chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 61.0
Sex: M
Vaccine: COVID19
Symptoms: Acute myocardial infarction, Arterial catheterisation, Breast cancer metastatic, COVID-19, Cardiac arrest
Clinical narrative: I am the epidemiologist reporting on behalf of 61 year-old male patient.  This patient experienced a fatal heart attack the same day as receiving the fourth dose of a Pfizer vaccine on 4/22/22, according to state immunization records. He previously received the first dose of the Pfizer vaccine on 4/23/2021, the second dose of the Pfizer vaccine on 5/14/2021, and the third dose of the Pfizer vaccine on 12/3/2021.  The patient has previously tested positive for COVID-19 on 1/9/22 and 1/10/22 via PCR. He subsequently had two negative PCR tests on 3/4/2022, 3/29/22 and 4/21/22, according to records. There is no previous infection history documented prior to 2022.  According to provider notes,  The patient was found down unresponsive and pulseless. On EMS arrival, ACLS was begun and he was found to be in pulseless electrical activity (PEA). He received 40 minutes of advanced cardiovascular life support (ACLS) with 5 rounds of epi, achieved return of spontaneous circulation (ROSC) twice, and was intubated for airway protection, but he lost pulses again prior to arrival. On arrival, CPR in progress with Lucas device, rhythm PEA. Calcium and epi were given. After 2 rounds of CPR ROSC was achieved. Levophed was started as he was hypotensive. Propofol and fentanyl initiated. Femoral central line and left radial arterial line were placed. Patient was last seen eating dinner at 7 PM by facility staff and was noted to be more tired than usual. The HPI, ROS, past medical history, social history and family history documentation element(s) were limited due to the patient being unconscious. Etiology of cardiac arrest is unclear at this time, consider pulmonary embolism (PE) given his malignancy although he was not hypoxic on resuscitation will consider hypoxic in the setting of large pleural effusion and malignant. Patient has a past medical history of Anemia, Cerebral amyloid angiopathy (CODE), CKD (chronic kidney disease), Diabetes mellitus, Diabetes type 2, controlled, Esophageal reflux, History of peptic ulcer disease, Hyperlipidemia, Hypertension, and Metastatic breast cancer (03/07/2019). The cause of death is listed as ?multiorgan failure as a consequence of acute myocardial infarction and metastatic breast cancer? on the death certificate. This patient is also currently being enumerated as a COVID-19 related fatality, based on previous infection history.
Age: 61.0
Sex: M
Vaccine: COVID19
Symptoms: Central venous catheterisation, Death, Endotracheal intubation, Fatigue, Hypotension
Clinical narrative: I am the epidemiologist reporting on behalf of 61 year-old male patient.  This patient experienced a fatal heart attack the same day as receiving the fourth dose of a Pfizer vaccine on 4/22/22, according to state immunization records. He previously received the first dose of the Pfizer vaccine on 4/23/2021, the second dose of the Pfizer vaccine on 5/14/2021, and the third dose of the Pfizer vaccine on 12/3/2021.  The patient has previously tested positive for COVID-19 on 1/9/22 and 1/10/22 via PCR. He subsequently had two negative PCR tests on 3/4/2022, 3/29/22 and 4/21/22, according to records. There is no previous infection history documented prior to 2022.  According to provider notes,  The patient was found down unresponsive and pulseless. On EMS arrival, ACLS was begun and he was found to be in pulseless electrical activity (PEA). He received 40 minutes of advanced cardiovascular life support (ACLS) with 5 rounds of epi, achieved return of spontaneous circulation (ROSC) twice, and was intubated for airway protection, but he lost pulses again prior to arrival. On arrival, CPR in progress with Lucas device, rhythm PEA. Calcium and epi were given. After 2 rounds of CPR ROSC was achieved. Levophed was started as he was hypotensive. Propofol and fentanyl initiated. Femoral central line and left radial arterial line were placed. Patient was last seen eating dinner at 7 PM by facility staff and was noted to be more tired than usual. The HPI, ROS, past medical history, social history and family history documentation element(s) were limited due to the patient being unconscious. Etiology of cardiac arrest is unclear at this time, consider pulmonary embolism (PE) given his malignancy although he was not hypoxic on resuscitation will consider hypoxic in the setting of large pleural effusion and malignant. Patient has a past medical history of Anemia, Cerebral amyloid angiopathy (CODE), CKD (chronic kidney disease), Diabetes mellitus, Diabetes type 2, controlled, Esophageal reflux, History of peptic ulcer disease, Hyperlipidemia, Hypertension, and Metastatic breast cancer (03/07/2019). The cause of death is listed as ?multiorgan failure as a consequence of acute myocardial infarction and metastatic breast cancer? on the death certificate. This patient is also currently being enumerated as a COVID-19 related fatality, based on previous infection history.
Age: 61.0
Sex: M
Vaccine: COVID19
Symptoms: Life support, Loss of consciousness, Multiple organ dysfunction syndrome, Myocardial infarction, Pleural effusion
Clinical narrative: I am the epidemiologist reporting on behalf of 61 year-old male patient.  This patient experienced a fatal heart attack the same day as receiving the fourth dose of a Pfizer vaccine on 4/22/22, according to state immunization records. He previously received the first dose of the Pfizer vaccine on 4/23/2021, the second dose of the Pfizer vaccine on 5/14/2021, and the third dose of the Pfizer vaccine on 12/3/2021.  The patient has previously tested positive for COVID-19 on 1/9/22 and 1/10/22 via PCR. He subsequently had two negative PCR tests on 3/4/2022, 3/29/22 and 4/21/22, according to records. There is no previous infection history documented prior to 2022.  According to provider notes,  The patient was found down unresponsive and pulseless. On EMS arrival, ACLS was begun and he was found to be in pulseless electrical activity (PEA). He received 40 minutes of advanced cardiovascular life support (ACLS) with 5 rounds of epi, achieved return of spontaneous circulation (ROSC) twice, and was intubated for airway protection, but he lost pulses again prior to arrival. On arrival, CPR in progress with Lucas device, rhythm PEA. Calcium and epi were given. After 2 rounds of CPR ROSC was achieved. Levophed was started as he was hypotensive. Propofol and fentanyl initiated. Femoral central line and left radial arterial line were placed. Patient was last seen eating dinner at 7 PM by facility staff and was noted to be more tired than usual. The HPI, ROS, past medical history, social history and family history documentation element(s) were limited due to the patient being unconscious. Etiology of cardiac arrest is unclear at this time, consider pulmonary embolism (PE) given his malignancy although he was not hypoxic on resuscitation will consider hypoxic in the setting of large pleural effusion and malignant. Patient has a past medical history of Anemia, Cerebral amyloid angiopathy (CODE), CKD (chronic kidney disease), Diabetes mellitus, Diabetes type 2, controlled, Esophageal reflux, History of peptic ulcer disease, Hyperlipidemia, Hypertension, and Metastatic breast cancer (03/07/2019). The cause of death is listed as ?multiorgan failure as a consequence of acute myocardial infarction and metastatic breast cancer? on the death certificate. This patient is also currently being enumerated as a COVID-19 related fatality, based on previous infection history.
Age: 61.0
Sex: M
Vaccine: COVID19
Symptoms: Pulse absent, Pulseless electrical activity, Resuscitation, SARS-CoV-2 test positive, Unresponsive to stimuli
Clinical narrative: I am the epidemiologist reporting on behalf of 61 year-old male patient.  This patient experienced a fatal heart attack the same day as receiving the fourth dose of a Pfizer vaccine on 4/22/22, according to state immunization records. He previously received the first dose of the Pfizer vaccine on 4/23/2021, the second dose of the Pfizer vaccine on 5/14/2021, and the third dose of the Pfizer vaccine on 12/3/2021.  The patient has previously tested positive for COVID-19 on 1/9/22 and 1/10/22 via PCR. He subsequently had two negative PCR tests on 3/4/2022, 3/29/22 and 4/21/22, according to records. There is no previous infection history documented prior to 2022.  According to provider notes,  The patient was found down unresponsive and pulseless. On EMS arrival, ACLS was begun and he was found to be in pulseless electrical activity (PEA). He received 40 minutes of advanced cardiovascular life support (ACLS) with 5 rounds of epi, achieved return of spontaneous circulation (ROSC) twice, and was intubated for airway protection, but he lost pulses again prior to arrival. On arrival, CPR in progress with Lucas device, rhythm PEA. Calcium and epi were given. After 2 rounds of CPR ROSC was achieved. Levophed was started as he was hypotensive. Propofol and fentanyl initiated. Femoral central line and left radial arterial line were placed. Patient was last seen eating dinner at 7 PM by facility staff and was noted to be more tired than usual. The HPI, ROS, past medical history, social history and family history documentation element(s) were limited due to the patient being unconscious. Etiology of cardiac arrest is unclear at this time, consider pulmonary embolism (PE) given his malignancy although he was not hypoxic on resuscitation will consider hypoxic in the setting of large pleural effusion and malignant. Patient has a past medical history of Anemia, Cerebral amyloid angiopathy (CODE), CKD (chronic kidney disease), Diabetes mellitus, Diabetes type 2, controlled, Esophageal reflux, History of peptic ulcer disease, Hyperlipidemia, Hypertension, and Metastatic breast cancer (03/07/2019). The cause of death is listed as ?multiorgan failure as a consequence of acute myocardial infarction and metastatic breast cancer? on the death certificate. This patient is also currently being enumerated as a COVID-19 related fatality, based on previous infection history.
Age: 81.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Death, SARS-CoV-2 test positive
Clinical narrative: Pfizer vaccine x 2. Tested positive for Covid 01/15/2022. Admitted to Medical Center on 06/17/2022. Expired on 06/18/2022.
Age: 81.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Brain injury, Breath sounds abnormal, COVID-19 pneumonia, Dyspnoea, Fall
Clinical narrative: Pt was complaining of chest congestion 2-3 days before admission and wife noted that he was breathing louder and harder.  Pt had a PMH of COPD, but was brought to the ER due to a fall at home and it appeared that the patient had suffered an anoxic brain injury.  He also had COVID-19 pneumonia.
Age: 81.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Respiratory tract congestion
Clinical narrative: Pt was complaining of chest congestion 2-3 days before admission and wife noted that he was breathing louder and harder.  Pt had a PMH of COPD, but was brought to the ER due to a fall at home and it appeared that the patient had suffered an anoxic brain injury.  He also had COVID-19 pneumonia.
Age: 71.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: positive covid pt hospitalization fully vaccinated
Age: 89.0
Sex: F
Vaccine: COVID19
Symptoms: Death, Pulmonary thrombosis
Clinical narrative: Blood Clots Lungs resulting in Death  Many details are not available to me and will have to be edited
Age: 95.0
Sex: F
Vaccine: COVID19
Symptoms: Acute respiratory failure, Angiogram pulmonary abnormal, Anticoagulant therapy, Apnoea, Atrial fibrillation
Clinical narrative: Admission Date: 6/9/2022  PRESENTING PROBLEM: Atrial fibrillation with RVR [I48.91] Acute on chronic respiratory failure with hypoxia [J96.21] Acute on chronic congestive heart failure, unspecified heart failure type [I50.9] COVID-19 virus infection [U07.1]  HOSPITAL COURSE: The patient is a 96 yo female with PMH which includes HTN, HLD, DM II, hypothyroidism, osteoporosis, arthritis and chronic back pain, b/l cataracts, recent bouts of community-acquired pneumonia and recently diagnosed (5/4/22) Atrial fibrillation with RVR, started on diltiazem and Eliquis the day prior to presentation. She came in with a chief complaint of worsening back pain and shortness of breath/respiratory distress.    Patient was found to have severe sepsis and acute on chronic hypoxic hypercapneic respiratory failure likely secondary to acute COVID 19 infection, A fib with RVR, and concern for acute heart failure (no prior history, but elevated BNP). Patient tachycardic, tachypneic (initially, now some intermittent apnea/bradypnea), worsening confusion/AMS with periods of lethargy/minimal responsiveness, consistent with severe sepsis at the time of admission. Mental status improved, although still some mild intermitt confusion. Continued to require increased respiratory support with HFNC/Non-breather at times with CXR showing worsening effusions and colidations.Patient had some intermittent improvement with IV steroids and lasix. However, CTA thorax was obtained on 6/11 due to concern PE with worsening chest pain, tachycardia, and elevated D-dimer (b/l doppler US negative). CTA showed no evidence of PE, but worsening bilateral pleural effusions, including her chronic complex R pleural effusion with thickening and concern for possible exudative process. Bilateral lower lobe consolidations were significantly worse as well, especially on the left.  On 6/12/22, patient asked to stop aggressive cares and transition to hospice. Team spoke with patient's activated DPOA (son) and he was in agreement with patient's desire to become comfort care/hospice. Palliative care was consulted, active treatment was discontinued and comfort meds initiated.    Paged by nursing that patient had passed on evening of 6/14. On my evaluation, patient not responsive to verbal stimuli or sternal rub. Pupils fixed and nonreactive. No heart or lung sounds heard after a full minute of auscultation. Peripheral pulses not present. Death pronounced at 7:25pm. Personally notified patient's son and DPOA, of death. All questions answered.
Age: 95.0
Sex: F
Vaccine: COVID19
Symptoms: Back pain, Bradypnoea, Brain natriuretic peptide increased, Breath sounds abnormal, COVID-19
Clinical narrative: Admission Date: 6/9/2022  PRESENTING PROBLEM: Atrial fibrillation with RVR [I48.91] Acute on chronic respiratory failure with hypoxia [J96.21] Acute on chronic congestive heart failure, unspecified heart failure type [I50.9] COVID-19 virus infection [U07.1]  HOSPITAL COURSE: The patient is a 96 yo female with PMH which includes HTN, HLD, DM II, hypothyroidism, osteoporosis, arthritis and chronic back pain, b/l cataracts, recent bouts of community-acquired pneumonia and recently diagnosed (5/4/22) Atrial fibrillation with RVR, started on diltiazem and Eliquis the day prior to presentation. She came in with a chief complaint of worsening back pain and shortness of breath/respiratory distress.    Patient was found to have severe sepsis and acute on chronic hypoxic hypercapneic respiratory failure likely secondary to acute COVID 19 infection, A fib with RVR, and concern for acute heart failure (no prior history, but elevated BNP). Patient tachycardic, tachypneic (initially, now some intermittent apnea/bradypnea), worsening confusion/AMS with periods of lethargy/minimal responsiveness, consistent with severe sepsis at the time of admission. Mental status improved, although still some mild intermitt confusion. Continued to require increased respiratory support with HFNC/Non-breather at times with CXR showing worsening effusions and colidations.Patient had some intermittent improvement with IV steroids and lasix. However, CTA thorax was obtained on 6/11 due to concern PE with worsening chest pain, tachycardia, and elevated D-dimer (b/l doppler US negative). CTA showed no evidence of PE, but worsening bilateral pleural effusions, including her chronic complex R pleural effusion with thickening and concern for possible exudative process. Bilateral lower lobe consolidations were significantly worse as well, especially on the left.  On 6/12/22, patient asked to stop aggressive cares and transition to hospice. Team spoke with patient's activated DPOA (son) and he was in agreement with patient's desire to become comfort care/hospice. Palliative care was consulted, active treatment was discontinued and comfort meds initiated.    Paged by nursing that patient had passed on evening of 6/14. On my evaluation, patient not responsive to verbal stimuli or sternal rub. Pupils fixed and nonreactive. No heart or lung sounds heard after a full minute of auscultation. Peripheral pulses not present. Death pronounced at 7:25pm. Personally notified patient's son and DPOA, of death. All questions answered.
Age: 95.0
Sex: F
Vaccine: COVID19
Symptoms: Cardiac failure congestive, Chest X-ray abnormal, Chest pain, Condition aggravated, Confusional state
Clinical narrative: Admission Date: 6/9/2022  PRESENTING PROBLEM: Atrial fibrillation with RVR [I48.91] Acute on chronic respiratory failure with hypoxia [J96.21] Acute on chronic congestive heart failure, unspecified heart failure type [I50.9] COVID-19 virus infection [U07.1]  HOSPITAL COURSE: The patient is a 96 yo female with PMH which includes HTN, HLD, DM II, hypothyroidism, osteoporosis, arthritis and chronic back pain, b/l cataracts, recent bouts of community-acquired pneumonia and recently diagnosed (5/4/22) Atrial fibrillation with RVR, started on diltiazem and Eliquis the day prior to presentation. She came in with a chief complaint of worsening back pain and shortness of breath/respiratory distress.    Patient was found to have severe sepsis and acute on chronic hypoxic hypercapneic respiratory failure likely secondary to acute COVID 19 infection, A fib with RVR, and concern for acute heart failure (no prior history, but elevated BNP). Patient tachycardic, tachypneic (initially, now some intermittent apnea/bradypnea), worsening confusion/AMS with periods of lethargy/minimal responsiveness, consistent with severe sepsis at the time of admission. Mental status improved, although still some mild intermitt confusion. Continued to require increased respiratory support with HFNC/Non-breather at times with CXR showing worsening effusions and colidations.Patient had some intermittent improvement with IV steroids and lasix. However, CTA thorax was obtained on 6/11 due to concern PE with worsening chest pain, tachycardia, and elevated D-dimer (b/l doppler US negative). CTA showed no evidence of PE, but worsening bilateral pleural effusions, including her chronic complex R pleural effusion with thickening and concern for possible exudative process. Bilateral lower lobe consolidations were significantly worse as well, especially on the left.  On 6/12/22, patient asked to stop aggressive cares and transition to hospice. Team spoke with patient's activated DPOA (son) and he was in agreement with patient's desire to become comfort care/hospice. Palliative care was consulted, active treatment was discontinued and comfort meds initiated.    Paged by nursing that patient had passed on evening of 6/14. On my evaluation, patient not responsive to verbal stimuli or sternal rub. Pupils fixed and nonreactive. No heart or lung sounds heard after a full minute of auscultation. Peripheral pulses not present. Death pronounced at 7:25pm. Personally notified patient's son and DPOA, of death. All questions answered.
Age: 95.0
Sex: F
Vaccine: COVID19
Symptoms: Death, Dyspnoea, Fibrin D dimer increased, Heart sounds abnormal, Hyporesponsive to stimuli
Clinical narrative: Admission Date: 6/9/2022  PRESENTING PROBLEM: Atrial fibrillation with RVR [I48.91] Acute on chronic respiratory failure with hypoxia [J96.21] Acute on chronic congestive heart failure, unspecified heart failure type [I50.9] COVID-19 virus infection [U07.1]  HOSPITAL COURSE: The patient is a 96 yo female with PMH which includes HTN, HLD, DM II, hypothyroidism, osteoporosis, arthritis and chronic back pain, b/l cataracts, recent bouts of community-acquired pneumonia and recently diagnosed (5/4/22) Atrial fibrillation with RVR, started on diltiazem and Eliquis the day prior to presentation. She came in with a chief complaint of worsening back pain and shortness of breath/respiratory distress.    Patient was found to have severe sepsis and acute on chronic hypoxic hypercapneic respiratory failure likely secondary to acute COVID 19 infection, A fib with RVR, and concern for acute heart failure (no prior history, but elevated BNP). Patient tachycardic, tachypneic (initially, now some intermittent apnea/bradypnea), worsening confusion/AMS with periods of lethargy/minimal responsiveness, consistent with severe sepsis at the time of admission. Mental status improved, although still some mild intermitt confusion. Continued to require increased respiratory support with HFNC/Non-breather at times with CXR showing worsening effusions and colidations.Patient had some intermittent improvement with IV steroids and lasix. However, CTA thorax was obtained on 6/11 due to concern PE with worsening chest pain, tachycardia, and elevated D-dimer (b/l doppler US negative). CTA showed no evidence of PE, but worsening bilateral pleural effusions, including her chronic complex R pleural effusion with thickening and concern for possible exudative process. Bilateral lower lobe consolidations were significantly worse as well, especially on the left.  On 6/12/22, patient asked to stop aggressive cares and transition to hospice. Team spoke with patient's activated DPOA (son) and he was in agreement with patient's desire to become comfort care/hospice. Palliative care was consulted, active treatment was discontinued and comfort meds initiated.    Paged by nursing that patient had passed on evening of 6/14. On my evaluation, patient not responsive to verbal stimuli or sternal rub. Pupils fixed and nonreactive. No heart or lung sounds heard after a full minute of auscultation. Peripheral pulses not present. Death pronounced at 7:25pm. Personally notified patient's son and DPOA, of death. All questions answered.
Age: 95.0
Sex: F
Vaccine: COVID19
Symptoms: Hypoxia, Lethargy, Lung consolidation, Mental status changes, Pleural effusion
Clinical narrative: Admission Date: 6/9/2022  PRESENTING PROBLEM: Atrial fibrillation with RVR [I48.91] Acute on chronic respiratory failure with hypoxia [J96.21] Acute on chronic congestive heart failure, unspecified heart failure type [I50.9] COVID-19 virus infection [U07.1]  HOSPITAL COURSE: The patient is a 96 yo female with PMH which includes HTN, HLD, DM II, hypothyroidism, osteoporosis, arthritis and chronic back pain, b/l cataracts, recent bouts of community-acquired pneumonia and recently diagnosed (5/4/22) Atrial fibrillation with RVR, started on diltiazem and Eliquis the day prior to presentation. She came in with a chief complaint of worsening back pain and shortness of breath/respiratory distress.    Patient was found to have severe sepsis and acute on chronic hypoxic hypercapneic respiratory failure likely secondary to acute COVID 19 infection, A fib with RVR, and concern for acute heart failure (no prior history, but elevated BNP). Patient tachycardic, tachypneic (initially, now some intermittent apnea/bradypnea), worsening confusion/AMS with periods of lethargy/minimal responsiveness, consistent with severe sepsis at the time of admission. Mental status improved, although still some mild intermitt confusion. Continued to require increased respiratory support with HFNC/Non-breather at times with CXR showing worsening effusions and colidations.Patient had some intermittent improvement with IV steroids and lasix. However, CTA thorax was obtained on 6/11 due to concern PE with worsening chest pain, tachycardia, and elevated D-dimer (b/l doppler US negative). CTA showed no evidence of PE, but worsening bilateral pleural effusions, including her chronic complex R pleural effusion with thickening and concern for possible exudative process. Bilateral lower lobe consolidations were significantly worse as well, especially on the left.  On 6/12/22, patient asked to stop aggressive cares and transition to hospice. Team spoke with patient's activated DPOA (son) and he was in agreement with patient's desire to become comfort care/hospice. Palliative care was consulted, active treatment was discontinued and comfort meds initiated.    Paged by nursing that patient had passed on evening of 6/14. On my evaluation, patient not responsive to verbal stimuli or sternal rub. Pupils fixed and nonreactive. No heart or lung sounds heard after a full minute of auscultation. Peripheral pulses not present. Death pronounced at 7:25pm. Personally notified patient's son and DPOA, of death. All questions answered.
Age: 95.0
Sex: F
Vaccine: COVID19
Symptoms: Pneumonia, Pulse absent, Pupil fixed, Pupillary light reflex tests abnormal, Respiratory distress
Clinical narrative: Admission Date: 6/9/2022  PRESENTING PROBLEM: Atrial fibrillation with RVR [I48.91] Acute on chronic respiratory failure with hypoxia [J96.21] Acute on chronic congestive heart failure, unspecified heart failure type [I50.9] COVID-19 virus infection [U07.1]  HOSPITAL COURSE: The patient is a 96 yo female with PMH which includes HTN, HLD, DM II, hypothyroidism, osteoporosis, arthritis and chronic back pain, b/l cataracts, recent bouts of community-acquired pneumonia and recently diagnosed (5/4/22) Atrial fibrillation with RVR, started on diltiazem and Eliquis the day prior to presentation. She came in with a chief complaint of worsening back pain and shortness of breath/respiratory distress.    Patient was found to have severe sepsis and acute on chronic hypoxic hypercapneic respiratory failure likely secondary to acute COVID 19 infection, A fib with RVR, and concern for acute heart failure (no prior history, but elevated BNP). Patient tachycardic, tachypneic (initially, now some intermittent apnea/bradypnea), worsening confusion/AMS with periods of lethargy/minimal responsiveness, consistent with severe sepsis at the time of admission. Mental status improved, although still some mild intermitt confusion. Continued to require increased respiratory support with HFNC/Non-breather at times with CXR showing worsening effusions and colidations.Patient had some intermittent improvement with IV steroids and lasix. However, CTA thorax was obtained on 6/11 due to concern PE with worsening chest pain, tachycardia, and elevated D-dimer (b/l doppler US negative). CTA showed no evidence of PE, but worsening bilateral pleural effusions, including her chronic complex R pleural effusion with thickening and concern for possible exudative process. Bilateral lower lobe consolidations were significantly worse as well, especially on the left.  On 6/12/22, patient asked to stop aggressive cares and transition to hospice. Team spoke with patient's activated DPOA (son) and he was in agreement with patient's desire to become comfort care/hospice. Palliative care was consulted, active treatment was discontinued and comfort meds initiated.    Paged by nursing that patient had passed on evening of 6/14. On my evaluation, patient not responsive to verbal stimuli or sternal rub. Pupils fixed and nonreactive. No heart or lung sounds heard after a full minute of auscultation. Peripheral pulses not present. Death pronounced at 7:25pm. Personally notified patient's son and DPOA, of death. All questions answered.
Age: 95.0
Sex: F
Vaccine: COVID19
Symptoms: Respiratory failure, Sepsis, Tachycardia, Tachypnoea, Ultrasound Doppler normal
Clinical narrative: Admission Date: 6/9/2022  PRESENTING PROBLEM: Atrial fibrillation with RVR [I48.91] Acute on chronic respiratory failure with hypoxia [J96.21] Acute on chronic congestive heart failure, unspecified heart failure type [I50.9] COVID-19 virus infection [U07.1]  HOSPITAL COURSE: The patient is a 96 yo female with PMH which includes HTN, HLD, DM II, hypothyroidism, osteoporosis, arthritis and chronic back pain, b/l cataracts, recent bouts of community-acquired pneumonia and recently diagnosed (5/4/22) Atrial fibrillation with RVR, started on diltiazem and Eliquis the day prior to presentation. She came in with a chief complaint of worsening back pain and shortness of breath/respiratory distress.    Patient was found to have severe sepsis and acute on chronic hypoxic hypercapneic respiratory failure likely secondary to acute COVID 19 infection, A fib with RVR, and concern for acute heart failure (no prior history, but elevated BNP). Patient tachycardic, tachypneic (initially, now some intermittent apnea/bradypnea), worsening confusion/AMS with periods of lethargy/minimal responsiveness, consistent with severe sepsis at the time of admission. Mental status improved, although still some mild intermitt confusion. Continued to require increased respiratory support with HFNC/Non-breather at times with CXR showing worsening effusions and colidations.Patient had some intermittent improvement with IV steroids and lasix. However, CTA thorax was obtained on 6/11 due to concern PE with worsening chest pain, tachycardia, and elevated D-dimer (b/l doppler US negative). CTA showed no evidence of PE, but worsening bilateral pleural effusions, including her chronic complex R pleural effusion with thickening and concern for possible exudative process. Bilateral lower lobe consolidations were significantly worse as well, especially on the left.  On 6/12/22, patient asked to stop aggressive cares and transition to hospice. Team spoke with patient's activated DPOA (son) and he was in agreement with patient's desire to become comfort care/hospice. Palliative care was consulted, active treatment was discontinued and comfort meds initiated.    Paged by nursing that patient had passed on evening of 6/14. On my evaluation, patient not responsive to verbal stimuli or sternal rub. Pupils fixed and nonreactive. No heart or lung sounds heard after a full minute of auscultation. Peripheral pulses not present. Death pronounced at 7:25pm. Personally notified patient's son and DPOA, of death. All questions answered.
Age: 95.0
Sex: F
Vaccine: COVID19
Symptoms: Unresponsive to stimuli
Clinical narrative: Admission Date: 6/9/2022  PRESENTING PROBLEM: Atrial fibrillation with RVR [I48.91] Acute on chronic respiratory failure with hypoxia [J96.21] Acute on chronic congestive heart failure, unspecified heart failure type [I50.9] COVID-19 virus infection [U07.1]  HOSPITAL COURSE: The patient is a 96 yo female with PMH which includes HTN, HLD, DM II, hypothyroidism, osteoporosis, arthritis and chronic back pain, b/l cataracts, recent bouts of community-acquired pneumonia and recently diagnosed (5/4/22) Atrial fibrillation with RVR, started on diltiazem and Eliquis the day prior to presentation. She came in with a chief complaint of worsening back pain and shortness of breath/respiratory distress.    Patient was found to have severe sepsis and acute on chronic hypoxic hypercapneic respiratory failure likely secondary to acute COVID 19 infection, A fib with RVR, and concern for acute heart failure (no prior history, but elevated BNP). Patient tachycardic, tachypneic (initially, now some intermittent apnea/bradypnea), worsening confusion/AMS with periods of lethargy/minimal responsiveness, consistent with severe sepsis at the time of admission. Mental status improved, although still some mild intermitt confusion. Continued to require increased respiratory support with HFNC/Non-breather at times with CXR showing worsening effusions and colidations.Patient had some intermittent improvement with IV steroids and lasix. However, CTA thorax was obtained on 6/11 due to concern PE with worsening chest pain, tachycardia, and elevated D-dimer (b/l doppler US negative). CTA showed no evidence of PE, but worsening bilateral pleural effusions, including her chronic complex R pleural effusion with thickening and concern for possible exudative process. Bilateral lower lobe consolidations were significantly worse as well, especially on the left.  On 6/12/22, patient asked to stop aggressive cares and transition to hospice. Team spoke with patient's activated DPOA (son) and he was in agreement with patient's desire to become comfort care/hospice. Palliative care was consulted, active treatment was discontinued and comfort meds initiated.    Paged by nursing that patient had passed on evening of 6/14. On my evaluation, patient not responsive to verbal stimuli or sternal rub. Pupils fixed and nonreactive. No heart or lung sounds heard after a full minute of auscultation. Peripheral pulses not present. Death pronounced at 7:25pm. Personally notified patient's son and DPOA, of death. All questions answered.
Age: 52.0
Sex: F
Vaccine: COVID19
Symptoms: Chest X-ray abnormal, Cough, Crepitations, Influenza A virus test negative, Influenza B virus test
Clinical narrative: I received my 2nd COVID booster on Thursday 6/9/22 (age over 50).  I waited for a while as I was recovering from back surgery in March 2022.  I have not had COVID since the pandemic started. I was feeling the normal side effects of the vaccine with body aches and arm soreness until Saturday 6/11/22 when I developed a sore throat, cough and continued fever.  I did 2 covid tests @ home Saturday/Sunday and both were negative but still experiencing symptoms, especially respiratory.  I was starting to cough more so I went to urgent care first thing on Monday and they tested me for COVID, Strep and Flu A/B--all negative.  They only did telemedicine at that time so no vitals or assessment was done.  They said if I still was not feeling better to get a COVID PCR on Tuesday.  I did and that was negative too;  I was having more respiratory issues so I went back to urgent care and the did a chest x-ray which revealed pneumonia with wheezing and crackles.  I'm reporting this as I thought it was kind of unusual that I got pneumonia following the vaccine which probably started two days post the vaccine.  No longer have fever and respiratory is improved but still have a cough.  Also as a side note I'm seeing a rheumatologist at the end of July for possible psoriatic arthritis (my spine doctor recommended this due to a psoriasis type of rash on my elbows).  I was treated with Zithro, steroids, inhalers and a prescription cough medicine.
Age: 52.0
Sex: F
Vaccine: COVID19
Symptoms: Oropharyngeal pain, Pain, Pain in extremity, Pneumonia, Pyrexia
Clinical narrative: I received my 2nd COVID booster on Thursday 6/9/22 (age over 50).  I waited for a while as I was recovering from back surgery in March 2022.  I have not had COVID since the pandemic started. I was feeling the normal side effects of the vaccine with body aches and arm soreness until Saturday 6/11/22 when I developed a sore throat, cough and continued fever.  I did 2 covid tests @ home Saturday/Sunday and both were negative but still experiencing symptoms, especially respiratory.  I was starting to cough more so I went to urgent care first thing on Monday and they tested me for COVID, Strep and Flu A/B--all negative.  They only did telemedicine at that time so no vitals or assessment was done.  They said if I still was not feeling better to get a COVID PCR on Tuesday.  I did and that was negative too;  I was having more respiratory issues so I went back to urgent care and the did a chest x-ray which revealed pneumonia with wheezing and crackles.  I'm reporting this as I thought it was kind of unusual that I got pneumonia following the vaccine which probably started two days post the vaccine.  No longer have fever and respiratory is improved but still have a cough.  Also as a side note I'm seeing a rheumatologist at the end of July for possible psoriatic arthritis (my spine doctor recommended this due to a psoriasis type of rash on my elbows).  I was treated with Zithro, steroids, inhalers and a prescription cough medicine.
Age: 52.0
Sex: F
Vaccine: COVID19
Symptoms: Respiratory symptom, SARS-CoV-2 test negative, Streptococcus test negative, Wheezing
Clinical narrative: I received my 2nd COVID booster on Thursday 6/9/22 (age over 50).  I waited for a while as I was recovering from back surgery in March 2022.  I have not had COVID since the pandemic started. I was feeling the normal side effects of the vaccine with body aches and arm soreness until Saturday 6/11/22 when I developed a sore throat, cough and continued fever.  I did 2 covid tests @ home Saturday/Sunday and both were negative but still experiencing symptoms, especially respiratory.  I was starting to cough more so I went to urgent care first thing on Monday and they tested me for COVID, Strep and Flu A/B--all negative.  They only did telemedicine at that time so no vitals or assessment was done.  They said if I still was not feeling better to get a COVID PCR on Tuesday.  I did and that was negative too;  I was having more respiratory issues so I went back to urgent care and the did a chest x-ray which revealed pneumonia with wheezing and crackles.  I'm reporting this as I thought it was kind of unusual that I got pneumonia following the vaccine which probably started two days post the vaccine.  No longer have fever and respiratory is improved but still have a cough.  Also as a side note I'm seeing a rheumatologist at the end of July for possible psoriatic arthritis (my spine doctor recommended this due to a psoriasis type of rash on my elbows).  I was treated with Zithro, steroids, inhalers and a prescription cough medicine.
Age: 75.0
Sex: F
Vaccine: COVID19
Symptoms: Acute respiratory failure, Angiogram pulmonary abnormal, Blood phosphorus decreased, Blood potassium decreased, Bronchial secretion retention
Clinical narrative: Discharge Provider: "Private" DO Primary Care Provider: "Private" DNP, A-GNP Admission Date: 6/9/2022 Discharge Date: Jun 13, 2022  DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Nonspecific chest pain [R07.9] Acute hypoxemic respiratory failure due to COVID-19 (HCC) [U07.1, J96.01] COVID-19 [U07.1]   HOSPITAL COURSE: Patient is a 75y.o. female with a HX of COPD, as well as loss of sense of taste and smell d/t sinus surgery, and NSCLC on left with resection of middle lobe, who presented to the local ER on 6/9/2022 with worsening shortness of breath and left sided chest discomfort. Work-up in the ER r/o cardiac etiology for her chest discomfort but she was found to be COVID-19 positive. In addition she was found to be hypoxic with mild exertion and hypertensive w/o prior HX of HTN. Chest imaging was not consistent with presence of pneumonia. She was admitted for TX of COVID-19 associated acute on chronic bronchitis. She required 4 liters of O2 supplement via NC. She was started on Dexamethasone 6 g q day per protocol. A repeat X-ray revealed what appeared to be worsening air space opacity and pleural fluid on the left. As a result CT angio chest was performed revealing a mucus plug in the left main bronchus. There was no evidence of pneumothorax or PE. Given the proximity of the mucus plug, we contacted the vICU team for input re: the possibility for transfer to higher echelon of care to undergo bronchoscopy. The recommendation was to encourage use of flutter valve device as well as huff coughing and increasing ambulation as tolerated. By 6/12 in the AM the patient's O2 requirement had improved to 2 and subsequently in the evening was weaned off O2 supplement except at bedtime. For reference, her home O2 requirements are 2L via NC at bedtime. Serum potassium and Phos was noted to be low thus PO supplement was initiated. On 6/13 with labs and vitals in stable condition and the patient feeling back to baseline she was discharged to home.
Age: 75.0
Sex: F
Vaccine: COVID19
Symptoms: Bronchitis, COVID-19, Chest X-ray abnormal, Chest discomfort, Chest pain
Clinical narrative: Discharge Provider: "Private" DO Primary Care Provider: "Private" DNP, A-GNP Admission Date: 6/9/2022 Discharge Date: Jun 13, 2022  DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Nonspecific chest pain [R07.9] Acute hypoxemic respiratory failure due to COVID-19 (HCC) [U07.1, J96.01] COVID-19 [U07.1]   HOSPITAL COURSE: Patient is a 75y.o. female with a HX of COPD, as well as loss of sense of taste and smell d/t sinus surgery, and NSCLC on left with resection of middle lobe, who presented to the local ER on 6/9/2022 with worsening shortness of breath and left sided chest discomfort. Work-up in the ER r/o cardiac etiology for her chest discomfort but she was found to be COVID-19 positive. In addition she was found to be hypoxic with mild exertion and hypertensive w/o prior HX of HTN. Chest imaging was not consistent with presence of pneumonia. She was admitted for TX of COVID-19 associated acute on chronic bronchitis. She required 4 liters of O2 supplement via NC. She was started on Dexamethasone 6 g q day per protocol. A repeat X-ray revealed what appeared to be worsening air space opacity and pleural fluid on the left. As a result CT angio chest was performed revealing a mucus plug in the left main bronchus. There was no evidence of pneumothorax or PE. Given the proximity of the mucus plug, we contacted the vICU team for input re: the possibility for transfer to higher echelon of care to undergo bronchoscopy. The recommendation was to encourage use of flutter valve device as well as huff coughing and increasing ambulation as tolerated. By 6/12 in the AM the patient's O2 requirement had improved to 2 and subsequently in the evening was weaned off O2 supplement except at bedtime. For reference, her home O2 requirements are 2L via NC at bedtime. Serum potassium and Phos was noted to be low thus PO supplement was initiated. On 6/13 with labs and vitals in stable condition and the patient feeling back to baseline she was discharged to home.
Age: 75.0
Sex: F
Vaccine: COVID19
Symptoms: Dyspnoea, Hypertension, Hypoxia, Lung opacity, Pleural effusion
Clinical narrative: Discharge Provider: "Private" DO Primary Care Provider: "Private" DNP, A-GNP Admission Date: 6/9/2022 Discharge Date: Jun 13, 2022  DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Nonspecific chest pain [R07.9] Acute hypoxemic respiratory failure due to COVID-19 (HCC) [U07.1, J96.01] COVID-19 [U07.1]   HOSPITAL COURSE: Patient is a 75y.o. female with a HX of COPD, as well as loss of sense of taste and smell d/t sinus surgery, and NSCLC on left with resection of middle lobe, who presented to the local ER on 6/9/2022 with worsening shortness of breath and left sided chest discomfort. Work-up in the ER r/o cardiac etiology for her chest discomfort but she was found to be COVID-19 positive. In addition she was found to be hypoxic with mild exertion and hypertensive w/o prior HX of HTN. Chest imaging was not consistent with presence of pneumonia. She was admitted for TX of COVID-19 associated acute on chronic bronchitis. She required 4 liters of O2 supplement via NC. She was started on Dexamethasone 6 g q day per protocol. A repeat X-ray revealed what appeared to be worsening air space opacity and pleural fluid on the left. As a result CT angio chest was performed revealing a mucus plug in the left main bronchus. There was no evidence of pneumothorax or PE. Given the proximity of the mucus plug, we contacted the vICU team for input re: the possibility for transfer to higher echelon of care to undergo bronchoscopy. The recommendation was to encourage use of flutter valve device as well as huff coughing and increasing ambulation as tolerated. By 6/12 in the AM the patient's O2 requirement had improved to 2 and subsequently in the evening was weaned off O2 supplement except at bedtime. For reference, her home O2 requirements are 2L via NC at bedtime. Serum potassium and Phos was noted to be low thus PO supplement was initiated. On 6/13 with labs and vitals in stable condition and the patient feeling back to baseline she was discharged to home.
Age: 75.0
Sex: F
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive
Clinical narrative: Discharge Provider: "Private" DO Primary Care Provider: "Private" DNP, A-GNP Admission Date: 6/9/2022 Discharge Date: Jun 13, 2022  DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Nonspecific chest pain [R07.9] Acute hypoxemic respiratory failure due to COVID-19 (HCC) [U07.1, J96.01] COVID-19 [U07.1]   HOSPITAL COURSE: Patient is a 75y.o. female with a HX of COPD, as well as loss of sense of taste and smell d/t sinus surgery, and NSCLC on left with resection of middle lobe, who presented to the local ER on 6/9/2022 with worsening shortness of breath and left sided chest discomfort. Work-up in the ER r/o cardiac etiology for her chest discomfort but she was found to be COVID-19 positive. In addition she was found to be hypoxic with mild exertion and hypertensive w/o prior HX of HTN. Chest imaging was not consistent with presence of pneumonia. She was admitted for TX of COVID-19 associated acute on chronic bronchitis. She required 4 liters of O2 supplement via NC. She was started on Dexamethasone 6 g q day per protocol. A repeat X-ray revealed what appeared to be worsening air space opacity and pleural fluid on the left. As a result CT angio chest was performed revealing a mucus plug in the left main bronchus. There was no evidence of pneumothorax or PE. Given the proximity of the mucus plug, we contacted the vICU team for input re: the possibility for transfer to higher echelon of care to undergo bronchoscopy. The recommendation was to encourage use of flutter valve device as well as huff coughing and increasing ambulation as tolerated. By 6/12 in the AM the patient's O2 requirement had improved to 2 and subsequently in the evening was weaned off O2 supplement except at bedtime. For reference, her home O2 requirements are 2L via NC at bedtime. Serum potassium and Phos was noted to be low thus PO supplement was initiated. On 6/13 with labs and vitals in stable condition and the patient feeling back to baseline she was discharged to home.
Age: 58.0
Sex: F
Vaccine: VARCEL
Symptoms: Expired product administered
Clinical narrative: vaccine was given then noted that it had expired the previous month 05/08/2022 vaccine was given 06/16/2022
Age: 55.0
Sex: F
Vaccine: COVID19
Symptoms: Amnesia, Arthralgia, Fatigue, Feeling abnormal, Musculoskeletal stiffness
Clinical narrative: severe joint pain including stiffening up of extremities starting the evening of the vaccine and lasting 24 hours afterwards.   Unusually bad muscle pain (compared to previous three Pfizer vaccines) starting the evening of the vaccine and lasting 24 hours afterwards.   Unusually bad fatigue (compared to previous three Pfizer vaccines) starting the evening of the vaccine and lasting 4 days afterwards.   Severe brain fog including loss of memory up to three days after vaccine.
Age: 55.0
Sex: F
Vaccine: COVID19
Symptoms: Myalgia
Clinical narrative: severe joint pain including stiffening up of extremities starting the evening of the vaccine and lasting 24 hours afterwards.   Unusually bad muscle pain (compared to previous three Pfizer vaccines) starting the evening of the vaccine and lasting 24 hours afterwards.   Unusually bad fatigue (compared to previous three Pfizer vaccines) starting the evening of the vaccine and lasting 4 days afterwards.   Severe brain fog including loss of memory up to three days after vaccine.
Age: 60.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Pt vaccinated x3 (Pfizer: 3/22/21, 4/12/21, 10/28/21) Pt tested positive for COVID 6/17/22 and admitted to hospital
Age: 4.0
Sex: M
Vaccine: DTAPIPV
Symptoms: Expired product administered
Clinical narrative: Child was given accidentally an expired dose of Kinrix. When I verified the expiration date I read it was July 4th instead of June 4th. Did not notice until after given that was expired. Mother was advised of the incident by nurse manager. Mother understood and all questions were answered. Per CDC guidelines, vaccine could have been re-administered today, but mother declined and will come back to receive vaccine. Vaccine records were printed and provided to mother with the vaccine highlighted so mother knew which vaccine needed to be repeated.
Age: 3.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect dose administered, Injection site swelling
Clinical narrative: 3 year old Pt was given pediatric dose of Pfizer Covid-19 injection of 0.2mL/10mcg instead of 0.2mL/3mcg. Follow up completed with Pt's parents 3 days later who state that the Pt has no side effects besides some localized swelling at the injection site. Pt is well and acting normally.