: Reports that he drinks only on weekends but drinks "a lot" reports no signs of withdrawal. 6. Nicotine dependence: Uses e-cigarettes.  Refused patch.  Cessation advised.
Age: 31.0
Sex: M
Vaccine: COVID19-2
Symptoms: Echocardiogram normal, Hepatitis viral test negative, Immunisation reaction, Inflammation, Leukocytosis
Clinical narrative: A 31 y.o. male with no significant past medical history who presented to RMH 4/1/2023 with complaints of right lower extremity pain.  Patient went to urgent care 3/31/2023 and was given antibiotics and steroids for arthritis.  Admitted for concerns of ischemic limb   1. Right LE vasculopathy: Presented with swelling, skin discoloration. Pulses, sensation Intact.  Duplex negative.  Right ABI abnormal.  CTA abdominal aorta with lower extremity runoff 4/1/2023 with no evidence of RLE large vessel arterial occlusion, likely small vessel occlusion , COVID vasculitis per vascular medicine. C3, C4, Hepatitis panel, ANA, ANCA mixing studies normal. Cryoglobulins pending.  Continued heparin drip- changed to eliquis 4/6/2023. Peripheral vascular cardiology advised norvasc, pletal and consideration for formal angio 4/4/23. TTE 4/2/23 with NLVEF, no vegetations. R foot MRI 4/3/23 neg for abscess, blood cultures 4/2/23 negative to date. RLE angio 4/4/23 with evidence of diffuse inflammation of the right foot as evidenced by vasodilation induced rapid flow and occlusion of digital vessels of R toe- likely related to COVID induced coagulopathy/vasculopathy. Hyperbaric Rx started 4/5/2023. To discharge on plavix, eliquis, pletal and norvasc. ID started vancomycin 4/2/23- stopped 4/5/23. Continued supportive care with IV/PO narcs. Pain team followed for optimal pain control. 2. COVID-19: Reportedly diagnosed 3/28/2023 with home test.  Had symptoms of malaise, cough, roughly a week before that.  Vaccinated and boosted.  + 4/1/2023.  No respiratory distress.  Not a candidate for remdesivir/steroids . Vascular complications as above. 3. Leukocytosis: Likely reactive due to steroid use as given by urgent care .  Afebrile.  Trended. 4. Marijuana dependence: Daily use.  Cessation advised 5. Alcohol dependence: Reports that he drinks only on weekends but drinks "a lot" reports no signs of withdrawal. 6. Nicotine dependence: Uses e-cigarettes.  Refused patch.  Cessation advised.
Age: 31.0
Sex: M
Vaccine: COVID19-2
Symptoms: Magnetic resonance imaging normal, Pain in extremity, Peripheral swelling, Peripheral vascular disorder, SARS-CoV-2 test positive
Clinical narrative: A 31 y.o. male with no significant past medical history who presented to RMH 4/1/2023 with complaints of right lower extremity pain.  Patient went to urgent care 3/31/2023 and was given antibiotics and steroids for arthritis.  Admitted for concerns of ischemic limb   1. Right LE vasculopathy: Presented with swelling, skin discoloration. Pulses, sensation Intact.  Duplex negative.  Right ABI abnormal.  CTA abdominal aorta with lower extremity runoff 4/1/2023 with no evidence of RLE large vessel arterial occlusion, likely small vessel occlusion , COVID vasculitis per vascular medicine. C3, C4, Hepatitis panel, ANA, ANCA mixing studies normal. Cryoglobulins pending.  Continued heparin drip- changed to eliquis 4/6/2023. Peripheral vascular cardiology advised norvasc, pletal and consideration for formal angio 4/4/23. TTE 4/2/23 with NLVEF, no vegetations. R foot MRI 4/3/23 neg for abscess, blood cultures 4/2/23 negative to date. RLE angio 4/4/23 with evidence of diffuse inflammation of the right foot as evidenced by vasodilation induced rapid flow and occlusion of digital vessels of R toe- likely related to COVID induced coagulopathy/vasculopathy. Hyperbaric Rx started 4/5/2023. To discharge on plavix, eliquis, pletal and norvasc. ID started vancomycin 4/2/23- stopped 4/5/23. Continued supportive care with IV/PO narcs. Pain team followed for optimal pain control. 2. COVID-19: Reportedly diagnosed 3/28/2023 with home test.  Had symptoms of malaise, cough, roughly a week before that.  Vaccinated and boosted.  + 4/1/2023.  No respiratory distress.  Not a candidate for remdesivir/steroids . Vascular complications as above. 3. Leukocytosis: Likely reactive due to steroid use as given by urgent care .  Afebrile.  Trended. 4. Marijuana dependence: Daily use.  Cessation advised 5. Alcohol dependence: Reports that he drinks only on weekends but drinks "a lot" reports no signs of withdrawal. 6. Nicotine dependence: Uses e-cigarettes.  Refused patch.  Cessation advised.
Age: 31.0
Sex: M
Vaccine: COVID19-2
Symptoms: Skin discolouration, Ultrasound Doppler normal, Vascular occlusion, Vasculitis
Clinical narrative: A 31 y.o. male with no significant past medical history who presented to RMH 4/1/2023 with complaints of right lower extremity pain.  Patient went to urgent care 3/31/2023 and was given antibiotics and steroids for arthritis.  Admitted for concerns of ischemic limb   1. Right LE vasculopathy: Presented with swelling, skin discoloration. Pulses, sensation Intact.  Duplex negative.  Right ABI abnormal.  CTA abdominal aorta with lower extremity runoff 4/1/2023 with no evidence of RLE large vessel arterial occlusion, likely small vessel occlusion , COVID vasculitis per vascular medicine. C3, C4, Hepatitis panel, ANA, ANCA mixing studies normal. Cryoglobulins pending.  Continued heparin drip- changed to eliquis 4/6/2023. Peripheral vascular cardiology advised norvasc, pletal and consideration for formal angio 4/4/23. TTE 4/2/23 with NLVEF, no vegetations. R foot MRI 4/3/23 neg for abscess, blood cultures 4/2/23 negative to date. RLE angio 4/4/23 with evidence of diffuse inflammation of the right foot as evidenced by vasodilation induced rapid flow and occlusion of digital vessels of R toe- likely related to COVID induced coagulopathy/vasculopathy. Hyperbaric Rx started 4/5/2023. To discharge on plavix, eliquis, pletal and norvasc. ID started vancomycin 4/2/23- stopped 4/5/23. Continued supportive care with IV/PO narcs. Pain team followed for optimal pain control. 2. COVID-19: Reportedly diagnosed 3/28/2023 with home test.  Had symptoms of malaise, cough, roughly a week before that.  Vaccinated and boosted.  + 4/1/2023.  No respiratory distress.  Not a candidate for remdesivir/steroids . Vascular complications as above. 3. Leukocytosis: Likely reactive due to steroid use as given by urgent care .  Afebrile.  Trended. 4. Marijuana dependence: Daily use.  Cessation advised 5. Alcohol dependence: Reports that he drinks only on weekends but drinks "a lot" reports no signs of withdrawal. 6. Nicotine dependence: Uses e-cigarettes.  Refused patch.  Cessation advised.
Age: 57.0
Sex: F
Vaccine: PNC20, TDAP, VARZOS
Symptoms: Feeling hot
Clinical narrative: pt felt hot, sat and fanned herself. was okay after sitting a few mins
Age: 14.0
Sex: M
Vaccine: COVID19-2
Symptoms: Product storage error
Clinical narrative: The vaccine was accidentally stored in the freezer.
Age: 16.0
Sex: M
Vaccine: MNQ
Symptoms: Blood glucose normal, Depressed level of consciousness, Dizziness, Hyperhidrosis, Pallor
Clinical narrative: 09:32 Patient reported lightheadedness and dizziness to physician upon standing in room after immunization while getting ready to leave. Dr. advised patient to sit and requested to move patient to room with a chair that leaned back. Patient and father reported patient felt well enough to walk to other exam room. 09:34am Patient requested to stop and use the bathroom, nurse requested father go with patient. Patient turned on light and reported he couldn't see the light, father supported patient, patient's legs went weak. Nursing staff gathered chair for patient to sit. Patient became very pale, diaphoretic, and noted decreased level of consciousness. @09:36 Unable to obtain BP, P - 50, R - 16, O2 sat 99%. Dr. called ER, reported to Dr. who accepted patient. Nursing staff applied cool compress to patient's neck. Patient cooperative, verbally communicating, still appears diaphoretic and pale. Father remains at patient's side. Patient escorted to ER and care turned over. Patient was given oral electrolytes in ER, monitiored, and discharged to home 07/03/23@10:55am.
Age: 71.0
Sex: M
Vaccine: COVID19-2
Symptoms: Acute respiratory failure, Asthma, Blood culture negative, Blood lactic acid normal, Blood pressure increased
Clinical narrative: Patient is a 72 y.o. male patient of, CNP with history of COPD, asthma, ataxia, hypertension, hypothyroidism, BPH, seizure disorder,  presented to Hospital with shortness of breath found to have pneumonia at outside facility and transferred for further work-up and management Covid Pneumonia Acute exacerbation Asthma  Acute hypoxic respiratory failure Covid-19 Virus Infection Leukocytosis  Date of onset of symptoms: 3/27/23 Symptoms present on admission: Fever, shortness of breath, cough  Date of covid positive test: 4/3/23 Vaccination status: vaccinated Imaging: Chest x-ray reveals ill-defined hazy nodular opacities, concern for bronchopneumonia Oxygen requirements on admission: 6 L Covid Pneumonia Acute exacerbation Asthma  Acute hypoxic respiratory failure Covid-19 Virus Infection Leukocytosis  Date of onset of symptoms: 3/27/23 Symptoms present on admission: Fever, shortness of breath, cough  Date of covid positive test: 4/3/23 Vaccination status: vaccinated Imaging: Chest x-ray reveals ill-defined hazy nodular opacities, concern for bronchopneumonia Oxygen requirements on admission: 6 L Current oxygen requirements: Room air  Medical therapy: steroids, Remdesivir  Consultants following: ID Anticipated special isolation end date: 4/13/23 Initial lactate was normal Respiratory panel positive for COVID  Chest CT showing diffuse patchy airspace disease throughout the left lung concerning for multifocal PNA  Oxygen per protocol, wean as appropriate, does not wear oxygen at home  S/p  IV Azithromycin, completed  Rocephin for 5 day course, s/p oral Azithromycin  Blood cultures showing Coagulase negative staph, likely contaminate, Repeat cultures negative  Continue on bronchodilators and DuoNebs Sputum Culture showing Yeast    Hypertension BNP was normal Continue Lasix 20 mg daily, Diamox  500 mg daily  S/P IV hydration  ECHO to be done outpatient-discussed with Cardiology who recommends outpatient  Blood pressure stable, elevated at times but appropriate for age, recommending close monitoring on discharge    Hyperlipidemia Hold statin for elevated liver enzymes    Hypothyroidism Continue Synthroid
Age: 71.0
Sex: M
Vaccine: COVID19-2
Symptoms: Brain natriuretic peptide normal, COVID-19, COVID-19 pneumonia, Chest X-ray abnormal, Computerised tomogram thorax abnormal
Clinical narrative: Patient is a 72 y.o. male patient of, CNP with history of COPD, asthma, ataxia, hypertension, hypothyroidism, BPH, seizure disorder,  presented to Hospital with shortness of breath found to have pneumonia at outside facility and transferred for further work-up and management Covid Pneumonia Acute exacerbation Asthma  Acute hypoxic respiratory failure Covid-19 Virus Infection Leukocytosis  Date of onset of symptoms: 3/27/23 Symptoms present on admission: Fever, shortness of breath, cough  Date of covid positive test: 4/3/23 Vaccination status: vaccinated Imaging: Chest x-ray reveals ill-defined hazy nodular opacities, concern for bronchopneumonia Oxygen requirements on admission: 6 L Covid Pneumonia Acute exacerbation Asthma  Acute hypoxic respiratory failure Covid-19 Virus Infection Leukocytosis  Date of onset of symptoms: 3/27/23 Symptoms present on admission: Fever, shortness of breath, cough  Date of covid positive test: 4/3/23 Vaccination status: vaccinated Imaging: Chest x-ray reveals ill-defined hazy nodular opacities, concern for bronchopneumonia Oxygen requirements on admission: 6 L Current oxygen requirements: Room air  Medical therapy: steroids, Remdesivir  Consultants following: ID Anticipated special isolation end date: 4/13/23 Initial lactate was normal Respiratory panel positive for COVID  Chest CT showing diffuse patchy airspace disease throughout the left lung concerning for multifocal PNA  Oxygen per protocol, wean as appropriate, does not wear oxygen at home  S/p  IV Azithromycin, completed  Rocephin for 5 day course, s/p oral Azithromycin  Blood cultures showing Coagulase negative staph, likely contaminate, Repeat cultures negative  Continue on bronchodilators and DuoNebs Sputum Culture showing Yeast    Hypertension BNP was normal Continue Lasix 20 mg daily, Diamox  500 mg daily  S/P IV hydration  ECHO to be done outpatient-discussed with Cardiology who recommends outpatient  Blood pressure stable, elevated at times but appropriate for age, recommending close monitoring on discharge    Hyperlipidemia Hold statin for elevated liver enzymes    Hypothyroidism Continue Synthroid
Age: 71.0
Sex: M
Vaccine: COVID19-2
Symptoms: Condition aggravated, Cough, Dyspnoea, Fungal test positive, Leukocytosis
Clinical narrative: Patient is a 72 y.o. male patient of, CNP with history of COPD, asthma, ataxia, hypertension, hypothyroidism, BPH, seizure disorder,  presented to Hospital with shortness of breath found to have pneumonia at outside facility and transferred for further work-up and management Covid Pneumonia Acute exacerbation Asthma  Acute hypoxic respiratory failure Covid-19 Virus Infection Leukocytosis  Date of onset of symptoms: 3/27/23 Symptoms present on admission: Fever, shortness of breath, cough  Date of covid positive test: 4/3/23 Vaccination status: vaccinated Imaging: Chest x-ray reveals ill-defined hazy nodular opacities, concern for bronchopneumonia Oxygen requirements on admission: 6 L Covid Pneumonia Acute exacerbation Asthma  Acute hypoxic respiratory failure Covid-19 Virus Infection Leukocytosis  Date of onset of symptoms: 3/27/23 Symptoms present on admission: Fever, shortness of breath, cough  Date of covid positive test: 4/3/23 Vaccination status: vaccinated Imaging: Chest x-ray reveals ill-defined hazy nodular opacities, concern for bronchopneumonia Oxygen requirements on admission: 6 L Current oxygen requirements: Room air  Medical therapy: steroids, Remdesivir  Consultants following: ID Anticipated special isolation end date: 4/13/23 Initial lactate was normal Respiratory panel positive for COVID  Chest CT showing diffuse patchy airspace disease throughout the left lung concerning for multifocal PNA  Oxygen per protocol, wean as appropriate, does not wear oxygen at home  S/p  IV Azithromycin, completed  Rocephin for 5 day course, s/p oral Azithromycin  Blood cultures showing Coagulase negative staph, likely contaminate, Repeat cultures negative  Continue on bronchodilators and DuoNebs Sputum Culture showing Yeast    Hypertension BNP was normal Continue Lasix 20 mg daily, Diamox  500 mg daily  S/P IV hydration  ECHO to be done outpatient-discussed with Cardiology who recommends outpatient  Blood pressure stable, elevated at times but appropriate for age, recommending close monitoring on discharge    Hyperlipidemia Hold statin for elevated liver enzymes    Hypothyroidism Continue Synthroid