chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 82.0
Sex: M
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: COVID-19, Road traffic accident, SARS-CoV-2 test positive, Syncope
Clinical narrative: Patient was admitted as Inpatient on 9/5/2022 as a level yellow trauma following MVC. Per report, patient had a syncopal episode while driving and struck a tree at highway speeds. Patient was seat belted. Patient's family reported that patient had a syncopal episode earlier in the day and his son was able to wake him up. Patient was brought tohospital via Helicopter. See H&P for detailed injury list; Cardiology and Neurosurgery consulted.  Patient was tested for COVID-19 and was positive on 9/5/2022.
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Acute respiratory failure, COVID-19, Chronic obstructive pulmonary disease, Condition aggravated, Tobacco abuse
Clinical narrative: 69 y.o. 11/21/1952   Admit Date:  8/3/2022   Discharge Date: 8/6/22   Principal Dx/ Final Dx: Acute respiratory failure with hypoxia   Relevant Inpt Dx: Principal Problem:   Acute respiratory failure with hypoxia Active Problems:   Tobacco abuse   COPD (chronic obstructive pulmonary disease)       HPI:   Hospital Course:   This 69 year old woman with copd was admitted with copd exacerbation and covid.  She was treated with steroids and nebs and remdesivir and is improved.  Today her lungs show improved air movement and her pulse ox on room air at rest was 97%.  She will go home later today.  She will complete steroids.  She will be assessed for home oxygen.  Follow up with pcp.          Consults:   IP CONSULT TO SOCIAL WORK       Disposition:  home   Discharge Condition:  fair
Age: 60.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Administered expired vaccine.
Age: 90.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Administration error: Vaccine given beyond-use-date.
Age: 77.0
Sex: M
Vaccine: COVID19
Symptoms: Asthenia, Atrial fibrillation, COVID-19, Chest X-ray, Computerised tomogram head
Clinical narrative: 79 y.o. 6/22/1943   Admit Date:  8/3/2022   Discharge Date:   8/10/2022   Discharge Diagnosis:  Principal Problem:   Acute metabolic encephalopathy Active Problems:   Paroxysmal atrial fibrillation   Acute UTI   COVID-19     Hospital Course:  79 year old resident was admitted with UTI and generalized weakness. He was treated with Paxlovid for the Covid-19 infection at the facility. Urine culture grew E coli and the treatment was completed here. His facility determined they could not take him back due to him requiring assistance with mobility. He has been undergoing PT and OT here. He is accepted at facility and pre cert has been approved. He will be transferred there today.    Physical Exam on the day of discharge: Last Recorded Vital Signs: Temp: 97.9 °F (36.6 °C) Heart Rate (Monitor): 99 Pulse: 94 BP: (!) 137/91 Respirations: 16 SpO2: 92 % O2 Flow Rate (l/min): 0 l/min General Appearance: no distress  Eyes: PERRLA ENT: moist mucus membranes, no adenopathy Lungs: clear to auscultation bilaterally  Heart: regular rate and rhythm Abdomen: soft, non-tender  Skin: No rashes or lesions  Extremities: no edema Neuro: alert   Consults:  IP CONSULT TO SOCIAL WORK   Significant Diagnostic Studies:   CT head, ABI, CXR   Operations: none   Disposition:  SNF   Discharge Condition:  Fair
Age: 77.0
Sex: M
Vaccine: COVID19
Symptoms: Culture urine positive, Escherichia test positive, Laboratory test, Metabolic encephalopathy, Mobility decreased
Clinical narrative: 79 y.o. 6/22/1943   Admit Date:  8/3/2022   Discharge Date:   8/10/2022   Discharge Diagnosis:  Principal Problem:   Acute metabolic encephalopathy Active Problems:   Paroxysmal atrial fibrillation   Acute UTI   COVID-19     Hospital Course:  79 year old resident was admitted with UTI and generalized weakness. He was treated with Paxlovid for the Covid-19 infection at the facility. Urine culture grew E coli and the treatment was completed here. His facility determined they could not take him back due to him requiring assistance with mobility. He has been undergoing PT and OT here. He is accepted at facility and pre cert has been approved. He will be transferred there today.    Physical Exam on the day of discharge: Last Recorded Vital Signs: Temp: 97.9 °F (36.6 °C) Heart Rate (Monitor): 99 Pulse: 94 BP: (!) 137/91 Respirations: 16 SpO2: 92 % O2 Flow Rate (l/min): 0 l/min General Appearance: no distress  Eyes: PERRLA ENT: moist mucus membranes, no adenopathy Lungs: clear to auscultation bilaterally  Heart: regular rate and rhythm Abdomen: soft, non-tender  Skin: No rashes or lesions  Extremities: no edema Neuro: alert   Consults:  IP CONSULT TO SOCIAL WORK   Significant Diagnostic Studies:   CT head, ABI, CXR   Operations: none   Disposition:  SNF   Discharge Condition:  Fair
Age: 77.0
Sex: M
Vaccine: COVID19
Symptoms: Urinary tract infection
Clinical narrative: 79 y.o. 6/22/1943   Admit Date:  8/3/2022   Discharge Date:   8/10/2022   Discharge Diagnosis:  Principal Problem:   Acute metabolic encephalopathy Active Problems:   Paroxysmal atrial fibrillation   Acute UTI   COVID-19     Hospital Course:  79 year old resident was admitted with UTI and generalized weakness. He was treated with Paxlovid for the Covid-19 infection at the facility. Urine culture grew E coli and the treatment was completed here. His facility determined they could not take him back due to him requiring assistance with mobility. He has been undergoing PT and OT here. He is accepted at facility and pre cert has been approved. He will be transferred there today.    Physical Exam on the day of discharge: Last Recorded Vital Signs: Temp: 97.9 °F (36.6 °C) Heart Rate (Monitor): 99 Pulse: 94 BP: (!) 137/91 Respirations: 16 SpO2: 92 % O2 Flow Rate (l/min): 0 l/min General Appearance: no distress  Eyes: PERRLA ENT: moist mucus membranes, no adenopathy Lungs: clear to auscultation bilaterally  Heart: regular rate and rhythm Abdomen: soft, non-tender  Skin: No rashes or lesions  Extremities: no edema Neuro: alert   Consults:  IP CONSULT TO SOCIAL WORK   Significant Diagnostic Studies:   CT head, ABI, CXR   Operations: none   Disposition:  SNF   Discharge Condition:  Fair
Age: 17.0
Sex: M
Vaccine: MNQ
Symptoms: Inappropriate schedule of product administration, No adverse event
Clinical narrative: The patient had already received his 2nd dose of a 2 dose series and was given a 3rd. The patient needed the 2nd dose of Men B which we do not have in this clinic.  There was not a reaction to the 3rd dose given.
Age: 3.0
Sex: M
Vaccine: COVID19
Symptoms: Abdominal pain upper, Asthenia, Decreased appetite, Discomfort, Hypersomnia
Clinical narrative: He had the vaccination on 09/02/2022. On 09/03/2022 his symptoms were lethargy, low energy unsure of temperature but he was warm. He complained of stomachache vomited a few times and loss of appetite. We called the doctor who said it was normal and we gave him TYLENOL that day which didn't make much of a difference. 09/04/2022 the lethargy continued and was worse. He slept a lot of the day the nausea went away and still loss of appetite with mild temperature. He would say his foot hurts his hands hurt and he seemed in physical discomfort with possible joint pain. On Monday 09/05/2022 he seemed to get his appetite back and the symptoms cleared up a lot. He still complained of stomachache. On Tuesday 09/06/2022 I took him to the doctors because he had a rash on his hand and face was splotchy with hives. Doctor said he was processing a viral infection or that it could be from vaccine. I gave him ZYRTEC and sent to day care. They called as the hives spread. I took him back to doctors but they stated it was not allergic reaction. Today 09/07/2022 he seems to be doing much better and rash has cleared up.
Age: 3.0
Sex: M
Vaccine: COVID19
Symptoms: Lethargy, Nausea, Pain in extremity, Rash, Rash macular
Clinical narrative: He had the vaccination on 09/02/2022. On 09/03/2022 his symptoms were lethargy, low energy unsure of temperature but he was warm. He complained of stomachache vomited a few times and loss of appetite. We called the doctor who said it was normal and we gave him TYLENOL that day which didn't make much of a difference. 09/04/2022 the lethargy continued and was worse. He slept a lot of the day the nausea went away and still loss of appetite with mild temperature. He would say his foot hurts his hands hurt and he seemed in physical discomfort with possible joint pain. On Monday 09/05/2022 he seemed to get his appetite back and the symptoms cleared up a lot. He still complained of stomachache. On Tuesday 09/06/2022 I took him to the doctors because he had a rash on his hand and face was splotchy with hives. Doctor said he was processing a viral infection or that it could be from vaccine. I gave him ZYRTEC and sent to day care. They called as the hives spread. I took him back to doctors but they stated it was not allergic reaction. Today 09/07/2022 he seems to be doing much better and rash has cleared up.
Age: 3.0
Sex: M
Vaccine: COVID19
Symptoms: Skin warm, Urticaria, Viral infection, Vomiting
Clinical narrative: He had the vaccination on 09/02/2022. On 09/03/2022 his symptoms were lethargy, low energy unsure of temperature but he was warm. He complained of stomachache vomited a few times and loss of appetite. We called the doctor who said it was normal and we gave him TYLENOL that day which didn't make much of a difference. 09/04/2022 the lethargy continued and was worse. He slept a lot of the day the nausea went away and still loss of appetite with mild temperature. He would say his foot hurts his hands hurt and he seemed in physical discomfort with possible joint pain. On Monday 09/05/2022 he seemed to get his appetite back and the symptoms cleared up a lot. He still complained of stomachache. On Tuesday 09/06/2022 I took him to the doctors because he had a rash on his hand and face was splotchy with hives. Doctor said he was processing a viral infection or that it could be from vaccine. I gave him ZYRTEC and sent to day care. They called as the hives spread. I took him back to doctors but they stated it was not allergic reaction. Today 09/07/2022 he seems to be doing much better and rash has cleared up.
Age: 46.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: ADMINISTERED EXPIRED VACCINE.
Age: 23.0
Sex: F
Vaccine: FLU4
Symptoms: Dizziness, Ear pain, Paraesthesia
Clinical narrative: tingling up legs, dizziness, feeling faint, pain in ears
Age: 85.0
Sex: M
Vaccine: COVID19
Symptoms: Blood glucose decreased, COVID-19, Death, Dyspnoea, Mental status changes
Clinical narrative: pt died in the home with hospice after being brought to ED via EMS for SOB, AMS; when EMS got to the home, pt unresponsive with BS of 27; treated for low BS; found to be positive for COVID; DNR; wife decided to take him home with hospice
Age: 85.0
Sex: M
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive, Unresponsive to stimuli
Clinical narrative: pt died in the home with hospice after being brought to ED via EMS for SOB, AMS; when EMS got to the home, pt unresponsive with BS of 27; treated for low BS; found to be positive for COVID; DNR; wife decided to take him home with hospice
Age: 84.0
Sex: F
Vaccine: COVID19
Symptoms: Asthenia, COVID-19, Decreased appetite, Fatigue, SARS-CoV-2 test positive
Clinical narrative: Patient tested positive for covid 8/12 and treated with antiviral medication.  She came to the ED on 8/20 for worsening fatigue, weakness, and decreased appetite.  Patient was admitted to the hospital to be treated for Covid.
Age: 53.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Asthenia, COVID-19, Fatigue, SARS-CoV-2 test positive
Clinical narrative: WEAKNESS AND FATIGUE
Age: 88.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered, Product administration error
Clinical narrative: administration error/vaccine given beyond use date.
Age: 84.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: ADMINISTERED EXPIRED VACCINE.
Age: 87.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered, Product administration error
Clinical narrative: administration error/vaccine given beyond use date.
Age: 78.0
Sex: M
Vaccine: COVID19
Symptoms: Acute kidney injury, Asymptomatic COVID-19, Ataxia, Chronic left ventricular failure, Computerised tomogram abdomen abnormal
Clinical narrative: Discharge Diagnosis:  Acute renal failure, E.coli cystitis, COVID 19, Dm2, Acute metabolic encephalopathy.    Hospital Course:  The patient was admitted with the above. He did not have sx from C19 and was not on oxygne so only supportive tx was given. E.coli grew in the urine. He was initally on rocephin but was changed to vantin to complete a 5 day course. His acute metabolic encephalopathy was felt to be due to the prior two dignoses and was improved at D/C. He was asked to follow up outpatinet.   Consults to:  Nephrology.    Significant Diagnostic Studies:  CT abdomen and npelvis.    Procedure(s): none.    Disposition:  SNF   Discharge Condition:  fair
Age: 78.0
Sex: M
Vaccine: COVID19
Symptoms: Culture urine positive, Cystitis escherichia, Escherichia test positive, Metabolic encephalopathy, Type 2 diabetes mellitus
Clinical narrative: Discharge Diagnosis:  Acute renal failure, E.coli cystitis, COVID 19, Dm2, Acute metabolic encephalopathy.    Hospital Course:  The patient was admitted with the above. He did not have sx from C19 and was not on oxygne so only supportive tx was given. E.coli grew in the urine. He was initally on rocephin but was changed to vantin to complete a 5 day course. His acute metabolic encephalopathy was felt to be due to the prior two dignoses and was improved at D/C. He was asked to follow up outpatinet.   Consults to:  Nephrology.    Significant Diagnostic Studies:  CT abdomen and npelvis.    Procedure(s): none.    Disposition:  SNF   Discharge Condition:  fair
Age: 85.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: administration error/vaccine given beyond use date.
Age: 73.0
Sex: F
Vaccine: COVID19
Symptoms: Antibody test abnormal, Antinuclear antibody, Laboratory test normal, Skin discolouration, Skin induration
Clinical narrative: One morning, I noticed I had very hard skin on my neck. A couple of days later, my whole body was darker than normal. It looked like I had a suntan. I went to my PCP. She said I should see a Rheumatologist. I also have Raynaud's disease. My fingers turn white when I get cold. I've had Raynaud's disease for over ten years.
Age: 49.0
Sex: F
Vaccine: COVID19
Symptoms: Acute respiratory failure, COVID-19, COVID-19 pneumonia, Chest X-ray abnormal, Essential hypertension
Clinical narrative: Hospital Course:  50 year old vaccinated female was admitted for Covid-19 pneumonia with respiratory failure. She was treated with Remdesivir and steroids. She has improved after 3 doses of Remdesivir and discharged home in stable condition. Patient educated on appropriate level of care post-discharge. Follow up with Primary Care Doctor in 5-7 days.   Physical Exam on the day of discharge: Last Recorded Vital Signs: Temp: 97.6 °F (36.4 °C) Heart Rate (Monitor): 83 Pulse: 66 BP: 117/68 Respirations: 16 SpO2: 100 % O2 Flow Rate (l/min): 2 l/min General Appearance: no distress  Eyes: PERRLA ENT: moist mucus membranes, no adenopathy Lungs: clear to auscultation bilaterally  Heart: regular rate and rhythm Abdomen: soft, non-tender  Skin: No rashes or lesions  Extremities: full ROM Neuro: alert, normal strength and tone    Consults:  IP CONSULT TO WOUND CARE   Significant Diagnostic Studies:   CXR   Operations: none   Disposition:  Home    Discharge Condition:  Fair
Age: 49.0
Sex: F
Vaccine: COVID19
Symptoms: Hypertension, Respiratory failure, Type 2 diabetes mellitus
Clinical narrative: Hospital Course:  50 year old vaccinated female was admitted for Covid-19 pneumonia with respiratory failure. She was treated with Remdesivir and steroids. She has improved after 3 doses of Remdesivir and discharged home in stable condition. Patient educated on appropriate level of care post-discharge. Follow up with Primary Care Doctor in 5-7 days.   Physical Exam on the day of discharge: Last Recorded Vital Signs: Temp: 97.6 °F (36.4 °C) Heart Rate (Monitor): 83 Pulse: 66 BP: 117/68 Respirations: 16 SpO2: 100 % O2 Flow Rate (l/min): 2 l/min General Appearance: no distress  Eyes: PERRLA ENT: moist mucus membranes, no adenopathy Lungs: clear to auscultation bilaterally  Heart: regular rate and rhythm Abdomen: soft, non-tender  Skin: No rashes or lesions  Extremities: full ROM Neuro: alert, normal strength and tone    Consults:  IP CONSULT TO WOUND CARE   Significant Diagnostic Studies:   CXR   Operations: none   Disposition:  Home    Discharge Condition:  Fair
Age: 5.0
Sex: F
Vaccine: MMRV, TDAP
Symptoms: No adverse event, Product administered to patient of inappropriate age, Wrong product administered
Clinical narrative: Patient mistakenly given Tdap instead of dTap for per age. No signs or symptoms of event
Age: 89.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Death, Fall, Oxygen saturation decreased, Pneumonia
Clinical narrative: EMS brought pt to ED at local hospital after a fall during the night and upper respiratory gurgling sounds; low O2 saturation; found to be positive for COVID; pneumonia; DNR; family took pt home with hospice from the ED; pt passed away in the home
Age: 89.0
Sex: M
Vaccine: COVID19
Symptoms: Respiratory symptom, SARS-CoV-2 test positive
Clinical narrative: EMS brought pt to ED at local hospital after a fall during the night and upper respiratory gurgling sounds; low O2 saturation; found to be positive for COVID; pneumonia; DNR; family took pt home with hospice from the ED; pt passed away in the home
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Acute motor axonal neuropathy, Asthenia, Dialysis, Electrophoresis, Gait inability
Clinical narrative: Described above.  Hospital treatment followed by now 16 months of physical and occasional therapy.
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Gastrointestinal tube insertion, Guillain-Barre syndrome, Immunoglobulin therapy, Intensive care, Mechanical ventilation
Clinical narrative: Described above.  Hospital treatment followed by now 16 months of physical and occasional therapy.
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Paralysis
Clinical narrative: Described above.  Hospital treatment followed by now 16 months of physical and occasional therapy.
Age: 84.0
Sex: F
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Acute cardiac event, Death
Clinical narrative: VAERS REPORT WRITE-UP FOR MY MOTHER, KILLED BY MODERNA ON 08/15/22   On August 15, 2022, my Mother died from a sudden cardiac event while vacationing.  She visits every August for 2-3 weeks.  SHE HAD NO HEART ISSUES.  NO UNDERLYING BLOOD PRESSURE OR CARDIAC EVENTS IN HER ENTIRE LIFE.  She did not have one single underlying major medical condition.  No cancer, no autoimmune issues, no asthma, no lung problems. Perfect weight.  Active until the day she died both physically and mentally. Walked up to 3 miles a day, read every night before she went to sleep and played bridge weekly her entire adult life.     Her mind was sharp as a tack, and she never even had a bout with depression.  She lived a stress-free life by enjoying sports, her friends, volunteering at the local community center and participating in her grandchildren?s lives.  She was not taking any prescription medications.  She traveled often.  She had NO PROBLEMS while on vacation. She was active every single day.  On Monday, August 15th her sister heard her wake up at 6 am to use the bathroom, and when she went to tell her coffee was ready at 8 am she had passed.  In under two hours.  For no reason. LIKE SOMEONE TURNED OFF THE LIGHTSWITCH TO HER HEART.   The ONE PROBLEM SHE DID HAVE was FOUR SHOTS OF MODERNA MRNA COVID-19 VACCINE.  THE ONLY COMMON DENOMINATOR. THE LAST BOOSTER WAS 4/26/21.  FOUR SHOTS WITHIN FIFTEEN MONTHS of a toxic pharmaceutical put in a 125 lb. body killed her.  Moderna has THREE TIMES the amount of lipid nanoparticles than the other bioweapon Pfizer.  She was told to take those shots by her government up and down the line.  Using all sorts of scare tactics.  From the County Public Health Director to Health and Human Services Secretary.  MY MOM DID NOT LIVE IN FEAR.  BUT SHE BELIEVED IN FOLLOWING THE RULES.  DO AS YOU ARE TOLD BY THE POWERS THAT BE.  THAT IS THE WAY SHE WAS RAISED AND NOW THE WAY SHE DIED TOO.   HER SHOT HISTORY:   01/27/21:  #-029L20A   02/24/21: #011A21A   11/12/21: #032F21A   04/26/22: #056A22A   HERE ARE THE LINKS TO THE CORRESPONDING DEATH REPORTS IN VAERS FOR THESE EXACT TOXIC BATCH #?S.  YOU NEED TO RECALL THESE TOXIC BATCHES AND NOTIFY THE PUBLIC ACCORDINGLY.   #029L20A:     #011A21A     #032F21A     #056A22A    MY MOTHER DIED ON 8/15/22. MEDICAL MURDER. CLEAR AS DAY.       ?THERE WILL BE JUSTICE. PRESERVE YOUR DOCUMENTS.?
Age: 68.0
Sex: M
Vaccine: COVID19
Symptoms: Asthenia, COVID-19, COVID-19 pneumonia, Cough, Fatigue
Clinical narrative: Patient tested positive for covid 8/14/22 and treated with dexamethasone, azithromycin, and albuterol inhaler.  Patient came back to the ED 8/21/22 with persistent weakness, malaise, fatigue, sore throat, and cough.  Patient admitted to hospital for viral pneumonia from Covid.
Age: 68.0
Sex: M
Vaccine: COVID19
Symptoms: Malaise, Oropharyngeal pain, Pneumonia viral, SARS-CoV-2 test positive
Clinical narrative: Patient tested positive for covid 8/14/22 and treated with dexamethasone, azithromycin, and albuterol inhaler.  Patient came back to the ED 8/21/22 with persistent weakness, malaise, fatigue, sore throat, and cough.  Patient admitted to hospital for viral pneumonia from Covid.
Age: 84.0
Sex: F
Vaccine: COVID19
Symptoms: Blood sodium decreased, COVID-19, Chest X-ray, Hyponatraemia, Refusal of treatment by patient
Clinical narrative: Patient ID: 86 y.o.    Admit Date:  8/5/2022   Discharge Date:   8/11/2022   Discharge Diagnosis:  Principal Problem:   Hyponatremia Active Problems:   Benign essential HTN   COVID-19   Diabetes mellitus without complication     Hospital Course:  86 year old female was admitted for severe hyponatremia. She also tested (+) for Covid-19 infection. She refused Remdesivir. She was given IV fluids and a dose of Tolvaptan. Na was 115 on admission. It has improved to 129 today. She will be discharged home on salt tablets. Patient educated on appropriate level of care post-discharge. Follow up with Primary Care Doctor in 5-7 days.   Physical Exam on the day of discharge: Last Recorded Vital Signs: Temp: 98.1 °F (36.7 °C) Heart Rate (Monitor): 84 Pulse: 75 BP: 113/63 Respirations: 16 SpO2: 99 % O2 Flow Rate (l/min): 0 l/min General Appearance: no distress  Eyes: PERRLA ENT: moist mucus membranes, no adenopathy Lungs: clear to auscultation bilaterally  Heart: regular rate and rhythm Abdomen: soft, non-tender  Skin: No rashes or lesions  Extremities: full ROM Neuro: alert, normal strength and tone    Consults:  IP CONSULT TO NEPHROLOGY IP CONSULT TO SOCIAL WORK   Significant Diagnostic Studies:   CXR   Operations: none   Disposition:  Home    Discharge Condition:  Fair
Age: 84.0
Sex: F
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive
Clinical narrative: Patient ID: 86 y.o.    Admit Date:  8/5/2022   Discharge Date:   8/11/2022   Discharge Diagnosis:  Principal Problem:   Hyponatremia Active Problems:   Benign essential HTN   COVID-19   Diabetes mellitus without complication     Hospital Course:  86 year old female was admitted for severe hyponatremia. She also tested (+) for Covid-19 infection. She refused Remdesivir. She was given IV fluids and a dose of Tolvaptan. Na was 115 on admission. It has improved to 129 today. She will be discharged home on salt tablets. Patient educated on appropriate level of care post-discharge. Follow up with Primary Care Doctor in 5-7 days.   Physical Exam on the day of discharge: Last Recorded Vital Signs: Temp: 98.1 °F (36.7 °C) Heart Rate (Monitor): 84 Pulse: 75 BP: 113/63 Respirations: 16 SpO2: 99 % O2 Flow Rate (l/min): 0 l/min General Appearance: no distress  Eyes: PERRLA ENT: moist mucus membranes, no adenopathy Lungs: clear to auscultation bilaterally  Heart: regular rate and rhythm Abdomen: soft, non-tender  Skin: No rashes or lesions  Extremities: full ROM Neuro: alert, normal strength and tone    Consults:  IP CONSULT TO NEPHROLOGY IP CONSULT TO SOCIAL WORK   Significant Diagnostic Studies:   CXR   Operations: none   Disposition:  Home    Discharge Condition:  Fair
Age: 3.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Incorrect dose administered
Clinical narrative: She was given Covid vaccines for ages 5-11yrs. I called RN to see what to do. She said should be fine. Watch for side effects and notify mom which I did do.
Age: 3.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Chills, Fatigue, Incorrect product formulation administered, Pain, Pyrexia
Clinical narrative: She was given Covid vaccines for ages 5-11yrs. I called RN to see what to do. She said should be fine. Watch for side effects and notify mom which I did do.
Age: 3.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Rhinorrhoea
Clinical narrative: She was given Covid vaccines for ages 5-11yrs. I called RN to see what to do. She said should be fine. Watch for side effects and notify mom which I did do.
Age: 3.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Limb injury, Paraesthesia
Clinical narrative: Error: Shoulder Joint Injury (prolonged pain, tingling, etc.)-
Age: 51.0
Sex: M
Vaccine: COVID19
Symptoms: Death, Life support, Resuscitation, Unresponsive to stimuli, Ventricular fibrillation
Clinical narrative: sx 6/20/22  ,to hosp 7/12/22 found unresponsive in his car at a medical center where he works.  CPR initiated, ems called.  VFIB on arrival. ACLS drugs given including epi, lidocaine, amiodarone  and failed to have ROSC.  Deceased 7-12-22.
Age: 56.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: COVID-19, Dyspnoea, SARS-CoV-2 test positive
Clinical narrative: SOB
Age: 0.75
Sex: M
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: He was given the Covid 5-11yr old vaccine. I contacted RN and she said it should be fine just monitor for any side effects and notify mom. Mom was made aware.
Age: 72.0
Sex: F
Vaccine: COVID19
Symptoms: Cardiac failure acute, Cardiac failure congestive
Clinical narrative: Acute congestive heart failure
Age: 58.0
Sex: M
Vaccine: SMALLMNK
Symptoms: Urticaria
Clinical narrative: First attempt at wheal not achieved, second attempt needed, wheal achieved on second attempt successfully.
Age: 61.0
Sex: F
Vaccine: COVID19
Symptoms: Extra dose administered, No adverse event
Clinical narrative: Patient was admitted to this facility on 8/31/2022 and record verified which indicated last dose administered on 2/25/2022. Patient received what was thought to be second booster on 9/2/2022 but when information was added to tracker it noted file had been updated with vaccine information indicating had already received second booster on 8/1/2022. Verified with administering facility that information was entered into tracker on 9/1/2022. Patient suffered no adverse effect.
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Acute respiratory failure, COVID-19, Chest X-ray abnormal, Death, SARS-CoV-2 test positive
Clinical narrative: pt to hospital 1/11/22; positive for COVID; treated with dexamethasone and empiric ABX; O2 supplementation; AHRF; during hospitalization, CXR showed some improvement; pt dc'd to home on 2/2/22 with home O2; pt passed away in the home on 2/5/22
Age: 79.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: COVID-19, Productive cough, SARS-CoV-2 test positive, Syncope, Ventricular tachycardia
Clinical narrative: Pt has a PMH of CAD and atrial fibrillation. He was transferred from an outlying facility after experiencing frequent syncopal episodes over the last 2 weeks. Pt was found to be V. tach. The pt did have a cough with sputum production and was found to be COVID positive the day after admission.
Age: 63.0
Sex: F
Vaccine: COVID19
Symptoms: Dizziness postural, Vertigo positional
Clinical narrative: Symptom:  Dizziness with certain head movements. Diagnosis:  Benign paroxysmal positional vertigo, bilateral. Treatment: Physical Therapy (Vestibular Rehab) - resolved within 5 days.
Age: 51.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: COVID-19, Dyspnoea, SARS-CoV-2 test positive
Clinical narrative: SOB
Age: 27.0
Sex: M
Vaccine: COVID19-2, FLUC4
Symptoms: Dizziness, Fall, Feeling hot, Hypoacusis, Nausea
Clinical narrative: Patient received flucelvax and covid pfizer bivalent booster around 1pm.  A few minutes after receiving the  vaccines patient was walking around store waiting his 15 minutes before leaving. Front end staff notified pharmacists that a patient had fainted. Patient reports becoming lightheaded and lightly fell into a display and slid down to the floor. Patient was with 2 family members and they reported that he didn't hit his head, but slid down to the ground. By the time the two pharmacists arrived to patient, he was sitting on floor leaning against pole. I asked patient questions to keep him talking. He said he felt warm, lightheaded, a bit nauseous, and hearing was a bit dull. I had patient clench and unclench fists to keep him from passing out again. A front end team member got patient a cold rag for his neck. Patient reported lightheadedness came back briefly, so patient sat on floor for 15 minutes, then moved to  chair for another 10 minutes before walking around the store with his family members before leaving. Patient says he doesn't have a primary provider and said he was feeling fine when he left. He said he has never had this reaction before.
Age: 27.0
Sex: M
Vaccine: COVID19-2, FLUC4
Symptoms: Syncope
Clinical narrative: Patient received flucelvax and covid pfizer bivalent booster around 1pm.  A few minutes after receiving the  vaccines patient was walking around store waiting his 15 minutes before leaving. Front end staff notified pharmacists that a patient had fainted. Patient reports becoming lightheaded and lightly fell into a display and slid down to the floor. Patient was with 2 family members and they reported that he didn't hit his head, but slid down to the ground. By the time the two pharmacists arrived to patient, he was sitting on floor leaning against pole. I asked patient questions to keep him talking. He said he felt warm, lightheaded, a bit nauseous, and hearing was a bit dull. I had patient clench and unclench fists to keep him from passing out again. A front end team member got patient a cold rag for his neck. Patient reported lightheadedness came back briefly, so patient sat on floor for 15 minutes, then moved to  chair for another 10 minutes before walking around the store with his family members before leaving. Patient says he doesn't have a primary provider and said he was feeling fine when he left. He said he has never had this reaction before.
Age: 1.0
Sex: F
Vaccine: COVID19
Symptoms: Unevaluable event
Clinical narrative: None.
Age: 73.0
Sex: M
Vaccine: COVID19
Symptoms: Acute respiratory failure, Anticoagulant therapy, COVID-19, COVID-19 pneumonia, Computerised tomogram thorax abnormal
Clinical narrative: Patient ID:  73 y.o.  Admit Date:  8/6/2022   Discharge Date:   8/9/2022   Discharge Diagnosis:  Principal Problem:   Acute hypoxemic respiratory failure due to COVID-19 Active Problems:   Hypokalemia   Pulmonary embolism associated with COVID-19   Chronic systolic CHF (congestive heart failure)   Essential hypertension   Atrial fibrillation     Hospital Course:  73 year old male on Trilogy at home was admitted with Covid-19 pneumonia and associated PE. He was started on anticoagulation and switched to Eliquis yesterday. He will be discharged home today in stable condition. He will have to be on Eliquis for 6 months. Patient educated on appropriate level of care post-discharge. Follow up with Primary Care Doctor in 5-7 days.   Physical Exam on the day of discharge: Last Recorded Vital Signs: Temp: 97.4 °F (36.3 °C) Heart Rate (Monitor): 83 Pulse: 100 BP: 130/78 Respirations: 14 SpO2: 95 % O2 Flow Rate (l/min): 0 l/min General Appearance: no distress  Eyes: PERRLA ENT: moist mucus membranes, no adenopathy Lungs: clear to auscultation bilaterally  Heart: irregular rate and rhythm Abdomen: soft, non-tender  Skin: No rashes or lesions  Extremities: full ROM Neuro: alert, normal strength and tone    Consults:  IP CONSULT TO SOCIAL WORK   Significant Diagnostic Studies:   CT chest   Operations: none   Disposition:  Home    Discharge Condition:  Fair
Age: 73.0
Sex: M
Vaccine: COVID19
Symptoms: Heart rate irregular, Hypokalaemia, Pulmonary embolism
Clinical narrative: Patient ID:  73 y.o.  Admit Date:  8/6/2022   Discharge Date:   8/9/2022   Discharge Diagnosis:  Principal Problem:   Acute hypoxemic respiratory failure due to COVID-19 Active Problems:   Hypokalemia   Pulmonary embolism associated with COVID-19   Chronic systolic CHF (congestive heart failure)   Essential hypertension   Atrial fibrillation     Hospital Course:  73 year old male on Trilogy at home was admitted with Covid-19 pneumonia and associated PE. He was started on anticoagulation and switched to Eliquis yesterday. He will be discharged home today in stable condition. He will have to be on Eliquis for 6 months. Patient educated on appropriate level of care post-discharge. Follow up with Primary Care Doctor in 5-7 days.   Physical Exam on the day of discharge: Last Recorded Vital Signs: Temp: 97.4 °F (36.3 °C) Heart Rate (Monitor): 83 Pulse: 100 BP: 130/78 Respirations: 14 SpO2: 95 % O2 Flow Rate (l/min): 0 l/min General Appearance: no distress  Eyes: PERRLA ENT: moist mucus membranes, no adenopathy Lungs: clear to auscultation bilaterally  Heart: irregular rate and rhythm Abdomen: soft, non-tender  Skin: No rashes or lesions  Extremities: full ROM Neuro: alert, normal strength and tone    Consults:  IP CONSULT TO SOCIAL WORK   Significant Diagnostic Studies:   CT chest   Operations: none   Disposition:  Home    Discharge Condition:  Fair
Age: 68.0
Sex: F
Vaccine: COVID19-2
Symptoms: COVID-19, Oropharyngeal pain, Pain, Pyrexia, Respiratory tract congestion
Clinical narrative: I received sore throat; high temperature; congestion and body aches for 5 days.  I took Molnupiravir and I felt better.
Age: 68.0
Sex: F
Vaccine: COVID19-2
Symptoms: SARS-CoV-2 test positive
Clinical narrative: I received sore throat; high temperature; congestion and body aches for 5 days.  I took Molnupiravir and I felt better.
Age: 45.0
Sex: F
Vaccine: FLU4
Symptoms: Arthralgia, Injected limb mobility decreased, Loss of personal independence in daily activities
Clinical narrative: Patient initially presented with postvaccination symptoms (initial vaccine was on 11/22/21 was given by medical assistant) via message on 12/9/2021 experiencing soreness in her left shoulder joint.  She has not had any previous flu reactions.  She was surprised at the time of the reaction due to her significant pain.  She had difficulty with deep joint pain and ADLs such as difficulty pulling her shirt off, putting her hair in a ponytail. At that time we recommended seeing a provider for ongoing joint pain however patient did not follow-up. She was then seen again on 5/23/2022 during her annual physical exam complaining of ongoing L shoulder pain since her flu shot the previous fall. Some of this has resolved with passive range of motion exercises however she continues to struggle with flexion of her left shoulder past 90 degrees and abduction of her left shoulder.  Denies any changes in strength or sensation.  No previous injuries, traumas or surgeries.  Physical exam revealed:   Inspection of the left shoulder reveals no deformity, asymmetry, bruising, swelling or erythema. Full range of motion of bilateral shoulders to flexion, extension, internal rotation, external rotation. Strength 5 out of 5 in bilateral upper extremities Sensation intact bilaterally in upper extremities. No tenderness to palpation of L shoulder POSITIVE empty can test in affected shoulder. POSITIVE drop arm test negative in affected shoulder.  No pain elicited on external rotation against resistance. Lift off test negative bilaterally.  Suspected etiology at that time related to history and physical exam was a supraspinatus dysfunction/ rotator cuff syndrome.- unclear link to her flu shot however it did present immediately following administration (2 weeks later).  Recommendation at that time to proceed with physical therapy- referral was placed. Patient continue to have pain and has not been seen in our clinic since then.
Age: 41.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Acoustic stimulation tests abnormal, Dizziness, Magnetic resonance imaging normal, Tinnitus, Vertigo
Clinical narrative: Tinnitus ringing in the left ear almost immediately after the first shot and increased after the second.  Within 2 mths I started experiencing dizziness and ultimately vertigo attacks.  The symptoms continue today.
Age: 57.0
Sex: F
Vaccine: COVID19, VARZOS
Symptoms: COVID-19, COVID-19 pneumonia, Chest X-ray normal, Chills, Cough
Clinical narrative: PRESENTING PROBLEM:  Hypoxia [R09.02] COVID-19 virus infection [U07.1] Pneumonia due to COVID-19 virus [U07.1, J12.82]   HOSPITAL COURSE: 58-year-old lady with medical history of bipolar disorder, chronic obstructive pulmonary disease, cervical cancer, cognitive impairment presenting with dyspnea, fever, dry cough, headaches and chills for 1 day.  In ER patient was found to be COVID positive.  Upon ambulation she had hypoxia to 87%.  Patient's rest of the labs unremarkable.  Chest x-ray without any infiltrates.  No concerns for superimposed bacterial infection.  She was started on 6 mg dexamethasone and kept overnight for observation.  In the morning patient was able to walk without getting short of breath or hypoxic.  Patient had no complaints including no dyspnea are chest pain or cough or nausea or vomiting.  Patient was advised to take dexamethasone for total of 10 days.  She was also advised to be compliant with her home inhalers (which she has not been using lately).  Patient was discharged in stable condition to home with family.  ER return precautions also given.
Age: 57.0
Sex: F
Vaccine: COVID19, VARZOS
Symptoms: Dyspnoea, Headache, Hypoxia, Laboratory test normal, Pyrexia
Clinical narrative: PRESENTING PROBLEM:  Hypoxia [R09.02] COVID-19 virus infection [U07.1] Pneumonia due to COVID-19 virus [U07.1, J12.82]   HOSPITAL COURSE: 58-year-old lady with medical history of bipolar disorder, chronic obstructive pulmonary disease, cervical cancer, cognitive impairment presenting with dyspnea, fever, dry cough, headaches and chills for 1 day.  In ER patient was found to be COVID positive.  Upon ambulation she had hypoxia to 87%.  Patient's rest of the labs unremarkable.  Chest x-ray without any infiltrates.  No concerns for superimposed bacterial infection.  She was started on 6 mg dexamethasone and kept overnight for observation.  In the morning patient was able to walk without getting short of breath or hypoxic.  Patient had no complaints including no dyspnea are chest pain or cough or nausea or vomiting.  Patient was advised to take dexamethasone for total of 10 days.  She was also advised to be compliant with her home inhalers (which she has not been using lately).  Patient was discharged in stable condition to home with family.  ER return precautions also given.
Age: 57.0
Sex: F
Vaccine: COVID19, VARZOS
Symptoms: SARS-CoV-2 test positive, Treatment noncompliance
Clinical narrative: PRESENTING PROBLEM:  Hypoxia [R09.02] COVID-19 virus infection [U07.1] Pneumonia due to COVID-19 virus [U07.1, J12.82]   HOSPITAL COURSE: 58-year-old lady with medical history of bipolar disorder, chronic obstructive pulmonary disease, cervical cancer, cognitive impairment presenting with dyspnea, fever, dry cough, headaches and chills for 1 day.  In ER patient was found to be COVID positive.  Upon ambulation she had hypoxia to 87%.  Patient's rest of the labs unremarkable.  Chest x-ray without any infiltrates.  No concerns for superimposed bacterial infection.  She was started on 6 mg dexamethasone and kept overnight for observation.  In the morning patient was able to walk without getting short of breath or hypoxic.  Patient had no complaints including no dyspnea are chest pain or cough or nausea or vomiting.  Patient was advised to take dexamethasone for total of 10 days.  She was also advised to be compliant with her home inhalers (which she has not been using lately).  Patient was discharged in stable condition to home with family.  ER return precautions also given.
Age: 79.0
Sex: M
Vaccine: COVID19
Symptoms: Acute left ventricular failure, Acute myocardial infarction, COVID-19, Chest X-ray, Chronic kidney disease
Clinical narrative: Patient ID:   80 y.o.    Admit Date:  8/8/2022   Discharge Date:   8/11/2022   Discharge Diagnosis:  Principal Problem:   Acute systolic heart failure Active Problems:   NSTEMI (non-ST elevated myocardial infarction)   COVID-19 virus infection   Type 2 diabetes mellitus with stage 3 chronic kidney disease, with long-term current use of insulin   Stage 3a chronic kidney disease     Hospital Course:  80 year old male with dementia was admitted for CHF and MI. He also tested (+) for Covid-19 infection but did not require Remdesivir therapy. Cardiology saw him and started him on Amiodarone. TTE show moderate global hypokinesis of the left ventricle with 30-35% LVEF. He was also diuresed. Renal function remained stable. He will be discharged home today for follow up with cardiology. Patient educated on appropriate level of care post-discharge.    Physical Exam on the day of discharge: Last Recorded Vital Signs: Temp: 97.4 °F (36.3 °C) Heart Rate (Monitor): 87 Pulse: 77 BP: 115/74 Respirations: 18 SpO2: 99 % O2 Flow Rate (l/min): 0 l/min General Appearance: no distress  Eyes: PERRLA ENT: moist mucus membranes, no adenopathy Lungs: clear to auscultation bilaterally  Heart: regular rate and rhythm Abdomen: soft, non-tender  Skin: No rashes or lesions  Extremities: full ROM Neuro: alert   Consults:  IP CONSULT TO HEART FAILURE NURSE IP CONSULT TO DIETARY IP CONSULT TO SOCIAL WORK IP CONSULT TO CARDIOLOGY IP CONSULT TO HEART FAILURE NURSE   Significant Diagnostic Studies:   TTE, CXR   Operations: none   Disposition:  Home with HH   Discharge Condition:  Fair
Age: 79.0
Sex: M
Vaccine: COVID19
Symptoms: Echocardiogram, Polyuria, Renal impairment, SARS-CoV-2 test positive, Type 2 diabetes mellitus
Clinical narrative: Patient ID:   80 y.o.    Admit Date:  8/8/2022   Discharge Date:   8/11/2022   Discharge Diagnosis:  Principal Problem:   Acute systolic heart failure Active Problems:   NSTEMI (non-ST elevated myocardial infarction)   COVID-19 virus infection   Type 2 diabetes mellitus with stage 3 chronic kidney disease, with long-term current use of insulin   Stage 3a chronic kidney disease     Hospital Course:  80 year old male with dementia was admitted for CHF and MI. He also tested (+) for Covid-19 infection but did not require Remdesivir therapy. Cardiology saw him and started him on Amiodarone. TTE show moderate global hypokinesis of the left ventricle with 30-35% LVEF. He was also diuresed. Renal function remained stable. He will be discharged home today for follow up with cardiology. Patient educated on appropriate level of care post-discharge.    Physical Exam on the day of discharge: Last Recorded Vital Signs: Temp: 97.4 °F (36.3 °C) Heart Rate (Monitor): 87 Pulse: 77 BP: 115/74 Respirations: 18 SpO2: 99 % O2 Flow Rate (l/min): 0 l/min General Appearance: no distress  Eyes: PERRLA ENT: moist mucus membranes, no adenopathy Lungs: clear to auscultation bilaterally  Heart: regular rate and rhythm Abdomen: soft, non-tender  Skin: No rashes or lesions  Extremities: full ROM Neuro: alert   Consults:  IP CONSULT TO HEART FAILURE NURSE IP CONSULT TO DIETARY IP CONSULT TO SOCIAL WORK IP CONSULT TO CARDIOLOGY IP CONSULT TO HEART FAILURE NURSE   Significant Diagnostic Studies:   TTE, CXR   Operations: none   Disposition:  Home with HH   Discharge Condition:  Fair
Age: 79.0
Sex: M
Vaccine: COVID19
Symptoms: Ventricular hypokinesia
Clinical narrative: Patient ID:   80 y.o.    Admit Date:  8/8/2022   Discharge Date:   8/11/2022   Discharge Diagnosis:  Principal Problem:   Acute systolic heart failure Active Problems:   NSTEMI (non-ST elevated myocardial infarction)   COVID-19 virus infection   Type 2 diabetes mellitus with stage 3 chronic kidney disease, with long-term current use of insulin   Stage 3a chronic kidney disease     Hospital Course:  80 year old male with dementia was admitted for CHF and MI. He also tested (+) for Covid-19 infection but did not require Remdesivir therapy. Cardiology saw him and started him on Amiodarone. TTE show moderate global hypokinesis of the left ventricle with 30-35% LVEF. He was also diuresed. Renal function remained stable. He will be discharged home today for follow up with cardiology. Patient educated on appropriate level of care post-discharge.    Physical Exam on the day of discharge: Last Recorded Vital Signs: Temp: 97.4 °F (36.3 °C) Heart Rate (Monitor): 87 Pulse: 77 BP: 115/74 Respirations: 18 SpO2: 99 % O2 Flow Rate (l/min): 0 l/min General Appearance: no distress  Eyes: PERRLA ENT: moist mucus membranes, no adenopathy Lungs: clear to auscultation bilaterally  Heart: regular rate and rhythm Abdomen: soft, non-tender  Skin: No rashes or lesions  Extremities: full ROM Neuro: alert   Consults:  IP CONSULT TO HEART FAILURE NURSE IP CONSULT TO DIETARY IP CONSULT TO SOCIAL WORK IP CONSULT TO CARDIOLOGY IP CONSULT TO HEART FAILURE NURSE   Significant Diagnostic Studies:   TTE, CXR   Operations: none   Disposition:  Home with HH   Discharge Condition:  Fair
Age: 23.0
Sex: M
Vaccine: VARCEL
Symptoms: Inappropriate schedule of product administration, No adverse event
Clinical narrative: Unknowingly gave third dose in two dose series. First dose 06/27/22 Second dose 08/02/22 Third dose 08/30/33  Followed up with pt, no adverse effects, no treatment.
Age: 11.0
Sex: M
Vaccine: HPV9, MNQ
Symptoms: Injection site erythema, Injection site pain, Injection site warmth
Clinical narrative: left deltoid 4x4 in erythema warm and tender
Age: 77.0
Sex: F
Vaccine: COVID19
Symptoms: Anticoagulant therapy, Arrhythmia, Atrial fibrillation, COVID-19, COVID-19 pneumonia
Clinical narrative: Physician Discharge Summary   Patient ID:  79 y.o.    Admit Date:  8/8/2022   Discharge Date:   8/11/2022   Discharge Diagnosis:  Principal Problem:   Pneumonia due to COVID-19 virus Active Problems:   Essential hypertension   Paroxysmal atrial fibrillation     Hospital Course:  79 year old female was admitted for Covid-19 pneumonia and treated with Remdesivir and steroids. Cardiology was involved for a fib with RVR. Rate became controlled later and she was started on anticoagulation. TTE showed normal LVEF. She is stable now and will be discharged home with NOAC and to resume Quinidine to keep the HR under control. Patient educated on appropriate level of care post-discharge. Follow up with Primary Care Doctor in 5-7 days.   Physical Exam on the day of discharge: Last Recorded Vital Signs: Temp: 97.9 °F (36.6 °C) Heart Rate (Monitor): 103 Pulse: 78 BP: (!) 129/94 Respirations: 18 SpO2: 99 % O2 Flow Rate (l/min): 0 l/min General Appearance: no distress  Eyes: PERRLA ENT: moist mucus membranes, no adenopathy Lungs: clear to auscultation bilaterally  Heart: irregular rate and rhythm Abdomen: soft, non-tender  Skin: No rashes or lesions  Extremities: full ROM Neuro: alert, normal strength and tone    Consults:  IP CONSULT TO DIETARY IP CONSULT TO SOCIAL WORK IP CONSULT TO CARDIOLOGY   Significant Diagnostic Studies:   TTE, CT thorax   Operations: none   Disposition:  Home