"Notes"	"VAERS ID"	"VAERS ID Code"	"Symptoms"	"Symptoms Code"	"Age"	"Age Code"	Adverse Event Description
	"0918518-1"	"0918518-1"	"AUTOPSY"	"10050117"	"50-59 years"	"50-59"	"syncopal episode - arrested - CPR - death"
	"0918518-1"	"0918518-1"	"CARDIO-RESPIRATORY ARREST"	"10007617"	"50-59 years"	"50-59"	"syncopal episode - arrested - CPR - death"
	"0918518-1"	"0918518-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"syncopal episode - arrested - CPR - death"
	"0918518-1"	"0918518-1"	"RESUSCITATION"	"10038749"	"50-59 years"	"50-59"	"syncopal episode - arrested - CPR - death"
	"0918518-1"	"0918518-1"	"SYNCOPE"	"10042772"	"50-59 years"	"50-59"	"syncopal episode - arrested - CPR - death"
	"0920815-1"	"0920815-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Found deceased in her home, unknown cause, 6 days after vaccine."
	"0921768-1"	"0921768-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"Vaccine received at about 0900 on 01/04/2021 at her place of work, Medical Center, where she was employed as a housekeeper. About one hour after receiving the vaccine she experienced a hot flash, nausea, and feeling like she was going to pass out after she had bent down. Later at about 1500 hours she appeared tired and lethargic, then a short time later, at about 1600 hours, upon arrival to a friends home she complained of feeling hot and having difficulty breathing. She then collapsed, then when medics arrived, she was still breathing slowly then went into cardiac arrest and was unable to be revived."
	"0921768-1"	"0921768-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Vaccine received at about 0900 on 01/04/2021 at her place of work, Medical Center, where she was employed as a housekeeper. About one hour after receiving the vaccine she experienced a hot flash, nausea, and feeling like she was going to pass out after she had bent down. Later at about 1500 hours she appeared tired and lethargic, then a short time later, at about 1600 hours, upon arrival to a friends home she complained of feeling hot and having difficulty breathing. She then collapsed, then when medics arrived, she was still breathing slowly then went into cardiac arrest and was unable to be revived."
	"0921768-1"	"0921768-1"	"DIZZINESS"	"10013573"	"50-59 years"	"50-59"	"Vaccine received at about 0900 on 01/04/2021 at her place of work, Medical Center, where she was employed as a housekeeper. About one hour after receiving the vaccine she experienced a hot flash, nausea, and feeling like she was going to pass out after she had bent down. Later at about 1500 hours she appeared tired and lethargic, then a short time later, at about 1600 hours, upon arrival to a friends home she complained of feeling hot and having difficulty breathing. She then collapsed, then when medics arrived, she was still breathing slowly then went into cardiac arrest and was unable to be revived."
	"0921768-1"	"0921768-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"Vaccine received at about 0900 on 01/04/2021 at her place of work, Medical Center, where she was employed as a housekeeper. About one hour after receiving the vaccine she experienced a hot flash, nausea, and feeling like she was going to pass out after she had bent down. Later at about 1500 hours she appeared tired and lethargic, then a short time later, at about 1600 hours, upon arrival to a friends home she complained of feeling hot and having difficulty breathing. She then collapsed, then when medics arrived, she was still breathing slowly then went into cardiac arrest and was unable to be revived."
	"0921768-1"	"0921768-1"	"FATIGUE"	"10016256"	"50-59 years"	"50-59"	"Vaccine received at about 0900 on 01/04/2021 at her place of work, Medical Center, where she was employed as a housekeeper. About one hour after receiving the vaccine she experienced a hot flash, nausea, and feeling like she was going to pass out after she had bent down. Later at about 1500 hours she appeared tired and lethargic, then a short time later, at about 1600 hours, upon arrival to a friends home she complained of feeling hot and having difficulty breathing. She then collapsed, then when medics arrived, she was still breathing slowly then went into cardiac arrest and was unable to be revived."
	"0921768-1"	"0921768-1"	"FEELING HOT"	"10016334"	"50-59 years"	"50-59"	"Vaccine received at about 0900 on 01/04/2021 at her place of work, Medical Center, where she was employed as a housekeeper. About one hour after receiving the vaccine she experienced a hot flash, nausea, and feeling like she was going to pass out after she had bent down. Later at about 1500 hours she appeared tired and lethargic, then a short time later, at about 1600 hours, upon arrival to a friends home she complained of feeling hot and having difficulty breathing. She then collapsed, then when medics arrived, she was still breathing slowly then went into cardiac arrest and was unable to be revived."
	"0921768-1"	"0921768-1"	"HOT FLUSH"	"10060800"	"50-59 years"	"50-59"	"Vaccine received at about 0900 on 01/04/2021 at her place of work, Medical Center, where she was employed as a housekeeper. About one hour after receiving the vaccine she experienced a hot flash, nausea, and feeling like she was going to pass out after she had bent down. Later at about 1500 hours she appeared tired and lethargic, then a short time later, at about 1600 hours, upon arrival to a friends home she complained of feeling hot and having difficulty breathing. She then collapsed, then when medics arrived, she was still breathing slowly then went into cardiac arrest and was unable to be revived."
	"0921768-1"	"0921768-1"	"LETHARGY"	"10024264"	"50-59 years"	"50-59"	"Vaccine received at about 0900 on 01/04/2021 at her place of work, Medical Center, where she was employed as a housekeeper. About one hour after receiving the vaccine she experienced a hot flash, nausea, and feeling like she was going to pass out after she had bent down. Later at about 1500 hours she appeared tired and lethargic, then a short time later, at about 1600 hours, upon arrival to a friends home she complained of feeling hot and having difficulty breathing. She then collapsed, then when medics arrived, she was still breathing slowly then went into cardiac arrest and was unable to be revived."
	"0921768-1"	"0921768-1"	"NAUSEA"	"10028813"	"50-59 years"	"50-59"	"Vaccine received at about 0900 on 01/04/2021 at her place of work, Medical Center, where she was employed as a housekeeper. About one hour after receiving the vaccine she experienced a hot flash, nausea, and feeling like she was going to pass out after she had bent down. Later at about 1500 hours she appeared tired and lethargic, then a short time later, at about 1600 hours, upon arrival to a friends home she complained of feeling hot and having difficulty breathing. She then collapsed, then when medics arrived, she was still breathing slowly then went into cardiac arrest and was unable to be revived."
	"0921768-1"	"0921768-1"	"RESPIRATORY RATE DECREASED"	"10038710"	"50-59 years"	"50-59"	"Vaccine received at about 0900 on 01/04/2021 at her place of work, Medical Center, where she was employed as a housekeeper. About one hour after receiving the vaccine she experienced a hot flash, nausea, and feeling like she was going to pass out after she had bent down. Later at about 1500 hours she appeared tired and lethargic, then a short time later, at about 1600 hours, upon arrival to a friends home she complained of feeling hot and having difficulty breathing. She then collapsed, then when medics arrived, she was still breathing slowly then went into cardiac arrest and was unable to be revived."
	"0921768-1"	"0921768-1"	"SYNCOPE"	"10042772"	"50-59 years"	"50-59"	"Vaccine received at about 0900 on 01/04/2021 at her place of work, Medical Center, where she was employed as a housekeeper. About one hour after receiving the vaccine she experienced a hot flash, nausea, and feeling like she was going to pass out after she had bent down. Later at about 1500 hours she appeared tired and lethargic, then a short time later, at about 1600 hours, upon arrival to a friends home she complained of feeling hot and having difficulty breathing. She then collapsed, then when medics arrived, she was still breathing slowly then went into cardiac arrest and was unable to be revived."
	"0928933-1"	"0928933-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient had been diagnosed with COVID-19 on Dec. 11th, 2020. Symptoms were thought to have started on 12/5/2020. Received Moderna vaccine on 12/23. Unexpected death on 1/8/2021. Resuscitation attempts unsuccessful"
	"0928933-1"	"0928933-1"	"RESUSCITATION"	"10038749"	"50-59 years"	"50-59"	"Patient had been diagnosed with COVID-19 on Dec. 11th, 2020. Symptoms were thought to have started on 12/5/2020. Received Moderna vaccine on 12/23. Unexpected death on 1/8/2021. Resuscitation attempts unsuccessful"
	"0930910-1"	"0930910-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient received COVID vaccination around 12:15pm. Patient was monitored for the appropriate amount of time by nursing staff. Patient passed away at 2:15pm."
	"0933739-1"	"0933739-1"	"BRAIN DEATH"	"10049054"	"50-59 years"	"50-59"	""Staff member checked on her at 3am and patient stated that she felt like she couldn't breathe.  911 was called and taken to the hospital.  While in the ambulance, patient coded.  Patient was given CPR and ""brought back"".  Once at the hospital, patient was placed on a ventilator and efforts were made to contact the guardian for end of life decisions.  Two EEGs were given to determine that patient had no brain activity.  Guardian, made the decision to end all life saving measures.  Patient was taken off the ventilator on 1/9/2021 and passed away at 1:30am on 1/10/2021.  The initial indication from the ICU doctor was the patient had a mucus plug that she couldn't clear.""
	"0933739-1"	"0933739-1"	"BRONCHIAL SECRETION RETENTION"	"10066820"	"50-59 years"	"50-59"	""Staff member checked on her at 3am and patient stated that she felt like she couldn't breathe.  911 was called and taken to the hospital.  While in the ambulance, patient coded.  Patient was given CPR and ""brought back"".  Once at the hospital, patient was placed on a ventilator and efforts were made to contact the guardian for end of life decisions.  Two EEGs were given to determine that patient had no brain activity.  Guardian, made the decision to end all life saving measures.  Patient was taken off the ventilator on 1/9/2021 and passed away at 1:30am on 1/10/2021.  The initial indication from the ICU doctor was the patient had a mucus plug that she couldn't clear.""
	"0933739-1"	"0933739-1"	"CARDIO-RESPIRATORY ARREST"	"10007617"	"50-59 years"	"50-59"	""Staff member checked on her at 3am and patient stated that she felt like she couldn't breathe.  911 was called and taken to the hospital.  While in the ambulance, patient coded.  Patient was given CPR and ""brought back"".  Once at the hospital, patient was placed on a ventilator and efforts were made to contact the guardian for end of life decisions.  Two EEGs were given to determine that patient had no brain activity.  Guardian, made the decision to end all life saving measures.  Patient was taken off the ventilator on 1/9/2021 and passed away at 1:30am on 1/10/2021.  The initial indication from the ICU doctor was the patient had a mucus plug that she couldn't clear.""
	"0933739-1"	"0933739-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	""Staff member checked on her at 3am and patient stated that she felt like she couldn't breathe.  911 was called and taken to the hospital.  While in the ambulance, patient coded.  Patient was given CPR and ""brought back"".  Once at the hospital, patient was placed on a ventilator and efforts were made to contact the guardian for end of life decisions.  Two EEGs were given to determine that patient had no brain activity.  Guardian, made the decision to end all life saving measures.  Patient was taken off the ventilator on 1/9/2021 and passed away at 1:30am on 1/10/2021.  The initial indication from the ICU doctor was the patient had a mucus plug that she couldn't clear.""
	"0933739-1"	"0933739-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	""Staff member checked on her at 3am and patient stated that she felt like she couldn't breathe.  911 was called and taken to the hospital.  While in the ambulance, patient coded.  Patient was given CPR and ""brought back"".  Once at the hospital, patient was placed on a ventilator and efforts were made to contact the guardian for end of life decisions.  Two EEGs were given to determine that patient had no brain activity.  Guardian, made the decision to end all life saving measures.  Patient was taken off the ventilator on 1/9/2021 and passed away at 1:30am on 1/10/2021.  The initial indication from the ICU doctor was the patient had a mucus plug that she couldn't clear.""
	"0933739-1"	"0933739-1"	"ELECTROENCEPHALOGRAM ABNORMAL"	"10014408"	"50-59 years"	"50-59"	""Staff member checked on her at 3am and patient stated that she felt like she couldn't breathe.  911 was called and taken to the hospital.  While in the ambulance, patient coded.  Patient was given CPR and ""brought back"".  Once at the hospital, patient was placed on a ventilator and efforts were made to contact the guardian for end of life decisions.  Two EEGs were given to determine that patient had no brain activity.  Guardian, made the decision to end all life saving measures.  Patient was taken off the ventilator on 1/9/2021 and passed away at 1:30am on 1/10/2021.  The initial indication from the ICU doctor was the patient had a mucus plug that she couldn't clear.""
	"0933739-1"	"0933739-1"	"INTENSIVE CARE"	"10022519"	"50-59 years"	"50-59"	""Staff member checked on her at 3am and patient stated that she felt like she couldn't breathe.  911 was called and taken to the hospital.  While in the ambulance, patient coded.  Patient was given CPR and ""brought back"".  Once at the hospital, patient was placed on a ventilator and efforts were made to contact the guardian for end of life decisions.  Two EEGs were given to determine that patient had no brain activity.  Guardian, made the decision to end all life saving measures.  Patient was taken off the ventilator on 1/9/2021 and passed away at 1:30am on 1/10/2021.  The initial indication from the ICU doctor was the patient had a mucus plug that she couldn't clear.""
	"0933739-1"	"0933739-1"	"MECHANICAL VENTILATION"	"10067221"	"50-59 years"	"50-59"	""Staff member checked on her at 3am and patient stated that she felt like she couldn't breathe.  911 was called and taken to the hospital.  While in the ambulance, patient coded.  Patient was given CPR and ""brought back"".  Once at the hospital, patient was placed on a ventilator and efforts were made to contact the guardian for end of life decisions.  Two EEGs were given to determine that patient had no brain activity.  Guardian, made the decision to end all life saving measures.  Patient was taken off the ventilator on 1/9/2021 and passed away at 1:30am on 1/10/2021.  The initial indication from the ICU doctor was the patient had a mucus plug that she couldn't clear.""
	"0933739-1"	"0933739-1"	"RESUSCITATION"	"10038749"	"50-59 years"	"50-59"	""Staff member checked on her at 3am and patient stated that she felt like she couldn't breathe.  911 was called and taken to the hospital.  While in the ambulance, patient coded.  Patient was given CPR and ""brought back"".  Once at the hospital, patient was placed on a ventilator and efforts were made to contact the guardian for end of life decisions.  Two EEGs were given to determine that patient had no brain activity.  Guardian, made the decision to end all life saving measures.  Patient was taken off the ventilator on 1/9/2021 and passed away at 1:30am on 1/10/2021.  The initial indication from the ICU doctor was the patient had a mucus plug that she couldn't clear.""
	"0933739-1"	"0933739-1"	"SARS-COV-2 TEST NEGATIVE"	"10084273"	"50-59 years"	"50-59"	""Staff member checked on her at 3am and patient stated that she felt like she couldn't breathe.  911 was called and taken to the hospital.  While in the ambulance, patient coded.  Patient was given CPR and ""brought back"".  Once at the hospital, patient was placed on a ventilator and efforts were made to contact the guardian for end of life decisions.  Two EEGs were given to determine that patient had no brain activity.  Guardian, made the decision to end all life saving measures.  Patient was taken off the ventilator on 1/9/2021 and passed away at 1:30am on 1/10/2021.  The initial indication from the ICU doctor was the patient had a mucus plug that she couldn't clear.""
	"0933739-1"	"0933739-1"	"WITHDRAWAL OF LIFE SUPPORT"	"10067595"	"50-59 years"	"50-59"	""Staff member checked on her at 3am and patient stated that she felt like she couldn't breathe.  911 was called and taken to the hospital.  While in the ambulance, patient coded.  Patient was given CPR and ""brought back"".  Once at the hospital, patient was placed on a ventilator and efforts were made to contact the guardian for end of life decisions.  Two EEGs were given to determine that patient had no brain activity.  Guardian, made the decision to end all life saving measures.  Patient was taken off the ventilator on 1/9/2021 and passed away at 1:30am on 1/10/2021.  The initial indication from the ICU doctor was the patient had a mucus plug that she couldn't clear.""
	"0934968-1"	"0934968-1"	"AGITATION"	"10001497"	"50-59 years"	"50-59"	"he passed away; not responsive; mind just seemed like it was racing; body was hyper dried; Restless; not feeling well; ate a bit but not much; kind of pale; Agitated; Vomiting; trouble in breathing; This is a spontaneous report from a contactable consumer (brother of the patient). A 54-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, on 04Jan2021 (at the age of 54-years-old) as a single dose for COVID-19 immunization. Medical history included diabetes and high blood pressure. Concomitant medications included metformin (MANUFACTURER UNKNOWN) taken for diabetes, glimepiride (MANUFACTURER UNKNOWN) taken for diabetes, lisinopril (MANUFACTURER UNKNOWN), and amlodipine (MANUFACTURER UNKNOWN). The patient experienced not feeling well, ate a bit but not much, kind of pale, vomiting, trouble in breathing, and agitated on 04Jan2021; body was hyper dried and restless on 05Jan2021; mind just seemed like it was racing on 06Jan2021; and not responsive and he passed away on 06Jan2021 at 10:15 (reported as: around 10:15 AM). The clinical course was reported as follows: The patient received the vaccine on 04Jan2021, after which he started not feeling well. He went right home and went to bed. He woke up and ate a bit but not much and then was kind of pale. The patient then started to vomit, which continued throughout the night. He was having trouble in breathing. Emergency services were called, and they took his vitals and said that everything was okay, but he was very agitated; reported as not like this prior to the vaccine. The patient was taken to urgent care where they gave him an unspecified steroid shot and unspecified medication for vomiting. The patient was told he was probably having a reaction to the vaccine, but he was just dried up. The patient continued to vomit throughout the day and then he was very agitated again and would fall asleep for may be 15-20 minutes. When the patient woke up, he was very restless (reported as: his body was just amped up and could not calm down). The patient calmed down just a little bit in the evening. When the patient was awoken at 6:00 AM in the morning, he was still agitated. The patient stated that he couldn't breathe, and his mind was racing. The patient's other brother went to him and he was not responsive, and he passed away on 06Jan2021 around 10:15 AM. It was reported that none of the symptoms occurred until the patient received the vaccine. Therapeutic measures were taken as a result of vomiting as aforementioned. The clinical outcome of all of the events was unknown; not responsive was not recovered, the patient died on 06Jan2021. The cause of death was unknown (reported as: not known by reporter). An autopsy was not performed.  The batch/lot number for the vaccine, BNT162B2, was not provided and has been requested during follow up.; Reported Cause(s) of Death: not responsive and he passed away"
	"0934968-1"	"0934968-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"he passed away; not responsive; mind just seemed like it was racing; body was hyper dried; Restless; not feeling well; ate a bit but not much; kind of pale; Agitated; Vomiting; trouble in breathing; This is a spontaneous report from a contactable consumer (brother of the patient). A 54-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, on 04Jan2021 (at the age of 54-years-old) as a single dose for COVID-19 immunization. Medical history included diabetes and high blood pressure. Concomitant medications included metformin (MANUFACTURER UNKNOWN) taken for diabetes, glimepiride (MANUFACTURER UNKNOWN) taken for diabetes, lisinopril (MANUFACTURER UNKNOWN), and amlodipine (MANUFACTURER UNKNOWN). The patient experienced not feeling well, ate a bit but not much, kind of pale, vomiting, trouble in breathing, and agitated on 04Jan2021; body was hyper dried and restless on 05Jan2021; mind just seemed like it was racing on 06Jan2021; and not responsive and he passed away on 06Jan2021 at 10:15 (reported as: around 10:15 AM). The clinical course was reported as follows: The patient received the vaccine on 04Jan2021, after which he started not feeling well. He went right home and went to bed. He woke up and ate a bit but not much and then was kind of pale. The patient then started to vomit, which continued throughout the night. He was having trouble in breathing. Emergency services were called, and they took his vitals and said that everything was okay, but he was very agitated; reported as not like this prior to the vaccine. The patient was taken to urgent care where they gave him an unspecified steroid shot and unspecified medication for vomiting. The patient was told he was probably having a reaction to the vaccine, but he was just dried up. The patient continued to vomit throughout the day and then he was very agitated again and would fall asleep for may be 15-20 minutes. When the patient woke up, he was very restless (reported as: his body was just amped up and could not calm down). The patient calmed down just a little bit in the evening. When the patient was awoken at 6:00 AM in the morning, he was still agitated. The patient stated that he couldn't breathe, and his mind was racing. The patient's other brother went to him and he was not responsive, and he passed away on 06Jan2021 around 10:15 AM. It was reported that none of the symptoms occurred until the patient received the vaccine. Therapeutic measures were taken as a result of vomiting as aforementioned. The clinical outcome of all of the events was unknown; not responsive was not recovered, the patient died on 06Jan2021. The cause of death was unknown (reported as: not known by reporter). An autopsy was not performed.  The batch/lot number for the vaccine, BNT162B2, was not provided and has been requested during follow up.; Reported Cause(s) of Death: not responsive and he passed away"
	"0934968-1"	"0934968-1"	"DECREASED APPETITE"	"10061428"	"50-59 years"	"50-59"	"he passed away; not responsive; mind just seemed like it was racing; body was hyper dried; Restless; not feeling well; ate a bit but not much; kind of pale; Agitated; Vomiting; trouble in breathing; This is a spontaneous report from a contactable consumer (brother of the patient). A 54-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, on 04Jan2021 (at the age of 54-years-old) as a single dose for COVID-19 immunization. Medical history included diabetes and high blood pressure. Concomitant medications included metformin (MANUFACTURER UNKNOWN) taken for diabetes, glimepiride (MANUFACTURER UNKNOWN) taken for diabetes, lisinopril (MANUFACTURER UNKNOWN), and amlodipine (MANUFACTURER UNKNOWN). The patient experienced not feeling well, ate a bit but not much, kind of pale, vomiting, trouble in breathing, and agitated on 04Jan2021; body was hyper dried and restless on 05Jan2021; mind just seemed like it was racing on 06Jan2021; and not responsive and he passed away on 06Jan2021 at 10:15 (reported as: around 10:15 AM). The clinical course was reported as follows: The patient received the vaccine on 04Jan2021, after which he started not feeling well. He went right home and went to bed. He woke up and ate a bit but not much and then was kind of pale. The patient then started to vomit, which continued throughout the night. He was having trouble in breathing. Emergency services were called, and they took his vitals and said that everything was okay, but he was very agitated; reported as not like this prior to the vaccine. The patient was taken to urgent care where they gave him an unspecified steroid shot and unspecified medication for vomiting. The patient was told he was probably having a reaction to the vaccine, but he was just dried up. The patient continued to vomit throughout the day and then he was very agitated again and would fall asleep for may be 15-20 minutes. When the patient woke up, he was very restless (reported as: his body was just amped up and could not calm down). The patient calmed down just a little bit in the evening. When the patient was awoken at 6:00 AM in the morning, he was still agitated. The patient stated that he couldn't breathe, and his mind was racing. The patient's other brother went to him and he was not responsive, and he passed away on 06Jan2021 around 10:15 AM. It was reported that none of the symptoms occurred until the patient received the vaccine. Therapeutic measures were taken as a result of vomiting as aforementioned. The clinical outcome of all of the events was unknown; not responsive was not recovered, the patient died on 06Jan2021. The cause of death was unknown (reported as: not known by reporter). An autopsy was not performed.  The batch/lot number for the vaccine, BNT162B2, was not provided and has been requested during follow up.; Reported Cause(s) of Death: not responsive and he passed away"
	"0934968-1"	"0934968-1"	"DEHYDRATION"	"10012174"	"50-59 years"	"50-59"	"he passed away; not responsive; mind just seemed like it was racing; body was hyper dried; Restless; not feeling well; ate a bit but not much; kind of pale; Agitated; Vomiting; trouble in breathing; This is a spontaneous report from a contactable consumer (brother of the patient). A 54-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, on 04Jan2021 (at the age of 54-years-old) as a single dose for COVID-19 immunization. Medical history included diabetes and high blood pressure. Concomitant medications included metformin (MANUFACTURER UNKNOWN) taken for diabetes, glimepiride (MANUFACTURER UNKNOWN) taken for diabetes, lisinopril (MANUFACTURER UNKNOWN), and amlodipine (MANUFACTURER UNKNOWN). The patient experienced not feeling well, ate a bit but not much, kind of pale, vomiting, trouble in breathing, and agitated on 04Jan2021; body was hyper dried and restless on 05Jan2021; mind just seemed like it was racing on 06Jan2021; and not responsive and he passed away on 06Jan2021 at 10:15 (reported as: around 10:15 AM). The clinical course was reported as follows: The patient received the vaccine on 04Jan2021, after which he started not feeling well. He went right home and went to bed. He woke up and ate a bit but not much and then was kind of pale. The patient then started to vomit, which continued throughout the night. He was having trouble in breathing. Emergency services were called, and they took his vitals and said that everything was okay, but he was very agitated; reported as not like this prior to the vaccine. The patient was taken to urgent care where they gave him an unspecified steroid shot and unspecified medication for vomiting. The patient was told he was probably having a reaction to the vaccine, but he was just dried up. The patient continued to vomit throughout the day and then he was very agitated again and would fall asleep for may be 15-20 minutes. When the patient woke up, he was very restless (reported as: his body was just amped up and could not calm down). The patient calmed down just a little bit in the evening. When the patient was awoken at 6:00 AM in the morning, he was still agitated. The patient stated that he couldn't breathe, and his mind was racing. The patient's other brother went to him and he was not responsive, and he passed away on 06Jan2021 around 10:15 AM. It was reported that none of the symptoms occurred until the patient received the vaccine. Therapeutic measures were taken as a result of vomiting as aforementioned. The clinical outcome of all of the events was unknown; not responsive was not recovered, the patient died on 06Jan2021. The cause of death was unknown (reported as: not known by reporter). An autopsy was not performed.  The batch/lot number for the vaccine, BNT162B2, was not provided and has been requested during follow up.; Reported Cause(s) of Death: not responsive and he passed away"
	"0934968-1"	"0934968-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"he passed away; not responsive; mind just seemed like it was racing; body was hyper dried; Restless; not feeling well; ate a bit but not much; kind of pale; Agitated; Vomiting; trouble in breathing; This is a spontaneous report from a contactable consumer (brother of the patient). A 54-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, on 04Jan2021 (at the age of 54-years-old) as a single dose for COVID-19 immunization. Medical history included diabetes and high blood pressure. Concomitant medications included metformin (MANUFACTURER UNKNOWN) taken for diabetes, glimepiride (MANUFACTURER UNKNOWN) taken for diabetes, lisinopril (MANUFACTURER UNKNOWN), and amlodipine (MANUFACTURER UNKNOWN). The patient experienced not feeling well, ate a bit but not much, kind of pale, vomiting, trouble in breathing, and agitated on 04Jan2021; body was hyper dried and restless on 05Jan2021; mind just seemed like it was racing on 06Jan2021; and not responsive and he passed away on 06Jan2021 at 10:15 (reported as: around 10:15 AM). The clinical course was reported as follows: The patient received the vaccine on 04Jan2021, after which he started not feeling well. He went right home and went to bed. He woke up and ate a bit but not much and then was kind of pale. The patient then started to vomit, which continued throughout the night. He was having trouble in breathing. Emergency services were called, and they took his vitals and said that everything was okay, but he was very agitated; reported as not like this prior to the vaccine. The patient was taken to urgent care where they gave him an unspecified steroid shot and unspecified medication for vomiting. The patient was told he was probably having a reaction to the vaccine, but he was just dried up. The patient continued to vomit throughout the day and then he was very agitated again and would fall asleep for may be 15-20 minutes. When the patient woke up, he was very restless (reported as: his body was just amped up and could not calm down). The patient calmed down just a little bit in the evening. When the patient was awoken at 6:00 AM in the morning, he was still agitated. The patient stated that he couldn't breathe, and his mind was racing. The patient's other brother went to him and he was not responsive, and he passed away on 06Jan2021 around 10:15 AM. It was reported that none of the symptoms occurred until the patient received the vaccine. Therapeutic measures were taken as a result of vomiting as aforementioned. The clinical outcome of all of the events was unknown; not responsive was not recovered, the patient died on 06Jan2021. The cause of death was unknown (reported as: not known by reporter). An autopsy was not performed.  The batch/lot number for the vaccine, BNT162B2, was not provided and has been requested during follow up.; Reported Cause(s) of Death: not responsive and he passed away"
	"0934968-1"	"0934968-1"	"MALAISE"	"10025482"	"50-59 years"	"50-59"	"he passed away; not responsive; mind just seemed like it was racing; body was hyper dried; Restless; not feeling well; ate a bit but not much; kind of pale; Agitated; Vomiting; trouble in breathing; This is a spontaneous report from a contactable consumer (brother of the patient). A 54-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, on 04Jan2021 (at the age of 54-years-old) as a single dose for COVID-19 immunization. Medical history included diabetes and high blood pressure. Concomitant medications included metformin (MANUFACTURER UNKNOWN) taken for diabetes, glimepiride (MANUFACTURER UNKNOWN) taken for diabetes, lisinopril (MANUFACTURER UNKNOWN), and amlodipine (MANUFACTURER UNKNOWN). The patient experienced not feeling well, ate a bit but not much, kind of pale, vomiting, trouble in breathing, and agitated on 04Jan2021; body was hyper dried and restless on 05Jan2021; mind just seemed like it was racing on 06Jan2021; and not responsive and he passed away on 06Jan2021 at 10:15 (reported as: around 10:15 AM). The clinical course was reported as follows: The patient received the vaccine on 04Jan2021, after which he started not feeling well. He went right home and went to bed. He woke up and ate a bit but not much and then was kind of pale. The patient then started to vomit, which continued throughout the night. He was having trouble in breathing. Emergency services were called, and they took his vitals and said that everything was okay, but he was very agitated; reported as not like this prior to the vaccine. The patient was taken to urgent care where they gave him an unspecified steroid shot and unspecified medication for vomiting. The patient was told he was probably having a reaction to the vaccine, but he was just dried up. The patient continued to vomit throughout the day and then he was very agitated again and would fall asleep for may be 15-20 minutes. When the patient woke up, he was very restless (reported as: his body was just amped up and could not calm down). The patient calmed down just a little bit in the evening. When the patient was awoken at 6:00 AM in the morning, he was still agitated. The patient stated that he couldn't breathe, and his mind was racing. The patient's other brother went to him and he was not responsive, and he passed away on 06Jan2021 around 10:15 AM. It was reported that none of the symptoms occurred until the patient received the vaccine. Therapeutic measures were taken as a result of vomiting as aforementioned. The clinical outcome of all of the events was unknown; not responsive was not recovered, the patient died on 06Jan2021. The cause of death was unknown (reported as: not known by reporter). An autopsy was not performed.  The batch/lot number for the vaccine, BNT162B2, was not provided and has been requested during follow up.; Reported Cause(s) of Death: not responsive and he passed away"
	"0934968-1"	"0934968-1"	"PALLOR"	"10033546"	"50-59 years"	"50-59"	"he passed away; not responsive; mind just seemed like it was racing; body was hyper dried; Restless; not feeling well; ate a bit but not much; kind of pale; Agitated; Vomiting; trouble in breathing; This is a spontaneous report from a contactable consumer (brother of the patient). A 54-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, on 04Jan2021 (at the age of 54-years-old) as a single dose for COVID-19 immunization. Medical history included diabetes and high blood pressure. Concomitant medications included metformin (MANUFACTURER UNKNOWN) taken for diabetes, glimepiride (MANUFACTURER UNKNOWN) taken for diabetes, lisinopril (MANUFACTURER UNKNOWN), and amlodipine (MANUFACTURER UNKNOWN). The patient experienced not feeling well, ate a bit but not much, kind of pale, vomiting, trouble in breathing, and agitated on 04Jan2021; body was hyper dried and restless on 05Jan2021; mind just seemed like it was racing on 06Jan2021; and not responsive and he passed away on 06Jan2021 at 10:15 (reported as: around 10:15 AM). The clinical course was reported as follows: The patient received the vaccine on 04Jan2021, after which he started not feeling well. He went right home and went to bed. He woke up and ate a bit but not much and then was kind of pale. The patient then started to vomit, which continued throughout the night. He was having trouble in breathing. Emergency services were called, and they took his vitals and said that everything was okay, but he was very agitated; reported as not like this prior to the vaccine. The patient was taken to urgent care where they gave him an unspecified steroid shot and unspecified medication for vomiting. The patient was told he was probably having a reaction to the vaccine, but he was just dried up. The patient continued to vomit throughout the day and then he was very agitated again and would fall asleep for may be 15-20 minutes. When the patient woke up, he was very restless (reported as: his body was just amped up and could not calm down). The patient calmed down just a little bit in the evening. When the patient was awoken at 6:00 AM in the morning, he was still agitated. The patient stated that he couldn't breathe, and his mind was racing. The patient's other brother went to him and he was not responsive, and he passed away on 06Jan2021 around 10:15 AM. It was reported that none of the symptoms occurred until the patient received the vaccine. Therapeutic measures were taken as a result of vomiting as aforementioned. The clinical outcome of all of the events was unknown; not responsive was not recovered, the patient died on 06Jan2021. The cause of death was unknown (reported as: not known by reporter). An autopsy was not performed.  The batch/lot number for the vaccine, BNT162B2, was not provided and has been requested during follow up.; Reported Cause(s) of Death: not responsive and he passed away"
	"0934968-1"	"0934968-1"	"RESTLESSNESS"	"10038743"	"50-59 years"	"50-59"	"he passed away; not responsive; mind just seemed like it was racing; body was hyper dried; Restless; not feeling well; ate a bit but not much; kind of pale; Agitated; Vomiting; trouble in breathing; This is a spontaneous report from a contactable consumer (brother of the patient). A 54-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, on 04Jan2021 (at the age of 54-years-old) as a single dose for COVID-19 immunization. Medical history included diabetes and high blood pressure. Concomitant medications included metformin (MANUFACTURER UNKNOWN) taken for diabetes, glimepiride (MANUFACTURER UNKNOWN) taken for diabetes, lisinopril (MANUFACTURER UNKNOWN), and amlodipine (MANUFACTURER UNKNOWN). The patient experienced not feeling well, ate a bit but not much, kind of pale, vomiting, trouble in breathing, and agitated on 04Jan2021; body was hyper dried and restless on 05Jan2021; mind just seemed like it was racing on 06Jan2021; and not responsive and he passed away on 06Jan2021 at 10:15 (reported as: around 10:15 AM). The clinical course was reported as follows: The patient received the vaccine on 04Jan2021, after which he started not feeling well. He went right home and went to bed. He woke up and ate a bit but not much and then was kind of pale. The patient then started to vomit, which continued throughout the night. He was having trouble in breathing. Emergency services were called, and they took his vitals and said that everything was okay, but he was very agitated; reported as not like this prior to the vaccine. The patient was taken to urgent care where they gave him an unspecified steroid shot and unspecified medication for vomiting. The patient was told he was probably having a reaction to the vaccine, but he was just dried up. The patient continued to vomit throughout the day and then he was very agitated again and would fall asleep for may be 15-20 minutes. When the patient woke up, he was very restless (reported as: his body was just amped up and could not calm down). The patient calmed down just a little bit in the evening. When the patient was awoken at 6:00 AM in the morning, he was still agitated. The patient stated that he couldn't breathe, and his mind was racing. The patient's other brother went to him and he was not responsive, and he passed away on 06Jan2021 around 10:15 AM. It was reported that none of the symptoms occurred until the patient received the vaccine. Therapeutic measures were taken as a result of vomiting as aforementioned. The clinical outcome of all of the events was unknown; not responsive was not recovered, the patient died on 06Jan2021. The cause of death was unknown (reported as: not known by reporter). An autopsy was not performed.  The batch/lot number for the vaccine, BNT162B2, was not provided and has been requested during follow up.; Reported Cause(s) of Death: not responsive and he passed away"
	"0934968-1"	"0934968-1"	"TACHYPHRENIA"	"10064805"	"50-59 years"	"50-59"	"he passed away; not responsive; mind just seemed like it was racing; body was hyper dried; Restless; not feeling well; ate a bit but not much; kind of pale; Agitated; Vomiting; trouble in breathing; This is a spontaneous report from a contactable consumer (brother of the patient). A 54-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, on 04Jan2021 (at the age of 54-years-old) as a single dose for COVID-19 immunization. Medical history included diabetes and high blood pressure. Concomitant medications included metformin (MANUFACTURER UNKNOWN) taken for diabetes, glimepiride (MANUFACTURER UNKNOWN) taken for diabetes, lisinopril (MANUFACTURER UNKNOWN), and amlodipine (MANUFACTURER UNKNOWN). The patient experienced not feeling well, ate a bit but not much, kind of pale, vomiting, trouble in breathing, and agitated on 04Jan2021; body was hyper dried and restless on 05Jan2021; mind just seemed like it was racing on 06Jan2021; and not responsive and he passed away on 06Jan2021 at 10:15 (reported as: around 10:15 AM). The clinical course was reported as follows: The patient received the vaccine on 04Jan2021, after which he started not feeling well. He went right home and went to bed. He woke up and ate a bit but not much and then was kind of pale. The patient then started to vomit, which continued throughout the night. He was having trouble in breathing. Emergency services were called, and they took his vitals and said that everything was okay, but he was very agitated; reported as not like this prior to the vaccine. The patient was taken to urgent care where they gave him an unspecified steroid shot and unspecified medication for vomiting. The patient was told he was probably having a reaction to the vaccine, but he was just dried up. The patient continued to vomit throughout the day and then he was very agitated again and would fall asleep for may be 15-20 minutes. When the patient woke up, he was very restless (reported as: his body was just amped up and could not calm down). The patient calmed down just a little bit in the evening. When the patient was awoken at 6:00 AM in the morning, he was still agitated. The patient stated that he couldn't breathe, and his mind was racing. The patient's other brother went to him and he was not responsive, and he passed away on 06Jan2021 around 10:15 AM. It was reported that none of the symptoms occurred until the patient received the vaccine. Therapeutic measures were taken as a result of vomiting as aforementioned. The clinical outcome of all of the events was unknown; not responsive was not recovered, the patient died on 06Jan2021. The cause of death was unknown (reported as: not known by reporter). An autopsy was not performed.  The batch/lot number for the vaccine, BNT162B2, was not provided and has been requested during follow up.; Reported Cause(s) of Death: not responsive and he passed away"
	"0934968-1"	"0934968-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"50-59 years"	"50-59"	"he passed away; not responsive; mind just seemed like it was racing; body was hyper dried; Restless; not feeling well; ate a bit but not much; kind of pale; Agitated; Vomiting; trouble in breathing; This is a spontaneous report from a contactable consumer (brother of the patient). A 54-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, on 04Jan2021 (at the age of 54-years-old) as a single dose for COVID-19 immunization. Medical history included diabetes and high blood pressure. Concomitant medications included metformin (MANUFACTURER UNKNOWN) taken for diabetes, glimepiride (MANUFACTURER UNKNOWN) taken for diabetes, lisinopril (MANUFACTURER UNKNOWN), and amlodipine (MANUFACTURER UNKNOWN). The patient experienced not feeling well, ate a bit but not much, kind of pale, vomiting, trouble in breathing, and agitated on 04Jan2021; body was hyper dried and restless on 05Jan2021; mind just seemed like it was racing on 06Jan2021; and not responsive and he passed away on 06Jan2021 at 10:15 (reported as: around 10:15 AM). The clinical course was reported as follows: The patient received the vaccine on 04Jan2021, after which he started not feeling well. He went right home and went to bed. He woke up and ate a bit but not much and then was kind of pale. The patient then started to vomit, which continued throughout the night. He was having trouble in breathing. Emergency services were called, and they took his vitals and said that everything was okay, but he was very agitated; reported as not like this prior to the vaccine. The patient was taken to urgent care where they gave him an unspecified steroid shot and unspecified medication for vomiting. The patient was told he was probably having a reaction to the vaccine, but he was just dried up. The patient continued to vomit throughout the day and then he was very agitated again and would fall asleep for may be 15-20 minutes. When the patient woke up, he was very restless (reported as: his body was just amped up and could not calm down). The patient calmed down just a little bit in the evening. When the patient was awoken at 6:00 AM in the morning, he was still agitated. The patient stated that he couldn't breathe, and his mind was racing. The patient's other brother went to him and he was not responsive, and he passed away on 06Jan2021 around 10:15 AM. It was reported that none of the symptoms occurred until the patient received the vaccine. Therapeutic measures were taken as a result of vomiting as aforementioned. The clinical outcome of all of the events was unknown; not responsive was not recovered, the patient died on 06Jan2021. The cause of death was unknown (reported as: not known by reporter). An autopsy was not performed.  The batch/lot number for the vaccine, BNT162B2, was not provided and has been requested during follow up.; Reported Cause(s) of Death: not responsive and he passed away"
	"0934968-1"	"0934968-1"	"VACCINATION COMPLICATION"	"10046861"	"50-59 years"	"50-59"	"he passed away; not responsive; mind just seemed like it was racing; body was hyper dried; Restless; not feeling well; ate a bit but not much; kind of pale; Agitated; Vomiting; trouble in breathing; This is a spontaneous report from a contactable consumer (brother of the patient). A 54-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, on 04Jan2021 (at the age of 54-years-old) as a single dose for COVID-19 immunization. Medical history included diabetes and high blood pressure. Concomitant medications included metformin (MANUFACTURER UNKNOWN) taken for diabetes, glimepiride (MANUFACTURER UNKNOWN) taken for diabetes, lisinopril (MANUFACTURER UNKNOWN), and amlodipine (MANUFACTURER UNKNOWN). The patient experienced not feeling well, ate a bit but not much, kind of pale, vomiting, trouble in breathing, and agitated on 04Jan2021; body was hyper dried and restless on 05Jan2021; mind just seemed like it was racing on 06Jan2021; and not responsive and he passed away on 06Jan2021 at 10:15 (reported as: around 10:15 AM). The clinical course was reported as follows: The patient received the vaccine on 04Jan2021, after which he started not feeling well. He went right home and went to bed. He woke up and ate a bit but not much and then was kind of pale. The patient then started to vomit, which continued throughout the night. He was having trouble in breathing. Emergency services were called, and they took his vitals and said that everything was okay, but he was very agitated; reported as not like this prior to the vaccine. The patient was taken to urgent care where they gave him an unspecified steroid shot and unspecified medication for vomiting. The patient was told he was probably having a reaction to the vaccine, but he was just dried up. The patient continued to vomit throughout the day and then he was very agitated again and would fall asleep for may be 15-20 minutes. When the patient woke up, he was very restless (reported as: his body was just amped up and could not calm down). The patient calmed down just a little bit in the evening. When the patient was awoken at 6:00 AM in the morning, he was still agitated. The patient stated that he couldn't breathe, and his mind was racing. The patient's other brother went to him and he was not responsive, and he passed away on 06Jan2021 around 10:15 AM. It was reported that none of the symptoms occurred until the patient received the vaccine. Therapeutic measures were taken as a result of vomiting as aforementioned. The clinical outcome of all of the events was unknown; not responsive was not recovered, the patient died on 06Jan2021. The cause of death was unknown (reported as: not known by reporter). An autopsy was not performed.  The batch/lot number for the vaccine, BNT162B2, was not provided and has been requested during follow up.; Reported Cause(s) of Death: not responsive and he passed away"
	"0934968-1"	"0934968-1"	"VOMITING"	"10047700"	"50-59 years"	"50-59"	"he passed away; not responsive; mind just seemed like it was racing; body was hyper dried; Restless; not feeling well; ate a bit but not much; kind of pale; Agitated; Vomiting; trouble in breathing; This is a spontaneous report from a contactable consumer (brother of the patient). A 54-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, on 04Jan2021 (at the age of 54-years-old) as a single dose for COVID-19 immunization. Medical history included diabetes and high blood pressure. Concomitant medications included metformin (MANUFACTURER UNKNOWN) taken for diabetes, glimepiride (MANUFACTURER UNKNOWN) taken for diabetes, lisinopril (MANUFACTURER UNKNOWN), and amlodipine (MANUFACTURER UNKNOWN). The patient experienced not feeling well, ate a bit but not much, kind of pale, vomiting, trouble in breathing, and agitated on 04Jan2021; body was hyper dried and restless on 05Jan2021; mind just seemed like it was racing on 06Jan2021; and not responsive and he passed away on 06Jan2021 at 10:15 (reported as: around 10:15 AM). The clinical course was reported as follows: The patient received the vaccine on 04Jan2021, after which he started not feeling well. He went right home and went to bed. He woke up and ate a bit but not much and then was kind of pale. The patient then started to vomit, which continued throughout the night. He was having trouble in breathing. Emergency services were called, and they took his vitals and said that everything was okay, but he was very agitated; reported as not like this prior to the vaccine. The patient was taken to urgent care where they gave him an unspecified steroid shot and unspecified medication for vomiting. The patient was told he was probably having a reaction to the vaccine, but he was just dried up. The patient continued to vomit throughout the day and then he was very agitated again and would fall asleep for may be 15-20 minutes. When the patient woke up, he was very restless (reported as: his body was just amped up and could not calm down). The patient calmed down just a little bit in the evening. When the patient was awoken at 6:00 AM in the morning, he was still agitated. The patient stated that he couldn't breathe, and his mind was racing. The patient's other brother went to him and he was not responsive, and he passed away on 06Jan2021 around 10:15 AM. It was reported that none of the symptoms occurred until the patient received the vaccine. Therapeutic measures were taken as a result of vomiting as aforementioned. The clinical outcome of all of the events was unknown; not responsive was not recovered, the patient died on 06Jan2021. The cause of death was unknown (reported as: not known by reporter). An autopsy was not performed.  The batch/lot number for the vaccine, BNT162B2, was not provided and has been requested during follow up.; Reported Cause(s) of Death: not responsive and he passed away"
	"0935511-1"	"0935511-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient received the 1st dose of Moderna and was found deceased in her home the next day."
	"0938118-1"	"0938118-1"	"ABDOMINAL X-RAY"	"10061612"	"50-59 years"	"50-59"	"on 1/8/2021 17:30 patient taken to ER, cerebellar hemorrhage, stroke,  aneurysm"
	"0938118-1"	"0938118-1"	"ANEURYSM"	"10002329"	"50-59 years"	"50-59"	"on 1/8/2021 17:30 patient taken to ER, cerebellar hemorrhage, stroke,  aneurysm"
	"0938118-1"	"0938118-1"	"ANGIOGRAM CEREBRAL"	"10052905"	"50-59 years"	"50-59"	"on 1/8/2021 17:30 patient taken to ER, cerebellar hemorrhage, stroke,  aneurysm"
	"0938118-1"	"0938118-1"	"ARTERIOGRAM CAROTID"	"10003194"	"50-59 years"	"50-59"	"on 1/8/2021 17:30 patient taken to ER, cerebellar hemorrhage, stroke,  aneurysm"
	"0938118-1"	"0938118-1"	"CEREBELLAR HAEMORRHAGE"	"10008030"	"50-59 years"	"50-59"	"on 1/8/2021 17:30 patient taken to ER, cerebellar hemorrhage, stroke,  aneurysm"
	"0938118-1"	"0938118-1"	"CEREBROVASCULAR ACCIDENT"	"10008190"	"50-59 years"	"50-59"	"on 1/8/2021 17:30 patient taken to ER, cerebellar hemorrhage, stroke,  aneurysm"
	"0938118-1"	"0938118-1"	"CHEST X-RAY"	"10008498"	"50-59 years"	"50-59"	"on 1/8/2021 17:30 patient taken to ER, cerebellar hemorrhage, stroke,  aneurysm"
	"0938118-1"	"0938118-1"	"COMPUTERISED TOMOGRAM ABDOMEN"	"10053876"	"50-59 years"	"50-59"	"on 1/8/2021 17:30 patient taken to ER, cerebellar hemorrhage, stroke,  aneurysm"
	"0938118-1"	"0938118-1"	"COMPUTERISED TOMOGRAM HEAD"	"10054003"	"50-59 years"	"50-59"	"on 1/8/2021 17:30 patient taken to ER, cerebellar hemorrhage, stroke,  aneurysm"
	"0938118-1"	"0938118-1"	"COMPUTERISED TOMOGRAM PELVIS"	"10075023"	"50-59 years"	"50-59"	"on 1/8/2021 17:30 patient taken to ER, cerebellar hemorrhage, stroke,  aneurysm"
	"0938118-1"	"0938118-1"	"COMPUTERISED TOMOGRAM SPINE"	"10081777"	"50-59 years"	"50-59"	"on 1/8/2021 17:30 patient taken to ER, cerebellar hemorrhage, stroke,  aneurysm"
	"0938118-1"	"0938118-1"	"COMPUTERISED TOMOGRAM THORAX"	"10053875"	"50-59 years"	"50-59"	"on 1/8/2021 17:30 patient taken to ER, cerebellar hemorrhage, stroke,  aneurysm"
	"0942106-1"	"0942106-1"	"ABDOMINAL PAIN"	"10000081"	"50-59 years"	"50-59"	"54 y/o M with PMH of HTN, HLD, Alcoholic Cirrhosis, Aortic Valve Stenosis, and angina BIBA as a Medical Alert for cardiac arrest noted PTA. Per EMS, the patient called because he was having constant, diffuse abdominal pain x 1 day that radiated to his chest. On scene, the patient had a witnessed arrest with EMS starting CPR. He was given 3 rounds of epi without ROSC. Pt had no associated shockable rhythm. Of note, pt's wife, had noted pt had received covid vaccine the prior day."
	"0942106-1"	"0942106-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"54 y/o M with PMH of HTN, HLD, Alcoholic Cirrhosis, Aortic Valve Stenosis, and angina BIBA as a Medical Alert for cardiac arrest noted PTA. Per EMS, the patient called because he was having constant, diffuse abdominal pain x 1 day that radiated to his chest. On scene, the patient had a witnessed arrest with EMS starting CPR. He was given 3 rounds of epi without ROSC. Pt had no associated shockable rhythm. Of note, pt's wife, had noted pt had received covid vaccine the prior day."
	"0942106-1"	"0942106-1"	"CHEST PAIN"	"10008479"	"50-59 years"	"50-59"	"54 y/o M with PMH of HTN, HLD, Alcoholic Cirrhosis, Aortic Valve Stenosis, and angina BIBA as a Medical Alert for cardiac arrest noted PTA. Per EMS, the patient called because he was having constant, diffuse abdominal pain x 1 day that radiated to his chest. On scene, the patient had a witnessed arrest with EMS starting CPR. He was given 3 rounds of epi without ROSC. Pt had no associated shockable rhythm. Of note, pt's wife, had noted pt had received covid vaccine the prior day."
	"0942106-1"	"0942106-1"	"PAIN"	"10033371"	"50-59 years"	"50-59"	"54 y/o M with PMH of HTN, HLD, Alcoholic Cirrhosis, Aortic Valve Stenosis, and angina BIBA as a Medical Alert for cardiac arrest noted PTA. Per EMS, the patient called because he was having constant, diffuse abdominal pain x 1 day that radiated to his chest. On scene, the patient had a witnessed arrest with EMS starting CPR. He was given 3 rounds of epi without ROSC. Pt had no associated shockable rhythm. Of note, pt's wife, had noted pt had received covid vaccine the prior day."
	"0942106-1"	"0942106-1"	"PULSE ABSENT"	"10037469"	"50-59 years"	"50-59"	"54 y/o M with PMH of HTN, HLD, Alcoholic Cirrhosis, Aortic Valve Stenosis, and angina BIBA as a Medical Alert for cardiac arrest noted PTA. Per EMS, the patient called because he was having constant, diffuse abdominal pain x 1 day that radiated to his chest. On scene, the patient had a witnessed arrest with EMS starting CPR. He was given 3 rounds of epi without ROSC. Pt had no associated shockable rhythm. Of note, pt's wife, had noted pt had received covid vaccine the prior day."
	"0942106-1"	"0942106-1"	"RESUSCITATION"	"10038749"	"50-59 years"	"50-59"	"54 y/o M with PMH of HTN, HLD, Alcoholic Cirrhosis, Aortic Valve Stenosis, and angina BIBA as a Medical Alert for cardiac arrest noted PTA. Per EMS, the patient called because he was having constant, diffuse abdominal pain x 1 day that radiated to his chest. On scene, the patient had a witnessed arrest with EMS starting CPR. He was given 3 rounds of epi without ROSC. Pt had no associated shockable rhythm. Of note, pt's wife, had noted pt had received covid vaccine the prior day."
	"0944595-1"	"0944595-1"	"BRAIN DEATH"	"10049054"	"50-59 years"	"50-59"	"Cardiac arrest within 1 hour  Patient had the second vaccine approximately 2 pm on   Tuesday Jan 12th  He works at the extended care community and was in  good health that morning with  no  complaints.  He  waited  10-15 minutes at the  vaccine  admin site  and then   told them  he  felt  fine and was  ready to get back to work.  He  then was  found unresponsive at 3 pm within an hour of the 2nd vaccine.   EMS called immediately  worked on him 30 minutes in field then 30 minutes at ER  was able to put him on  life support  yet deemed Brain  dead  1-14-21 and pronounced dead an hour or  so later"
	"0944595-1"	"0944595-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"Cardiac arrest within 1 hour  Patient had the second vaccine approximately 2 pm on   Tuesday Jan 12th  He works at the extended care community and was in  good health that morning with  no  complaints.  He  waited  10-15 minutes at the  vaccine  admin site  and then   told them  he  felt  fine and was  ready to get back to work.  He  then was  found unresponsive at 3 pm within an hour of the 2nd vaccine.   EMS called immediately  worked on him 30 minutes in field then 30 minutes at ER  was able to put him on  life support  yet deemed Brain  dead  1-14-21 and pronounced dead an hour or  so later"
	"0944595-1"	"0944595-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Cardiac arrest within 1 hour  Patient had the second vaccine approximately 2 pm on   Tuesday Jan 12th  He works at the extended care community and was in  good health that morning with  no  complaints.  He  waited  10-15 minutes at the  vaccine  admin site  and then   told them  he  felt  fine and was  ready to get back to work.  He  then was  found unresponsive at 3 pm within an hour of the 2nd vaccine.   EMS called immediately  worked on him 30 minutes in field then 30 minutes at ER  was able to put him on  life support  yet deemed Brain  dead  1-14-21 and pronounced dead an hour or  so later"
	"0944595-1"	"0944595-1"	"INTENSIVE CARE"	"10022519"	"50-59 years"	"50-59"	"Cardiac arrest within 1 hour  Patient had the second vaccine approximately 2 pm on   Tuesday Jan 12th  He works at the extended care community and was in  good health that morning with  no  complaints.  He  waited  10-15 minutes at the  vaccine  admin site  and then   told them  he  felt  fine and was  ready to get back to work.  He  then was  found unresponsive at 3 pm within an hour of the 2nd vaccine.   EMS called immediately  worked on him 30 minutes in field then 30 minutes at ER  was able to put him on  life support  yet deemed Brain  dead  1-14-21 and pronounced dead an hour or  so later"
	"0944595-1"	"0944595-1"	"LIFE SUPPORT"	"10024447"	"50-59 years"	"50-59"	"Cardiac arrest within 1 hour  Patient had the second vaccine approximately 2 pm on   Tuesday Jan 12th  He works at the extended care community and was in  good health that morning with  no  complaints.  He  waited  10-15 minutes at the  vaccine  admin site  and then   told them  he  felt  fine and was  ready to get back to work.  He  then was  found unresponsive at 3 pm within an hour of the 2nd vaccine.   EMS called immediately  worked on him 30 minutes in field then 30 minutes at ER  was able to put him on  life support  yet deemed Brain  dead  1-14-21 and pronounced dead an hour or  so later"
	"0944595-1"	"0944595-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"50-59 years"	"50-59"	"Cardiac arrest within 1 hour  Patient had the second vaccine approximately 2 pm on   Tuesday Jan 12th  He works at the extended care community and was in  good health that morning with  no  complaints.  He  waited  10-15 minutes at the  vaccine  admin site  and then   told them  he  felt  fine and was  ready to get back to work.  He  then was  found unresponsive at 3 pm within an hour of the 2nd vaccine.   EMS called immediately  worked on him 30 minutes in field then 30 minutes at ER  was able to put him on  life support  yet deemed Brain  dead  1-14-21 and pronounced dead an hour or  so later"
	"0946293-1"	"0946293-1"	"ACUTE RESPIRATORY FAILURE"	"10001053"	"50-59 years"	"50-59"	"51 year old M with h/o O2 dependent COPD, Severe pulmonary fibrosis became increasingly hypoxic around 1800hours 1/7/2021. He was transported to hospital for acute on chronic hypoxia respiratory failure. On 1/12/2021 he decompensated further, and after discussing with family and palliative care, He was changed to comfort care. He expired on 1/12/2021@2325 at medical center."
	"0946293-1"	"0946293-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"51 year old M with h/o O2 dependent COPD, Severe pulmonary fibrosis became increasingly hypoxic around 1800hours 1/7/2021. He was transported to hospital for acute on chronic hypoxia respiratory failure. On 1/12/2021 he decompensated further, and after discussing with family and palliative care, He was changed to comfort care. He expired on 1/12/2021@2325 at medical center."
	"0946293-1"	"0946293-1"	"HYPOXIA"	"10021143"	"50-59 years"	"50-59"	"51 year old M with h/o O2 dependent COPD, Severe pulmonary fibrosis became increasingly hypoxic around 1800hours 1/7/2021. He was transported to hospital for acute on chronic hypoxia respiratory failure. On 1/12/2021 he decompensated further, and after discussing with family and palliative care, He was changed to comfort care. He expired on 1/12/2021@2325 at medical center."
	"0950108-1"	"0950108-1"	"CATHETERISATION CARDIAC ABNORMAL"	"10007816"	"50-59 years"	"50-59"	""""Moderna COVID-19 Vaccine EUA"" It has been reported to me that pt. had gone into hospital for a heart catheterization on 1/12/2021.  It was found during this procedure that pt. had suffered a MI.  She was release to home the following day and passed away at her residence on 1/15/2021.""
	"0950108-1"	"0950108-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	""""Moderna COVID-19 Vaccine EUA"" It has been reported to me that pt. had gone into hospital for a heart catheterization on 1/12/2021.  It was found during this procedure that pt. had suffered a MI.  She was release to home the following day and passed away at her residence on 1/15/2021.""
	"0950108-1"	"0950108-1"	"MYOCARDIAL INFARCTION"	"10028596"	"50-59 years"	"50-59"	""""Moderna COVID-19 Vaccine EUA"" It has been reported to me that pt. had gone into hospital for a heart catheterization on 1/12/2021.  It was found during this procedure that pt. had suffered a MI.  She was release to home the following day and passed away at her residence on 1/15/2021.""
	"0955597-1"	"0955597-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Death"
	"0958072-1"	"0958072-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Death 3 days after receiving 2nd dose of COVID vaccine, unknown if related to vaccine administration."
	"0959001-1"	"0959001-1"	"NAUSEA"	"10028813"	"50-59 years"	"50-59"	"Patient woke apx 0200 complaining of nausea to group home staff.  Vitals were checked at that time and WNL.  Patient went back to bed.  When staff went to wake patient apx 0530, he was unresponsive and had no pulse. Chest compressions were started and EMS called."
	"0959001-1"	"0959001-1"	"PULSE ABSENT"	"10037469"	"50-59 years"	"50-59"	"Patient woke apx 0200 complaining of nausea to group home staff.  Vitals were checked at that time and WNL.  Patient went back to bed.  When staff went to wake patient apx 0530, he was unresponsive and had no pulse. Chest compressions were started and EMS called."
	"0959001-1"	"0959001-1"	"RESUSCITATION"	"10038749"	"50-59 years"	"50-59"	"Patient woke apx 0200 complaining of nausea to group home staff.  Vitals were checked at that time and WNL.  Patient went back to bed.  When staff went to wake patient apx 0530, he was unresponsive and had no pulse. Chest compressions were started and EMS called."
	"0959001-1"	"0959001-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"50-59 years"	"50-59"	"Patient woke apx 0200 complaining of nausea to group home staff.  Vitals were checked at that time and WNL.  Patient went back to bed.  When staff went to wake patient apx 0530, he was unresponsive and had no pulse. Chest compressions were started and EMS called."
	"0964401-1"	"0964401-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Pt died 4 days after vaccine, no known reaction to the vaccination"
	"0965564-1"	"0965564-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"Cardiac arrest Narrative:"
	"0965910-1"	"0965910-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"The employee found dead at her home on 1/21/2021."
	"0966888-1"	"0966888-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"At 04:30 on 1/22/2021, facility was notified of employee death at home."
	"0967399-1"	"0967399-1"	"SUDDEN DEATH"	"10042434"	"50-59 years"	"50-59"	"Sudden death"
	"0974960-1"	"0974960-1"	"CONDITION AGGRAVATED"	"10010264"	"50-59 years"	"50-59"	"ON 1/14/2021 TYPICAL UTI SYMPTOMS FOR RESIDENT DEVELOPED INCLUDING FEVER AND RIGIDITY. RESIDENT IS NON-VERBAL. IV ANTIBIOTICS WERE STARTED. FREQUENT UTI'S ARE COMMON FOR THIS RESIDENT."
	"0974960-1"	"0974960-1"	"CULTURE URINE"	"10011638"	"50-59 years"	"50-59"	"ON 1/14/2021 TYPICAL UTI SYMPTOMS FOR RESIDENT DEVELOPED INCLUDING FEVER AND RIGIDITY. RESIDENT IS NON-VERBAL. IV ANTIBIOTICS WERE STARTED. FREQUENT UTI'S ARE COMMON FOR THIS RESIDENT."
	"0974960-1"	"0974960-1"	"FULL BLOOD COUNT"	"10017411"	"50-59 years"	"50-59"	"ON 1/14/2021 TYPICAL UTI SYMPTOMS FOR RESIDENT DEVELOPED INCLUDING FEVER AND RIGIDITY. RESIDENT IS NON-VERBAL. IV ANTIBIOTICS WERE STARTED. FREQUENT UTI'S ARE COMMON FOR THIS RESIDENT."
	"0974960-1"	"0974960-1"	"MUSCLE RIGIDITY"	"10028330"	"50-59 years"	"50-59"	"ON 1/14/2021 TYPICAL UTI SYMPTOMS FOR RESIDENT DEVELOPED INCLUDING FEVER AND RIGIDITY. RESIDENT IS NON-VERBAL. IV ANTIBIOTICS WERE STARTED. FREQUENT UTI'S ARE COMMON FOR THIS RESIDENT."
	"0974960-1"	"0974960-1"	"PYREXIA"	"10037660"	"50-59 years"	"50-59"	"ON 1/14/2021 TYPICAL UTI SYMPTOMS FOR RESIDENT DEVELOPED INCLUDING FEVER AND RIGIDITY. RESIDENT IS NON-VERBAL. IV ANTIBIOTICS WERE STARTED. FREQUENT UTI'S ARE COMMON FOR THIS RESIDENT."
	"0974960-1"	"0974960-1"	"URINARY TRACT INFECTION"	"10046571"	"50-59 years"	"50-59"	"ON 1/14/2021 TYPICAL UTI SYMPTOMS FOR RESIDENT DEVELOPED INCLUDING FEVER AND RIGIDITY. RESIDENT IS NON-VERBAL. IV ANTIBIOTICS WERE STARTED. FREQUENT UTI'S ARE COMMON FOR THIS RESIDENT."
	"0974960-1"	"0974960-1"	"URINE ANALYSIS"	"10046614"	"50-59 years"	"50-59"	"ON 1/14/2021 TYPICAL UTI SYMPTOMS FOR RESIDENT DEVELOPED INCLUDING FEVER AND RIGIDITY. RESIDENT IS NON-VERBAL. IV ANTIBIOTICS WERE STARTED. FREQUENT UTI'S ARE COMMON FOR THIS RESIDENT."
	"0975762-1"	"0975762-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Pt deceased"
	"0981225-1"	"0981225-1"	"ABDOMINAL PAIN"	"10000081"	"50-59 years"	"50-59"	"Patient with inoperable pancreatic cancer received second Pfizer vaccine approximately 12:30 pm on 1/27/21. At approximataely 16:30, patient complained of abdominal pain and was given Levsin 0.125mg and morphine 5mg orally.  At approximately 19:30 patient was found on the floor covered in a large amount of emesis, unresponsive  without a pulse."
	"0981225-1"	"0981225-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient with inoperable pancreatic cancer received second Pfizer vaccine approximately 12:30 pm on 1/27/21. At approximataely 16:30, patient complained of abdominal pain and was given Levsin 0.125mg and morphine 5mg orally.  At approximately 19:30 patient was found on the floor covered in a large amount of emesis, unresponsive  without a pulse."
	"0981225-1"	"0981225-1"	"PULSE ABSENT"	"10037469"	"50-59 years"	"50-59"	"Patient with inoperable pancreatic cancer received second Pfizer vaccine approximately 12:30 pm on 1/27/21. At approximataely 16:30, patient complained of abdominal pain and was given Levsin 0.125mg and morphine 5mg orally.  At approximately 19:30 patient was found on the floor covered in a large amount of emesis, unresponsive  without a pulse."
	"0981225-1"	"0981225-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"50-59 years"	"50-59"	"Patient with inoperable pancreatic cancer received second Pfizer vaccine approximately 12:30 pm on 1/27/21. At approximataely 16:30, patient complained of abdominal pain and was given Levsin 0.125mg and morphine 5mg orally.  At approximately 19:30 patient was found on the floor covered in a large amount of emesis, unresponsive  without a pulse."
	"0981225-1"	"0981225-1"	"VOMITING"	"10047700"	"50-59 years"	"50-59"	"Patient with inoperable pancreatic cancer received second Pfizer vaccine approximately 12:30 pm on 1/27/21. At approximataely 16:30, patient complained of abdominal pain and was given Levsin 0.125mg and morphine 5mg orally.  At approximately 19:30 patient was found on the floor covered in a large amount of emesis, unresponsive  without a pulse."
	"0982942-1"	"0982942-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"per recipient spouse - vaccine recipient became ill during the night of 1/21/21 or early morning of 1/22/21 and was deceased in the morning of 1/22/21."
	"0982942-1"	"0982942-1"	"ILLNESS"	"10080284"	"50-59 years"	"50-59"	"per recipient spouse - vaccine recipient became ill during the night of 1/21/21 or early morning of 1/22/21 and was deceased in the morning of 1/22/21."
	"0985004-1"	"0985004-1"	"ABDOMINAL PAIN"	"10000081"	"50-59 years"	"50-59"	"The week of 1/18/2021 The patient complained of Abdominal pain and called off work (we are also her employer) She was seen for constipation on 1/20/2021.   Employee returned to work on 1/25/2021 Had occasional episodes during work where she would sweat and become tired but would rest until she felt better. On the Night of 1/27/2021 she was feeling fine no issues, later in the shift a co worker found her unresponsive, CPR was initiated but unsuccessful."
	"0985004-1"	"0985004-1"	"CONSTIPATION"	"10010774"	"50-59 years"	"50-59"	"The week of 1/18/2021 The patient complained of Abdominal pain and called off work (we are also her employer) She was seen for constipation on 1/20/2021.   Employee returned to work on 1/25/2021 Had occasional episodes during work where she would sweat and become tired but would rest until she felt better. On the Night of 1/27/2021 she was feeling fine no issues, later in the shift a co worker found her unresponsive, CPR was initiated but unsuccessful."
	"0985004-1"	"0985004-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"The week of 1/18/2021 The patient complained of Abdominal pain and called off work (we are also her employer) She was seen for constipation on 1/20/2021.   Employee returned to work on 1/25/2021 Had occasional episodes during work where she would sweat and become tired but would rest until she felt better. On the Night of 1/27/2021 she was feeling fine no issues, later in the shift a co worker found her unresponsive, CPR was initiated but unsuccessful."
	"0985004-1"	"0985004-1"	"FATIGUE"	"10016256"	"50-59 years"	"50-59"	"The week of 1/18/2021 The patient complained of Abdominal pain and called off work (we are also her employer) She was seen for constipation on 1/20/2021.   Employee returned to work on 1/25/2021 Had occasional episodes during work where she would sweat and become tired but would rest until she felt better. On the Night of 1/27/2021 she was feeling fine no issues, later in the shift a co worker found her unresponsive, CPR was initiated but unsuccessful."
	"0985004-1"	"0985004-1"	"HYPERHIDROSIS"	"10020642"	"50-59 years"	"50-59"	"The week of 1/18/2021 The patient complained of Abdominal pain and called off work (we are also her employer) She was seen for constipation on 1/20/2021.   Employee returned to work on 1/25/2021 Had occasional episodes during work where she would sweat and become tired but would rest until she felt better. On the Night of 1/27/2021 she was feeling fine no issues, later in the shift a co worker found her unresponsive, CPR was initiated but unsuccessful."
	"0985004-1"	"0985004-1"	"IMPAIRED WORK ABILITY"	"10052302"	"50-59 years"	"50-59"	"The week of 1/18/2021 The patient complained of Abdominal pain and called off work (we are also her employer) She was seen for constipation on 1/20/2021.   Employee returned to work on 1/25/2021 Had occasional episodes during work where she would sweat and become tired but would rest until she felt better. On the Night of 1/27/2021 she was feeling fine no issues, later in the shift a co worker found her unresponsive, CPR was initiated but unsuccessful."
	"0985004-1"	"0985004-1"	"RESUSCITATION"	"10038749"	"50-59 years"	"50-59"	"The week of 1/18/2021 The patient complained of Abdominal pain and called off work (we are also her employer) She was seen for constipation on 1/20/2021.   Employee returned to work on 1/25/2021 Had occasional episodes during work where she would sweat and become tired but would rest until she felt better. On the Night of 1/27/2021 she was feeling fine no issues, later in the shift a co worker found her unresponsive, CPR was initiated but unsuccessful."
	"0985004-1"	"0985004-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"50-59 years"	"50-59"	"The week of 1/18/2021 The patient complained of Abdominal pain and called off work (we are also her employer) She was seen for constipation on 1/20/2021.   Employee returned to work on 1/25/2021 Had occasional episodes during work where she would sweat and become tired but would rest until she felt better. On the Night of 1/27/2021 she was feeling fine no issues, later in the shift a co worker found her unresponsive, CPR was initiated but unsuccessful."
	"0989006-1"	"0989006-1"	"AIRWAY SECRETION CLEARANCE THERAPY"	"10074363"	"50-59 years"	"50-59"	"After being observed for approximately 20 minutes and patient walked to her car without assistance I was called to assess the patient in the parking lot for troubles breathing.  EMS was called as I made my way outside.  Upon my arrival patient was leaning out of the car and stating that she could not breath.  She was able to tell me that she was allergic to penicillin.  Oxygen was immediately placed on the patient with minimal relief.  Lung sounds were coarse throughout.  She then  began to vomit about every 20-30 seconds.  Epipen was administered in the right leg with no relief.  Patient continued to complain of troubles breathing and vomiting.  A second epipen was administered in the patients right arm again with no relief.  A few minutes later patient was given racemic epinephrine through the oxygen mask.  There appeared to be mild improvement in her breathing as she appeared more comfortable, but still complaining of shortness of breath and vomiting.  When EMS arrived patient was unable to transport herself to the stretcher.  When EMS and clinical staff transferred patient to the stretcher she became unresponsive.  She appeared to still be breathing.  She did not respond to verbal stimuli.  Per ED report large amount of fluid was suctioned from the patients lungs following intubation in the ambulance.  When patient arrived to the ED she was extubated and re-intubated without difficulty and further fluid was suctioned.  At that time patient was found to be in PEA, shock was delivered.  Shortly thereafter no cardiac activity was found and patient pronounced dead."
	"0989006-1"	"0989006-1"	"BREATH SOUNDS ABNORMAL"	"10064780"	"50-59 years"	"50-59"	"After being observed for approximately 20 minutes and patient walked to her car without assistance I was called to assess the patient in the parking lot for troubles breathing.  EMS was called as I made my way outside.  Upon my arrival patient was leaning out of the car and stating that she could not breath.  She was able to tell me that she was allergic to penicillin.  Oxygen was immediately placed on the patient with minimal relief.  Lung sounds were coarse throughout.  She then  began to vomit about every 20-30 seconds.  Epipen was administered in the right leg with no relief.  Patient continued to complain of troubles breathing and vomiting.  A second epipen was administered in the patients right arm again with no relief.  A few minutes later patient was given racemic epinephrine through the oxygen mask.  There appeared to be mild improvement in her breathing as she appeared more comfortable, but still complaining of shortness of breath and vomiting.  When EMS arrived patient was unable to transport herself to the stretcher.  When EMS and clinical staff transferred patient to the stretcher she became unresponsive.  She appeared to still be breathing.  She did not respond to verbal stimuli.  Per ED report large amount of fluid was suctioned from the patients lungs following intubation in the ambulance.  When patient arrived to the ED she was extubated and re-intubated without difficulty and further fluid was suctioned.  At that time patient was found to be in PEA, shock was delivered.  Shortly thereafter no cardiac activity was found and patient pronounced dead."
	"0989006-1"	"0989006-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"After being observed for approximately 20 minutes and patient walked to her car without assistance I was called to assess the patient in the parking lot for troubles breathing.  EMS was called as I made my way outside.  Upon my arrival patient was leaning out of the car and stating that she could not breath.  She was able to tell me that she was allergic to penicillin.  Oxygen was immediately placed on the patient with minimal relief.  Lung sounds were coarse throughout.  She then  began to vomit about every 20-30 seconds.  Epipen was administered in the right leg with no relief.  Patient continued to complain of troubles breathing and vomiting.  A second epipen was administered in the patients right arm again with no relief.  A few minutes later patient was given racemic epinephrine through the oxygen mask.  There appeared to be mild improvement in her breathing as she appeared more comfortable, but still complaining of shortness of breath and vomiting.  When EMS arrived patient was unable to transport herself to the stretcher.  When EMS and clinical staff transferred patient to the stretcher she became unresponsive.  She appeared to still be breathing.  She did not respond to verbal stimuli.  Per ED report large amount of fluid was suctioned from the patients lungs following intubation in the ambulance.  When patient arrived to the ED she was extubated and re-intubated without difficulty and further fluid was suctioned.  At that time patient was found to be in PEA, shock was delivered.  Shortly thereafter no cardiac activity was found and patient pronounced dead."
	"0989006-1"	"0989006-1"	"CARDIOVERSION"	"10007661"	"50-59 years"	"50-59"	"After being observed for approximately 20 minutes and patient walked to her car without assistance I was called to assess the patient in the parking lot for troubles breathing.  EMS was called as I made my way outside.  Upon my arrival patient was leaning out of the car and stating that she could not breath.  She was able to tell me that she was allergic to penicillin.  Oxygen was immediately placed on the patient with minimal relief.  Lung sounds were coarse throughout.  She then  began to vomit about every 20-30 seconds.  Epipen was administered in the right leg with no relief.  Patient continued to complain of troubles breathing and vomiting.  A second epipen was administered in the patients right arm again with no relief.  A few minutes later patient was given racemic epinephrine through the oxygen mask.  There appeared to be mild improvement in her breathing as she appeared more comfortable, but still complaining of shortness of breath and vomiting.  When EMS arrived patient was unable to transport herself to the stretcher.  When EMS and clinical staff transferred patient to the stretcher she became unresponsive.  She appeared to still be breathing.  She did not respond to verbal stimuli.  Per ED report large amount of fluid was suctioned from the patients lungs following intubation in the ambulance.  When patient arrived to the ED she was extubated and re-intubated without difficulty and further fluid was suctioned.  At that time patient was found to be in PEA, shock was delivered.  Shortly thereafter no cardiac activity was found and patient pronounced dead."
	"0989006-1"	"0989006-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"After being observed for approximately 20 minutes and patient walked to her car without assistance I was called to assess the patient in the parking lot for troubles breathing.  EMS was called as I made my way outside.  Upon my arrival patient was leaning out of the car and stating that she could not breath.  She was able to tell me that she was allergic to penicillin.  Oxygen was immediately placed on the patient with minimal relief.  Lung sounds were coarse throughout.  She then  began to vomit about every 20-30 seconds.  Epipen was administered in the right leg with no relief.  Patient continued to complain of troubles breathing and vomiting.  A second epipen was administered in the patients right arm again with no relief.  A few minutes later patient was given racemic epinephrine through the oxygen mask.  There appeared to be mild improvement in her breathing as she appeared more comfortable, but still complaining of shortness of breath and vomiting.  When EMS arrived patient was unable to transport herself to the stretcher.  When EMS and clinical staff transferred patient to the stretcher she became unresponsive.  She appeared to still be breathing.  She did not respond to verbal stimuli.  Per ED report large amount of fluid was suctioned from the patients lungs following intubation in the ambulance.  When patient arrived to the ED she was extubated and re-intubated without difficulty and further fluid was suctioned.  At that time patient was found to be in PEA, shock was delivered.  Shortly thereafter no cardiac activity was found and patient pronounced dead."
	"0989006-1"	"0989006-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"After being observed for approximately 20 minutes and patient walked to her car without assistance I was called to assess the patient in the parking lot for troubles breathing.  EMS was called as I made my way outside.  Upon my arrival patient was leaning out of the car and stating that she could not breath.  She was able to tell me that she was allergic to penicillin.  Oxygen was immediately placed on the patient with minimal relief.  Lung sounds were coarse throughout.  She then  began to vomit about every 20-30 seconds.  Epipen was administered in the right leg with no relief.  Patient continued to complain of troubles breathing and vomiting.  A second epipen was administered in the patients right arm again with no relief.  A few minutes later patient was given racemic epinephrine through the oxygen mask.  There appeared to be mild improvement in her breathing as she appeared more comfortable, but still complaining of shortness of breath and vomiting.  When EMS arrived patient was unable to transport herself to the stretcher.  When EMS and clinical staff transferred patient to the stretcher she became unresponsive.  She appeared to still be breathing.  She did not respond to verbal stimuli.  Per ED report large amount of fluid was suctioned from the patients lungs following intubation in the ambulance.  When patient arrived to the ED she was extubated and re-intubated without difficulty and further fluid was suctioned.  At that time patient was found to be in PEA, shock was delivered.  Shortly thereafter no cardiac activity was found and patient pronounced dead."
	"0989006-1"	"0989006-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"50-59 years"	"50-59"	"After being observed for approximately 20 minutes and patient walked to her car without assistance I was called to assess the patient in the parking lot for troubles breathing.  EMS was called as I made my way outside.  Upon my arrival patient was leaning out of the car and stating that she could not breath.  She was able to tell me that she was allergic to penicillin.  Oxygen was immediately placed on the patient with minimal relief.  Lung sounds were coarse throughout.  She then  began to vomit about every 20-30 seconds.  Epipen was administered in the right leg with no relief.  Patient continued to complain of troubles breathing and vomiting.  A second epipen was administered in the patients right arm again with no relief.  A few minutes later patient was given racemic epinephrine through the oxygen mask.  There appeared to be mild improvement in her breathing as she appeared more comfortable, but still complaining of shortness of breath and vomiting.  When EMS arrived patient was unable to transport herself to the stretcher.  When EMS and clinical staff transferred patient to the stretcher she became unresponsive.  She appeared to still be breathing.  She did not respond to verbal stimuli.  Per ED report large amount of fluid was suctioned from the patients lungs following intubation in the ambulance.  When patient arrived to the ED she was extubated and re-intubated without difficulty and further fluid was suctioned.  At that time patient was found to be in PEA, shock was delivered.  Shortly thereafter no cardiac activity was found and patient pronounced dead."
	"0989006-1"	"0989006-1"	"MOBILITY DECREASED"	"10048334"	"50-59 years"	"50-59"	"After being observed for approximately 20 minutes and patient walked to her car without assistance I was called to assess the patient in the parking lot for troubles breathing.  EMS was called as I made my way outside.  Upon my arrival patient was leaning out of the car and stating that she could not breath.  She was able to tell me that she was allergic to penicillin.  Oxygen was immediately placed on the patient with minimal relief.  Lung sounds were coarse throughout.  She then  began to vomit about every 20-30 seconds.  Epipen was administered in the right leg with no relief.  Patient continued to complain of troubles breathing and vomiting.  A second epipen was administered in the patients right arm again with no relief.  A few minutes later patient was given racemic epinephrine through the oxygen mask.  There appeared to be mild improvement in her breathing as she appeared more comfortable, but still complaining of shortness of breath and vomiting.  When EMS arrived patient was unable to transport herself to the stretcher.  When EMS and clinical staff transferred patient to the stretcher she became unresponsive.  She appeared to still be breathing.  She did not respond to verbal stimuli.  Per ED report large amount of fluid was suctioned from the patients lungs following intubation in the ambulance.  When patient arrived to the ED she was extubated and re-intubated without difficulty and further fluid was suctioned.  At that time patient was found to be in PEA, shock was delivered.  Shortly thereafter no cardiac activity was found and patient pronounced dead."
	"0989006-1"	"0989006-1"	"PULSELESS ELECTRICAL ACTIVITY"	"10058151"	"50-59 years"	"50-59"	"After being observed for approximately 20 minutes and patient walked to her car without assistance I was called to assess the patient in the parking lot for troubles breathing.  EMS was called as I made my way outside.  Upon my arrival patient was leaning out of the car and stating that she could not breath.  She was able to tell me that she was allergic to penicillin.  Oxygen was immediately placed on the patient with minimal relief.  Lung sounds were coarse throughout.  She then  began to vomit about every 20-30 seconds.  Epipen was administered in the right leg with no relief.  Patient continued to complain of troubles breathing and vomiting.  A second epipen was administered in the patients right arm again with no relief.  A few minutes later patient was given racemic epinephrine through the oxygen mask.  There appeared to be mild improvement in her breathing as she appeared more comfortable, but still complaining of shortness of breath and vomiting.  When EMS arrived patient was unable to transport herself to the stretcher.  When EMS and clinical staff transferred patient to the stretcher she became unresponsive.  She appeared to still be breathing.  She did not respond to verbal stimuli.  Per ED report large amount of fluid was suctioned from the patients lungs following intubation in the ambulance.  When patient arrived to the ED she was extubated and re-intubated without difficulty and further fluid was suctioned.  At that time patient was found to be in PEA, shock was delivered.  Shortly thereafter no cardiac activity was found and patient pronounced dead."
	"0989006-1"	"0989006-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"50-59 years"	"50-59"	"After being observed for approximately 20 minutes and patient walked to her car without assistance I was called to assess the patient in the parking lot for troubles breathing.  EMS was called as I made my way outside.  Upon my arrival patient was leaning out of the car and stating that she could not breath.  She was able to tell me that she was allergic to penicillin.  Oxygen was immediately placed on the patient with minimal relief.  Lung sounds were coarse throughout.  She then  began to vomit about every 20-30 seconds.  Epipen was administered in the right leg with no relief.  Patient continued to complain of troubles breathing and vomiting.  A second epipen was administered in the patients right arm again with no relief.  A few minutes later patient was given racemic epinephrine through the oxygen mask.  There appeared to be mild improvement in her breathing as she appeared more comfortable, but still complaining of shortness of breath and vomiting.  When EMS arrived patient was unable to transport herself to the stretcher.  When EMS and clinical staff transferred patient to the stretcher she became unresponsive.  She appeared to still be breathing.  She did not respond to verbal stimuli.  Per ED report large amount of fluid was suctioned from the patients lungs following intubation in the ambulance.  When patient arrived to the ED she was extubated and re-intubated without difficulty and further fluid was suctioned.  At that time patient was found to be in PEA, shock was delivered.  Shortly thereafter no cardiac activity was found and patient pronounced dead."
	"0989006-1"	"0989006-1"	"VOMITING"	"10047700"	"50-59 years"	"50-59"	"After being observed for approximately 20 minutes and patient walked to her car without assistance I was called to assess the patient in the parking lot for troubles breathing.  EMS was called as I made my way outside.  Upon my arrival patient was leaning out of the car and stating that she could not breath.  She was able to tell me that she was allergic to penicillin.  Oxygen was immediately placed on the patient with minimal relief.  Lung sounds were coarse throughout.  She then  began to vomit about every 20-30 seconds.  Epipen was administered in the right leg with no relief.  Patient continued to complain of troubles breathing and vomiting.  A second epipen was administered in the patients right arm again with no relief.  A few minutes later patient was given racemic epinephrine through the oxygen mask.  There appeared to be mild improvement in her breathing as she appeared more comfortable, but still complaining of shortness of breath and vomiting.  When EMS arrived patient was unable to transport herself to the stretcher.  When EMS and clinical staff transferred patient to the stretcher she became unresponsive.  She appeared to still be breathing.  She did not respond to verbal stimuli.  Per ED report large amount of fluid was suctioned from the patients lungs following intubation in the ambulance.  When patient arrived to the ED she was extubated and re-intubated without difficulty and further fluid was suctioned.  At that time patient was found to be in PEA, shock was delivered.  Shortly thereafter no cardiac activity was found and patient pronounced dead."
	"0992884-1"	"0992884-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"The next morning after vaccine, patient ran a fever, vomited, and was very tired.  Mom laid her down to sleep and when she checked later, patient had passed away."
	"0992884-1"	"0992884-1"	"FATIGUE"	"10016256"	"50-59 years"	"50-59"	"The next morning after vaccine, patient ran a fever, vomited, and was very tired.  Mom laid her down to sleep and when she checked later, patient had passed away."
	"0992884-1"	"0992884-1"	"PYREXIA"	"10037660"	"50-59 years"	"50-59"	"The next morning after vaccine, patient ran a fever, vomited, and was very tired.  Mom laid her down to sleep and when she checked later, patient had passed away."
	"0992884-1"	"0992884-1"	"VOMITING"	"10047700"	"50-59 years"	"50-59"	"The next morning after vaccine, patient ran a fever, vomited, and was very tired.  Mom laid her down to sleep and when she checked later, patient had passed away."
	"0994790-1"	"0994790-1"	"CARDIO-RESPIRATORY ARREST"	"10007617"	"50-59 years"	"50-59"	"Resident found unresponsive in room this am at approx. 9:30 am. Resident was observed eating breakfast around 8:45 am. Housekeeper reported seeing resident between breakfast and time found unresponsive. Resident had voiced no complaints. Code was initiated until EMS arrived and transported resident to hospital. Resident expired."
	"0994790-1"	"0994790-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Resident found unresponsive in room this am at approx. 9:30 am. Resident was observed eating breakfast around 8:45 am. Housekeeper reported seeing resident between breakfast and time found unresponsive. Resident had voiced no complaints. Code was initiated until EMS arrived and transported resident to hospital. Resident expired."
	"0994790-1"	"0994790-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"50-59 years"	"50-59"	"Resident found unresponsive in room this am at approx. 9:30 am. Resident was observed eating breakfast around 8:45 am. Housekeeper reported seeing resident between breakfast and time found unresponsive. Resident had voiced no complaints. Code was initiated until EMS arrived and transported resident to hospital. Resident expired."
	"0994989-1"	"0994989-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Employee was found unresponsive in floor at her home. EMS arrived and person had expired."
	"0994989-1"	"0994989-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"50-59 years"	"50-59"	"Employee was found unresponsive in floor at her home. EMS arrived and person had expired."
	"0995977-1"	"0995977-1"	"ACUTE RESPIRATORY FAILURE"	"10001053"	"50-59 years"	"50-59"	"Lethargy/altered level of consciousness lead to hospital admission.  Multiple interventions during hospitalization.  Final hospital diagnoses:  Acute respiratory failure with hypercapnia, acute pansinusitis."
	"0995977-1"	"0995977-1"	"ALTERED STATE OF CONSCIOUSNESS"	"10001854"	"50-59 years"	"50-59"	"Lethargy/altered level of consciousness lead to hospital admission.  Multiple interventions during hospitalization.  Final hospital diagnoses:  Acute respiratory failure with hypercapnia, acute pansinusitis."
	"0995977-1"	"0995977-1"	"HYPERCAPNIA"	"10020591"	"50-59 years"	"50-59"	"Lethargy/altered level of consciousness lead to hospital admission.  Multiple interventions during hospitalization.  Final hospital diagnoses:  Acute respiratory failure with hypercapnia, acute pansinusitis."
	"0995977-1"	"0995977-1"	"IMAGING PROCEDURE"	"10068979"	"50-59 years"	"50-59"	"Lethargy/altered level of consciousness lead to hospital admission.  Multiple interventions during hospitalization.  Final hospital diagnoses:  Acute respiratory failure with hypercapnia, acute pansinusitis."
	"0995977-1"	"0995977-1"	"LABORATORY TEST"	"10059938"	"50-59 years"	"50-59"	"Lethargy/altered level of consciousness lead to hospital admission.  Multiple interventions during hospitalization.  Final hospital diagnoses:  Acute respiratory failure with hypercapnia, acute pansinusitis."
	"0995977-1"	"0995977-1"	"LETHARGY"	"10024264"	"50-59 years"	"50-59"	"Lethargy/altered level of consciousness lead to hospital admission.  Multiple interventions during hospitalization.  Final hospital diagnoses:  Acute respiratory failure with hypercapnia, acute pansinusitis."
	"0995977-1"	"0995977-1"	"SARS-COV-2 TEST NEGATIVE"	"10084273"	"50-59 years"	"50-59"	"Lethargy/altered level of consciousness lead to hospital admission.  Multiple interventions during hospitalization.  Final hospital diagnoses:  Acute respiratory failure with hypercapnia, acute pansinusitis."
	"0995977-1"	"0995977-1"	"SINUSITIS"	"10040753"	"50-59 years"	"50-59"	"Lethargy/altered level of consciousness lead to hospital admission.  Multiple interventions during hospitalization.  Final hospital diagnoses:  Acute respiratory failure with hypercapnia, acute pansinusitis."
	"0996086-1"	"0996086-1"	"ACUTE KIDNEY INJURY"	"10069339"	"50-59 years"	"50-59"	"Pt received vaccine on 7 jan. 2021   Twelve days later, on 19 January 2021, Pt developed symptoms of COVID (cough, sore throat, fever, myalgias), on 20 Jan, pt admitted to hospital for worsening symptoms. Pt tested positive for COVID 19.  Pt admitted to ICU where pt had complicated hospital course to include ARDS secondary to COVID pneumonia, nonSTEMI, with biventricular heart failure, on  multiple pressor,  rhabdomyolysis with acute kidney injury, requiring CRRT.   Pt was in hospital for 10 days; he passed away on 31 Jan 2021."
	"0996086-1"	"0996086-1"	"ACUTE MYOCARDIAL INFARCTION"	"10000891"	"50-59 years"	"50-59"	"Pt received vaccine on 7 jan. 2021   Twelve days later, on 19 January 2021, Pt developed symptoms of COVID (cough, sore throat, fever, myalgias), on 20 Jan, pt admitted to hospital for worsening symptoms. Pt tested positive for COVID 19.  Pt admitted to ICU where pt had complicated hospital course to include ARDS secondary to COVID pneumonia, nonSTEMI, with biventricular heart failure, on  multiple pressor,  rhabdomyolysis with acute kidney injury, requiring CRRT.   Pt was in hospital for 10 days; he passed away on 31 Jan 2021."
	"0996086-1"	"0996086-1"	"ACUTE RESPIRATORY DISTRESS SYNDROME"	"10001052"	"50-59 years"	"50-59"	"Pt received vaccine on 7 jan. 2021   Twelve days later, on 19 January 2021, Pt developed symptoms of COVID (cough, sore throat, fever, myalgias), on 20 Jan, pt admitted to hospital for worsening symptoms. Pt tested positive for COVID 19.  Pt admitted to ICU where pt had complicated hospital course to include ARDS secondary to COVID pneumonia, nonSTEMI, with biventricular heart failure, on  multiple pressor,  rhabdomyolysis with acute kidney injury, requiring CRRT.   Pt was in hospital for 10 days; he passed away on 31 Jan 2021."
	"0996086-1"	"0996086-1"	"CARDIAC FAILURE ACUTE"	"10007556"	"50-59 years"	"50-59"	"Pt received vaccine on 7 jan. 2021   Twelve days later, on 19 January 2021, Pt developed symptoms of COVID (cough, sore throat, fever, myalgias), on 20 Jan, pt admitted to hospital for worsening symptoms. Pt tested positive for COVID 19.  Pt admitted to ICU where pt had complicated hospital course to include ARDS secondary to COVID pneumonia, nonSTEMI, with biventricular heart failure, on  multiple pressor,  rhabdomyolysis with acute kidney injury, requiring CRRT.   Pt was in hospital for 10 days; he passed away on 31 Jan 2021."
	"0996086-1"	"0996086-1"	"COUGH"	"10011224"	"50-59 years"	"50-59"	"Pt received vaccine on 7 jan. 2021   Twelve days later, on 19 January 2021, Pt developed symptoms of COVID (cough, sore throat, fever, myalgias), on 20 Jan, pt admitted to hospital for worsening symptoms. Pt tested positive for COVID 19.  Pt admitted to ICU where pt had complicated hospital course to include ARDS secondary to COVID pneumonia, nonSTEMI, with biventricular heart failure, on  multiple pressor,  rhabdomyolysis with acute kidney injury, requiring CRRT.   Pt was in hospital for 10 days; he passed away on 31 Jan 2021."
	"0996086-1"	"0996086-1"	"COVID-19 PNEUMONIA"	"10084380"	"50-59 years"	"50-59"	"Pt received vaccine on 7 jan. 2021   Twelve days later, on 19 January 2021, Pt developed symptoms of COVID (cough, sore throat, fever, myalgias), on 20 Jan, pt admitted to hospital for worsening symptoms. Pt tested positive for COVID 19.  Pt admitted to ICU where pt had complicated hospital course to include ARDS secondary to COVID pneumonia, nonSTEMI, with biventricular heart failure, on  multiple pressor,  rhabdomyolysis with acute kidney injury, requiring CRRT.   Pt was in hospital for 10 days; he passed away on 31 Jan 2021."
	"0996086-1"	"0996086-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Pt received vaccine on 7 jan. 2021   Twelve days later, on 19 January 2021, Pt developed symptoms of COVID (cough, sore throat, fever, myalgias), on 20 Jan, pt admitted to hospital for worsening symptoms. Pt tested positive for COVID 19.  Pt admitted to ICU where pt had complicated hospital course to include ARDS secondary to COVID pneumonia, nonSTEMI, with biventricular heart failure, on  multiple pressor,  rhabdomyolysis with acute kidney injury, requiring CRRT.   Pt was in hospital for 10 days; he passed away on 31 Jan 2021."
	"0996086-1"	"0996086-1"	"INTENSIVE CARE"	"10022519"	"50-59 years"	"50-59"	"Pt received vaccine on 7 jan. 2021   Twelve days later, on 19 January 2021, Pt developed symptoms of COVID (cough, sore throat, fever, myalgias), on 20 Jan, pt admitted to hospital for worsening symptoms. Pt tested positive for COVID 19.  Pt admitted to ICU where pt had complicated hospital course to include ARDS secondary to COVID pneumonia, nonSTEMI, with biventricular heart failure, on  multiple pressor,  rhabdomyolysis with acute kidney injury, requiring CRRT.   Pt was in hospital for 10 days; he passed away on 31 Jan 2021."
	"0996086-1"	"0996086-1"	"MYALGIA"	"10028411"	"50-59 years"	"50-59"	"Pt received vaccine on 7 jan. 2021   Twelve days later, on 19 January 2021, Pt developed symptoms of COVID (cough, sore throat, fever, myalgias), on 20 Jan, pt admitted to hospital for worsening symptoms. Pt tested positive for COVID 19.  Pt admitted to ICU where pt had complicated hospital course to include ARDS secondary to COVID pneumonia, nonSTEMI, with biventricular heart failure, on  multiple pressor,  rhabdomyolysis with acute kidney injury, requiring CRRT.   Pt was in hospital for 10 days; he passed away on 31 Jan 2021."
	"0996086-1"	"0996086-1"	"OROPHARYNGEAL PAIN"	"10068319"	"50-59 years"	"50-59"	"Pt received vaccine on 7 jan. 2021   Twelve days later, on 19 January 2021, Pt developed symptoms of COVID (cough, sore throat, fever, myalgias), on 20 Jan, pt admitted to hospital for worsening symptoms. Pt tested positive for COVID 19.  Pt admitted to ICU where pt had complicated hospital course to include ARDS secondary to COVID pneumonia, nonSTEMI, with biventricular heart failure, on  multiple pressor,  rhabdomyolysis with acute kidney injury, requiring CRRT.   Pt was in hospital for 10 days; he passed away on 31 Jan 2021."
	"0996086-1"	"0996086-1"	"PYREXIA"	"10037660"	"50-59 years"	"50-59"	"Pt received vaccine on 7 jan. 2021   Twelve days later, on 19 January 2021, Pt developed symptoms of COVID (cough, sore throat, fever, myalgias), on 20 Jan, pt admitted to hospital for worsening symptoms. Pt tested positive for COVID 19.  Pt admitted to ICU where pt had complicated hospital course to include ARDS secondary to COVID pneumonia, nonSTEMI, with biventricular heart failure, on  multiple pressor,  rhabdomyolysis with acute kidney injury, requiring CRRT.   Pt was in hospital for 10 days; he passed away on 31 Jan 2021."
	"0996086-1"	"0996086-1"	"RENAL REPLACEMENT THERAPY"	"10074746"	"50-59 years"	"50-59"	"Pt received vaccine on 7 jan. 2021   Twelve days later, on 19 January 2021, Pt developed symptoms of COVID (cough, sore throat, fever, myalgias), on 20 Jan, pt admitted to hospital for worsening symptoms. Pt tested positive for COVID 19.  Pt admitted to ICU where pt had complicated hospital course to include ARDS secondary to COVID pneumonia, nonSTEMI, with biventricular heart failure, on  multiple pressor,  rhabdomyolysis with acute kidney injury, requiring CRRT.   Pt was in hospital for 10 days; he passed away on 31 Jan 2021."
	"0996086-1"	"0996086-1"	"RHABDOMYOLYSIS"	"10039020"	"50-59 years"	"50-59"	"Pt received vaccine on 7 jan. 2021   Twelve days later, on 19 January 2021, Pt developed symptoms of COVID (cough, sore throat, fever, myalgias), on 20 Jan, pt admitted to hospital for worsening symptoms. Pt tested positive for COVID 19.  Pt admitted to ICU where pt had complicated hospital course to include ARDS secondary to COVID pneumonia, nonSTEMI, with biventricular heart failure, on  multiple pressor,  rhabdomyolysis with acute kidney injury, requiring CRRT.   Pt was in hospital for 10 days; he passed away on 31 Jan 2021."
	"0996086-1"	"0996086-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"Pt received vaccine on 7 jan. 2021   Twelve days later, on 19 January 2021, Pt developed symptoms of COVID (cough, sore throat, fever, myalgias), on 20 Jan, pt admitted to hospital for worsening symptoms. Pt tested positive for COVID 19.  Pt admitted to ICU where pt had complicated hospital course to include ARDS secondary to COVID pneumonia, nonSTEMI, with biventricular heart failure, on  multiple pressor,  rhabdomyolysis with acute kidney injury, requiring CRRT.   Pt was in hospital for 10 days; he passed away on 31 Jan 2021."
	"0996156-1"	"0996156-1"	"ARTHRALGIA"	"10003239"	"50-59 years"	"50-59"	""Client came to nursing station about 2pm to report she ""was not feeling well"". Nurses took vital signs, then referred her to the vaccination clinic that was onsite. She was observed by vaccination team for a period of time. She reported shoulder pain radiating into shoulder blade in arm vaccine was received. Vaccination team offered ice pack to her, observed for a period of time, and released back to work. About 10pm that evening, she sent a text to another coworker that her pain was ""off the charts"" and that she had pain covering her whole left side of her body.  She did not come to work in the morning and did not contact work. Well being check was performed at approximately 9am on 2/2/2021 and she was found dead in her home.  911 was immediately called and authorities took over the scene.""
	"0996156-1"	"0996156-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	""Client came to nursing station about 2pm to report she ""was not feeling well"". Nurses took vital signs, then referred her to the vaccination clinic that was onsite. She was observed by vaccination team for a period of time. She reported shoulder pain radiating into shoulder blade in arm vaccine was received. Vaccination team offered ice pack to her, observed for a period of time, and released back to work. About 10pm that evening, she sent a text to another coworker that her pain was ""off the charts"" and that she had pain covering her whole left side of her body.  She did not come to work in the morning and did not contact work. Well being check was performed at approximately 9am on 2/2/2021 and she was found dead in her home.  911 was immediately called and authorities took over the scene.""
	"0996156-1"	"0996156-1"	"IMPAIRED WORK ABILITY"	"10052302"	"50-59 years"	"50-59"	""Client came to nursing station about 2pm to report she ""was not feeling well"". Nurses took vital signs, then referred her to the vaccination clinic that was onsite. She was observed by vaccination team for a period of time. She reported shoulder pain radiating into shoulder blade in arm vaccine was received. Vaccination team offered ice pack to her, observed for a period of time, and released back to work. About 10pm that evening, she sent a text to another coworker that her pain was ""off the charts"" and that she had pain covering her whole left side of her body.  She did not come to work in the morning and did not contact work. Well being check was performed at approximately 9am on 2/2/2021 and she was found dead in her home.  911 was immediately called and authorities took over the scene.""
	"0996156-1"	"0996156-1"	"INJECTION SITE PAIN"	"10022086"	"50-59 years"	"50-59"	""Client came to nursing station about 2pm to report she ""was not feeling well"". Nurses took vital signs, then referred her to the vaccination clinic that was onsite. She was observed by vaccination team for a period of time. She reported shoulder pain radiating into shoulder blade in arm vaccine was received. Vaccination team offered ice pack to her, observed for a period of time, and released back to work. About 10pm that evening, she sent a text to another coworker that her pain was ""off the charts"" and that she had pain covering her whole left side of her body.  She did not come to work in the morning and did not contact work. Well being check was performed at approximately 9am on 2/2/2021 and she was found dead in her home.  911 was immediately called and authorities took over the scene.""
	"0996156-1"	"0996156-1"	"MALAISE"	"10025482"	"50-59 years"	"50-59"	""Client came to nursing station about 2pm to report she ""was not feeling well"". Nurses took vital signs, then referred her to the vaccination clinic that was onsite. She was observed by vaccination team for a period of time. She reported shoulder pain radiating into shoulder blade in arm vaccine was received. Vaccination team offered ice pack to her, observed for a period of time, and released back to work. About 10pm that evening, she sent a text to another coworker that her pain was ""off the charts"" and that she had pain covering her whole left side of her body.  She did not come to work in the morning and did not contact work. Well being check was performed at approximately 9am on 2/2/2021 and she was found dead in her home.  911 was immediately called and authorities took over the scene.""
	"0996156-1"	"0996156-1"	"PAIN"	"10033371"	"50-59 years"	"50-59"	""Client came to nursing station about 2pm to report she ""was not feeling well"". Nurses took vital signs, then referred her to the vaccination clinic that was onsite. She was observed by vaccination team for a period of time. She reported shoulder pain radiating into shoulder blade in arm vaccine was received. Vaccination team offered ice pack to her, observed for a period of time, and released back to work. About 10pm that evening, she sent a text to another coworker that her pain was ""off the charts"" and that she had pain covering her whole left side of her body.  She did not come to work in the morning and did not contact work. Well being check was performed at approximately 9am on 2/2/2021 and she was found dead in her home.  911 was immediately called and authorities took over the scene.""
	"1002418-1"	"1002418-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient death"
	"1003624-1"	"1003624-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient awake at 0300. When going into the room to get him ready for dialysis he was cold to touch, unresponsive other than to sound, and nonverbal. O2 sat was 67 via finger probe. Oxygen immediately initiated and a venturi mask retrieved and initiated. When unable to arouse him via sternal rub this RN called 911.  Send to ED.  Febrile 39.2 and hypotensive 58/43.  Admitted.  unknown after that as patient expired in hospital."
	"1003624-1"	"1003624-1"	"HYPOTENSION"	"10021097"	"50-59 years"	"50-59"	"Patient awake at 0300. When going into the room to get him ready for dialysis he was cold to touch, unresponsive other than to sound, and nonverbal. O2 sat was 67 via finger probe. Oxygen immediately initiated and a venturi mask retrieved and initiated. When unable to arouse him via sternal rub this RN called 911.  Send to ED.  Febrile 39.2 and hypotensive 58/43.  Admitted.  unknown after that as patient expired in hospital."
	"1003624-1"	"1003624-1"	"OXYGEN SATURATION DECREASED"	"10033318"	"50-59 years"	"50-59"	"Patient awake at 0300. When going into the room to get him ready for dialysis he was cold to touch, unresponsive other than to sound, and nonverbal. O2 sat was 67 via finger probe. Oxygen immediately initiated and a venturi mask retrieved and initiated. When unable to arouse him via sternal rub this RN called 911.  Send to ED.  Febrile 39.2 and hypotensive 58/43.  Admitted.  unknown after that as patient expired in hospital."
	"1003624-1"	"1003624-1"	"PERIPHERAL COLDNESS"	"10034568"	"50-59 years"	"50-59"	"Patient awake at 0300. When going into the room to get him ready for dialysis he was cold to touch, unresponsive other than to sound, and nonverbal. O2 sat was 67 via finger probe. Oxygen immediately initiated and a venturi mask retrieved and initiated. When unable to arouse him via sternal rub this RN called 911.  Send to ED.  Febrile 39.2 and hypotensive 58/43.  Admitted.  unknown after that as patient expired in hospital."
	"1003624-1"	"1003624-1"	"PYREXIA"	"10037660"	"50-59 years"	"50-59"	"Patient awake at 0300. When going into the room to get him ready for dialysis he was cold to touch, unresponsive other than to sound, and nonverbal. O2 sat was 67 via finger probe. Oxygen immediately initiated and a venturi mask retrieved and initiated. When unable to arouse him via sternal rub this RN called 911.  Send to ED.  Febrile 39.2 and hypotensive 58/43.  Admitted.  unknown after that as patient expired in hospital."
	"1003624-1"	"1003624-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"50-59 years"	"50-59"	"Patient awake at 0300. When going into the room to get him ready for dialysis he was cold to touch, unresponsive other than to sound, and nonverbal. O2 sat was 67 via finger probe. Oxygen immediately initiated and a venturi mask retrieved and initiated. When unable to arouse him via sternal rub this RN called 911.  Send to ED.  Febrile 39.2 and hypotensive 58/43.  Admitted.  unknown after that as patient expired in hospital."
	"1006168-1"	"1006168-1"	"ACUTE KIDNEY INJURY"	"10069339"	"50-59 years"	"50-59"	"The patient,  who was a pharmacist, developed fatigue and shortness of breath hours after receiving vaccine.  Two days later, on 01/28/2021, the patient went to local urgent care for worsening shortness of breath and was referred to Hospital for worsening dyspnea and hypoxia.  The patient was admitted to the hospital   We was found to have bilateral pulmonary infiltrates and treated for pneumonia with Rocephin and azithromycin.  He was tested for COVID-19 multiple times, but each of the results were negative.  Despite the negative results, there was high clinical suspicion for COVID-19 and the patient was started on Remdesivir and Decadron.  The  patient's oxygen requirements continued to worsen and the patient was transferred to another facility for higher level of care.  There  his hypoxia worsened and he required mechanical ventilation.  Patient then developed hypotension and required vasopressors for blood pressure support.  Furthermore, patient developed acute renal failure requiring hemodialysis.  Despite mechanical ventilation with FiO2 100%, and for vasopressors, patient clinically deteriorated and family decided to palliatively extubate on 02/05/2021."
	"1006168-1"	"1006168-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"The patient,  who was a pharmacist, developed fatigue and shortness of breath hours after receiving vaccine.  Two days later, on 01/28/2021, the patient went to local urgent care for worsening shortness of breath and was referred to Hospital for worsening dyspnea and hypoxia.  The patient was admitted to the hospital   We was found to have bilateral pulmonary infiltrates and treated for pneumonia with Rocephin and azithromycin.  He was tested for COVID-19 multiple times, but each of the results were negative.  Despite the negative results, there was high clinical suspicion for COVID-19 and the patient was started on Remdesivir and Decadron.  The  patient's oxygen requirements continued to worsen and the patient was transferred to another facility for higher level of care.  There  his hypoxia worsened and he required mechanical ventilation.  Patient then developed hypotension and required vasopressors for blood pressure support.  Furthermore, patient developed acute renal failure requiring hemodialysis.  Despite mechanical ventilation with FiO2 100%, and for vasopressors, patient clinically deteriorated and family decided to palliatively extubate on 02/05/2021."
	"1006168-1"	"1006168-1"	"FATIGUE"	"10016256"	"50-59 years"	"50-59"	"The patient,  who was a pharmacist, developed fatigue and shortness of breath hours after receiving vaccine.  Two days later, on 01/28/2021, the patient went to local urgent care for worsening shortness of breath and was referred to Hospital for worsening dyspnea and hypoxia.  The patient was admitted to the hospital   We was found to have bilateral pulmonary infiltrates and treated for pneumonia with Rocephin and azithromycin.  He was tested for COVID-19 multiple times, but each of the results were negative.  Despite the negative results, there was high clinical suspicion for COVID-19 and the patient was started on Remdesivir and Decadron.  The  patient's oxygen requirements continued to worsen and the patient was transferred to another facility for higher level of care.  There  his hypoxia worsened and he required mechanical ventilation.  Patient then developed hypotension and required vasopressors for blood pressure support.  Furthermore, patient developed acute renal failure requiring hemodialysis.  Despite mechanical ventilation with FiO2 100%, and for vasopressors, patient clinically deteriorated and family decided to palliatively extubate on 02/05/2021."
	"1006168-1"	"1006168-1"	"GENERAL PHYSICAL HEALTH DETERIORATION"	"10049438"	"50-59 years"	"50-59"	"The patient,  who was a pharmacist, developed fatigue and shortness of breath hours after receiving vaccine.  Two days later, on 01/28/2021, the patient went to local urgent care for worsening shortness of breath and was referred to Hospital for worsening dyspnea and hypoxia.  The patient was admitted to the hospital   We was found to have bilateral pulmonary infiltrates and treated for pneumonia with Rocephin and azithromycin.  He was tested for COVID-19 multiple times, but each of the results were negative.  Despite the negative results, there was high clinical suspicion for COVID-19 and the patient was started on Remdesivir and Decadron.  The  patient's oxygen requirements continued to worsen and the patient was transferred to another facility for higher level of care.  There  his hypoxia worsened and he required mechanical ventilation.  Patient then developed hypotension and required vasopressors for blood pressure support.  Furthermore, patient developed acute renal failure requiring hemodialysis.  Despite mechanical ventilation with FiO2 100%, and for vasopressors, patient clinically deteriorated and family decided to palliatively extubate on 02/05/2021."
	"1006168-1"	"1006168-1"	"HAEMODIALYSIS"	"10018875"	"50-59 years"	"50-59"	"The patient,  who was a pharmacist, developed fatigue and shortness of breath hours after receiving vaccine.  Two days later, on 01/28/2021, the patient went to local urgent care for worsening shortness of breath and was referred to Hospital for worsening dyspnea and hypoxia.  The patient was admitted to the hospital   We was found to have bilateral pulmonary infiltrates and treated for pneumonia with Rocephin and azithromycin.  He was tested for COVID-19 multiple times, but each of the results were negative.  Despite the negative results, there was high clinical suspicion for COVID-19 and the patient was started on Remdesivir and Decadron.  The  patient's oxygen requirements continued to worsen and the patient was transferred to another facility for higher level of care.  There  his hypoxia worsened and he required mechanical ventilation.  Patient then developed hypotension and required vasopressors for blood pressure support.  Furthermore, patient developed acute renal failure requiring hemodialysis.  Despite mechanical ventilation with FiO2 100%, and for vasopressors, patient clinically deteriorated and family decided to palliatively extubate on 02/05/2021."
	"1006168-1"	"1006168-1"	"HYPOTENSION"	"10021097"	"50-59 years"	"50-59"	"The patient,  who was a pharmacist, developed fatigue and shortness of breath hours after receiving vaccine.  Two days later, on 01/28/2021, the patient went to local urgent care for worsening shortness of breath and was referred to Hospital for worsening dyspnea and hypoxia.  The patient was admitted to the hospital   We was found to have bilateral pulmonary infiltrates and treated for pneumonia with Rocephin and azithromycin.  He was tested for COVID-19 multiple times, but each of the results were negative.  Despite the negative results, there was high clinical suspicion for COVID-19 and the patient was started on Remdesivir and Decadron.  The  patient's oxygen requirements continued to worsen and the patient was transferred to another facility for higher level of care.  There  his hypoxia worsened and he required mechanical ventilation.  Patient then developed hypotension and required vasopressors for blood pressure support.  Furthermore, patient developed acute renal failure requiring hemodialysis.  Despite mechanical ventilation with FiO2 100%, and for vasopressors, patient clinically deteriorated and family decided to palliatively extubate on 02/05/2021."
	"1006168-1"	"1006168-1"	"HYPOXIA"	"10021143"	"50-59 years"	"50-59"	"The patient,  who was a pharmacist, developed fatigue and shortness of breath hours after receiving vaccine.  Two days later, on 01/28/2021, the patient went to local urgent care for worsening shortness of breath and was referred to Hospital for worsening dyspnea and hypoxia.  The patient was admitted to the hospital   We was found to have bilateral pulmonary infiltrates and treated for pneumonia with Rocephin and azithromycin.  He was tested for COVID-19 multiple times, but each of the results were negative.  Despite the negative results, there was high clinical suspicion for COVID-19 and the patient was started on Remdesivir and Decadron.  The  patient's oxygen requirements continued to worsen and the patient was transferred to another facility for higher level of care.  There  his hypoxia worsened and he required mechanical ventilation.  Patient then developed hypotension and required vasopressors for blood pressure support.  Furthermore, patient developed acute renal failure requiring hemodialysis.  Despite mechanical ventilation with FiO2 100%, and for vasopressors, patient clinically deteriorated and family decided to palliatively extubate on 02/05/2021."
	"1006168-1"	"1006168-1"	"LUNG INFILTRATION"	"10025102"	"50-59 years"	"50-59"	"The patient,  who was a pharmacist, developed fatigue and shortness of breath hours after receiving vaccine.  Two days later, on 01/28/2021, the patient went to local urgent care for worsening shortness of breath and was referred to Hospital for worsening dyspnea and hypoxia.  The patient was admitted to the hospital   We was found to have bilateral pulmonary infiltrates and treated for pneumonia with Rocephin and azithromycin.  He was tested for COVID-19 multiple times, but each of the results were negative.  Despite the negative results, there was high clinical suspicion for COVID-19 and the patient was started on Remdesivir and Decadron.  The  patient's oxygen requirements continued to worsen and the patient was transferred to another facility for higher level of care.  There  his hypoxia worsened and he required mechanical ventilation.  Patient then developed hypotension and required vasopressors for blood pressure support.  Furthermore, patient developed acute renal failure requiring hemodialysis.  Despite mechanical ventilation with FiO2 100%, and for vasopressors, patient clinically deteriorated and family decided to palliatively extubate on 02/05/2021."
	"1006168-1"	"1006168-1"	"MECHANICAL VENTILATION"	"10067221"	"50-59 years"	"50-59"	"The patient,  who was a pharmacist, developed fatigue and shortness of breath hours after receiving vaccine.  Two days later, on 01/28/2021, the patient went to local urgent care for worsening shortness of breath and was referred to Hospital for worsening dyspnea and hypoxia.  The patient was admitted to the hospital   We was found to have bilateral pulmonary infiltrates and treated for pneumonia with Rocephin and azithromycin.  He was tested for COVID-19 multiple times, but each of the results were negative.  Despite the negative results, there was high clinical suspicion for COVID-19 and the patient was started on Remdesivir and Decadron.  The  patient's oxygen requirements continued to worsen and the patient was transferred to another facility for higher level of care.  There  his hypoxia worsened and he required mechanical ventilation.  Patient then developed hypotension and required vasopressors for blood pressure support.  Furthermore, patient developed acute renal failure requiring hemodialysis.  Despite mechanical ventilation with FiO2 100%, and for vasopressors, patient clinically deteriorated and family decided to palliatively extubate on 02/05/2021."
	"1006168-1"	"1006168-1"	"PNEUMONIA"	"10035664"	"50-59 years"	"50-59"	"The patient,  who was a pharmacist, developed fatigue and shortness of breath hours after receiving vaccine.  Two days later, on 01/28/2021, the patient went to local urgent care for worsening shortness of breath and was referred to Hospital for worsening dyspnea and hypoxia.  The patient was admitted to the hospital   We was found to have bilateral pulmonary infiltrates and treated for pneumonia with Rocephin and azithromycin.  He was tested for COVID-19 multiple times, but each of the results were negative.  Despite the negative results, there was high clinical suspicion for COVID-19 and the patient was started on Remdesivir and Decadron.  The  patient's oxygen requirements continued to worsen and the patient was transferred to another facility for higher level of care.  There  his hypoxia worsened and he required mechanical ventilation.  Patient then developed hypotension and required vasopressors for blood pressure support.  Furthermore, patient developed acute renal failure requiring hemodialysis.  Despite mechanical ventilation with FiO2 100%, and for vasopressors, patient clinically deteriorated and family decided to palliatively extubate on 02/05/2021."
	"1006168-1"	"1006168-1"	"SARS-COV-2 TEST NEGATIVE"	"10084273"	"50-59 years"	"50-59"	"The patient,  who was a pharmacist, developed fatigue and shortness of breath hours after receiving vaccine.  Two days later, on 01/28/2021, the patient went to local urgent care for worsening shortness of breath and was referred to Hospital for worsening dyspnea and hypoxia.  The patient was admitted to the hospital   We was found to have bilateral pulmonary infiltrates and treated for pneumonia with Rocephin and azithromycin.  He was tested for COVID-19 multiple times, but each of the results were negative.  Despite the negative results, there was high clinical suspicion for COVID-19 and the patient was started on Remdesivir and Decadron.  The  patient's oxygen requirements continued to worsen and the patient was transferred to another facility for higher level of care.  There  his hypoxia worsened and he required mechanical ventilation.  Patient then developed hypotension and required vasopressors for blood pressure support.  Furthermore, patient developed acute renal failure requiring hemodialysis.  Despite mechanical ventilation with FiO2 100%, and for vasopressors, patient clinically deteriorated and family decided to palliatively extubate on 02/05/2021."
	"1006168-1"	"1006168-1"	"VASOPRESSIVE THERAPY"	"10064148"	"50-59 years"	"50-59"	"The patient,  who was a pharmacist, developed fatigue and shortness of breath hours after receiving vaccine.  Two days later, on 01/28/2021, the patient went to local urgent care for worsening shortness of breath and was referred to Hospital for worsening dyspnea and hypoxia.  The patient was admitted to the hospital   We was found to have bilateral pulmonary infiltrates and treated for pneumonia with Rocephin and azithromycin.  He was tested for COVID-19 multiple times, but each of the results were negative.  Despite the negative results, there was high clinical suspicion for COVID-19 and the patient was started on Remdesivir and Decadron.  The  patient's oxygen requirements continued to worsen and the patient was transferred to another facility for higher level of care.  There  his hypoxia worsened and he required mechanical ventilation.  Patient then developed hypotension and required vasopressors for blood pressure support.  Furthermore, patient developed acute renal failure requiring hemodialysis.  Despite mechanical ventilation with FiO2 100%, and for vasopressors, patient clinically deteriorated and family decided to palliatively extubate on 02/05/2021."
	"1006416-1"	"1006416-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient died of a heart attack on 1/31/21, 2.5 weeks after vaccination"
	"1006416-1"	"1006416-1"	"MYOCARDIAL INFARCTION"	"10028596"	"50-59 years"	"50-59"	"Patient died of a heart attack on 1/31/21, 2.5 weeks after vaccination"
	"1006662-1"	"1006662-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	""Pt had 2nd vaccine, went home and started having ""cramping"" in all of her muscles.  It became bad enough that she was taken to local ED where she then started coughing up blood, required intubation and about 6 hrs later, died.""
	"1006662-1"	"1006662-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"50-59 years"	"50-59"	""Pt had 2nd vaccine, went home and started having ""cramping"" in all of her muscles.  It became bad enough that she was taken to local ED where she then started coughing up blood, required intubation and about 6 hrs later, died.""
	"1006662-1"	"1006662-1"	"HAEMOPTYSIS"	"10018964"	"50-59 years"	"50-59"	""Pt had 2nd vaccine, went home and started having ""cramping"" in all of her muscles.  It became bad enough that she was taken to local ED where she then started coughing up blood, required intubation and about 6 hrs later, died.""
	"1006662-1"	"1006662-1"	"MUSCLE SPASMS"	"10028334"	"50-59 years"	"50-59"	""Pt had 2nd vaccine, went home and started having ""cramping"" in all of her muscles.  It became bad enough that she was taken to local ED where she then started coughing up blood, required intubation and about 6 hrs later, died.""
	"1010114-1"	"1010114-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient passed away (Dead on Arrival on presentation to ER) on 02/03/2021"
	"1010114-1"	"1010114-1"	"SARS-COV-2 TEST"	"10084354"	"50-59 years"	"50-59"	"Patient passed away (Dead on Arrival on presentation to ER) on 02/03/2021"
	"1012047-1"	"1012047-1"	"ACIDOSIS"	"10000486"	"50-59 years"	"50-59"	"Sudden death 2/7/21 @ 0309 Started acute encephalopathy & required intubation Soon after intubation went into cardiac arrest Likely severe acidosis."
	"1012047-1"	"1012047-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"Sudden death 2/7/21 @ 0309 Started acute encephalopathy & required intubation Soon after intubation went into cardiac arrest Likely severe acidosis."
	"1012047-1"	"1012047-1"	"ENCEPHALOPATHY"	"10014625"	"50-59 years"	"50-59"	"Sudden death 2/7/21 @ 0309 Started acute encephalopathy & required intubation Soon after intubation went into cardiac arrest Likely severe acidosis."
	"1012047-1"	"1012047-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"50-59 years"	"50-59"	"Sudden death 2/7/21 @ 0309 Started acute encephalopathy & required intubation Soon after intubation went into cardiac arrest Likely severe acidosis."
	"1012047-1"	"1012047-1"	"SUDDEN DEATH"	"10042434"	"50-59 years"	"50-59"	"Sudden death 2/7/21 @ 0309 Started acute encephalopathy & required intubation Soon after intubation went into cardiac arrest Likely severe acidosis."
	"1013145-1"	"1013145-1"	"FATIGUE"	"10016256"	"50-59 years"	"50-59"	"Patient texted a friend on 2/7/2021 c/o arm pain and feeling tired. I don't know if he was taken to a hospital.  Autopsy today."
	"1013145-1"	"1013145-1"	"PAIN IN EXTREMITY"	"10033425"	"50-59 years"	"50-59"	"Patient texted a friend on 2/7/2021 c/o arm pain and feeling tired. I don't know if he was taken to a hospital.  Autopsy today."
	"1019670-1"	"1019670-1"	"ALANINE AMINOTRANSFERASE INCREASED"	"10001551"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"ANION GAP"	"10002522"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"ASPARTATE AMINOTRANSFERASE INCREASED"	"10003481"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"ASTHENIA"	"10003549"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"BACTERIAL TEST POSITIVE"	"10059421"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"BASE EXCESS"	"10059961"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"BASOPHIL COUNT INCREASED"	"10004169"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"BILIRUBIN URINE"	"10053113"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"BLOOD ALBUMIN DECREASED"	"10005287"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"BLOOD ALKALINE PHOSPHATASE INCREASED"	"10059570"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"BLOOD BICARBONATE INCREASED"	"10005360"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"BLOOD BILIRUBIN NORMAL"	"10005367"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"BLOOD CALCIUM DECREASED"	"10005395"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"BLOOD CHLORIDE DECREASED"	"10005419"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"BLOOD CREATINE PHOSPHOKINASE MB DECREASED"	"10067537"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"BLOOD CREATINE PHOSPHOKINASE NORMAL"	"10005479"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"BLOOD CREATININE INCREASED"	"10005483"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"BLOOD GLUCOSE INCREASED"	"10005557"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"BLOOD LACTIC ACID NORMAL"	"10005636"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"BLOOD PH DECREASED"	"10005706"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"BLOOD POTASSIUM NORMAL"	"10005726"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"BLOOD SODIUM DECREASED"	"10005802"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"BLOOD SODIUM NORMAL"	"10005804"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"BLOOD UREA INCREASED"	"10005851"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"BLOOD UREA NITROGEN/CREATININE RATIO INCREASED"	"10050760"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"C-REACTIVE PROTEIN NORMAL"	"10006826"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"CARBON DIOXIDE DECREASED"	"10007223"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"CHEST X-RAY ABNORMAL"	"10008499"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"CHROMATURIA"	"10008796"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"CREATINE URINE INCREASED"	"10011356"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"CRYSTAL URINE PRESENT"	"10011512"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"DIFFERENTIAL WHITE BLOOD CELL COUNT NORMAL"	"10012787"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"DYSURIA"	"10013990"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"EOSINOPHIL COUNT DECREASED"	"10014943"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"ERYTHEMA"	"10015150"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"FLUID OVERLOAD"	"10016803"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"FULL BLOOD COUNT NORMAL"	"10017414"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"GLOBULINS DECREASED"	"10058001"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"GLOMERULAR FILTRATION RATE DECREASED"	"10018358"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"GLUCOSE URINE ABSENT"	"10018474"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"HAEMATOCRIT NORMAL"	"10018842"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"HAEMOGLOBIN DECREASED"	"10018884"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"HYPOPERFUSION"	"10058558"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"HYPOTENSION"	"10021097"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"IMMATURE GRANULOCYTE COUNT INCREASED"	"10081727"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"INFLUENZA VIRUS TEST NEGATIVE"	"10070718"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"INTESTINAL ISCHAEMIA"	"10022680"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"LIPASE"	"10050659"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"LUNG OPACITY"	"10081792"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"LYMPHOCYTE COUNT NORMAL"	"10025260"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"MEAN CELL HAEMOGLOBIN CONCENTRATION DECREASED"	"10026991"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"MEAN CELL HAEMOGLOBIN NORMAL"	"10026997"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"MEAN CELL VOLUME INCREASED"	"10027004"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"MEAN PLATELET VOLUME NORMAL"	"10055070"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"METABOLIC FUNCTION TEST"	"10062191"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"METAMYELOCYTE PERCENTAGE"	"10059469"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"MONOCYTE COUNT DECREASED"	"10027878"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"MONOCYTE COUNT NORMAL"	"10027882"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"NEUTROPHIL COUNT"	"10029363"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"NEUTROPHIL COUNT NORMAL"	"10029370"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"NITRITE URINE ABSENT"	"10060799"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"OPIATES NEGATIVE"	"10063225"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"OXYGEN SATURATION DECREASED"	"10033318"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"PCO2 INCREASED"	"10034183"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"PH URINE NORMAL"	"10034797"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"PLATELET COUNT NORMAL"	"10035530"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"PLEURAL EFFUSION"	"10035598"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"PNEUMONIA ASPIRATION"	"10035669"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"PNEUMONITIS"	"10035742"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"PO2 NORMAL"	"10035770"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"PROCALCITONIN DECREASED"	"10077830"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"PROTEIN TOTAL DECREASED"	"10037014"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"PROTEIN URINE PRESENT"	"10053123"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"PULSE ABSENT"	"10037469"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"PYREXIA"	"10037660"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"RED BLOOD CELL COUNT DECREASED"	"10038153"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"RED BLOOD CELL SEDIMENTATION RATE NORMAL"	"10049408"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"RED BLOOD CELLS URINE"	"10050676"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"RED CELL DISTRIBUTION WIDTH INCREASED"	"10053920"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"RESUSCITATION"	"10038749"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"RIB FRACTURE"	"10039117"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"SARS-COV-2 TEST NEGATIVE"	"10084273"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"SMALL INTESTINAL OBSTRUCTION"	"10041101"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"SPECIFIC GRAVITY URINE NORMAL"	"10041440"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"TOXICOLOGIC TEST NORMAL"	"10061383"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"TROPONIN I NORMAL"	"10073406"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"URINARY CASTS"	"10046533"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"URINARY LIPIDS PRESENT"	"10065297"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"URINARY OCCULT BLOOD POSITIVE"	"10052287"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"URINE ANALYSIS"	"10046614"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"URINE ANALYSIS ABNORMAL"	"10062226"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"URINE ANALYSIS NORMAL"	"10061578"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"URINE KETONE BODY PRESENT"	"10057597"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"URINE LEUKOCYTE ESTERASE"	"10050413"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"UROBILINOGEN URINE"	"10059506"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"VOMITING"	"10047700"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"WHITE BLOOD CELL COUNT NORMAL"	"10047944"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1019670-1"	"1019670-1"	"WHITE BLOOD CELLS URINE POSITIVE"	"10047967"	"50-59 years"	"50-59"	"2/2/2021- seen in Ed with c/o intermittent fever following 2nd dose.  Redness to bilateral upper extremities, c/o some pain with urination, weak.  V/S stable, afebrile in ED.  Assess for infection.   No significant abnormal labs (see below), hydrated and discharged.   2/4/2021-  arrived in ED with c/o vomiting, seen earlier by PCP that day labs drawn.  Shortly after arriving in the ED copious amouts of emesis noted, the patient went into full cardiac arrest and CPR was started.   -Please see HPI above, in addition after intubation the patient coded again.  More epinephrine and lidocaine were given.  CPR was resumed.  We did obtain ROSC and targeted temperature management was pursued.  He is placed on a lidocaine drip and a right femoral central line was placed by myself.  At this time, norepinephrine drip was initiated given his continued hypotension.  Post intubation chest x-ray suggests possible abdominal pathology and once the patient was stabilized further, he was sent to the CT scanner where CT head without IV contrast and CT chest, abdomen and pelvis with IV contrast was obtained.  He did lose pulses once in the radiology suite.  This was brief.  IV fluids were initiated and he received over 2 L of crystalloid therapy.  He continued to be hypotensive in the emergency department and vasopressin was added.  He also had a single dose of Neo-Synephrine and IV push fashion to help bring his blood pressure up.  CT scan reveals probable bilateral aspiration pneumonia/pneumonitis and dilated loops of small bowel without a transition point and pneumatosis involving loops in the left upper quadrant.  I did try to initiate consult with critical care and possible transfer, however he continued to be unstable and coded requiring CPR multiple times.  He was given IV bicarbonate given his prolonged CPR state and pH.  Ultimately, the family decided to make the patient comfort measures only given his critical illness.  Shortly after making this decision he did pass away in the emergency department.  RADIOLOGY DIAGNOSTIC - CHEST PORTABLE 02/04 2051 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2059 IMPRESSION: 1. Findings highly suspicious for portal venous gas which can be seen in the setting of bowel ischemia.  Consider CT for further evaluation and/or surgical consultation. 2. Endotracheal tube 3.7 cm above the carina. 3. Low lung volumes with mild patchy perihilar opacities.   Final Report Signed by: M.D.,  Sign Date/Time: 02/04/2021 8:55 PM Impression By: MD CT SCAN - CT HEAD WO 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2200 IMPRESSION: Negative for acute intracranial process.  No evidence of mass effect, acute hemorrhage or definite acute cortical infarct.   Final Report Signed by: M.D., Sign Date/Time: 02/04/2021 9:57 PM Impression By: - MD CT SCAN - CT CHEST/ABD/PELVIS W 02/04 2140 *** Report Impression - Status: SIGNED  Entered: 02/04/2021 2214 IMPRESSION: 1. Ill-defined patchy opacities within the bilateral upper lobes, right middle lobe, in consolidative opacities within bilateral lower lobes which could represent aspiration, and/or multifocal pneumonia. 2. Small right trace left pleural effusions. 3. Diffusely dilated small bowel without a transition point and mucosal hyperenhancement involving the colon with areas of pneumatosis involving loops of small bowel within the left upper quadrant and portal venous air consistent with hypoperfusion complex. There is a small caliber appearance of the aorta and a flattened appearance of the IVC is well. 4. Intravascular air within the IVC and bilateral iliac veins could be secondary to right femoral central lying injection. 5. Somewhat abnormal enhancement pattern of the kidneys with hypoenhancement of the medullary pyramids which may suggest hypoperfusion injury as well. 6. Probable nondisplaced rib fractures on the right at ribs 2 through"
	"1024067-1"	"1024067-1"	"CHILLS"	"10008531"	"50-59 years"	"50-59"	"1/15: Pfizer vaccine dose 1 administered 1/16: Fever, chills 1/22: Sore throat, coughing w/white phlegm, taking Tylenol and Mucinex.  Fever and chills from 1/16 subsided. Had telehealth consultation with PA. Per her notes, patient said he gets these symptoms annually, requested for an antibiotic. PA referred him for a COVID test. Ordered hydrocodone/chlorphen ER suspension for his cough and an antibiotic. Antibiotic was recommended if symptoms do not subside.  1/23: COVID test administered 1/25: Reported positive for COVID 1/26: Telehealth session w/PA: she informed patient of his positive test, advised to quarantine and seek medical help at hospital if symptoms worsen. Patient reported that his sore throat mostly subsided but is still coughing at night. Said that the pharmacy didn't receive the prescription order for the antibiotic, so this was re-ordered. 1/31: Partner found him dead at 8:18AM on his bed.  Death certificate issued by state says cause of death: COVID. Autopsy was not performed. Buried on 2/9/21."
	"1024067-1"	"1024067-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"1/15: Pfizer vaccine dose 1 administered 1/16: Fever, chills 1/22: Sore throat, coughing w/white phlegm, taking Tylenol and Mucinex.  Fever and chills from 1/16 subsided. Had telehealth consultation with PA. Per her notes, patient said he gets these symptoms annually, requested for an antibiotic. PA referred him for a COVID test. Ordered hydrocodone/chlorphen ER suspension for his cough and an antibiotic. Antibiotic was recommended if symptoms do not subside.  1/23: COVID test administered 1/25: Reported positive for COVID 1/26: Telehealth session w/PA: she informed patient of his positive test, advised to quarantine and seek medical help at hospital if symptoms worsen. Patient reported that his sore throat mostly subsided but is still coughing at night. Said that the pharmacy didn't receive the prescription order for the antibiotic, so this was re-ordered. 1/31: Partner found him dead at 8:18AM on his bed.  Death certificate issued by state says cause of death: COVID. Autopsy was not performed. Buried on 2/9/21."
	"1024067-1"	"1024067-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"1/15: Pfizer vaccine dose 1 administered 1/16: Fever, chills 1/22: Sore throat, coughing w/white phlegm, taking Tylenol and Mucinex.  Fever and chills from 1/16 subsided. Had telehealth consultation with PA. Per her notes, patient said he gets these symptoms annually, requested for an antibiotic. PA referred him for a COVID test. Ordered hydrocodone/chlorphen ER suspension for his cough and an antibiotic. Antibiotic was recommended if symptoms do not subside.  1/23: COVID test administered 1/25: Reported positive for COVID 1/26: Telehealth session w/PA: she informed patient of his positive test, advised to quarantine and seek medical help at hospital if symptoms worsen. Patient reported that his sore throat mostly subsided but is still coughing at night. Said that the pharmacy didn't receive the prescription order for the antibiotic, so this was re-ordered. 1/31: Partner found him dead at 8:18AM on his bed.  Death certificate issued by state says cause of death: COVID. Autopsy was not performed. Buried on 2/9/21."
	"1024067-1"	"1024067-1"	"OROPHARYNGEAL PAIN"	"10068319"	"50-59 years"	"50-59"	"1/15: Pfizer vaccine dose 1 administered 1/16: Fever, chills 1/22: Sore throat, coughing w/white phlegm, taking Tylenol and Mucinex.  Fever and chills from 1/16 subsided. Had telehealth consultation with PA. Per her notes, patient said he gets these symptoms annually, requested for an antibiotic. PA referred him for a COVID test. Ordered hydrocodone/chlorphen ER suspension for his cough and an antibiotic. Antibiotic was recommended if symptoms do not subside.  1/23: COVID test administered 1/25: Reported positive for COVID 1/26: Telehealth session w/PA: she informed patient of his positive test, advised to quarantine and seek medical help at hospital if symptoms worsen. Patient reported that his sore throat mostly subsided but is still coughing at night. Said that the pharmacy didn't receive the prescription order for the antibiotic, so this was re-ordered. 1/31: Partner found him dead at 8:18AM on his bed.  Death certificate issued by state says cause of death: COVID. Autopsy was not performed. Buried on 2/9/21."
	"1024067-1"	"1024067-1"	"PRODUCTIVE COUGH"	"10036790"	"50-59 years"	"50-59"	"1/15: Pfizer vaccine dose 1 administered 1/16: Fever, chills 1/22: Sore throat, coughing w/white phlegm, taking Tylenol and Mucinex.  Fever and chills from 1/16 subsided. Had telehealth consultation with PA. Per her notes, patient said he gets these symptoms annually, requested for an antibiotic. PA referred him for a COVID test. Ordered hydrocodone/chlorphen ER suspension for his cough and an antibiotic. Antibiotic was recommended if symptoms do not subside.  1/23: COVID test administered 1/25: Reported positive for COVID 1/26: Telehealth session w/PA: she informed patient of his positive test, advised to quarantine and seek medical help at hospital if symptoms worsen. Patient reported that his sore throat mostly subsided but is still coughing at night. Said that the pharmacy didn't receive the prescription order for the antibiotic, so this was re-ordered. 1/31: Partner found him dead at 8:18AM on his bed.  Death certificate issued by state says cause of death: COVID. Autopsy was not performed. Buried on 2/9/21."
	"1024067-1"	"1024067-1"	"PYREXIA"	"10037660"	"50-59 years"	"50-59"	"1/15: Pfizer vaccine dose 1 administered 1/16: Fever, chills 1/22: Sore throat, coughing w/white phlegm, taking Tylenol and Mucinex.  Fever and chills from 1/16 subsided. Had telehealth consultation with PA. Per her notes, patient said he gets these symptoms annually, requested for an antibiotic. PA referred him for a COVID test. Ordered hydrocodone/chlorphen ER suspension for his cough and an antibiotic. Antibiotic was recommended if symptoms do not subside.  1/23: COVID test administered 1/25: Reported positive for COVID 1/26: Telehealth session w/PA: she informed patient of his positive test, advised to quarantine and seek medical help at hospital if symptoms worsen. Patient reported that his sore throat mostly subsided but is still coughing at night. Said that the pharmacy didn't receive the prescription order for the antibiotic, so this was re-ordered. 1/31: Partner found him dead at 8:18AM on his bed.  Death certificate issued by state says cause of death: COVID. Autopsy was not performed. Buried on 2/9/21."
	"1024067-1"	"1024067-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"1/15: Pfizer vaccine dose 1 administered 1/16: Fever, chills 1/22: Sore throat, coughing w/white phlegm, taking Tylenol and Mucinex.  Fever and chills from 1/16 subsided. Had telehealth consultation with PA. Per her notes, patient said he gets these symptoms annually, requested for an antibiotic. PA referred him for a COVID test. Ordered hydrocodone/chlorphen ER suspension for his cough and an antibiotic. Antibiotic was recommended if symptoms do not subside.  1/23: COVID test administered 1/25: Reported positive for COVID 1/26: Telehealth session w/PA: she informed patient of his positive test, advised to quarantine and seek medical help at hospital if symptoms worsen. Patient reported that his sore throat mostly subsided but is still coughing at night. Said that the pharmacy didn't receive the prescription order for the antibiotic, so this was re-ordered. 1/31: Partner found him dead at 8:18AM on his bed.  Death certificate issued by state says cause of death: COVID. Autopsy was not performed. Buried on 2/9/21."
	"1024067-1"	"1024067-1"	"SPUTUM DISCOLOURED"	"10041807"	"50-59 years"	"50-59"	"1/15: Pfizer vaccine dose 1 administered 1/16: Fever, chills 1/22: Sore throat, coughing w/white phlegm, taking Tylenol and Mucinex.  Fever and chills from 1/16 subsided. Had telehealth consultation with PA. Per her notes, patient said he gets these symptoms annually, requested for an antibiotic. PA referred him for a COVID test. Ordered hydrocodone/chlorphen ER suspension for his cough and an antibiotic. Antibiotic was recommended if symptoms do not subside.  1/23: COVID test administered 1/25: Reported positive for COVID 1/26: Telehealth session w/PA: she informed patient of his positive test, advised to quarantine and seek medical help at hospital if symptoms worsen. Patient reported that his sore throat mostly subsided but is still coughing at night. Said that the pharmacy didn't receive the prescription order for the antibiotic, so this was re-ordered. 1/31: Partner found him dead at 8:18AM on his bed.  Death certificate issued by state says cause of death: COVID. Autopsy was not performed. Buried on 2/9/21."
	"1026379-1"	"1026379-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"patient 6 hours post vaccination"
	"1031189-1"	"1031189-1"	"CONDITION AGGRAVATED"	"10010264"	"50-59 years"	"50-59"	"COVID 19 symptoms and a positive test was confirmed on 1/6, employee noted previous exposure to positive family members Narrative: Employee noted exposure to COVID prior to presenting for 1st dose of vaccine on 1/5/21. On 1/6/21 employee reported the onset of symptoms and was tested and was confirmed COVID positive that day. Positive result was reported to employee health on 1/8/21. Employee Health continued to track employees progress and was informed of the need for hospitalization on 1/14/21. Course of hospitalization noted the need for intubation and significant issue with comorbid condition (rheumatoid arthritis). Employee died on 2/9/2021. Unable to confirm a direct connection to Vaccine vs. COVID infection, but felt it should be reported."
	"1031189-1"	"1031189-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"COVID 19 symptoms and a positive test was confirmed on 1/6, employee noted previous exposure to positive family members Narrative: Employee noted exposure to COVID prior to presenting for 1st dose of vaccine on 1/5/21. On 1/6/21 employee reported the onset of symptoms and was tested and was confirmed COVID positive that day. Positive result was reported to employee health on 1/8/21. Employee Health continued to track employees progress and was informed of the need for hospitalization on 1/14/21. Course of hospitalization noted the need for intubation and significant issue with comorbid condition (rheumatoid arthritis). Employee died on 2/9/2021. Unable to confirm a direct connection to Vaccine vs. COVID infection, but felt it should be reported."
	"1031189-1"	"1031189-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"COVID 19 symptoms and a positive test was confirmed on 1/6, employee noted previous exposure to positive family members Narrative: Employee noted exposure to COVID prior to presenting for 1st dose of vaccine on 1/5/21. On 1/6/21 employee reported the onset of symptoms and was tested and was confirmed COVID positive that day. Positive result was reported to employee health on 1/8/21. Employee Health continued to track employees progress and was informed of the need for hospitalization on 1/14/21. Course of hospitalization noted the need for intubation and significant issue with comorbid condition (rheumatoid arthritis). Employee died on 2/9/2021. Unable to confirm a direct connection to Vaccine vs. COVID infection, but felt it should be reported."
	"1031189-1"	"1031189-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"50-59 years"	"50-59"	"COVID 19 symptoms and a positive test was confirmed on 1/6, employee noted previous exposure to positive family members Narrative: Employee noted exposure to COVID prior to presenting for 1st dose of vaccine on 1/5/21. On 1/6/21 employee reported the onset of symptoms and was tested and was confirmed COVID positive that day. Positive result was reported to employee health on 1/8/21. Employee Health continued to track employees progress and was informed of the need for hospitalization on 1/14/21. Course of hospitalization noted the need for intubation and significant issue with comorbid condition (rheumatoid arthritis). Employee died on 2/9/2021. Unable to confirm a direct connection to Vaccine vs. COVID infection, but felt it should be reported."
	"1031189-1"	"1031189-1"	"RHEUMATOID ARTHRITIS"	"10039073"	"50-59 years"	"50-59"	"COVID 19 symptoms and a positive test was confirmed on 1/6, employee noted previous exposure to positive family members Narrative: Employee noted exposure to COVID prior to presenting for 1st dose of vaccine on 1/5/21. On 1/6/21 employee reported the onset of symptoms and was tested and was confirmed COVID positive that day. Positive result was reported to employee health on 1/8/21. Employee Health continued to track employees progress and was informed of the need for hospitalization on 1/14/21. Course of hospitalization noted the need for intubation and significant issue with comorbid condition (rheumatoid arthritis). Employee died on 2/9/2021. Unable to confirm a direct connection to Vaccine vs. COVID infection, but felt it should be reported."
	"1031189-1"	"1031189-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"COVID 19 symptoms and a positive test was confirmed on 1/6, employee noted previous exposure to positive family members Narrative: Employee noted exposure to COVID prior to presenting for 1st dose of vaccine on 1/5/21. On 1/6/21 employee reported the onset of symptoms and was tested and was confirmed COVID positive that day. Positive result was reported to employee health on 1/8/21. Employee Health continued to track employees progress and was informed of the need for hospitalization on 1/14/21. Course of hospitalization noted the need for intubation and significant issue with comorbid condition (rheumatoid arthritis). Employee died on 2/9/2021. Unable to confirm a direct connection to Vaccine vs. COVID infection, but felt it should be reported."
	"1031909-1"	"1031909-1"	"BACK PAIN"	"10003988"	"50-59 years"	"50-59"	"Pt received dose #1 of COVID-19 vaccine (Pfizer-BioNTech) on 12/18/20 and dose #2 ( Pfizer-BioNTech) on 1/8/21. On 1/30, patient was evaluated at urgent care due to back pain. No bloodwork done; metronidazole prescribed for 7 days. On 2/8, patient was admitted to outside hospital due to ongoing symptom progression. At time of admission, hgb 5 g/dL and plt 9k. Per Dr. (hematology/oncology), pt with schistocytes, LDH 1500, and elevated reticulocyte count consistent with thrombotic thrombocytopenic purpura (TTP). SCr >2 mg/dL. Patient immediately treated with plasma exchange and steroids, however continued to decline. Patient expired on 2/14/21."
	"1031909-1"	"1031909-1"	"BLOOD CREATININE INCREASED"	"10005483"	"50-59 years"	"50-59"	"Pt received dose #1 of COVID-19 vaccine (Pfizer-BioNTech) on 12/18/20 and dose #2 ( Pfizer-BioNTech) on 1/8/21. On 1/30, patient was evaluated at urgent care due to back pain. No bloodwork done; metronidazole prescribed for 7 days. On 2/8, patient was admitted to outside hospital due to ongoing symptom progression. At time of admission, hgb 5 g/dL and plt 9k. Per Dr. (hematology/oncology), pt with schistocytes, LDH 1500, and elevated reticulocyte count consistent with thrombotic thrombocytopenic purpura (TTP). SCr >2 mg/dL. Patient immediately treated with plasma exchange and steroids, however continued to decline. Patient expired on 2/14/21."
	"1031909-1"	"1031909-1"	"BLOOD LACTATE DEHYDROGENASE INCREASED"	"10005630"	"50-59 years"	"50-59"	"Pt received dose #1 of COVID-19 vaccine (Pfizer-BioNTech) on 12/18/20 and dose #2 ( Pfizer-BioNTech) on 1/8/21. On 1/30, patient was evaluated at urgent care due to back pain. No bloodwork done; metronidazole prescribed for 7 days. On 2/8, patient was admitted to outside hospital due to ongoing symptom progression. At time of admission, hgb 5 g/dL and plt 9k. Per Dr. (hematology/oncology), pt with schistocytes, LDH 1500, and elevated reticulocyte count consistent with thrombotic thrombocytopenic purpura (TTP). SCr >2 mg/dL. Patient immediately treated with plasma exchange and steroids, however continued to decline. Patient expired on 2/14/21."
	"1031909-1"	"1031909-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Pt received dose #1 of COVID-19 vaccine (Pfizer-BioNTech) on 12/18/20 and dose #2 ( Pfizer-BioNTech) on 1/8/21. On 1/30, patient was evaluated at urgent care due to back pain. No bloodwork done; metronidazole prescribed for 7 days. On 2/8, patient was admitted to outside hospital due to ongoing symptom progression. At time of admission, hgb 5 g/dL and plt 9k. Per Dr. (hematology/oncology), pt with schistocytes, LDH 1500, and elevated reticulocyte count consistent with thrombotic thrombocytopenic purpura (TTP). SCr >2 mg/dL. Patient immediately treated with plasma exchange and steroids, however continued to decline. Patient expired on 2/14/21."
	"1031909-1"	"1031909-1"	"HAEMOGLOBIN DECREASED"	"10018884"	"50-59 years"	"50-59"	"Pt received dose #1 of COVID-19 vaccine (Pfizer-BioNTech) on 12/18/20 and dose #2 ( Pfizer-BioNTech) on 1/8/21. On 1/30, patient was evaluated at urgent care due to back pain. No bloodwork done; metronidazole prescribed for 7 days. On 2/8, patient was admitted to outside hospital due to ongoing symptom progression. At time of admission, hgb 5 g/dL and plt 9k. Per Dr. (hematology/oncology), pt with schistocytes, LDH 1500, and elevated reticulocyte count consistent with thrombotic thrombocytopenic purpura (TTP). SCr >2 mg/dL. Patient immediately treated with plasma exchange and steroids, however continued to decline. Patient expired on 2/14/21."
	"1031909-1"	"1031909-1"	"PLATELET COUNT DECREASED"	"10035528"	"50-59 years"	"50-59"	"Pt received dose #1 of COVID-19 vaccine (Pfizer-BioNTech) on 12/18/20 and dose #2 ( Pfizer-BioNTech) on 1/8/21. On 1/30, patient was evaluated at urgent care due to back pain. No bloodwork done; metronidazole prescribed for 7 days. On 2/8, patient was admitted to outside hospital due to ongoing symptom progression. At time of admission, hgb 5 g/dL and plt 9k. Per Dr. (hematology/oncology), pt with schistocytes, LDH 1500, and elevated reticulocyte count consistent with thrombotic thrombocytopenic purpura (TTP). SCr >2 mg/dL. Patient immediately treated with plasma exchange and steroids, however continued to decline. Patient expired on 2/14/21."
	"1031909-1"	"1031909-1"	"RED BLOOD CELL SCHISTOCYTES"	"10080983"	"50-59 years"	"50-59"	"Pt received dose #1 of COVID-19 vaccine (Pfizer-BioNTech) on 12/18/20 and dose #2 ( Pfizer-BioNTech) on 1/8/21. On 1/30, patient was evaluated at urgent care due to back pain. No bloodwork done; metronidazole prescribed for 7 days. On 2/8, patient was admitted to outside hospital due to ongoing symptom progression. At time of admission, hgb 5 g/dL and plt 9k. Per Dr. (hematology/oncology), pt with schistocytes, LDH 1500, and elevated reticulocyte count consistent with thrombotic thrombocytopenic purpura (TTP). SCr >2 mg/dL. Patient immediately treated with plasma exchange and steroids, however continued to decline. Patient expired on 2/14/21."
	"1031909-1"	"1031909-1"	"RETICULOCYTE COUNT INCREASED"	"10038792"	"50-59 years"	"50-59"	"Pt received dose #1 of COVID-19 vaccine (Pfizer-BioNTech) on 12/18/20 and dose #2 ( Pfizer-BioNTech) on 1/8/21. On 1/30, patient was evaluated at urgent care due to back pain. No bloodwork done; metronidazole prescribed for 7 days. On 2/8, patient was admitted to outside hospital due to ongoing symptom progression. At time of admission, hgb 5 g/dL and plt 9k. Per Dr. (hematology/oncology), pt with schistocytes, LDH 1500, and elevated reticulocyte count consistent with thrombotic thrombocytopenic purpura (TTP). SCr >2 mg/dL. Patient immediately treated with plasma exchange and steroids, however continued to decline. Patient expired on 2/14/21."
	"1031909-1"	"1031909-1"	"THROMBOTIC THROMBOCYTOPENIC PURPURA"	"10043648"	"50-59 years"	"50-59"	"Pt received dose #1 of COVID-19 vaccine (Pfizer-BioNTech) on 12/18/20 and dose #2 ( Pfizer-BioNTech) on 1/8/21. On 1/30, patient was evaluated at urgent care due to back pain. No bloodwork done; metronidazole prescribed for 7 days. On 2/8, patient was admitted to outside hospital due to ongoing symptom progression. At time of admission, hgb 5 g/dL and plt 9k. Per Dr. (hematology/oncology), pt with schistocytes, LDH 1500, and elevated reticulocyte count consistent with thrombotic thrombocytopenic purpura (TTP). SCr >2 mg/dL. Patient immediately treated with plasma exchange and steroids, however continued to decline. Patient expired on 2/14/21."
	"1032163-1"	"1032163-1"	"ANAEMIA"	"10002034"	"50-59 years"	"50-59"	"Patient received dose #1 of COVID-19 vaccine on 1/16/21. Within 3 days, she developed petechiae up to ankles, later rising up to her knees. Pt admitted to hospital on 2/6/21 for symptomatic anemia 2/2 vaginal bleeding. Patient received 4 units FFP, 4 units PRBC, 1 unit cryoprecipitate, and vitamin K 5 mg IV. Also started on medroxyprogesterone 20 mg PO TID. Alectinib d/ced due to worsening liver function. Evalauted by OB/GYN and Hematology. Diagnosed with DIC. Patient with worsening bilateral lower extremity edema and purpura  with pain and weakness. Palliative care consulted. Patient passed away on 2/11."
	"1032163-1"	"1032163-1"	"ASTHENIA"	"10003549"	"50-59 years"	"50-59"	"Patient received dose #1 of COVID-19 vaccine on 1/16/21. Within 3 days, she developed petechiae up to ankles, later rising up to her knees. Pt admitted to hospital on 2/6/21 for symptomatic anemia 2/2 vaginal bleeding. Patient received 4 units FFP, 4 units PRBC, 1 unit cryoprecipitate, and vitamin K 5 mg IV. Also started on medroxyprogesterone 20 mg PO TID. Alectinib d/ced due to worsening liver function. Evalauted by OB/GYN and Hematology. Diagnosed with DIC. Patient with worsening bilateral lower extremity edema and purpura  with pain and weakness. Palliative care consulted. Patient passed away on 2/11."
	"1032163-1"	"1032163-1"	"COMPUTERISED TOMOGRAM ABNORMAL"	"10010235"	"50-59 years"	"50-59"	"Patient received dose #1 of COVID-19 vaccine on 1/16/21. Within 3 days, she developed petechiae up to ankles, later rising up to her knees. Pt admitted to hospital on 2/6/21 for symptomatic anemia 2/2 vaginal bleeding. Patient received 4 units FFP, 4 units PRBC, 1 unit cryoprecipitate, and vitamin K 5 mg IV. Also started on medroxyprogesterone 20 mg PO TID. Alectinib d/ced due to worsening liver function. Evalauted by OB/GYN and Hematology. Diagnosed with DIC. Patient with worsening bilateral lower extremity edema and purpura  with pain and weakness. Palliative care consulted. Patient passed away on 2/11."
	"1032163-1"	"1032163-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient received dose #1 of COVID-19 vaccine on 1/16/21. Within 3 days, she developed petechiae up to ankles, later rising up to her knees. Pt admitted to hospital on 2/6/21 for symptomatic anemia 2/2 vaginal bleeding. Patient received 4 units FFP, 4 units PRBC, 1 unit cryoprecipitate, and vitamin K 5 mg IV. Also started on medroxyprogesterone 20 mg PO TID. Alectinib d/ced due to worsening liver function. Evalauted by OB/GYN and Hematology. Diagnosed with DIC. Patient with worsening bilateral lower extremity edema and purpura  with pain and weakness. Palliative care consulted. Patient passed away on 2/11."
	"1032163-1"	"1032163-1"	"DISSEMINATED INTRAVASCULAR COAGULATION"	"10013442"	"50-59 years"	"50-59"	"Patient received dose #1 of COVID-19 vaccine on 1/16/21. Within 3 days, she developed petechiae up to ankles, later rising up to her knees. Pt admitted to hospital on 2/6/21 for symptomatic anemia 2/2 vaginal bleeding. Patient received 4 units FFP, 4 units PRBC, 1 unit cryoprecipitate, and vitamin K 5 mg IV. Also started on medroxyprogesterone 20 mg PO TID. Alectinib d/ced due to worsening liver function. Evalauted by OB/GYN and Hematology. Diagnosed with DIC. Patient with worsening bilateral lower extremity edema and purpura  with pain and weakness. Palliative care consulted. Patient passed away on 2/11."
	"1032163-1"	"1032163-1"	"HAEMOGLOBIN DECREASED"	"10018884"	"50-59 years"	"50-59"	"Patient received dose #1 of COVID-19 vaccine on 1/16/21. Within 3 days, she developed petechiae up to ankles, later rising up to her knees. Pt admitted to hospital on 2/6/21 for symptomatic anemia 2/2 vaginal bleeding. Patient received 4 units FFP, 4 units PRBC, 1 unit cryoprecipitate, and vitamin K 5 mg IV. Also started on medroxyprogesterone 20 mg PO TID. Alectinib d/ced due to worsening liver function. Evalauted by OB/GYN and Hematology. Diagnosed with DIC. Patient with worsening bilateral lower extremity edema and purpura  with pain and weakness. Palliative care consulted. Patient passed away on 2/11."
	"1032163-1"	"1032163-1"	"HEPATIC FUNCTION ABNORMAL"	"10019670"	"50-59 years"	"50-59"	"Patient received dose #1 of COVID-19 vaccine on 1/16/21. Within 3 days, she developed petechiae up to ankles, later rising up to her knees. Pt admitted to hospital on 2/6/21 for symptomatic anemia 2/2 vaginal bleeding. Patient received 4 units FFP, 4 units PRBC, 1 unit cryoprecipitate, and vitamin K 5 mg IV. Also started on medroxyprogesterone 20 mg PO TID. Alectinib d/ced due to worsening liver function. Evalauted by OB/GYN and Hematology. Diagnosed with DIC. Patient with worsening bilateral lower extremity edema and purpura  with pain and weakness. Palliative care consulted. Patient passed away on 2/11."
	"1032163-1"	"1032163-1"	"METASTASES TO LIVER"	"10027457"	"50-59 years"	"50-59"	"Patient received dose #1 of COVID-19 vaccine on 1/16/21. Within 3 days, she developed petechiae up to ankles, later rising up to her knees. Pt admitted to hospital on 2/6/21 for symptomatic anemia 2/2 vaginal bleeding. Patient received 4 units FFP, 4 units PRBC, 1 unit cryoprecipitate, and vitamin K 5 mg IV. Also started on medroxyprogesterone 20 mg PO TID. Alectinib d/ced due to worsening liver function. Evalauted by OB/GYN and Hematology. Diagnosed with DIC. Patient with worsening bilateral lower extremity edema and purpura  with pain and weakness. Palliative care consulted. Patient passed away on 2/11."
	"1032163-1"	"1032163-1"	"OEDEMA PERIPHERAL"	"10030124"	"50-59 years"	"50-59"	"Patient received dose #1 of COVID-19 vaccine on 1/16/21. Within 3 days, she developed petechiae up to ankles, later rising up to her knees. Pt admitted to hospital on 2/6/21 for symptomatic anemia 2/2 vaginal bleeding. Patient received 4 units FFP, 4 units PRBC, 1 unit cryoprecipitate, and vitamin K 5 mg IV. Also started on medroxyprogesterone 20 mg PO TID. Alectinib d/ced due to worsening liver function. Evalauted by OB/GYN and Hematology. Diagnosed with DIC. Patient with worsening bilateral lower extremity edema and purpura  with pain and weakness. Palliative care consulted. Patient passed away on 2/11."
	"1032163-1"	"1032163-1"	"PAIN"	"10033371"	"50-59 years"	"50-59"	"Patient received dose #1 of COVID-19 vaccine on 1/16/21. Within 3 days, she developed petechiae up to ankles, later rising up to her knees. Pt admitted to hospital on 2/6/21 for symptomatic anemia 2/2 vaginal bleeding. Patient received 4 units FFP, 4 units PRBC, 1 unit cryoprecipitate, and vitamin K 5 mg IV. Also started on medroxyprogesterone 20 mg PO TID. Alectinib d/ced due to worsening liver function. Evalauted by OB/GYN and Hematology. Diagnosed with DIC. Patient with worsening bilateral lower extremity edema and purpura  with pain and weakness. Palliative care consulted. Patient passed away on 2/11."
	"1032163-1"	"1032163-1"	"PETECHIAE"	"10034754"	"50-59 years"	"50-59"	"Patient received dose #1 of COVID-19 vaccine on 1/16/21. Within 3 days, she developed petechiae up to ankles, later rising up to her knees. Pt admitted to hospital on 2/6/21 for symptomatic anemia 2/2 vaginal bleeding. Patient received 4 units FFP, 4 units PRBC, 1 unit cryoprecipitate, and vitamin K 5 mg IV. Also started on medroxyprogesterone 20 mg PO TID. Alectinib d/ced due to worsening liver function. Evalauted by OB/GYN and Hematology. Diagnosed with DIC. Patient with worsening bilateral lower extremity edema and purpura  with pain and weakness. Palliative care consulted. Patient passed away on 2/11."
	"1032163-1"	"1032163-1"	"PLATELET COUNT DECREASED"	"10035528"	"50-59 years"	"50-59"	"Patient received dose #1 of COVID-19 vaccine on 1/16/21. Within 3 days, she developed petechiae up to ankles, later rising up to her knees. Pt admitted to hospital on 2/6/21 for symptomatic anemia 2/2 vaginal bleeding. Patient received 4 units FFP, 4 units PRBC, 1 unit cryoprecipitate, and vitamin K 5 mg IV. Also started on medroxyprogesterone 20 mg PO TID. Alectinib d/ced due to worsening liver function. Evalauted by OB/GYN and Hematology. Diagnosed with DIC. Patient with worsening bilateral lower extremity edema and purpura  with pain and weakness. Palliative care consulted. Patient passed away on 2/11."
	"1032163-1"	"1032163-1"	"PURPURA"	"10037549"	"50-59 years"	"50-59"	"Patient received dose #1 of COVID-19 vaccine on 1/16/21. Within 3 days, she developed petechiae up to ankles, later rising up to her knees. Pt admitted to hospital on 2/6/21 for symptomatic anemia 2/2 vaginal bleeding. Patient received 4 units FFP, 4 units PRBC, 1 unit cryoprecipitate, and vitamin K 5 mg IV. Also started on medroxyprogesterone 20 mg PO TID. Alectinib d/ced due to worsening liver function. Evalauted by OB/GYN and Hematology. Diagnosed with DIC. Patient with worsening bilateral lower extremity edema and purpura  with pain and weakness. Palliative care consulted. Patient passed away on 2/11."
	"1032163-1"	"1032163-1"	"TRANSFUSION"	"10066152"	"50-59 years"	"50-59"	"Patient received dose #1 of COVID-19 vaccine on 1/16/21. Within 3 days, she developed petechiae up to ankles, later rising up to her knees. Pt admitted to hospital on 2/6/21 for symptomatic anemia 2/2 vaginal bleeding. Patient received 4 units FFP, 4 units PRBC, 1 unit cryoprecipitate, and vitamin K 5 mg IV. Also started on medroxyprogesterone 20 mg PO TID. Alectinib d/ced due to worsening liver function. Evalauted by OB/GYN and Hematology. Diagnosed with DIC. Patient with worsening bilateral lower extremity edema and purpura  with pain and weakness. Palliative care consulted. Patient passed away on 2/11."
	"1032163-1"	"1032163-1"	"VAGINAL HAEMORRHAGE"	"10046910"	"50-59 years"	"50-59"	"Patient received dose #1 of COVID-19 vaccine on 1/16/21. Within 3 days, she developed petechiae up to ankles, later rising up to her knees. Pt admitted to hospital on 2/6/21 for symptomatic anemia 2/2 vaginal bleeding. Patient received 4 units FFP, 4 units PRBC, 1 unit cryoprecipitate, and vitamin K 5 mg IV. Also started on medroxyprogesterone 20 mg PO TID. Alectinib d/ced due to worsening liver function. Evalauted by OB/GYN and Hematology. Diagnosed with DIC. Patient with worsening bilateral lower extremity edema and purpura  with pain and weakness. Palliative care consulted. Patient passed away on 2/11."
	"1032163-1"	"1032163-1"	"WHITE BLOOD CELL COUNT INCREASED"	"10047943"	"50-59 years"	"50-59"	"Patient received dose #1 of COVID-19 vaccine on 1/16/21. Within 3 days, she developed petechiae up to ankles, later rising up to her knees. Pt admitted to hospital on 2/6/21 for symptomatic anemia 2/2 vaginal bleeding. Patient received 4 units FFP, 4 units PRBC, 1 unit cryoprecipitate, and vitamin K 5 mg IV. Also started on medroxyprogesterone 20 mg PO TID. Alectinib d/ced due to worsening liver function. Evalauted by OB/GYN and Hematology. Diagnosed with DIC. Patient with worsening bilateral lower extremity edema and purpura  with pain and weakness. Palliative care consulted. Patient passed away on 2/11."
	"1032575-1"	"1032575-1"	"CHILLS"	"10008531"	"50-59 years"	"50-59"	"Two days later passed away; difficulty breathing, shortness of breath; difficulty breathing, gurgling; Not feeling well; Achiness; Severe fever; Chills; A spontaneous report was received from a physician concerning a 56-year-old female patient who received Moderna's COVID-19 Vaccine (mRNA-1273) and developed fever, chills, achiness, shortness of breath, gurgling and unresponsive.     The patient's medical history was not provided. Concomitant product use was not provided.  On 19 Jan 2021, prior to the onset of the events, the patient received their second of two planned doses of mRNA-1273 (Lot 042L20A) intramuscularly in the left arm for prophylaxis of COVID-19 infection.   After receiving the vaccine on 19 Jan 2021, the patient experienced fever, chills, shortness of breath, gurgling and achiness. On 21 Jan 2021, the patient was found unresponsive. Emergency medical services were called to perform life saving measures however, they were unsuccessful. No further treatment information was provided.   The patient died on 21 Jan 2021. The cause of death was reported as unknown. An autopsy was planned.; Reporter's Comments: This case concerns a 56-year-old, female, who experienced a serious event of death, with many other events after receiving second dose of mRNA-1273 (Lot# 042L20A). Very limited information regarding these events has been provided at this time. Further information has been requested.; Reported Cause(s) of Death: Unknown cause of death"
	"1032575-1"	"1032575-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Two days later passed away; difficulty breathing, shortness of breath; difficulty breathing, gurgling; Not feeling well; Achiness; Severe fever; Chills; A spontaneous report was received from a physician concerning a 56-year-old female patient who received Moderna's COVID-19 Vaccine (mRNA-1273) and developed fever, chills, achiness, shortness of breath, gurgling and unresponsive.     The patient's medical history was not provided. Concomitant product use was not provided.  On 19 Jan 2021, prior to the onset of the events, the patient received their second of two planned doses of mRNA-1273 (Lot 042L20A) intramuscularly in the left arm for prophylaxis of COVID-19 infection.   After receiving the vaccine on 19 Jan 2021, the patient experienced fever, chills, shortness of breath, gurgling and achiness. On 21 Jan 2021, the patient was found unresponsive. Emergency medical services were called to perform life saving measures however, they were unsuccessful. No further treatment information was provided.   The patient died on 21 Jan 2021. The cause of death was reported as unknown. An autopsy was planned.; Reporter's Comments: This case concerns a 56-year-old, female, who experienced a serious event of death, with many other events after receiving second dose of mRNA-1273 (Lot# 042L20A). Very limited information regarding these events has been provided at this time. Further information has been requested.; Reported Cause(s) of Death: Unknown cause of death"
	"1032575-1"	"1032575-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"Two days later passed away; difficulty breathing, shortness of breath; difficulty breathing, gurgling; Not feeling well; Achiness; Severe fever; Chills; A spontaneous report was received from a physician concerning a 56-year-old female patient who received Moderna's COVID-19 Vaccine (mRNA-1273) and developed fever, chills, achiness, shortness of breath, gurgling and unresponsive.     The patient's medical history was not provided. Concomitant product use was not provided.  On 19 Jan 2021, prior to the onset of the events, the patient received their second of two planned doses of mRNA-1273 (Lot 042L20A) intramuscularly in the left arm for prophylaxis of COVID-19 infection.   After receiving the vaccine on 19 Jan 2021, the patient experienced fever, chills, shortness of breath, gurgling and achiness. On 21 Jan 2021, the patient was found unresponsive. Emergency medical services were called to perform life saving measures however, they were unsuccessful. No further treatment information was provided.   The patient died on 21 Jan 2021. The cause of death was reported as unknown. An autopsy was planned.; Reporter's Comments: This case concerns a 56-year-old, female, who experienced a serious event of death, with many other events after receiving second dose of mRNA-1273 (Lot# 042L20A). Very limited information regarding these events has been provided at this time. Further information has been requested.; Reported Cause(s) of Death: Unknown cause of death"
	"1032575-1"	"1032575-1"	"MALAISE"	"10025482"	"50-59 years"	"50-59"	"Two days later passed away; difficulty breathing, shortness of breath; difficulty breathing, gurgling; Not feeling well; Achiness; Severe fever; Chills; A spontaneous report was received from a physician concerning a 56-year-old female patient who received Moderna's COVID-19 Vaccine (mRNA-1273) and developed fever, chills, achiness, shortness of breath, gurgling and unresponsive.     The patient's medical history was not provided. Concomitant product use was not provided.  On 19 Jan 2021, prior to the onset of the events, the patient received their second of two planned doses of mRNA-1273 (Lot 042L20A) intramuscularly in the left arm for prophylaxis of COVID-19 infection.   After receiving the vaccine on 19 Jan 2021, the patient experienced fever, chills, shortness of breath, gurgling and achiness. On 21 Jan 2021, the patient was found unresponsive. Emergency medical services were called to perform life saving measures however, they were unsuccessful. No further treatment information was provided.   The patient died on 21 Jan 2021. The cause of death was reported as unknown. An autopsy was planned.; Reporter's Comments: This case concerns a 56-year-old, female, who experienced a serious event of death, with many other events after receiving second dose of mRNA-1273 (Lot# 042L20A). Very limited information regarding these events has been provided at this time. Further information has been requested.; Reported Cause(s) of Death: Unknown cause of death"
	"1032575-1"	"1032575-1"	"MYALGIA"	"10028411"	"50-59 years"	"50-59"	"Two days later passed away; difficulty breathing, shortness of breath; difficulty breathing, gurgling; Not feeling well; Achiness; Severe fever; Chills; A spontaneous report was received from a physician concerning a 56-year-old female patient who received Moderna's COVID-19 Vaccine (mRNA-1273) and developed fever, chills, achiness, shortness of breath, gurgling and unresponsive.     The patient's medical history was not provided. Concomitant product use was not provided.  On 19 Jan 2021, prior to the onset of the events, the patient received their second of two planned doses of mRNA-1273 (Lot 042L20A) intramuscularly in the left arm for prophylaxis of COVID-19 infection.   After receiving the vaccine on 19 Jan 2021, the patient experienced fever, chills, shortness of breath, gurgling and achiness. On 21 Jan 2021, the patient was found unresponsive. Emergency medical services were called to perform life saving measures however, they were unsuccessful. No further treatment information was provided.   The patient died on 21 Jan 2021. The cause of death was reported as unknown. An autopsy was planned.; Reporter's Comments: This case concerns a 56-year-old, female, who experienced a serious event of death, with many other events after receiving second dose of mRNA-1273 (Lot# 042L20A). Very limited information regarding these events has been provided at this time. Further information has been requested.; Reported Cause(s) of Death: Unknown cause of death"
	"1032575-1"	"1032575-1"	"PYREXIA"	"10037660"	"50-59 years"	"50-59"	"Two days later passed away; difficulty breathing, shortness of breath; difficulty breathing, gurgling; Not feeling well; Achiness; Severe fever; Chills; A spontaneous report was received from a physician concerning a 56-year-old female patient who received Moderna's COVID-19 Vaccine (mRNA-1273) and developed fever, chills, achiness, shortness of breath, gurgling and unresponsive.     The patient's medical history was not provided. Concomitant product use was not provided.  On 19 Jan 2021, prior to the onset of the events, the patient received their second of two planned doses of mRNA-1273 (Lot 042L20A) intramuscularly in the left arm for prophylaxis of COVID-19 infection.   After receiving the vaccine on 19 Jan 2021, the patient experienced fever, chills, shortness of breath, gurgling and achiness. On 21 Jan 2021, the patient was found unresponsive. Emergency medical services were called to perform life saving measures however, they were unsuccessful. No further treatment information was provided.   The patient died on 21 Jan 2021. The cause of death was reported as unknown. An autopsy was planned.; Reporter's Comments: This case concerns a 56-year-old, female, who experienced a serious event of death, with many other events after receiving second dose of mRNA-1273 (Lot# 042L20A). Very limited information regarding these events has been provided at this time. Further information has been requested.; Reported Cause(s) of Death: Unknown cause of death"
	"1032575-1"	"1032575-1"	"RESPIRATION ABNORMAL"	"10038647"	"50-59 years"	"50-59"	"Two days later passed away; difficulty breathing, shortness of breath; difficulty breathing, gurgling; Not feeling well; Achiness; Severe fever; Chills; A spontaneous report was received from a physician concerning a 56-year-old female patient who received Moderna's COVID-19 Vaccine (mRNA-1273) and developed fever, chills, achiness, shortness of breath, gurgling and unresponsive.     The patient's medical history was not provided. Concomitant product use was not provided.  On 19 Jan 2021, prior to the onset of the events, the patient received their second of two planned doses of mRNA-1273 (Lot 042L20A) intramuscularly in the left arm for prophylaxis of COVID-19 infection.   After receiving the vaccine on 19 Jan 2021, the patient experienced fever, chills, shortness of breath, gurgling and achiness. On 21 Jan 2021, the patient was found unresponsive. Emergency medical services were called to perform life saving measures however, they were unsuccessful. No further treatment information was provided.   The patient died on 21 Jan 2021. The cause of death was reported as unknown. An autopsy was planned.; Reporter's Comments: This case concerns a 56-year-old, female, who experienced a serious event of death, with many other events after receiving second dose of mRNA-1273 (Lot# 042L20A). Very limited information regarding these events has been provided at this time. Further information has been requested.; Reported Cause(s) of Death: Unknown cause of death"
	"1034055-1"	"1034055-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Associate developed SOB on 2/12/21.  Taken to Hospital on 2/13/21.  Reported deceased 2/14/21."
	"1034055-1"	"1034055-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"Associate developed SOB on 2/12/21.  Taken to Hospital on 2/13/21.  Reported deceased 2/14/21."
	"1034116-1"	"1034116-1"	"BIOPSY SKIN ABNORMAL"	"10004874"	"50-59 years"	"50-59"	"Presented from clinic with 3-4 days of extensive rash.  There were multiple areas of skin sloughing on bilateral upper extremities and abdominal wall."
	"1034116-1"	"1034116-1"	"BLISTER"	"10005191"	"50-59 years"	"50-59"	"Presented from clinic with 3-4 days of extensive rash.  There were multiple areas of skin sloughing on bilateral upper extremities and abdominal wall."
	"1034116-1"	"1034116-1"	"DERMATITIS"	"10012431"	"50-59 years"	"50-59"	"Presented from clinic with 3-4 days of extensive rash.  There were multiple areas of skin sloughing on bilateral upper extremities and abdominal wall."
	"1034116-1"	"1034116-1"	"EPIDERMAL NECROSIS"	"10059284"	"50-59 years"	"50-59"	"Presented from clinic with 3-4 days of extensive rash.  There were multiple areas of skin sloughing on bilateral upper extremities and abdominal wall."
	"1034116-1"	"1034116-1"	"RASH"	"10037844"	"50-59 years"	"50-59"	"Presented from clinic with 3-4 days of extensive rash.  There were multiple areas of skin sloughing on bilateral upper extremities and abdominal wall."
	"1034116-1"	"1034116-1"	"SKIN EXFOLIATION"	"10040844"	"50-59 years"	"50-59"	"Presented from clinic with 3-4 days of extensive rash.  There were multiple areas of skin sloughing on bilateral upper extremities and abdominal wall."
	"1034116-1"	"1034116-1"	"TOXIC EPIDERMAL NECROLYSIS"	"10044223"	"50-59 years"	"50-59"	"Presented from clinic with 3-4 days of extensive rash.  There were multiple areas of skin sloughing on bilateral upper extremities and abdominal wall."
	"1037124-1"	"1037124-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient was at a gym watching his daughter. He slumped over unconscious. EMS was called. He was found to be in fine ventricular fibrillation and resuscitation efforts failed. He was brought to Hospital ED where he was pronounced dead. He had underlying cardiac disease but his family requested I report this event as possibly related to the recent COVID vaccination."
	"1037124-1"	"1037124-1"	"LOSS OF CONSCIOUSNESS"	"10024855"	"50-59 years"	"50-59"	"Patient was at a gym watching his daughter. He slumped over unconscious. EMS was called. He was found to be in fine ventricular fibrillation and resuscitation efforts failed. He was brought to Hospital ED where he was pronounced dead. He had underlying cardiac disease but his family requested I report this event as possibly related to the recent COVID vaccination."
	"1037124-1"	"1037124-1"	"RESUSCITATION"	"10038749"	"50-59 years"	"50-59"	"Patient was at a gym watching his daughter. He slumped over unconscious. EMS was called. He was found to be in fine ventricular fibrillation and resuscitation efforts failed. He was brought to Hospital ED where he was pronounced dead. He had underlying cardiac disease but his family requested I report this event as possibly related to the recent COVID vaccination."
	"1037124-1"	"1037124-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"50-59 years"	"50-59"	"Patient was at a gym watching his daughter. He slumped over unconscious. EMS was called. He was found to be in fine ventricular fibrillation and resuscitation efforts failed. He was brought to Hospital ED where he was pronounced dead. He had underlying cardiac disease but his family requested I report this event as possibly related to the recent COVID vaccination."
	"1037124-1"	"1037124-1"	"VENTRICULAR FIBRILLATION"	"10047290"	"50-59 years"	"50-59"	"Patient was at a gym watching his daughter. He slumped over unconscious. EMS was called. He was found to be in fine ventricular fibrillation and resuscitation efforts failed. He was brought to Hospital ED where he was pronounced dead. He had underlying cardiac disease but his family requested I report this event as possibly related to the recent COVID vaccination."
	"1038442-1"	"1038442-1"	"BLOOD CHLORIDE INCREASED"	"10005420"	"50-59 years"	"50-59"	"Death within thirty days of vaccine.  Multiple co-morbidities and placed on hospice 12/28/20."
	"1038442-1"	"1038442-1"	"BLOOD CREATININE INCREASED"	"10005483"	"50-59 years"	"50-59"	"Death within thirty days of vaccine.  Multiple co-morbidities and placed on hospice 12/28/20."
	"1038442-1"	"1038442-1"	"BLOOD GLUCOSE INCREASED"	"10005557"	"50-59 years"	"50-59"	"Death within thirty days of vaccine.  Multiple co-morbidities and placed on hospice 12/28/20."
	"1038442-1"	"1038442-1"	"BLOOD POTASSIUM INCREASED"	"10005725"	"50-59 years"	"50-59"	"Death within thirty days of vaccine.  Multiple co-morbidities and placed on hospice 12/28/20."
	"1038442-1"	"1038442-1"	"BLOOD SODIUM INCREASED"	"10005803"	"50-59 years"	"50-59"	"Death within thirty days of vaccine.  Multiple co-morbidities and placed on hospice 12/28/20."
	"1038442-1"	"1038442-1"	"BLOOD UREA INCREASED"	"10005851"	"50-59 years"	"50-59"	"Death within thirty days of vaccine.  Multiple co-morbidities and placed on hospice 12/28/20."
	"1038442-1"	"1038442-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Death within thirty days of vaccine.  Multiple co-morbidities and placed on hospice 12/28/20."
	"1038442-1"	"1038442-1"	"DRUG SCREEN POSITIVE"	"10049177"	"50-59 years"	"50-59"	"Death within thirty days of vaccine.  Multiple co-morbidities and placed on hospice 12/28/20."
	"1038442-1"	"1038442-1"	"GLOMERULAR FILTRATION RATE DECREASED"	"10018358"	"50-59 years"	"50-59"	"Death within thirty days of vaccine.  Multiple co-morbidities and placed on hospice 12/28/20."
	"1040633-1"	"1040633-1"	"COMPUTERISED TOMOGRAM"	"10010234"	"50-59 years"	"50-59"	"Death due to hemorrhagic stroke."
	"1040633-1"	"1040633-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Death due to hemorrhagic stroke."
	"1040633-1"	"1040633-1"	"HAEMORRHAGIC STROKE"	"10019016"	"50-59 years"	"50-59"	"Death due to hemorrhagic stroke."
	"1040877-1"	"1040877-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"unknown if related to vaccine.  patient received 2nd vaccine at 0830, observed 15 minutes, discharged, arrested at 0915 upon entering her home.  vaccine was administered by DOH at their community location.  patient was pronounced lifeless in the ED."
	"1040877-1"	"1040877-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"unknown if related to vaccine.  patient received 2nd vaccine at 0830, observed 15 minutes, discharged, arrested at 0915 upon entering her home.  vaccine was administered by DOH at their community location.  patient was pronounced lifeless in the ED."
	"1042012-1"	"1042012-1"	"SUDDEN DEATH"	"10042434"	"50-59 years"	"50-59"	"Patient died suddenly 2/14/2021"
	"1043880-1"	"1043880-1"	"ASPIRATION"	"10003504"	"50-59 years"	"50-59"	"Pt received second Moderna COVID-19 vaccination administered in left arm at her assisted living facility by Pharmacist at 1153 on 2/19/2021. Pt was monitored for vaccine reaction with no known adverse reaction. Approximately  18 hours post-vaccine, she was found deceased in her sleep at 0540 on 2/20/21. Per circumstances/pt history, it is presumed that the patient aspirated while sleeping, perhaps secondary to a seizure. Coroner was notified and declined as coroner's case. VAERS notification being made due to pt death within 24 hours of receiving a vaccine."
	"1043880-1"	"1043880-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Pt received second Moderna COVID-19 vaccination administered in left arm at her assisted living facility by Pharmacist at 1153 on 2/19/2021. Pt was monitored for vaccine reaction with no known adverse reaction. Approximately  18 hours post-vaccine, she was found deceased in her sleep at 0540 on 2/20/21. Per circumstances/pt history, it is presumed that the patient aspirated while sleeping, perhaps secondary to a seizure. Coroner was notified and declined as coroner's case. VAERS notification being made due to pt death within 24 hours of receiving a vaccine."
	"1043880-1"	"1043880-1"	"INSOMNIA"	"10022437"	"50-59 years"	"50-59"	"Pt received second Moderna COVID-19 vaccination administered in left arm at her assisted living facility by Pharmacist at 1153 on 2/19/2021. Pt was monitored for vaccine reaction with no known adverse reaction. Approximately  18 hours post-vaccine, she was found deceased in her sleep at 0540 on 2/20/21. Per circumstances/pt history, it is presumed that the patient aspirated while sleeping, perhaps secondary to a seizure. Coroner was notified and declined as coroner's case. VAERS notification being made due to pt death within 24 hours of receiving a vaccine."
	"1043880-1"	"1043880-1"	"SEIZURE"	"10039906"	"50-59 years"	"50-59"	"Pt received second Moderna COVID-19 vaccination administered in left arm at her assisted living facility by Pharmacist at 1153 on 2/19/2021. Pt was monitored for vaccine reaction with no known adverse reaction. Approximately  18 hours post-vaccine, she was found deceased in her sleep at 0540 on 2/20/21. Per circumstances/pt history, it is presumed that the patient aspirated while sleeping, perhaps secondary to a seizure. Coroner was notified and declined as coroner's case. VAERS notification being made due to pt death within 24 hours of receiving a vaccine."
	"1045150-1"	"1045150-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient found in home deceased."
	"1047351-1"	"1047351-1"	"ABDOMINAL PAIN"	"10000081"	"50-59 years"	"50-59"	"Patient was tested for covid on 2/2/21 with positive resulted. Presented to Hospital ER on 2/10/21 with c/o of abdominal pain. Diagnosed with gastritis, prescribed metoclopromide and famotidine and dc home. Returned to ER on 2/13/21 with c/o of weakness, diarrhea, foot ulcer, and loss of appetite.  Diagnosed:   1) Dyspnea and hypoxia secondary to Covid-19 2) Extensive bilateral lung infiltrates secondary to Covid-19 3) Increased Cr 4) Increased LFTs, ferritin, d-dimer, troponin secondary to Covid-19 5) Elevated procalcitonin placing the patient at high risk for sepsis 6) Chronic appearing Right foot wound without signs of secondary infection Patient transferred to a different hospital in another city."
	"1047351-1"	"1047351-1"	"ASTHENIA"	"10003549"	"50-59 years"	"50-59"	"Patient was tested for covid on 2/2/21 with positive resulted. Presented to Hospital ER on 2/10/21 with c/o of abdominal pain. Diagnosed with gastritis, prescribed metoclopromide and famotidine and dc home. Returned to ER on 2/13/21 with c/o of weakness, diarrhea, foot ulcer, and loss of appetite.  Diagnosed:   1) Dyspnea and hypoxia secondary to Covid-19 2) Extensive bilateral lung infiltrates secondary to Covid-19 3) Increased Cr 4) Increased LFTs, ferritin, d-dimer, troponin secondary to Covid-19 5) Elevated procalcitonin placing the patient at high risk for sepsis 6) Chronic appearing Right foot wound without signs of secondary infection Patient transferred to a different hospital in another city."
	"1047351-1"	"1047351-1"	"BLOOD CREATININE INCREASED"	"10005483"	"50-59 years"	"50-59"	"Patient was tested for covid on 2/2/21 with positive resulted. Presented to Hospital ER on 2/10/21 with c/o of abdominal pain. Diagnosed with gastritis, prescribed metoclopromide and famotidine and dc home. Returned to ER on 2/13/21 with c/o of weakness, diarrhea, foot ulcer, and loss of appetite.  Diagnosed:   1) Dyspnea and hypoxia secondary to Covid-19 2) Extensive bilateral lung infiltrates secondary to Covid-19 3) Increased Cr 4) Increased LFTs, ferritin, d-dimer, troponin secondary to Covid-19 5) Elevated procalcitonin placing the patient at high risk for sepsis 6) Chronic appearing Right foot wound without signs of secondary infection Patient transferred to a different hospital in another city."
	"1047351-1"	"1047351-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Patient was tested for covid on 2/2/21 with positive resulted. Presented to Hospital ER on 2/10/21 with c/o of abdominal pain. Diagnosed with gastritis, prescribed metoclopromide and famotidine and dc home. Returned to ER on 2/13/21 with c/o of weakness, diarrhea, foot ulcer, and loss of appetite.  Diagnosed:   1) Dyspnea and hypoxia secondary to Covid-19 2) Extensive bilateral lung infiltrates secondary to Covid-19 3) Increased Cr 4) Increased LFTs, ferritin, d-dimer, troponin secondary to Covid-19 5) Elevated procalcitonin placing the patient at high risk for sepsis 6) Chronic appearing Right foot wound without signs of secondary infection Patient transferred to a different hospital in another city."
	"1047351-1"	"1047351-1"	"DECREASED APPETITE"	"10061428"	"50-59 years"	"50-59"	"Patient was tested for covid on 2/2/21 with positive resulted. Presented to Hospital ER on 2/10/21 with c/o of abdominal pain. Diagnosed with gastritis, prescribed metoclopromide and famotidine and dc home. Returned to ER on 2/13/21 with c/o of weakness, diarrhea, foot ulcer, and loss of appetite.  Diagnosed:   1) Dyspnea and hypoxia secondary to Covid-19 2) Extensive bilateral lung infiltrates secondary to Covid-19 3) Increased Cr 4) Increased LFTs, ferritin, d-dimer, troponin secondary to Covid-19 5) Elevated procalcitonin placing the patient at high risk for sepsis 6) Chronic appearing Right foot wound without signs of secondary infection Patient transferred to a different hospital in another city."
	"1047351-1"	"1047351-1"	"DIARRHOEA"	"10012735"	"50-59 years"	"50-59"	"Patient was tested for covid on 2/2/21 with positive resulted. Presented to Hospital ER on 2/10/21 with c/o of abdominal pain. Diagnosed with gastritis, prescribed metoclopromide and famotidine and dc home. Returned to ER on 2/13/21 with c/o of weakness, diarrhea, foot ulcer, and loss of appetite.  Diagnosed:   1) Dyspnea and hypoxia secondary to Covid-19 2) Extensive bilateral lung infiltrates secondary to Covid-19 3) Increased Cr 4) Increased LFTs, ferritin, d-dimer, troponin secondary to Covid-19 5) Elevated procalcitonin placing the patient at high risk for sepsis 6) Chronic appearing Right foot wound without signs of secondary infection Patient transferred to a different hospital in another city."
	"1047351-1"	"1047351-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"Patient was tested for covid on 2/2/21 with positive resulted. Presented to Hospital ER on 2/10/21 with c/o of abdominal pain. Diagnosed with gastritis, prescribed metoclopromide and famotidine and dc home. Returned to ER on 2/13/21 with c/o of weakness, diarrhea, foot ulcer, and loss of appetite.  Diagnosed:   1) Dyspnea and hypoxia secondary to Covid-19 2) Extensive bilateral lung infiltrates secondary to Covid-19 3) Increased Cr 4) Increased LFTs, ferritin, d-dimer, troponin secondary to Covid-19 5) Elevated procalcitonin placing the patient at high risk for sepsis 6) Chronic appearing Right foot wound without signs of secondary infection Patient transferred to a different hospital in another city."
	"1047351-1"	"1047351-1"	"FIBRIN D DIMER INCREASED"	"10016581"	"50-59 years"	"50-59"	"Patient was tested for covid on 2/2/21 with positive resulted. Presented to Hospital ER on 2/10/21 with c/o of abdominal pain. Diagnosed with gastritis, prescribed metoclopromide and famotidine and dc home. Returned to ER on 2/13/21 with c/o of weakness, diarrhea, foot ulcer, and loss of appetite.  Diagnosed:   1) Dyspnea and hypoxia secondary to Covid-19 2) Extensive bilateral lung infiltrates secondary to Covid-19 3) Increased Cr 4) Increased LFTs, ferritin, d-dimer, troponin secondary to Covid-19 5) Elevated procalcitonin placing the patient at high risk for sepsis 6) Chronic appearing Right foot wound without signs of secondary infection Patient transferred to a different hospital in another city."
	"1047351-1"	"1047351-1"	"GASTRITIS"	"10017853"	"50-59 years"	"50-59"	"Patient was tested for covid on 2/2/21 with positive resulted. Presented to Hospital ER on 2/10/21 with c/o of abdominal pain. Diagnosed with gastritis, prescribed metoclopromide and famotidine and dc home. Returned to ER on 2/13/21 with c/o of weakness, diarrhea, foot ulcer, and loss of appetite.  Diagnosed:   1) Dyspnea and hypoxia secondary to Covid-19 2) Extensive bilateral lung infiltrates secondary to Covid-19 3) Increased Cr 4) Increased LFTs, ferritin, d-dimer, troponin secondary to Covid-19 5) Elevated procalcitonin placing the patient at high risk for sepsis 6) Chronic appearing Right foot wound without signs of secondary infection Patient transferred to a different hospital in another city."
	"1047351-1"	"1047351-1"	"HYPOXIA"	"10021143"	"50-59 years"	"50-59"	"Patient was tested for covid on 2/2/21 with positive resulted. Presented to Hospital ER on 2/10/21 with c/o of abdominal pain. Diagnosed with gastritis, prescribed metoclopromide and famotidine and dc home. Returned to ER on 2/13/21 with c/o of weakness, diarrhea, foot ulcer, and loss of appetite.  Diagnosed:   1) Dyspnea and hypoxia secondary to Covid-19 2) Extensive bilateral lung infiltrates secondary to Covid-19 3) Increased Cr 4) Increased LFTs, ferritin, d-dimer, troponin secondary to Covid-19 5) Elevated procalcitonin placing the patient at high risk for sepsis 6) Chronic appearing Right foot wound without signs of secondary infection Patient transferred to a different hospital in another city."
	"1047351-1"	"1047351-1"	"LIMB INJURY"	"10061225"	"50-59 years"	"50-59"	"Patient was tested for covid on 2/2/21 with positive resulted. Presented to Hospital ER on 2/10/21 with c/o of abdominal pain. Diagnosed with gastritis, prescribed metoclopromide and famotidine and dc home. Returned to ER on 2/13/21 with c/o of weakness, diarrhea, foot ulcer, and loss of appetite.  Diagnosed:   1) Dyspnea and hypoxia secondary to Covid-19 2) Extensive bilateral lung infiltrates secondary to Covid-19 3) Increased Cr 4) Increased LFTs, ferritin, d-dimer, troponin secondary to Covid-19 5) Elevated procalcitonin placing the patient at high risk for sepsis 6) Chronic appearing Right foot wound without signs of secondary infection Patient transferred to a different hospital in another city."
	"1047351-1"	"1047351-1"	"LIVER FUNCTION TEST INCREASED"	"10077692"	"50-59 years"	"50-59"	"Patient was tested for covid on 2/2/21 with positive resulted. Presented to Hospital ER on 2/10/21 with c/o of abdominal pain. Diagnosed with gastritis, prescribed metoclopromide and famotidine and dc home. Returned to ER on 2/13/21 with c/o of weakness, diarrhea, foot ulcer, and loss of appetite.  Diagnosed:   1) Dyspnea and hypoxia secondary to Covid-19 2) Extensive bilateral lung infiltrates secondary to Covid-19 3) Increased Cr 4) Increased LFTs, ferritin, d-dimer, troponin secondary to Covid-19 5) Elevated procalcitonin placing the patient at high risk for sepsis 6) Chronic appearing Right foot wound without signs of secondary infection Patient transferred to a different hospital in another city."
	"1047351-1"	"1047351-1"	"LUNG INFILTRATION"	"10025102"	"50-59 years"	"50-59"	"Patient was tested for covid on 2/2/21 with positive resulted. Presented to Hospital ER on 2/10/21 with c/o of abdominal pain. Diagnosed with gastritis, prescribed metoclopromide and famotidine and dc home. Returned to ER on 2/13/21 with c/o of weakness, diarrhea, foot ulcer, and loss of appetite.  Diagnosed:   1) Dyspnea and hypoxia secondary to Covid-19 2) Extensive bilateral lung infiltrates secondary to Covid-19 3) Increased Cr 4) Increased LFTs, ferritin, d-dimer, troponin secondary to Covid-19 5) Elevated procalcitonin placing the patient at high risk for sepsis 6) Chronic appearing Right foot wound without signs of secondary infection Patient transferred to a different hospital in another city."
	"1047351-1"	"1047351-1"	"PROCALCITONIN INCREASED"	"10067081"	"50-59 years"	"50-59"	"Patient was tested for covid on 2/2/21 with positive resulted. Presented to Hospital ER on 2/10/21 with c/o of abdominal pain. Diagnosed with gastritis, prescribed metoclopromide and famotidine and dc home. Returned to ER on 2/13/21 with c/o of weakness, diarrhea, foot ulcer, and loss of appetite.  Diagnosed:   1) Dyspnea and hypoxia secondary to Covid-19 2) Extensive bilateral lung infiltrates secondary to Covid-19 3) Increased Cr 4) Increased LFTs, ferritin, d-dimer, troponin secondary to Covid-19 5) Elevated procalcitonin placing the patient at high risk for sepsis 6) Chronic appearing Right foot wound without signs of secondary infection Patient transferred to a different hospital in another city."
	"1047351-1"	"1047351-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"Patient was tested for covid on 2/2/21 with positive resulted. Presented to Hospital ER on 2/10/21 with c/o of abdominal pain. Diagnosed with gastritis, prescribed metoclopromide and famotidine and dc home. Returned to ER on 2/13/21 with c/o of weakness, diarrhea, foot ulcer, and loss of appetite.  Diagnosed:   1) Dyspnea and hypoxia secondary to Covid-19 2) Extensive bilateral lung infiltrates secondary to Covid-19 3) Increased Cr 4) Increased LFTs, ferritin, d-dimer, troponin secondary to Covid-19 5) Elevated procalcitonin placing the patient at high risk for sepsis 6) Chronic appearing Right foot wound without signs of secondary infection Patient transferred to a different hospital in another city."
	"1047351-1"	"1047351-1"	"SERUM FERRITIN INCREASED"	"10040250"	"50-59 years"	"50-59"	"Patient was tested for covid on 2/2/21 with positive resulted. Presented to Hospital ER on 2/10/21 with c/o of abdominal pain. Diagnosed with gastritis, prescribed metoclopromide and famotidine and dc home. Returned to ER on 2/13/21 with c/o of weakness, diarrhea, foot ulcer, and loss of appetite.  Diagnosed:   1) Dyspnea and hypoxia secondary to Covid-19 2) Extensive bilateral lung infiltrates secondary to Covid-19 3) Increased Cr 4) Increased LFTs, ferritin, d-dimer, troponin secondary to Covid-19 5) Elevated procalcitonin placing the patient at high risk for sepsis 6) Chronic appearing Right foot wound without signs of secondary infection Patient transferred to a different hospital in another city."
	"1047351-1"	"1047351-1"	"SKIN ULCER"	"10040943"	"50-59 years"	"50-59"	"Patient was tested for covid on 2/2/21 with positive resulted. Presented to Hospital ER on 2/10/21 with c/o of abdominal pain. Diagnosed with gastritis, prescribed metoclopromide and famotidine and dc home. Returned to ER on 2/13/21 with c/o of weakness, diarrhea, foot ulcer, and loss of appetite.  Diagnosed:   1) Dyspnea and hypoxia secondary to Covid-19 2) Extensive bilateral lung infiltrates secondary to Covid-19 3) Increased Cr 4) Increased LFTs, ferritin, d-dimer, troponin secondary to Covid-19 5) Elevated procalcitonin placing the patient at high risk for sepsis 6) Chronic appearing Right foot wound without signs of secondary infection Patient transferred to a different hospital in another city."
	"1047351-1"	"1047351-1"	"TROPONIN INCREASED"	"10058267"	"50-59 years"	"50-59"	"Patient was tested for covid on 2/2/21 with positive resulted. Presented to Hospital ER on 2/10/21 with c/o of abdominal pain. Diagnosed with gastritis, prescribed metoclopromide and famotidine and dc home. Returned to ER on 2/13/21 with c/o of weakness, diarrhea, foot ulcer, and loss of appetite.  Diagnosed:   1) Dyspnea and hypoxia secondary to Covid-19 2) Extensive bilateral lung infiltrates secondary to Covid-19 3) Increased Cr 4) Increased LFTs, ferritin, d-dimer, troponin secondary to Covid-19 5) Elevated procalcitonin placing the patient at high risk for sepsis 6) Chronic appearing Right foot wound without signs of secondary infection Patient transferred to a different hospital in another city."
	"1049963-1"	"1049963-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Found lying face down without respiration or pulse, believed to be within 5 minutes of event.  ACLS procedures unsuccessful.  Unable to get autopsy.  Believed to be heart attack secondary to COVID infection, but unconfirmed.  Relative contribution of recent vaccination unknown."
	"1049963-1"	"1049963-1"	"MYOCARDIAL INFARCTION"	"10028596"	"50-59 years"	"50-59"	"Found lying face down without respiration or pulse, believed to be within 5 minutes of event.  ACLS procedures unsuccessful.  Unable to get autopsy.  Believed to be heart attack secondary to COVID infection, but unconfirmed.  Relative contribution of recent vaccination unknown."
	"1049963-1"	"1049963-1"	"PULSE ABSENT"	"10037469"	"50-59 years"	"50-59"	"Found lying face down without respiration or pulse, believed to be within 5 minutes of event.  ACLS procedures unsuccessful.  Unable to get autopsy.  Believed to be heart attack secondary to COVID infection, but unconfirmed.  Relative contribution of recent vaccination unknown."
	"1049963-1"	"1049963-1"	"RESPIRATORY ARREST"	"10038669"	"50-59 years"	"50-59"	"Found lying face down without respiration or pulse, believed to be within 5 minutes of event.  ACLS procedures unsuccessful.  Unable to get autopsy.  Believed to be heart attack secondary to COVID infection, but unconfirmed.  Relative contribution of recent vaccination unknown."
	"1049963-1"	"1049963-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"Found lying face down without respiration or pulse, believed to be within 5 minutes of event.  ACLS procedures unsuccessful.  Unable to get autopsy.  Believed to be heart attack secondary to COVID infection, but unconfirmed.  Relative contribution of recent vaccination unknown."
	"1051651-1"	"1051651-1"	"ABDOMINAL PAIN"	"10000081"	"50-59 years"	"50-59"	"Abdominal pain, nausea and vomiting, shortness of breath, acidosis, hypoglycemia, death.  Onset of abdominal pain was 30 minutes after administration of the vaccine followed by 20+ episodes of vomiting and dry heaving."
	"1051651-1"	"1051651-1"	"ACIDOSIS"	"10000486"	"50-59 years"	"50-59"	"Abdominal pain, nausea and vomiting, shortness of breath, acidosis, hypoglycemia, death.  Onset of abdominal pain was 30 minutes after administration of the vaccine followed by 20+ episodes of vomiting and dry heaving."
	"1051651-1"	"1051651-1"	"ACTIVATED PARTIAL THROMBOPLASTIN TIME PROLONGED"	"10000636"	"50-59 years"	"50-59"	"Abdominal pain, nausea and vomiting, shortness of breath, acidosis, hypoglycemia, death.  Onset of abdominal pain was 30 minutes after administration of the vaccine followed by 20+ episodes of vomiting and dry heaving."
	"1051651-1"	"1051651-1"	"ALANINE AMINOTRANSFERASE INCREASED"	"10001551"	"50-59 years"	"50-59"	"Abdominal pain, nausea and vomiting, shortness of breath, acidosis, hypoglycemia, death.  Onset of abdominal pain was 30 minutes after administration of the vaccine followed by 20+ episodes of vomiting and dry heaving."
	"1051651-1"	"1051651-1"	"ANGIOGRAM PULMONARY ABNORMAL"	"10002441"	"50-59 years"	"50-59"	"Abdominal pain, nausea and vomiting, shortness of breath, acidosis, hypoglycemia, death.  Onset of abdominal pain was 30 minutes after administration of the vaccine followed by 20+ episodes of vomiting and dry heaving."
	"1051651-1"	"1051651-1"	"ANGIOGRAM PULMONARY NORMAL"	"10002442"	"50-59 years"	"50-59"	"Abdominal pain, nausea and vomiting, shortness of breath, acidosis, hypoglycemia, death.  Onset of abdominal pain was 30 minutes after administration of the vaccine followed by 20+ episodes of vomiting and dry heaving."
	"1051651-1"	"1051651-1"	"ANION GAP"	"10002522"	"50-59 years"	"50-59"	"Abdominal pain, nausea and vomiting, shortness of breath, acidosis, hypoglycemia, death.  Onset of abdominal pain was 30 minutes after administration of the vaccine followed by 20+ episodes of vomiting and dry heaving."
	"1051651-1"	"1051651-1"	"ASCITES"	"10003445"	"50-59 years"	"50-59"	"Abdominal pain, nausea and vomiting, shortness of breath, acidosis, hypoglycemia, death.  Onset of abdominal pain was 30 minutes after administration of the vaccine followed by 20+ episodes of vomiting and dry heaving."
	"1051651-1"	"1051651-1"	"ASPARTATE AMINOTRANSFERASE INCREASED"	"10003481"	"50-59 years"	"50-59"	"Abdominal pain, nausea and vomiting, shortness of breath, acidosis, hypoglycemia, death.  Onset of abdominal pain was 30 minutes after administration of the vaccine followed by 20+ episodes of vomiting and dry heaving."
	"1051651-1"	"1051651-1"	"ATELECTASIS"	"10003598"	"50-59 years"	"50-59"	"Abdominal pain, nausea and vomiting, shortness of breath, acidosis, hypoglycemia, death.  Onset of abdominal pain was 30 minutes after administration of the vaccine followed by 20+ episodes of vomiting and dry heaving."
	"1051651-1"	"1051651-1"	"ATYPICAL MYCOBACTERIAL INFECTION"	"10061663"	"50-59 years"	"50-59"	"Abdominal pain, nausea and vomiting, shortness of breath, acidosis, hypoglycemia, death.  Onset of abdominal pain was 30 minutes after administration of the vaccine followed by 20+ episodes of vomiting and dry heaving."
	"1051651-1"	"1051651-1"	"BILIRUBIN CONJUGATED"	"10004684"	"50-59 years"	"50-59"	"Abdominal pain, nausea and vomiting, shortness of breath, acidosis, hypoglycemia, death.  Onset of abdominal pain was 30 minutes after administration of the vaccine followed by 20+ episodes of vomiting and dry heaving."
	"1051651-1"	"1051651-1"	"BLOOD ALBUMIN"	"10005285"	"50-59 years"	"50-59"	"Abdominal pain, nausea and vomiting, shortness of breath, acidosis, hypoglycemia, death.  Onset of abdominal pain was 30 minutes after administration of the vaccine followed by 20+ episodes of vomiting and dry heaving."
	"1051651-1"	"1051651-1"	"BLOOD ALKALINE PHOSPHATASE INCREASED"	"10059570"	"50-59 years"	"50-59"	"Abdominal pain, nausea and vomiting, shortness of breath, acidosis, hypoglycemia, death.  Onset of abdominal pain was 30 minutes after administration of the vaccine followed by 20+ episodes of vomiting and dry heaving."
	"1051651-1"	"1051651-1"	"BLOOD BICARBONATE DECREASED"	"10005359"	"50-59 years"	"50-59"	"Abdominal pain, nausea and vomiting, shortness of breath, acidosis, hypoglycemia, death.  Onset of abdominal pain was 30 minutes after administration of the vaccine followed by 20+ episodes of vomiting and dry heaving."
	"1051651-1"	"1051651-1"	"BLOOD BILIRUBIN"	"10005362"	"50-59 years"	"50-59"	"Abdominal pain, nausea and vomiting, shortness of breath, acidosis, hypoglycemia, death.  Onset of abdominal pain was 30 minutes after administration of the vaccine followed by 20+ episodes of vomiting and dry heaving."
	"1051651-1"	"1051651-1"	"BLOOD CREATININE INCREASED"	"10005483"	"50-59 years"	"50-59"	"Abdominal pain, nausea and vomiting, shortness of breath, acidosis, hypoglycemia, death.  Onset of abdominal pain was 30 minutes after administration of the vaccine followed by 20+ episodes of vomiting and dry heaving."
	"1051651-1"	"1051651-1"	"BLOOD GLUCOSE DECREASED"	"10005555"	"50-59 years"	"50-59"	"Abdominal pain, nausea and vomiting, shortness of breath, acidosis, hypoglycemia, death.  Onset of abdominal pain was 30 minutes after administration of the vaccine followed by 20+ episodes of vomiting and dry heaving."
	"1051651-1"	"1051651-1"	"BLOOD LACTIC ACID"	"10005632"	"50-59 years"	"50-59"	"Abdominal pain, nausea and vomiting, shortness of breath, acidosis, hypoglycemia, death.  Onset of abdominal pain was 30 minutes after administration of the vaccine followed by 20+ episodes of vomiting and dry heaving."
	"1051651-1"	"1051651-1"	"BLOOD LACTIC ACID NORMAL"	"10005636"	"50-59 years"	"50-59"	"Abdominal pain, nausea and vomiting, shortness of breath, acidosis, hypoglycemia, death.  Onset of abdominal pain was 30 minutes after administration of the vaccine followed by 20+ episodes of vomiting and dry heaving."
	"1051651-1"	"1051651-1"	"BLOOD PH DECREASED"	"10005706"	"50-59 years"	"50-59"	"Abdominal pain, nausea and vomiting, shortness of breath, acidosis, hypoglycemia, death.  Onset of abdominal pain was 30 minutes after administration of the vaccine followed by 20+ episodes of vomiting and dry heaving."
	"1051651-1"	"1051651-1"	"BLOOD PH INCREASED"	"10005708"	"50-59 years"	"50-59"	"Abdominal pain, nausea and vomiting, shortness of breath, acidosis, hypoglycemia, death.  Onset of abdominal pain was 30 minutes after administration of the vaccine followed by 20+ episodes of vomiting and dry heaving."
	"1051651-1"	"1051651-1"	"BLOOD POTASSIUM DECREASED"	"10005724"	"50-59 years"	"50-59"	"Abdominal pain, nausea and vomiting, shortness of breath, acidosis, hypoglycemia, death.  Onset of abdominal pain was 30 minutes after administration of the vaccine followed by 20+ episodes of vomiting and dry heaving."
	"1051651-1"	"1051651-1"	"BLOOD UREA INCREASED"	"10005851"	"50-59 years"	"50-59"	"Abdominal pain, nausea and vomiting, shortness of breath, acidosis, hypoglycemia, death.  Onset of abdominal pain was 30 minutes after administration of the vaccine followed by 20+ episodes of vomiting and dry heaving."
	"1051651-1"	"1051651-1"	"CHOLELITHIASIS"	"10008629"	"50-59 years"	"50-59"	"Abdominal pain, nausea and vomiting, shortness of breath, acidosis, hypoglycemia, death.  Onset of abdominal pain was 30 minutes after administration of the vaccine followed by 20+ episodes of vomiting and dry heaving."
	"1051651-1"	"1051651-1"	"COMPUTERISED TOMOGRAM ABDOMEN ABNORMAL"	"10057798"	"50-59 years"	"50-59"	"Abdominal pain, nausea and vomiting, shortness of breath, acidosis, hypoglycemia, death.  Onset of abdominal pain was 30 minutes after administration of the vaccine followed by 20+ episodes of vomiting and dry heaving."
	"1051651-1"	"1051651-1"	"COMPUTERISED TOMOGRAM PELVIS ABNORMAL"	"10081333"	"50-59 years"	"50-59"	"Abdominal pain, nausea and vomiting, shortness of breath, acidosis, hypoglycemia, death.  Onset of abdominal pain was 30 minutes after administration of the vaccine followed by 20+ episodes of vomiting and dry heaving."
	"1051651-1"	"1051651-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Abdominal pain, nausea and vomiting, shortness of breath, acidosis, hypoglycemia, death.  Onset of abdominal pain was 30 minutes after administration of the vaccine followed by 20+ episodes of vomiting and dry heaving."
	"1051651-1"	"1051651-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"Abdominal pain, nausea and vomiting, shortness of breath, acidosis, hypoglycemia, death.  Onset of abdominal pain was 30 minutes after administration of the vaccine followed by 20+ episodes of vomiting and dry heaving."
	"1051651-1"	"1051651-1"	"ENTERITIS"	"10014866"	"50-59 years"	"50-59"	"Abdominal pain, nausea and vomiting, shortness of breath, acidosis, hypoglycemia, death.  Onset of abdominal pain was 30 minutes after administration of the vaccine followed by 20+ episodes of vomiting and dry heaving."
	"1051651-1"	"1051651-1"	"FIBRIN D DIMER"	"10016577"	"50-59 years"	"50-59"	"Abdominal pain, nausea and vomiting, shortness of breath, acidosis, hypoglycemia, death.  Onset of abdominal pain was 30 minutes after administration of the vaccine followed by 20+ episodes of vomiting and dry heaving."
	"1051651-1"	"1051651-1"	"HYPOGLYCAEMIA"	"10020993"	"50-59 years"	"50-59"	"Abdominal pain, nausea and vomiting, shortness of breath, acidosis, hypoglycemia, death.  Onset of abdominal pain was 30 minutes after administration of the vaccine followed by 20+ episodes of vomiting and dry heaving."
	"1051651-1"	"1051651-1"	"ILEUS"	"10021328"	"50-59 years"	"50-59"	"Abdominal pain, nausea and vomiting, shortness of breath, acidosis, hypoglycemia, death.  Onset of abdominal pain was 30 minutes after administration of the vaccine followed by 20+ episodes of vomiting and dry heaving."
	"1051651-1"	"1051651-1"	"INTERNATIONAL NORMALISED RATIO INCREASED"	"10022595"	"50-59 years"	"50-59"	"Abdominal pain, nausea and vomiting, shortness of breath, acidosis, hypoglycemia, death.  Onset of abdominal pain was 30 minutes after administration of the vaccine followed by 20+ episodes of vomiting and dry heaving."
	"1051651-1"	"1051651-1"	"N-TERMINAL PROHORMONE BRAIN NATRIURETIC PEPTIDE INCREASED"	"10071662"	"50-59 years"	"50-59"	"Abdominal pain, nausea and vomiting, shortness of breath, acidosis, hypoglycemia, death.  Onset of abdominal pain was 30 minutes after administration of the vaccine followed by 20+ episodes of vomiting and dry heaving."
	"1051651-1"	"1051651-1"	"NAUSEA"	"10028813"	"50-59 years"	"50-59"	"Abdominal pain, nausea and vomiting, shortness of breath, acidosis, hypoglycemia, death.  Onset of abdominal pain was 30 minutes after administration of the vaccine followed by 20+ episodes of vomiting and dry heaving."
	"1051651-1"	"1051651-1"	"PCO2 INCREASED"	"10034183"	"50-59 years"	"50-59"	"Abdominal pain, nausea and vomiting, shortness of breath, acidosis, hypoglycemia, death.  Onset of abdominal pain was 30 minutes after administration of the vaccine followed by 20+ episodes of vomiting and dry heaving."
	"1051651-1"	"1051651-1"	"PERICARDIAL EFFUSION"	"10034474"	"50-59 years"	"50-59"	"Abdominal pain, nausea and vomiting, shortness of breath, acidosis, hypoglycemia, death.  Onset of abdominal pain was 30 minutes after administration of the vaccine followed by 20+ episodes of vomiting and dry heaving."
	"1051651-1"	"1051651-1"	"PLATELET COUNT DECREASED"	"10035528"	"50-59 years"	"50-59"	"Abdominal pain, nausea and vomiting, shortness of breath, acidosis, hypoglycemia, death.  Onset of abdominal pain was 30 minutes after administration of the vaccine followed by 20+ episodes of vomiting and dry heaving."
	"1051651-1"	"1051651-1"	"PLEURAL EFFUSION"	"10035598"	"50-59 years"	"50-59"	"Abdominal pain, nausea and vomiting, shortness of breath, acidosis, hypoglycemia, death.  Onset of abdominal pain was 30 minutes after administration of the vaccine followed by 20+ episodes of vomiting and dry heaving."
	"1051651-1"	"1051651-1"	"PROCTITIS"	"10036774"	"50-59 years"	"50-59"	"Abdominal pain, nausea and vomiting, shortness of breath, acidosis, hypoglycemia, death.  Onset of abdominal pain was 30 minutes after administration of the vaccine followed by 20+ episodes of vomiting and dry heaving."
	"1051651-1"	"1051651-1"	"RETCHING"	"10038776"	"50-59 years"	"50-59"	"Abdominal pain, nausea and vomiting, shortness of breath, acidosis, hypoglycemia, death.  Onset of abdominal pain was 30 minutes after administration of the vaccine followed by 20+ episodes of vomiting and dry heaving."
	"1051651-1"	"1051651-1"	"TROPONIN"	"10061576"	"50-59 years"	"50-59"	"Abdominal pain, nausea and vomiting, shortness of breath, acidosis, hypoglycemia, death.  Onset of abdominal pain was 30 minutes after administration of the vaccine followed by 20+ episodes of vomiting and dry heaving."
	"1051651-1"	"1051651-1"	"VARICES OESOPHAGEAL"	"10056091"	"50-59 years"	"50-59"	"Abdominal pain, nausea and vomiting, shortness of breath, acidosis, hypoglycemia, death.  Onset of abdominal pain was 30 minutes after administration of the vaccine followed by 20+ episodes of vomiting and dry heaving."
	"1051651-1"	"1051651-1"	"VOMITING"	"10047700"	"50-59 years"	"50-59"	"Abdominal pain, nausea and vomiting, shortness of breath, acidosis, hypoglycemia, death.  Onset of abdominal pain was 30 minutes after administration of the vaccine followed by 20+ episodes of vomiting and dry heaving."
	"1051651-1"	"1051651-1"	"WHITE BLOOD CELL COUNT DECREASED"	"10047942"	"50-59 years"	"50-59"	"Abdominal pain, nausea and vomiting, shortness of breath, acidosis, hypoglycemia, death.  Onset of abdominal pain was 30 minutes after administration of the vaccine followed by 20+ episodes of vomiting and dry heaving."
	"1052106-1"	"1052106-1"	"BLOOD CHOLESTEROL INCREASED"	"10005425"	"50-59 years"	"50-59"	"While at counseling appointment on February 17  patient had witnessed sudden cardiac arrest and was not able to be resuscitated. She was pronounced dead at 12:09. At the time of death her glucose was about 500."
	"1052106-1"	"1052106-1"	"BLOOD CREATININE NORMAL"	"10005484"	"50-59 years"	"50-59"	"While at counseling appointment on February 17  patient had witnessed sudden cardiac arrest and was not able to be resuscitated. She was pronounced dead at 12:09. At the time of death her glucose was about 500."
	"1052106-1"	"1052106-1"	"BLOOD GLUCOSE INCREASED"	"10005557"	"50-59 years"	"50-59"	"While at counseling appointment on February 17  patient had witnessed sudden cardiac arrest and was not able to be resuscitated. She was pronounced dead at 12:09. At the time of death her glucose was about 500."
	"1052106-1"	"1052106-1"	"BLOOD POTASSIUM NORMAL"	"10005726"	"50-59 years"	"50-59"	"While at counseling appointment on February 17  patient had witnessed sudden cardiac arrest and was not able to be resuscitated. She was pronounced dead at 12:09. At the time of death her glucose was about 500."
	"1052106-1"	"1052106-1"	"BLOOD TRIGLYCERIDES INCREASED"	"10005839"	"50-59 years"	"50-59"	"While at counseling appointment on February 17  patient had witnessed sudden cardiac arrest and was not able to be resuscitated. She was pronounced dead at 12:09. At the time of death her glucose was about 500."
	"1052106-1"	"1052106-1"	"BLOOD UREA INCREASED"	"10005851"	"50-59 years"	"50-59"	"While at counseling appointment on February 17  patient had witnessed sudden cardiac arrest and was not able to be resuscitated. She was pronounced dead at 12:09. At the time of death her glucose was about 500."
	"1052106-1"	"1052106-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"While at counseling appointment on February 17  patient had witnessed sudden cardiac arrest and was not able to be resuscitated. She was pronounced dead at 12:09. At the time of death her glucose was about 500."
	"1052106-1"	"1052106-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"While at counseling appointment on February 17  patient had witnessed sudden cardiac arrest and was not able to be resuscitated. She was pronounced dead at 12:09. At the time of death her glucose was about 500."
	"1052106-1"	"1052106-1"	"LOW DENSITY LIPOPROTEIN NORMAL"	"10024911"	"50-59 years"	"50-59"	"While at counseling appointment on February 17  patient had witnessed sudden cardiac arrest and was not able to be resuscitated. She was pronounced dead at 12:09. At the time of death her glucose was about 500."
	"1052106-1"	"1052106-1"	"RESUSCITATION"	"10038749"	"50-59 years"	"50-59"	"While at counseling appointment on February 17  patient had witnessed sudden cardiac arrest and was not able to be resuscitated. She was pronounced dead at 12:09. At the time of death her glucose was about 500."
	"1052172-1"	"1052172-1"	"AUTOPSY"	"10050117"	"50-59 years"	"50-59"	""Agency contacted 2/19 In evening by employer representative- client Died Suddenly after work""""
	"1052172-1"	"1052172-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	""Agency contacted 2/19 In evening by employer representative- client Died Suddenly after work""""
	"1052172-1"	"1052172-1"	"SUDDEN DEATH"	"10042434"	"50-59 years"	"50-59"	""Agency contacted 2/19 In evening by employer representative- client Died Suddenly after work""""
	"1058569-1"	"1058569-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"PATIENT DIED IN HIS SLEEP NIGHT AFTER ADMINISTRATION"
	"1069316-1"	"1069316-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"death"
	"1073167-1"	"1073167-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"She passed away 2/24/2021"
	"1073435-1"	"1073435-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient received dose 1 and dose 2 of the COVID 19 vaccine, 2/2/21 (Lot EL9265, Pfizer)  and 2/24/21 (Lot EN6202, Pfizer), on 2/28/21 patient presented to the Emergency Department at our facility. CBC lab test was abnormal, possible Leukemia, patient transferred to Medical Center for further evaluation and treatment. Patient expired on March 2, 2021."
	"1073435-1"	"1073435-1"	"FULL BLOOD COUNT ABNORMAL"	"10017412"	"50-59 years"	"50-59"	"Patient received dose 1 and dose 2 of the COVID 19 vaccine, 2/2/21 (Lot EL9265, Pfizer)  and 2/24/21 (Lot EN6202, Pfizer), on 2/28/21 patient presented to the Emergency Department at our facility. CBC lab test was abnormal, possible Leukemia, patient transferred to Medical Center for further evaluation and treatment. Patient expired on March 2, 2021."
	"1073435-1"	"1073435-1"	"LIVER FUNCTION TEST ABNORMAL"	"10024690"	"50-59 years"	"50-59"	"Patient received dose 1 and dose 2 of the COVID 19 vaccine, 2/2/21 (Lot EL9265, Pfizer)  and 2/24/21 (Lot EN6202, Pfizer), on 2/28/21 patient presented to the Emergency Department at our facility. CBC lab test was abnormal, possible Leukemia, patient transferred to Medical Center for further evaluation and treatment. Patient expired on March 2, 2021."
	"1073435-1"	"1073435-1"	"SERUM FERRITIN ABNORMAL"	"10040247"	"50-59 years"	"50-59"	"Patient received dose 1 and dose 2 of the COVID 19 vaccine, 2/2/21 (Lot EL9265, Pfizer)  and 2/24/21 (Lot EN6202, Pfizer), on 2/28/21 patient presented to the Emergency Department at our facility. CBC lab test was abnormal, possible Leukemia, patient transferred to Medical Center for further evaluation and treatment. Patient expired on March 2, 2021."
	"1075639-1"	"1075639-1"	"BLOOD GLUCOSE INCREASED"	"10005557"	"50-59 years"	"50-59"	"Patient is a 53 year old man with a past medical history of follicular lymphoma diagnosed in 2008, more recently with DLBCL with CNS involvement (involving hypothalamus; dx 8/2018; s/p HD MTX, s/p BMT- followed by Dr.), autoimmune hepatitis, obesity, adipic DI, central hypothyroidism and type 2 DM who presented to Hospital via EMS after a  fall at home with multisystem organ failure leading to intubation in the ED and subsequent transfer to Oncology ICU for further management.   He was in his usual state if health until Sunday. On Saturday he got COVID vaccine at 4pm, that evening he had no issues. Sunday night around 10pm he didn't make complete sense and his wife was concerned because of his history of DM and treated CNS lymphoma. BG was 320-340 at that time. Monday he was good and Monday night he started to have shaking of his left hand. Tuesday he had one episode of diarrhea. Later he was more shaky in the shower and he started to fall and his wife was unable to grab him and he slid down the wall and could not get up.  Family was called to help and he was not making sense so they called EMS.  Wife reports that he was down approximately 3 hours before EMS was able to get him up. In EMS he was noted to have a large area of skin desquamation from the right posterior knee to the ankle. His GCS was 15. He had stable blood pressure and heart rate. He was hypoxia to the 50s and oxygen was applied.   In the ED he was found to be in multisystem organ failure and was intubated and had rapid progression of shock requiring  Epinephrine, Levophed and Vasopressin. Crash lines were placed and he was sent to hospital.  Upon arrival he was noted to have a cold pulseless right lower extremity and surgery was called. He was evaluated by Trauma Surgery, Orthopedic surgery and Vascular surgery and eventually underwent above the knee amputation. Unfortunately they were not able to remove all nonviable tissue and he continued to deteriorate. He was taken level 1 back to the OR and an additional 10 cm of nonviable tissue was removed. Unfortunately upon arrive he suffered cardiac arrest in the setting of severe lactic acidosis and hyperkalemia."
	"1075639-1"	"1075639-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"Patient is a 53 year old man with a past medical history of follicular lymphoma diagnosed in 2008, more recently with DLBCL with CNS involvement (involving hypothalamus; dx 8/2018; s/p HD MTX, s/p BMT- followed by Dr.), autoimmune hepatitis, obesity, adipic DI, central hypothyroidism and type 2 DM who presented to Hospital via EMS after a  fall at home with multisystem organ failure leading to intubation in the ED and subsequent transfer to Oncology ICU for further management.   He was in his usual state if health until Sunday. On Saturday he got COVID vaccine at 4pm, that evening he had no issues. Sunday night around 10pm he didn't make complete sense and his wife was concerned because of his history of DM and treated CNS lymphoma. BG was 320-340 at that time. Monday he was good and Monday night he started to have shaking of his left hand. Tuesday he had one episode of diarrhea. Later he was more shaky in the shower and he started to fall and his wife was unable to grab him and he slid down the wall and could not get up.  Family was called to help and he was not making sense so they called EMS.  Wife reports that he was down approximately 3 hours before EMS was able to get him up. In EMS he was noted to have a large area of skin desquamation from the right posterior knee to the ankle. His GCS was 15. He had stable blood pressure and heart rate. He was hypoxia to the 50s and oxygen was applied.   In the ED he was found to be in multisystem organ failure and was intubated and had rapid progression of shock requiring  Epinephrine, Levophed and Vasopressin. Crash lines were placed and he was sent to hospital.  Upon arrival he was noted to have a cold pulseless right lower extremity and surgery was called. He was evaluated by Trauma Surgery, Orthopedic surgery and Vascular surgery and eventually underwent above the knee amputation. Unfortunately they were not able to remove all nonviable tissue and he continued to deteriorate. He was taken level 1 back to the OR and an additional 10 cm of nonviable tissue was removed. Unfortunately upon arrive he suffered cardiac arrest in the setting of severe lactic acidosis and hyperkalemia."
	"1075639-1"	"1075639-1"	"COMA SCALE NORMAL"	"10069707"	"50-59 years"	"50-59"	"Patient is a 53 year old man with a past medical history of follicular lymphoma diagnosed in 2008, more recently with DLBCL with CNS involvement (involving hypothalamus; dx 8/2018; s/p HD MTX, s/p BMT- followed by Dr.), autoimmune hepatitis, obesity, adipic DI, central hypothyroidism and type 2 DM who presented to Hospital via EMS after a  fall at home with multisystem organ failure leading to intubation in the ED and subsequent transfer to Oncology ICU for further management.   He was in his usual state if health until Sunday. On Saturday he got COVID vaccine at 4pm, that evening he had no issues. Sunday night around 10pm he didn't make complete sense and his wife was concerned because of his history of DM and treated CNS lymphoma. BG was 320-340 at that time. Monday he was good and Monday night he started to have shaking of his left hand. Tuesday he had one episode of diarrhea. Later he was more shaky in the shower and he started to fall and his wife was unable to grab him and he slid down the wall and could not get up.  Family was called to help and he was not making sense so they called EMS.  Wife reports that he was down approximately 3 hours before EMS was able to get him up. In EMS he was noted to have a large area of skin desquamation from the right posterior knee to the ankle. His GCS was 15. He had stable blood pressure and heart rate. He was hypoxia to the 50s and oxygen was applied.   In the ED he was found to be in multisystem organ failure and was intubated and had rapid progression of shock requiring  Epinephrine, Levophed and Vasopressin. Crash lines were placed and he was sent to hospital.  Upon arrival he was noted to have a cold pulseless right lower extremity and surgery was called. He was evaluated by Trauma Surgery, Orthopedic surgery and Vascular surgery and eventually underwent above the knee amputation. Unfortunately they were not able to remove all nonviable tissue and he continued to deteriorate. He was taken level 1 back to the OR and an additional 10 cm of nonviable tissue was removed. Unfortunately upon arrive he suffered cardiac arrest in the setting of severe lactic acidosis and hyperkalemia."
	"1075639-1"	"1075639-1"	"DIARRHOEA"	"10012735"	"50-59 years"	"50-59"	"Patient is a 53 year old man with a past medical history of follicular lymphoma diagnosed in 2008, more recently with DLBCL with CNS involvement (involving hypothalamus; dx 8/2018; s/p HD MTX, s/p BMT- followed by Dr.), autoimmune hepatitis, obesity, adipic DI, central hypothyroidism and type 2 DM who presented to Hospital via EMS after a  fall at home with multisystem organ failure leading to intubation in the ED and subsequent transfer to Oncology ICU for further management.   He was in his usual state if health until Sunday. On Saturday he got COVID vaccine at 4pm, that evening he had no issues. Sunday night around 10pm he didn't make complete sense and his wife was concerned because of his history of DM and treated CNS lymphoma. BG was 320-340 at that time. Monday he was good and Monday night he started to have shaking of his left hand. Tuesday he had one episode of diarrhea. Later he was more shaky in the shower and he started to fall and his wife was unable to grab him and he slid down the wall and could not get up.  Family was called to help and he was not making sense so they called EMS.  Wife reports that he was down approximately 3 hours before EMS was able to get him up. In EMS he was noted to have a large area of skin desquamation from the right posterior knee to the ankle. His GCS was 15. He had stable blood pressure and heart rate. He was hypoxia to the 50s and oxygen was applied.   In the ED he was found to be in multisystem organ failure and was intubated and had rapid progression of shock requiring  Epinephrine, Levophed and Vasopressin. Crash lines were placed and he was sent to hospital.  Upon arrival he was noted to have a cold pulseless right lower extremity and surgery was called. He was evaluated by Trauma Surgery, Orthopedic surgery and Vascular surgery and eventually underwent above the knee amputation. Unfortunately they were not able to remove all nonviable tissue and he continued to deteriorate. He was taken level 1 back to the OR and an additional 10 cm of nonviable tissue was removed. Unfortunately upon arrive he suffered cardiac arrest in the setting of severe lactic acidosis and hyperkalemia."
	"1075639-1"	"1075639-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"50-59 years"	"50-59"	"Patient is a 53 year old man with a past medical history of follicular lymphoma diagnosed in 2008, more recently with DLBCL with CNS involvement (involving hypothalamus; dx 8/2018; s/p HD MTX, s/p BMT- followed by Dr.), autoimmune hepatitis, obesity, adipic DI, central hypothyroidism and type 2 DM who presented to Hospital via EMS after a  fall at home with multisystem organ failure leading to intubation in the ED and subsequent transfer to Oncology ICU for further management.   He was in his usual state if health until Sunday. On Saturday he got COVID vaccine at 4pm, that evening he had no issues. Sunday night around 10pm he didn't make complete sense and his wife was concerned because of his history of DM and treated CNS lymphoma. BG was 320-340 at that time. Monday he was good and Monday night he started to have shaking of his left hand. Tuesday he had one episode of diarrhea. Later he was more shaky in the shower and he started to fall and his wife was unable to grab him and he slid down the wall and could not get up.  Family was called to help and he was not making sense so they called EMS.  Wife reports that he was down approximately 3 hours before EMS was able to get him up. In EMS he was noted to have a large area of skin desquamation from the right posterior knee to the ankle. His GCS was 15. He had stable blood pressure and heart rate. He was hypoxia to the 50s and oxygen was applied.   In the ED he was found to be in multisystem organ failure and was intubated and had rapid progression of shock requiring  Epinephrine, Levophed and Vasopressin. Crash lines were placed and he was sent to hospital.  Upon arrival he was noted to have a cold pulseless right lower extremity and surgery was called. He was evaluated by Trauma Surgery, Orthopedic surgery and Vascular surgery and eventually underwent above the knee amputation. Unfortunately they were not able to remove all nonviable tissue and he continued to deteriorate. He was taken level 1 back to the OR and an additional 10 cm of nonviable tissue was removed. Unfortunately upon arrive he suffered cardiac arrest in the setting of severe lactic acidosis and hyperkalemia."
	"1075639-1"	"1075639-1"	"FALL"	"10016173"	"50-59 years"	"50-59"	"Patient is a 53 year old man with a past medical history of follicular lymphoma diagnosed in 2008, more recently with DLBCL with CNS involvement (involving hypothalamus; dx 8/2018; s/p HD MTX, s/p BMT- followed by Dr.), autoimmune hepatitis, obesity, adipic DI, central hypothyroidism and type 2 DM who presented to Hospital via EMS after a  fall at home with multisystem organ failure leading to intubation in the ED and subsequent transfer to Oncology ICU for further management.   He was in his usual state if health until Sunday. On Saturday he got COVID vaccine at 4pm, that evening he had no issues. Sunday night around 10pm he didn't make complete sense and his wife was concerned because of his history of DM and treated CNS lymphoma. BG was 320-340 at that time. Monday he was good and Monday night he started to have shaking of his left hand. Tuesday he had one episode of diarrhea. Later he was more shaky in the shower and he started to fall and his wife was unable to grab him and he slid down the wall and could not get up.  Family was called to help and he was not making sense so they called EMS.  Wife reports that he was down approximately 3 hours before EMS was able to get him up. In EMS he was noted to have a large area of skin desquamation from the right posterior knee to the ankle. His GCS was 15. He had stable blood pressure and heart rate. He was hypoxia to the 50s and oxygen was applied.   In the ED he was found to be in multisystem organ failure and was intubated and had rapid progression of shock requiring  Epinephrine, Levophed and Vasopressin. Crash lines were placed and he was sent to hospital.  Upon arrival he was noted to have a cold pulseless right lower extremity and surgery was called. He was evaluated by Trauma Surgery, Orthopedic surgery and Vascular surgery and eventually underwent above the knee amputation. Unfortunately they were not able to remove all nonviable tissue and he continued to deteriorate. He was taken level 1 back to the OR and an additional 10 cm of nonviable tissue was removed. Unfortunately upon arrive he suffered cardiac arrest in the setting of severe lactic acidosis and hyperkalemia."
	"1075639-1"	"1075639-1"	"GENERAL PHYSICAL HEALTH DETERIORATION"	"10049438"	"50-59 years"	"50-59"	"Patient is a 53 year old man with a past medical history of follicular lymphoma diagnosed in 2008, more recently with DLBCL with CNS involvement (involving hypothalamus; dx 8/2018; s/p HD MTX, s/p BMT- followed by Dr.), autoimmune hepatitis, obesity, adipic DI, central hypothyroidism and type 2 DM who presented to Hospital via EMS after a  fall at home with multisystem organ failure leading to intubation in the ED and subsequent transfer to Oncology ICU for further management.   He was in his usual state if health until Sunday. On Saturday he got COVID vaccine at 4pm, that evening he had no issues. Sunday night around 10pm he didn't make complete sense and his wife was concerned because of his history of DM and treated CNS lymphoma. BG was 320-340 at that time. Monday he was good and Monday night he started to have shaking of his left hand. Tuesday he had one episode of diarrhea. Later he was more shaky in the shower and he started to fall and his wife was unable to grab him and he slid down the wall and could not get up.  Family was called to help and he was not making sense so they called EMS.  Wife reports that he was down approximately 3 hours before EMS was able to get him up. In EMS he was noted to have a large area of skin desquamation from the right posterior knee to the ankle. His GCS was 15. He had stable blood pressure and heart rate. He was hypoxia to the 50s and oxygen was applied.   In the ED he was found to be in multisystem organ failure and was intubated and had rapid progression of shock requiring  Epinephrine, Levophed and Vasopressin. Crash lines were placed and he was sent to hospital.  Upon arrival he was noted to have a cold pulseless right lower extremity and surgery was called. He was evaluated by Trauma Surgery, Orthopedic surgery and Vascular surgery and eventually underwent above the knee amputation. Unfortunately they were not able to remove all nonviable tissue and he continued to deteriorate. He was taken level 1 back to the OR and an additional 10 cm of nonviable tissue was removed. Unfortunately upon arrive he suffered cardiac arrest in the setting of severe lactic acidosis and hyperkalemia."
	"1075639-1"	"1075639-1"	"HYPERKALAEMIA"	"10020646"	"50-59 years"	"50-59"	"Patient is a 53 year old man with a past medical history of follicular lymphoma diagnosed in 2008, more recently with DLBCL with CNS involvement (involving hypothalamus; dx 8/2018; s/p HD MTX, s/p BMT- followed by Dr.), autoimmune hepatitis, obesity, adipic DI, central hypothyroidism and type 2 DM who presented to Hospital via EMS after a  fall at home with multisystem organ failure leading to intubation in the ED and subsequent transfer to Oncology ICU for further management.   He was in his usual state if health until Sunday. On Saturday he got COVID vaccine at 4pm, that evening he had no issues. Sunday night around 10pm he didn't make complete sense and his wife was concerned because of his history of DM and treated CNS lymphoma. BG was 320-340 at that time. Monday he was good and Monday night he started to have shaking of his left hand. Tuesday he had one episode of diarrhea. Later he was more shaky in the shower and he started to fall and his wife was unable to grab him and he slid down the wall and could not get up.  Family was called to help and he was not making sense so they called EMS.  Wife reports that he was down approximately 3 hours before EMS was able to get him up. In EMS he was noted to have a large area of skin desquamation from the right posterior knee to the ankle. His GCS was 15. He had stable blood pressure and heart rate. He was hypoxia to the 50s and oxygen was applied.   In the ED he was found to be in multisystem organ failure and was intubated and had rapid progression of shock requiring  Epinephrine, Levophed and Vasopressin. Crash lines were placed and he was sent to hospital.  Upon arrival he was noted to have a cold pulseless right lower extremity and surgery was called. He was evaluated by Trauma Surgery, Orthopedic surgery and Vascular surgery and eventually underwent above the knee amputation. Unfortunately they were not able to remove all nonviable tissue and he continued to deteriorate. He was taken level 1 back to the OR and an additional 10 cm of nonviable tissue was removed. Unfortunately upon arrive he suffered cardiac arrest in the setting of severe lactic acidosis and hyperkalemia."
	"1075639-1"	"1075639-1"	"HYPOXIA"	"10021143"	"50-59 years"	"50-59"	"Patient is a 53 year old man with a past medical history of follicular lymphoma diagnosed in 2008, more recently with DLBCL with CNS involvement (involving hypothalamus; dx 8/2018; s/p HD MTX, s/p BMT- followed by Dr.), autoimmune hepatitis, obesity, adipic DI, central hypothyroidism and type 2 DM who presented to Hospital via EMS after a  fall at home with multisystem organ failure leading to intubation in the ED and subsequent transfer to Oncology ICU for further management.   He was in his usual state if health until Sunday. On Saturday he got COVID vaccine at 4pm, that evening he had no issues. Sunday night around 10pm he didn't make complete sense and his wife was concerned because of his history of DM and treated CNS lymphoma. BG was 320-340 at that time. Monday he was good and Monday night he started to have shaking of his left hand. Tuesday he had one episode of diarrhea. Later he was more shaky in the shower and he started to fall and his wife was unable to grab him and he slid down the wall and could not get up.  Family was called to help and he was not making sense so they called EMS.  Wife reports that he was down approximately 3 hours before EMS was able to get him up. In EMS he was noted to have a large area of skin desquamation from the right posterior knee to the ankle. His GCS was 15. He had stable blood pressure and heart rate. He was hypoxia to the 50s and oxygen was applied.   In the ED he was found to be in multisystem organ failure and was intubated and had rapid progression of shock requiring  Epinephrine, Levophed and Vasopressin. Crash lines were placed and he was sent to hospital.  Upon arrival he was noted to have a cold pulseless right lower extremity and surgery was called. He was evaluated by Trauma Surgery, Orthopedic surgery and Vascular surgery and eventually underwent above the knee amputation. Unfortunately they were not able to remove all nonviable tissue and he continued to deteriorate. He was taken level 1 back to the OR and an additional 10 cm of nonviable tissue was removed. Unfortunately upon arrive he suffered cardiac arrest in the setting of severe lactic acidosis and hyperkalemia."
	"1075639-1"	"1075639-1"	"INCOHERENT"	"10021630"	"50-59 years"	"50-59"	"Patient is a 53 year old man with a past medical history of follicular lymphoma diagnosed in 2008, more recently with DLBCL with CNS involvement (involving hypothalamus; dx 8/2018; s/p HD MTX, s/p BMT- followed by Dr.), autoimmune hepatitis, obesity, adipic DI, central hypothyroidism and type 2 DM who presented to Hospital via EMS after a  fall at home with multisystem organ failure leading to intubation in the ED and subsequent transfer to Oncology ICU for further management.   He was in his usual state if health until Sunday. On Saturday he got COVID vaccine at 4pm, that evening he had no issues. Sunday night around 10pm he didn't make complete sense and his wife was concerned because of his history of DM and treated CNS lymphoma. BG was 320-340 at that time. Monday he was good and Monday night he started to have shaking of his left hand. Tuesday he had one episode of diarrhea. Later he was more shaky in the shower and he started to fall and his wife was unable to grab him and he slid down the wall and could not get up.  Family was called to help and he was not making sense so they called EMS.  Wife reports that he was down approximately 3 hours before EMS was able to get him up. In EMS he was noted to have a large area of skin desquamation from the right posterior knee to the ankle. His GCS was 15. He had stable blood pressure and heart rate. He was hypoxia to the 50s and oxygen was applied.   In the ED he was found to be in multisystem organ failure and was intubated and had rapid progression of shock requiring  Epinephrine, Levophed and Vasopressin. Crash lines were placed and he was sent to hospital.  Upon arrival he was noted to have a cold pulseless right lower extremity and surgery was called. He was evaluated by Trauma Surgery, Orthopedic surgery and Vascular surgery and eventually underwent above the knee amputation. Unfortunately they were not able to remove all nonviable tissue and he continued to deteriorate. He was taken level 1 back to the OR and an additional 10 cm of nonviable tissue was removed. Unfortunately upon arrive he suffered cardiac arrest in the setting of severe lactic acidosis and hyperkalemia."
	"1075639-1"	"1075639-1"	"INTENSIVE CARE"	"10022519"	"50-59 years"	"50-59"	"Patient is a 53 year old man with a past medical history of follicular lymphoma diagnosed in 2008, more recently with DLBCL with CNS involvement (involving hypothalamus; dx 8/2018; s/p HD MTX, s/p BMT- followed by Dr.), autoimmune hepatitis, obesity, adipic DI, central hypothyroidism and type 2 DM who presented to Hospital via EMS after a  fall at home with multisystem organ failure leading to intubation in the ED and subsequent transfer to Oncology ICU for further management.   He was in his usual state if health until Sunday. On Saturday he got COVID vaccine at 4pm, that evening he had no issues. Sunday night around 10pm he didn't make complete sense and his wife was concerned because of his history of DM and treated CNS lymphoma. BG was 320-340 at that time. Monday he was good and Monday night he started to have shaking of his left hand. Tuesday he had one episode of diarrhea. Later he was more shaky in the shower and he started to fall and his wife was unable to grab him and he slid down the wall and could not get up.  Family was called to help and he was not making sense so they called EMS.  Wife reports that he was down approximately 3 hours before EMS was able to get him up. In EMS he was noted to have a large area of skin desquamation from the right posterior knee to the ankle. His GCS was 15. He had stable blood pressure and heart rate. He was hypoxia to the 50s and oxygen was applied.   In the ED he was found to be in multisystem organ failure and was intubated and had rapid progression of shock requiring  Epinephrine, Levophed and Vasopressin. Crash lines were placed and he was sent to hospital.  Upon arrival he was noted to have a cold pulseless right lower extremity and surgery was called. He was evaluated by Trauma Surgery, Orthopedic surgery and Vascular surgery and eventually underwent above the knee amputation. Unfortunately they were not able to remove all nonviable tissue and he continued to deteriorate. He was taken level 1 back to the OR and an additional 10 cm of nonviable tissue was removed. Unfortunately upon arrive he suffered cardiac arrest in the setting of severe lactic acidosis and hyperkalemia."
	"1075639-1"	"1075639-1"	"LACTIC ACIDOSIS"	"10023676"	"50-59 years"	"50-59"	"Patient is a 53 year old man with a past medical history of follicular lymphoma diagnosed in 2008, more recently with DLBCL with CNS involvement (involving hypothalamus; dx 8/2018; s/p HD MTX, s/p BMT- followed by Dr.), autoimmune hepatitis, obesity, adipic DI, central hypothyroidism and type 2 DM who presented to Hospital via EMS after a  fall at home with multisystem organ failure leading to intubation in the ED and subsequent transfer to Oncology ICU for further management.   He was in his usual state if health until Sunday. On Saturday he got COVID vaccine at 4pm, that evening he had no issues. Sunday night around 10pm he didn't make complete sense and his wife was concerned because of his history of DM and treated CNS lymphoma. BG was 320-340 at that time. Monday he was good and Monday night he started to have shaking of his left hand. Tuesday he had one episode of diarrhea. Later he was more shaky in the shower and he started to fall and his wife was unable to grab him and he slid down the wall and could not get up.  Family was called to help and he was not making sense so they called EMS.  Wife reports that he was down approximately 3 hours before EMS was able to get him up. In EMS he was noted to have a large area of skin desquamation from the right posterior knee to the ankle. His GCS was 15. He had stable blood pressure and heart rate. He was hypoxia to the 50s and oxygen was applied.   In the ED he was found to be in multisystem organ failure and was intubated and had rapid progression of shock requiring  Epinephrine, Levophed and Vasopressin. Crash lines were placed and he was sent to hospital.  Upon arrival he was noted to have a cold pulseless right lower extremity and surgery was called. He was evaluated by Trauma Surgery, Orthopedic surgery and Vascular surgery and eventually underwent above the knee amputation. Unfortunately they were not able to remove all nonviable tissue and he continued to deteriorate. He was taken level 1 back to the OR and an additional 10 cm of nonviable tissue was removed. Unfortunately upon arrive he suffered cardiac arrest in the setting of severe lactic acidosis and hyperkalemia."
	"1075639-1"	"1075639-1"	"LEG AMPUTATION"	"10024124"	"50-59 years"	"50-59"	"Patient is a 53 year old man with a past medical history of follicular lymphoma diagnosed in 2008, more recently with DLBCL with CNS involvement (involving hypothalamus; dx 8/2018; s/p HD MTX, s/p BMT- followed by Dr.), autoimmune hepatitis, obesity, adipic DI, central hypothyroidism and type 2 DM who presented to Hospital via EMS after a  fall at home with multisystem organ failure leading to intubation in the ED and subsequent transfer to Oncology ICU for further management.   He was in his usual state if health until Sunday. On Saturday he got COVID vaccine at 4pm, that evening he had no issues. Sunday night around 10pm he didn't make complete sense and his wife was concerned because of his history of DM and treated CNS lymphoma. BG was 320-340 at that time. Monday he was good and Monday night he started to have shaking of his left hand. Tuesday he had one episode of diarrhea. Later he was more shaky in the shower and he started to fall and his wife was unable to grab him and he slid down the wall and could not get up.  Family was called to help and he was not making sense so they called EMS.  Wife reports that he was down approximately 3 hours before EMS was able to get him up. In EMS he was noted to have a large area of skin desquamation from the right posterior knee to the ankle. His GCS was 15. He had stable blood pressure and heart rate. He was hypoxia to the 50s and oxygen was applied.   In the ED he was found to be in multisystem organ failure and was intubated and had rapid progression of shock requiring  Epinephrine, Levophed and Vasopressin. Crash lines were placed and he was sent to hospital.  Upon arrival he was noted to have a cold pulseless right lower extremity and surgery was called. He was evaluated by Trauma Surgery, Orthopedic surgery and Vascular surgery and eventually underwent above the knee amputation. Unfortunately they were not able to remove all nonviable tissue and he continued to deteriorate. He was taken level 1 back to the OR and an additional 10 cm of nonviable tissue was removed. Unfortunately upon arrive he suffered cardiac arrest in the setting of severe lactic acidosis and hyperkalemia."
	"1075639-1"	"1075639-1"	"MULTIPLE ORGAN DYSFUNCTION SYNDROME"	"10077361"	"50-59 years"	"50-59"	"Patient is a 53 year old man with a past medical history of follicular lymphoma diagnosed in 2008, more recently with DLBCL with CNS involvement (involving hypothalamus; dx 8/2018; s/p HD MTX, s/p BMT- followed by Dr.), autoimmune hepatitis, obesity, adipic DI, central hypothyroidism and type 2 DM who presented to Hospital via EMS after a  fall at home with multisystem organ failure leading to intubation in the ED and subsequent transfer to Oncology ICU for further management.   He was in his usual state if health until Sunday. On Saturday he got COVID vaccine at 4pm, that evening he had no issues. Sunday night around 10pm he didn't make complete sense and his wife was concerned because of his history of DM and treated CNS lymphoma. BG was 320-340 at that time. Monday he was good and Monday night he started to have shaking of his left hand. Tuesday he had one episode of diarrhea. Later he was more shaky in the shower and he started to fall and his wife was unable to grab him and he slid down the wall and could not get up.  Family was called to help and he was not making sense so they called EMS.  Wife reports that he was down approximately 3 hours before EMS was able to get him up. In EMS he was noted to have a large area of skin desquamation from the right posterior knee to the ankle. His GCS was 15. He had stable blood pressure and heart rate. He was hypoxia to the 50s and oxygen was applied.   In the ED he was found to be in multisystem organ failure and was intubated and had rapid progression of shock requiring  Epinephrine, Levophed and Vasopressin. Crash lines were placed and he was sent to hospital.  Upon arrival he was noted to have a cold pulseless right lower extremity and surgery was called. He was evaluated by Trauma Surgery, Orthopedic surgery and Vascular surgery and eventually underwent above the knee amputation. Unfortunately they were not able to remove all nonviable tissue and he continued to deteriorate. He was taken level 1 back to the OR and an additional 10 cm of nonviable tissue was removed. Unfortunately upon arrive he suffered cardiac arrest in the setting of severe lactic acidosis and hyperkalemia."
	"1075639-1"	"1075639-1"	"PERIPHERAL COLDNESS"	"10034568"	"50-59 years"	"50-59"	"Patient is a 53 year old man with a past medical history of follicular lymphoma diagnosed in 2008, more recently with DLBCL with CNS involvement (involving hypothalamus; dx 8/2018; s/p HD MTX, s/p BMT- followed by Dr.), autoimmune hepatitis, obesity, adipic DI, central hypothyroidism and type 2 DM who presented to Hospital via EMS after a  fall at home with multisystem organ failure leading to intubation in the ED and subsequent transfer to Oncology ICU for further management.   He was in his usual state if health until Sunday. On Saturday he got COVID vaccine at 4pm, that evening he had no issues. Sunday night around 10pm he didn't make complete sense and his wife was concerned because of his history of DM and treated CNS lymphoma. BG was 320-340 at that time. Monday he was good and Monday night he started to have shaking of his left hand. Tuesday he had one episode of diarrhea. Later he was more shaky in the shower and he started to fall and his wife was unable to grab him and he slid down the wall and could not get up.  Family was called to help and he was not making sense so they called EMS.  Wife reports that he was down approximately 3 hours before EMS was able to get him up. In EMS he was noted to have a large area of skin desquamation from the right posterior knee to the ankle. His GCS was 15. He had stable blood pressure and heart rate. He was hypoxia to the 50s and oxygen was applied.   In the ED he was found to be in multisystem organ failure and was intubated and had rapid progression of shock requiring  Epinephrine, Levophed and Vasopressin. Crash lines were placed and he was sent to hospital.  Upon arrival he was noted to have a cold pulseless right lower extremity and surgery was called. He was evaluated by Trauma Surgery, Orthopedic surgery and Vascular surgery and eventually underwent above the knee amputation. Unfortunately they were not able to remove all nonviable tissue and he continued to deteriorate. He was taken level 1 back to the OR and an additional 10 cm of nonviable tissue was removed. Unfortunately upon arrive he suffered cardiac arrest in the setting of severe lactic acidosis and hyperkalemia."
	"1075639-1"	"1075639-1"	"PULSE ABSENT"	"10037469"	"50-59 years"	"50-59"	"Patient is a 53 year old man with a past medical history of follicular lymphoma diagnosed in 2008, more recently with DLBCL with CNS involvement (involving hypothalamus; dx 8/2018; s/p HD MTX, s/p BMT- followed by Dr.), autoimmune hepatitis, obesity, adipic DI, central hypothyroidism and type 2 DM who presented to Hospital via EMS after a  fall at home with multisystem organ failure leading to intubation in the ED and subsequent transfer to Oncology ICU for further management.   He was in his usual state if health until Sunday. On Saturday he got COVID vaccine at 4pm, that evening he had no issues. Sunday night around 10pm he didn't make complete sense and his wife was concerned because of his history of DM and treated CNS lymphoma. BG was 320-340 at that time. Monday he was good and Monday night he started to have shaking of his left hand. Tuesday he had one episode of diarrhea. Later he was more shaky in the shower and he started to fall and his wife was unable to grab him and he slid down the wall and could not get up.  Family was called to help and he was not making sense so they called EMS.  Wife reports that he was down approximately 3 hours before EMS was able to get him up. In EMS he was noted to have a large area of skin desquamation from the right posterior knee to the ankle. His GCS was 15. He had stable blood pressure and heart rate. He was hypoxia to the 50s and oxygen was applied.   In the ED he was found to be in multisystem organ failure and was intubated and had rapid progression of shock requiring  Epinephrine, Levophed and Vasopressin. Crash lines were placed and he was sent to hospital.  Upon arrival he was noted to have a cold pulseless right lower extremity and surgery was called. He was evaluated by Trauma Surgery, Orthopedic surgery and Vascular surgery and eventually underwent above the knee amputation. Unfortunately they were not able to remove all nonviable tissue and he continued to deteriorate. He was taken level 1 back to the OR and an additional 10 cm of nonviable tissue was removed. Unfortunately upon arrive he suffered cardiac arrest in the setting of severe lactic acidosis and hyperkalemia."
	"1075639-1"	"1075639-1"	"SHOCK"	"10040560"	"50-59 years"	"50-59"	"Patient is a 53 year old man with a past medical history of follicular lymphoma diagnosed in 2008, more recently with DLBCL with CNS involvement (involving hypothalamus; dx 8/2018; s/p HD MTX, s/p BMT- followed by Dr.), autoimmune hepatitis, obesity, adipic DI, central hypothyroidism and type 2 DM who presented to Hospital via EMS after a  fall at home with multisystem organ failure leading to intubation in the ED and subsequent transfer to Oncology ICU for further management.   He was in his usual state if health until Sunday. On Saturday he got COVID vaccine at 4pm, that evening he had no issues. Sunday night around 10pm he didn't make complete sense and his wife was concerned because of his history of DM and treated CNS lymphoma. BG was 320-340 at that time. Monday he was good and Monday night he started to have shaking of his left hand. Tuesday he had one episode of diarrhea. Later he was more shaky in the shower and he started to fall and his wife was unable to grab him and he slid down the wall and could not get up.  Family was called to help and he was not making sense so they called EMS.  Wife reports that he was down approximately 3 hours before EMS was able to get him up. In EMS he was noted to have a large area of skin desquamation from the right posterior knee to the ankle. His GCS was 15. He had stable blood pressure and heart rate. He was hypoxia to the 50s and oxygen was applied.   In the ED he was found to be in multisystem organ failure and was intubated and had rapid progression of shock requiring  Epinephrine, Levophed and Vasopressin. Crash lines were placed and he was sent to hospital.  Upon arrival he was noted to have a cold pulseless right lower extremity and surgery was called. He was evaluated by Trauma Surgery, Orthopedic surgery and Vascular surgery and eventually underwent above the knee amputation. Unfortunately they were not able to remove all nonviable tissue and he continued to deteriorate. He was taken level 1 back to the OR and an additional 10 cm of nonviable tissue was removed. Unfortunately upon arrive he suffered cardiac arrest in the setting of severe lactic acidosis and hyperkalemia."
	"1075639-1"	"1075639-1"	"SKIN EXFOLIATION"	"10040844"	"50-59 years"	"50-59"	"Patient is a 53 year old man with a past medical history of follicular lymphoma diagnosed in 2008, more recently with DLBCL with CNS involvement (involving hypothalamus; dx 8/2018; s/p HD MTX, s/p BMT- followed by Dr.), autoimmune hepatitis, obesity, adipic DI, central hypothyroidism and type 2 DM who presented to Hospital via EMS after a  fall at home with multisystem organ failure leading to intubation in the ED and subsequent transfer to Oncology ICU for further management.   He was in his usual state if health until Sunday. On Saturday he got COVID vaccine at 4pm, that evening he had no issues. Sunday night around 10pm he didn't make complete sense and his wife was concerned because of his history of DM and treated CNS lymphoma. BG was 320-340 at that time. Monday he was good and Monday night he started to have shaking of his left hand. Tuesday he had one episode of diarrhea. Later he was more shaky in the shower and he started to fall and his wife was unable to grab him and he slid down the wall and could not get up.  Family was called to help and he was not making sense so they called EMS.  Wife reports that he was down approximately 3 hours before EMS was able to get him up. In EMS he was noted to have a large area of skin desquamation from the right posterior knee to the ankle. His GCS was 15. He had stable blood pressure and heart rate. He was hypoxia to the 50s and oxygen was applied.   In the ED he was found to be in multisystem organ failure and was intubated and had rapid progression of shock requiring  Epinephrine, Levophed and Vasopressin. Crash lines were placed and he was sent to hospital.  Upon arrival he was noted to have a cold pulseless right lower extremity and surgery was called. He was evaluated by Trauma Surgery, Orthopedic surgery and Vascular surgery and eventually underwent above the knee amputation. Unfortunately they were not able to remove all nonviable tissue and he continued to deteriorate. He was taken level 1 back to the OR and an additional 10 cm of nonviable tissue was removed. Unfortunately upon arrive he suffered cardiac arrest in the setting of severe lactic acidosis and hyperkalemia."
	"1075639-1"	"1075639-1"	"SURGERY"	"10042609"	"50-59 years"	"50-59"	"Patient is a 53 year old man with a past medical history of follicular lymphoma diagnosed in 2008, more recently with DLBCL with CNS involvement (involving hypothalamus; dx 8/2018; s/p HD MTX, s/p BMT- followed by Dr.), autoimmune hepatitis, obesity, adipic DI, central hypothyroidism and type 2 DM who presented to Hospital via EMS after a  fall at home with multisystem organ failure leading to intubation in the ED and subsequent transfer to Oncology ICU for further management.   He was in his usual state if health until Sunday. On Saturday he got COVID vaccine at 4pm, that evening he had no issues. Sunday night around 10pm he didn't make complete sense and his wife was concerned because of his history of DM and treated CNS lymphoma. BG was 320-340 at that time. Monday he was good and Monday night he started to have shaking of his left hand. Tuesday he had one episode of diarrhea. Later he was more shaky in the shower and he started to fall and his wife was unable to grab him and he slid down the wall and could not get up.  Family was called to help and he was not making sense so they called EMS.  Wife reports that he was down approximately 3 hours before EMS was able to get him up. In EMS he was noted to have a large area of skin desquamation from the right posterior knee to the ankle. His GCS was 15. He had stable blood pressure and heart rate. He was hypoxia to the 50s and oxygen was applied.   In the ED he was found to be in multisystem organ failure and was intubated and had rapid progression of shock requiring  Epinephrine, Levophed and Vasopressin. Crash lines were placed and he was sent to hospital.  Upon arrival he was noted to have a cold pulseless right lower extremity and surgery was called. He was evaluated by Trauma Surgery, Orthopedic surgery and Vascular surgery and eventually underwent above the knee amputation. Unfortunately they were not able to remove all nonviable tissue and he continued to deteriorate. He was taken level 1 back to the OR and an additional 10 cm of nonviable tissue was removed. Unfortunately upon arrive he suffered cardiac arrest in the setting of severe lactic acidosis and hyperkalemia."
	"1075639-1"	"1075639-1"	"TREMOR"	"10044565"	"50-59 years"	"50-59"	"Patient is a 53 year old man with a past medical history of follicular lymphoma diagnosed in 2008, more recently with DLBCL with CNS involvement (involving hypothalamus; dx 8/2018; s/p HD MTX, s/p BMT- followed by Dr.), autoimmune hepatitis, obesity, adipic DI, central hypothyroidism and type 2 DM who presented to Hospital via EMS after a  fall at home with multisystem organ failure leading to intubation in the ED and subsequent transfer to Oncology ICU for further management.   He was in his usual state if health until Sunday. On Saturday he got COVID vaccine at 4pm, that evening he had no issues. Sunday night around 10pm he didn't make complete sense and his wife was concerned because of his history of DM and treated CNS lymphoma. BG was 320-340 at that time. Monday he was good and Monday night he started to have shaking of his left hand. Tuesday he had one episode of diarrhea. Later he was more shaky in the shower and he started to fall and his wife was unable to grab him and he slid down the wall and could not get up.  Family was called to help and he was not making sense so they called EMS.  Wife reports that he was down approximately 3 hours before EMS was able to get him up. In EMS he was noted to have a large area of skin desquamation from the right posterior knee to the ankle. His GCS was 15. He had stable blood pressure and heart rate. He was hypoxia to the 50s and oxygen was applied.   In the ED he was found to be in multisystem organ failure and was intubated and had rapid progression of shock requiring  Epinephrine, Levophed and Vasopressin. Crash lines were placed and he was sent to hospital.  Upon arrival he was noted to have a cold pulseless right lower extremity and surgery was called. He was evaluated by Trauma Surgery, Orthopedic surgery and Vascular surgery and eventually underwent above the knee amputation. Unfortunately they were not able to remove all nonviable tissue and he continued to deteriorate. He was taken level 1 back to the OR and an additional 10 cm of nonviable tissue was removed. Unfortunately upon arrive he suffered cardiac arrest in the setting of severe lactic acidosis and hyperkalemia."
	"1080430-1"	"1080430-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Death Narrative: Death was not determined to be related to COVID vaccination. COVID vaccination (dose 1) occurred on 1/27/21 with no noted side effects. Death occurred on 2/14/21."
	"1080538-1"	"1080538-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Unexpected Death. No details known at this time."
	"1081132-1"	"1081132-1"	"PLATELET COUNT DECREASED"	"10035528"	"50-59 years"	"50-59"	"Severe thrombocytopenia approx. 10 days after vaccine administration."
	"1081132-1"	"1081132-1"	"THROMBOCYTOPENIA"	"10043554"	"50-59 years"	"50-59"	"Severe thrombocytopenia approx. 10 days after vaccine administration."
	"1081305-1"	"1081305-1"	"AUTOPSY"	"10050117"	"50-59 years"	"50-59"	"Sudden death approximately 24 hours after receiving 2nd COVID vaccine - symptoms unknown - autopsy revealed cardiac disease as the cause of death"
	"1081305-1"	"1081305-1"	"CARDIAC DISORDER"	"10061024"	"50-59 years"	"50-59"	"Sudden death approximately 24 hours after receiving 2nd COVID vaccine - symptoms unknown - autopsy revealed cardiac disease as the cause of death"
	"1081305-1"	"1081305-1"	"SUDDEN DEATH"	"10042434"	"50-59 years"	"50-59"	"Sudden death approximately 24 hours after receiving 2nd COVID vaccine - symptoms unknown - autopsy revealed cardiac disease as the cause of death"
	"1082707-1"	"1082707-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"death"
	"1084036-1"	"1084036-1"	"ASTHENIA"	"10003549"	"50-59 years"	"50-59"	"Profoundly weak by Saturday the day after the injection (2/6/2021), hospitalized by Monday (2/8/2021), on a ventilator by Wednesday (2/10/2021) and died the following Monday, (2/15/2021) She was treated for HLH (hemophagocyticlymphoistiocytosis)"
	"1084036-1"	"1084036-1"	"CULTURE NEGATIVE"	"10061448"	"50-59 years"	"50-59"	"Profoundly weak by Saturday the day after the injection (2/6/2021), hospitalized by Monday (2/8/2021), on a ventilator by Wednesday (2/10/2021) and died the following Monday, (2/15/2021) She was treated for HLH (hemophagocyticlymphoistiocytosis)"
	"1084036-1"	"1084036-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Profoundly weak by Saturday the day after the injection (2/6/2021), hospitalized by Monday (2/8/2021), on a ventilator by Wednesday (2/10/2021) and died the following Monday, (2/15/2021) She was treated for HLH (hemophagocyticlymphoistiocytosis)"
	"1084036-1"	"1084036-1"	"DEPENDENCE ON RESPIRATOR"	"10057482"	"50-59 years"	"50-59"	"Profoundly weak by Saturday the day after the injection (2/6/2021), hospitalized by Monday (2/8/2021), on a ventilator by Wednesday (2/10/2021) and died the following Monday, (2/15/2021) She was treated for HLH (hemophagocyticlymphoistiocytosis)"
	"1084036-1"	"1084036-1"	"HAEMOPHAGOCYTIC LYMPHOHISTIOCYTOSIS"	"10071583"	"50-59 years"	"50-59"	"Profoundly weak by Saturday the day after the injection (2/6/2021), hospitalized by Monday (2/8/2021), on a ventilator by Wednesday (2/10/2021) and died the following Monday, (2/15/2021) She was treated for HLH (hemophagocyticlymphoistiocytosis)"
	"1084036-1"	"1084036-1"	"LABORATORY TEST NORMAL"	"10054052"	"50-59 years"	"50-59"	"Profoundly weak by Saturday the day after the injection (2/6/2021), hospitalized by Monday (2/8/2021), on a ventilator by Wednesday (2/10/2021) and died the following Monday, (2/15/2021) She was treated for HLH (hemophagocyticlymphoistiocytosis)"
	"1084036-1"	"1084036-1"	"MECHANICAL VENTILATION"	"10067221"	"50-59 years"	"50-59"	"Profoundly weak by Saturday the day after the injection (2/6/2021), hospitalized by Monday (2/8/2021), on a ventilator by Wednesday (2/10/2021) and died the following Monday, (2/15/2021) She was treated for HLH (hemophagocyticlymphoistiocytosis)"
	"1084800-1"	"1084800-1"	"AUTOPSY"	"10050117"	"50-59 years"	"50-59"	"Death.  EMS called to residence 9 hours later for cardiac arrest. Pt pronounced at Emergency Room.  Pt sent to ME office for autopsy."
	"1084800-1"	"1084800-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"Death.  EMS called to residence 9 hours later for cardiac arrest. Pt pronounced at Emergency Room.  Pt sent to ME office for autopsy."
	"1084800-1"	"1084800-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Death.  EMS called to residence 9 hours later for cardiac arrest. Pt pronounced at Emergency Room.  Pt sent to ME office for autopsy."
	"1085032-1"	"1085032-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient received dose #2 of her Moderna COVID vaccine on 2/25/21. Patient called in to work the next day 2/26/21 because she was not feeling well. Patient did not show up to work on Monday 3/1/21 and her supervisor, called the PD to check in on her and she was found deceased in her home."
	"1085032-1"	"1085032-1"	"IMPAIRED WORK ABILITY"	"10052302"	"50-59 years"	"50-59"	"Patient received dose #2 of her Moderna COVID vaccine on 2/25/21. Patient called in to work the next day 2/26/21 because she was not feeling well. Patient did not show up to work on Monday 3/1/21 and her supervisor, called the PD to check in on her and she was found deceased in her home."
	"1085032-1"	"1085032-1"	"MALAISE"	"10025482"	"50-59 years"	"50-59"	"Patient received dose #2 of her Moderna COVID vaccine on 2/25/21. Patient called in to work the next day 2/26/21 because she was not feeling well. Patient did not show up to work on Monday 3/1/21 and her supervisor, called the PD to check in on her and she was found deceased in her home."
	"1085375-1"	"1085375-1"	"BACK PAIN"	"10003988"	"50-59 years"	"50-59"	"Patient presented to medical center emergency room on 02/21/2020 at 19:00, patient complained of shortness of breath and feeling fullness of her throat. Patient stated that she had Motrin 800 mg TID and Flexeril PRN due to her back pain. Patient also stated that she ate a banana after she took her medications. Her systolic blood pressure was 50, and her HR was 109, patient also stated that she had her 2 shots of Moderna Vaccine, her first shot was on 01/06 and her second shot was on 02/02. Patient was treated with:  1 Duoneb, 0.3 ML IM of epinephrine, Solumedrol 125 mg, Benadryl IV 50 mg, Normal Saline infusion IV 1000 ml/hr, and Pepcid IV 20 mg.  Patient lactic acid was 10.6, WBC 24.2 and Temp 97 F, patient was diagnosed as sepsis shock and patient received:  Piperacillin-tazobactam 3.375 g in D5W 50 ml IVPB (3.375 g once)  Vancomycin 1 g in D5W 200 ml IVPB (1 g once).  Patient pH was < 6.780 and PCO2 was 55 and bicarbonate level was 5.0, patient received Sodium bicarbonate IV 50 mEq once.  Patient was not stable as her BP and HR were fluctuating patient received DilTlazem IV 2.5 mg for 2 doses. Patient received Levophed 16 mg /NS 250 ml IV.  At 23:13 patient was intubated, patient received a local anesthesia through a central line of lidocaine 2% without epinephrine, and patient was transferred to the ICU to be monitored. At 00:33 CODE BLUE was called and patient became unresponsive and lost pulse while patient was brought to ICU. Patient was coded twice before ROSC, during intubation patient patient noted to have coffee-ground drainage."
	"1085375-1"	"1085375-1"	"BLOOD BICARBONATE DECREASED"	"10005359"	"50-59 years"	"50-59"	"Patient presented to medical center emergency room on 02/21/2020 at 19:00, patient complained of shortness of breath and feeling fullness of her throat. Patient stated that she had Motrin 800 mg TID and Flexeril PRN due to her back pain. Patient also stated that she ate a banana after she took her medications. Her systolic blood pressure was 50, and her HR was 109, patient also stated that she had her 2 shots of Moderna Vaccine, her first shot was on 01/06 and her second shot was on 02/02. Patient was treated with:  1 Duoneb, 0.3 ML IM of epinephrine, Solumedrol 125 mg, Benadryl IV 50 mg, Normal Saline infusion IV 1000 ml/hr, and Pepcid IV 20 mg.  Patient lactic acid was 10.6, WBC 24.2 and Temp 97 F, patient was diagnosed as sepsis shock and patient received:  Piperacillin-tazobactam 3.375 g in D5W 50 ml IVPB (3.375 g once)  Vancomycin 1 g in D5W 200 ml IVPB (1 g once).  Patient pH was < 6.780 and PCO2 was 55 and bicarbonate level was 5.0, patient received Sodium bicarbonate IV 50 mEq once.  Patient was not stable as her BP and HR were fluctuating patient received DilTlazem IV 2.5 mg for 2 doses. Patient received Levophed 16 mg /NS 250 ml IV.  At 23:13 patient was intubated, patient received a local anesthesia through a central line of lidocaine 2% without epinephrine, and patient was transferred to the ICU to be monitored. At 00:33 CODE BLUE was called and patient became unresponsive and lost pulse while patient was brought to ICU. Patient was coded twice before ROSC, during intubation patient patient noted to have coffee-ground drainage."
	"1085375-1"	"1085375-1"	"BLOOD LACTIC ACID"	"10005632"	"50-59 years"	"50-59"	"Patient presented to medical center emergency room on 02/21/2020 at 19:00, patient complained of shortness of breath and feeling fullness of her throat. Patient stated that she had Motrin 800 mg TID and Flexeril PRN due to her back pain. Patient also stated that she ate a banana after she took her medications. Her systolic blood pressure was 50, and her HR was 109, patient also stated that she had her 2 shots of Moderna Vaccine, her first shot was on 01/06 and her second shot was on 02/02. Patient was treated with:  1 Duoneb, 0.3 ML IM of epinephrine, Solumedrol 125 mg, Benadryl IV 50 mg, Normal Saline infusion IV 1000 ml/hr, and Pepcid IV 20 mg.  Patient lactic acid was 10.6, WBC 24.2 and Temp 97 F, patient was diagnosed as sepsis shock and patient received:  Piperacillin-tazobactam 3.375 g in D5W 50 ml IVPB (3.375 g once)  Vancomycin 1 g in D5W 200 ml IVPB (1 g once).  Patient pH was < 6.780 and PCO2 was 55 and bicarbonate level was 5.0, patient received Sodium bicarbonate IV 50 mEq once.  Patient was not stable as her BP and HR were fluctuating patient received DilTlazem IV 2.5 mg for 2 doses. Patient received Levophed 16 mg /NS 250 ml IV.  At 23:13 patient was intubated, patient received a local anesthesia through a central line of lidocaine 2% without epinephrine, and patient was transferred to the ICU to be monitored. At 00:33 CODE BLUE was called and patient became unresponsive and lost pulse while patient was brought to ICU. Patient was coded twice before ROSC, during intubation patient patient noted to have coffee-ground drainage."
	"1085375-1"	"1085375-1"	"BLOOD PH DECREASED"	"10005706"	"50-59 years"	"50-59"	"Patient presented to medical center emergency room on 02/21/2020 at 19:00, patient complained of shortness of breath and feeling fullness of her throat. Patient stated that she had Motrin 800 mg TID and Flexeril PRN due to her back pain. Patient also stated that she ate a banana after she took her medications. Her systolic blood pressure was 50, and her HR was 109, patient also stated that she had her 2 shots of Moderna Vaccine, her first shot was on 01/06 and her second shot was on 02/02. Patient was treated with:  1 Duoneb, 0.3 ML IM of epinephrine, Solumedrol 125 mg, Benadryl IV 50 mg, Normal Saline infusion IV 1000 ml/hr, and Pepcid IV 20 mg.  Patient lactic acid was 10.6, WBC 24.2 and Temp 97 F, patient was diagnosed as sepsis shock and patient received:  Piperacillin-tazobactam 3.375 g in D5W 50 ml IVPB (3.375 g once)  Vancomycin 1 g in D5W 200 ml IVPB (1 g once).  Patient pH was < 6.780 and PCO2 was 55 and bicarbonate level was 5.0, patient received Sodium bicarbonate IV 50 mEq once.  Patient was not stable as her BP and HR were fluctuating patient received DilTlazem IV 2.5 mg for 2 doses. Patient received Levophed 16 mg /NS 250 ml IV.  At 23:13 patient was intubated, patient received a local anesthesia through a central line of lidocaine 2% without epinephrine, and patient was transferred to the ICU to be monitored. At 00:33 CODE BLUE was called and patient became unresponsive and lost pulse while patient was brought to ICU. Patient was coded twice before ROSC, during intubation patient patient noted to have coffee-ground drainage."
	"1085375-1"	"1085375-1"	"BLOOD PRESSURE FLUCTUATION"	"10005746"	"50-59 years"	"50-59"	"Patient presented to medical center emergency room on 02/21/2020 at 19:00, patient complained of shortness of breath and feeling fullness of her throat. Patient stated that she had Motrin 800 mg TID and Flexeril PRN due to her back pain. Patient also stated that she ate a banana after she took her medications. Her systolic blood pressure was 50, and her HR was 109, patient also stated that she had her 2 shots of Moderna Vaccine, her first shot was on 01/06 and her second shot was on 02/02. Patient was treated with:  1 Duoneb, 0.3 ML IM of epinephrine, Solumedrol 125 mg, Benadryl IV 50 mg, Normal Saline infusion IV 1000 ml/hr, and Pepcid IV 20 mg.  Patient lactic acid was 10.6, WBC 24.2 and Temp 97 F, patient was diagnosed as sepsis shock and patient received:  Piperacillin-tazobactam 3.375 g in D5W 50 ml IVPB (3.375 g once)  Vancomycin 1 g in D5W 200 ml IVPB (1 g once).  Patient pH was < 6.780 and PCO2 was 55 and bicarbonate level was 5.0, patient received Sodium bicarbonate IV 50 mEq once.  Patient was not stable as her BP and HR were fluctuating patient received DilTlazem IV 2.5 mg for 2 doses. Patient received Levophed 16 mg /NS 250 ml IV.  At 23:13 patient was intubated, patient received a local anesthesia through a central line of lidocaine 2% without epinephrine, and patient was transferred to the ICU to be monitored. At 00:33 CODE BLUE was called and patient became unresponsive and lost pulse while patient was brought to ICU. Patient was coded twice before ROSC, during intubation patient patient noted to have coffee-ground drainage."
	"1085375-1"	"1085375-1"	"CARDIO-RESPIRATORY ARREST"	"10007617"	"50-59 years"	"50-59"	"Patient presented to medical center emergency room on 02/21/2020 at 19:00, patient complained of shortness of breath and feeling fullness of her throat. Patient stated that she had Motrin 800 mg TID and Flexeril PRN due to her back pain. Patient also stated that she ate a banana after she took her medications. Her systolic blood pressure was 50, and her HR was 109, patient also stated that she had her 2 shots of Moderna Vaccine, her first shot was on 01/06 and her second shot was on 02/02. Patient was treated with:  1 Duoneb, 0.3 ML IM of epinephrine, Solumedrol 125 mg, Benadryl IV 50 mg, Normal Saline infusion IV 1000 ml/hr, and Pepcid IV 20 mg.  Patient lactic acid was 10.6, WBC 24.2 and Temp 97 F, patient was diagnosed as sepsis shock and patient received:  Piperacillin-tazobactam 3.375 g in D5W 50 ml IVPB (3.375 g once)  Vancomycin 1 g in D5W 200 ml IVPB (1 g once).  Patient pH was < 6.780 and PCO2 was 55 and bicarbonate level was 5.0, patient received Sodium bicarbonate IV 50 mEq once.  Patient was not stable as her BP and HR were fluctuating patient received DilTlazem IV 2.5 mg for 2 doses. Patient received Levophed 16 mg /NS 250 ml IV.  At 23:13 patient was intubated, patient received a local anesthesia through a central line of lidocaine 2% without epinephrine, and patient was transferred to the ICU to be monitored. At 00:33 CODE BLUE was called and patient became unresponsive and lost pulse while patient was brought to ICU. Patient was coded twice before ROSC, during intubation patient patient noted to have coffee-ground drainage."
	"1085375-1"	"1085375-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"Patient presented to medical center emergency room on 02/21/2020 at 19:00, patient complained of shortness of breath and feeling fullness of her throat. Patient stated that she had Motrin 800 mg TID and Flexeril PRN due to her back pain. Patient also stated that she ate a banana after she took her medications. Her systolic blood pressure was 50, and her HR was 109, patient also stated that she had her 2 shots of Moderna Vaccine, her first shot was on 01/06 and her second shot was on 02/02. Patient was treated with:  1 Duoneb, 0.3 ML IM of epinephrine, Solumedrol 125 mg, Benadryl IV 50 mg, Normal Saline infusion IV 1000 ml/hr, and Pepcid IV 20 mg.  Patient lactic acid was 10.6, WBC 24.2 and Temp 97 F, patient was diagnosed as sepsis shock and patient received:  Piperacillin-tazobactam 3.375 g in D5W 50 ml IVPB (3.375 g once)  Vancomycin 1 g in D5W 200 ml IVPB (1 g once).  Patient pH was < 6.780 and PCO2 was 55 and bicarbonate level was 5.0, patient received Sodium bicarbonate IV 50 mEq once.  Patient was not stable as her BP and HR were fluctuating patient received DilTlazem IV 2.5 mg for 2 doses. Patient received Levophed 16 mg /NS 250 ml IV.  At 23:13 patient was intubated, patient received a local anesthesia through a central line of lidocaine 2% without epinephrine, and patient was transferred to the ICU to be monitored. At 00:33 CODE BLUE was called and patient became unresponsive and lost pulse while patient was brought to ICU. Patient was coded twice before ROSC, during intubation patient patient noted to have coffee-ground drainage."
	"1085375-1"	"1085375-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"50-59 years"	"50-59"	"Patient presented to medical center emergency room on 02/21/2020 at 19:00, patient complained of shortness of breath and feeling fullness of her throat. Patient stated that she had Motrin 800 mg TID and Flexeril PRN due to her back pain. Patient also stated that she ate a banana after she took her medications. Her systolic blood pressure was 50, and her HR was 109, patient also stated that she had her 2 shots of Moderna Vaccine, her first shot was on 01/06 and her second shot was on 02/02. Patient was treated with:  1 Duoneb, 0.3 ML IM of epinephrine, Solumedrol 125 mg, Benadryl IV 50 mg, Normal Saline infusion IV 1000 ml/hr, and Pepcid IV 20 mg.  Patient lactic acid was 10.6, WBC 24.2 and Temp 97 F, patient was diagnosed as sepsis shock and patient received:  Piperacillin-tazobactam 3.375 g in D5W 50 ml IVPB (3.375 g once)  Vancomycin 1 g in D5W 200 ml IVPB (1 g once).  Patient pH was < 6.780 and PCO2 was 55 and bicarbonate level was 5.0, patient received Sodium bicarbonate IV 50 mEq once.  Patient was not stable as her BP and HR were fluctuating patient received DilTlazem IV 2.5 mg for 2 doses. Patient received Levophed 16 mg /NS 250 ml IV.  At 23:13 patient was intubated, patient received a local anesthesia through a central line of lidocaine 2% without epinephrine, and patient was transferred to the ICU to be monitored. At 00:33 CODE BLUE was called and patient became unresponsive and lost pulse while patient was brought to ICU. Patient was coded twice before ROSC, during intubation patient patient noted to have coffee-ground drainage."
	"1085375-1"	"1085375-1"	"HEART RATE IRREGULAR"	"10019304"	"50-59 years"	"50-59"	"Patient presented to medical center emergency room on 02/21/2020 at 19:00, patient complained of shortness of breath and feeling fullness of her throat. Patient stated that she had Motrin 800 mg TID and Flexeril PRN due to her back pain. Patient also stated that she ate a banana after she took her medications. Her systolic blood pressure was 50, and her HR was 109, patient also stated that she had her 2 shots of Moderna Vaccine, her first shot was on 01/06 and her second shot was on 02/02. Patient was treated with:  1 Duoneb, 0.3 ML IM of epinephrine, Solumedrol 125 mg, Benadryl IV 50 mg, Normal Saline infusion IV 1000 ml/hr, and Pepcid IV 20 mg.  Patient lactic acid was 10.6, WBC 24.2 and Temp 97 F, patient was diagnosed as sepsis shock and patient received:  Piperacillin-tazobactam 3.375 g in D5W 50 ml IVPB (3.375 g once)  Vancomycin 1 g in D5W 200 ml IVPB (1 g once).  Patient pH was < 6.780 and PCO2 was 55 and bicarbonate level was 5.0, patient received Sodium bicarbonate IV 50 mEq once.  Patient was not stable as her BP and HR were fluctuating patient received DilTlazem IV 2.5 mg for 2 doses. Patient received Levophed 16 mg /NS 250 ml IV.  At 23:13 patient was intubated, patient received a local anesthesia through a central line of lidocaine 2% without epinephrine, and patient was transferred to the ICU to be monitored. At 00:33 CODE BLUE was called and patient became unresponsive and lost pulse while patient was brought to ICU. Patient was coded twice before ROSC, during intubation patient patient noted to have coffee-ground drainage."
	"1085375-1"	"1085375-1"	"INTENSIVE CARE"	"10022519"	"50-59 years"	"50-59"	"Patient presented to medical center emergency room on 02/21/2020 at 19:00, patient complained of shortness of breath and feeling fullness of her throat. Patient stated that she had Motrin 800 mg TID and Flexeril PRN due to her back pain. Patient also stated that she ate a banana after she took her medications. Her systolic blood pressure was 50, and her HR was 109, patient also stated that she had her 2 shots of Moderna Vaccine, her first shot was on 01/06 and her second shot was on 02/02. Patient was treated with:  1 Duoneb, 0.3 ML IM of epinephrine, Solumedrol 125 mg, Benadryl IV 50 mg, Normal Saline infusion IV 1000 ml/hr, and Pepcid IV 20 mg.  Patient lactic acid was 10.6, WBC 24.2 and Temp 97 F, patient was diagnosed as sepsis shock and patient received:  Piperacillin-tazobactam 3.375 g in D5W 50 ml IVPB (3.375 g once)  Vancomycin 1 g in D5W 200 ml IVPB (1 g once).  Patient pH was < 6.780 and PCO2 was 55 and bicarbonate level was 5.0, patient received Sodium bicarbonate IV 50 mEq once.  Patient was not stable as her BP and HR were fluctuating patient received DilTlazem IV 2.5 mg for 2 doses. Patient received Levophed 16 mg /NS 250 ml IV.  At 23:13 patient was intubated, patient received a local anesthesia through a central line of lidocaine 2% without epinephrine, and patient was transferred to the ICU to be monitored. At 00:33 CODE BLUE was called and patient became unresponsive and lost pulse while patient was brought to ICU. Patient was coded twice before ROSC, during intubation patient patient noted to have coffee-ground drainage."
	"1085375-1"	"1085375-1"	"PCO2 INCREASED"	"10034183"	"50-59 years"	"50-59"	"Patient presented to medical center emergency room on 02/21/2020 at 19:00, patient complained of shortness of breath and feeling fullness of her throat. Patient stated that she had Motrin 800 mg TID and Flexeril PRN due to her back pain. Patient also stated that she ate a banana after she took her medications. Her systolic blood pressure was 50, and her HR was 109, patient also stated that she had her 2 shots of Moderna Vaccine, her first shot was on 01/06 and her second shot was on 02/02. Patient was treated with:  1 Duoneb, 0.3 ML IM of epinephrine, Solumedrol 125 mg, Benadryl IV 50 mg, Normal Saline infusion IV 1000 ml/hr, and Pepcid IV 20 mg.  Patient lactic acid was 10.6, WBC 24.2 and Temp 97 F, patient was diagnosed as sepsis shock and patient received:  Piperacillin-tazobactam 3.375 g in D5W 50 ml IVPB (3.375 g once)  Vancomycin 1 g in D5W 200 ml IVPB (1 g once).  Patient pH was < 6.780 and PCO2 was 55 and bicarbonate level was 5.0, patient received Sodium bicarbonate IV 50 mEq once.  Patient was not stable as her BP and HR were fluctuating patient received DilTlazem IV 2.5 mg for 2 doses. Patient received Levophed 16 mg /NS 250 ml IV.  At 23:13 patient was intubated, patient received a local anesthesia through a central line of lidocaine 2% without epinephrine, and patient was transferred to the ICU to be monitored. At 00:33 CODE BLUE was called and patient became unresponsive and lost pulse while patient was brought to ICU. Patient was coded twice before ROSC, during intubation patient patient noted to have coffee-ground drainage."
	"1085375-1"	"1085375-1"	"PULSE ABSENT"	"10037469"	"50-59 years"	"50-59"	"Patient presented to medical center emergency room on 02/21/2020 at 19:00, patient complained of shortness of breath and feeling fullness of her throat. Patient stated that she had Motrin 800 mg TID and Flexeril PRN due to her back pain. Patient also stated that she ate a banana after she took her medications. Her systolic blood pressure was 50, and her HR was 109, patient also stated that she had her 2 shots of Moderna Vaccine, her first shot was on 01/06 and her second shot was on 02/02. Patient was treated with:  1 Duoneb, 0.3 ML IM of epinephrine, Solumedrol 125 mg, Benadryl IV 50 mg, Normal Saline infusion IV 1000 ml/hr, and Pepcid IV 20 mg.  Patient lactic acid was 10.6, WBC 24.2 and Temp 97 F, patient was diagnosed as sepsis shock and patient received:  Piperacillin-tazobactam 3.375 g in D5W 50 ml IVPB (3.375 g once)  Vancomycin 1 g in D5W 200 ml IVPB (1 g once).  Patient pH was < 6.780 and PCO2 was 55 and bicarbonate level was 5.0, patient received Sodium bicarbonate IV 50 mEq once.  Patient was not stable as her BP and HR were fluctuating patient received DilTlazem IV 2.5 mg for 2 doses. Patient received Levophed 16 mg /NS 250 ml IV.  At 23:13 patient was intubated, patient received a local anesthesia through a central line of lidocaine 2% without epinephrine, and patient was transferred to the ICU to be monitored. At 00:33 CODE BLUE was called and patient became unresponsive and lost pulse while patient was brought to ICU. Patient was coded twice before ROSC, during intubation patient patient noted to have coffee-ground drainage."
	"1085375-1"	"1085375-1"	"SEPTIC SHOCK"	"10040070"	"50-59 years"	"50-59"	"Patient presented to medical center emergency room on 02/21/2020 at 19:00, patient complained of shortness of breath and feeling fullness of her throat. Patient stated that she had Motrin 800 mg TID and Flexeril PRN due to her back pain. Patient also stated that she ate a banana after she took her medications. Her systolic blood pressure was 50, and her HR was 109, patient also stated that she had her 2 shots of Moderna Vaccine, her first shot was on 01/06 and her second shot was on 02/02. Patient was treated with:  1 Duoneb, 0.3 ML IM of epinephrine, Solumedrol 125 mg, Benadryl IV 50 mg, Normal Saline infusion IV 1000 ml/hr, and Pepcid IV 20 mg.  Patient lactic acid was 10.6, WBC 24.2 and Temp 97 F, patient was diagnosed as sepsis shock and patient received:  Piperacillin-tazobactam 3.375 g in D5W 50 ml IVPB (3.375 g once)  Vancomycin 1 g in D5W 200 ml IVPB (1 g once).  Patient pH was < 6.780 and PCO2 was 55 and bicarbonate level was 5.0, patient received Sodium bicarbonate IV 50 mEq once.  Patient was not stable as her BP and HR were fluctuating patient received DilTlazem IV 2.5 mg for 2 doses. Patient received Levophed 16 mg /NS 250 ml IV.  At 23:13 patient was intubated, patient received a local anesthesia through a central line of lidocaine 2% without epinephrine, and patient was transferred to the ICU to be monitored. At 00:33 CODE BLUE was called and patient became unresponsive and lost pulse while patient was brought to ICU. Patient was coded twice before ROSC, during intubation patient patient noted to have coffee-ground drainage."
	"1085375-1"	"1085375-1"	"THROAT TIGHTNESS"	"10043528"	"50-59 years"	"50-59"	"Patient presented to medical center emergency room on 02/21/2020 at 19:00, patient complained of shortness of breath and feeling fullness of her throat. Patient stated that she had Motrin 800 mg TID and Flexeril PRN due to her back pain. Patient also stated that she ate a banana after she took her medications. Her systolic blood pressure was 50, and her HR was 109, patient also stated that she had her 2 shots of Moderna Vaccine, her first shot was on 01/06 and her second shot was on 02/02. Patient was treated with:  1 Duoneb, 0.3 ML IM of epinephrine, Solumedrol 125 mg, Benadryl IV 50 mg, Normal Saline infusion IV 1000 ml/hr, and Pepcid IV 20 mg.  Patient lactic acid was 10.6, WBC 24.2 and Temp 97 F, patient was diagnosed as sepsis shock and patient received:  Piperacillin-tazobactam 3.375 g in D5W 50 ml IVPB (3.375 g once)  Vancomycin 1 g in D5W 200 ml IVPB (1 g once).  Patient pH was < 6.780 and PCO2 was 55 and bicarbonate level was 5.0, patient received Sodium bicarbonate IV 50 mEq once.  Patient was not stable as her BP and HR were fluctuating patient received DilTlazem IV 2.5 mg for 2 doses. Patient received Levophed 16 mg /NS 250 ml IV.  At 23:13 patient was intubated, patient received a local anesthesia through a central line of lidocaine 2% without epinephrine, and patient was transferred to the ICU to be monitored. At 00:33 CODE BLUE was called and patient became unresponsive and lost pulse while patient was brought to ICU. Patient was coded twice before ROSC, during intubation patient patient noted to have coffee-ground drainage."
	"1085375-1"	"1085375-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"50-59 years"	"50-59"	"Patient presented to medical center emergency room on 02/21/2020 at 19:00, patient complained of shortness of breath and feeling fullness of her throat. Patient stated that she had Motrin 800 mg TID and Flexeril PRN due to her back pain. Patient also stated that she ate a banana after she took her medications. Her systolic blood pressure was 50, and her HR was 109, patient also stated that she had her 2 shots of Moderna Vaccine, her first shot was on 01/06 and her second shot was on 02/02. Patient was treated with:  1 Duoneb, 0.3 ML IM of epinephrine, Solumedrol 125 mg, Benadryl IV 50 mg, Normal Saline infusion IV 1000 ml/hr, and Pepcid IV 20 mg.  Patient lactic acid was 10.6, WBC 24.2 and Temp 97 F, patient was diagnosed as sepsis shock and patient received:  Piperacillin-tazobactam 3.375 g in D5W 50 ml IVPB (3.375 g once)  Vancomycin 1 g in D5W 200 ml IVPB (1 g once).  Patient pH was < 6.780 and PCO2 was 55 and bicarbonate level was 5.0, patient received Sodium bicarbonate IV 50 mEq once.  Patient was not stable as her BP and HR were fluctuating patient received DilTlazem IV 2.5 mg for 2 doses. Patient received Levophed 16 mg /NS 250 ml IV.  At 23:13 patient was intubated, patient received a local anesthesia through a central line of lidocaine 2% without epinephrine, and patient was transferred to the ICU to be monitored. At 00:33 CODE BLUE was called and patient became unresponsive and lost pulse while patient was brought to ICU. Patient was coded twice before ROSC, during intubation patient patient noted to have coffee-ground drainage."
	"1085375-1"	"1085375-1"	"WHITE BLOOD CELL COUNT INCREASED"	"10047943"	"50-59 years"	"50-59"	"Patient presented to medical center emergency room on 02/21/2020 at 19:00, patient complained of shortness of breath and feeling fullness of her throat. Patient stated that she had Motrin 800 mg TID and Flexeril PRN due to her back pain. Patient also stated that she ate a banana after she took her medications. Her systolic blood pressure was 50, and her HR was 109, patient also stated that she had her 2 shots of Moderna Vaccine, her first shot was on 01/06 and her second shot was on 02/02. Patient was treated with:  1 Duoneb, 0.3 ML IM of epinephrine, Solumedrol 125 mg, Benadryl IV 50 mg, Normal Saline infusion IV 1000 ml/hr, and Pepcid IV 20 mg.  Patient lactic acid was 10.6, WBC 24.2 and Temp 97 F, patient was diagnosed as sepsis shock and patient received:  Piperacillin-tazobactam 3.375 g in D5W 50 ml IVPB (3.375 g once)  Vancomycin 1 g in D5W 200 ml IVPB (1 g once).  Patient pH was < 6.780 and PCO2 was 55 and bicarbonate level was 5.0, patient received Sodium bicarbonate IV 50 mEq once.  Patient was not stable as her BP and HR were fluctuating patient received DilTlazem IV 2.5 mg for 2 doses. Patient received Levophed 16 mg /NS 250 ml IV.  At 23:13 patient was intubated, patient received a local anesthesia through a central line of lidocaine 2% without epinephrine, and patient was transferred to the ICU to be monitored. At 00:33 CODE BLUE was called and patient became unresponsive and lost pulse while patient was brought to ICU. Patient was coded twice before ROSC, during intubation patient patient noted to have coffee-ground drainage."
	"1088184-1"	"1088184-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Pronounced dead on 3/9/21 approximately 72 hours after receiving vaccination. Unknown symptoms prior."
	"1088539-1"	"1088539-1"	"MUSCLE RIGIDITY"	"10028330"	"50-59 years"	"50-59"	"He was found unresponsive, cold and with rigor mortis  present after family requested welfare check. He had not been seen for 36 hours."
	"1088539-1"	"1088539-1"	"PERIPHERAL COLDNESS"	"10034568"	"50-59 years"	"50-59"	"He was found unresponsive, cold and with rigor mortis  present after family requested welfare check. He had not been seen for 36 hours."
	"1088539-1"	"1088539-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"50-59 years"	"50-59"	"He was found unresponsive, cold and with rigor mortis  present after family requested welfare check. He had not been seen for 36 hours."
	"1088615-1"	"1088615-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Death within 30 days of vaccination, vaccinated on 3/5/2021 pronounced dead on 3/6/2021. Unknown if any side effects from vaccine.  No ER visit found at local hospital."
	"1088830-1"	"1088830-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient died after feeling unwell for about ten minutes."
	"1088830-1"	"1088830-1"	"MALAISE"	"10025482"	"50-59 years"	"50-59"	"Patient died after feeling unwell for about ten minutes."
	"1094102-1"	"1094102-1"	"BLOOD TEST"	"10061726"	"50-59 years"	"50-59"	"NO ADVERSE EVENT NOTICE RECEIVED ON DATE OF VACCINE.   RECEIVED NOTICE FROM CORONOER THAT THIS PATIENT EXPIRED  2/28/2021.  COLLECTED URINE, BLOOD, AND TOXICOLOGY SCREEN.  NOT SENT TO HOSPITAL.  SENT TO FUNERAL HOME"
	"1094102-1"	"1094102-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"NO ADVERSE EVENT NOTICE RECEIVED ON DATE OF VACCINE.   RECEIVED NOTICE FROM CORONOER THAT THIS PATIENT EXPIRED  2/28/2021.  COLLECTED URINE, BLOOD, AND TOXICOLOGY SCREEN.  NOT SENT TO HOSPITAL.  SENT TO FUNERAL HOME"
	"1094102-1"	"1094102-1"	"NO ADVERSE EVENT"	"10067482"	"50-59 years"	"50-59"	"NO ADVERSE EVENT NOTICE RECEIVED ON DATE OF VACCINE.   RECEIVED NOTICE FROM CORONOER THAT THIS PATIENT EXPIRED  2/28/2021.  COLLECTED URINE, BLOOD, AND TOXICOLOGY SCREEN.  NOT SENT TO HOSPITAL.  SENT TO FUNERAL HOME"
	"1094102-1"	"1094102-1"	"TOXICOLOGIC TEST"	"10061384"	"50-59 years"	"50-59"	"NO ADVERSE EVENT NOTICE RECEIVED ON DATE OF VACCINE.   RECEIVED NOTICE FROM CORONOER THAT THIS PATIENT EXPIRED  2/28/2021.  COLLECTED URINE, BLOOD, AND TOXICOLOGY SCREEN.  NOT SENT TO HOSPITAL.  SENT TO FUNERAL HOME"
	"1094102-1"	"1094102-1"	"URINE ANALYSIS"	"10046614"	"50-59 years"	"50-59"	"NO ADVERSE EVENT NOTICE RECEIVED ON DATE OF VACCINE.   RECEIVED NOTICE FROM CORONOER THAT THIS PATIENT EXPIRED  2/28/2021.  COLLECTED URINE, BLOOD, AND TOXICOLOGY SCREEN.  NOT SENT TO HOSPITAL.  SENT TO FUNERAL HOME"
	"1095300-1"	"1095300-1"	"CHEST PAIN"	"10008479"	"50-59 years"	"50-59"	"According to Medical Center's report,  patient was brought to ED deceased upon arrival via EMS on 03/12/2021 at 8:57am.  Patient had been seen on 3/11/2021 at same ED complaining of a heavy type of chest pain in the mid chest, also noting body aches, headache, and nausea."
	"1095300-1"	"1095300-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"According to Medical Center's report,  patient was brought to ED deceased upon arrival via EMS on 03/12/2021 at 8:57am.  Patient had been seen on 3/11/2021 at same ED complaining of a heavy type of chest pain in the mid chest, also noting body aches, headache, and nausea."
	"1095300-1"	"1095300-1"	"HEADACHE"	"10019211"	"50-59 years"	"50-59"	"According to Medical Center's report,  patient was brought to ED deceased upon arrival via EMS on 03/12/2021 at 8:57am.  Patient had been seen on 3/11/2021 at same ED complaining of a heavy type of chest pain in the mid chest, also noting body aches, headache, and nausea."
	"1095300-1"	"1095300-1"	"NAUSEA"	"10028813"	"50-59 years"	"50-59"	"According to Medical Center's report,  patient was brought to ED deceased upon arrival via EMS on 03/12/2021 at 8:57am.  Patient had been seen on 3/11/2021 at same ED complaining of a heavy type of chest pain in the mid chest, also noting body aches, headache, and nausea."
	"1095300-1"	"1095300-1"	"PAIN"	"10033371"	"50-59 years"	"50-59"	"According to Medical Center's report,  patient was brought to ED deceased upon arrival via EMS on 03/12/2021 at 8:57am.  Patient had been seen on 3/11/2021 at same ED complaining of a heavy type of chest pain in the mid chest, also noting body aches, headache, and nausea."
	"1095435-1"	"1095435-1"	"AUTOPSY"	"10050117"	"50-59 years"	"50-59"	"Headache, nausea on 1/25 progressed to SOB 1/26 and death 1/27"
	"1095435-1"	"1095435-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Headache, nausea on 1/25 progressed to SOB 1/26 and death 1/27"
	"1095435-1"	"1095435-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"Headache, nausea on 1/25 progressed to SOB 1/26 and death 1/27"
	"1095435-1"	"1095435-1"	"HEADACHE"	"10019211"	"50-59 years"	"50-59"	"Headache, nausea on 1/25 progressed to SOB 1/26 and death 1/27"
	"1095435-1"	"1095435-1"	"NAUSEA"	"10028813"	"50-59 years"	"50-59"	"Headache, nausea on 1/25 progressed to SOB 1/26 and death 1/27"
	"1095435-1"	"1095435-1"	"PULMONARY EMBOLISM"	"10037377"	"50-59 years"	"50-59"	"Headache, nausea on 1/25 progressed to SOB 1/26 and death 1/27"
	"1096600-1"	"1096600-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Per the patient's spouse and Hospital: The patient received a rapid COVID test at clinic prior to vaccination, which read negative.  The patient received vaccination on 2/23/21 and the following day (2/24/21) began to experience breathing difficulties.  The patient was admitted to the emergency room at Hospital on 2/26/21 and diagnosed with hypoxic respiratory failure d/t COVID-19 (oxygen saturation < 50%).  Patient was intubated on 3/2/21.  Per Hospital pharmacist, patient expired on 3/12/21 at 6:40pm."
	"1096600-1"	"1096600-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Per the patient's spouse and Hospital: The patient received a rapid COVID test at clinic prior to vaccination, which read negative.  The patient received vaccination on 2/23/21 and the following day (2/24/21) began to experience breathing difficulties.  The patient was admitted to the emergency room at Hospital on 2/26/21 and diagnosed with hypoxic respiratory failure d/t COVID-19 (oxygen saturation < 50%).  Patient was intubated on 3/2/21.  Per Hospital pharmacist, patient expired on 3/12/21 at 6:40pm."
	"1096600-1"	"1096600-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"Per the patient's spouse and Hospital: The patient received a rapid COVID test at clinic prior to vaccination, which read negative.  The patient received vaccination on 2/23/21 and the following day (2/24/21) began to experience breathing difficulties.  The patient was admitted to the emergency room at Hospital on 2/26/21 and diagnosed with hypoxic respiratory failure d/t COVID-19 (oxygen saturation < 50%).  Patient was intubated on 3/2/21.  Per Hospital pharmacist, patient expired on 3/12/21 at 6:40pm."
	"1096600-1"	"1096600-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"50-59 years"	"50-59"	"Per the patient's spouse and Hospital: The patient received a rapid COVID test at clinic prior to vaccination, which read negative.  The patient received vaccination on 2/23/21 and the following day (2/24/21) began to experience breathing difficulties.  The patient was admitted to the emergency room at Hospital on 2/26/21 and diagnosed with hypoxic respiratory failure d/t COVID-19 (oxygen saturation < 50%).  Patient was intubated on 3/2/21.  Per Hospital pharmacist, patient expired on 3/12/21 at 6:40pm."
	"1096600-1"	"1096600-1"	"RESPIRATORY FAILURE"	"10038695"	"50-59 years"	"50-59"	"Per the patient's spouse and Hospital: The patient received a rapid COVID test at clinic prior to vaccination, which read negative.  The patient received vaccination on 2/23/21 and the following day (2/24/21) began to experience breathing difficulties.  The patient was admitted to the emergency room at Hospital on 2/26/21 and diagnosed with hypoxic respiratory failure d/t COVID-19 (oxygen saturation < 50%).  Patient was intubated on 3/2/21.  Per Hospital pharmacist, patient expired on 3/12/21 at 6:40pm."
	"1098119-1"	"1098119-1"	"ABDOMINAL PAIN UPPER"	"10000087"	"50-59 years"	"50-59"	"in the early am she had bad diarrhea , she went to work and then started having really bad stomach pains and before noon she had to  go home because she started puking. She laid down to take a nap around 3:30pm and never woke up."
	"1098119-1"	"1098119-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"in the early am she had bad diarrhea , she went to work and then started having really bad stomach pains and before noon she had to  go home because she started puking. She laid down to take a nap around 3:30pm and never woke up."
	"1098119-1"	"1098119-1"	"DIARRHOEA"	"10012735"	"50-59 years"	"50-59"	"in the early am she had bad diarrhea , she went to work and then started having really bad stomach pains and before noon she had to  go home because she started puking. She laid down to take a nap around 3:30pm and never woke up."
	"1098119-1"	"1098119-1"	"VOMITING"	"10047700"	"50-59 years"	"50-59"	"in the early am she had bad diarrhea , she went to work and then started having really bad stomach pains and before noon she had to  go home because she started puking. She laid down to take a nap around 3:30pm and never woke up."
	"1098902-1"	"1098902-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Death"
	"1102754-1"	"1102754-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient contacted her employer 2 days after vaccination with complaint of new onset rash.  Was seen by her PCP  and was reportedly being treated for Shingles.  Missed work week of 8-12 March for same.  When didn't report to work today (3/15/21), supervisor went to home to conduct a safety check and found the patient dead in her home."
	"1102754-1"	"1102754-1"	"HERPES ZOSTER"	"10019974"	"50-59 years"	"50-59"	"Patient contacted her employer 2 days after vaccination with complaint of new onset rash.  Was seen by her PCP  and was reportedly being treated for Shingles.  Missed work week of 8-12 March for same.  When didn't report to work today (3/15/21), supervisor went to home to conduct a safety check and found the patient dead in her home."
	"1102754-1"	"1102754-1"	"IMPAIRED WORK ABILITY"	"10052302"	"50-59 years"	"50-59"	"Patient contacted her employer 2 days after vaccination with complaint of new onset rash.  Was seen by her PCP  and was reportedly being treated for Shingles.  Missed work week of 8-12 March for same.  When didn't report to work today (3/15/21), supervisor went to home to conduct a safety check and found the patient dead in her home."
	"1102754-1"	"1102754-1"	"RASH"	"10037844"	"50-59 years"	"50-59"	"Patient contacted her employer 2 days after vaccination with complaint of new onset rash.  Was seen by her PCP  and was reportedly being treated for Shingles.  Missed work week of 8-12 March for same.  When didn't report to work today (3/15/21), supervisor went to home to conduct a safety check and found the patient dead in her home."
	"1104031-1"	"1104031-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"Patient died of cardiac arrest at hospital 3/12/2021"
	"1104031-1"	"1104031-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient died of cardiac arrest at hospital 3/12/2021"
	"1106581-1"	"1106581-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient was discovered deceased in her apartment  at 3pm on March 12, 2021."
	"1106719-1"	"1106719-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Her daughter  informed pharmacy staff that pt passed away on sunday 3/14/21"
	"1107265-1"	"1107265-1"	"BLOOD TEST"	"10061726"	"50-59 years"	"50-59"	"white blood cell count was very high; death; This is a spontaneous report from a contactable consumer (ex-spouse) via medical information team. A 52-year-old male patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number and expiration date were not reported), via an unspecified route of administration on 02Mar2021 at a single dose (at the age of 52-years-old) for COVID-19 immunisation. Medical history included back pain: At some point before the vaccine was administered, he had a telehealth visit for reported back pain. Concomitant medications were not reported. The patient died on 05Mar2021 at his home. The patient received the first dose of COVID vaccine at a hospital on 02Mar2021. The patient was a fairly healthy active 52-year-old. At some point before the vaccine was administered, he had a telehealth visit for reported back pain. He was instructed to get blood work/labs done. A letter was received the day of his death that states his white blood cell count was very high and with it a recommendation that he seek medical attention. She (ex-spouse) reports the autopsy results won't be complete for a few months. The cause of death is unknown. The outcome of white blood cell count was very high was unknown.   Information on the lot/ batch number has been requested.; Reported Cause(s) of Death: Death"
	"1107265-1"	"1107265-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"white blood cell count was very high; death; This is a spontaneous report from a contactable consumer (ex-spouse) via medical information team. A 52-year-old male patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number and expiration date were not reported), via an unspecified route of administration on 02Mar2021 at a single dose (at the age of 52-years-old) for COVID-19 immunisation. Medical history included back pain: At some point before the vaccine was administered, he had a telehealth visit for reported back pain. Concomitant medications were not reported. The patient died on 05Mar2021 at his home. The patient received the first dose of COVID vaccine at a hospital on 02Mar2021. The patient was a fairly healthy active 52-year-old. At some point before the vaccine was administered, he had a telehealth visit for reported back pain. He was instructed to get blood work/labs done. A letter was received the day of his death that states his white blood cell count was very high and with it a recommendation that he seek medical attention. She (ex-spouse) reports the autopsy results won't be complete for a few months. The cause of death is unknown. The outcome of white blood cell count was very high was unknown.   Information on the lot/ batch number has been requested.; Reported Cause(s) of Death: Death"
	"1107265-1"	"1107265-1"	"WHITE BLOOD CELL COUNT"	"10047939"	"50-59 years"	"50-59"	"white blood cell count was very high; death; This is a spontaneous report from a contactable consumer (ex-spouse) via medical information team. A 52-year-old male patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number and expiration date were not reported), via an unspecified route of administration on 02Mar2021 at a single dose (at the age of 52-years-old) for COVID-19 immunisation. Medical history included back pain: At some point before the vaccine was administered, he had a telehealth visit for reported back pain. Concomitant medications were not reported. The patient died on 05Mar2021 at his home. The patient received the first dose of COVID vaccine at a hospital on 02Mar2021. The patient was a fairly healthy active 52-year-old. At some point before the vaccine was administered, he had a telehealth visit for reported back pain. He was instructed to get blood work/labs done. A letter was received the day of his death that states his white blood cell count was very high and with it a recommendation that he seek medical attention. She (ex-spouse) reports the autopsy results won't be complete for a few months. The cause of death is unknown. The outcome of white blood cell count was very high was unknown.   Information on the lot/ batch number has been requested.; Reported Cause(s) of Death: Death"
	"1107265-1"	"1107265-1"	"WHITE BLOOD CELL COUNT INCREASED"	"10047943"	"50-59 years"	"50-59"	"white blood cell count was very high; death; This is a spontaneous report from a contactable consumer (ex-spouse) via medical information team. A 52-year-old male patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number and expiration date were not reported), via an unspecified route of administration on 02Mar2021 at a single dose (at the age of 52-years-old) for COVID-19 immunisation. Medical history included back pain: At some point before the vaccine was administered, he had a telehealth visit for reported back pain. Concomitant medications were not reported. The patient died on 05Mar2021 at his home. The patient received the first dose of COVID vaccine at a hospital on 02Mar2021. The patient was a fairly healthy active 52-year-old. At some point before the vaccine was administered, he had a telehealth visit for reported back pain. He was instructed to get blood work/labs done. A letter was received the day of his death that states his white blood cell count was very high and with it a recommendation that he seek medical attention. She (ex-spouse) reports the autopsy results won't be complete for a few months. The cause of death is unknown. The outcome of white blood cell count was very high was unknown.   Information on the lot/ batch number has been requested.; Reported Cause(s) of Death: Death"
	"1108472-1"	"1108472-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"cardiac arrest Narrative: Per medics, Patient was gardening when he stated he felt dizzy and collapsed. Wife started CPR until medics arrived. Patient arrived at the hospital after 20min of pulseless V tach and 10 min of PEA."
	"1108472-1"	"1108472-1"	"DIZZINESS"	"10013573"	"50-59 years"	"50-59"	"cardiac arrest Narrative: Per medics, Patient was gardening when he stated he felt dizzy and collapsed. Wife started CPR until medics arrived. Patient arrived at the hospital after 20min of pulseless V tach and 10 min of PEA."
	"1108472-1"	"1108472-1"	"PULSELESS ELECTRICAL ACTIVITY"	"10058151"	"50-59 years"	"50-59"	"cardiac arrest Narrative: Per medics, Patient was gardening when he stated he felt dizzy and collapsed. Wife started CPR until medics arrived. Patient arrived at the hospital after 20min of pulseless V tach and 10 min of PEA."
	"1108472-1"	"1108472-1"	"RESUSCITATION"	"10038749"	"50-59 years"	"50-59"	"cardiac arrest Narrative: Per medics, Patient was gardening when he stated he felt dizzy and collapsed. Wife started CPR until medics arrived. Patient arrived at the hospital after 20min of pulseless V tach and 10 min of PEA."
	"1108472-1"	"1108472-1"	"SYNCOPE"	"10042772"	"50-59 years"	"50-59"	"cardiac arrest Narrative: Per medics, Patient was gardening when he stated he felt dizzy and collapsed. Wife started CPR until medics arrived. Patient arrived at the hospital after 20min of pulseless V tach and 10 min of PEA."
	"1108472-1"	"1108472-1"	"VENTRICULAR TACHYCARDIA"	"10047302"	"50-59 years"	"50-59"	"cardiac arrest Narrative: Per medics, Patient was gardening when he stated he felt dizzy and collapsed. Wife started CPR until medics arrived. Patient arrived at the hospital after 20min of pulseless V tach and 10 min of PEA."
	"1112773-1"	"1112773-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Moderna #1 vaccine given at 130pm March 11th 2021. Pt had history of asthma and frequent nebulizer use and had it in car with her for drive-thru vaccine clinic we did at location, which has a large parking lot. We gave 80 doses. Pt checked off anaphylaxis on the intake form so Dr spoke to her and she changed it to no history of anaphylaxis and only has history of asthma. So we gave her the vaccine. About 5 minutes later in car parking lot she started to use her personal nebulizer. I saw her in passenger side of car using a personal nebulizer so I talked to her and her daughter to find out what was going on. They said she has exacerbations all the time and this was not out of ordinary for her. I checked pulse ox and did a lung exam, etc, and she was stable.  She seemed baseline according to history by her and her daughter.  As she seemed at baseline and clinically was comfortable and conversant whole time, and she felt better after her nebulizer, I told them to have a low threshold for going to ER or calling 911 if her asthma was worse or different than her usual symptoms.  They agreed. According to daughter, she did well until about 24 hours the next day. The daughter said she was fine and she went to store and when she returned EMTs were intubating patient and apparently the patient used her epipen and called 911 herself. Approximate time of expiration was 230pm on March12th 2021."
	"1112773-1"	"1112773-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"50-59 years"	"50-59"	"Moderna #1 vaccine given at 130pm March 11th 2021. Pt had history of asthma and frequent nebulizer use and had it in car with her for drive-thru vaccine clinic we did at location, which has a large parking lot. We gave 80 doses. Pt checked off anaphylaxis on the intake form so Dr spoke to her and she changed it to no history of anaphylaxis and only has history of asthma. So we gave her the vaccine. About 5 minutes later in car parking lot she started to use her personal nebulizer. I saw her in passenger side of car using a personal nebulizer so I talked to her and her daughter to find out what was going on. They said she has exacerbations all the time and this was not out of ordinary for her. I checked pulse ox and did a lung exam, etc, and she was stable.  She seemed baseline according to history by her and her daughter.  As she seemed at baseline and clinically was comfortable and conversant whole time, and she felt better after her nebulizer, I told them to have a low threshold for going to ER or calling 911 if her asthma was worse or different than her usual symptoms.  They agreed. According to daughter, she did well until about 24 hours the next day. The daughter said she was fine and she went to store and when she returned EMTs were intubating patient and apparently the patient used her epipen and called 911 herself. Approximate time of expiration was 230pm on March12th 2021."
	"1114822-1"	"1114822-1"	"COUGH"	"10011224"	"50-59 years"	"50-59"	"Diagnosed with COVID (confirmed with a positive COVID test) the say after her vaccine.  Eventually died from complications of COVID.  Because vaccine was administered prior to her illness, I am putting this in the VAERS system.  Symptoms included  SOB, coughing, muscle aches. headache, fever."
	"1114822-1"	"1114822-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Diagnosed with COVID (confirmed with a positive COVID test) the say after her vaccine.  Eventually died from complications of COVID.  Because vaccine was administered prior to her illness, I am putting this in the VAERS system.  Symptoms included  SOB, coughing, muscle aches. headache, fever."
	"1114822-1"	"1114822-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Diagnosed with COVID (confirmed with a positive COVID test) the say after her vaccine.  Eventually died from complications of COVID.  Because vaccine was administered prior to her illness, I am putting this in the VAERS system.  Symptoms included  SOB, coughing, muscle aches. headache, fever."
	"1114822-1"	"1114822-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"Diagnosed with COVID (confirmed with a positive COVID test) the say after her vaccine.  Eventually died from complications of COVID.  Because vaccine was administered prior to her illness, I am putting this in the VAERS system.  Symptoms included  SOB, coughing, muscle aches. headache, fever."
	"1114822-1"	"1114822-1"	"HEADACHE"	"10019211"	"50-59 years"	"50-59"	"Diagnosed with COVID (confirmed with a positive COVID test) the say after her vaccine.  Eventually died from complications of COVID.  Because vaccine was administered prior to her illness, I am putting this in the VAERS system.  Symptoms included  SOB, coughing, muscle aches. headache, fever."
	"1114822-1"	"1114822-1"	"MYALGIA"	"10028411"	"50-59 years"	"50-59"	"Diagnosed with COVID (confirmed with a positive COVID test) the say after her vaccine.  Eventually died from complications of COVID.  Because vaccine was administered prior to her illness, I am putting this in the VAERS system.  Symptoms included  SOB, coughing, muscle aches. headache, fever."
	"1114822-1"	"1114822-1"	"PYREXIA"	"10037660"	"50-59 years"	"50-59"	"Diagnosed with COVID (confirmed with a positive COVID test) the say after her vaccine.  Eventually died from complications of COVID.  Because vaccine was administered prior to her illness, I am putting this in the VAERS system.  Symptoms included  SOB, coughing, muscle aches. headache, fever."
	"1114822-1"	"1114822-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"Diagnosed with COVID (confirmed with a positive COVID test) the say after her vaccine.  Eventually died from complications of COVID.  Because vaccine was administered prior to her illness, I am putting this in the VAERS system.  Symptoms included  SOB, coughing, muscle aches. headache, fever."
	"1115045-1"	"1115045-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Death; A spontaneous report was received from a consumer concerning a 57 years old male patient who received mRNA-1273 for prophylaxis of COVID-19 infection and had died (death).  The patient's medical history was not provided. Concomitant product use was not provided by the reporter.   On 2 Mar 2021, approximately three hours prior to the onset of the symptoms, the patient received hia second of two planned doses of mRNA-1273 for prophylaxis of COVID-19 infection.   It was reported that  the patient died three hours after receiving the 2nd dose in the ER. Treatment information was not provided. The cause of death was unknown. Plans for an autopsy were unknown.  Action taken with mRNA-1273 in response to the event was not applicable.  The outcome of the event of death  was considered as fatal.; Reporter's Comments: This is a case of sudden concerning a 57 year old male who died three hours after receiving the second dose of the vaccine. Very limited information regarding this event has been provided at this time.; Reported Cause(s) of Death: unknown cause of Death"
	"1115944-1"	"1115944-1"	"CHEST PAIN"	"10008479"	"50-59 years"	"50-59"	"1-2 hours after receiving Moderna vaccination patient began complaining of chest pain to family members but refused to seek medical attention. He was found deceased this morning (03/19/21) by his family. Medical Examiner determined time of death was around 8:40pm on 03/18/21."
	"1115944-1"	"1115944-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"1-2 hours after receiving Moderna vaccination patient began complaining of chest pain to family members but refused to seek medical attention. He was found deceased this morning (03/19/21) by his family. Medical Examiner determined time of death was around 8:40pm on 03/18/21."
	"1115944-1"	"1115944-1"	"REFUSAL OF TREATMENT BY PATIENT"	"10056407"	"50-59 years"	"50-59"	"1-2 hours after receiving Moderna vaccination patient began complaining of chest pain to family members but refused to seek medical attention. He was found deceased this morning (03/19/21) by his family. Medical Examiner determined time of death was around 8:40pm on 03/18/21."
	"1116099-1"	"1116099-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"Cardiac  Arrest Narrative: Patient received vaccine at 1209 on 3/13/2021, observed for 15min no reaction noted. Later that evening patient was not feeling well presented to ER where he was admitted. Had cardiac arrest during hospitalization on 3/16/2021 where patient passed away. Had a Hx of CHF, A-Fib, had  a cardiac stent placement in 2020.."
	"1116099-1"	"1116099-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Cardiac  Arrest Narrative: Patient received vaccine at 1209 on 3/13/2021, observed for 15min no reaction noted. Later that evening patient was not feeling well presented to ER where he was admitted. Had cardiac arrest during hospitalization on 3/16/2021 where patient passed away. Had a Hx of CHF, A-Fib, had  a cardiac stent placement in 2020.."
	"1116099-1"	"1116099-1"	"MALAISE"	"10025482"	"50-59 years"	"50-59"	"Cardiac  Arrest Narrative: Patient received vaccine at 1209 on 3/13/2021, observed for 15min no reaction noted. Later that evening patient was not feeling well presented to ER where he was admitted. Had cardiac arrest during hospitalization on 3/16/2021 where patient passed away. Had a Hx of CHF, A-Fib, had  a cardiac stent placement in 2020.."
	"1116407-1"	"1116407-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient got sick over the weekend. Went to facility on 03/02/2021 and then passed on 03/18/2021"
	"1116407-1"	"1116407-1"	"ILLNESS"	"10080284"	"50-59 years"	"50-59"	"Patient got sick over the weekend. Went to facility on 03/02/2021 and then passed on 03/18/2021"
	"1118314-1"	"1118314-1"	"AUTOPSY"	"10050117"	"50-59 years"	"50-59"	"She received the Johnson and Johnson vaccine on Wednesday and died on Sunday 3/14/2021.  Her autopsy is pending."
	"1118314-1"	"1118314-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"She received the Johnson and Johnson vaccine on Wednesday and died on Sunday 3/14/2021.  Her autopsy is pending."
	"1122441-1"	"1122441-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"Patient passed away unrelated to covid vaccine Narrative: The patient had with a history of ischemic cardiomyopathy and multiple PCI's, CABG history of acute renal failure and hypokalemia and decompensated heart failure. Patient received his first dose of Pfizer dose on 2/18. Patient passed away on 3/8 due to cardiac arrest upon arrival to ER. Cause of death is not related to COVID-19 vaccination."
	"1122441-1"	"1122441-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient passed away unrelated to covid vaccine Narrative: The patient had with a history of ischemic cardiomyopathy and multiple PCI's, CABG history of acute renal failure and hypokalemia and decompensated heart failure. Patient received his first dose of Pfizer dose on 2/18. Patient passed away on 3/8 due to cardiac arrest upon arrival to ER. Cause of death is not related to COVID-19 vaccination."
	"1122640-1"	"1122640-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Death 3/11/21"
	"1122741-1"	"1122741-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"suspected pulmonary embolism; shock; cardiac arrest; This is a spontaneous report from a non-contactable consumer (patient's wife). A 51-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; Solution for injection, unknown lot number and expiration), via an unspecified route of administration on 04Mar2021 at 11:45 AM at a single dose for COVID-19 immunization.  Medical history reported as none.  The patient has no known allergies. The patient's concomitant medications were not reported.  The patient experienced a suspected pulmonary embolism on Monday 08Mar2021 at 11:30 AM. Embolism led to shock and cardiac arrest. The patient did not have COVID prior to vaccination and was not tested for COVID post vaccination. The patient did not receive other vaccine in four weeks. The patient received unspecified treatment for the events. The patient died on 08Mar2021 at 11:30 AM.  It was not reported if an autopsy was performed.  Information on the lot/batch number has been requested.; Reported Cause(s) of Death: suspected pulmonary embolism; shock; cardiac arrest"
	"1122741-1"	"1122741-1"	"PULMONARY EMBOLISM"	"10037377"	"50-59 years"	"50-59"	"suspected pulmonary embolism; shock; cardiac arrest; This is a spontaneous report from a non-contactable consumer (patient's wife). A 51-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; Solution for injection, unknown lot number and expiration), via an unspecified route of administration on 04Mar2021 at 11:45 AM at a single dose for COVID-19 immunization.  Medical history reported as none.  The patient has no known allergies. The patient's concomitant medications were not reported.  The patient experienced a suspected pulmonary embolism on Monday 08Mar2021 at 11:30 AM. Embolism led to shock and cardiac arrest. The patient did not have COVID prior to vaccination and was not tested for COVID post vaccination. The patient did not receive other vaccine in four weeks. The patient received unspecified treatment for the events. The patient died on 08Mar2021 at 11:30 AM.  It was not reported if an autopsy was performed.  Information on the lot/batch number has been requested.; Reported Cause(s) of Death: suspected pulmonary embolism; shock; cardiac arrest"
	"1122741-1"	"1122741-1"	"SHOCK"	"10040560"	"50-59 years"	"50-59"	"suspected pulmonary embolism; shock; cardiac arrest; This is a spontaneous report from a non-contactable consumer (patient's wife). A 51-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; Solution for injection, unknown lot number and expiration), via an unspecified route of administration on 04Mar2021 at 11:45 AM at a single dose for COVID-19 immunization.  Medical history reported as none.  The patient has no known allergies. The patient's concomitant medications were not reported.  The patient experienced a suspected pulmonary embolism on Monday 08Mar2021 at 11:30 AM. Embolism led to shock and cardiac arrest. The patient did not have COVID prior to vaccination and was not tested for COVID post vaccination. The patient did not receive other vaccine in four weeks. The patient received unspecified treatment for the events. The patient died on 08Mar2021 at 11:30 AM.  It was not reported if an autopsy was performed.  Information on the lot/batch number has been requested.; Reported Cause(s) of Death: suspected pulmonary embolism; shock; cardiac arrest"
	"1123847-1"	"1123847-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient had no reactions to first vaccine post dialysis.  The morning after the patient received the vaccine, patient expired at home. Police stated that the death was vaccine related."
	"1123927-1"	"1123927-1"	"ABDOMINAL PAIN"	"10000081"	"50-59 years"	"50-59"	"NA  CAD, Chronic Abd pain with Opioid treatment - Chronic Pancreatitis"
	"1123927-1"	"1123927-1"	"CORONARY ARTERY DISEASE"	"10011078"	"50-59 years"	"50-59"	"NA  CAD, Chronic Abd pain with Opioid treatment - Chronic Pancreatitis"
	"1123927-1"	"1123927-1"	"PANCREATITIS CHRONIC"	"10033649"	"50-59 years"	"50-59"	"NA  CAD, Chronic Abd pain with Opioid treatment - Chronic Pancreatitis"
	"1126876-1"	"1126876-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient passed away in the early morning of 3/13/21."
	"1127175-1"	"1127175-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Death"
	"1129117-1"	"1129117-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient passed away in her sleep 8 days after receiving 2nd dose of Moderna vaccine. Patient's family reports they believe it was a massive heart attack. They do not believe this was related to the vaccine."
	"1129427-1"	"1129427-1"	"CARDIO-RESPIRATORY ARREST"	"10007617"	"50-59 years"	"50-59"	"Pt received vaccine on Friday, March 19th.  On Monday, March 23rd, t was hiking with boy scout troop, became short of breath, collapsed and went into full arrest.  BLS done on scene, transported to local ER where pt was pronounced dead."
	"1129427-1"	"1129427-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Pt received vaccine on Friday, March 19th.  On Monday, March 23rd, t was hiking with boy scout troop, became short of breath, collapsed and went into full arrest.  BLS done on scene, transported to local ER where pt was pronounced dead."
	"1129427-1"	"1129427-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"Pt received vaccine on Friday, March 19th.  On Monday, March 23rd, t was hiking with boy scout troop, became short of breath, collapsed and went into full arrest.  BLS done on scene, transported to local ER where pt was pronounced dead."
	"1129427-1"	"1129427-1"	"RESUSCITATION"	"10038749"	"50-59 years"	"50-59"	"Pt received vaccine on Friday, March 19th.  On Monday, March 23rd, t was hiking with boy scout troop, became short of breath, collapsed and went into full arrest.  BLS done on scene, transported to local ER where pt was pronounced dead."
	"1129427-1"	"1129427-1"	"SYNCOPE"	"10042772"	"50-59 years"	"50-59"	"Pt received vaccine on Friday, March 19th.  On Monday, March 23rd, t was hiking with boy scout troop, became short of breath, collapsed and went into full arrest.  BLS done on scene, transported to local ER where pt was pronounced dead."
	"1130386-1"	"1130386-1"	"CORONARY ARTERY OCCLUSION"	"10011086"	"50-59 years"	"50-59"	"syncopal event. 911 was then called. Once EMS arrived he was found unresponsive and was in V fib.; transferred to the cath lab where he was found to have a proximal LAD occlusion deceased 3/17/2021"
	"1130386-1"	"1130386-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"syncopal event. 911 was then called. Once EMS arrived he was found unresponsive and was in V fib.; transferred to the cath lab where he was found to have a proximal LAD occlusion deceased 3/17/2021"
	"1130386-1"	"1130386-1"	"SYNCOPE"	"10042772"	"50-59 years"	"50-59"	"syncopal event. 911 was then called. Once EMS arrived he was found unresponsive and was in V fib.; transferred to the cath lab where he was found to have a proximal LAD occlusion deceased 3/17/2021"
	"1130386-1"	"1130386-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"50-59 years"	"50-59"	"syncopal event. 911 was then called. Once EMS arrived he was found unresponsive and was in V fib.; transferred to the cath lab where he was found to have a proximal LAD occlusion deceased 3/17/2021"
	"1130386-1"	"1130386-1"	"VENTRICULAR FIBRILLATION"	"10047290"	"50-59 years"	"50-59"	"syncopal event. 911 was then called. Once EMS arrived he was found unresponsive and was in V fib.; transferred to the cath lab where he was found to have a proximal LAD occlusion deceased 3/17/2021"
	"1132062-1"	"1132062-1"	"HYPOPHAGIA"	"10063743"	"50-59 years"	"50-59"	"Had multiple hospitalizations for COPD prior to  COVID-19 infection in December 2020.  Had been admitted to Hospice for further decompensation after COVID diagnosis.  Limited oral intake and hospice began using morphine and Ativan.   Was on comfort medications only prior to 1/26/2021"
	"1134697-1"	"1134697-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient reportedly passed away on 3-24-21 on the day after the vaccine was given.  We have no further information at our facility regarding the event."
	"1134819-1"	"1134819-1"	"BRAIN NATRIURETIC PEPTIDE"	"10053406"	"50-59 years"	"50-59"	"She developed a large pulmonary embolus, and she died on 3/17 at Hospital. She developed symptoms of SOB on 3/11, and was admitted to the hospital. She was initially stable and not requiring oxygen and was sent home on anticoagulation. However she returned the same day with worsening symptoms, troponin now elevated, and ECHO showing signs of right heart strain. Embolus on imaging had increased in just over days from previous CT scan. She became pulseless and died despite resuscitative efforts. It is my opinion (Dr.) that she died of a pulmonary embolus, and an autopsy is pending."
	"1134819-1"	"1134819-1"	"CARDIAC FAILURE"	"10007554"	"50-59 years"	"50-59"	"She developed a large pulmonary embolus, and she died on 3/17 at Hospital. She developed symptoms of SOB on 3/11, and was admitted to the hospital. She was initially stable and not requiring oxygen and was sent home on anticoagulation. However she returned the same day with worsening symptoms, troponin now elevated, and ECHO showing signs of right heart strain. Embolus on imaging had increased in just over days from previous CT scan. She became pulseless and died despite resuscitative efforts. It is my opinion (Dr.) that she died of a pulmonary embolus, and an autopsy is pending."
	"1134819-1"	"1134819-1"	"COMPUTERISED TOMOGRAM ABNORMAL"	"10010235"	"50-59 years"	"50-59"	"She developed a large pulmonary embolus, and she died on 3/17 at Hospital. She developed symptoms of SOB on 3/11, and was admitted to the hospital. She was initially stable and not requiring oxygen and was sent home on anticoagulation. However she returned the same day with worsening symptoms, troponin now elevated, and ECHO showing signs of right heart strain. Embolus on imaging had increased in just over days from previous CT scan. She became pulseless and died despite resuscitative efforts. It is my opinion (Dr.) that she died of a pulmonary embolus, and an autopsy is pending."
	"1134819-1"	"1134819-1"	"CONDITION AGGRAVATED"	"10010264"	"50-59 years"	"50-59"	"She developed a large pulmonary embolus, and she died on 3/17 at Hospital. She developed symptoms of SOB on 3/11, and was admitted to the hospital. She was initially stable and not requiring oxygen and was sent home on anticoagulation. However she returned the same day with worsening symptoms, troponin now elevated, and ECHO showing signs of right heart strain. Embolus on imaging had increased in just over days from previous CT scan. She became pulseless and died despite resuscitative efforts. It is my opinion (Dr.) that she died of a pulmonary embolus, and an autopsy is pending."
	"1134819-1"	"1134819-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"She developed a large pulmonary embolus, and she died on 3/17 at Hospital. She developed symptoms of SOB on 3/11, and was admitted to the hospital. She was initially stable and not requiring oxygen and was sent home on anticoagulation. However she returned the same day with worsening symptoms, troponin now elevated, and ECHO showing signs of right heart strain. Embolus on imaging had increased in just over days from previous CT scan. She became pulseless and died despite resuscitative efforts. It is my opinion (Dr.) that she died of a pulmonary embolus, and an autopsy is pending."
	"1134819-1"	"1134819-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"She developed a large pulmonary embolus, and she died on 3/17 at Hospital. She developed symptoms of SOB on 3/11, and was admitted to the hospital. She was initially stable and not requiring oxygen and was sent home on anticoagulation. However she returned the same day with worsening symptoms, troponin now elevated, and ECHO showing signs of right heart strain. Embolus on imaging had increased in just over days from previous CT scan. She became pulseless and died despite resuscitative efforts. It is my opinion (Dr.) that she died of a pulmonary embolus, and an autopsy is pending."
	"1134819-1"	"1134819-1"	"ECHOCARDIOGRAM ABNORMAL"	"10061593"	"50-59 years"	"50-59"	"She developed a large pulmonary embolus, and she died on 3/17 at Hospital. She developed symptoms of SOB on 3/11, and was admitted to the hospital. She was initially stable and not requiring oxygen and was sent home on anticoagulation. However she returned the same day with worsening symptoms, troponin now elevated, and ECHO showing signs of right heart strain. Embolus on imaging had increased in just over days from previous CT scan. She became pulseless and died despite resuscitative efforts. It is my opinion (Dr.) that she died of a pulmonary embolus, and an autopsy is pending."
	"1134819-1"	"1134819-1"	"MYOCARDIAL STRAIN"	"10066954"	"50-59 years"	"50-59"	"She developed a large pulmonary embolus, and she died on 3/17 at Hospital. She developed symptoms of SOB on 3/11, and was admitted to the hospital. She was initially stable and not requiring oxygen and was sent home on anticoagulation. However she returned the same day with worsening symptoms, troponin now elevated, and ECHO showing signs of right heart strain. Embolus on imaging had increased in just over days from previous CT scan. She became pulseless and died despite resuscitative efforts. It is my opinion (Dr.) that she died of a pulmonary embolus, and an autopsy is pending."
	"1134819-1"	"1134819-1"	"PULMONARY EMBOLISM"	"10037377"	"50-59 years"	"50-59"	"She developed a large pulmonary embolus, and she died on 3/17 at Hospital. She developed symptoms of SOB on 3/11, and was admitted to the hospital. She was initially stable and not requiring oxygen and was sent home on anticoagulation. However she returned the same day with worsening symptoms, troponin now elevated, and ECHO showing signs of right heart strain. Embolus on imaging had increased in just over days from previous CT scan. She became pulseless and died despite resuscitative efforts. It is my opinion (Dr.) that she died of a pulmonary embolus, and an autopsy is pending."
	"1134819-1"	"1134819-1"	"PULSE ABSENT"	"10037469"	"50-59 years"	"50-59"	"She developed a large pulmonary embolus, and she died on 3/17 at Hospital. She developed symptoms of SOB on 3/11, and was admitted to the hospital. She was initially stable and not requiring oxygen and was sent home on anticoagulation. However she returned the same day with worsening symptoms, troponin now elevated, and ECHO showing signs of right heart strain. Embolus on imaging had increased in just over days from previous CT scan. She became pulseless and died despite resuscitative efforts. It is my opinion (Dr.) that she died of a pulmonary embolus, and an autopsy is pending."
	"1134819-1"	"1134819-1"	"RESUSCITATION"	"10038749"	"50-59 years"	"50-59"	"She developed a large pulmonary embolus, and she died on 3/17 at Hospital. She developed symptoms of SOB on 3/11, and was admitted to the hospital. She was initially stable and not requiring oxygen and was sent home on anticoagulation. However she returned the same day with worsening symptoms, troponin now elevated, and ECHO showing signs of right heart strain. Embolus on imaging had increased in just over days from previous CT scan. She became pulseless and died despite resuscitative efforts. It is my opinion (Dr.) that she died of a pulmonary embolus, and an autopsy is pending."
	"1134819-1"	"1134819-1"	"TROPONIN INCREASED"	"10058267"	"50-59 years"	"50-59"	"She developed a large pulmonary embolus, and she died on 3/17 at Hospital. She developed symptoms of SOB on 3/11, and was admitted to the hospital. She was initially stable and not requiring oxygen and was sent home on anticoagulation. However she returned the same day with worsening symptoms, troponin now elevated, and ECHO showing signs of right heart strain. Embolus on imaging had increased in just over days from previous CT scan. She became pulseless and died despite resuscitative efforts. It is my opinion (Dr.) that she died of a pulmonary embolus, and an autopsy is pending."
	"1137069-1"	"1137069-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"57yo Male,  resident, declared dead 01/11/2021 , following a period of ill health related to diabetic ulcers."
	"1137069-1"	"1137069-1"	"GENERAL PHYSICAL HEALTH DETERIORATION"	"10049438"	"50-59 years"	"50-59"	"57yo Male,  resident, declared dead 01/11/2021 , following a period of ill health related to diabetic ulcers."
	"1137069-1"	"1137069-1"	"TOE AMPUTATION"	"10043913"	"50-59 years"	"50-59"	"57yo Male,  resident, declared dead 01/11/2021 , following a period of ill health related to diabetic ulcers."
	"1137286-1"	"1137286-1"	"ACUTE KIDNEY INJURY"	"10069339"	"50-59 years"	"50-59"	"Brought in from ED, family concerned for altered mental status, hyperthermia, Tmax in 105.  The patient stated that after the covid-19 vaccine on Friday, he experienced acute onset of R shoulder pain, constant, associated with decreased ROM. On PM Monday, he noticed first episode of chills, that lasted a few minutes, accompanied with sweating. This episode recurred 4 times over the week, then the family started noticed the patient was unable to answer questions and was somnolent. Blood Cultures in the ED were positive for MRSA 2:2. He was positive for endocarditis (previous dental work). Acute metabolic encephalopathy due to severe sepsis most likely 2/2 MRSA bacteremia complicated by NSTEMI and AKI in setting of newly diagnosed aortic valve endocarditis complicated by septic emboli to the bilateral cerebral hemispheres"
	"1137286-1"	"1137286-1"	"ACUTE MYOCARDIAL INFARCTION"	"10000891"	"50-59 years"	"50-59"	"Brought in from ED, family concerned for altered mental status, hyperthermia, Tmax in 105.  The patient stated that after the covid-19 vaccine on Friday, he experienced acute onset of R shoulder pain, constant, associated with decreased ROM. On PM Monday, he noticed first episode of chills, that lasted a few minutes, accompanied with sweating. This episode recurred 4 times over the week, then the family started noticed the patient was unable to answer questions and was somnolent. Blood Cultures in the ED were positive for MRSA 2:2. He was positive for endocarditis (previous dental work). Acute metabolic encephalopathy due to severe sepsis most likely 2/2 MRSA bacteremia complicated by NSTEMI and AKI in setting of newly diagnosed aortic valve endocarditis complicated by septic emboli to the bilateral cerebral hemispheres"
	"1137286-1"	"1137286-1"	"APHASIA"	"10002948"	"50-59 years"	"50-59"	"Brought in from ED, family concerned for altered mental status, hyperthermia, Tmax in 105.  The patient stated that after the covid-19 vaccine on Friday, he experienced acute onset of R shoulder pain, constant, associated with decreased ROM. On PM Monday, he noticed first episode of chills, that lasted a few minutes, accompanied with sweating. This episode recurred 4 times over the week, then the family started noticed the patient was unable to answer questions and was somnolent. Blood Cultures in the ED were positive for MRSA 2:2. He was positive for endocarditis (previous dental work). Acute metabolic encephalopathy due to severe sepsis most likely 2/2 MRSA bacteremia complicated by NSTEMI and AKI in setting of newly diagnosed aortic valve endocarditis complicated by septic emboli to the bilateral cerebral hemispheres"
	"1137286-1"	"1137286-1"	"ARTHRALGIA"	"10003239"	"50-59 years"	"50-59"	"Brought in from ED, family concerned for altered mental status, hyperthermia, Tmax in 105.  The patient stated that after the covid-19 vaccine on Friday, he experienced acute onset of R shoulder pain, constant, associated with decreased ROM. On PM Monday, he noticed first episode of chills, that lasted a few minutes, accompanied with sweating. This episode recurred 4 times over the week, then the family started noticed the patient was unable to answer questions and was somnolent. Blood Cultures in the ED were positive for MRSA 2:2. He was positive for endocarditis (previous dental work). Acute metabolic encephalopathy due to severe sepsis most likely 2/2 MRSA bacteremia complicated by NSTEMI and AKI in setting of newly diagnosed aortic valve endocarditis complicated by septic emboli to the bilateral cerebral hemispheres"
	"1137286-1"	"1137286-1"	"BACK PAIN"	"10003988"	"50-59 years"	"50-59"	"Brought in from ED, family concerned for altered mental status, hyperthermia, Tmax in 105.  The patient stated that after the covid-19 vaccine on Friday, he experienced acute onset of R shoulder pain, constant, associated with decreased ROM. On PM Monday, he noticed first episode of chills, that lasted a few minutes, accompanied with sweating. This episode recurred 4 times over the week, then the family started noticed the patient was unable to answer questions and was somnolent. Blood Cultures in the ED were positive for MRSA 2:2. He was positive for endocarditis (previous dental work). Acute metabolic encephalopathy due to severe sepsis most likely 2/2 MRSA bacteremia complicated by NSTEMI and AKI in setting of newly diagnosed aortic valve endocarditis complicated by septic emboli to the bilateral cerebral hemispheres"
	"1137286-1"	"1137286-1"	"BLOOD CREATINE PHOSPHOKINASE INCREASED"	"10005470"	"50-59 years"	"50-59"	"Brought in from ED, family concerned for altered mental status, hyperthermia, Tmax in 105.  The patient stated that after the covid-19 vaccine on Friday, he experienced acute onset of R shoulder pain, constant, associated with decreased ROM. On PM Monday, he noticed first episode of chills, that lasted a few minutes, accompanied with sweating. This episode recurred 4 times over the week, then the family started noticed the patient was unable to answer questions and was somnolent. Blood Cultures in the ED were positive for MRSA 2:2. He was positive for endocarditis (previous dental work). Acute metabolic encephalopathy due to severe sepsis most likely 2/2 MRSA bacteremia complicated by NSTEMI and AKI in setting of newly diagnosed aortic valve endocarditis complicated by septic emboli to the bilateral cerebral hemispheres"
	"1137286-1"	"1137286-1"	"BLOOD CULTURE POSITIVE"	"10005488"	"50-59 years"	"50-59"	"Brought in from ED, family concerned for altered mental status, hyperthermia, Tmax in 105.  The patient stated that after the covid-19 vaccine on Friday, he experienced acute onset of R shoulder pain, constant, associated with decreased ROM. On PM Monday, he noticed first episode of chills, that lasted a few minutes, accompanied with sweating. This episode recurred 4 times over the week, then the family started noticed the patient was unable to answer questions and was somnolent. Blood Cultures in the ED were positive for MRSA 2:2. He was positive for endocarditis (previous dental work). Acute metabolic encephalopathy due to severe sepsis most likely 2/2 MRSA bacteremia complicated by NSTEMI and AKI in setting of newly diagnosed aortic valve endocarditis complicated by septic emboli to the bilateral cerebral hemispheres"
	"1137286-1"	"1137286-1"	"BLOOD GASES ABNORMAL"	"10005539"	"50-59 years"	"50-59"	"Brought in from ED, family concerned for altered mental status, hyperthermia, Tmax in 105.  The patient stated that after the covid-19 vaccine on Friday, he experienced acute onset of R shoulder pain, constant, associated with decreased ROM. On PM Monday, he noticed first episode of chills, that lasted a few minutes, accompanied with sweating. This episode recurred 4 times over the week, then the family started noticed the patient was unable to answer questions and was somnolent. Blood Cultures in the ED were positive for MRSA 2:2. He was positive for endocarditis (previous dental work). Acute metabolic encephalopathy due to severe sepsis most likely 2/2 MRSA bacteremia complicated by NSTEMI and AKI in setting of newly diagnosed aortic valve endocarditis complicated by septic emboli to the bilateral cerebral hemispheres"
	"1137286-1"	"1137286-1"	"BODY TEMPERATURE INCREASED"	"10005911"	"50-59 years"	"50-59"	"Brought in from ED, family concerned for altered mental status, hyperthermia, Tmax in 105.  The patient stated that after the covid-19 vaccine on Friday, he experienced acute onset of R shoulder pain, constant, associated with decreased ROM. On PM Monday, he noticed first episode of chills, that lasted a few minutes, accompanied with sweating. This episode recurred 4 times over the week, then the family started noticed the patient was unable to answer questions and was somnolent. Blood Cultures in the ED were positive for MRSA 2:2. He was positive for endocarditis (previous dental work). Acute metabolic encephalopathy due to severe sepsis most likely 2/2 MRSA bacteremia complicated by NSTEMI and AKI in setting of newly diagnosed aortic valve endocarditis complicated by septic emboli to the bilateral cerebral hemispheres"
	"1137286-1"	"1137286-1"	"C-REACTIVE PROTEIN INCREASED"	"10006825"	"50-59 years"	"50-59"	"Brought in from ED, family concerned for altered mental status, hyperthermia, Tmax in 105.  The patient stated that after the covid-19 vaccine on Friday, he experienced acute onset of R shoulder pain, constant, associated with decreased ROM. On PM Monday, he noticed first episode of chills, that lasted a few minutes, accompanied with sweating. This episode recurred 4 times over the week, then the family started noticed the patient was unable to answer questions and was somnolent. Blood Cultures in the ED were positive for MRSA 2:2. He was positive for endocarditis (previous dental work). Acute metabolic encephalopathy due to severe sepsis most likely 2/2 MRSA bacteremia complicated by NSTEMI and AKI in setting of newly diagnosed aortic valve endocarditis complicated by septic emboli to the bilateral cerebral hemispheres"
	"1137286-1"	"1137286-1"	"CHILLS"	"10008531"	"50-59 years"	"50-59"	"Brought in from ED, family concerned for altered mental status, hyperthermia, Tmax in 105.  The patient stated that after the covid-19 vaccine on Friday, he experienced acute onset of R shoulder pain, constant, associated with decreased ROM. On PM Monday, he noticed first episode of chills, that lasted a few minutes, accompanied with sweating. This episode recurred 4 times over the week, then the family started noticed the patient was unable to answer questions and was somnolent. Blood Cultures in the ED were positive for MRSA 2:2. He was positive for endocarditis (previous dental work). Acute metabolic encephalopathy due to severe sepsis most likely 2/2 MRSA bacteremia complicated by NSTEMI and AKI in setting of newly diagnosed aortic valve endocarditis complicated by septic emboli to the bilateral cerebral hemispheres"
	"1137286-1"	"1137286-1"	"COMPUTERISED TOMOGRAM ABNORMAL"	"10010235"	"50-59 years"	"50-59"	"Brought in from ED, family concerned for altered mental status, hyperthermia, Tmax in 105.  The patient stated that after the covid-19 vaccine on Friday, he experienced acute onset of R shoulder pain, constant, associated with decreased ROM. On PM Monday, he noticed first episode of chills, that lasted a few minutes, accompanied with sweating. This episode recurred 4 times over the week, then the family started noticed the patient was unable to answer questions and was somnolent. Blood Cultures in the ED were positive for MRSA 2:2. He was positive for endocarditis (previous dental work). Acute metabolic encephalopathy due to severe sepsis most likely 2/2 MRSA bacteremia complicated by NSTEMI and AKI in setting of newly diagnosed aortic valve endocarditis complicated by septic emboli to the bilateral cerebral hemispheres"
	"1137286-1"	"1137286-1"	"CSF CELL COUNT INCREASED"	"10011522"	"50-59 years"	"50-59"	"Brought in from ED, family concerned for altered mental status, hyperthermia, Tmax in 105.  The patient stated that after the covid-19 vaccine on Friday, he experienced acute onset of R shoulder pain, constant, associated with decreased ROM. On PM Monday, he noticed first episode of chills, that lasted a few minutes, accompanied with sweating. This episode recurred 4 times over the week, then the family started noticed the patient was unable to answer questions and was somnolent. Blood Cultures in the ED were positive for MRSA 2:2. He was positive for endocarditis (previous dental work). Acute metabolic encephalopathy due to severe sepsis most likely 2/2 MRSA bacteremia complicated by NSTEMI and AKI in setting of newly diagnosed aortic valve endocarditis complicated by septic emboli to the bilateral cerebral hemispheres"
	"1137286-1"	"1137286-1"	"CSF GLUCOSE INCREASED"	"10050763"	"50-59 years"	"50-59"	"Brought in from ED, family concerned for altered mental status, hyperthermia, Tmax in 105.  The patient stated that after the covid-19 vaccine on Friday, he experienced acute onset of R shoulder pain, constant, associated with decreased ROM. On PM Monday, he noticed first episode of chills, that lasted a few minutes, accompanied with sweating. This episode recurred 4 times over the week, then the family started noticed the patient was unable to answer questions and was somnolent. Blood Cultures in the ED were positive for MRSA 2:2. He was positive for endocarditis (previous dental work). Acute metabolic encephalopathy due to severe sepsis most likely 2/2 MRSA bacteremia complicated by NSTEMI and AKI in setting of newly diagnosed aortic valve endocarditis complicated by septic emboli to the bilateral cerebral hemispheres"
	"1137286-1"	"1137286-1"	"CSF LYMPHOCYTE COUNT"	"10011547"	"50-59 years"	"50-59"	"Brought in from ED, family concerned for altered mental status, hyperthermia, Tmax in 105.  The patient stated that after the covid-19 vaccine on Friday, he experienced acute onset of R shoulder pain, constant, associated with decreased ROM. On PM Monday, he noticed first episode of chills, that lasted a few minutes, accompanied with sweating. This episode recurred 4 times over the week, then the family started noticed the patient was unable to answer questions and was somnolent. Blood Cultures in the ED were positive for MRSA 2:2. He was positive for endocarditis (previous dental work). Acute metabolic encephalopathy due to severe sepsis most likely 2/2 MRSA bacteremia complicated by NSTEMI and AKI in setting of newly diagnosed aortic valve endocarditis complicated by septic emboli to the bilateral cerebral hemispheres"
	"1137286-1"	"1137286-1"	"CSF NEUTROPHIL COUNT INCREASED"	"10053803"	"50-59 years"	"50-59"	"Brought in from ED, family concerned for altered mental status, hyperthermia, Tmax in 105.  The patient stated that after the covid-19 vaccine on Friday, he experienced acute onset of R shoulder pain, constant, associated with decreased ROM. On PM Monday, he noticed first episode of chills, that lasted a few minutes, accompanied with sweating. This episode recurred 4 times over the week, then the family started noticed the patient was unable to answer questions and was somnolent. Blood Cultures in the ED were positive for MRSA 2:2. He was positive for endocarditis (previous dental work). Acute metabolic encephalopathy due to severe sepsis most likely 2/2 MRSA bacteremia complicated by NSTEMI and AKI in setting of newly diagnosed aortic valve endocarditis complicated by septic emboli to the bilateral cerebral hemispheres"
	"1137286-1"	"1137286-1"	"CSF PROTEIN INCREASED"	"10011575"	"50-59 years"	"50-59"	"Brought in from ED, family concerned for altered mental status, hyperthermia, Tmax in 105.  The patient stated that after the covid-19 vaccine on Friday, he experienced acute onset of R shoulder pain, constant, associated with decreased ROM. On PM Monday, he noticed first episode of chills, that lasted a few minutes, accompanied with sweating. This episode recurred 4 times over the week, then the family started noticed the patient was unable to answer questions and was somnolent. Blood Cultures in the ED were positive for MRSA 2:2. He was positive for endocarditis (previous dental work). Acute metabolic encephalopathy due to severe sepsis most likely 2/2 MRSA bacteremia complicated by NSTEMI and AKI in setting of newly diagnosed aortic valve endocarditis complicated by septic emboli to the bilateral cerebral hemispheres"
	"1137286-1"	"1137286-1"	"DELIRIUM"	"10012218"	"50-59 years"	"50-59"	"Brought in from ED, family concerned for altered mental status, hyperthermia, Tmax in 105.  The patient stated that after the covid-19 vaccine on Friday, he experienced acute onset of R shoulder pain, constant, associated with decreased ROM. On PM Monday, he noticed first episode of chills, that lasted a few minutes, accompanied with sweating. This episode recurred 4 times over the week, then the family started noticed the patient was unable to answer questions and was somnolent. Blood Cultures in the ED were positive for MRSA 2:2. He was positive for endocarditis (previous dental work). Acute metabolic encephalopathy due to severe sepsis most likely 2/2 MRSA bacteremia complicated by NSTEMI and AKI in setting of newly diagnosed aortic valve endocarditis complicated by septic emboli to the bilateral cerebral hemispheres"
	"1137286-1"	"1137286-1"	"ECHOCARDIOGRAM"	"10014113"	"50-59 years"	"50-59"	"Brought in from ED, family concerned for altered mental status, hyperthermia, Tmax in 105.  The patient stated that after the covid-19 vaccine on Friday, he experienced acute onset of R shoulder pain, constant, associated with decreased ROM. On PM Monday, he noticed first episode of chills, that lasted a few minutes, accompanied with sweating. This episode recurred 4 times over the week, then the family started noticed the patient was unable to answer questions and was somnolent. Blood Cultures in the ED were positive for MRSA 2:2. He was positive for endocarditis (previous dental work). Acute metabolic encephalopathy due to severe sepsis most likely 2/2 MRSA bacteremia complicated by NSTEMI and AKI in setting of newly diagnosed aortic valve endocarditis complicated by septic emboli to the bilateral cerebral hemispheres"
	"1137286-1"	"1137286-1"	"ECHOCARDIOGRAM ABNORMAL"	"10061593"	"50-59 years"	"50-59"	"Brought in from ED, family concerned for altered mental status, hyperthermia, Tmax in 105.  The patient stated that after the covid-19 vaccine on Friday, he experienced acute onset of R shoulder pain, constant, associated with decreased ROM. On PM Monday, he noticed first episode of chills, that lasted a few minutes, accompanied with sweating. This episode recurred 4 times over the week, then the family started noticed the patient was unable to answer questions and was somnolent. Blood Cultures in the ED were positive for MRSA 2:2. He was positive for endocarditis (previous dental work). Acute metabolic encephalopathy due to severe sepsis most likely 2/2 MRSA bacteremia complicated by NSTEMI and AKI in setting of newly diagnosed aortic valve endocarditis complicated by septic emboli to the bilateral cerebral hemispheres"
	"1137286-1"	"1137286-1"	"ENDOCARDITIS"	"10014665"	"50-59 years"	"50-59"	"Brought in from ED, family concerned for altered mental status, hyperthermia, Tmax in 105.  The patient stated that after the covid-19 vaccine on Friday, he experienced acute onset of R shoulder pain, constant, associated with decreased ROM. On PM Monday, he noticed first episode of chills, that lasted a few minutes, accompanied with sweating. This episode recurred 4 times over the week, then the family started noticed the patient was unable to answer questions and was somnolent. Blood Cultures in the ED were positive for MRSA 2:2. He was positive for endocarditis (previous dental work). Acute metabolic encephalopathy due to severe sepsis most likely 2/2 MRSA bacteremia complicated by NSTEMI and AKI in setting of newly diagnosed aortic valve endocarditis complicated by septic emboli to the bilateral cerebral hemispheres"
	"1137286-1"	"1137286-1"	"HAEMATOCRIT DECREASED"	"10018838"	"50-59 years"	"50-59"	"Brought in from ED, family concerned for altered mental status, hyperthermia, Tmax in 105.  The patient stated that after the covid-19 vaccine on Friday, he experienced acute onset of R shoulder pain, constant, associated with decreased ROM. On PM Monday, he noticed first episode of chills, that lasted a few minutes, accompanied with sweating. This episode recurred 4 times over the week, then the family started noticed the patient was unable to answer questions and was somnolent. Blood Cultures in the ED were positive for MRSA 2:2. He was positive for endocarditis (previous dental work). Acute metabolic encephalopathy due to severe sepsis most likely 2/2 MRSA bacteremia complicated by NSTEMI and AKI in setting of newly diagnosed aortic valve endocarditis complicated by septic emboli to the bilateral cerebral hemispheres"
	"1137286-1"	"1137286-1"	"HAEMOGLOBIN DECREASED"	"10018884"	"50-59 years"	"50-59"	"Brought in from ED, family concerned for altered mental status, hyperthermia, Tmax in 105.  The patient stated that after the covid-19 vaccine on Friday, he experienced acute onset of R shoulder pain, constant, associated with decreased ROM. On PM Monday, he noticed first episode of chills, that lasted a few minutes, accompanied with sweating. This episode recurred 4 times over the week, then the family started noticed the patient was unable to answer questions and was somnolent. Blood Cultures in the ED were positive for MRSA 2:2. He was positive for endocarditis (previous dental work). Acute metabolic encephalopathy due to severe sepsis most likely 2/2 MRSA bacteremia complicated by NSTEMI and AKI in setting of newly diagnosed aortic valve endocarditis complicated by septic emboli to the bilateral cerebral hemispheres"
	"1137286-1"	"1137286-1"	"HYPERHIDROSIS"	"10020642"	"50-59 years"	"50-59"	"Brought in from ED, family concerned for altered mental status, hyperthermia, Tmax in 105.  The patient stated that after the covid-19 vaccine on Friday, he experienced acute onset of R shoulder pain, constant, associated with decreased ROM. On PM Monday, he noticed first episode of chills, that lasted a few minutes, accompanied with sweating. This episode recurred 4 times over the week, then the family started noticed the patient was unable to answer questions and was somnolent. Blood Cultures in the ED were positive for MRSA 2:2. He was positive for endocarditis (previous dental work). Acute metabolic encephalopathy due to severe sepsis most likely 2/2 MRSA bacteremia complicated by NSTEMI and AKI in setting of newly diagnosed aortic valve endocarditis complicated by septic emboli to the bilateral cerebral hemispheres"
	"1137286-1"	"1137286-1"	"HYPERTHERMIA"	"10020843"	"50-59 years"	"50-59"	"Brought in from ED, family concerned for altered mental status, hyperthermia, Tmax in 105.  The patient stated that after the covid-19 vaccine on Friday, he experienced acute onset of R shoulder pain, constant, associated with decreased ROM. On PM Monday, he noticed first episode of chills, that lasted a few minutes, accompanied with sweating. This episode recurred 4 times over the week, then the family started noticed the patient was unable to answer questions and was somnolent. Blood Cultures in the ED were positive for MRSA 2:2. He was positive for endocarditis (previous dental work). Acute metabolic encephalopathy due to severe sepsis most likely 2/2 MRSA bacteremia complicated by NSTEMI and AKI in setting of newly diagnosed aortic valve endocarditis complicated by septic emboli to the bilateral cerebral hemispheres"
	"1137286-1"	"1137286-1"	"IMMATURE GRANULOCYTE COUNT INCREASED"	"10081727"	"50-59 years"	"50-59"	"Brought in from ED, family concerned for altered mental status, hyperthermia, Tmax in 105.  The patient stated that after the covid-19 vaccine on Friday, he experienced acute onset of R shoulder pain, constant, associated with decreased ROM. On PM Monday, he noticed first episode of chills, that lasted a few minutes, accompanied with sweating. This episode recurred 4 times over the week, then the family started noticed the patient was unable to answer questions and was somnolent. Blood Cultures in the ED were positive for MRSA 2:2. He was positive for endocarditis (previous dental work). Acute metabolic encephalopathy due to severe sepsis most likely 2/2 MRSA bacteremia complicated by NSTEMI and AKI in setting of newly diagnosed aortic valve endocarditis complicated by septic emboli to the bilateral cerebral hemispheres"
	"1137286-1"	"1137286-1"	"JOINT RANGE OF MOTION DECREASED"	"10048706"	"50-59 years"	"50-59"	"Brought in from ED, family concerned for altered mental status, hyperthermia, Tmax in 105.  The patient stated that after the covid-19 vaccine on Friday, he experienced acute onset of R shoulder pain, constant, associated with decreased ROM. On PM Monday, he noticed first episode of chills, that lasted a few minutes, accompanied with sweating. This episode recurred 4 times over the week, then the family started noticed the patient was unable to answer questions and was somnolent. Blood Cultures in the ED were positive for MRSA 2:2. He was positive for endocarditis (previous dental work). Acute metabolic encephalopathy due to severe sepsis most likely 2/2 MRSA bacteremia complicated by NSTEMI and AKI in setting of newly diagnosed aortic valve endocarditis complicated by septic emboli to the bilateral cerebral hemispheres"
	"1137286-1"	"1137286-1"	"LYMPHOCYTE COUNT DECREASED"	"10025256"	"50-59 years"	"50-59"	"Brought in from ED, family concerned for altered mental status, hyperthermia, Tmax in 105.  The patient stated that after the covid-19 vaccine on Friday, he experienced acute onset of R shoulder pain, constant, associated with decreased ROM. On PM Monday, he noticed first episode of chills, that lasted a few minutes, accompanied with sweating. This episode recurred 4 times over the week, then the family started noticed the patient was unable to answer questions and was somnolent. Blood Cultures in the ED were positive for MRSA 2:2. He was positive for endocarditis (previous dental work). Acute metabolic encephalopathy due to severe sepsis most likely 2/2 MRSA bacteremia complicated by NSTEMI and AKI in setting of newly diagnosed aortic valve endocarditis complicated by septic emboli to the bilateral cerebral hemispheres"
	"1137286-1"	"1137286-1"	"MAGNETIC RESONANCE IMAGING HEAD ABNORMAL"	"10085256"	"50-59 years"	"50-59"	"Brought in from ED, family concerned for altered mental status, hyperthermia, Tmax in 105.  The patient stated that after the covid-19 vaccine on Friday, he experienced acute onset of R shoulder pain, constant, associated with decreased ROM. On PM Monday, he noticed first episode of chills, that lasted a few minutes, accompanied with sweating. This episode recurred 4 times over the week, then the family started noticed the patient was unable to answer questions and was somnolent. Blood Cultures in the ED were positive for MRSA 2:2. He was positive for endocarditis (previous dental work). Acute metabolic encephalopathy due to severe sepsis most likely 2/2 MRSA bacteremia complicated by NSTEMI and AKI in setting of newly diagnosed aortic valve endocarditis complicated by septic emboli to the bilateral cerebral hemispheres"
	"1137286-1"	"1137286-1"	"MEAN PLATELET VOLUME INCREASED"	"10055052"	"50-59 years"	"50-59"	"Brought in from ED, family concerned for altered mental status, hyperthermia, Tmax in 105.  The patient stated that after the covid-19 vaccine on Friday, he experienced acute onset of R shoulder pain, constant, associated with decreased ROM. On PM Monday, he noticed first episode of chills, that lasted a few minutes, accompanied with sweating. This episode recurred 4 times over the week, then the family started noticed the patient was unable to answer questions and was somnolent. Blood Cultures in the ED were positive for MRSA 2:2. He was positive for endocarditis (previous dental work). Acute metabolic encephalopathy due to severe sepsis most likely 2/2 MRSA bacteremia complicated by NSTEMI and AKI in setting of newly diagnosed aortic valve endocarditis complicated by septic emboli to the bilateral cerebral hemispheres"
	"1137286-1"	"1137286-1"	"MENTAL STATUS CHANGES"	"10048294"	"50-59 years"	"50-59"	"Brought in from ED, family concerned for altered mental status, hyperthermia, Tmax in 105.  The patient stated that after the covid-19 vaccine on Friday, he experienced acute onset of R shoulder pain, constant, associated with decreased ROM. On PM Monday, he noticed first episode of chills, that lasted a few minutes, accompanied with sweating. This episode recurred 4 times over the week, then the family started noticed the patient was unable to answer questions and was somnolent. Blood Cultures in the ED were positive for MRSA 2:2. He was positive for endocarditis (previous dental work). Acute metabolic encephalopathy due to severe sepsis most likely 2/2 MRSA bacteremia complicated by NSTEMI and AKI in setting of newly diagnosed aortic valve endocarditis complicated by septic emboli to the bilateral cerebral hemispheres"
	"1137286-1"	"1137286-1"	"MOBILITY DECREASED"	"10048334"	"50-59 years"	"50-59"	"Brought in from ED, family concerned for altered mental status, hyperthermia, Tmax in 105.  The patient stated that after the covid-19 vaccine on Friday, he experienced acute onset of R shoulder pain, constant, associated with decreased ROM. On PM Monday, he noticed first episode of chills, that lasted a few minutes, accompanied with sweating. This episode recurred 4 times over the week, then the family started noticed the patient was unable to answer questions and was somnolent. Blood Cultures in the ED were positive for MRSA 2:2. He was positive for endocarditis (previous dental work). Acute metabolic encephalopathy due to severe sepsis most likely 2/2 MRSA bacteremia complicated by NSTEMI and AKI in setting of newly diagnosed aortic valve endocarditis complicated by septic emboli to the bilateral cerebral hemispheres"
	"1137286-1"	"1137286-1"	"MYALGIA"	"10028411"	"50-59 years"	"50-59"	"Brought in from ED, family concerned for altered mental status, hyperthermia, Tmax in 105.  The patient stated that after the covid-19 vaccine on Friday, he experienced acute onset of R shoulder pain, constant, associated with decreased ROM. On PM Monday, he noticed first episode of chills, that lasted a few minutes, accompanied with sweating. This episode recurred 4 times over the week, then the family started noticed the patient was unable to answer questions and was somnolent. Blood Cultures in the ED were positive for MRSA 2:2. He was positive for endocarditis (previous dental work). Acute metabolic encephalopathy due to severe sepsis most likely 2/2 MRSA bacteremia complicated by NSTEMI and AKI in setting of newly diagnosed aortic valve endocarditis complicated by septic emboli to the bilateral cerebral hemispheres"
	"1137286-1"	"1137286-1"	"NEUTROPHIL COUNT INCREASED"	"10029368"	"50-59 years"	"50-59"	"Brought in from ED, family concerned for altered mental status, hyperthermia, Tmax in 105.  The patient stated that after the covid-19 vaccine on Friday, he experienced acute onset of R shoulder pain, constant, associated with decreased ROM. On PM Monday, he noticed first episode of chills, that lasted a few minutes, accompanied with sweating. This episode recurred 4 times over the week, then the family started noticed the patient was unable to answer questions and was somnolent. Blood Cultures in the ED were positive for MRSA 2:2. He was positive for endocarditis (previous dental work). Acute metabolic encephalopathy due to severe sepsis most likely 2/2 MRSA bacteremia complicated by NSTEMI and AKI in setting of newly diagnosed aortic valve endocarditis complicated by septic emboli to the bilateral cerebral hemispheres"
	"1137286-1"	"1137286-1"	"PLATELET COUNT DECREASED"	"10035528"	"50-59 years"	"50-59"	"Brought in from ED, family concerned for altered mental status, hyperthermia, Tmax in 105.  The patient stated that after the covid-19 vaccine on Friday, he experienced acute onset of R shoulder pain, constant, associated with decreased ROM. On PM Monday, he noticed first episode of chills, that lasted a few minutes, accompanied with sweating. This episode recurred 4 times over the week, then the family started noticed the patient was unable to answer questions and was somnolent. Blood Cultures in the ED were positive for MRSA 2:2. He was positive for endocarditis (previous dental work). Acute metabolic encephalopathy due to severe sepsis most likely 2/2 MRSA bacteremia complicated by NSTEMI and AKI in setting of newly diagnosed aortic valve endocarditis complicated by septic emboli to the bilateral cerebral hemispheres"
	"1137286-1"	"1137286-1"	"PLATELET MORPHOLOGY ABNORMAL"	"10035538"	"50-59 years"	"50-59"	"Brought in from ED, family concerned for altered mental status, hyperthermia, Tmax in 105.  The patient stated that after the covid-19 vaccine on Friday, he experienced acute onset of R shoulder pain, constant, associated with decreased ROM. On PM Monday, he noticed first episode of chills, that lasted a few minutes, accompanied with sweating. This episode recurred 4 times over the week, then the family started noticed the patient was unable to answer questions and was somnolent. Blood Cultures in the ED were positive for MRSA 2:2. He was positive for endocarditis (previous dental work). Acute metabolic encephalopathy due to severe sepsis most likely 2/2 MRSA bacteremia complicated by NSTEMI and AKI in setting of newly diagnosed aortic valve endocarditis complicated by septic emboli to the bilateral cerebral hemispheres"
	"1137286-1"	"1137286-1"	"PSEUDOHYPONATRAEMIA"	"10072126"	"50-59 years"	"50-59"	"Brought in from ED, family concerned for altered mental status, hyperthermia, Tmax in 105.  The patient stated that after the covid-19 vaccine on Friday, he experienced acute onset of R shoulder pain, constant, associated with decreased ROM. On PM Monday, he noticed first episode of chills, that lasted a few minutes, accompanied with sweating. This episode recurred 4 times over the week, then the family started noticed the patient was unable to answer questions and was somnolent. Blood Cultures in the ED were positive for MRSA 2:2. He was positive for endocarditis (previous dental work). Acute metabolic encephalopathy due to severe sepsis most likely 2/2 MRSA bacteremia complicated by NSTEMI and AKI in setting of newly diagnosed aortic valve endocarditis complicated by septic emboli to the bilateral cerebral hemispheres"
	"1137286-1"	"1137286-1"	"PYREXIA"	"10037660"	"50-59 years"	"50-59"	"Brought in from ED, family concerned for altered mental status, hyperthermia, Tmax in 105.  The patient stated that after the covid-19 vaccine on Friday, he experienced acute onset of R shoulder pain, constant, associated with decreased ROM. On PM Monday, he noticed first episode of chills, that lasted a few minutes, accompanied with sweating. This episode recurred 4 times over the week, then the family started noticed the patient was unable to answer questions and was somnolent. Blood Cultures in the ED were positive for MRSA 2:2. He was positive for endocarditis (previous dental work). Acute metabolic encephalopathy due to severe sepsis most likely 2/2 MRSA bacteremia complicated by NSTEMI and AKI in setting of newly diagnosed aortic valve endocarditis complicated by septic emboli to the bilateral cerebral hemispheres"
	"1137286-1"	"1137286-1"	"RED BLOOD CELL COUNT DECREASED"	"10038153"	"50-59 years"	"50-59"	"Brought in from ED, family concerned for altered mental status, hyperthermia, Tmax in 105.  The patient stated that after the covid-19 vaccine on Friday, he experienced acute onset of R shoulder pain, constant, associated with decreased ROM. On PM Monday, he noticed first episode of chills, that lasted a few minutes, accompanied with sweating. This episode recurred 4 times over the week, then the family started noticed the patient was unable to answer questions and was somnolent. Blood Cultures in the ED were positive for MRSA 2:2. He was positive for endocarditis (previous dental work). Acute metabolic encephalopathy due to severe sepsis most likely 2/2 MRSA bacteremia complicated by NSTEMI and AKI in setting of newly diagnosed aortic valve endocarditis complicated by septic emboli to the bilateral cerebral hemispheres"
	"1137286-1"	"1137286-1"	"RED BLOOD CELL SEDIMENTATION RATE INCREASED"	"10049187"	"50-59 years"	"50-59"	"Brought in from ED, family concerned for altered mental status, hyperthermia, Tmax in 105.  The patient stated that after the covid-19 vaccine on Friday, he experienced acute onset of R shoulder pain, constant, associated with decreased ROM. On PM Monday, he noticed first episode of chills, that lasted a few minutes, accompanied with sweating. This episode recurred 4 times over the week, then the family started noticed the patient was unable to answer questions and was somnolent. Blood Cultures in the ED were positive for MRSA 2:2. He was positive for endocarditis (previous dental work). Acute metabolic encephalopathy due to severe sepsis most likely 2/2 MRSA bacteremia complicated by NSTEMI and AKI in setting of newly diagnosed aortic valve endocarditis complicated by septic emboli to the bilateral cerebral hemispheres"
	"1137286-1"	"1137286-1"	"RESPIRATORY RATE INCREASED"	"10038712"	"50-59 years"	"50-59"	"Brought in from ED, family concerned for altered mental status, hyperthermia, Tmax in 105.  The patient stated that after the covid-19 vaccine on Friday, he experienced acute onset of R shoulder pain, constant, associated with decreased ROM. On PM Monday, he noticed first episode of chills, that lasted a few minutes, accompanied with sweating. This episode recurred 4 times over the week, then the family started noticed the patient was unable to answer questions and was somnolent. Blood Cultures in the ED were positive for MRSA 2:2. He was positive for endocarditis (previous dental work). Acute metabolic encephalopathy due to severe sepsis most likely 2/2 MRSA bacteremia complicated by NSTEMI and AKI in setting of newly diagnosed aortic valve endocarditis complicated by septic emboli to the bilateral cerebral hemispheres"
	"1137286-1"	"1137286-1"	"SEPSIS"	"10040047"	"50-59 years"	"50-59"	"Brought in from ED, family concerned for altered mental status, hyperthermia, Tmax in 105.  The patient stated that after the covid-19 vaccine on Friday, he experienced acute onset of R shoulder pain, constant, associated with decreased ROM. On PM Monday, he noticed first episode of chills, that lasted a few minutes, accompanied with sweating. This episode recurred 4 times over the week, then the family started noticed the patient was unable to answer questions and was somnolent. Blood Cultures in the ED were positive for MRSA 2:2. He was positive for endocarditis (previous dental work). Acute metabolic encephalopathy due to severe sepsis most likely 2/2 MRSA bacteremia complicated by NSTEMI and AKI in setting of newly diagnosed aortic valve endocarditis complicated by septic emboli to the bilateral cerebral hemispheres"
	"1137286-1"	"1137286-1"	"SEPTIC EMBOLUS"	"10040067"	"50-59 years"	"50-59"	"Brought in from ED, family concerned for altered mental status, hyperthermia, Tmax in 105.  The patient stated that after the covid-19 vaccine on Friday, he experienced acute onset of R shoulder pain, constant, associated with decreased ROM. On PM Monday, he noticed first episode of chills, that lasted a few minutes, accompanied with sweating. This episode recurred 4 times over the week, then the family started noticed the patient was unable to answer questions and was somnolent. Blood Cultures in the ED were positive for MRSA 2:2. He was positive for endocarditis (previous dental work). Acute metabolic encephalopathy due to severe sepsis most likely 2/2 MRSA bacteremia complicated by NSTEMI and AKI in setting of newly diagnosed aortic valve endocarditis complicated by septic emboli to the bilateral cerebral hemispheres"
	"1137286-1"	"1137286-1"	"SOMNOLENCE"	"10041349"	"50-59 years"	"50-59"	"Brought in from ED, family concerned for altered mental status, hyperthermia, Tmax in 105.  The patient stated that after the covid-19 vaccine on Friday, he experienced acute onset of R shoulder pain, constant, associated with decreased ROM. On PM Monday, he noticed first episode of chills, that lasted a few minutes, accompanied with sweating. This episode recurred 4 times over the week, then the family started noticed the patient was unable to answer questions and was somnolent. Blood Cultures in the ED were positive for MRSA 2:2. He was positive for endocarditis (previous dental work). Acute metabolic encephalopathy due to severe sepsis most likely 2/2 MRSA bacteremia complicated by NSTEMI and AKI in setting of newly diagnosed aortic valve endocarditis complicated by septic emboli to the bilateral cerebral hemispheres"
	"1137286-1"	"1137286-1"	"STAPHYLOCOCCAL INFECTION"	"10058080"	"50-59 years"	"50-59"	"Brought in from ED, family concerned for altered mental status, hyperthermia, Tmax in 105.  The patient stated that after the covid-19 vaccine on Friday, he experienced acute onset of R shoulder pain, constant, associated with decreased ROM. On PM Monday, he noticed first episode of chills, that lasted a few minutes, accompanied with sweating. This episode recurred 4 times over the week, then the family started noticed the patient was unable to answer questions and was somnolent. Blood Cultures in the ED were positive for MRSA 2:2. He was positive for endocarditis (previous dental work). Acute metabolic encephalopathy due to severe sepsis most likely 2/2 MRSA bacteremia complicated by NSTEMI and AKI in setting of newly diagnosed aortic valve endocarditis complicated by septic emboli to the bilateral cerebral hemispheres"
	"1137286-1"	"1137286-1"	"TACHYCARDIA"	"10043071"	"50-59 years"	"50-59"	"Brought in from ED, family concerned for altered mental status, hyperthermia, Tmax in 105.  The patient stated that after the covid-19 vaccine on Friday, he experienced acute onset of R shoulder pain, constant, associated with decreased ROM. On PM Monday, he noticed first episode of chills, that lasted a few minutes, accompanied with sweating. This episode recurred 4 times over the week, then the family started noticed the patient was unable to answer questions and was somnolent. Blood Cultures in the ED were positive for MRSA 2:2. He was positive for endocarditis (previous dental work). Acute metabolic encephalopathy due to severe sepsis most likely 2/2 MRSA bacteremia complicated by NSTEMI and AKI in setting of newly diagnosed aortic valve endocarditis complicated by septic emboli to the bilateral cerebral hemispheres"
	"1137286-1"	"1137286-1"	"TOXIC ENCEPHALOPATHY"	"10044221"	"50-59 years"	"50-59"	"Brought in from ED, family concerned for altered mental status, hyperthermia, Tmax in 105.  The patient stated that after the covid-19 vaccine on Friday, he experienced acute onset of R shoulder pain, constant, associated with decreased ROM. On PM Monday, he noticed first episode of chills, that lasted a few minutes, accompanied with sweating. This episode recurred 4 times over the week, then the family started noticed the patient was unable to answer questions and was somnolent. Blood Cultures in the ED were positive for MRSA 2:2. He was positive for endocarditis (previous dental work). Acute metabolic encephalopathy due to severe sepsis most likely 2/2 MRSA bacteremia complicated by NSTEMI and AKI in setting of newly diagnosed aortic valve endocarditis complicated by septic emboli to the bilateral cerebral hemispheres"
	"1137286-1"	"1137286-1"	"TOXICOLOGIC TEST ABNORMAL"	"10061382"	"50-59 years"	"50-59"	"Brought in from ED, family concerned for altered mental status, hyperthermia, Tmax in 105.  The patient stated that after the covid-19 vaccine on Friday, he experienced acute onset of R shoulder pain, constant, associated with decreased ROM. On PM Monday, he noticed first episode of chills, that lasted a few minutes, accompanied with sweating. This episode recurred 4 times over the week, then the family started noticed the patient was unable to answer questions and was somnolent. Blood Cultures in the ED were positive for MRSA 2:2. He was positive for endocarditis (previous dental work). Acute metabolic encephalopathy due to severe sepsis most likely 2/2 MRSA bacteremia complicated by NSTEMI and AKI in setting of newly diagnosed aortic valve endocarditis complicated by septic emboli to the bilateral cerebral hemispheres"
	"1137286-1"	"1137286-1"	"WHITE BLOOD CELL COUNT NORMAL"	"10047944"	"50-59 years"	"50-59"	"Brought in from ED, family concerned for altered mental status, hyperthermia, Tmax in 105.  The patient stated that after the covid-19 vaccine on Friday, he experienced acute onset of R shoulder pain, constant, associated with decreased ROM. On PM Monday, he noticed first episode of chills, that lasted a few minutes, accompanied with sweating. This episode recurred 4 times over the week, then the family started noticed the patient was unable to answer questions and was somnolent. Blood Cultures in the ED were positive for MRSA 2:2. He was positive for endocarditis (previous dental work). Acute metabolic encephalopathy due to severe sepsis most likely 2/2 MRSA bacteremia complicated by NSTEMI and AKI in setting of newly diagnosed aortic valve endocarditis complicated by septic emboli to the bilateral cerebral hemispheres"
	"1138309-1"	"1138309-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Death - unattended"
	"1138370-1"	"1138370-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"he started feeling sick day after vaccine with flu like symptoms, seen in ED 5 days after vaccination, diagnosed with COVID19,  About 1 week after that, he was found dead at home on his couch."
	"1138370-1"	"1138370-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"he started feeling sick day after vaccine with flu like symptoms, seen in ED 5 days after vaccination, diagnosed with COVID19,  About 1 week after that, he was found dead at home on his couch."
	"1138370-1"	"1138370-1"	"INFLUENZA LIKE ILLNESS"	"10022004"	"50-59 years"	"50-59"	"he started feeling sick day after vaccine with flu like symptoms, seen in ED 5 days after vaccination, diagnosed with COVID19,  About 1 week after that, he was found dead at home on his couch."
	"1138370-1"	"1138370-1"	"MALAISE"	"10025482"	"50-59 years"	"50-59"	"he started feeling sick day after vaccine with flu like symptoms, seen in ED 5 days after vaccination, diagnosed with COVID19,  About 1 week after that, he was found dead at home on his couch."
	"1138695-1"	"1138695-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"expiration"
	"1141968-1"	"1141968-1"	"MYOCARDIAL INFARCTION"	"10028596"	"50-59 years"	"50-59"	"My husband died of a sudden massive heart attack.  He was one of two teachers who died after the moderna vaccine, second dose.  A third teacher had a stroke."
	"1141968-1"	"1141968-1"	"SUDDEN DEATH"	"10042434"	"50-59 years"	"50-59"	"My husband died of a sudden massive heart attack.  He was one of two teachers who died after the moderna vaccine, second dose.  A third teacher had a stroke."
	"1142969-1"	"1142969-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Thrombocytopenia (CMS/HCC) Prostate cancer (CMS/HCC) Pain VOMITING DEATH"
	"1142969-1"	"1142969-1"	"PAIN"	"10033371"	"50-59 years"	"50-59"	"Thrombocytopenia (CMS/HCC) Prostate cancer (CMS/HCC) Pain VOMITING DEATH"
	"1142969-1"	"1142969-1"	"PROSTATE CANCER"	"10060862"	"50-59 years"	"50-59"	"Thrombocytopenia (CMS/HCC) Prostate cancer (CMS/HCC) Pain VOMITING DEATH"
	"1142969-1"	"1142969-1"	"THROMBOCYTOPENIA"	"10043554"	"50-59 years"	"50-59"	"Thrombocytopenia (CMS/HCC) Prostate cancer (CMS/HCC) Pain VOMITING DEATH"
	"1142969-1"	"1142969-1"	"VOMITING"	"10047700"	"50-59 years"	"50-59"	"Thrombocytopenia (CMS/HCC) Prostate cancer (CMS/HCC) Pain VOMITING DEATH"
	"1143895-1"	"1143895-1"	"COMPUTERISED TOMOGRAM ABNORMAL"	"10010235"	"50-59 years"	"50-59"	"13th of January received first Moderna shot. 18-19th began to have headaches 22nd headaches worsened 25th at the doctor's (tested negative nose swab) home till 28th (28th tested positive for corona after having her first shot at Advent) stroke symptoms at school 28th Advent did CT scan MRI venous thrombosis diagnosis, from front to back, hemorrage in the northern hemisphere 29th blood thinner administered to attempt to drain clot, seizures 31st passed away"
	"1143895-1"	"1143895-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"13th of January received first Moderna shot. 18-19th began to have headaches 22nd headaches worsened 25th at the doctor's (tested negative nose swab) home till 28th (28th tested positive for corona after having her first shot at Advent) stroke symptoms at school 28th Advent did CT scan MRI venous thrombosis diagnosis, from front to back, hemorrage in the northern hemisphere 29th blood thinner administered to attempt to drain clot, seizures 31st passed away"
	"1143895-1"	"1143895-1"	"HEADACHE"	"10019211"	"50-59 years"	"50-59"	"13th of January received first Moderna shot. 18-19th began to have headaches 22nd headaches worsened 25th at the doctor's (tested negative nose swab) home till 28th (28th tested positive for corona after having her first shot at Advent) stroke symptoms at school 28th Advent did CT scan MRI venous thrombosis diagnosis, from front to back, hemorrage in the northern hemisphere 29th blood thinner administered to attempt to drain clot, seizures 31st passed away"
	"1143895-1"	"1143895-1"	"MAGNETIC RESONANCE IMAGING ABNORMAL"	"10078224"	"50-59 years"	"50-59"	"13th of January received first Moderna shot. 18-19th began to have headaches 22nd headaches worsened 25th at the doctor's (tested negative nose swab) home till 28th (28th tested positive for corona after having her first shot at Advent) stroke symptoms at school 28th Advent did CT scan MRI venous thrombosis diagnosis, from front to back, hemorrage in the northern hemisphere 29th blood thinner administered to attempt to drain clot, seizures 31st passed away"
	"1143895-1"	"1143895-1"	"NEUROLOGICAL SYMPTOM"	"10060860"	"50-59 years"	"50-59"	"13th of January received first Moderna shot. 18-19th began to have headaches 22nd headaches worsened 25th at the doctor's (tested negative nose swab) home till 28th (28th tested positive for corona after having her first shot at Advent) stroke symptoms at school 28th Advent did CT scan MRI venous thrombosis diagnosis, from front to back, hemorrage in the northern hemisphere 29th blood thinner administered to attempt to drain clot, seizures 31st passed away"
	"1143895-1"	"1143895-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"13th of January received first Moderna shot. 18-19th began to have headaches 22nd headaches worsened 25th at the doctor's (tested negative nose swab) home till 28th (28th tested positive for corona after having her first shot at Advent) stroke symptoms at school 28th Advent did CT scan MRI venous thrombosis diagnosis, from front to back, hemorrage in the northern hemisphere 29th blood thinner administered to attempt to drain clot, seizures 31st passed away"
	"1143895-1"	"1143895-1"	"SEIZURE"	"10039906"	"50-59 years"	"50-59"	"13th of January received first Moderna shot. 18-19th began to have headaches 22nd headaches worsened 25th at the doctor's (tested negative nose swab) home till 28th (28th tested positive for corona after having her first shot at Advent) stroke symptoms at school 28th Advent did CT scan MRI venous thrombosis diagnosis, from front to back, hemorrage in the northern hemisphere 29th blood thinner administered to attempt to drain clot, seizures 31st passed away"
	"1143895-1"	"1143895-1"	"VENOUS THROMBOSIS"	"10047249"	"50-59 years"	"50-59"	"13th of January received first Moderna shot. 18-19th began to have headaches 22nd headaches worsened 25th at the doctor's (tested negative nose swab) home till 28th (28th tested positive for corona after having her first shot at Advent) stroke symptoms at school 28th Advent did CT scan MRI venous thrombosis diagnosis, from front to back, hemorrage in the northern hemisphere 29th blood thinner administered to attempt to drain clot, seizures 31st passed away"
	"1144355-1"	"1144355-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"no details provided, informed patient died on 3/21/21"
	"1145887-1"	"1145887-1"	"COMPUTERISED TOMOGRAM HEAD ABNORMAL"	"10072168"	"50-59 years"	"50-59"	"She received the vaccine on March 23.  On March 28 she felt unwell and early on March 29, 2021 developed severe headache and came to the Medical Center ER.  She had a large intracranial hemorrhage.  Platelet count was 4,000.  She had a normal platelet count in December 2020.  She had not received chemotherapy for her breast cancer, only radiation.  The hemorrhage rapidly expanded.  She was intubated and admitted to the ICU under my care.   Her husband opted for palliative extubation and she died soon after."
	"1145887-1"	"1145887-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"She received the vaccine on March 23.  On March 28 she felt unwell and early on March 29, 2021 developed severe headache and came to the Medical Center ER.  She had a large intracranial hemorrhage.  Platelet count was 4,000.  She had a normal platelet count in December 2020.  She had not received chemotherapy for her breast cancer, only radiation.  The hemorrhage rapidly expanded.  She was intubated and admitted to the ICU under my care.   Her husband opted for palliative extubation and she died soon after."
	"1145887-1"	"1145887-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"50-59 years"	"50-59"	"She received the vaccine on March 23.  On March 28 she felt unwell and early on March 29, 2021 developed severe headache and came to the Medical Center ER.  She had a large intracranial hemorrhage.  Platelet count was 4,000.  She had a normal platelet count in December 2020.  She had not received chemotherapy for her breast cancer, only radiation.  The hemorrhage rapidly expanded.  She was intubated and admitted to the ICU under my care.   Her husband opted for palliative extubation and she died soon after."
	"1145887-1"	"1145887-1"	"HAEMORRHAGE INTRACRANIAL"	"10018985"	"50-59 years"	"50-59"	"She received the vaccine on March 23.  On March 28 she felt unwell and early on March 29, 2021 developed severe headache and came to the Medical Center ER.  She had a large intracranial hemorrhage.  Platelet count was 4,000.  She had a normal platelet count in December 2020.  She had not received chemotherapy for her breast cancer, only radiation.  The hemorrhage rapidly expanded.  She was intubated and admitted to the ICU under my care.   Her husband opted for palliative extubation and she died soon after."
	"1145887-1"	"1145887-1"	"HEADACHE"	"10019211"	"50-59 years"	"50-59"	"She received the vaccine on March 23.  On March 28 she felt unwell and early on March 29, 2021 developed severe headache and came to the Medical Center ER.  She had a large intracranial hemorrhage.  Platelet count was 4,000.  She had a normal platelet count in December 2020.  She had not received chemotherapy for her breast cancer, only radiation.  The hemorrhage rapidly expanded.  She was intubated and admitted to the ICU under my care.   Her husband opted for palliative extubation and she died soon after."
	"1145887-1"	"1145887-1"	"INTENSIVE CARE"	"10022519"	"50-59 years"	"50-59"	"She received the vaccine on March 23.  On March 28 she felt unwell and early on March 29, 2021 developed severe headache and came to the Medical Center ER.  She had a large intracranial hemorrhage.  Platelet count was 4,000.  She had a normal platelet count in December 2020.  She had not received chemotherapy for her breast cancer, only radiation.  The hemorrhage rapidly expanded.  She was intubated and admitted to the ICU under my care.   Her husband opted for palliative extubation and she died soon after."
	"1145887-1"	"1145887-1"	"MALAISE"	"10025482"	"50-59 years"	"50-59"	"She received the vaccine on March 23.  On March 28 she felt unwell and early on March 29, 2021 developed severe headache and came to the Medical Center ER.  She had a large intracranial hemorrhage.  Platelet count was 4,000.  She had a normal platelet count in December 2020.  She had not received chemotherapy for her breast cancer, only radiation.  The hemorrhage rapidly expanded.  She was intubated and admitted to the ICU under my care.   Her husband opted for palliative extubation and she died soon after."
	"1145887-1"	"1145887-1"	"PLATELET COUNT DECREASED"	"10035528"	"50-59 years"	"50-59"	"She received the vaccine on March 23.  On March 28 she felt unwell and early on March 29, 2021 developed severe headache and came to the Medical Center ER.  She had a large intracranial hemorrhage.  Platelet count was 4,000.  She had a normal platelet count in December 2020.  She had not received chemotherapy for her breast cancer, only radiation.  The hemorrhage rapidly expanded.  She was intubated and admitted to the ICU under my care.   Her husband opted for palliative extubation and she died soon after."
	"1145916-1"	"1145916-1"	"BLOOD LACTIC ACID"	"10005632"	"50-59 years"	"50-59"	"Extreme rigors, fever, shortness of breath/hypoxemia within hours of receiving vaccine according to staff at the care home. leukopenia, pulmonary edema, death"
	"1145916-1"	"1145916-1"	"BLOOD PH DECREASED"	"10005706"	"50-59 years"	"50-59"	"Extreme rigors, fever, shortness of breath/hypoxemia within hours of receiving vaccine according to staff at the care home. leukopenia, pulmonary edema, death"
	"1145916-1"	"1145916-1"	"CHEST X-RAY ABNORMAL"	"10008499"	"50-59 years"	"50-59"	"Extreme rigors, fever, shortness of breath/hypoxemia within hours of receiving vaccine according to staff at the care home. leukopenia, pulmonary edema, death"
	"1145916-1"	"1145916-1"	"CHILLS"	"10008531"	"50-59 years"	"50-59"	"Extreme rigors, fever, shortness of breath/hypoxemia within hours of receiving vaccine according to staff at the care home. leukopenia, pulmonary edema, death"
	"1145916-1"	"1145916-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Extreme rigors, fever, shortness of breath/hypoxemia within hours of receiving vaccine according to staff at the care home. leukopenia, pulmonary edema, death"
	"1145916-1"	"1145916-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"Extreme rigors, fever, shortness of breath/hypoxemia within hours of receiving vaccine according to staff at the care home. leukopenia, pulmonary edema, death"
	"1145916-1"	"1145916-1"	"HYPOXIA"	"10021143"	"50-59 years"	"50-59"	"Extreme rigors, fever, shortness of breath/hypoxemia within hours of receiving vaccine according to staff at the care home. leukopenia, pulmonary edema, death"
	"1145916-1"	"1145916-1"	"LEUKOPENIA"	"10024384"	"50-59 years"	"50-59"	"Extreme rigors, fever, shortness of breath/hypoxemia within hours of receiving vaccine according to staff at the care home. leukopenia, pulmonary edema, death"
	"1145916-1"	"1145916-1"	"LUNG OPACITY"	"10081792"	"50-59 years"	"50-59"	"Extreme rigors, fever, shortness of breath/hypoxemia within hours of receiving vaccine according to staff at the care home. leukopenia, pulmonary edema, death"
	"1145916-1"	"1145916-1"	"PROCALCITONIN INCREASED"	"10067081"	"50-59 years"	"50-59"	"Extreme rigors, fever, shortness of breath/hypoxemia within hours of receiving vaccine according to staff at the care home. leukopenia, pulmonary edema, death"
	"1145916-1"	"1145916-1"	"PULMONARY OEDEMA"	"10037423"	"50-59 years"	"50-59"	"Extreme rigors, fever, shortness of breath/hypoxemia within hours of receiving vaccine according to staff at the care home. leukopenia, pulmonary edema, death"
	"1145916-1"	"1145916-1"	"PYREXIA"	"10037660"	"50-59 years"	"50-59"	"Extreme rigors, fever, shortness of breath/hypoxemia within hours of receiving vaccine according to staff at the care home. leukopenia, pulmonary edema, death"
	"1145916-1"	"1145916-1"	"WHITE BLOOD CELL COUNT DECREASED"	"10047942"	"50-59 years"	"50-59"	"Extreme rigors, fever, shortness of breath/hypoxemia within hours of receiving vaccine according to staff at the care home. leukopenia, pulmonary edema, death"
	"1147618-1"	"1147618-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"cardiac arrest"
	"1147783-1"	"1147783-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Had 2nd COVID shot died next day physician advised me to notify."
	"1148204-1"	"1148204-1"	"CORONARY ARTERY DISEASE"	"10011078"	"50-59 years"	"50-59"	"My husband died on Feb 5. 2021.  I do not know if the vaccination had any effect but he died of heart attack from Coronary Artery Disease which was unknown."
	"1148204-1"	"1148204-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"My husband died on Feb 5. 2021.  I do not know if the vaccination had any effect but he died of heart attack from Coronary Artery Disease which was unknown."
	"1148204-1"	"1148204-1"	"MYOCARDIAL INFARCTION"	"10028596"	"50-59 years"	"50-59"	"My husband died on Feb 5. 2021.  I do not know if the vaccination had any effect but he died of heart attack from Coronary Artery Disease which was unknown."
	"1149202-1"	"1149202-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"Per ED Provider Report, the patient collapsed while outside on 3/25/21. Ambulance was called to the scene where patient was found unresponsive. Patient was transferred to Hospital.  Patient was in full cardiac arrest upon arrival. CPR was initiated. Patient deceased. Patient's mother stated the patient had been feeling badly for 2-days, but refused to seek medical treatment."
	"1149202-1"	"1149202-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Per ED Provider Report, the patient collapsed while outside on 3/25/21. Ambulance was called to the scene where patient was found unresponsive. Patient was transferred to Hospital.  Patient was in full cardiac arrest upon arrival. CPR was initiated. Patient deceased. Patient's mother stated the patient had been feeling badly for 2-days, but refused to seek medical treatment."
	"1149202-1"	"1149202-1"	"FEELING ABNORMAL"	"10016322"	"50-59 years"	"50-59"	"Per ED Provider Report, the patient collapsed while outside on 3/25/21. Ambulance was called to the scene where patient was found unresponsive. Patient was transferred to Hospital.  Patient was in full cardiac arrest upon arrival. CPR was initiated. Patient deceased. Patient's mother stated the patient had been feeling badly for 2-days, but refused to seek medical treatment."
	"1149202-1"	"1149202-1"	"REFUSAL OF TREATMENT BY PATIENT"	"10056407"	"50-59 years"	"50-59"	"Per ED Provider Report, the patient collapsed while outside on 3/25/21. Ambulance was called to the scene where patient was found unresponsive. Patient was transferred to Hospital.  Patient was in full cardiac arrest upon arrival. CPR was initiated. Patient deceased. Patient's mother stated the patient had been feeling badly for 2-days, but refused to seek medical treatment."
	"1149202-1"	"1149202-1"	"RESUSCITATION"	"10038749"	"50-59 years"	"50-59"	"Per ED Provider Report, the patient collapsed while outside on 3/25/21. Ambulance was called to the scene where patient was found unresponsive. Patient was transferred to Hospital.  Patient was in full cardiac arrest upon arrival. CPR was initiated. Patient deceased. Patient's mother stated the patient had been feeling badly for 2-days, but refused to seek medical treatment."
	"1149202-1"	"1149202-1"	"SYNCOPE"	"10042772"	"50-59 years"	"50-59"	"Per ED Provider Report, the patient collapsed while outside on 3/25/21. Ambulance was called to the scene where patient was found unresponsive. Patient was transferred to Hospital.  Patient was in full cardiac arrest upon arrival. CPR was initiated. Patient deceased. Patient's mother stated the patient had been feeling badly for 2-days, but refused to seek medical treatment."
	"1149202-1"	"1149202-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"50-59 years"	"50-59"	"Per ED Provider Report, the patient collapsed while outside on 3/25/21. Ambulance was called to the scene where patient was found unresponsive. Patient was transferred to Hospital.  Patient was in full cardiac arrest upon arrival. CPR was initiated. Patient deceased. Patient's mother stated the patient had been feeling badly for 2-days, but refused to seek medical treatment."
	"1151500-1"	"1151500-1"	"RESUSCITATION"	"10038749"	"50-59 years"	"50-59"	"Found unresponsive by family member after falling asleep. Started CPR .Rescue squad arrived. Transported to Hospital. Cease resuscitation order at 1:32 am."
	"1151500-1"	"1151500-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"50-59 years"	"50-59"	"Found unresponsive by family member after falling asleep. Started CPR .Rescue squad arrived. Transported to Hospital. Cease resuscitation order at 1:32 am."
	"1155829-1"	"1155829-1"	"CARDIO-RESPIRATORY ARREST"	"10007617"	"50-59 years"	"50-59"	"Cardiopulmonary arrest and death at 0822 4/1/21"
	"1155829-1"	"1155829-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Cardiopulmonary arrest and death at 0822 4/1/21"
	"1158952-1"	"1158952-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Death of patient reported to have happened on 3/30/2021"
	"1160874-1"	"1160874-1"	"ASTHENIA"	"10003549"	"50-59 years"	"50-59"	"Patient was seen in ED on 03/12/2021.  Symptoms included fatigue and weakness, she was flown out to hospital. She passed away on 03/14/2021 in hospital."
	"1160874-1"	"1160874-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient was seen in ED on 03/12/2021.  Symptoms included fatigue and weakness, she was flown out to hospital. She passed away on 03/14/2021 in hospital."
	"1160874-1"	"1160874-1"	"ELECTROCARDIOGRAM"	"10014362"	"50-59 years"	"50-59"	"Patient was seen in ED on 03/12/2021.  Symptoms included fatigue and weakness, she was flown out to hospital. She passed away on 03/14/2021 in hospital."
	"1160874-1"	"1160874-1"	"FATIGUE"	"10016256"	"50-59 years"	"50-59"	"Patient was seen in ED on 03/12/2021.  Symptoms included fatigue and weakness, she was flown out to hospital. She passed away on 03/14/2021 in hospital."
	"1160874-1"	"1160874-1"	"LABORATORY TEST"	"10059938"	"50-59 years"	"50-59"	"Patient was seen in ED on 03/12/2021.  Symptoms included fatigue and weakness, she was flown out to hospital. She passed away on 03/14/2021 in hospital."
	"1161015-1"	"1161015-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	""Per RN at Group Home where patient worked, on 3/19/21 he called the RN with complaints of a ""low grade"" fever (99-100 degrees) but otherwise reportedly felt fine. He was advised to stay home, was offered Covid testing but refused. On 3/22/21 the RN received an email from patient's supervisor that he still felt unwell and reported vomiting and diarrhea. Was offered a Covid test but refused.  -Per patient's friend (a nurse who informed us of the case) various friends spoke with patient up until the morning of 3/25 and he reportedly had no respiratory or cardiac complaints. They were unable to reach him the evening of 3/25, nor the morning of 3/26 so sent the police for a well check and patient was found dead. He lived alone. -Per OSME. Patient did not receive an autopsy but did have an ""inspection"" which includes an external exam, toxicology and other testing including Covid testing which was positive. The specimen has been sent for sequencing. -Of note, Patient worked in a group  home that had an outbreak of Covid in Jan/early Feb. His last exposure to a + person was likely 2/8/21 but possibly 2/10/21. He had a Covid test 2/15/21 that was ""inconclusive"". The test was re-run (same assay) and was also ""inconclusive""""
	"1161015-1"	"1161015-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	""Per RN at Group Home where patient worked, on 3/19/21 he called the RN with complaints of a ""low grade"" fever (99-100 degrees) but otherwise reportedly felt fine. He was advised to stay home, was offered Covid testing but refused. On 3/22/21 the RN received an email from patient's supervisor that he still felt unwell and reported vomiting and diarrhea. Was offered a Covid test but refused.  -Per patient's friend (a nurse who informed us of the case) various friends spoke with patient up until the morning of 3/25 and he reportedly had no respiratory or cardiac complaints. They were unable to reach him the evening of 3/25, nor the morning of 3/26 so sent the police for a well check and patient was found dead. He lived alone. -Per OSME. Patient did not receive an autopsy but did have an ""inspection"" which includes an external exam, toxicology and other testing including Covid testing which was positive. The specimen has been sent for sequencing. -Of note, Patient worked in a group  home that had an outbreak of Covid in Jan/early Feb. His last exposure to a + person was likely 2/8/21 but possibly 2/10/21. He had a Covid test 2/15/21 that was ""inconclusive"". The test was re-run (same assay) and was also ""inconclusive""""
	"1161015-1"	"1161015-1"	"DIARRHOEA"	"10012735"	"50-59 years"	"50-59"	""Per RN at Group Home where patient worked, on 3/19/21 he called the RN with complaints of a ""low grade"" fever (99-100 degrees) but otherwise reportedly felt fine. He was advised to stay home, was offered Covid testing but refused. On 3/22/21 the RN received an email from patient's supervisor that he still felt unwell and reported vomiting and diarrhea. Was offered a Covid test but refused.  -Per patient's friend (a nurse who informed us of the case) various friends spoke with patient up until the morning of 3/25 and he reportedly had no respiratory or cardiac complaints. They were unable to reach him the evening of 3/25, nor the morning of 3/26 so sent the police for a well check and patient was found dead. He lived alone. -Per OSME. Patient did not receive an autopsy but did have an ""inspection"" which includes an external exam, toxicology and other testing including Covid testing which was positive. The specimen has been sent for sequencing. -Of note, Patient worked in a group  home that had an outbreak of Covid in Jan/early Feb. His last exposure to a + person was likely 2/8/21 but possibly 2/10/21. He had a Covid test 2/15/21 that was ""inconclusive"". The test was re-run (same assay) and was also ""inconclusive""""
	"1161015-1"	"1161015-1"	"MALAISE"	"10025482"	"50-59 years"	"50-59"	""Per RN at Group Home where patient worked, on 3/19/21 he called the RN with complaints of a ""low grade"" fever (99-100 degrees) but otherwise reportedly felt fine. He was advised to stay home, was offered Covid testing but refused. On 3/22/21 the RN received an email from patient's supervisor that he still felt unwell and reported vomiting and diarrhea. Was offered a Covid test but refused.  -Per patient's friend (a nurse who informed us of the case) various friends spoke with patient up until the morning of 3/25 and he reportedly had no respiratory or cardiac complaints. They were unable to reach him the evening of 3/25, nor the morning of 3/26 so sent the police for a well check and patient was found dead. He lived alone. -Per OSME. Patient did not receive an autopsy but did have an ""inspection"" which includes an external exam, toxicology and other testing including Covid testing which was positive. The specimen has been sent for sequencing. -Of note, Patient worked in a group  home that had an outbreak of Covid in Jan/early Feb. His last exposure to a + person was likely 2/8/21 but possibly 2/10/21. He had a Covid test 2/15/21 that was ""inconclusive"". The test was re-run (same assay) and was also ""inconclusive""""
	"1161015-1"	"1161015-1"	"PYREXIA"	"10037660"	"50-59 years"	"50-59"	""Per RN at Group Home where patient worked, on 3/19/21 he called the RN with complaints of a ""low grade"" fever (99-100 degrees) but otherwise reportedly felt fine. He was advised to stay home, was offered Covid testing but refused. On 3/22/21 the RN received an email from patient's supervisor that he still felt unwell and reported vomiting and diarrhea. Was offered a Covid test but refused.  -Per patient's friend (a nurse who informed us of the case) various friends spoke with patient up until the morning of 3/25 and he reportedly had no respiratory or cardiac complaints. They were unable to reach him the evening of 3/25, nor the morning of 3/26 so sent the police for a well check and patient was found dead. He lived alone. -Per OSME. Patient did not receive an autopsy but did have an ""inspection"" which includes an external exam, toxicology and other testing including Covid testing which was positive. The specimen has been sent for sequencing. -Of note, Patient worked in a group  home that had an outbreak of Covid in Jan/early Feb. His last exposure to a + person was likely 2/8/21 but possibly 2/10/21. He had a Covid test 2/15/21 that was ""inconclusive"". The test was re-run (same assay) and was also ""inconclusive""""
	"1161015-1"	"1161015-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	""Per RN at Group Home where patient worked, on 3/19/21 he called the RN with complaints of a ""low grade"" fever (99-100 degrees) but otherwise reportedly felt fine. He was advised to stay home, was offered Covid testing but refused. On 3/22/21 the RN received an email from patient's supervisor that he still felt unwell and reported vomiting and diarrhea. Was offered a Covid test but refused.  -Per patient's friend (a nurse who informed us of the case) various friends spoke with patient up until the morning of 3/25 and he reportedly had no respiratory or cardiac complaints. They were unable to reach him the evening of 3/25, nor the morning of 3/26 so sent the police for a well check and patient was found dead. He lived alone. -Per OSME. Patient did not receive an autopsy but did have an ""inspection"" which includes an external exam, toxicology and other testing including Covid testing which was positive. The specimen has been sent for sequencing. -Of note, Patient worked in a group  home that had an outbreak of Covid in Jan/early Feb. His last exposure to a + person was likely 2/8/21 but possibly 2/10/21. He had a Covid test 2/15/21 that was ""inconclusive"". The test was re-run (same assay) and was also ""inconclusive""""
	"1161015-1"	"1161015-1"	"TOXICOLOGIC TEST"	"10061384"	"50-59 years"	"50-59"	""Per RN at Group Home where patient worked, on 3/19/21 he called the RN with complaints of a ""low grade"" fever (99-100 degrees) but otherwise reportedly felt fine. He was advised to stay home, was offered Covid testing but refused. On 3/22/21 the RN received an email from patient's supervisor that he still felt unwell and reported vomiting and diarrhea. Was offered a Covid test but refused.  -Per patient's friend (a nurse who informed us of the case) various friends spoke with patient up until the morning of 3/25 and he reportedly had no respiratory or cardiac complaints. They were unable to reach him the evening of 3/25, nor the morning of 3/26 so sent the police for a well check and patient was found dead. He lived alone. -Per OSME. Patient did not receive an autopsy but did have an ""inspection"" which includes an external exam, toxicology and other testing including Covid testing which was positive. The specimen has been sent for sequencing. -Of note, Patient worked in a group  home that had an outbreak of Covid in Jan/early Feb. His last exposure to a + person was likely 2/8/21 but possibly 2/10/21. He had a Covid test 2/15/21 that was ""inconclusive"". The test was re-run (same assay) and was also ""inconclusive""""
	"1161015-1"	"1161015-1"	"VOMITING"	"10047700"	"50-59 years"	"50-59"	""Per RN at Group Home where patient worked, on 3/19/21 he called the RN with complaints of a ""low grade"" fever (99-100 degrees) but otherwise reportedly felt fine. He was advised to stay home, was offered Covid testing but refused. On 3/22/21 the RN received an email from patient's supervisor that he still felt unwell and reported vomiting and diarrhea. Was offered a Covid test but refused.  -Per patient's friend (a nurse who informed us of the case) various friends spoke with patient up until the morning of 3/25 and he reportedly had no respiratory or cardiac complaints. They were unable to reach him the evening of 3/25, nor the morning of 3/26 so sent the police for a well check and patient was found dead. He lived alone. -Per OSME. Patient did not receive an autopsy but did have an ""inspection"" which includes an external exam, toxicology and other testing including Covid testing which was positive. The specimen has been sent for sequencing. -Of note, Patient worked in a group  home that had an outbreak of Covid in Jan/early Feb. His last exposure to a + person was likely 2/8/21 but possibly 2/10/21. He had a Covid test 2/15/21 that was ""inconclusive"". The test was re-run (same assay) and was also ""inconclusive""""
	"1162930-1"	"1162930-1"	"CEREBRAL HAEMORRHAGE"	"10008111"	"50-59 years"	"50-59"	"Patient died of a cerebral hemorrhage on 3/15/2021 at 11:30 AM."
	"1162930-1"	"1162930-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient died of a cerebral hemorrhage on 3/15/2021 at 11:30 AM."
	"1163428-1"	"1163428-1"	"ASTHENIA"	"10003549"	"50-59 years"	"50-59"	"Began with weakness of March 24th and stroke- like symptoms despite a clear CT Scan and EKG. Trouble walking or staying awake. Heart stopped on March 28th. Deceased."
	"1163428-1"	"1163428-1"	"BLOOD TEST"	"10061726"	"50-59 years"	"50-59"	"Began with weakness of March 24th and stroke- like symptoms despite a clear CT Scan and EKG. Trouble walking or staying awake. Heart stopped on March 28th. Deceased."
	"1163428-1"	"1163428-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"Began with weakness of March 24th and stroke- like symptoms despite a clear CT Scan and EKG. Trouble walking or staying awake. Heart stopped on March 28th. Deceased."
	"1163428-1"	"1163428-1"	"COMPUTERISED TOMOGRAM NORMAL"	"10010236"	"50-59 years"	"50-59"	"Began with weakness of March 24th and stroke- like symptoms despite a clear CT Scan and EKG. Trouble walking or staying awake. Heart stopped on March 28th. Deceased."
	"1163428-1"	"1163428-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Began with weakness of March 24th and stroke- like symptoms despite a clear CT Scan and EKG. Trouble walking or staying awake. Heart stopped on March 28th. Deceased."
	"1163428-1"	"1163428-1"	"ELECTROCARDIOGRAM NORMAL"	"10014373"	"50-59 years"	"50-59"	"Began with weakness of March 24th and stroke- like symptoms despite a clear CT Scan and EKG. Trouble walking or staying awake. Heart stopped on March 28th. Deceased."
	"1163428-1"	"1163428-1"	"GAIT DISTURBANCE"	"10017577"	"50-59 years"	"50-59"	"Began with weakness of March 24th and stroke- like symptoms despite a clear CT Scan and EKG. Trouble walking or staying awake. Heart stopped on March 28th. Deceased."
	"1163428-1"	"1163428-1"	"NEUROLOGICAL SYMPTOM"	"10060860"	"50-59 years"	"50-59"	"Began with weakness of March 24th and stroke- like symptoms despite a clear CT Scan and EKG. Trouble walking or staying awake. Heart stopped on March 28th. Deceased."
	"1163428-1"	"1163428-1"	"SOMNOLENCE"	"10041349"	"50-59 years"	"50-59"	"Began with weakness of March 24th and stroke- like symptoms despite a clear CT Scan and EKG. Trouble walking or staying awake. Heart stopped on March 28th. Deceased."
	"1168240-1"	"1168240-1"	"COMPLETED SUICIDE"	"10010144"	"50-59 years"	"50-59"	"Patient deceased 3/23/21 due to suicide."
	"1169518-1"	"1169518-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	""This report is being submitted following a periodic review of death certificates .    Death certificate for this individual indicates ""recent COVID vaccine"" in   ""PART II. OTHER SIGNIFICANT CONDITIONS contributing to death but not resulting in the underlying cause""""
	"1169584-1"	"1169584-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient appeared in no distress the day after vaccination other than complaint of nausea. It is unclear but patient expired sometime the night of 4/3/21 or early morning of 4/4/21"
	"1169584-1"	"1169584-1"	"NAUSEA"	"10028813"	"50-59 years"	"50-59"	"Patient appeared in no distress the day after vaccination other than complaint of nausea. It is unclear but patient expired sometime the night of 4/3/21 or early morning of 4/4/21"
	"1170462-1"	"1170462-1"	"MALAISE"	"10025482"	"50-59 years"	"50-59"	""Presented with rash and malaise ""since I got my COVID shot"". Rash red raised macular t/o body""
	"1170462-1"	"1170462-1"	"RASH"	"10037844"	"50-59 years"	"50-59"	""Presented with rash and malaise ""since I got my COVID shot"". Rash red raised macular t/o body""
	"1170462-1"	"1170462-1"	"RASH ERYTHEMATOUS"	"10037855"	"50-59 years"	"50-59"	""Presented with rash and malaise ""since I got my COVID shot"". Rash red raised macular t/o body""
	"1170462-1"	"1170462-1"	"RASH MACULAR"	"10037867"	"50-59 years"	"50-59"	""Presented with rash and malaise ""since I got my COVID shot"". Rash red raised macular t/o body""
	"1170462-1"	"1170462-1"	"RASH PAPULAR"	"10037876"	"50-59 years"	"50-59"	""Presented with rash and malaise ""since I got my COVID shot"". Rash red raised macular t/o body""
	"1172767-1"	"1172767-1"	"CHEST PAIN"	"10008479"	"50-59 years"	"50-59"	"Patient presented 4/3 stating received Pfizer COVID-19 vaccine on Monday and began having sympoms about Wednesday.  Developed fever by Thursday and cough/nausea/vomiting by Friday.  Cough ongoing and feels like he should have production but is not able sputum out.  The pain is chest is described as not being able to fully expand his lungs when he tries to inhale. Patient presented 4/6-DOA"
	"1172767-1"	"1172767-1"	"COUGH"	"10011224"	"50-59 years"	"50-59"	"Patient presented 4/3 stating received Pfizer COVID-19 vaccine on Monday and began having sympoms about Wednesday.  Developed fever by Thursday and cough/nausea/vomiting by Friday.  Cough ongoing and feels like he should have production but is not able sputum out.  The pain is chest is described as not being able to fully expand his lungs when he tries to inhale. Patient presented 4/6-DOA"
	"1172767-1"	"1172767-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Patient presented 4/3 stating received Pfizer COVID-19 vaccine on Monday and began having sympoms about Wednesday.  Developed fever by Thursday and cough/nausea/vomiting by Friday.  Cough ongoing and feels like he should have production but is not able sputum out.  The pain is chest is described as not being able to fully expand his lungs when he tries to inhale. Patient presented 4/6-DOA"
	"1172767-1"	"1172767-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient presented 4/3 stating received Pfizer COVID-19 vaccine on Monday and began having sympoms about Wednesday.  Developed fever by Thursday and cough/nausea/vomiting by Friday.  Cough ongoing and feels like he should have production but is not able sputum out.  The pain is chest is described as not being able to fully expand his lungs when he tries to inhale. Patient presented 4/6-DOA"
	"1172767-1"	"1172767-1"	"NAUSEA"	"10028813"	"50-59 years"	"50-59"	"Patient presented 4/3 stating received Pfizer COVID-19 vaccine on Monday and began having sympoms about Wednesday.  Developed fever by Thursday and cough/nausea/vomiting by Friday.  Cough ongoing and feels like he should have production but is not able sputum out.  The pain is chest is described as not being able to fully expand his lungs when he tries to inhale. Patient presented 4/6-DOA"
	"1172767-1"	"1172767-1"	"PYREXIA"	"10037660"	"50-59 years"	"50-59"	"Patient presented 4/3 stating received Pfizer COVID-19 vaccine on Monday and began having sympoms about Wednesday.  Developed fever by Thursday and cough/nausea/vomiting by Friday.  Cough ongoing and feels like he should have production but is not able sputum out.  The pain is chest is described as not being able to fully expand his lungs when he tries to inhale. Patient presented 4/6-DOA"
	"1172767-1"	"1172767-1"	"RESPIRATORY SYMPTOM"	"10075535"	"50-59 years"	"50-59"	"Patient presented 4/3 stating received Pfizer COVID-19 vaccine on Monday and began having sympoms about Wednesday.  Developed fever by Thursday and cough/nausea/vomiting by Friday.  Cough ongoing and feels like he should have production but is not able sputum out.  The pain is chest is described as not being able to fully expand his lungs when he tries to inhale. Patient presented 4/6-DOA"
	"1172767-1"	"1172767-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"Patient presented 4/3 stating received Pfizer COVID-19 vaccine on Monday and began having sympoms about Wednesday.  Developed fever by Thursday and cough/nausea/vomiting by Friday.  Cough ongoing and feels like he should have production but is not able sputum out.  The pain is chest is described as not being able to fully expand his lungs when he tries to inhale. Patient presented 4/6-DOA"
	"1172767-1"	"1172767-1"	"VOMITING"	"10047700"	"50-59 years"	"50-59"	"Patient presented 4/3 stating received Pfizer COVID-19 vaccine on Monday and began having sympoms about Wednesday.  Developed fever by Thursday and cough/nausea/vomiting by Friday.  Cough ongoing and feels like he should have production but is not able sputum out.  The pain is chest is described as not being able to fully expand his lungs when he tries to inhale. Patient presented 4/6-DOA"
	"1176131-1"	"1176131-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient died."
	"1177076-1"	"1177076-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"On Saturday, April 3rd,  patient told her son she was tired and was going to take a nap.  Her son tried to wake her the next morning since she had not come out of her room from the day before.  He was unable to wake her."
	"1177076-1"	"1177076-1"	"FATIGUE"	"10016256"	"50-59 years"	"50-59"	"On Saturday, April 3rd,  patient told her son she was tired and was going to take a nap.  Her son tried to wake her the next morning since she had not come out of her room from the day before.  He was unable to wake her."
	"1177173-1"	"1177173-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Husband and wife came in 4/5 and received their COVID vaccines at 11am. They waited the 15 minutes to check for reactions and were unsymptomatic when time was up. The pharmacy did a courtesy call around 3:15 pm on 4/7 to check in with them and see how they were feeling. The wife stated that her husband had passed away the night of 4/5. Wife stated that they were getting ready to go to bed and husband felt hot and shaky so he laid in front of a fan. Wife eventually had to do CPR and stated that she thinks that he passed away during the time while they were waiting for EMS, which took about 45 minutes. Patient was pronounced dead night of 4/5.  Wife stated that patient has a history of heart problems including hypertension and multiple stents place and that she does not think the vaccine had to do with her husband's death."
	"1177173-1"	"1177173-1"	"FEELING HOT"	"10016334"	"50-59 years"	"50-59"	"Husband and wife came in 4/5 and received their COVID vaccines at 11am. They waited the 15 minutes to check for reactions and were unsymptomatic when time was up. The pharmacy did a courtesy call around 3:15 pm on 4/7 to check in with them and see how they were feeling. The wife stated that her husband had passed away the night of 4/5. Wife stated that they were getting ready to go to bed and husband felt hot and shaky so he laid in front of a fan. Wife eventually had to do CPR and stated that she thinks that he passed away during the time while they were waiting for EMS, which took about 45 minutes. Patient was pronounced dead night of 4/5.  Wife stated that patient has a history of heart problems including hypertension and multiple stents place and that she does not think the vaccine had to do with her husband's death."
	"1177173-1"	"1177173-1"	"NERVOUSNESS"	"10029216"	"50-59 years"	"50-59"	"Husband and wife came in 4/5 and received their COVID vaccines at 11am. They waited the 15 minutes to check for reactions and were unsymptomatic when time was up. The pharmacy did a courtesy call around 3:15 pm on 4/7 to check in with them and see how they were feeling. The wife stated that her husband had passed away the night of 4/5. Wife stated that they were getting ready to go to bed and husband felt hot and shaky so he laid in front of a fan. Wife eventually had to do CPR and stated that she thinks that he passed away during the time while they were waiting for EMS, which took about 45 minutes. Patient was pronounced dead night of 4/5.  Wife stated that patient has a history of heart problems including hypertension and multiple stents place and that she does not think the vaccine had to do with her husband's death."
	"1177173-1"	"1177173-1"	"RESUSCITATION"	"10038749"	"50-59 years"	"50-59"	"Husband and wife came in 4/5 and received their COVID vaccines at 11am. They waited the 15 minutes to check for reactions and were unsymptomatic when time was up. The pharmacy did a courtesy call around 3:15 pm on 4/7 to check in with them and see how they were feeling. The wife stated that her husband had passed away the night of 4/5. Wife stated that they were getting ready to go to bed and husband felt hot and shaky so he laid in front of a fan. Wife eventually had to do CPR and stated that she thinks that he passed away during the time while they were waiting for EMS, which took about 45 minutes. Patient was pronounced dead night of 4/5.  Wife stated that patient has a history of heart problems including hypertension and multiple stents place and that she does not think the vaccine had to do with her husband's death."
	"1178071-1"	"1178071-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient found expired at home about 12 hours after administration of vaccine"
	"1178537-1"	"1178537-1"	"ACUTE RESPIRATORY FAILURE"	"10001053"	"50-59 years"	"50-59"	"Pt was found deceased at home on 3/10/21. He had had a cough prior to, recent hospitalization for pneumonia/acute on chronic resp. failure."
	"1178537-1"	"1178537-1"	"COUGH"	"10011224"	"50-59 years"	"50-59"	"Pt was found deceased at home on 3/10/21. He had had a cough prior to, recent hospitalization for pneumonia/acute on chronic resp. failure."
	"1178537-1"	"1178537-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Pt was found deceased at home on 3/10/21. He had had a cough prior to, recent hospitalization for pneumonia/acute on chronic resp. failure."
	"1178537-1"	"1178537-1"	"PNEUMONIA"	"10035664"	"50-59 years"	"50-59"	"Pt was found deceased at home on 3/10/21. He had had a cough prior to, recent hospitalization for pneumonia/acute on chronic resp. failure."
	"1178571-1"	"1178571-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Pt was found deceased at home, 4/2/2021."
	"1178571-1"	"1178571-1"	"SCAN MYOCARDIAL PERFUSION NORMAL"	"10061514"	"50-59 years"	"50-59"	"Pt was found deceased at home, 4/2/2021."
	"1179444-1"	"1179444-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Systemic: Unknown, patient found deceased at home evening after receiving vaccine.-Severe, Additional Details: called pharmacy inquiring about vaccine for patient. She received her COVID vaccine on 4/6/21 and later that evening was found at home deceased. Called to gather information on the patient/vaccine. Caregiver stated that the patient did not have a PCP, therefore they do not have much medical history on her. There were no notes on adverse reaction during post-vaccine observation. It is unknown at this time if vaccine played any role."
	"1180886-1"	"1180886-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Patient contracted COVID  during an outbreak.  Patient went to the ED on 2/28  and was sent home.  Patient returned to the ED on 1/2 and was admitted.  Patient expired on 1/3"
	"1180886-1"	"1180886-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient contracted COVID  during an outbreak.  Patient went to the ED on 2/28  and was sent home.  Patient returned to the ED on 1/2 and was admitted.  Patient expired on 1/3"
	"1181925-1"	"1181925-1"	"BACK PAIN"	"10003988"	"50-59 years"	"50-59"	"Patient started complaining of extreme back pain and trouble walking within days after receiving the vaccine. His pain got increasingly worse. On the 23rd he had to be taken into the hospital in an ambulance. He said he felt as if his lower body was separated from his torso, and visible was having trouble walking. They prescribed him Valium, preformed an x-ray, and sent him home.  On the 27th he was taken back to the hospital due to leg weakness, tingling in his hands and feet, and extreme pain. He was diagnosed with Guillain-Barre Syndrome. He passed away April 6, 2021 after spending 11 days in the hospital, and 6 days on a ventilator."
	"1181925-1"	"1181925-1"	"COMPUTERISED TOMOGRAM"	"10010234"	"50-59 years"	"50-59"	"Patient started complaining of extreme back pain and trouble walking within days after receiving the vaccine. His pain got increasingly worse. On the 23rd he had to be taken into the hospital in an ambulance. He said he felt as if his lower body was separated from his torso, and visible was having trouble walking. They prescribed him Valium, preformed an x-ray, and sent him home.  On the 27th he was taken back to the hospital due to leg weakness, tingling in his hands and feet, and extreme pain. He was diagnosed with Guillain-Barre Syndrome. He passed away April 6, 2021 after spending 11 days in the hospital, and 6 days on a ventilator."
	"1181925-1"	"1181925-1"	"CONDITION AGGRAVATED"	"10010264"	"50-59 years"	"50-59"	"Patient started complaining of extreme back pain and trouble walking within days after receiving the vaccine. His pain got increasingly worse. On the 23rd he had to be taken into the hospital in an ambulance. He said he felt as if his lower body was separated from his torso, and visible was having trouble walking. They prescribed him Valium, preformed an x-ray, and sent him home.  On the 27th he was taken back to the hospital due to leg weakness, tingling in his hands and feet, and extreme pain. He was diagnosed with Guillain-Barre Syndrome. He passed away April 6, 2021 after spending 11 days in the hospital, and 6 days on a ventilator."
	"1181925-1"	"1181925-1"	"CSF PROTEIN"	"10011572"	"50-59 years"	"50-59"	"Patient started complaining of extreme back pain and trouble walking within days after receiving the vaccine. His pain got increasingly worse. On the 23rd he had to be taken into the hospital in an ambulance. He said he felt as if his lower body was separated from his torso, and visible was having trouble walking. They prescribed him Valium, preformed an x-ray, and sent him home.  On the 27th he was taken back to the hospital due to leg weakness, tingling in his hands and feet, and extreme pain. He was diagnosed with Guillain-Barre Syndrome. He passed away April 6, 2021 after spending 11 days in the hospital, and 6 days on a ventilator."
	"1181925-1"	"1181925-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient started complaining of extreme back pain and trouble walking within days after receiving the vaccine. His pain got increasingly worse. On the 23rd he had to be taken into the hospital in an ambulance. He said he felt as if his lower body was separated from his torso, and visible was having trouble walking. They prescribed him Valium, preformed an x-ray, and sent him home.  On the 27th he was taken back to the hospital due to leg weakness, tingling in his hands and feet, and extreme pain. He was diagnosed with Guillain-Barre Syndrome. He passed away April 6, 2021 after spending 11 days in the hospital, and 6 days on a ventilator."
	"1181925-1"	"1181925-1"	"GAIT DISTURBANCE"	"10017577"	"50-59 years"	"50-59"	"Patient started complaining of extreme back pain and trouble walking within days after receiving the vaccine. His pain got increasingly worse. On the 23rd he had to be taken into the hospital in an ambulance. He said he felt as if his lower body was separated from his torso, and visible was having trouble walking. They prescribed him Valium, preformed an x-ray, and sent him home.  On the 27th he was taken back to the hospital due to leg weakness, tingling in his hands and feet, and extreme pain. He was diagnosed with Guillain-Barre Syndrome. He passed away April 6, 2021 after spending 11 days in the hospital, and 6 days on a ventilator."
	"1181925-1"	"1181925-1"	"GUILLAIN-BARRE SYNDROME"	"10018767"	"50-59 years"	"50-59"	"Patient started complaining of extreme back pain and trouble walking within days after receiving the vaccine. His pain got increasingly worse. On the 23rd he had to be taken into the hospital in an ambulance. He said he felt as if his lower body was separated from his torso, and visible was having trouble walking. They prescribed him Valium, preformed an x-ray, and sent him home.  On the 27th he was taken back to the hospital due to leg weakness, tingling in his hands and feet, and extreme pain. He was diagnosed with Guillain-Barre Syndrome. He passed away April 6, 2021 after spending 11 days in the hospital, and 6 days on a ventilator."
	"1181925-1"	"1181925-1"	"IMMUNOGLOBULIN THERAPY"	"10069534"	"50-59 years"	"50-59"	"Patient started complaining of extreme back pain and trouble walking within days after receiving the vaccine. His pain got increasingly worse. On the 23rd he had to be taken into the hospital in an ambulance. He said he felt as if his lower body was separated from his torso, and visible was having trouble walking. They prescribed him Valium, preformed an x-ray, and sent him home.  On the 27th he was taken back to the hospital due to leg weakness, tingling in his hands and feet, and extreme pain. He was diagnosed with Guillain-Barre Syndrome. He passed away April 6, 2021 after spending 11 days in the hospital, and 6 days on a ventilator."
	"1181925-1"	"1181925-1"	"MAGNETIC RESONANCE IMAGING"	"10078223"	"50-59 years"	"50-59"	"Patient started complaining of extreme back pain and trouble walking within days after receiving the vaccine. His pain got increasingly worse. On the 23rd he had to be taken into the hospital in an ambulance. He said he felt as if his lower body was separated from his torso, and visible was having trouble walking. They prescribed him Valium, preformed an x-ray, and sent him home.  On the 27th he was taken back to the hospital due to leg weakness, tingling in his hands and feet, and extreme pain. He was diagnosed with Guillain-Barre Syndrome. He passed away April 6, 2021 after spending 11 days in the hospital, and 6 days on a ventilator."
	"1181925-1"	"1181925-1"	"MECHANICAL VENTILATION"	"10067221"	"50-59 years"	"50-59"	"Patient started complaining of extreme back pain and trouble walking within days after receiving the vaccine. His pain got increasingly worse. On the 23rd he had to be taken into the hospital in an ambulance. He said he felt as if his lower body was separated from his torso, and visible was having trouble walking. They prescribed him Valium, preformed an x-ray, and sent him home.  On the 27th he was taken back to the hospital due to leg weakness, tingling in his hands and feet, and extreme pain. He was diagnosed with Guillain-Barre Syndrome. He passed away April 6, 2021 after spending 11 days in the hospital, and 6 days on a ventilator."
	"1181925-1"	"1181925-1"	"MUSCULAR WEAKNESS"	"10028372"	"50-59 years"	"50-59"	"Patient started complaining of extreme back pain and trouble walking within days after receiving the vaccine. His pain got increasingly worse. On the 23rd he had to be taken into the hospital in an ambulance. He said he felt as if his lower body was separated from his torso, and visible was having trouble walking. They prescribed him Valium, preformed an x-ray, and sent him home.  On the 27th he was taken back to the hospital due to leg weakness, tingling in his hands and feet, and extreme pain. He was diagnosed with Guillain-Barre Syndrome. He passed away April 6, 2021 after spending 11 days in the hospital, and 6 days on a ventilator."
	"1181925-1"	"1181925-1"	"PAIN"	"10033371"	"50-59 years"	"50-59"	"Patient started complaining of extreme back pain and trouble walking within days after receiving the vaccine. His pain got increasingly worse. On the 23rd he had to be taken into the hospital in an ambulance. He said he felt as if his lower body was separated from his torso, and visible was having trouble walking. They prescribed him Valium, preformed an x-ray, and sent him home.  On the 27th he was taken back to the hospital due to leg weakness, tingling in his hands and feet, and extreme pain. He was diagnosed with Guillain-Barre Syndrome. He passed away April 6, 2021 after spending 11 days in the hospital, and 6 days on a ventilator."
	"1181925-1"	"1181925-1"	"PARAESTHESIA"	"10033775"	"50-59 years"	"50-59"	"Patient started complaining of extreme back pain and trouble walking within days after receiving the vaccine. His pain got increasingly worse. On the 23rd he had to be taken into the hospital in an ambulance. He said he felt as if his lower body was separated from his torso, and visible was having trouble walking. They prescribed him Valium, preformed an x-ray, and sent him home.  On the 27th he was taken back to the hospital due to leg weakness, tingling in his hands and feet, and extreme pain. He was diagnosed with Guillain-Barre Syndrome. He passed away April 6, 2021 after spending 11 days in the hospital, and 6 days on a ventilator."
	"1181925-1"	"1181925-1"	"X-RAY"	"10048064"	"50-59 years"	"50-59"	"Patient started complaining of extreme back pain and trouble walking within days after receiving the vaccine. His pain got increasingly worse. On the 23rd he had to be taken into the hospital in an ambulance. He said he felt as if his lower body was separated from his torso, and visible was having trouble walking. They prescribed him Valium, preformed an x-ray, and sent him home.  On the 27th he was taken back to the hospital due to leg weakness, tingling in his hands and feet, and extreme pain. He was diagnosed with Guillain-Barre Syndrome. He passed away April 6, 2021 after spending 11 days in the hospital, and 6 days on a ventilator."
	"1186943-1"	"1186943-1"	"ARTERIOGRAM CAROTID ABNORMAL"	"10003195"	"50-59 years"	"50-59"	"55-year-old male with no diagnosed past medical history presents emergency department after cardiac arrest.  Per patient's daughter, patient was feeling at baseline today.  He got his COVID vaccine at 5 PM this evening.  He was running some errands and called his daughter at 8:40 PM.  He told his daughter he was not feeling well.  She reports he sounded out of breath and sounded as if he was slurring his words.  Daughter told him to pull over and she called 911.  She met him on the side of the road and he was gasping for air.  She arrived at the same time as EMS.  Upon arrival of EMS patient was in ventricular fibrillation.  He was defibrillated 3 times.  He also had one episode of ventricular tachycardia.  He was given 300 mg of amiodarone and 3 rounds of epinephrine with had return of spontaneous circulation.  King airway was placed and patient was brought to the emergency department."
	"1186943-1"	"1186943-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"55-year-old male with no diagnosed past medical history presents emergency department after cardiac arrest.  Per patient's daughter, patient was feeling at baseline today.  He got his COVID vaccine at 5 PM this evening.  He was running some errands and called his daughter at 8:40 PM.  He told his daughter he was not feeling well.  She reports he sounded out of breath and sounded as if he was slurring his words.  Daughter told him to pull over and she called 911.  She met him on the side of the road and he was gasping for air.  She arrived at the same time as EMS.  Upon arrival of EMS patient was in ventricular fibrillation.  He was defibrillated 3 times.  He also had one episode of ventricular tachycardia.  He was given 300 mg of amiodarone and 3 rounds of epinephrine with had return of spontaneous circulation.  King airway was placed and patient was brought to the emergency department."
	"1186943-1"	"1186943-1"	"CARDIOVERSION"	"10007661"	"50-59 years"	"50-59"	"55-year-old male with no diagnosed past medical history presents emergency department after cardiac arrest.  Per patient's daughter, patient was feeling at baseline today.  He got his COVID vaccine at 5 PM this evening.  He was running some errands and called his daughter at 8:40 PM.  He told his daughter he was not feeling well.  She reports he sounded out of breath and sounded as if he was slurring his words.  Daughter told him to pull over and she called 911.  She met him on the side of the road and he was gasping for air.  She arrived at the same time as EMS.  Upon arrival of EMS patient was in ventricular fibrillation.  He was defibrillated 3 times.  He also had one episode of ventricular tachycardia.  He was given 300 mg of amiodarone and 3 rounds of epinephrine with had return of spontaneous circulation.  King airway was placed and patient was brought to the emergency department."
	"1186943-1"	"1186943-1"	"CEREBROVASCULAR ACCIDENT"	"10008190"	"50-59 years"	"50-59"	"55-year-old male with no diagnosed past medical history presents emergency department after cardiac arrest.  Per patient's daughter, patient was feeling at baseline today.  He got his COVID vaccine at 5 PM this evening.  He was running some errands and called his daughter at 8:40 PM.  He told his daughter he was not feeling well.  She reports he sounded out of breath and sounded as if he was slurring his words.  Daughter told him to pull over and she called 911.  She met him on the side of the road and he was gasping for air.  She arrived at the same time as EMS.  Upon arrival of EMS patient was in ventricular fibrillation.  He was defibrillated 3 times.  He also had one episode of ventricular tachycardia.  He was given 300 mg of amiodarone and 3 rounds of epinephrine with had return of spontaneous circulation.  King airway was placed and patient was brought to the emergency department."
	"1186943-1"	"1186943-1"	"CHEST X-RAY ABNORMAL"	"10008499"	"50-59 years"	"50-59"	"55-year-old male with no diagnosed past medical history presents emergency department after cardiac arrest.  Per patient's daughter, patient was feeling at baseline today.  He got his COVID vaccine at 5 PM this evening.  He was running some errands and called his daughter at 8:40 PM.  He told his daughter he was not feeling well.  She reports he sounded out of breath and sounded as if he was slurring his words.  Daughter told him to pull over and she called 911.  She met him on the side of the road and he was gasping for air.  She arrived at the same time as EMS.  Upon arrival of EMS patient was in ventricular fibrillation.  He was defibrillated 3 times.  He also had one episode of ventricular tachycardia.  He was given 300 mg of amiodarone and 3 rounds of epinephrine with had return of spontaneous circulation.  King airway was placed and patient was brought to the emergency department."
	"1186943-1"	"1186943-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"55-year-old male with no diagnosed past medical history presents emergency department after cardiac arrest.  Per patient's daughter, patient was feeling at baseline today.  He got his COVID vaccine at 5 PM this evening.  He was running some errands and called his daughter at 8:40 PM.  He told his daughter he was not feeling well.  She reports he sounded out of breath and sounded as if he was slurring his words.  Daughter told him to pull over and she called 911.  She met him on the side of the road and he was gasping for air.  She arrived at the same time as EMS.  Upon arrival of EMS patient was in ventricular fibrillation.  He was defibrillated 3 times.  He also had one episode of ventricular tachycardia.  He was given 300 mg of amiodarone and 3 rounds of epinephrine with had return of spontaneous circulation.  King airway was placed and patient was brought to the emergency department."
	"1186943-1"	"1186943-1"	"MALAISE"	"10025482"	"50-59 years"	"50-59"	"55-year-old male with no diagnosed past medical history presents emergency department after cardiac arrest.  Per patient's daughter, patient was feeling at baseline today.  He got his COVID vaccine at 5 PM this evening.  He was running some errands and called his daughter at 8:40 PM.  He told his daughter he was not feeling well.  She reports he sounded out of breath and sounded as if he was slurring his words.  Daughter told him to pull over and she called 911.  She met him on the side of the road and he was gasping for air.  She arrived at the same time as EMS.  Upon arrival of EMS patient was in ventricular fibrillation.  He was defibrillated 3 times.  He also had one episode of ventricular tachycardia.  He was given 300 mg of amiodarone and 3 rounds of epinephrine with had return of spontaneous circulation.  King airway was placed and patient was brought to the emergency department."
	"1186943-1"	"1186943-1"	"PNEUMONIA"	"10035664"	"50-59 years"	"50-59"	"55-year-old male with no diagnosed past medical history presents emergency department after cardiac arrest.  Per patient's daughter, patient was feeling at baseline today.  He got his COVID vaccine at 5 PM this evening.  He was running some errands and called his daughter at 8:40 PM.  He told his daughter he was not feeling well.  She reports he sounded out of breath and sounded as if he was slurring his words.  Daughter told him to pull over and she called 911.  She met him on the side of the road and he was gasping for air.  She arrived at the same time as EMS.  Upon arrival of EMS patient was in ventricular fibrillation.  He was defibrillated 3 times.  He also had one episode of ventricular tachycardia.  He was given 300 mg of amiodarone and 3 rounds of epinephrine with had return of spontaneous circulation.  King airway was placed and patient was brought to the emergency department."
	"1186943-1"	"1186943-1"	"PULMONARY OEDEMA"	"10037423"	"50-59 years"	"50-59"	"55-year-old male with no diagnosed past medical history presents emergency department after cardiac arrest.  Per patient's daughter, patient was feeling at baseline today.  He got his COVID vaccine at 5 PM this evening.  He was running some errands and called his daughter at 8:40 PM.  He told his daughter he was not feeling well.  She reports he sounded out of breath and sounded as if he was slurring his words.  Daughter told him to pull over and she called 911.  She met him on the side of the road and he was gasping for air.  She arrived at the same time as EMS.  Upon arrival of EMS patient was in ventricular fibrillation.  He was defibrillated 3 times.  He also had one episode of ventricular tachycardia.  He was given 300 mg of amiodarone and 3 rounds of epinephrine with had return of spontaneous circulation.  King airway was placed and patient was brought to the emergency department."
	"1186943-1"	"1186943-1"	"VENTRICULAR FIBRILLATION"	"10047290"	"50-59 years"	"50-59"	"55-year-old male with no diagnosed past medical history presents emergency department after cardiac arrest.  Per patient's daughter, patient was feeling at baseline today.  He got his COVID vaccine at 5 PM this evening.  He was running some errands and called his daughter at 8:40 PM.  He told his daughter he was not feeling well.  She reports he sounded out of breath and sounded as if he was slurring his words.  Daughter told him to pull over and she called 911.  She met him on the side of the road and he was gasping for air.  She arrived at the same time as EMS.  Upon arrival of EMS patient was in ventricular fibrillation.  He was defibrillated 3 times.  He also had one episode of ventricular tachycardia.  He was given 300 mg of amiodarone and 3 rounds of epinephrine with had return of spontaneous circulation.  King airway was placed and patient was brought to the emergency department."
	"1186943-1"	"1186943-1"	"VENTRICULAR TACHYCARDIA"	"10047302"	"50-59 years"	"50-59"	"55-year-old male with no diagnosed past medical history presents emergency department after cardiac arrest.  Per patient's daughter, patient was feeling at baseline today.  He got his COVID vaccine at 5 PM this evening.  He was running some errands and called his daughter at 8:40 PM.  He told his daughter he was not feeling well.  She reports he sounded out of breath and sounded as if he was slurring his words.  Daughter told him to pull over and she called 911.  She met him on the side of the road and he was gasping for air.  She arrived at the same time as EMS.  Upon arrival of EMS patient was in ventricular fibrillation.  He was defibrillated 3 times.  He also had one episode of ventricular tachycardia.  He was given 300 mg of amiodarone and 3 rounds of epinephrine with had return of spontaneous circulation.  King airway was placed and patient was brought to the emergency department."
	"1192099-1"	"1192099-1"	"CARDIAC FAILURE"	"10007554"	"50-59 years"	"50-59"	"Reported cause(s) of patient death: Heart failure; chills; fever; This is a spontaneous report from a contactable consumer (patient's spouse). A 59-year-old male patient received his first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number: EN6205) at the age of 59-years-old, via an unspecified route of administration in left arm on 17Mar2021 at 11:00 at single dose for COVID-19 immunization. Medical history included congestive heart failure, diabetes, and high blood pressure. He has no allergies to medications, food, or other products. Prior to vaccination, the patient was not diagnosed with COVID-19. Concomitant medications included olmesartan medoxomil, furosemide, repaglinide, metformin, amlodipine, atorvastatin, carvedilol, hydrochlorothiazide, and metoprolol. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The facility where the most recent COVID-19 vaccine was administered was reported as other. The patient experienced chills, fever, and heart failure on 18Mar2021. The events resulted in emergency room/department or urgent care, doctor or other healthcare professional office/clinic visit, and hospitalization for 8 days from Mar2021 to Mar2021. He eventually passed away on 31Mar2021. Treatment received for the events was reported as unknown. The patient underwent lab test and procedure which included nasal swab for COVID which was negative on 20Mar2021. The outcome of the events chills and fever were unknown. The patient died on 31Mar2021. The cause of death was heart failure. An autopsy was not performed.  No follow-up attempts are possible. No further information is expected.; Reported Cause(s) of Death: Heart failure"
	"1192099-1"	"1192099-1"	"CHILLS"	"10008531"	"50-59 years"	"50-59"	"Reported cause(s) of patient death: Heart failure; chills; fever; This is a spontaneous report from a contactable consumer (patient's spouse). A 59-year-old male patient received his first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number: EN6205) at the age of 59-years-old, via an unspecified route of administration in left arm on 17Mar2021 at 11:00 at single dose for COVID-19 immunization. Medical history included congestive heart failure, diabetes, and high blood pressure. He has no allergies to medications, food, or other products. Prior to vaccination, the patient was not diagnosed with COVID-19. Concomitant medications included olmesartan medoxomil, furosemide, repaglinide, metformin, amlodipine, atorvastatin, carvedilol, hydrochlorothiazide, and metoprolol. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The facility where the most recent COVID-19 vaccine was administered was reported as other. The patient experienced chills, fever, and heart failure on 18Mar2021. The events resulted in emergency room/department or urgent care, doctor or other healthcare professional office/clinic visit, and hospitalization for 8 days from Mar2021 to Mar2021. He eventually passed away on 31Mar2021. Treatment received for the events was reported as unknown. The patient underwent lab test and procedure which included nasal swab for COVID which was negative on 20Mar2021. The outcome of the events chills and fever were unknown. The patient died on 31Mar2021. The cause of death was heart failure. An autopsy was not performed.  No follow-up attempts are possible. No further information is expected.; Reported Cause(s) of Death: Heart failure"
	"1192099-1"	"1192099-1"	"PYREXIA"	"10037660"	"50-59 years"	"50-59"	"Reported cause(s) of patient death: Heart failure; chills; fever; This is a spontaneous report from a contactable consumer (patient's spouse). A 59-year-old male patient received his first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number: EN6205) at the age of 59-years-old, via an unspecified route of administration in left arm on 17Mar2021 at 11:00 at single dose for COVID-19 immunization. Medical history included congestive heart failure, diabetes, and high blood pressure. He has no allergies to medications, food, or other products. Prior to vaccination, the patient was not diagnosed with COVID-19. Concomitant medications included olmesartan medoxomil, furosemide, repaglinide, metformin, amlodipine, atorvastatin, carvedilol, hydrochlorothiazide, and metoprolol. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The facility where the most recent COVID-19 vaccine was administered was reported as other. The patient experienced chills, fever, and heart failure on 18Mar2021. The events resulted in emergency room/department or urgent care, doctor or other healthcare professional office/clinic visit, and hospitalization for 8 days from Mar2021 to Mar2021. He eventually passed away on 31Mar2021. Treatment received for the events was reported as unknown. The patient underwent lab test and procedure which included nasal swab for COVID which was negative on 20Mar2021. The outcome of the events chills and fever were unknown. The patient died on 31Mar2021. The cause of death was heart failure. An autopsy was not performed.  No follow-up attempts are possible. No further information is expected.; Reported Cause(s) of Death: Heart failure"
	"1192099-1"	"1192099-1"	"SARS-COV-2 TEST"	"10084354"	"50-59 years"	"50-59"	"Reported cause(s) of patient death: Heart failure; chills; fever; This is a spontaneous report from a contactable consumer (patient's spouse). A 59-year-old male patient received his first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number: EN6205) at the age of 59-years-old, via an unspecified route of administration in left arm on 17Mar2021 at 11:00 at single dose for COVID-19 immunization. Medical history included congestive heart failure, diabetes, and high blood pressure. He has no allergies to medications, food, or other products. Prior to vaccination, the patient was not diagnosed with COVID-19. Concomitant medications included olmesartan medoxomil, furosemide, repaglinide, metformin, amlodipine, atorvastatin, carvedilol, hydrochlorothiazide, and metoprolol. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The facility where the most recent COVID-19 vaccine was administered was reported as other. The patient experienced chills, fever, and heart failure on 18Mar2021. The events resulted in emergency room/department or urgent care, doctor or other healthcare professional office/clinic visit, and hospitalization for 8 days from Mar2021 to Mar2021. He eventually passed away on 31Mar2021. Treatment received for the events was reported as unknown. The patient underwent lab test and procedure which included nasal swab for COVID which was negative on 20Mar2021. The outcome of the events chills and fever were unknown. The patient died on 31Mar2021. The cause of death was heart failure. An autopsy was not performed.  No follow-up attempts are possible. No further information is expected.; Reported Cause(s) of Death: Heart failure"
	"1194264-1"	"1194264-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient found deceased. Unwitnessed death."
	"1196968-1"	"1196968-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient found unresponsive at home 04/04/21 at 11pm per child. Sent to hospital via 911. Deceased 4/6/2021."
	"1196968-1"	"1196968-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"50-59 years"	"50-59"	"Patient found unresponsive at home 04/04/21 at 11pm per child. Sent to hospital via 911. Deceased 4/6/2021."
	"1199143-1"	"1199143-1"	"CRANIECTOMY"	"10052937"	"50-59 years"	"50-59"	"Headache and vomiting starting one week later (4/3/2021); seizure due to hemorrhagic stroke 04/ 5/2021; continued bleeds 04/06/2021, 04/07/2021; life support removed 04/08/2021."
	"1199143-1"	"1199143-1"	"HAEMORRHAGE"	"10055798"	"50-59 years"	"50-59"	"Headache and vomiting starting one week later (4/3/2021); seizure due to hemorrhagic stroke 04/ 5/2021; continued bleeds 04/06/2021, 04/07/2021; life support removed 04/08/2021."
	"1199143-1"	"1199143-1"	"HAEMORRHAGIC STROKE"	"10019016"	"50-59 years"	"50-59"	"Headache and vomiting starting one week later (4/3/2021); seizure due to hemorrhagic stroke 04/ 5/2021; continued bleeds 04/06/2021, 04/07/2021; life support removed 04/08/2021."
	"1199143-1"	"1199143-1"	"HEADACHE"	"10019211"	"50-59 years"	"50-59"	"Headache and vomiting starting one week later (4/3/2021); seizure due to hemorrhagic stroke 04/ 5/2021; continued bleeds 04/06/2021, 04/07/2021; life support removed 04/08/2021."
	"1199143-1"	"1199143-1"	"LIFE SUPPORT"	"10024447"	"50-59 years"	"50-59"	"Headache and vomiting starting one week later (4/3/2021); seizure due to hemorrhagic stroke 04/ 5/2021; continued bleeds 04/06/2021, 04/07/2021; life support removed 04/08/2021."
	"1199143-1"	"1199143-1"	"PLATELET COUNT DECREASED"	"10035528"	"50-59 years"	"50-59"	"Headache and vomiting starting one week later (4/3/2021); seizure due to hemorrhagic stroke 04/ 5/2021; continued bleeds 04/06/2021, 04/07/2021; life support removed 04/08/2021."
	"1199143-1"	"1199143-1"	"SEIZURE"	"10039906"	"50-59 years"	"50-59"	"Headache and vomiting starting one week later (4/3/2021); seizure due to hemorrhagic stroke 04/ 5/2021; continued bleeds 04/06/2021, 04/07/2021; life support removed 04/08/2021."
	"1199143-1"	"1199143-1"	"VOMITING"	"10047700"	"50-59 years"	"50-59"	"Headache and vomiting starting one week later (4/3/2021); seizure due to hemorrhagic stroke 04/ 5/2021; continued bleeds 04/06/2021, 04/07/2021; life support removed 04/08/2021."
	"1200573-1"	"1200573-1"	"BRAIN HERNIATION"	"10006126"	"50-59 years"	"50-59"	"She had a slight fever after administering vaccine. On Mar15 till 10:30PM she is doing good, working on household chores. All of a sudden she complained about a pain behind ear that creeped to her Head (Unbearable pain). With in a minute she became unconscious and we called 911, they took her to Medical Center and moved her to  another Medical Center Neurosurgeon is available. As per doctors, cause of death as per Death Certificate are as follows: Cerebral Herniation Malignant Cerebral Edema Anoxic Brain Injury Aneurysmal Subarachnoid Hemorrhage"
	"1200573-1"	"1200573-1"	"BRAIN INJURY"	"10067967"	"50-59 years"	"50-59"	"She had a slight fever after administering vaccine. On Mar15 till 10:30PM she is doing good, working on household chores. All of a sudden she complained about a pain behind ear that creeped to her Head (Unbearable pain). With in a minute she became unconscious and we called 911, they took her to Medical Center and moved her to  another Medical Center Neurosurgeon is available. As per doctors, cause of death as per Death Certificate are as follows: Cerebral Herniation Malignant Cerebral Edema Anoxic Brain Injury Aneurysmal Subarachnoid Hemorrhage"
	"1200573-1"	"1200573-1"	"BRAIN OEDEMA"	"10048962"	"50-59 years"	"50-59"	"She had a slight fever after administering vaccine. On Mar15 till 10:30PM she is doing good, working on household chores. All of a sudden she complained about a pain behind ear that creeped to her Head (Unbearable pain). With in a minute she became unconscious and we called 911, they took her to Medical Center and moved her to  another Medical Center Neurosurgeon is available. As per doctors, cause of death as per Death Certificate are as follows: Cerebral Herniation Malignant Cerebral Edema Anoxic Brain Injury Aneurysmal Subarachnoid Hemorrhage"
	"1200573-1"	"1200573-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"She had a slight fever after administering vaccine. On Mar15 till 10:30PM she is doing good, working on household chores. All of a sudden she complained about a pain behind ear that creeped to her Head (Unbearable pain). With in a minute she became unconscious and we called 911, they took her to Medical Center and moved her to  another Medical Center Neurosurgeon is available. As per doctors, cause of death as per Death Certificate are as follows: Cerebral Herniation Malignant Cerebral Edema Anoxic Brain Injury Aneurysmal Subarachnoid Hemorrhage"
	"1200573-1"	"1200573-1"	"EAR PAIN"	"10014020"	"50-59 years"	"50-59"	"She had a slight fever after administering vaccine. On Mar15 till 10:30PM she is doing good, working on household chores. All of a sudden she complained about a pain behind ear that creeped to her Head (Unbearable pain). With in a minute she became unconscious and we called 911, they took her to Medical Center and moved her to  another Medical Center Neurosurgeon is available. As per doctors, cause of death as per Death Certificate are as follows: Cerebral Herniation Malignant Cerebral Edema Anoxic Brain Injury Aneurysmal Subarachnoid Hemorrhage"
	"1200573-1"	"1200573-1"	"HEADACHE"	"10019211"	"50-59 years"	"50-59"	"She had a slight fever after administering vaccine. On Mar15 till 10:30PM she is doing good, working on household chores. All of a sudden she complained about a pain behind ear that creeped to her Head (Unbearable pain). With in a minute she became unconscious and we called 911, they took her to Medical Center and moved her to  another Medical Center Neurosurgeon is available. As per doctors, cause of death as per Death Certificate are as follows: Cerebral Herniation Malignant Cerebral Edema Anoxic Brain Injury Aneurysmal Subarachnoid Hemorrhage"
	"1200573-1"	"1200573-1"	"LOSS OF CONSCIOUSNESS"	"10024855"	"50-59 years"	"50-59"	"She had a slight fever after administering vaccine. On Mar15 till 10:30PM she is doing good, working on household chores. All of a sudden she complained about a pain behind ear that creeped to her Head (Unbearable pain). With in a minute she became unconscious and we called 911, they took her to Medical Center and moved her to  another Medical Center Neurosurgeon is available. As per doctors, cause of death as per Death Certificate are as follows: Cerebral Herniation Malignant Cerebral Edema Anoxic Brain Injury Aneurysmal Subarachnoid Hemorrhage"
	"1200573-1"	"1200573-1"	"PYREXIA"	"10037660"	"50-59 years"	"50-59"	"She had a slight fever after administering vaccine. On Mar15 till 10:30PM she is doing good, working on household chores. All of a sudden she complained about a pain behind ear that creeped to her Head (Unbearable pain). With in a minute she became unconscious and we called 911, they took her to Medical Center and moved her to  another Medical Center Neurosurgeon is available. As per doctors, cause of death as per Death Certificate are as follows: Cerebral Herniation Malignant Cerebral Edema Anoxic Brain Injury Aneurysmal Subarachnoid Hemorrhage"
	"1200573-1"	"1200573-1"	"SUBARACHNOID HAEMORRHAGE"	"10042316"	"50-59 years"	"50-59"	"She had a slight fever after administering vaccine. On Mar15 till 10:30PM she is doing good, working on household chores. All of a sudden she complained about a pain behind ear that creeped to her Head (Unbearable pain). With in a minute she became unconscious and we called 911, they took her to Medical Center and moved her to  another Medical Center Neurosurgeon is available. As per doctors, cause of death as per Death Certificate are as follows: Cerebral Herniation Malignant Cerebral Edema Anoxic Brain Injury Aneurysmal Subarachnoid Hemorrhage"
	"1200807-1"	"1200807-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Died within five days of receiving"
	"1201682-1"	"1201682-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"PATIENT HAD DIZZINESS, WENT TO DR, THEN NEXT DAY ER AND ENDED UP DYING 4-2-2021"
	"1201682-1"	"1201682-1"	"DIZZINESS"	"10013573"	"50-59 years"	"50-59"	"PATIENT HAD DIZZINESS, WENT TO DR, THEN NEXT DAY ER AND ENDED UP DYING 4-2-2021"
	"1201835-1"	"1201835-1"	"CEREBROVASCULAR ACCIDENT"	"10008190"	"50-59 years"	"50-59"	"Low grade fever, aches & chills on 3/13/21 & 3/14/21.  Felt better 3/15/21 through 3/18/21.  Side effects ( fever, aches, chills ) returned on 3/19/21 & 3/20/21.  Suffered stroke on 3/21/21 at 3:30 AM due to blood clots.  Passed away on 3/22/21."
	"1201835-1"	"1201835-1"	"CHILLS"	"10008531"	"50-59 years"	"50-59"	"Low grade fever, aches & chills on 3/13/21 & 3/14/21.  Felt better 3/15/21 through 3/18/21.  Side effects ( fever, aches, chills ) returned on 3/19/21 & 3/20/21.  Suffered stroke on 3/21/21 at 3:30 AM due to blood clots.  Passed away on 3/22/21."
	"1201835-1"	"1201835-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Low grade fever, aches & chills on 3/13/21 & 3/14/21.  Felt better 3/15/21 through 3/18/21.  Side effects ( fever, aches, chills ) returned on 3/19/21 & 3/20/21.  Suffered stroke on 3/21/21 at 3:30 AM due to blood clots.  Passed away on 3/22/21."
	"1201835-1"	"1201835-1"	"PAIN"	"10033371"	"50-59 years"	"50-59"	"Low grade fever, aches & chills on 3/13/21 & 3/14/21.  Felt better 3/15/21 through 3/18/21.  Side effects ( fever, aches, chills ) returned on 3/19/21 & 3/20/21.  Suffered stroke on 3/21/21 at 3:30 AM due to blood clots.  Passed away on 3/22/21."
	"1201835-1"	"1201835-1"	"PYREXIA"	"10037660"	"50-59 years"	"50-59"	"Low grade fever, aches & chills on 3/13/21 & 3/14/21.  Felt better 3/15/21 through 3/18/21.  Side effects ( fever, aches, chills ) returned on 3/19/21 & 3/20/21.  Suffered stroke on 3/21/21 at 3:30 AM due to blood clots.  Passed away on 3/22/21."
	"1201835-1"	"1201835-1"	"THROMBOSIS"	"10043607"	"50-59 years"	"50-59"	"Low grade fever, aches & chills on 3/13/21 & 3/14/21.  Felt better 3/15/21 through 3/18/21.  Side effects ( fever, aches, chills ) returned on 3/19/21 & 3/20/21.  Suffered stroke on 3/21/21 at 3:30 AM due to blood clots.  Passed away on 3/22/21."
	"1202366-1"	"1202366-1"	"ANGIOEDEMA"	"10002424"	"50-59 years"	"50-59"	"pt recieved vaccine at 1135 on 4/9,  pt reported tongue swelling around 1130 the next day (4/10, 24 hrs after), presented to ED via EMS 1518,  was diagnosed with angioedema likley due to ramipril, was intubated by 1624. pt had difficult intubation, was transferred to ICU, in critical condition on a ventilator, days later,  after multiple cardiac arrests and multiple rounds of  ACLS were performed, the pt was pronounced dead at 0127 on 4/12"
	"1202366-1"	"1202366-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"pt recieved vaccine at 1135 on 4/9,  pt reported tongue swelling around 1130 the next day (4/10, 24 hrs after), presented to ED via EMS 1518,  was diagnosed with angioedema likley due to ramipril, was intubated by 1624. pt had difficult intubation, was transferred to ICU, in critical condition on a ventilator, days later,  after multiple cardiac arrests and multiple rounds of  ACLS were performed, the pt was pronounced dead at 0127 on 4/12"
	"1202366-1"	"1202366-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"pt recieved vaccine at 1135 on 4/9,  pt reported tongue swelling around 1130 the next day (4/10, 24 hrs after), presented to ED via EMS 1518,  was diagnosed with angioedema likley due to ramipril, was intubated by 1624. pt had difficult intubation, was transferred to ICU, in critical condition on a ventilator, days later,  after multiple cardiac arrests and multiple rounds of  ACLS were performed, the pt was pronounced dead at 0127 on 4/12"
	"1202366-1"	"1202366-1"	"ENDOTRACHEAL INTUBATION COMPLICATION"	"10063349"	"50-59 years"	"50-59"	"pt recieved vaccine at 1135 on 4/9,  pt reported tongue swelling around 1130 the next day (4/10, 24 hrs after), presented to ED via EMS 1518,  was diagnosed with angioedema likley due to ramipril, was intubated by 1624. pt had difficult intubation, was transferred to ICU, in critical condition on a ventilator, days later,  after multiple cardiac arrests and multiple rounds of  ACLS were performed, the pt was pronounced dead at 0127 on 4/12"
	"1202366-1"	"1202366-1"	"INTENSIVE CARE"	"10022519"	"50-59 years"	"50-59"	"pt recieved vaccine at 1135 on 4/9,  pt reported tongue swelling around 1130 the next day (4/10, 24 hrs after), presented to ED via EMS 1518,  was diagnosed with angioedema likley due to ramipril, was intubated by 1624. pt had difficult intubation, was transferred to ICU, in critical condition on a ventilator, days later,  after multiple cardiac arrests and multiple rounds of  ACLS were performed, the pt was pronounced dead at 0127 on 4/12"
	"1202366-1"	"1202366-1"	"LABORATORY TEST"	"10059938"	"50-59 years"	"50-59"	"pt recieved vaccine at 1135 on 4/9,  pt reported tongue swelling around 1130 the next day (4/10, 24 hrs after), presented to ED via EMS 1518,  was diagnosed with angioedema likley due to ramipril, was intubated by 1624. pt had difficult intubation, was transferred to ICU, in critical condition on a ventilator, days later,  after multiple cardiac arrests and multiple rounds of  ACLS were performed, the pt was pronounced dead at 0127 on 4/12"
	"1202366-1"	"1202366-1"	"MECHANICAL VENTILATION"	"10067221"	"50-59 years"	"50-59"	"pt recieved vaccine at 1135 on 4/9,  pt reported tongue swelling around 1130 the next day (4/10, 24 hrs after), presented to ED via EMS 1518,  was diagnosed with angioedema likley due to ramipril, was intubated by 1624. pt had difficult intubation, was transferred to ICU, in critical condition on a ventilator, days later,  after multiple cardiac arrests and multiple rounds of  ACLS were performed, the pt was pronounced dead at 0127 on 4/12"
	"1202366-1"	"1202366-1"	"SWOLLEN TONGUE"	"10042727"	"50-59 years"	"50-59"	"pt recieved vaccine at 1135 on 4/9,  pt reported tongue swelling around 1130 the next day (4/10, 24 hrs after), presented to ED via EMS 1518,  was diagnosed with angioedema likley due to ramipril, was intubated by 1624. pt had difficult intubation, was transferred to ICU, in critical condition on a ventilator, days later,  after multiple cardiac arrests and multiple rounds of  ACLS were performed, the pt was pronounced dead at 0127 on 4/12"
	"1202719-1"	"1202719-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Death of patient within 24hrs of vaccine"
	"1203198-1"	"1203198-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Second vaccine received on 4/6/21. Pulmonary Embolism on 4/11/21. Death on 4/13/21."
	"1203198-1"	"1203198-1"	"LABORATORY TEST"	"10059938"	"50-59 years"	"50-59"	"Second vaccine received on 4/6/21. Pulmonary Embolism on 4/11/21. Death on 4/13/21."
	"1203198-1"	"1203198-1"	"PULMONARY EMBOLISM"	"10037377"	"50-59 years"	"50-59"	"Second vaccine received on 4/6/21. Pulmonary Embolism on 4/11/21. Death on 4/13/21."
	"1203631-1"	"1203631-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Flu like symptoms from the time received, patient passed away 03/11/2021"
	"1203631-1"	"1203631-1"	"INFLUENZA LIKE ILLNESS"	"10022004"	"50-59 years"	"50-59"	"Flu like symptoms from the time received, patient passed away 03/11/2021"
	"1204227-1"	"1204227-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient was hospitalized and died within 60 days of receiving a COVID vaccine series"
	"1205684-1"	"1205684-1"	"BRAIN OEDEMA"	"10048962"	"50-59 years"	"50-59"	"Blood Clot blocked oxygen to the brain. Suffered a severe stroke  Was hospitalized  Suffered brain swelling  Lost brain function Died."
	"1205684-1"	"1205684-1"	"CAROTID ARTERY STENOSIS"	"10007687"	"50-59 years"	"50-59"	"Blood Clot blocked oxygen to the brain. Suffered a severe stroke  Was hospitalized  Suffered brain swelling  Lost brain function Died."
	"1205684-1"	"1205684-1"	"CEREBROVASCULAR ACCIDENT"	"10008190"	"50-59 years"	"50-59"	"Blood Clot blocked oxygen to the brain. Suffered a severe stroke  Was hospitalized  Suffered brain swelling  Lost brain function Died."
	"1205684-1"	"1205684-1"	"COMPUTERISED TOMOGRAM HEAD ABNORMAL"	"10072168"	"50-59 years"	"50-59"	"Blood Clot blocked oxygen to the brain. Suffered a severe stroke  Was hospitalized  Suffered brain swelling  Lost brain function Died."
	"1205684-1"	"1205684-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Blood Clot blocked oxygen to the brain. Suffered a severe stroke  Was hospitalized  Suffered brain swelling  Lost brain function Died."
	"1205684-1"	"1205684-1"	"MENTAL IMPAIRMENT"	"10027374"	"50-59 years"	"50-59"	"Blood Clot blocked oxygen to the brain. Suffered a severe stroke  Was hospitalized  Suffered brain swelling  Lost brain function Died."
	"1205684-1"	"1205684-1"	"X-RAY"	"10048064"	"50-59 years"	"50-59"	"Blood Clot blocked oxygen to the brain. Suffered a severe stroke  Was hospitalized  Suffered brain swelling  Lost brain function Died."
	"1206428-1"	"1206428-1"	"BLOOD CALCIUM DECREASED"	"10005395"	"50-59 years"	"50-59"	"Presented with 2-3 weeks of fatigue and acute on chronic leg swelling (h/o chronic venous disease, phlebitis) 13 April; treated for dehydration and prescribed ASA.  Tachycardia on exam, resolved with resuscitation.  Asymptomatic 4 hours later, and expired overnight in his sleep.  Found unresponsive in the morning, time of death 09:57."
	"1206428-1"	"1206428-1"	"BLOOD GASES ABNORMAL"	"10005539"	"50-59 years"	"50-59"	"Presented with 2-3 weeks of fatigue and acute on chronic leg swelling (h/o chronic venous disease, phlebitis) 13 April; treated for dehydration and prescribed ASA.  Tachycardia on exam, resolved with resuscitation.  Asymptomatic 4 hours later, and expired overnight in his sleep.  Found unresponsive in the morning, time of death 09:57."
	"1206428-1"	"1206428-1"	"BLOOD GLUCOSE INCREASED"	"10005557"	"50-59 years"	"50-59"	"Presented with 2-3 weeks of fatigue and acute on chronic leg swelling (h/o chronic venous disease, phlebitis) 13 April; treated for dehydration and prescribed ASA.  Tachycardia on exam, resolved with resuscitation.  Asymptomatic 4 hours later, and expired overnight in his sleep.  Found unresponsive in the morning, time of death 09:57."
	"1206428-1"	"1206428-1"	"BLOOD POTASSIUM NORMAL"	"10005726"	"50-59 years"	"50-59"	"Presented with 2-3 weeks of fatigue and acute on chronic leg swelling (h/o chronic venous disease, phlebitis) 13 April; treated for dehydration and prescribed ASA.  Tachycardia on exam, resolved with resuscitation.  Asymptomatic 4 hours later, and expired overnight in his sleep.  Found unresponsive in the morning, time of death 09:57."
	"1206428-1"	"1206428-1"	"BLOOD SODIUM NORMAL"	"10005804"	"50-59 years"	"50-59"	"Presented with 2-3 weeks of fatigue and acute on chronic leg swelling (h/o chronic venous disease, phlebitis) 13 April; treated for dehydration and prescribed ASA.  Tachycardia on exam, resolved with resuscitation.  Asymptomatic 4 hours later, and expired overnight in his sleep.  Found unresponsive in the morning, time of death 09:57."
	"1206428-1"	"1206428-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Presented with 2-3 weeks of fatigue and acute on chronic leg swelling (h/o chronic venous disease, phlebitis) 13 April; treated for dehydration and prescribed ASA.  Tachycardia on exam, resolved with resuscitation.  Asymptomatic 4 hours later, and expired overnight in his sleep.  Found unresponsive in the morning, time of death 09:57."
	"1206428-1"	"1206428-1"	"DEHYDRATION"	"10012174"	"50-59 years"	"50-59"	"Presented with 2-3 weeks of fatigue and acute on chronic leg swelling (h/o chronic venous disease, phlebitis) 13 April; treated for dehydration and prescribed ASA.  Tachycardia on exam, resolved with resuscitation.  Asymptomatic 4 hours later, and expired overnight in his sleep.  Found unresponsive in the morning, time of death 09:57."
	"1206428-1"	"1206428-1"	"FATIGUE"	"10016256"	"50-59 years"	"50-59"	"Presented with 2-3 weeks of fatigue and acute on chronic leg swelling (h/o chronic venous disease, phlebitis) 13 April; treated for dehydration and prescribed ASA.  Tachycardia on exam, resolved with resuscitation.  Asymptomatic 4 hours later, and expired overnight in his sleep.  Found unresponsive in the morning, time of death 09:57."
	"1206428-1"	"1206428-1"	"HAEMATOCRIT NORMAL"	"10018842"	"50-59 years"	"50-59"	"Presented with 2-3 weeks of fatigue and acute on chronic leg swelling (h/o chronic venous disease, phlebitis) 13 April; treated for dehydration and prescribed ASA.  Tachycardia on exam, resolved with resuscitation.  Asymptomatic 4 hours later, and expired overnight in his sleep.  Found unresponsive in the morning, time of death 09:57."
	"1206428-1"	"1206428-1"	"PERIPHERAL SWELLING"	"10048959"	"50-59 years"	"50-59"	"Presented with 2-3 weeks of fatigue and acute on chronic leg swelling (h/o chronic venous disease, phlebitis) 13 April; treated for dehydration and prescribed ASA.  Tachycardia on exam, resolved with resuscitation.  Asymptomatic 4 hours later, and expired overnight in his sleep.  Found unresponsive in the morning, time of death 09:57."
	"1206428-1"	"1206428-1"	"RESUSCITATION"	"10038749"	"50-59 years"	"50-59"	"Presented with 2-3 weeks of fatigue and acute on chronic leg swelling (h/o chronic venous disease, phlebitis) 13 April; treated for dehydration and prescribed ASA.  Tachycardia on exam, resolved with resuscitation.  Asymptomatic 4 hours later, and expired overnight in his sleep.  Found unresponsive in the morning, time of death 09:57."
	"1206428-1"	"1206428-1"	"TACHYCARDIA"	"10043071"	"50-59 years"	"50-59"	"Presented with 2-3 weeks of fatigue and acute on chronic leg swelling (h/o chronic venous disease, phlebitis) 13 April; treated for dehydration and prescribed ASA.  Tachycardia on exam, resolved with resuscitation.  Asymptomatic 4 hours later, and expired overnight in his sleep.  Found unresponsive in the morning, time of death 09:57."
	"1206428-1"	"1206428-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"50-59 years"	"50-59"	"Presented with 2-3 weeks of fatigue and acute on chronic leg swelling (h/o chronic venous disease, phlebitis) 13 April; treated for dehydration and prescribed ASA.  Tachycardia on exam, resolved with resuscitation.  Asymptomatic 4 hours later, and expired overnight in his sleep.  Found unresponsive in the morning, time of death 09:57."
	"1207822-1"	"1207822-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"No adverse symptoms from vaccination.  Decedent died day after 2nd vaccination, death not related to vaccination"
	"1207869-1"	"1207869-1"	"BILEVEL POSITIVE AIRWAY PRESSURE"	"10064530"	"50-59 years"	"50-59"	"Presented to the ER on 3/19 at 23:57 with 2 days of worsening shortness of breath. HR 60, Pulse Ox: 85% on Room air. Placed on BiPAP. could not maintain oxygen, intubated. The patient rapidly decompensated and went into cardiac arrest with PEA. ACLS performed for 35 minutes without the ability to reverse. Patient expired at 0222 on 3/20/21."
	"1207869-1"	"1207869-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"Presented to the ER on 3/19 at 23:57 with 2 days of worsening shortness of breath. HR 60, Pulse Ox: 85% on Room air. Placed on BiPAP. could not maintain oxygen, intubated. The patient rapidly decompensated and went into cardiac arrest with PEA. ACLS performed for 35 minutes without the ability to reverse. Patient expired at 0222 on 3/20/21."
	"1207869-1"	"1207869-1"	"CARDIAC FAILURE"	"10007554"	"50-59 years"	"50-59"	"Presented to the ER on 3/19 at 23:57 with 2 days of worsening shortness of breath. HR 60, Pulse Ox: 85% on Room air. Placed on BiPAP. could not maintain oxygen, intubated. The patient rapidly decompensated and went into cardiac arrest with PEA. ACLS performed for 35 minutes without the ability to reverse. Patient expired at 0222 on 3/20/21."
	"1207869-1"	"1207869-1"	"CHEST X-RAY ABNORMAL"	"10008499"	"50-59 years"	"50-59"	"Presented to the ER on 3/19 at 23:57 with 2 days of worsening shortness of breath. HR 60, Pulse Ox: 85% on Room air. Placed on BiPAP. could not maintain oxygen, intubated. The patient rapidly decompensated and went into cardiac arrest with PEA. ACLS performed for 35 minutes without the ability to reverse. Patient expired at 0222 on 3/20/21."
	"1207869-1"	"1207869-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Presented to the ER on 3/19 at 23:57 with 2 days of worsening shortness of breath. HR 60, Pulse Ox: 85% on Room air. Placed on BiPAP. could not maintain oxygen, intubated. The patient rapidly decompensated and went into cardiac arrest with PEA. ACLS performed for 35 minutes without the ability to reverse. Patient expired at 0222 on 3/20/21."
	"1207869-1"	"1207869-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"Presented to the ER on 3/19 at 23:57 with 2 days of worsening shortness of breath. HR 60, Pulse Ox: 85% on Room air. Placed on BiPAP. could not maintain oxygen, intubated. The patient rapidly decompensated and went into cardiac arrest with PEA. ACLS performed for 35 minutes without the ability to reverse. Patient expired at 0222 on 3/20/21."
	"1207869-1"	"1207869-1"	"ELECTROCARDIOGRAM"	"10014362"	"50-59 years"	"50-59"	"Presented to the ER on 3/19 at 23:57 with 2 days of worsening shortness of breath. HR 60, Pulse Ox: 85% on Room air. Placed on BiPAP. could not maintain oxygen, intubated. The patient rapidly decompensated and went into cardiac arrest with PEA. ACLS performed for 35 minutes without the ability to reverse. Patient expired at 0222 on 3/20/21."
	"1207869-1"	"1207869-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"50-59 years"	"50-59"	"Presented to the ER on 3/19 at 23:57 with 2 days of worsening shortness of breath. HR 60, Pulse Ox: 85% on Room air. Placed on BiPAP. could not maintain oxygen, intubated. The patient rapidly decompensated and went into cardiac arrest with PEA. ACLS performed for 35 minutes without the ability to reverse. Patient expired at 0222 on 3/20/21."
	"1207869-1"	"1207869-1"	"LIFE SUPPORT"	"10024447"	"50-59 years"	"50-59"	"Presented to the ER on 3/19 at 23:57 with 2 days of worsening shortness of breath. HR 60, Pulse Ox: 85% on Room air. Placed on BiPAP. could not maintain oxygen, intubated. The patient rapidly decompensated and went into cardiac arrest with PEA. ACLS performed for 35 minutes without the ability to reverse. Patient expired at 0222 on 3/20/21."
	"1207869-1"	"1207869-1"	"LUNG INFILTRATION"	"10025102"	"50-59 years"	"50-59"	"Presented to the ER on 3/19 at 23:57 with 2 days of worsening shortness of breath. HR 60, Pulse Ox: 85% on Room air. Placed on BiPAP. could not maintain oxygen, intubated. The patient rapidly decompensated and went into cardiac arrest with PEA. ACLS performed for 35 minutes without the ability to reverse. Patient expired at 0222 on 3/20/21."
	"1207869-1"	"1207869-1"	"OXYGEN SATURATION DECREASED"	"10033318"	"50-59 years"	"50-59"	"Presented to the ER on 3/19 at 23:57 with 2 days of worsening shortness of breath. HR 60, Pulse Ox: 85% on Room air. Placed on BiPAP. could not maintain oxygen, intubated. The patient rapidly decompensated and went into cardiac arrest with PEA. ACLS performed for 35 minutes without the ability to reverse. Patient expired at 0222 on 3/20/21."
	"1207869-1"	"1207869-1"	"PULSELESS ELECTRICAL ACTIVITY"	"10058151"	"50-59 years"	"50-59"	"Presented to the ER on 3/19 at 23:57 with 2 days of worsening shortness of breath. HR 60, Pulse Ox: 85% on Room air. Placed on BiPAP. could not maintain oxygen, intubated. The patient rapidly decompensated and went into cardiac arrest with PEA. ACLS performed for 35 minutes without the ability to reverse. Patient expired at 0222 on 3/20/21."
	"1209825-1"	"1209825-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Hospitalized 03-13-2021, Diagnosed with Thrombotic Thrombocytopenic Purpura, Died 03-16-2021"
	"1209825-1"	"1209825-1"	"THROMBOTIC THROMBOCYTOPENIC PURPURA"	"10043648"	"50-59 years"	"50-59"	"Hospitalized 03-13-2021, Diagnosed with Thrombotic Thrombocytopenic Purpura, Died 03-16-2021"
	"1209873-1"	"1209873-1"	"ANAL INCONTINENCE"	"10077605"	"50-59 years"	"50-59"	"The day after receiving the first dose of the Pfizer vaccine, she developed a headache behind her right eye that never went away. Then on Wednesday morning, March 31st (two weeks after receiving the first dose), she was found in bed by my mother, unable to walk or talk, her face was drooping, she was very sweaty, and had defecated on herself. My mother called the ambulance. She was transported to Hospital where it was determined she had suffered a massive hemorrhagic stroke. She was immediately transported by ambulance to another Hospital. She spent one day in ICU and then was put on palliative care. She died around 12/N on Friday, April 2nd, two days after the stroke."
	"1209873-1"	"1209873-1"	"APHASIA"	"10002948"	"50-59 years"	"50-59"	"The day after receiving the first dose of the Pfizer vaccine, she developed a headache behind her right eye that never went away. Then on Wednesday morning, March 31st (two weeks after receiving the first dose), she was found in bed by my mother, unable to walk or talk, her face was drooping, she was very sweaty, and had defecated on herself. My mother called the ambulance. She was transported to Hospital where it was determined she had suffered a massive hemorrhagic stroke. She was immediately transported by ambulance to another Hospital. She spent one day in ICU and then was put on palliative care. She died around 12/N on Friday, April 2nd, two days after the stroke."
	"1209873-1"	"1209873-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"The day after receiving the first dose of the Pfizer vaccine, she developed a headache behind her right eye that never went away. Then on Wednesday morning, March 31st (two weeks after receiving the first dose), she was found in bed by my mother, unable to walk or talk, her face was drooping, she was very sweaty, and had defecated on herself. My mother called the ambulance. She was transported to Hospital where it was determined she had suffered a massive hemorrhagic stroke. She was immediately transported by ambulance to another Hospital. She spent one day in ICU and then was put on palliative care. She died around 12/N on Friday, April 2nd, two days after the stroke."
	"1209873-1"	"1209873-1"	"EYE PAIN"	"10015958"	"50-59 years"	"50-59"	"The day after receiving the first dose of the Pfizer vaccine, she developed a headache behind her right eye that never went away. Then on Wednesday morning, March 31st (two weeks after receiving the first dose), she was found in bed by my mother, unable to walk or talk, her face was drooping, she was very sweaty, and had defecated on herself. My mother called the ambulance. She was transported to Hospital where it was determined she had suffered a massive hemorrhagic stroke. She was immediately transported by ambulance to another Hospital. She spent one day in ICU and then was put on palliative care. She died around 12/N on Friday, April 2nd, two days after the stroke."
	"1209873-1"	"1209873-1"	"FACIAL PARALYSIS"	"10016062"	"50-59 years"	"50-59"	"The day after receiving the first dose of the Pfizer vaccine, she developed a headache behind her right eye that never went away. Then on Wednesday morning, March 31st (two weeks after receiving the first dose), she was found in bed by my mother, unable to walk or talk, her face was drooping, she was very sweaty, and had defecated on herself. My mother called the ambulance. She was transported to Hospital where it was determined she had suffered a massive hemorrhagic stroke. She was immediately transported by ambulance to another Hospital. She spent one day in ICU and then was put on palliative care. She died around 12/N on Friday, April 2nd, two days after the stroke."
	"1209873-1"	"1209873-1"	"GAIT INABILITY"	"10017581"	"50-59 years"	"50-59"	"The day after receiving the first dose of the Pfizer vaccine, she developed a headache behind her right eye that never went away. Then on Wednesday morning, March 31st (two weeks after receiving the first dose), she was found in bed by my mother, unable to walk or talk, her face was drooping, she was very sweaty, and had defecated on herself. My mother called the ambulance. She was transported to Hospital where it was determined she had suffered a massive hemorrhagic stroke. She was immediately transported by ambulance to another Hospital. She spent one day in ICU and then was put on palliative care. She died around 12/N on Friday, April 2nd, two days after the stroke."
	"1209873-1"	"1209873-1"	"HAEMORRHAGIC STROKE"	"10019016"	"50-59 years"	"50-59"	"The day after receiving the first dose of the Pfizer vaccine, she developed a headache behind her right eye that never went away. Then on Wednesday morning, March 31st (two weeks after receiving the first dose), she was found in bed by my mother, unable to walk or talk, her face was drooping, she was very sweaty, and had defecated on herself. My mother called the ambulance. She was transported to Hospital where it was determined she had suffered a massive hemorrhagic stroke. She was immediately transported by ambulance to another Hospital. She spent one day in ICU and then was put on palliative care. She died around 12/N on Friday, April 2nd, two days after the stroke."
	"1209873-1"	"1209873-1"	"HEADACHE"	"10019211"	"50-59 years"	"50-59"	"The day after receiving the first dose of the Pfizer vaccine, she developed a headache behind her right eye that never went away. Then on Wednesday morning, March 31st (two weeks after receiving the first dose), she was found in bed by my mother, unable to walk or talk, her face was drooping, she was very sweaty, and had defecated on herself. My mother called the ambulance. She was transported to Hospital where it was determined she had suffered a massive hemorrhagic stroke. She was immediately transported by ambulance to another Hospital. She spent one day in ICU and then was put on palliative care. She died around 12/N on Friday, April 2nd, two days after the stroke."
	"1209873-1"	"1209873-1"	"HYPERHIDROSIS"	"10020642"	"50-59 years"	"50-59"	"The day after receiving the first dose of the Pfizer vaccine, she developed a headache behind her right eye that never went away. Then on Wednesday morning, March 31st (two weeks after receiving the first dose), she was found in bed by my mother, unable to walk or talk, her face was drooping, she was very sweaty, and had defecated on herself. My mother called the ambulance. She was transported to Hospital where it was determined she had suffered a massive hemorrhagic stroke. She was immediately transported by ambulance to another Hospital. She spent one day in ICU and then was put on palliative care. She died around 12/N on Friday, April 2nd, two days after the stroke."
	"1209873-1"	"1209873-1"	"INTENSIVE CARE"	"10022519"	"50-59 years"	"50-59"	"The day after receiving the first dose of the Pfizer vaccine, she developed a headache behind her right eye that never went away. Then on Wednesday morning, March 31st (two weeks after receiving the first dose), she was found in bed by my mother, unable to walk or talk, her face was drooping, she was very sweaty, and had defecated on herself. My mother called the ambulance. She was transported to Hospital where it was determined she had suffered a massive hemorrhagic stroke. She was immediately transported by ambulance to another Hospital. She spent one day in ICU and then was put on palliative care. She died around 12/N on Friday, April 2nd, two days after the stroke."
	"1210317-1"	"1210317-1"	"ACUTE RESPIRATORY FAILURE"	"10001053"	"50-59 years"	"50-59"	"We both got our shot at the same time on March 17, 2021. Then on March 22, 2021 at 9:20 PM my husband suffered cardiac arrest and a seizure. His heart was revived however, due to lack of oxygen to his brain he suffered brain damage and never regained consciousness and passed on 4/3/21 with acute respiratory failure."
	"1210317-1"	"1210317-1"	"BRAIN HYPOXIA"	"10006127"	"50-59 years"	"50-59"	"We both got our shot at the same time on March 17, 2021. Then on March 22, 2021 at 9:20 PM my husband suffered cardiac arrest and a seizure. His heart was revived however, due to lack of oxygen to his brain he suffered brain damage and never regained consciousness and passed on 4/3/21 with acute respiratory failure."
	"1210317-1"	"1210317-1"	"BRAIN INJURY"	"10067967"	"50-59 years"	"50-59"	"We both got our shot at the same time on March 17, 2021. Then on March 22, 2021 at 9:20 PM my husband suffered cardiac arrest and a seizure. His heart was revived however, due to lack of oxygen to his brain he suffered brain damage and never regained consciousness and passed on 4/3/21 with acute respiratory failure."
	"1210317-1"	"1210317-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"We both got our shot at the same time on March 17, 2021. Then on March 22, 2021 at 9:20 PM my husband suffered cardiac arrest and a seizure. His heart was revived however, due to lack of oxygen to his brain he suffered brain damage and never regained consciousness and passed on 4/3/21 with acute respiratory failure."
	"1210317-1"	"1210317-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"We both got our shot at the same time on March 17, 2021. Then on March 22, 2021 at 9:20 PM my husband suffered cardiac arrest and a seizure. His heart was revived however, due to lack of oxygen to his brain he suffered brain damage and never regained consciousness and passed on 4/3/21 with acute respiratory failure."
	"1210317-1"	"1210317-1"	"LOSS OF CONSCIOUSNESS"	"10024855"	"50-59 years"	"50-59"	"We both got our shot at the same time on March 17, 2021. Then on March 22, 2021 at 9:20 PM my husband suffered cardiac arrest and a seizure. His heart was revived however, due to lack of oxygen to his brain he suffered brain damage and never regained consciousness and passed on 4/3/21 with acute respiratory failure."
	"1210317-1"	"1210317-1"	"RESUSCITATION"	"10038749"	"50-59 years"	"50-59"	"We both got our shot at the same time on March 17, 2021. Then on March 22, 2021 at 9:20 PM my husband suffered cardiac arrest and a seizure. His heart was revived however, due to lack of oxygen to his brain he suffered brain damage and never regained consciousness and passed on 4/3/21 with acute respiratory failure."
	"1210317-1"	"1210317-1"	"SEIZURE"	"10039906"	"50-59 years"	"50-59"	"We both got our shot at the same time on March 17, 2021. Then on March 22, 2021 at 9:20 PM my husband suffered cardiac arrest and a seizure. His heart was revived however, due to lack of oxygen to his brain he suffered brain damage and never regained consciousness and passed on 4/3/21 with acute respiratory failure."
	"1210630-1"	"1210630-1"	"ASTHENIA"	"10003549"	"50-59 years"	"50-59"	""Mother called health department today, 4/14/21, to report reactions son experienced after receiving vaccine 3/4/21.  She stated that on 3/6/21 he started having headaches, weakness and leg cramps.  He went to the hospital two times with complaints.  On 3/15/21 he was unable to walk/drive because headaches were severe.  On 3/30/21 he passed out, squad was called.  He was not responsive and was put on a vent at the hospital.  A ""scan"" showed blood clots in brain and heart.  This individual passed away on 4/4/21.""
	"1210630-1"	"1210630-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	""Mother called health department today, 4/14/21, to report reactions son experienced after receiving vaccine 3/4/21.  She stated that on 3/6/21 he started having headaches, weakness and leg cramps.  He went to the hospital two times with complaints.  On 3/15/21 he was unable to walk/drive because headaches were severe.  On 3/30/21 he passed out, squad was called.  He was not responsive and was put on a vent at the hospital.  A ""scan"" showed blood clots in brain and heart.  This individual passed away on 4/4/21.""
	"1210630-1"	"1210630-1"	"GAIT INABILITY"	"10017581"	"50-59 years"	"50-59"	""Mother called health department today, 4/14/21, to report reactions son experienced after receiving vaccine 3/4/21.  She stated that on 3/6/21 he started having headaches, weakness and leg cramps.  He went to the hospital two times with complaints.  On 3/15/21 he was unable to walk/drive because headaches were severe.  On 3/30/21 he passed out, squad was called.  He was not responsive and was put on a vent at the hospital.  A ""scan"" showed blood clots in brain and heart.  This individual passed away on 4/4/21.""
	"1210630-1"	"1210630-1"	"HEADACHE"	"10019211"	"50-59 years"	"50-59"	""Mother called health department today, 4/14/21, to report reactions son experienced after receiving vaccine 3/4/21.  She stated that on 3/6/21 he started having headaches, weakness and leg cramps.  He went to the hospital two times with complaints.  On 3/15/21 he was unable to walk/drive because headaches were severe.  On 3/30/21 he passed out, squad was called.  He was not responsive and was put on a vent at the hospital.  A ""scan"" showed blood clots in brain and heart.  This individual passed away on 4/4/21.""
	"1210630-1"	"1210630-1"	"IMPAIRED DRIVING ABILITY"	"10049564"	"50-59 years"	"50-59"	""Mother called health department today, 4/14/21, to report reactions son experienced after receiving vaccine 3/4/21.  She stated that on 3/6/21 he started having headaches, weakness and leg cramps.  He went to the hospital two times with complaints.  On 3/15/21 he was unable to walk/drive because headaches were severe.  On 3/30/21 he passed out, squad was called.  He was not responsive and was put on a vent at the hospital.  A ""scan"" showed blood clots in brain and heart.  This individual passed away on 4/4/21.""
	"1210630-1"	"1210630-1"	"LOSS OF CONSCIOUSNESS"	"10024855"	"50-59 years"	"50-59"	""Mother called health department today, 4/14/21, to report reactions son experienced after receiving vaccine 3/4/21.  She stated that on 3/6/21 he started having headaches, weakness and leg cramps.  He went to the hospital two times with complaints.  On 3/15/21 he was unable to walk/drive because headaches were severe.  On 3/30/21 he passed out, squad was called.  He was not responsive and was put on a vent at the hospital.  A ""scan"" showed blood clots in brain and heart.  This individual passed away on 4/4/21.""
	"1210630-1"	"1210630-1"	"MECHANICAL VENTILATION"	"10067221"	"50-59 years"	"50-59"	""Mother called health department today, 4/14/21, to report reactions son experienced after receiving vaccine 3/4/21.  She stated that on 3/6/21 he started having headaches, weakness and leg cramps.  He went to the hospital two times with complaints.  On 3/15/21 he was unable to walk/drive because headaches were severe.  On 3/30/21 he passed out, squad was called.  He was not responsive and was put on a vent at the hospital.  A ""scan"" showed blood clots in brain and heart.  This individual passed away on 4/4/21.""
	"1210630-1"	"1210630-1"	"MUSCLE SPASMS"	"10028334"	"50-59 years"	"50-59"	""Mother called health department today, 4/14/21, to report reactions son experienced after receiving vaccine 3/4/21.  She stated that on 3/6/21 he started having headaches, weakness and leg cramps.  He went to the hospital two times with complaints.  On 3/15/21 he was unable to walk/drive because headaches were severe.  On 3/30/21 he passed out, squad was called.  He was not responsive and was put on a vent at the hospital.  A ""scan"" showed blood clots in brain and heart.  This individual passed away on 4/4/21.""
	"1210630-1"	"1210630-1"	"THROMBOSIS"	"10043607"	"50-59 years"	"50-59"	""Mother called health department today, 4/14/21, to report reactions son experienced after receiving vaccine 3/4/21.  She stated that on 3/6/21 he started having headaches, weakness and leg cramps.  He went to the hospital two times with complaints.  On 3/15/21 he was unable to walk/drive because headaches were severe.  On 3/30/21 he passed out, squad was called.  He was not responsive and was put on a vent at the hospital.  A ""scan"" showed blood clots in brain and heart.  This individual passed away on 4/4/21.""
	"1210630-1"	"1210630-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"50-59 years"	"50-59"	""Mother called health department today, 4/14/21, to report reactions son experienced after receiving vaccine 3/4/21.  She stated that on 3/6/21 he started having headaches, weakness and leg cramps.  He went to the hospital two times with complaints.  On 3/15/21 he was unable to walk/drive because headaches were severe.  On 3/30/21 he passed out, squad was called.  He was not responsive and was put on a vent at the hospital.  A ""scan"" showed blood clots in brain and heart.  This individual passed away on 4/4/21.""
	"1212295-1"	"1212295-1"	"CHILLS"	"10008531"	"50-59 years"	"50-59"	""Patients mom states 12 hours after vaccination dev: fever, chills, stiff neck. Symptoms got progressively worse throughout the day. on the evening of 4/8/21 patients mom describes patient talking ""out of her head"", fever, chills, leg pain, ""bad"" headache. On 4/9/21 patient woke up around 5:30 AM, sister helped to bathroom. reported leg pain, neck pain, headache. Laid back down. Sister found patient unresponsive around 9:00 AM. Sister performed CPR. Pronounced dead at patient's home by EMS.""
	"1212295-1"	"1212295-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	""Patients mom states 12 hours after vaccination dev: fever, chills, stiff neck. Symptoms got progressively worse throughout the day. on the evening of 4/8/21 patients mom describes patient talking ""out of her head"", fever, chills, leg pain, ""bad"" headache. On 4/9/21 patient woke up around 5:30 AM, sister helped to bathroom. reported leg pain, neck pain, headache. Laid back down. Sister found patient unresponsive around 9:00 AM. Sister performed CPR. Pronounced dead at patient's home by EMS.""
	"1212295-1"	"1212295-1"	"DISORGANISED SPEECH"	"10076227"	"50-59 years"	"50-59"	""Patients mom states 12 hours after vaccination dev: fever, chills, stiff neck. Symptoms got progressively worse throughout the day. on the evening of 4/8/21 patients mom describes patient talking ""out of her head"", fever, chills, leg pain, ""bad"" headache. On 4/9/21 patient woke up around 5:30 AM, sister helped to bathroom. reported leg pain, neck pain, headache. Laid back down. Sister found patient unresponsive around 9:00 AM. Sister performed CPR. Pronounced dead at patient's home by EMS.""
	"1212295-1"	"1212295-1"	"HEADACHE"	"10019211"	"50-59 years"	"50-59"	""Patients mom states 12 hours after vaccination dev: fever, chills, stiff neck. Symptoms got progressively worse throughout the day. on the evening of 4/8/21 patients mom describes patient talking ""out of her head"", fever, chills, leg pain, ""bad"" headache. On 4/9/21 patient woke up around 5:30 AM, sister helped to bathroom. reported leg pain, neck pain, headache. Laid back down. Sister found patient unresponsive around 9:00 AM. Sister performed CPR. Pronounced dead at patient's home by EMS.""
	"1212295-1"	"1212295-1"	"MUSCULOSKELETAL STIFFNESS"	"10052904"	"50-59 years"	"50-59"	""Patients mom states 12 hours after vaccination dev: fever, chills, stiff neck. Symptoms got progressively worse throughout the day. on the evening of 4/8/21 patients mom describes patient talking ""out of her head"", fever, chills, leg pain, ""bad"" headache. On 4/9/21 patient woke up around 5:30 AM, sister helped to bathroom. reported leg pain, neck pain, headache. Laid back down. Sister found patient unresponsive around 9:00 AM. Sister performed CPR. Pronounced dead at patient's home by EMS.""
	"1212295-1"	"1212295-1"	"NECK PAIN"	"10028836"	"50-59 years"	"50-59"	""Patients mom states 12 hours after vaccination dev: fever, chills, stiff neck. Symptoms got progressively worse throughout the day. on the evening of 4/8/21 patients mom describes patient talking ""out of her head"", fever, chills, leg pain, ""bad"" headache. On 4/9/21 patient woke up around 5:30 AM, sister helped to bathroom. reported leg pain, neck pain, headache. Laid back down. Sister found patient unresponsive around 9:00 AM. Sister performed CPR. Pronounced dead at patient's home by EMS.""
	"1212295-1"	"1212295-1"	"PAIN IN EXTREMITY"	"10033425"	"50-59 years"	"50-59"	""Patients mom states 12 hours after vaccination dev: fever, chills, stiff neck. Symptoms got progressively worse throughout the day. on the evening of 4/8/21 patients mom describes patient talking ""out of her head"", fever, chills, leg pain, ""bad"" headache. On 4/9/21 patient woke up around 5:30 AM, sister helped to bathroom. reported leg pain, neck pain, headache. Laid back down. Sister found patient unresponsive around 9:00 AM. Sister performed CPR. Pronounced dead at patient's home by EMS.""
	"1212295-1"	"1212295-1"	"PYREXIA"	"10037660"	"50-59 years"	"50-59"	""Patients mom states 12 hours after vaccination dev: fever, chills, stiff neck. Symptoms got progressively worse throughout the day. on the evening of 4/8/21 patients mom describes patient talking ""out of her head"", fever, chills, leg pain, ""bad"" headache. On 4/9/21 patient woke up around 5:30 AM, sister helped to bathroom. reported leg pain, neck pain, headache. Laid back down. Sister found patient unresponsive around 9:00 AM. Sister performed CPR. Pronounced dead at patient's home by EMS.""
	"1212295-1"	"1212295-1"	"RESUSCITATION"	"10038749"	"50-59 years"	"50-59"	""Patients mom states 12 hours after vaccination dev: fever, chills, stiff neck. Symptoms got progressively worse throughout the day. on the evening of 4/8/21 patients mom describes patient talking ""out of her head"", fever, chills, leg pain, ""bad"" headache. On 4/9/21 patient woke up around 5:30 AM, sister helped to bathroom. reported leg pain, neck pain, headache. Laid back down. Sister found patient unresponsive around 9:00 AM. Sister performed CPR. Pronounced dead at patient's home by EMS.""
	"1212295-1"	"1212295-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"50-59 years"	"50-59"	""Patients mom states 12 hours after vaccination dev: fever, chills, stiff neck. Symptoms got progressively worse throughout the day. on the evening of 4/8/21 patients mom describes patient talking ""out of her head"", fever, chills, leg pain, ""bad"" headache. On 4/9/21 patient woke up around 5:30 AM, sister helped to bathroom. reported leg pain, neck pain, headache. Laid back down. Sister found patient unresponsive around 9:00 AM. Sister performed CPR. Pronounced dead at patient's home by EMS.""
	"1212373-1"	"1212373-1"	"ABDOMINAL PAIN"	"10000081"	"50-59 years"	"50-59"	"The patient had an uneventful post-operative course and was discharged on post-op day 2. By report, on post op day 4-5, the patient began complaining of headache, back pain and abdominal pain. Continued home meds for post-op pain and constipation. On POD 8/9, the patient notified her daughter that she woke up short of breath. She was transferred by EMS to Hospital where she reportedly expired (this event was reported by the patient's daughter to doctor's office, the spine surgeon who managed her while inpatient at Hospital"
	"1212373-1"	"1212373-1"	"BACK PAIN"	"10003988"	"50-59 years"	"50-59"	"The patient had an uneventful post-operative course and was discharged on post-op day 2. By report, on post op day 4-5, the patient began complaining of headache, back pain and abdominal pain. Continued home meds for post-op pain and constipation. On POD 8/9, the patient notified her daughter that she woke up short of breath. She was transferred by EMS to Hospital where she reportedly expired (this event was reported by the patient's daughter to doctor's office, the spine surgeon who managed her while inpatient at Hospital"
	"1212373-1"	"1212373-1"	"CONSTIPATION"	"10010774"	"50-59 years"	"50-59"	"The patient had an uneventful post-operative course and was discharged on post-op day 2. By report, on post op day 4-5, the patient began complaining of headache, back pain and abdominal pain. Continued home meds for post-op pain and constipation. On POD 8/9, the patient notified her daughter that she woke up short of breath. She was transferred by EMS to Hospital where she reportedly expired (this event was reported by the patient's daughter to doctor's office, the spine surgeon who managed her while inpatient at Hospital"
	"1212373-1"	"1212373-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"The patient had an uneventful post-operative course and was discharged on post-op day 2. By report, on post op day 4-5, the patient began complaining of headache, back pain and abdominal pain. Continued home meds for post-op pain and constipation. On POD 8/9, the patient notified her daughter that she woke up short of breath. She was transferred by EMS to Hospital where she reportedly expired (this event was reported by the patient's daughter to doctor's office, the spine surgeon who managed her while inpatient at Hospital"
	"1212373-1"	"1212373-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"The patient had an uneventful post-operative course and was discharged on post-op day 2. By report, on post op day 4-5, the patient began complaining of headache, back pain and abdominal pain. Continued home meds for post-op pain and constipation. On POD 8/9, the patient notified her daughter that she woke up short of breath. She was transferred by EMS to Hospital where she reportedly expired (this event was reported by the patient's daughter to doctor's office, the spine surgeon who managed her while inpatient at Hospital"
	"1212373-1"	"1212373-1"	"HEADACHE"	"10019211"	"50-59 years"	"50-59"	"The patient had an uneventful post-operative course and was discharged on post-op day 2. By report, on post op day 4-5, the patient began complaining of headache, back pain and abdominal pain. Continued home meds for post-op pain and constipation. On POD 8/9, the patient notified her daughter that she woke up short of breath. She was transferred by EMS to Hospital where she reportedly expired (this event was reported by the patient's daughter to doctor's office, the spine surgeon who managed her while inpatient at Hospital"
	"1212373-1"	"1212373-1"	"PROCEDURAL PAIN"	"10064882"	"50-59 years"	"50-59"	"The patient had an uneventful post-operative course and was discharged on post-op day 2. By report, on post op day 4-5, the patient began complaining of headache, back pain and abdominal pain. Continued home meds for post-op pain and constipation. On POD 8/9, the patient notified her daughter that she woke up short of breath. She was transferred by EMS to Hospital where she reportedly expired (this event was reported by the patient's daughter to doctor's office, the spine surgeon who managed her while inpatient at Hospital"
	"1214544-1"	"1214544-1"	"BRAIN STEM HAEMORRHAGE"	"10006145"	"50-59 years"	"50-59"	"Patient died of a brain stem bleed on 4/11/21.  It is unknown if the vaccine received on 3/8/21 is in any way related to his passing."
	"1214544-1"	"1214544-1"	"COMPUTERISED TOMOGRAM HEAD ABNORMAL"	"10072168"	"50-59 years"	"50-59"	"Patient died of a brain stem bleed on 4/11/21.  It is unknown if the vaccine received on 3/8/21 is in any way related to his passing."
	"1214544-1"	"1214544-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient died of a brain stem bleed on 4/11/21.  It is unknown if the vaccine received on 3/8/21 is in any way related to his passing."
	"1214544-1"	"1214544-1"	"HYDROCEPHALUS"	"10020508"	"50-59 years"	"50-59"	"Patient died of a brain stem bleed on 4/11/21.  It is unknown if the vaccine received on 3/8/21 is in any way related to his passing."
	"1214544-1"	"1214544-1"	"INTERNATIONAL NORMALISED RATIO NORMAL"	"10022596"	"50-59 years"	"50-59"	"Patient died of a brain stem bleed on 4/11/21.  It is unknown if the vaccine received on 3/8/21 is in any way related to his passing."
	"1214544-1"	"1214544-1"	"INTRAVENTRICULAR HAEMORRHAGE"	"10022840"	"50-59 years"	"50-59"	"Patient died of a brain stem bleed on 4/11/21.  It is unknown if the vaccine received on 3/8/21 is in any way related to his passing."
	"1214544-1"	"1214544-1"	"PROTHROMBIN TIME PROLONGED"	"10037063"	"50-59 years"	"50-59"	"Patient died of a brain stem bleed on 4/11/21.  It is unknown if the vaccine received on 3/8/21 is in any way related to his passing."
	"1215033-1"	"1215033-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient sister contacted Pharmacy on 4/09/2021 about 4:30pm to report that her sister  had passed away on 4/1/2021 approximately 7 hours after receiving her first Covid-19 vaccine at our clinic. The sister reports that she spoke with her the evening of 3/31/2021approximately at 7:45pm. The sister,  indicated that her sister had been drinking and drank frequently. Stated her sister was an unhealthy person, drank everyday and could have been taking Alprazolam but wasn't sure. The sister stated that the patient's son had spoke/seen mom in the house around 8:30 pm. Patient was found in the household bathtub at around 1:00am, 911 was called and she was reported to be deceased upon arrival."
	"1215033-1"	"1215033-1"	"TOXICOLOGIC TEST"	"10061384"	"50-59 years"	"50-59"	"Patient sister contacted Pharmacy on 4/09/2021 about 4:30pm to report that her sister  had passed away on 4/1/2021 approximately 7 hours after receiving her first Covid-19 vaccine at our clinic. The sister reports that she spoke with her the evening of 3/31/2021approximately at 7:45pm. The sister,  indicated that her sister had been drinking and drank frequently. Stated her sister was an unhealthy person, drank everyday and could have been taking Alprazolam but wasn't sure. The sister stated that the patient's son had spoke/seen mom in the house around 8:30 pm. Patient was found in the household bathtub at around 1:00am, 911 was called and she was reported to be deceased upon arrival."
	"1215373-1"	"1215373-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"The pt missed her scheduled appointment for COVID vaccine #2, so I called her to reschedule.  Today I reached her mother, who informed me that pt passed away last Tuesday.  I did not ask for any details of her death at this time."
	"1215882-1"	"1215882-1"	"AUTOPSY"	"10050117"	"50-59 years"	"50-59"	"fatal pulmonary embolism from RLE DVT"
	"1215882-1"	"1215882-1"	"DEEP VEIN THROMBOSIS"	"10051055"	"50-59 years"	"50-59"	"fatal pulmonary embolism from RLE DVT"
	"1215882-1"	"1215882-1"	"PULMONARY EMBOLISM"	"10037377"	"50-59 years"	"50-59"	"fatal pulmonary embolism from RLE DVT"
	"1216134-1"	"1216134-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"Cardiac arrest...death"
	"1216134-1"	"1216134-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Cardiac arrest...death"
	"1218454-1"	"1218454-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"Patient's sister, spoke to Public Health staff to say that he passed away suddenly on 4/3/21 from a cardiac arrest, he had no underlying health conditions she states but did take some medications, she believes for blood pressure."
	"1218454-1"	"1218454-1"	"SUDDEN DEATH"	"10042434"	"50-59 years"	"50-59"	"Patient's sister, spoke to Public Health staff to say that he passed away suddenly on 4/3/21 from a cardiac arrest, he had no underlying health conditions she states but did take some medications, she believes for blood pressure."
	"1219100-1"	"1219100-1"	"AUTOPSY"	"10050117"	"50-59 years"	"50-59"	"This patient was at work two days after her vaccine and went to the bathroom. When she did not come back to work after around 20 minutes, she was found unresponsive and an ambulance was called. The patient was declared deceased at the  ER with the cause of death initially as cardiac arrest however a full autopsy was performed and  Coroner's office is awaiting that report at this time. We did not know of the death until we went back this week to complete the second round of vaccinations. Since the death happened in such close proximity to the vaccination date we felt it prudent to report."
	"1219100-1"	"1219100-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"This patient was at work two days after her vaccine and went to the bathroom. When she did not come back to work after around 20 minutes, she was found unresponsive and an ambulance was called. The patient was declared deceased at the  ER with the cause of death initially as cardiac arrest however a full autopsy was performed and  Coroner's office is awaiting that report at this time. We did not know of the death until we went back this week to complete the second round of vaccinations. Since the death happened in such close proximity to the vaccination date we felt it prudent to report."
	"1219100-1"	"1219100-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"This patient was at work two days after her vaccine and went to the bathroom. When she did not come back to work after around 20 minutes, she was found unresponsive and an ambulance was called. The patient was declared deceased at the  ER with the cause of death initially as cardiac arrest however a full autopsy was performed and  Coroner's office is awaiting that report at this time. We did not know of the death until we went back this week to complete the second round of vaccinations. Since the death happened in such close proximity to the vaccination date we felt it prudent to report."
	"1219100-1"	"1219100-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"50-59 years"	"50-59"	"This patient was at work two days after her vaccine and went to the bathroom. When she did not come back to work after around 20 minutes, she was found unresponsive and an ambulance was called. The patient was declared deceased at the  ER with the cause of death initially as cardiac arrest however a full autopsy was performed and  Coroner's office is awaiting that report at this time. We did not know of the death until we went back this week to complete the second round of vaccinations. Since the death happened in such close proximity to the vaccination date we felt it prudent to report."
	"1221145-1"	"1221145-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"My uncle unexpectedly passed away during the early morning hours of April 13.  He had reported to my aunt that he was having shortness of breath, headaches, and in general not feeling well.  She found him sitting up with a clear liquid pouring out of his nose and then he fell over dead."
	"1221145-1"	"1221145-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"My uncle unexpectedly passed away during the early morning hours of April 13.  He had reported to my aunt that he was having shortness of breath, headaches, and in general not feeling well.  She found him sitting up with a clear liquid pouring out of his nose and then he fell over dead."
	"1221145-1"	"1221145-1"	"FALL"	"10016173"	"50-59 years"	"50-59"	"My uncle unexpectedly passed away during the early morning hours of April 13.  He had reported to my aunt that he was having shortness of breath, headaches, and in general not feeling well.  She found him sitting up with a clear liquid pouring out of his nose and then he fell over dead."
	"1221145-1"	"1221145-1"	"HEADACHE"	"10019211"	"50-59 years"	"50-59"	"My uncle unexpectedly passed away during the early morning hours of April 13.  He had reported to my aunt that he was having shortness of breath, headaches, and in general not feeling well.  She found him sitting up with a clear liquid pouring out of his nose and then he fell over dead."
	"1221145-1"	"1221145-1"	"MALAISE"	"10025482"	"50-59 years"	"50-59"	"My uncle unexpectedly passed away during the early morning hours of April 13.  He had reported to my aunt that he was having shortness of breath, headaches, and in general not feeling well.  She found him sitting up with a clear liquid pouring out of his nose and then he fell over dead."
	"1221145-1"	"1221145-1"	"RHINORRHOEA"	"10039101"	"50-59 years"	"50-59"	"My uncle unexpectedly passed away during the early morning hours of April 13.  He had reported to my aunt that he was having shortness of breath, headaches, and in general not feeling well.  She found him sitting up with a clear liquid pouring out of his nose and then he fell over dead."
	"1221425-1"	"1221425-1"	"ABDOMINAL PAIN UPPER"	"10000087"	"50-59 years"	"50-59"	""Patient felt ok the day of the shot, next day got very sick. Said he felt terrible, felt like the vaccine was going to ""do him in."" He complained of weakness and shortness of breath. He was dehydrated and worried about his kidney function. Said he had a hard time going to the bathroom with stomach pains. On Mar 31, 2021, said he had fever, but didn't go to doctor. Was taken by ambulance April 3 to ER, admitted that night, transferred to ICU on April 4, on ventilator, proceeded to experience multiple organ failure and died on April 11, 2021""
	"1221425-1"	"1221425-1"	"ASTHENIA"	"10003549"	"50-59 years"	"50-59"	""Patient felt ok the day of the shot, next day got very sick. Said he felt terrible, felt like the vaccine was going to ""do him in."" He complained of weakness and shortness of breath. He was dehydrated and worried about his kidney function. Said he had a hard time going to the bathroom with stomach pains. On Mar 31, 2021, said he had fever, but didn't go to doctor. Was taken by ambulance April 3 to ER, admitted that night, transferred to ICU on April 4, on ventilator, proceeded to experience multiple organ failure and died on April 11, 2021""
	"1221425-1"	"1221425-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	""Patient felt ok the day of the shot, next day got very sick. Said he felt terrible, felt like the vaccine was going to ""do him in."" He complained of weakness and shortness of breath. He was dehydrated and worried about his kidney function. Said he had a hard time going to the bathroom with stomach pains. On Mar 31, 2021, said he had fever, but didn't go to doctor. Was taken by ambulance April 3 to ER, admitted that night, transferred to ICU on April 4, on ventilator, proceeded to experience multiple organ failure and died on April 11, 2021""
	"1221425-1"	"1221425-1"	"DEHYDRATION"	"10012174"	"50-59 years"	"50-59"	""Patient felt ok the day of the shot, next day got very sick. Said he felt terrible, felt like the vaccine was going to ""do him in."" He complained of weakness and shortness of breath. He was dehydrated and worried about his kidney function. Said he had a hard time going to the bathroom with stomach pains. On Mar 31, 2021, said he had fever, but didn't go to doctor. Was taken by ambulance April 3 to ER, admitted that night, transferred to ICU on April 4, on ventilator, proceeded to experience multiple organ failure and died on April 11, 2021""
	"1221425-1"	"1221425-1"	"DIALYSIS"	"10061105"	"50-59 years"	"50-59"	""Patient felt ok the day of the shot, next day got very sick. Said he felt terrible, felt like the vaccine was going to ""do him in."" He complained of weakness and shortness of breath. He was dehydrated and worried about his kidney function. Said he had a hard time going to the bathroom with stomach pains. On Mar 31, 2021, said he had fever, but didn't go to doctor. Was taken by ambulance April 3 to ER, admitted that night, transferred to ICU on April 4, on ventilator, proceeded to experience multiple organ failure and died on April 11, 2021""
	"1221425-1"	"1221425-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	""Patient felt ok the day of the shot, next day got very sick. Said he felt terrible, felt like the vaccine was going to ""do him in."" He complained of weakness and shortness of breath. He was dehydrated and worried about his kidney function. Said he had a hard time going to the bathroom with stomach pains. On Mar 31, 2021, said he had fever, but didn't go to doctor. Was taken by ambulance April 3 to ER, admitted that night, transferred to ICU on April 4, on ventilator, proceeded to experience multiple organ failure and died on April 11, 2021""
	"1221425-1"	"1221425-1"	"ECHOCARDIOGRAM"	"10014113"	"50-59 years"	"50-59"	""Patient felt ok the day of the shot, next day got very sick. Said he felt terrible, felt like the vaccine was going to ""do him in."" He complained of weakness and shortness of breath. He was dehydrated and worried about his kidney function. Said he had a hard time going to the bathroom with stomach pains. On Mar 31, 2021, said he had fever, but didn't go to doctor. Was taken by ambulance April 3 to ER, admitted that night, transferred to ICU on April 4, on ventilator, proceeded to experience multiple organ failure and died on April 11, 2021""
	"1221425-1"	"1221425-1"	"FEELING ABNORMAL"	"10016322"	"50-59 years"	"50-59"	""Patient felt ok the day of the shot, next day got very sick. Said he felt terrible, felt like the vaccine was going to ""do him in."" He complained of weakness and shortness of breath. He was dehydrated and worried about his kidney function. Said he had a hard time going to the bathroom with stomach pains. On Mar 31, 2021, said he had fever, but didn't go to doctor. Was taken by ambulance April 3 to ER, admitted that night, transferred to ICU on April 4, on ventilator, proceeded to experience multiple organ failure and died on April 11, 2021""
	"1221425-1"	"1221425-1"	"ILLNESS"	"10080284"	"50-59 years"	"50-59"	""Patient felt ok the day of the shot, next day got very sick. Said he felt terrible, felt like the vaccine was going to ""do him in."" He complained of weakness and shortness of breath. He was dehydrated and worried about his kidney function. Said he had a hard time going to the bathroom with stomach pains. On Mar 31, 2021, said he had fever, but didn't go to doctor. Was taken by ambulance April 3 to ER, admitted that night, transferred to ICU on April 4, on ventilator, proceeded to experience multiple organ failure and died on April 11, 2021""
	"1221425-1"	"1221425-1"	"INTENSIVE CARE"	"10022519"	"50-59 years"	"50-59"	""Patient felt ok the day of the shot, next day got very sick. Said he felt terrible, felt like the vaccine was going to ""do him in."" He complained of weakness and shortness of breath. He was dehydrated and worried about his kidney function. Said he had a hard time going to the bathroom with stomach pains. On Mar 31, 2021, said he had fever, but didn't go to doctor. Was taken by ambulance April 3 to ER, admitted that night, transferred to ICU on April 4, on ventilator, proceeded to experience multiple organ failure and died on April 11, 2021""
	"1221425-1"	"1221425-1"	"LABORATORY TEST"	"10059938"	"50-59 years"	"50-59"	""Patient felt ok the day of the shot, next day got very sick. Said he felt terrible, felt like the vaccine was going to ""do him in."" He complained of weakness and shortness of breath. He was dehydrated and worried about his kidney function. Said he had a hard time going to the bathroom with stomach pains. On Mar 31, 2021, said he had fever, but didn't go to doctor. Was taken by ambulance April 3 to ER, admitted that night, transferred to ICU on April 4, on ventilator, proceeded to experience multiple organ failure and died on April 11, 2021""
	"1221425-1"	"1221425-1"	"MECHANICAL VENTILATION"	"10067221"	"50-59 years"	"50-59"	""Patient felt ok the day of the shot, next day got very sick. Said he felt terrible, felt like the vaccine was going to ""do him in."" He complained of weakness and shortness of breath. He was dehydrated and worried about his kidney function. Said he had a hard time going to the bathroom with stomach pains. On Mar 31, 2021, said he had fever, but didn't go to doctor. Was taken by ambulance April 3 to ER, admitted that night, transferred to ICU on April 4, on ventilator, proceeded to experience multiple organ failure and died on April 11, 2021""
	"1221425-1"	"1221425-1"	"MULTIPLE ORGAN DYSFUNCTION SYNDROME"	"10077361"	"50-59 years"	"50-59"	""Patient felt ok the day of the shot, next day got very sick. Said he felt terrible, felt like the vaccine was going to ""do him in."" He complained of weakness and shortness of breath. He was dehydrated and worried about his kidney function. Said he had a hard time going to the bathroom with stomach pains. On Mar 31, 2021, said he had fever, but didn't go to doctor. Was taken by ambulance April 3 to ER, admitted that night, transferred to ICU on April 4, on ventilator, proceeded to experience multiple organ failure and died on April 11, 2021""
	"1221425-1"	"1221425-1"	"PYREXIA"	"10037660"	"50-59 years"	"50-59"	""Patient felt ok the day of the shot, next day got very sick. Said he felt terrible, felt like the vaccine was going to ""do him in."" He complained of weakness and shortness of breath. He was dehydrated and worried about his kidney function. Said he had a hard time going to the bathroom with stomach pains. On Mar 31, 2021, said he had fever, but didn't go to doctor. Was taken by ambulance April 3 to ER, admitted that night, transferred to ICU on April 4, on ventilator, proceeded to experience multiple organ failure and died on April 11, 2021""
	"1221576-1"	"1221576-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Death"
	"1222469-1"	"1222469-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"REPOERTED BY FAMILY MEMBER THAT THEY FOUND PATIENT DEAD IN SLEEP, NOT BREATHING SUSPECTING HEART ATTACK...AUTOPSY WILL BE PERFORMED"
	"1222469-1"	"1222469-1"	"MYOCARDIAL INFARCTION"	"10028596"	"50-59 years"	"50-59"	"REPOERTED BY FAMILY MEMBER THAT THEY FOUND PATIENT DEAD IN SLEEP, NOT BREATHING SUSPECTING HEART ATTACK...AUTOPSY WILL BE PERFORMED"
	"1222469-1"	"1222469-1"	"RESPIRATORY ARREST"	"10038669"	"50-59 years"	"50-59"	"REPOERTED BY FAMILY MEMBER THAT THEY FOUND PATIENT DEAD IN SLEEP, NOT BREATHING SUSPECTING HEART ATTACK...AUTOPSY WILL BE PERFORMED"
	"1222886-1"	"1222886-1"	"ANEURYSM"	"10002329"	"50-59 years"	"50-59"	"Massive aneurysm - deceased 04-15-2021"
	"1222886-1"	"1222886-1"	"COMPUTERISED TOMOGRAM"	"10010234"	"50-59 years"	"50-59"	"Massive aneurysm - deceased 04-15-2021"
	"1222886-1"	"1222886-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Massive aneurysm - deceased 04-15-2021"
	"1223378-1"	"1223378-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"please find attached document provided by spouse."
	"1225854-1"	"1225854-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Death, 04/16/2021"
	"1226196-1"	"1226196-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"Patient arrived to Hospital in cardiac arrest 48 hours after administration of the Pfizer Vaccine."
	"1226196-1"	"1226196-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient arrived to Hospital in cardiac arrest 48 hours after administration of the Pfizer Vaccine."
	"1227980-1"	"1227980-1"	"FALL"	"10016173"	"50-59 years"	"50-59"	"Blood Clot/The Blood clot was in the legs and went to his lungs; Blood Clot/The Blood clot was in the legs and went to his lungs; fell; Leg pain; This is a spontaneous report from a contactable consumer.   A 51-year-old male patient received his first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE), via an unspecified route of administration on 27Mar2021 (Batch/Lot Number: EP6955) as single dose for covid-19 immunisation.  Medical history included thrombosis from 2020 to an unknown date, it was Months ago in 2020, He was prescribed a medicine for blood clots, but since then he has had no issues, anxiety from an unknown date and unknown if ongoing. Her brother in law had anxiety about even getting the vaccine. The patient experienced leg pain on Mar2021 , pulmonary thrombosis, leg thrombosis and fall on an unspecified date.  The patient died on 02Apr2021.  An autopsy was not performed. The clinical course was the following: The Blood clot was in the legs and went to his lungs, his leg never got red or anything and it was a blood clot. He was having such bad leg pain, it's too bad, had there been some sort of warning, he would have thought to wait till next year. There was nothing the day he got vaccine, but that night his leg started hurting, his girlfriend said let me go get a cold wrap and she wrapped it, he's a farmer. He wakes up the next day and his leg is still hurting, the 3rd day it goes on, his leg still hurting and no one is thinking it a blood clot, he calls the doctor and tells the doctor his leg is hurting, they suggest ibuprofen for inflammation, the next day thought maybe it's better, by Friday he was making breakfast, fell and died. With his girlfriend she said what's going on, and he went straight to hospital, they said the clot in his leg went to the lung. The Blood clot when it was in the leg it never got hot, red, or anything like that. He had the vaccine in the morning and on that same day the leg pain started later that night. It Started out with Leg Pain, she does not know if it was right or left but it was just one leg.; Reported Cause(s) of Death: Thrombosis pulmonary; Thrombosis leg; Fall; Leg pain"
	"1227980-1"	"1227980-1"	"PAIN IN EXTREMITY"	"10033425"	"50-59 years"	"50-59"	"Blood Clot/The Blood clot was in the legs and went to his lungs; Blood Clot/The Blood clot was in the legs and went to his lungs; fell; Leg pain; This is a spontaneous report from a contactable consumer.   A 51-year-old male patient received his first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE), via an unspecified route of administration on 27Mar2021 (Batch/Lot Number: EP6955) as single dose for covid-19 immunisation.  Medical history included thrombosis from 2020 to an unknown date, it was Months ago in 2020, He was prescribed a medicine for blood clots, but since then he has had no issues, anxiety from an unknown date and unknown if ongoing. Her brother in law had anxiety about even getting the vaccine. The patient experienced leg pain on Mar2021 , pulmonary thrombosis, leg thrombosis and fall on an unspecified date.  The patient died on 02Apr2021.  An autopsy was not performed. The clinical course was the following: The Blood clot was in the legs and went to his lungs, his leg never got red or anything and it was a blood clot. He was having such bad leg pain, it's too bad, had there been some sort of warning, he would have thought to wait till next year. There was nothing the day he got vaccine, but that night his leg started hurting, his girlfriend said let me go get a cold wrap and she wrapped it, he's a farmer. He wakes up the next day and his leg is still hurting, the 3rd day it goes on, his leg still hurting and no one is thinking it a blood clot, he calls the doctor and tells the doctor his leg is hurting, they suggest ibuprofen for inflammation, the next day thought maybe it's better, by Friday he was making breakfast, fell and died. With his girlfriend she said what's going on, and he went straight to hospital, they said the clot in his leg went to the lung. The Blood clot when it was in the leg it never got hot, red, or anything like that. He had the vaccine in the morning and on that same day the leg pain started later that night. It Started out with Leg Pain, she does not know if it was right or left but it was just one leg.; Reported Cause(s) of Death: Thrombosis pulmonary; Thrombosis leg; Fall; Leg pain"
	"1227980-1"	"1227980-1"	"PULMONARY THROMBOSIS"	"10037437"	"50-59 years"	"50-59"	"Blood Clot/The Blood clot was in the legs and went to his lungs; Blood Clot/The Blood clot was in the legs and went to his lungs; fell; Leg pain; This is a spontaneous report from a contactable consumer.   A 51-year-old male patient received his first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE), via an unspecified route of administration on 27Mar2021 (Batch/Lot Number: EP6955) as single dose for covid-19 immunisation.  Medical history included thrombosis from 2020 to an unknown date, it was Months ago in 2020, He was prescribed a medicine for blood clots, but since then he has had no issues, anxiety from an unknown date and unknown if ongoing. Her brother in law had anxiety about even getting the vaccine. The patient experienced leg pain on Mar2021 , pulmonary thrombosis, leg thrombosis and fall on an unspecified date.  The patient died on 02Apr2021.  An autopsy was not performed. The clinical course was the following: The Blood clot was in the legs and went to his lungs, his leg never got red or anything and it was a blood clot. He was having such bad leg pain, it's too bad, had there been some sort of warning, he would have thought to wait till next year. There was nothing the day he got vaccine, but that night his leg started hurting, his girlfriend said let me go get a cold wrap and she wrapped it, he's a farmer. He wakes up the next day and his leg is still hurting, the 3rd day it goes on, his leg still hurting and no one is thinking it a blood clot, he calls the doctor and tells the doctor his leg is hurting, they suggest ibuprofen for inflammation, the next day thought maybe it's better, by Friday he was making breakfast, fell and died. With his girlfriend she said what's going on, and he went straight to hospital, they said the clot in his leg went to the lung. The Blood clot when it was in the leg it never got hot, red, or anything like that. He had the vaccine in the morning and on that same day the leg pain started later that night. It Started out with Leg Pain, she does not know if it was right or left but it was just one leg.; Reported Cause(s) of Death: Thrombosis pulmonary; Thrombosis leg; Fall; Leg pain"
	"1227980-1"	"1227980-1"	"THROMBOSIS"	"10043607"	"50-59 years"	"50-59"	"Blood Clot/The Blood clot was in the legs and went to his lungs; Blood Clot/The Blood clot was in the legs and went to his lungs; fell; Leg pain; This is a spontaneous report from a contactable consumer.   A 51-year-old male patient received his first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE), via an unspecified route of administration on 27Mar2021 (Batch/Lot Number: EP6955) as single dose for covid-19 immunisation.  Medical history included thrombosis from 2020 to an unknown date, it was Months ago in 2020, He was prescribed a medicine for blood clots, but since then he has had no issues, anxiety from an unknown date and unknown if ongoing. Her brother in law had anxiety about even getting the vaccine. The patient experienced leg pain on Mar2021 , pulmonary thrombosis, leg thrombosis and fall on an unspecified date.  The patient died on 02Apr2021.  An autopsy was not performed. The clinical course was the following: The Blood clot was in the legs and went to his lungs, his leg never got red or anything and it was a blood clot. He was having such bad leg pain, it's too bad, had there been some sort of warning, he would have thought to wait till next year. There was nothing the day he got vaccine, but that night his leg started hurting, his girlfriend said let me go get a cold wrap and she wrapped it, he's a farmer. He wakes up the next day and his leg is still hurting, the 3rd day it goes on, his leg still hurting and no one is thinking it a blood clot, he calls the doctor and tells the doctor his leg is hurting, they suggest ibuprofen for inflammation, the next day thought maybe it's better, by Friday he was making breakfast, fell and died. With his girlfriend she said what's going on, and he went straight to hospital, they said the clot in his leg went to the lung. The Blood clot when it was in the leg it never got hot, red, or anything like that. He had the vaccine in the morning and on that same day the leg pain started later that night. It Started out with Leg Pain, she does not know if it was right or left but it was just one leg.; Reported Cause(s) of Death: Thrombosis pulmonary; Thrombosis leg; Fall; Leg pain"
	"1228481-1"	"1228481-1"	"AUTOPSY"	"10050117"	"50-59 years"	"50-59"	"The patient had previously been diagnosed with COVID-19 in November 2020, but did no require hospitalization and had recovered. He received his first dose of the Pfizer COVID vaccine on 2/25/2021, and on 3/15/2021, collapsed suddenly at home and was unable to be resuscitated. An autopsy was performed at the request of the family, and a massive pulmonary embolus was found in the main pulmonary artery and extending far into the segmental pulmonary arteries of both lungs."
	"1228481-1"	"1228481-1"	"PULMONARY EMBOLISM"	"10037377"	"50-59 years"	"50-59"	"The patient had previously been diagnosed with COVID-19 in November 2020, but did no require hospitalization and had recovered. He received his first dose of the Pfizer COVID vaccine on 2/25/2021, and on 3/15/2021, collapsed suddenly at home and was unable to be resuscitated. An autopsy was performed at the request of the family, and a massive pulmonary embolus was found in the main pulmonary artery and extending far into the segmental pulmonary arteries of both lungs."
	"1228481-1"	"1228481-1"	"RESUSCITATION"	"10038749"	"50-59 years"	"50-59"	"The patient had previously been diagnosed with COVID-19 in November 2020, but did no require hospitalization and had recovered. He received his first dose of the Pfizer COVID vaccine on 2/25/2021, and on 3/15/2021, collapsed suddenly at home and was unable to be resuscitated. An autopsy was performed at the request of the family, and a massive pulmonary embolus was found in the main pulmonary artery and extending far into the segmental pulmonary arteries of both lungs."
	"1228481-1"	"1228481-1"	"SYNCOPE"	"10042772"	"50-59 years"	"50-59"	"The patient had previously been diagnosed with COVID-19 in November 2020, but did no require hospitalization and had recovered. He received his first dose of the Pfizer COVID vaccine on 2/25/2021, and on 3/15/2021, collapsed suddenly at home and was unable to be resuscitated. An autopsy was performed at the request of the family, and a massive pulmonary embolus was found in the main pulmonary artery and extending far into the segmental pulmonary arteries of both lungs."
	"1228974-1"	"1228974-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"PATIENT GOT FIRST DOSE OF MODERNA ON 03/11/21 AND PASSED AWAY ON 03/28/2021"
	"1229059-1"	"1229059-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Patient diagnosed with COVID-19 on 3/24/2021 after receiving her first dose of Moderna COVID-19 vaccine on 3/19/2021"
	"1229552-1"	"1229552-1"	"CHILLS"	"10008531"	"50-59 years"	"50-59"	"We administered the second dose of the Moderna COVID-19 vaccine on Friday, April 16th. We were contacted by the patients family to report that the patient began a fever and chills the night of 4/16, she subsequently began having  nausea, vomitting, and sweating followed by a seizure, and was taken to the emergency department where she died the following day.  She was encouraged to receive the vaccine at the encouragement of her oncologist."
	"1229552-1"	"1229552-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"We administered the second dose of the Moderna COVID-19 vaccine on Friday, April 16th. We were contacted by the patients family to report that the patient began a fever and chills the night of 4/16, she subsequently began having  nausea, vomitting, and sweating followed by a seizure, and was taken to the emergency department where she died the following day.  She was encouraged to receive the vaccine at the encouragement of her oncologist."
	"1229552-1"	"1229552-1"	"HYPERHIDROSIS"	"10020642"	"50-59 years"	"50-59"	"We administered the second dose of the Moderna COVID-19 vaccine on Friday, April 16th. We were contacted by the patients family to report that the patient began a fever and chills the night of 4/16, she subsequently began having  nausea, vomitting, and sweating followed by a seizure, and was taken to the emergency department where she died the following day.  She was encouraged to receive the vaccine at the encouragement of her oncologist."
	"1229552-1"	"1229552-1"	"NAUSEA"	"10028813"	"50-59 years"	"50-59"	"We administered the second dose of the Moderna COVID-19 vaccine on Friday, April 16th. We were contacted by the patients family to report that the patient began a fever and chills the night of 4/16, she subsequently began having  nausea, vomitting, and sweating followed by a seizure, and was taken to the emergency department where she died the following day.  She was encouraged to receive the vaccine at the encouragement of her oncologist."
	"1229552-1"	"1229552-1"	"PYREXIA"	"10037660"	"50-59 years"	"50-59"	"We administered the second dose of the Moderna COVID-19 vaccine on Friday, April 16th. We were contacted by the patients family to report that the patient began a fever and chills the night of 4/16, she subsequently began having  nausea, vomitting, and sweating followed by a seizure, and was taken to the emergency department where she died the following day.  She was encouraged to receive the vaccine at the encouragement of her oncologist."
	"1229552-1"	"1229552-1"	"SEIZURE"	"10039906"	"50-59 years"	"50-59"	"We administered the second dose of the Moderna COVID-19 vaccine on Friday, April 16th. We were contacted by the patients family to report that the patient began a fever and chills the night of 4/16, she subsequently began having  nausea, vomitting, and sweating followed by a seizure, and was taken to the emergency department where she died the following day.  She was encouraged to receive the vaccine at the encouragement of her oncologist."
	"1229552-1"	"1229552-1"	"VOMITING"	"10047700"	"50-59 years"	"50-59"	"We administered the second dose of the Moderna COVID-19 vaccine on Friday, April 16th. We were contacted by the patients family to report that the patient began a fever and chills the night of 4/16, she subsequently began having  nausea, vomitting, and sweating followed by a seizure, and was taken to the emergency department where she died the following day.  She was encouraged to receive the vaccine at the encouragement of her oncologist."
	"1229878-1"	"1229878-1"	"CAROTID ARTERY DISSECTION"	"10050403"	"50-59 years"	"50-59"	"Dissection of the right ICA with occlusion of tthe right ICA, right MCA and portions of A1 segmenet of the ACA"
	"1229878-1"	"1229878-1"	"CAROTID ARTERY OCCLUSION"	"10048964"	"50-59 years"	"50-59"	"Dissection of the right ICA with occlusion of tthe right ICA, right MCA and portions of A1 segmenet of the ACA"
	"1229878-1"	"1229878-1"	"CEREBRAL ARTERY OCCLUSION"	"10008089"	"50-59 years"	"50-59"	"Dissection of the right ICA with occlusion of tthe right ICA, right MCA and portions of A1 segmenet of the ACA"
	"1230024-1"	"1230024-1"	"COMPUTERISED TOMOGRAM THORAX ABNORMAL"	"10057799"	"50-59 years"	"50-59"	"Shortness of breath, hypoxia, Pulmonary Embolism, intubation death."
	"1230024-1"	"1230024-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Shortness of breath, hypoxia, Pulmonary Embolism, intubation death."
	"1230024-1"	"1230024-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"Shortness of breath, hypoxia, Pulmonary Embolism, intubation death."
	"1230024-1"	"1230024-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"50-59 years"	"50-59"	"Shortness of breath, hypoxia, Pulmonary Embolism, intubation death."
	"1230024-1"	"1230024-1"	"HYPOXIA"	"10021143"	"50-59 years"	"50-59"	"Shortness of breath, hypoxia, Pulmonary Embolism, intubation death."
	"1230024-1"	"1230024-1"	"PLATELET DISORDER"	"10035532"	"50-59 years"	"50-59"	"Shortness of breath, hypoxia, Pulmonary Embolism, intubation death."
	"1230024-1"	"1230024-1"	"PULMONARY EMBOLISM"	"10037377"	"50-59 years"	"50-59"	"Shortness of breath, hypoxia, Pulmonary Embolism, intubation death."
	"1230324-1"	"1230324-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Fatigue, , Body aches, Swollen hands (noted on the 27th), Death (31st)"
	"1230324-1"	"1230324-1"	"FATIGUE"	"10016256"	"50-59 years"	"50-59"	"Fatigue, , Body aches, Swollen hands (noted on the 27th), Death (31st)"
	"1230324-1"	"1230324-1"	"PAIN"	"10033371"	"50-59 years"	"50-59"	"Fatigue, , Body aches, Swollen hands (noted on the 27th), Death (31st)"
	"1230324-1"	"1230324-1"	"PERIPHERAL SWELLING"	"10048959"	"50-59 years"	"50-59"	"Fatigue, , Body aches, Swollen hands (noted on the 27th), Death (31st)"
	"1232707-1"	"1232707-1"	"ACUTE CARDIAC EVENT"	"10081099"	"50-59 years"	"50-59"	"Patient died at home per medical examiner, suspected cardiovascular event"
	"1232707-1"	"1232707-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient died at home per medical examiner, suspected cardiovascular event"
	"1232799-1"	"1232799-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"No information really known. Office was notified yesterday by county coroner that patient was found deceased in his home on 4/9/19.  Coroner was requesting patient records. Unknown if death related to the Moderna Covie-19 vaccine but reporting this as death occurred 3 days after the vaccine and coroner gave office no information.  You can contact the coroner involved with this case."
	"1233445-1"	"1233445-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient found in pulseless arrest on stairwell of her apartment building on the night of 4/2/21.  Patient transported via ambulance to hospital where she passed away."
	"1233445-1"	"1233445-1"	"PULSELESS ELECTRICAL ACTIVITY"	"10058151"	"50-59 years"	"50-59"	"Patient found in pulseless arrest on stairwell of her apartment building on the night of 4/2/21.  Patient transported via ambulance to hospital where she passed away."
	"1233606-1"	"1233606-1"	"APNOEA"	"10002974"	"50-59 years"	"50-59"	"52 m active alcoholic with lab abnormalities c/w heavy etoh including pancytopenia (anemia to 7s, throbocytopenia to 70s, mild leukopenia-since 12/20); 2 recent admissions (feb march 2021) with likely etoh-induced pre-renal AKI; DM; who received 2nd dose of moderna 4/8/21.  After not being in contact with his family for several days, family sought him at his residence where he was found pulsless and apneic on the floor with some scant blood near his face.  CPR-- >transported to hospital where upon attempting to intubate profuse bleeding into larynx/pharynx noted.  Despite ongoing cpr and mechanical ventilation team in ER was unable to re-establish pulse.  He was pronounced dead at about 8 PM 4/9/21."
	"1233606-1"	"1233606-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"52 m active alcoholic with lab abnormalities c/w heavy etoh including pancytopenia (anemia to 7s, throbocytopenia to 70s, mild leukopenia-since 12/20); 2 recent admissions (feb march 2021) with likely etoh-induced pre-renal AKI; DM; who received 2nd dose of moderna 4/8/21.  After not being in contact with his family for several days, family sought him at his residence where he was found pulsless and apneic on the floor with some scant blood near his face.  CPR-- >transported to hospital where upon attempting to intubate profuse bleeding into larynx/pharynx noted.  Despite ongoing cpr and mechanical ventilation team in ER was unable to re-establish pulse.  He was pronounced dead at about 8 PM 4/9/21."
	"1233606-1"	"1233606-1"	"FALL"	"10016173"	"50-59 years"	"50-59"	"52 m active alcoholic with lab abnormalities c/w heavy etoh including pancytopenia (anemia to 7s, throbocytopenia to 70s, mild leukopenia-since 12/20); 2 recent admissions (feb march 2021) with likely etoh-induced pre-renal AKI; DM; who received 2nd dose of moderna 4/8/21.  After not being in contact with his family for several days, family sought him at his residence where he was found pulsless and apneic on the floor with some scant blood near his face.  CPR-- >transported to hospital where upon attempting to intubate profuse bleeding into larynx/pharynx noted.  Despite ongoing cpr and mechanical ventilation team in ER was unable to re-establish pulse.  He was pronounced dead at about 8 PM 4/9/21."
	"1233606-1"	"1233606-1"	"HAEMORRHAGE"	"10055798"	"50-59 years"	"50-59"	"52 m active alcoholic with lab abnormalities c/w heavy etoh including pancytopenia (anemia to 7s, throbocytopenia to 70s, mild leukopenia-since 12/20); 2 recent admissions (feb march 2021) with likely etoh-induced pre-renal AKI; DM; who received 2nd dose of moderna 4/8/21.  After not being in contact with his family for several days, family sought him at his residence where he was found pulsless and apneic on the floor with some scant blood near his face.  CPR-- >transported to hospital where upon attempting to intubate profuse bleeding into larynx/pharynx noted.  Despite ongoing cpr and mechanical ventilation team in ER was unable to re-establish pulse.  He was pronounced dead at about 8 PM 4/9/21."
	"1233606-1"	"1233606-1"	"LARYNGEAL HAEMORRHAGE"	"10065740"	"50-59 years"	"50-59"	"52 m active alcoholic with lab abnormalities c/w heavy etoh including pancytopenia (anemia to 7s, throbocytopenia to 70s, mild leukopenia-since 12/20); 2 recent admissions (feb march 2021) with likely etoh-induced pre-renal AKI; DM; who received 2nd dose of moderna 4/8/21.  After not being in contact with his family for several days, family sought him at his residence where he was found pulsless and apneic on the floor with some scant blood near his face.  CPR-- >transported to hospital where upon attempting to intubate profuse bleeding into larynx/pharynx noted.  Despite ongoing cpr and mechanical ventilation team in ER was unable to re-establish pulse.  He was pronounced dead at about 8 PM 4/9/21."
	"1233606-1"	"1233606-1"	"MECHANICAL VENTILATION"	"10067221"	"50-59 years"	"50-59"	"52 m active alcoholic with lab abnormalities c/w heavy etoh including pancytopenia (anemia to 7s, throbocytopenia to 70s, mild leukopenia-since 12/20); 2 recent admissions (feb march 2021) with likely etoh-induced pre-renal AKI; DM; who received 2nd dose of moderna 4/8/21.  After not being in contact with his family for several days, family sought him at his residence where he was found pulsless and apneic on the floor with some scant blood near his face.  CPR-- >transported to hospital where upon attempting to intubate profuse bleeding into larynx/pharynx noted.  Despite ongoing cpr and mechanical ventilation team in ER was unable to re-establish pulse.  He was pronounced dead at about 8 PM 4/9/21."
	"1233606-1"	"1233606-1"	"PHARYNGEAL HAEMORRHAGE"	"10034827"	"50-59 years"	"50-59"	"52 m active alcoholic with lab abnormalities c/w heavy etoh including pancytopenia (anemia to 7s, throbocytopenia to 70s, mild leukopenia-since 12/20); 2 recent admissions (feb march 2021) with likely etoh-induced pre-renal AKI; DM; who received 2nd dose of moderna 4/8/21.  After not being in contact with his family for several days, family sought him at his residence where he was found pulsless and apneic on the floor with some scant blood near his face.  CPR-- >transported to hospital where upon attempting to intubate profuse bleeding into larynx/pharynx noted.  Despite ongoing cpr and mechanical ventilation team in ER was unable to re-establish pulse.  He was pronounced dead at about 8 PM 4/9/21."
	"1233606-1"	"1233606-1"	"PULSE ABSENT"	"10037469"	"50-59 years"	"50-59"	"52 m active alcoholic with lab abnormalities c/w heavy etoh including pancytopenia (anemia to 7s, throbocytopenia to 70s, mild leukopenia-since 12/20); 2 recent admissions (feb march 2021) with likely etoh-induced pre-renal AKI; DM; who received 2nd dose of moderna 4/8/21.  After not being in contact with his family for several days, family sought him at his residence where he was found pulsless and apneic on the floor with some scant blood near his face.  CPR-- >transported to hospital where upon attempting to intubate profuse bleeding into larynx/pharynx noted.  Despite ongoing cpr and mechanical ventilation team in ER was unable to re-establish pulse.  He was pronounced dead at about 8 PM 4/9/21."
	"1233606-1"	"1233606-1"	"RESUSCITATION"	"10038749"	"50-59 years"	"50-59"	"52 m active alcoholic with lab abnormalities c/w heavy etoh including pancytopenia (anemia to 7s, throbocytopenia to 70s, mild leukopenia-since 12/20); 2 recent admissions (feb march 2021) with likely etoh-induced pre-renal AKI; DM; who received 2nd dose of moderna 4/8/21.  After not being in contact with his family for several days, family sought him at his residence where he was found pulsless and apneic on the floor with some scant blood near his face.  CPR-- >transported to hospital where upon attempting to intubate profuse bleeding into larynx/pharynx noted.  Despite ongoing cpr and mechanical ventilation team in ER was unable to re-establish pulse.  He was pronounced dead at about 8 PM 4/9/21."
	"1233769-1"	"1233769-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	""According to death certificate patient died of ""blunt force injuries from a motorcycle accident""""
	"1233769-1"	"1233769-1"	"INJURY"	"10022116"	"50-59 years"	"50-59"	""According to death certificate patient died of ""blunt force injuries from a motorcycle accident""""
	"1233769-1"	"1233769-1"	"ROAD TRAFFIC ACCIDENT"	"10039203"	"50-59 years"	"50-59"	""According to death certificate patient died of ""blunt force injuries from a motorcycle accident""""
	"1235811-1"	"1235811-1"	"ABDOMINAL DISCOMFORT"	"10000059"	"50-59 years"	"50-59"	""COVID pneumonia; Hematological; bleeding; having hemoxysis; slight troponin increase; GI bleed; headaches; COVID-19 test was positive; COVID-19 test was positive; nauseous; abdominal discomfort; body aches; This is a spontaneous report from a contactable physician. A 52-year-old female patient received her first dose of BNT162B2(PFIZER-BIONTECH COVID-19 VACCINE, Batch/Lot number was not reported), via an unspecified route of administration at the age 52-year-old on 12Mar2021 at single dose for COVID-19 immunisation. Medical history included hemodialysis for many years, adherent to medical care, multiple DVTs and Pes (On anticoagulants), morbid obesity, Patient was on dialysis for renal failure and had lupus anticoagulant (positive), Afib, allergic to shellfish. Family history included renal failure and had lupus anticoagulant. Concomitant medications included warfarin sodium (COUMADIN); metoprolol; amitriptyline; calcitriol; ergocalciferol (VIT D); calcium; calcium acetate (PHOSLO); amiodarone; albuterol. The patient previously allergic to Cipro, clindamycin, doxycyclin, Lyrica, tetracycline. The patient previously was non-responder to hepatitis B vaccine. The patient previously received first dose of BNT162B2(PFIZER-BIONTECH COVID-19 VACCINE) on 17Feb2021 for COVID-19 immunisation. The patient hasn't been treated with immunomodulating or immunosuppressing medications or received any other vaccines around the time of COVID-19 vaccination. The patient wasn't smoker/ former smoker. There was no any other vaccinations within four weeks prior to the first administration date of the suspect vaccine. A nephrologist who reported patient in her hemodialysis unit who were vaccinated with BNT162b2 but were recently diagnosed with COVID-19. More detail is below on each patient. The patient COVID results were sent to the local health department for genetic sequencing (pending) and SARS titers were drawn (pending). Unfortunately, the HD unit does not have B/L information (although the B/L # was put on the patient's COVID vaccine cards, a record was not kept in the HD unit). Day she came in for dialysis she was already short of breath she said she'd had body aches for 5 days, got short of breath on 05Apr2021. The day before, started getting cough, nauseous, chills, abdominal discomfort on 04Apr2021. The patient was sent to the ER from dialysis and was admitted for SOB on 05Apr2021 and passed away on 09Apr2021 due to a GI bleed. Patient is over 500lbs so was unable to fit into hospital imaging equiment for CT scans or weight measurements. COVID-19 test was positive on 05Apr2021; the patient experienced COVID pneumonia on 05Apr2021. The patient admitted on 05Apr2021 to regular floor. The patient was moved to an Intensive Care Unit on 06Apr2021. The patient experienced short of breath on 05Apr2021 and required much more O2 than normal. Sometimes required BP support while on Dialysis and BP was 113/61 in ER. Pressure dropped to 100/70 and required mitrodrine after fluid was removed. The patient needed 4 liters supplemental O2 vs. only needing 2 liters at home. The patient experienced tachypnea and hypoxemia and no Respiratory failure. Respiration was 22. After 5 litres of O2 improved. Pulse 93 in ER. Cardiovascular: There was no heart failure, cardiogenic shock, Acute myocardial infarction, arrhythmia and myocarditis. The patient Had chest pain which resolved when O2 was administered. Gastrointestinal/Hepatic: There was no Vomiting, Diarrhea. The patient experienced nausea but no vomiting or diarrhea and complained of abdominal pain. There was no Jaundice and acute liver failure. Neurological: There was no altered consciousness, altered consciousness, encephalopathy, meningitis and cerebrovascular accident. The patient had headaches a couple days before admitting to ER. Hematological: There was no Thrombocytopenia, Disseminated intravascular coagulation. INR was 3 due to large dose of coumadin, and platelets were 180 and white count 6.8. Slight troponin increased at 0.37 at admittance, BNP 39. The patient started coughing up blood, having hemoxysis and bleeding on unspecified date. Laboratory test or diagnostic studies was reported that test for SARS-CoV-2 by PCR, or other commercial or public health assay. Xray showed vascular congestion with superimposed infiltrate which could represent pneumonia. Blood count was 11 and 36.7% at ER. Clinical chemistry: Sodium was 133; BUN was 68; Creatinine was 10. Evidence of hypoxemia: Pulse oO2 was 90 in ER.  CT scans: unknown results. Urinalysis: On dialysis so does not make urine. The patient had received Remdesivir, from 06Apr2021, Hydroxychloroquine/chloroquine, Azithromycin from 06Apr2021 and Corticosteroids from 06Apr2021 for COVID-19.  The outcome of event ""GI bleed"" was fatal, the event ""chest pain"" and ""body aches"" was recovered and other events was unknown. The patient died on 09Apr2021. An autopsy was not performed.  Information on the lot/batch number has been requested.; Sender's Comments: Based on temporal association, a contributory role of the suspect drug cannot be excluded for the events vaccination failure, COVID-19, COVID-19 pneumonia, and sepsis. However, the patient's multiple medical comborbidities including renal failure requiring dialysis, lupus, and morbid obesity along with the risk of COVID-19 infection in light of the current pandemic are the more likely explanations for the development of these infections. The events gastrointestinal hemorrhage, hemorrhage, hemolysis and troponin increased are attributed to intercurrent medical conditions, and are considered unrelated to the suspect drug. The patient is currently on warfarin which may increase the risk for bleeds. This case will be reassessed upon receipt of additional information. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate.; Reported Cause(s) of Death: GI bleed""
	"1235811-1"	"1235811-1"	"ANTIPHOSPHOLIPID ANTIBODIES"	"10058341"	"50-59 years"	"50-59"	""COVID pneumonia; Hematological; bleeding; having hemoxysis; slight troponin increase; GI bleed; headaches; COVID-19 test was positive; COVID-19 test was positive; nauseous; abdominal discomfort; body aches; This is a spontaneous report from a contactable physician. A 52-year-old female patient received her first dose of BNT162B2(PFIZER-BIONTECH COVID-19 VACCINE, Batch/Lot number was not reported), via an unspecified route of administration at the age 52-year-old on 12Mar2021 at single dose for COVID-19 immunisation. Medical history included hemodialysis for many years, adherent to medical care, multiple DVTs and Pes (On anticoagulants), morbid obesity, Patient was on dialysis for renal failure and had lupus anticoagulant (positive), Afib, allergic to shellfish. Family history included renal failure and had lupus anticoagulant. Concomitant medications included warfarin sodium (COUMADIN); metoprolol; amitriptyline; calcitriol; ergocalciferol (VIT D); calcium; calcium acetate (PHOSLO); amiodarone; albuterol. The patient previously allergic to Cipro, clindamycin, doxycyclin, Lyrica, tetracycline. The patient previously was non-responder to hepatitis B vaccine. The patient previously received first dose of BNT162B2(PFIZER-BIONTECH COVID-19 VACCINE) on 17Feb2021 for COVID-19 immunisation. The patient hasn't been treated with immunomodulating or immunosuppressing medications or received any other vaccines around the time of COVID-19 vaccination. The patient wasn't smoker/ former smoker. There was no any other vaccinations within four weeks prior to the first administration date of the suspect vaccine. A nephrologist who reported patient in her hemodialysis unit who were vaccinated with BNT162b2 but were recently diagnosed with COVID-19. More detail is below on each patient. The patient COVID results were sent to the local health department for genetic sequencing (pending) and SARS titers were drawn (pending). Unfortunately, the HD unit does not have B/L information (although the B/L # was put on the patient's COVID vaccine cards, a record was not kept in the HD unit). Day she came in for dialysis she was already short of breath she said she'd had body aches for 5 days, got short of breath on 05Apr2021. The day before, started getting cough, nauseous, chills, abdominal discomfort on 04Apr2021. The patient was sent to the ER from dialysis and was admitted for SOB on 05Apr2021 and passed away on 09Apr2021 due to a GI bleed. Patient is over 500lbs so was unable to fit into hospital imaging equiment for CT scans or weight measurements. COVID-19 test was positive on 05Apr2021; the patient experienced COVID pneumonia on 05Apr2021. The patient admitted on 05Apr2021 to regular floor. The patient was moved to an Intensive Care Unit on 06Apr2021. The patient experienced short of breath on 05Apr2021 and required much more O2 than normal. Sometimes required BP support while on Dialysis and BP was 113/61 in ER. Pressure dropped to 100/70 and required mitrodrine after fluid was removed. The patient needed 4 liters supplemental O2 vs. only needing 2 liters at home. The patient experienced tachypnea and hypoxemia and no Respiratory failure. Respiration was 22. After 5 litres of O2 improved. Pulse 93 in ER. Cardiovascular: There was no heart failure, cardiogenic shock, Acute myocardial infarction, arrhythmia and myocarditis. The patient Had chest pain which resolved when O2 was administered. Gastrointestinal/Hepatic: There was no Vomiting, Diarrhea. The patient experienced nausea but no vomiting or diarrhea and complained of abdominal pain. There was no Jaundice and acute liver failure. Neurological: There was no altered consciousness, altered consciousness, encephalopathy, meningitis and cerebrovascular accident. The patient had headaches a couple days before admitting to ER. Hematological: There was no Thrombocytopenia, Disseminated intravascular coagulation. INR was 3 due to large dose of coumadin, and platelets were 180 and white count 6.8. Slight troponin increased at 0.37 at admittance, BNP 39. The patient started coughing up blood, having hemoxysis and bleeding on unspecified date. Laboratory test or diagnostic studies was reported that test for SARS-CoV-2 by PCR, or other commercial or public health assay. Xray showed vascular congestion with superimposed infiltrate which could represent pneumonia. Blood count was 11 and 36.7% at ER. Clinical chemistry: Sodium was 133; BUN was 68; Creatinine was 10. Evidence of hypoxemia: Pulse oO2 was 90 in ER.  CT scans: unknown results. Urinalysis: On dialysis so does not make urine. The patient had received Remdesivir, from 06Apr2021, Hydroxychloroquine/chloroquine, Azithromycin from 06Apr2021 and Corticosteroids from 06Apr2021 for COVID-19.  The outcome of event ""GI bleed"" was fatal, the event ""chest pain"" and ""body aches"" was recovered and other events was unknown. The patient died on 09Apr2021. An autopsy was not performed.  Information on the lot/batch number has been requested.; Sender's Comments: Based on temporal association, a contributory role of the suspect drug cannot be excluded for the events vaccination failure, COVID-19, COVID-19 pneumonia, and sepsis. However, the patient's multiple medical comborbidities including renal failure requiring dialysis, lupus, and morbid obesity along with the risk of COVID-19 infection in light of the current pandemic are the more likely explanations for the development of these infections. The events gastrointestinal hemorrhage, hemorrhage, hemolysis and troponin increased are attributed to intercurrent medical conditions, and are considered unrelated to the suspect drug. The patient is currently on warfarin which may increase the risk for bleeds. This case will be reassessed upon receipt of additional information. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate.; Reported Cause(s) of Death: GI bleed""
	"1235811-1"	"1235811-1"	"BLOOD COUNT"	"10064196"	"50-59 years"	"50-59"	""COVID pneumonia; Hematological; bleeding; having hemoxysis; slight troponin increase; GI bleed; headaches; COVID-19 test was positive; COVID-19 test was positive; nauseous; abdominal discomfort; body aches; This is a spontaneous report from a contactable physician. A 52-year-old female patient received her first dose of BNT162B2(PFIZER-BIONTECH COVID-19 VACCINE, Batch/Lot number was not reported), via an unspecified route of administration at the age 52-year-old on 12Mar2021 at single dose for COVID-19 immunisation. Medical history included hemodialysis for many years, adherent to medical care, multiple DVTs and Pes (On anticoagulants), morbid obesity, Patient was on dialysis for renal failure and had lupus anticoagulant (positive), Afib, allergic to shellfish. Family history included renal failure and had lupus anticoagulant. Concomitant medications included warfarin sodium (COUMADIN); metoprolol; amitriptyline; calcitriol; ergocalciferol (VIT D); calcium; calcium acetate (PHOSLO); amiodarone; albuterol. The patient previously allergic to Cipro, clindamycin, doxycyclin, Lyrica, tetracycline. The patient previously was non-responder to hepatitis B vaccine. The patient previously received first dose of BNT162B2(PFIZER-BIONTECH COVID-19 VACCINE) on 17Feb2021 for COVID-19 immunisation. The patient hasn't been treated with immunomodulating or immunosuppressing medications or received any other vaccines around the time of COVID-19 vaccination. The patient wasn't smoker/ former smoker. There was no any other vaccinations within four weeks prior to the first administration date of the suspect vaccine. A nephrologist who reported patient in her hemodialysis unit who were vaccinated with BNT162b2 but were recently diagnosed with COVID-19. More detail is below on each patient. The patient COVID results were sent to the local health department for genetic sequencing (pending) and SARS titers were drawn (pending). Unfortunately, the HD unit does not have B/L information (although the B/L # was put on the patient's COVID vaccine cards, a record was not kept in the HD unit). Day she came in for dialysis she was already short of breath she said she'd had body aches for 5 days, got short of breath on 05Apr2021. The day before, started getting cough, nauseous, chills, abdominal discomfort on 04Apr2021. The patient was sent to the ER from dialysis and was admitted for SOB on 05Apr2021 and passed away on 09Apr2021 due to a GI bleed. Patient is over 500lbs so was unable to fit into hospital imaging equiment for CT scans or weight measurements. COVID-19 test was positive on 05Apr2021; the patient experienced COVID pneumonia on 05Apr2021. The patient admitted on 05Apr2021 to regular floor. The patient was moved to an Intensive Care Unit on 06Apr2021. The patient experienced short of breath on 05Apr2021 and required much more O2 than normal. Sometimes required BP support while on Dialysis and BP was 113/61 in ER. Pressure dropped to 100/70 and required mitrodrine after fluid was removed. The patient needed 4 liters supplemental O2 vs. only needing 2 liters at home. The patient experienced tachypnea and hypoxemia and no Respiratory failure. Respiration was 22. After 5 litres of O2 improved. Pulse 93 in ER. Cardiovascular: There was no heart failure, cardiogenic shock, Acute myocardial infarction, arrhythmia and myocarditis. The patient Had chest pain which resolved when O2 was administered. Gastrointestinal/Hepatic: There was no Vomiting, Diarrhea. The patient experienced nausea but no vomiting or diarrhea and complained of abdominal pain. There was no Jaundice and acute liver failure. Neurological: There was no altered consciousness, altered consciousness, encephalopathy, meningitis and cerebrovascular accident. The patient had headaches a couple days before admitting to ER. Hematological: There was no Thrombocytopenia, Disseminated intravascular coagulation. INR was 3 due to large dose of coumadin, and platelets were 180 and white count 6.8. Slight troponin increased at 0.37 at admittance, BNP 39. The patient started coughing up blood, having hemoxysis and bleeding on unspecified date. Laboratory test or diagnostic studies was reported that test for SARS-CoV-2 by PCR, or other commercial or public health assay. Xray showed vascular congestion with superimposed infiltrate which could represent pneumonia. Blood count was 11 and 36.7% at ER. Clinical chemistry: Sodium was 133; BUN was 68; Creatinine was 10. Evidence of hypoxemia: Pulse oO2 was 90 in ER.  CT scans: unknown results. Urinalysis: On dialysis so does not make urine. The patient had received Remdesivir, from 06Apr2021, Hydroxychloroquine/chloroquine, Azithromycin from 06Apr2021 and Corticosteroids from 06Apr2021 for COVID-19.  The outcome of event ""GI bleed"" was fatal, the event ""chest pain"" and ""body aches"" was recovered and other events was unknown. The patient died on 09Apr2021. An autopsy was not performed.  Information on the lot/batch number has been requested.; Sender's Comments: Based on temporal association, a contributory role of the suspect drug cannot be excluded for the events vaccination failure, COVID-19, COVID-19 pneumonia, and sepsis. However, the patient's multiple medical comborbidities including renal failure requiring dialysis, lupus, and morbid obesity along with the risk of COVID-19 infection in light of the current pandemic are the more likely explanations for the development of these infections. The events gastrointestinal hemorrhage, hemorrhage, hemolysis and troponin increased are attributed to intercurrent medical conditions, and are considered unrelated to the suspect drug. The patient is currently on warfarin which may increase the risk for bleeds. This case will be reassessed upon receipt of additional information. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate.; Reported Cause(s) of Death: GI bleed""
	"1235811-1"	"1235811-1"	"BLOOD CREATININE"	"10005480"	"50-59 years"	"50-59"	""COVID pneumonia; Hematological; bleeding; having hemoxysis; slight troponin increase; GI bleed; headaches; COVID-19 test was positive; COVID-19 test was positive; nauseous; abdominal discomfort; body aches; This is a spontaneous report from a contactable physician. A 52-year-old female patient received her first dose of BNT162B2(PFIZER-BIONTECH COVID-19 VACCINE, Batch/Lot number was not reported), via an unspecified route of administration at the age 52-year-old on 12Mar2021 at single dose for COVID-19 immunisation. Medical history included hemodialysis for many years, adherent to medical care, multiple DVTs and Pes (On anticoagulants), morbid obesity, Patient was on dialysis for renal failure and had lupus anticoagulant (positive), Afib, allergic to shellfish. Family history included renal failure and had lupus anticoagulant. Concomitant medications included warfarin sodium (COUMADIN); metoprolol; amitriptyline; calcitriol; ergocalciferol (VIT D); calcium; calcium acetate (PHOSLO); amiodarone; albuterol. The patient previously allergic to Cipro, clindamycin, doxycyclin, Lyrica, tetracycline. The patient previously was non-responder to hepatitis B vaccine. The patient previously received first dose of BNT162B2(PFIZER-BIONTECH COVID-19 VACCINE) on 17Feb2021 for COVID-19 immunisation. The patient hasn't been treated with immunomodulating or immunosuppressing medications or received any other vaccines around the time of COVID-19 vaccination. The patient wasn't smoker/ former smoker. There was no any other vaccinations within four weeks prior to the first administration date of the suspect vaccine. A nephrologist who reported patient in her hemodialysis unit who were vaccinated with BNT162b2 but were recently diagnosed with COVID-19. More detail is below on each patient. The patient COVID results were sent to the local health department for genetic sequencing (pending) and SARS titers were drawn (pending). Unfortunately, the HD unit does not have B/L information (although the B/L # was put on the patient's COVID vaccine cards, a record was not kept in the HD unit). Day she came in for dialysis she was already short of breath she said she'd had body aches for 5 days, got short of breath on 05Apr2021. The day before, started getting cough, nauseous, chills, abdominal discomfort on 04Apr2021. The patient was sent to the ER from dialysis and was admitted for SOB on 05Apr2021 and passed away on 09Apr2021 due to a GI bleed. Patient is over 500lbs so was unable to fit into hospital imaging equiment for CT scans or weight measurements. COVID-19 test was positive on 05Apr2021; the patient experienced COVID pneumonia on 05Apr2021. The patient admitted on 05Apr2021 to regular floor. The patient was moved to an Intensive Care Unit on 06Apr2021. The patient experienced short of breath on 05Apr2021 and required much more O2 than normal. Sometimes required BP support while on Dialysis and BP was 113/61 in ER. Pressure dropped to 100/70 and required mitrodrine after fluid was removed. The patient needed 4 liters supplemental O2 vs. only needing 2 liters at home. The patient experienced tachypnea and hypoxemia and no Respiratory failure. Respiration was 22. After 5 litres of O2 improved. Pulse 93 in ER. Cardiovascular: There was no heart failure, cardiogenic shock, Acute myocardial infarction, arrhythmia and myocarditis. The patient Had chest pain which resolved when O2 was administered. Gastrointestinal/Hepatic: There was no Vomiting, Diarrhea. The patient experienced nausea but no vomiting or diarrhea and complained of abdominal pain. There was no Jaundice and acute liver failure. Neurological: There was no altered consciousness, altered consciousness, encephalopathy, meningitis and cerebrovascular accident. The patient had headaches a couple days before admitting to ER. Hematological: There was no Thrombocytopenia, Disseminated intravascular coagulation. INR was 3 due to large dose of coumadin, and platelets were 180 and white count 6.8. Slight troponin increased at 0.37 at admittance, BNP 39. The patient started coughing up blood, having hemoxysis and bleeding on unspecified date. Laboratory test or diagnostic studies was reported that test for SARS-CoV-2 by PCR, or other commercial or public health assay. Xray showed vascular congestion with superimposed infiltrate which could represent pneumonia. Blood count was 11 and 36.7% at ER. Clinical chemistry: Sodium was 133; BUN was 68; Creatinine was 10. Evidence of hypoxemia: Pulse oO2 was 90 in ER.  CT scans: unknown results. Urinalysis: On dialysis so does not make urine. The patient had received Remdesivir, from 06Apr2021, Hydroxychloroquine/chloroquine, Azithromycin from 06Apr2021 and Corticosteroids from 06Apr2021 for COVID-19.  The outcome of event ""GI bleed"" was fatal, the event ""chest pain"" and ""body aches"" was recovered and other events was unknown. The patient died on 09Apr2021. An autopsy was not performed.  Information on the lot/batch number has been requested.; Sender's Comments: Based on temporal association, a contributory role of the suspect drug cannot be excluded for the events vaccination failure, COVID-19, COVID-19 pneumonia, and sepsis. However, the patient's multiple medical comborbidities including renal failure requiring dialysis, lupus, and morbid obesity along with the risk of COVID-19 infection in light of the current pandemic are the more likely explanations for the development of these infections. The events gastrointestinal hemorrhage, hemorrhage, hemolysis and troponin increased are attributed to intercurrent medical conditions, and are considered unrelated to the suspect drug. The patient is currently on warfarin which may increase the risk for bleeds. This case will be reassessed upon receipt of additional information. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate.; Reported Cause(s) of Death: GI bleed""
	"1235811-1"	"1235811-1"	"BLOOD PRESSURE MEASUREMENT"	"10076581"	"50-59 years"	"50-59"	""COVID pneumonia; Hematological; bleeding; having hemoxysis; slight troponin increase; GI bleed; headaches; COVID-19 test was positive; COVID-19 test was positive; nauseous; abdominal discomfort; body aches; This is a spontaneous report from a contactable physician. A 52-year-old female patient received her first dose of BNT162B2(PFIZER-BIONTECH COVID-19 VACCINE, Batch/Lot number was not reported), via an unspecified route of administration at the age 52-year-old on 12Mar2021 at single dose for COVID-19 immunisation. Medical history included hemodialysis for many years, adherent to medical care, multiple DVTs and Pes (On anticoagulants), morbid obesity, Patient was on dialysis for renal failure and had lupus anticoagulant (positive), Afib, allergic to shellfish. Family history included renal failure and had lupus anticoagulant. Concomitant medications included warfarin sodium (COUMADIN); metoprolol; amitriptyline; calcitriol; ergocalciferol (VIT D); calcium; calcium acetate (PHOSLO); amiodarone; albuterol. The patient previously allergic to Cipro, clindamycin, doxycyclin, Lyrica, tetracycline. The patient previously was non-responder to hepatitis B vaccine. The patient previously received first dose of BNT162B2(PFIZER-BIONTECH COVID-19 VACCINE) on 17Feb2021 for COVID-19 immunisation. The patient hasn't been treated with immunomodulating or immunosuppressing medications or received any other vaccines around the time of COVID-19 vaccination. The patient wasn't smoker/ former smoker. There was no any other vaccinations within four weeks prior to the first administration date of the suspect vaccine. A nephrologist who reported patient in her hemodialysis unit who were vaccinated with BNT162b2 but were recently diagnosed with COVID-19. More detail is below on each patient. The patient COVID results were sent to the local health department for genetic sequencing (pending) and SARS titers were drawn (pending). Unfortunately, the HD unit does not have B/L information (although the B/L # was put on the patient's COVID vaccine cards, a record was not kept in the HD unit). Day she came in for dialysis she was already short of breath she said she'd had body aches for 5 days, got short of breath on 05Apr2021. The day before, started getting cough, nauseous, chills, abdominal discomfort on 04Apr2021. The patient was sent to the ER from dialysis and was admitted for SOB on 05Apr2021 and passed away on 09Apr2021 due to a GI bleed. Patient is over 500lbs so was unable to fit into hospital imaging equiment for CT scans or weight measurements. COVID-19 test was positive on 05Apr2021; the patient experienced COVID pneumonia on 05Apr2021. The patient admitted on 05Apr2021 to regular floor. The patient was moved to an Intensive Care Unit on 06Apr2021. The patient experienced short of breath on 05Apr2021 and required much more O2 than normal. Sometimes required BP support while on Dialysis and BP was 113/61 in ER. Pressure dropped to 100/70 and required mitrodrine after fluid was removed. The patient needed 4 liters supplemental O2 vs. only needing 2 liters at home. The patient experienced tachypnea and hypoxemia and no Respiratory failure. Respiration was 22. After 5 litres of O2 improved. Pulse 93 in ER. Cardiovascular: There was no heart failure, cardiogenic shock, Acute myocardial infarction, arrhythmia and myocarditis. The patient Had chest pain which resolved when O2 was administered. Gastrointestinal/Hepatic: There was no Vomiting, Diarrhea. The patient experienced nausea but no vomiting or diarrhea and complained of abdominal pain. There was no Jaundice and acute liver failure. Neurological: There was no altered consciousness, altered consciousness, encephalopathy, meningitis and cerebrovascular accident. The patient had headaches a couple days before admitting to ER. Hematological: There was no Thrombocytopenia, Disseminated intravascular coagulation. INR was 3 due to large dose of coumadin, and platelets were 180 and white count 6.8. Slight troponin increased at 0.37 at admittance, BNP 39. The patient started coughing up blood, having hemoxysis and bleeding on unspecified date. Laboratory test or diagnostic studies was reported that test for SARS-CoV-2 by PCR, or other commercial or public health assay. Xray showed vascular congestion with superimposed infiltrate which could represent pneumonia. Blood count was 11 and 36.7% at ER. Clinical chemistry: Sodium was 133; BUN was 68; Creatinine was 10. Evidence of hypoxemia: Pulse oO2 was 90 in ER.  CT scans: unknown results. Urinalysis: On dialysis so does not make urine. The patient had received Remdesivir, from 06Apr2021, Hydroxychloroquine/chloroquine, Azithromycin from 06Apr2021 and Corticosteroids from 06Apr2021 for COVID-19.  The outcome of event ""GI bleed"" was fatal, the event ""chest pain"" and ""body aches"" was recovered and other events was unknown. The patient died on 09Apr2021. An autopsy was not performed.  Information on the lot/batch number has been requested.; Sender's Comments: Based on temporal association, a contributory role of the suspect drug cannot be excluded for the events vaccination failure, COVID-19, COVID-19 pneumonia, and sepsis. However, the patient's multiple medical comborbidities including renal failure requiring dialysis, lupus, and morbid obesity along with the risk of COVID-19 infection in light of the current pandemic are the more likely explanations for the development of these infections. The events gastrointestinal hemorrhage, hemorrhage, hemolysis and troponin increased are attributed to intercurrent medical conditions, and are considered unrelated to the suspect drug. The patient is currently on warfarin which may increase the risk for bleeds. This case will be reassessed upon receipt of additional information. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate.; Reported Cause(s) of Death: GI bleed""
	"1235811-1"	"1235811-1"	"BLOOD SODIUM"	"10005799"	"50-59 years"	"50-59"	""COVID pneumonia; Hematological; bleeding; having hemoxysis; slight troponin increase; GI bleed; headaches; COVID-19 test was positive; COVID-19 test was positive; nauseous; abdominal discomfort; body aches; This is a spontaneous report from a contactable physician. A 52-year-old female patient received her first dose of BNT162B2(PFIZER-BIONTECH COVID-19 VACCINE, Batch/Lot number was not reported), via an unspecified route of administration at the age 52-year-old on 12Mar2021 at single dose for COVID-19 immunisation. Medical history included hemodialysis for many years, adherent to medical care, multiple DVTs and Pes (On anticoagulants), morbid obesity, Patient was on dialysis for renal failure and had lupus anticoagulant (positive), Afib, allergic to shellfish. Family history included renal failure and had lupus anticoagulant. Concomitant medications included warfarin sodium (COUMADIN); metoprolol; amitriptyline; calcitriol; ergocalciferol (VIT D); calcium; calcium acetate (PHOSLO); amiodarone; albuterol. The patient previously allergic to Cipro, clindamycin, doxycyclin, Lyrica, tetracycline. The patient previously was non-responder to hepatitis B vaccine. The patient previously received first dose of BNT162B2(PFIZER-BIONTECH COVID-19 VACCINE) on 17Feb2021 for COVID-19 immunisation. The patient hasn't been treated with immunomodulating or immunosuppressing medications or received any other vaccines around the time of COVID-19 vaccination. The patient wasn't smoker/ former smoker. There was no any other vaccinations within four weeks prior to the first administration date of the suspect vaccine. A nephrologist who reported patient in her hemodialysis unit who were vaccinated with BNT162b2 but were recently diagnosed with COVID-19. More detail is below on each patient. The patient COVID results were sent to the local health department for genetic sequencing (pending) and SARS titers were drawn (pending). Unfortunately, the HD unit does not have B/L information (although the B/L # was put on the patient's COVID vaccine cards, a record was not kept in the HD unit). Day she came in for dialysis she was already short of breath she said she'd had body aches for 5 days, got short of breath on 05Apr2021. The day before, started getting cough, nauseous, chills, abdominal discomfort on 04Apr2021. The patient was sent to the ER from dialysis and was admitted for SOB on 05Apr2021 and passed away on 09Apr2021 due to a GI bleed. Patient is over 500lbs so was unable to fit into hospital imaging equiment for CT scans or weight measurements. COVID-19 test was positive on 05Apr2021; the patient experienced COVID pneumonia on 05Apr2021. The patient admitted on 05Apr2021 to regular floor. The patient was moved to an Intensive Care Unit on 06Apr2021. The patient experienced short of breath on 05Apr2021 and required much more O2 than normal. Sometimes required BP support while on Dialysis and BP was 113/61 in ER. Pressure dropped to 100/70 and required mitrodrine after fluid was removed. The patient needed 4 liters supplemental O2 vs. only needing 2 liters at home. The patient experienced tachypnea and hypoxemia and no Respiratory failure. Respiration was 22. After 5 litres of O2 improved. Pulse 93 in ER. Cardiovascular: There was no heart failure, cardiogenic shock, Acute myocardial infarction, arrhythmia and myocarditis. The patient Had chest pain which resolved when O2 was administered. Gastrointestinal/Hepatic: There was no Vomiting, Diarrhea. The patient experienced nausea but no vomiting or diarrhea and complained of abdominal pain. There was no Jaundice and acute liver failure. Neurological: There was no altered consciousness, altered consciousness, encephalopathy, meningitis and cerebrovascular accident. The patient had headaches a couple days before admitting to ER. Hematological: There was no Thrombocytopenia, Disseminated intravascular coagulation. INR was 3 due to large dose of coumadin, and platelets were 180 and white count 6.8. Slight troponin increased at 0.37 at admittance, BNP 39. The patient started coughing up blood, having hemoxysis and bleeding on unspecified date. Laboratory test or diagnostic studies was reported that test for SARS-CoV-2 by PCR, or other commercial or public health assay. Xray showed vascular congestion with superimposed infiltrate which could represent pneumonia. Blood count was 11 and 36.7% at ER. Clinical chemistry: Sodium was 133; BUN was 68; Creatinine was 10. Evidence of hypoxemia: Pulse oO2 was 90 in ER.  CT scans: unknown results. Urinalysis: On dialysis so does not make urine. The patient had received Remdesivir, from 06Apr2021, Hydroxychloroquine/chloroquine, Azithromycin from 06Apr2021 and Corticosteroids from 06Apr2021 for COVID-19.  The outcome of event ""GI bleed"" was fatal, the event ""chest pain"" and ""body aches"" was recovered and other events was unknown. The patient died on 09Apr2021. An autopsy was not performed.  Information on the lot/batch number has been requested.; Sender's Comments: Based on temporal association, a contributory role of the suspect drug cannot be excluded for the events vaccination failure, COVID-19, COVID-19 pneumonia, and sepsis. However, the patient's multiple medical comborbidities including renal failure requiring dialysis, lupus, and morbid obesity along with the risk of COVID-19 infection in light of the current pandemic are the more likely explanations for the development of these infections. The events gastrointestinal hemorrhage, hemorrhage, hemolysis and troponin increased are attributed to intercurrent medical conditions, and are considered unrelated to the suspect drug. The patient is currently on warfarin which may increase the risk for bleeds. This case will be reassessed upon receipt of additional information. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate.; Reported Cause(s) of Death: GI bleed""
	"1235811-1"	"1235811-1"	"BLOOD UREA"	"10005845"	"50-59 years"	"50-59"	""COVID pneumonia; Hematological; bleeding; having hemoxysis; slight troponin increase; GI bleed; headaches; COVID-19 test was positive; COVID-19 test was positive; nauseous; abdominal discomfort; body aches; This is a spontaneous report from a contactable physician. A 52-year-old female patient received her first dose of BNT162B2(PFIZER-BIONTECH COVID-19 VACCINE, Batch/Lot number was not reported), via an unspecified route of administration at the age 52-year-old on 12Mar2021 at single dose for COVID-19 immunisation. Medical history included hemodialysis for many years, adherent to medical care, multiple DVTs and Pes (On anticoagulants), morbid obesity, Patient was on dialysis for renal failure and had lupus anticoagulant (positive), Afib, allergic to shellfish. Family history included renal failure and had lupus anticoagulant. Concomitant medications included warfarin sodium (COUMADIN); metoprolol; amitriptyline; calcitriol; ergocalciferol (VIT D); calcium; calcium acetate (PHOSLO); amiodarone; albuterol. The patient previously allergic to Cipro, clindamycin, doxycyclin, Lyrica, tetracycline. The patient previously was non-responder to hepatitis B vaccine. The patient previously received first dose of BNT162B2(PFIZER-BIONTECH COVID-19 VACCINE) on 17Feb2021 for COVID-19 immunisation. The patient hasn't been treated with immunomodulating or immunosuppressing medications or received any other vaccines around the time of COVID-19 vaccination. The patient wasn't smoker/ former smoker. There was no any other vaccinations within four weeks prior to the first administration date of the suspect vaccine. A nephrologist who reported patient in her hemodialysis unit who were vaccinated with BNT162b2 but were recently diagnosed with COVID-19. More detail is below on each patient. The patient COVID results were sent to the local health department for genetic sequencing (pending) and SARS titers were drawn (pending). Unfortunately, the HD unit does not have B/L information (although the B/L # was put on the patient's COVID vaccine cards, a record was not kept in the HD unit). Day she came in for dialysis she was already short of breath she said she'd had body aches for 5 days, got short of breath on 05Apr2021. The day before, started getting cough, nauseous, chills, abdominal discomfort on 04Apr2021. The patient was sent to the ER from dialysis and was admitted for SOB on 05Apr2021 and passed away on 09Apr2021 due to a GI bleed. Patient is over 500lbs so was unable to fit into hospital imaging equiment for CT scans or weight measurements. COVID-19 test was positive on 05Apr2021; the patient experienced COVID pneumonia on 05Apr2021. The patient admitted on 05Apr2021 to regular floor. The patient was moved to an Intensive Care Unit on 06Apr2021. The patient experienced short of breath on 05Apr2021 and required much more O2 than normal. Sometimes required BP support while on Dialysis and BP was 113/61 in ER. Pressure dropped to 100/70 and required mitrodrine after fluid was removed. The patient needed 4 liters supplemental O2 vs. only needing 2 liters at home. The patient experienced tachypnea and hypoxemia and no Respiratory failure. Respiration was 22. After 5 litres of O2 improved. Pulse 93 in ER. Cardiovascular: There was no heart failure, cardiogenic shock, Acute myocardial infarction, arrhythmia and myocarditis. The patient Had chest pain which resolved when O2 was administered. Gastrointestinal/Hepatic: There was no Vomiting, Diarrhea. The patient experienced nausea but no vomiting or diarrhea and complained of abdominal pain. There was no Jaundice and acute liver failure. Neurological: There was no altered consciousness, altered consciousness, encephalopathy, meningitis and cerebrovascular accident. The patient had headaches a couple days before admitting to ER. Hematological: There was no Thrombocytopenia, Disseminated intravascular coagulation. INR was 3 due to large dose of coumadin, and platelets were 180 and white count 6.8. Slight troponin increased at 0.37 at admittance, BNP 39. The patient started coughing up blood, having hemoxysis and bleeding on unspecified date. Laboratory test or diagnostic studies was reported that test for SARS-CoV-2 by PCR, or other commercial or public health assay. Xray showed vascular congestion with superimposed infiltrate which could represent pneumonia. Blood count was 11 and 36.7% at ER. Clinical chemistry: Sodium was 133; BUN was 68; Creatinine was 10. Evidence of hypoxemia: Pulse oO2 was 90 in ER.  CT scans: unknown results. Urinalysis: On dialysis so does not make urine. The patient had received Remdesivir, from 06Apr2021, Hydroxychloroquine/chloroquine, Azithromycin from 06Apr2021 and Corticosteroids from 06Apr2021 for COVID-19.  The outcome of event ""GI bleed"" was fatal, the event ""chest pain"" and ""body aches"" was recovered and other events was unknown. The patient died on 09Apr2021. An autopsy was not performed.  Information on the lot/batch number has been requested.; Sender's Comments: Based on temporal association, a contributory role of the suspect drug cannot be excluded for the events vaccination failure, COVID-19, COVID-19 pneumonia, and sepsis. However, the patient's multiple medical comborbidities including renal failure requiring dialysis, lupus, and morbid obesity along with the risk of COVID-19 infection in light of the current pandemic are the more likely explanations for the development of these infections. The events gastrointestinal hemorrhage, hemorrhage, hemolysis and troponin increased are attributed to intercurrent medical conditions, and are considered unrelated to the suspect drug. The patient is currently on warfarin which may increase the risk for bleeds. This case will be reassessed upon receipt of additional information. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate.; Reported Cause(s) of Death: GI bleed""
	"1235811-1"	"1235811-1"	"BRAIN NATRIURETIC PEPTIDE"	"10053406"	"50-59 years"	"50-59"	""COVID pneumonia; Hematological; bleeding; having hemoxysis; slight troponin increase; GI bleed; headaches; COVID-19 test was positive; COVID-19 test was positive; nauseous; abdominal discomfort; body aches; This is a spontaneous report from a contactable physician. A 52-year-old female patient received her first dose of BNT162B2(PFIZER-BIONTECH COVID-19 VACCINE, Batch/Lot number was not reported), via an unspecified route of administration at the age 52-year-old on 12Mar2021 at single dose for COVID-19 immunisation. Medical history included hemodialysis for many years, adherent to medical care, multiple DVTs and Pes (On anticoagulants), morbid obesity, Patient was on dialysis for renal failure and had lupus anticoagulant (positive), Afib, allergic to shellfish. Family history included renal failure and had lupus anticoagulant. Concomitant medications included warfarin sodium (COUMADIN); metoprolol; amitriptyline; calcitriol; ergocalciferol (VIT D); calcium; calcium acetate (PHOSLO); amiodarone; albuterol. The patient previously allergic to Cipro, clindamycin, doxycyclin, Lyrica, tetracycline. The patient previously was non-responder to hepatitis B vaccine. The patient previously received first dose of BNT162B2(PFIZER-BIONTECH COVID-19 VACCINE) on 17Feb2021 for COVID-19 immunisation. The patient hasn't been treated with immunomodulating or immunosuppressing medications or received any other vaccines around the time of COVID-19 vaccination. The patient wasn't smoker/ former smoker. There was no any other vaccinations within four weeks prior to the first administration date of the suspect vaccine. A nephrologist who reported patient in her hemodialysis unit who were vaccinated with BNT162b2 but were recently diagnosed with COVID-19. More detail is below on each patient. The patient COVID results were sent to the local health department for genetic sequencing (pending) and SARS titers were drawn (pending). Unfortunately, the HD unit does not have B/L information (although the B/L # was put on the patient's COVID vaccine cards, a record was not kept in the HD unit). Day she came in for dialysis she was already short of breath she said she'd had body aches for 5 days, got short of breath on 05Apr2021. The day before, started getting cough, nauseous, chills, abdominal discomfort on 04Apr2021. The patient was sent to the ER from dialysis and was admitted for SOB on 05Apr2021 and passed away on 09Apr2021 due to a GI bleed. Patient is over 500lbs so was unable to fit into hospital imaging equiment for CT scans or weight measurements. COVID-19 test was positive on 05Apr2021; the patient experienced COVID pneumonia on 05Apr2021. The patient admitted on 05Apr2021 to regular floor. The patient was moved to an Intensive Care Unit on 06Apr2021. The patient experienced short of breath on 05Apr2021 and required much more O2 than normal. Sometimes required BP support while on Dialysis and BP was 113/61 in ER. Pressure dropped to 100/70 and required mitrodrine after fluid was removed. The patient needed 4 liters supplemental O2 vs. only needing 2 liters at home. The patient experienced tachypnea and hypoxemia and no Respiratory failure. Respiration was 22. After 5 litres of O2 improved. Pulse 93 in ER. Cardiovascular: There was no heart failure, cardiogenic shock, Acute myocardial infarction, arrhythmia and myocarditis. The patient Had chest pain which resolved when O2 was administered. Gastrointestinal/Hepatic: There was no Vomiting, Diarrhea. The patient experienced nausea but no vomiting or diarrhea and complained of abdominal pain. There was no Jaundice and acute liver failure. Neurological: There was no altered consciousness, altered consciousness, encephalopathy, meningitis and cerebrovascular accident. The patient had headaches a couple days before admitting to ER. Hematological: There was no Thrombocytopenia, Disseminated intravascular coagulation. INR was 3 due to large dose of coumadin, and platelets were 180 and white count 6.8. Slight troponin increased at 0.37 at admittance, BNP 39. The patient started coughing up blood, having hemoxysis and bleeding on unspecified date. Laboratory test or diagnostic studies was reported that test for SARS-CoV-2 by PCR, or other commercial or public health assay. Xray showed vascular congestion with superimposed infiltrate which could represent pneumonia. Blood count was 11 and 36.7% at ER. Clinical chemistry: Sodium was 133; BUN was 68; Creatinine was 10. Evidence of hypoxemia: Pulse oO2 was 90 in ER.  CT scans: unknown results. Urinalysis: On dialysis so does not make urine. The patient had received Remdesivir, from 06Apr2021, Hydroxychloroquine/chloroquine, Azithromycin from 06Apr2021 and Corticosteroids from 06Apr2021 for COVID-19.  The outcome of event ""GI bleed"" was fatal, the event ""chest pain"" and ""body aches"" was recovered and other events was unknown. The patient died on 09Apr2021. An autopsy was not performed.  Information on the lot/batch number has been requested.; Sender's Comments: Based on temporal association, a contributory role of the suspect drug cannot be excluded for the events vaccination failure, COVID-19, COVID-19 pneumonia, and sepsis. However, the patient's multiple medical comborbidities including renal failure requiring dialysis, lupus, and morbid obesity along with the risk of COVID-19 infection in light of the current pandemic are the more likely explanations for the development of these infections. The events gastrointestinal hemorrhage, hemorrhage, hemolysis and troponin increased are attributed to intercurrent medical conditions, and are considered unrelated to the suspect drug. The patient is currently on warfarin which may increase the risk for bleeds. This case will be reassessed upon receipt of additional information. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate.; Reported Cause(s) of Death: GI bleed""
	"1235811-1"	"1235811-1"	"COMPUTERISED TOMOGRAM"	"10010234"	"50-59 years"	"50-59"	""COVID pneumonia; Hematological; bleeding; having hemoxysis; slight troponin increase; GI bleed; headaches; COVID-19 test was positive; COVID-19 test was positive; nauseous; abdominal discomfort; body aches; This is a spontaneous report from a contactable physician. A 52-year-old female patient received her first dose of BNT162B2(PFIZER-BIONTECH COVID-19 VACCINE, Batch/Lot number was not reported), via an unspecified route of administration at the age 52-year-old on 12Mar2021 at single dose for COVID-19 immunisation. Medical history included hemodialysis for many years, adherent to medical care, multiple DVTs and Pes (On anticoagulants), morbid obesity, Patient was on dialysis for renal failure and had lupus anticoagulant (positive), Afib, allergic to shellfish. Family history included renal failure and had lupus anticoagulant. Concomitant medications included warfarin sodium (COUMADIN); metoprolol; amitriptyline; calcitriol; ergocalciferol (VIT D); calcium; calcium acetate (PHOSLO); amiodarone; albuterol. The patient previously allergic to Cipro, clindamycin, doxycyclin, Lyrica, tetracycline. The patient previously was non-responder to hepatitis B vaccine. The patient previously received first dose of BNT162B2(PFIZER-BIONTECH COVID-19 VACCINE) on 17Feb2021 for COVID-19 immunisation. The patient hasn't been treated with immunomodulating or immunosuppressing medications or received any other vaccines around the time of COVID-19 vaccination. The patient wasn't smoker/ former smoker. There was no any other vaccinations within four weeks prior to the first administration date of the suspect vaccine. A nephrologist who reported patient in her hemodialysis unit who were vaccinated with BNT162b2 but were recently diagnosed with COVID-19. More detail is below on each patient. The patient COVID results were sent to the local health department for genetic sequencing (pending) and SARS titers were drawn (pending). Unfortunately, the HD unit does not have B/L information (although the B/L # was put on the patient's COVID vaccine cards, a record was not kept in the HD unit). Day she came in for dialysis she was already short of breath she said she'd had body aches for 5 days, got short of breath on 05Apr2021. The day before, started getting cough, nauseous, chills, abdominal discomfort on 04Apr2021. The patient was sent to the ER from dialysis and was admitted for SOB on 05Apr2021 and passed away on 09Apr2021 due to a GI bleed. Patient is over 500lbs so was unable to fit into hospital imaging equiment for CT scans or weight measurements. COVID-19 test was positive on 05Apr2021; the patient experienced COVID pneumonia on 05Apr2021. The patient admitted on 05Apr2021 to regular floor. The patient was moved to an Intensive Care Unit on 06Apr2021. The patient experienced short of breath on 05Apr2021 and required much more O2 than normal. Sometimes required BP support while on Dialysis and BP was 113/61 in ER. Pressure dropped to 100/70 and required mitrodrine after fluid was removed. The patient needed 4 liters supplemental O2 vs. only needing 2 liters at home. The patient experienced tachypnea and hypoxemia and no Respiratory failure. Respiration was 22. After 5 litres of O2 improved. Pulse 93 in ER. Cardiovascular: There was no heart failure, cardiogenic shock, Acute myocardial infarction, arrhythmia and myocarditis. The patient Had chest pain which resolved when O2 was administered. Gastrointestinal/Hepatic: There was no Vomiting, Diarrhea. The patient experienced nausea but no vomiting or diarrhea and complained of abdominal pain. There was no Jaundice and acute liver failure. Neurological: There was no altered consciousness, altered consciousness, encephalopathy, meningitis and cerebrovascular accident. The patient had headaches a couple days before admitting to ER. Hematological: There was no Thrombocytopenia, Disseminated intravascular coagulation. INR was 3 due to large dose of coumadin, and platelets were 180 and white count 6.8. Slight troponin increased at 0.37 at admittance, BNP 39. The patient started coughing up blood, having hemoxysis and bleeding on unspecified date. Laboratory test or diagnostic studies was reported that test for SARS-CoV-2 by PCR, or other commercial or public health assay. Xray showed vascular congestion with superimposed infiltrate which could represent pneumonia. Blood count was 11 and 36.7% at ER. Clinical chemistry: Sodium was 133; BUN was 68; Creatinine was 10. Evidence of hypoxemia: Pulse oO2 was 90 in ER.  CT scans: unknown results. Urinalysis: On dialysis so does not make urine. The patient had received Remdesivir, from 06Apr2021, Hydroxychloroquine/chloroquine, Azithromycin from 06Apr2021 and Corticosteroids from 06Apr2021 for COVID-19.  The outcome of event ""GI bleed"" was fatal, the event ""chest pain"" and ""body aches"" was recovered and other events was unknown. The patient died on 09Apr2021. An autopsy was not performed.  Information on the lot/batch number has been requested.; Sender's Comments: Based on temporal association, a contributory role of the suspect drug cannot be excluded for the events vaccination failure, COVID-19, COVID-19 pneumonia, and sepsis. However, the patient's multiple medical comborbidities including renal failure requiring dialysis, lupus, and morbid obesity along with the risk of COVID-19 infection in light of the current pandemic are the more likely explanations for the development of these infections. The events gastrointestinal hemorrhage, hemorrhage, hemolysis and troponin increased are attributed to intercurrent medical conditions, and are considered unrelated to the suspect drug. The patient is currently on warfarin which may increase the risk for bleeds. This case will be reassessed upon receipt of additional information. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate.; Reported Cause(s) of Death: GI bleed""
	"1235811-1"	"1235811-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	""COVID pneumonia; Hematological; bleeding; having hemoxysis; slight troponin increase; GI bleed; headaches; COVID-19 test was positive; COVID-19 test was positive; nauseous; abdominal discomfort; body aches; This is a spontaneous report from a contactable physician. A 52-year-old female patient received her first dose of BNT162B2(PFIZER-BIONTECH COVID-19 VACCINE, Batch/Lot number was not reported), via an unspecified route of administration at the age 52-year-old on 12Mar2021 at single dose for COVID-19 immunisation. Medical history included hemodialysis for many years, adherent to medical care, multiple DVTs and Pes (On anticoagulants), morbid obesity, Patient was on dialysis for renal failure and had lupus anticoagulant (positive), Afib, allergic to shellfish. Family history included renal failure and had lupus anticoagulant. Concomitant medications included warfarin sodium (COUMADIN); metoprolol; amitriptyline; calcitriol; ergocalciferol (VIT D); calcium; calcium acetate (PHOSLO); amiodarone; albuterol. The patient previously allergic to Cipro, clindamycin, doxycyclin, Lyrica, tetracycline. The patient previously was non-responder to hepatitis B vaccine. The patient previously received first dose of BNT162B2(PFIZER-BIONTECH COVID-19 VACCINE) on 17Feb2021 for COVID-19 immunisation. The patient hasn't been treated with immunomodulating or immunosuppressing medications or received any other vaccines around the time of COVID-19 vaccination. The patient wasn't smoker/ former smoker. There was no any other vaccinations within four weeks prior to the first administration date of the suspect vaccine. A nephrologist who reported patient in her hemodialysis unit who were vaccinated with BNT162b2 but were recently diagnosed with COVID-19. More detail is below on each patient. The patient COVID results were sent to the local health department for genetic sequencing (pending) and SARS titers were drawn (pending). Unfortunately, the HD unit does not have B/L information (although the B/L # was put on the patient's COVID vaccine cards, a record was not kept in the HD unit). Day she came in for dialysis she was already short of breath she said she'd had body aches for 5 days, got short of breath on 05Apr2021. The day before, started getting cough, nauseous, chills, abdominal discomfort on 04Apr2021. The patient was sent to the ER from dialysis and was admitted for SOB on 05Apr2021 and passed away on 09Apr2021 due to a GI bleed. Patient is over 500lbs so was unable to fit into hospital imaging equiment for CT scans or weight measurements. COVID-19 test was positive on 05Apr2021; the patient experienced COVID pneumonia on 05Apr2021. The patient admitted on 05Apr2021 to regular floor. The patient was moved to an Intensive Care Unit on 06Apr2021. The patient experienced short of breath on 05Apr2021 and required much more O2 than normal. Sometimes required BP support while on Dialysis and BP was 113/61 in ER. Pressure dropped to 100/70 and required mitrodrine after fluid was removed. The patient needed 4 liters supplemental O2 vs. only needing 2 liters at home. The patient experienced tachypnea and hypoxemia and no Respiratory failure. Respiration was 22. After 5 litres of O2 improved. Pulse 93 in ER. Cardiovascular: There was no heart failure, cardiogenic shock, Acute myocardial infarction, arrhythmia and myocarditis. The patient Had chest pain which resolved when O2 was administered. Gastrointestinal/Hepatic: There was no Vomiting, Diarrhea. The patient experienced nausea but no vomiting or diarrhea and complained of abdominal pain. There was no Jaundice and acute liver failure. Neurological: There was no altered consciousness, altered consciousness, encephalopathy, meningitis and cerebrovascular accident. The patient had headaches a couple days before admitting to ER. Hematological: There was no Thrombocytopenia, Disseminated intravascular coagulation. INR was 3 due to large dose of coumadin, and platelets were 180 and white count 6.8. Slight troponin increased at 0.37 at admittance, BNP 39. The patient started coughing up blood, having hemoxysis and bleeding on unspecified date. Laboratory test or diagnostic studies was reported that test for SARS-CoV-2 by PCR, or other commercial or public health assay. Xray showed vascular congestion with superimposed infiltrate which could represent pneumonia. Blood count was 11 and 36.7% at ER. Clinical chemistry: Sodium was 133; BUN was 68; Creatinine was 10. Evidence of hypoxemia: Pulse oO2 was 90 in ER.  CT scans: unknown results. Urinalysis: On dialysis so does not make urine. The patient had received Remdesivir, from 06Apr2021, Hydroxychloroquine/chloroquine, Azithromycin from 06Apr2021 and Corticosteroids from 06Apr2021 for COVID-19.  The outcome of event ""GI bleed"" was fatal, the event ""chest pain"" and ""body aches"" was recovered and other events was unknown. The patient died on 09Apr2021. An autopsy was not performed.  Information on the lot/batch number has been requested.; Sender's Comments: Based on temporal association, a contributory role of the suspect drug cannot be excluded for the events vaccination failure, COVID-19, COVID-19 pneumonia, and sepsis. However, the patient's multiple medical comborbidities including renal failure requiring dialysis, lupus, and morbid obesity along with the risk of COVID-19 infection in light of the current pandemic are the more likely explanations for the development of these infections. The events gastrointestinal hemorrhage, hemorrhage, hemolysis and troponin increased are attributed to intercurrent medical conditions, and are considered unrelated to the suspect drug. The patient is currently on warfarin which may increase the risk for bleeds. This case will be reassessed upon receipt of additional information. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate.; Reported Cause(s) of Death: GI bleed""
	"1235811-1"	"1235811-1"	"COVID-19 PNEUMONIA"	"10084380"	"50-59 years"	"50-59"	""COVID pneumonia; Hematological; bleeding; having hemoxysis; slight troponin increase; GI bleed; headaches; COVID-19 test was positive; COVID-19 test was positive; nauseous; abdominal discomfort; body aches; This is a spontaneous report from a contactable physician. A 52-year-old female patient received her first dose of BNT162B2(PFIZER-BIONTECH COVID-19 VACCINE, Batch/Lot number was not reported), via an unspecified route of administration at the age 52-year-old on 12Mar2021 at single dose for COVID-19 immunisation. Medical history included hemodialysis for many years, adherent to medical care, multiple DVTs and Pes (On anticoagulants), morbid obesity, Patient was on dialysis for renal failure and had lupus anticoagulant (positive), Afib, allergic to shellfish. Family history included renal failure and had lupus anticoagulant. Concomitant medications included warfarin sodium (COUMADIN); metoprolol; amitriptyline; calcitriol; ergocalciferol (VIT D); calcium; calcium acetate (PHOSLO); amiodarone; albuterol. The patient previously allergic to Cipro, clindamycin, doxycyclin, Lyrica, tetracycline. The patient previously was non-responder to hepatitis B vaccine. The patient previously received first dose of BNT162B2(PFIZER-BIONTECH COVID-19 VACCINE) on 17Feb2021 for COVID-19 immunisation. The patient hasn't been treated with immunomodulating or immunosuppressing medications or received any other vaccines around the time of COVID-19 vaccination. The patient wasn't smoker/ former smoker. There was no any other vaccinations within four weeks prior to the first administration date of the suspect vaccine. A nephrologist who reported patient in her hemodialysis unit who were vaccinated with BNT162b2 but were recently diagnosed with COVID-19. More detail is below on each patient. The patient COVID results were sent to the local health department for genetic sequencing (pending) and SARS titers were drawn (pending). Unfortunately, the HD unit does not have B/L information (although the B/L # was put on the patient's COVID vaccine cards, a record was not kept in the HD unit). Day she came in for dialysis she was already short of breath she said she'd had body aches for 5 days, got short of breath on 05Apr2021. The day before, started getting cough, nauseous, chills, abdominal discomfort on 04Apr2021. The patient was sent to the ER from dialysis and was admitted for SOB on 05Apr2021 and passed away on 09Apr2021 due to a GI bleed. Patient is over 500lbs so was unable to fit into hospital imaging equiment for CT scans or weight measurements. COVID-19 test was positive on 05Apr2021; the patient experienced COVID pneumonia on 05Apr2021. The patient admitted on 05Apr2021 to regular floor. The patient was moved to an Intensive Care Unit on 06Apr2021. The patient experienced short of breath on 05Apr2021 and required much more O2 than normal. Sometimes required BP support while on Dialysis and BP was 113/61 in ER. Pressure dropped to 100/70 and required mitrodrine after fluid was removed. The patient needed 4 liters supplemental O2 vs. only needing 2 liters at home. The patient experienced tachypnea and hypoxemia and no Respiratory failure. Respiration was 22. After 5 litres of O2 improved. Pulse 93 in ER. Cardiovascular: There was no heart failure, cardiogenic shock, Acute myocardial infarction, arrhythmia and myocarditis. The patient Had chest pain which resolved when O2 was administered. Gastrointestinal/Hepatic: There was no Vomiting, Diarrhea. The patient experienced nausea but no vomiting or diarrhea and complained of abdominal pain. There was no Jaundice and acute liver failure. Neurological: There was no altered consciousness, altered consciousness, encephalopathy, meningitis and cerebrovascular accident. The patient had headaches a couple days before admitting to ER. Hematological: There was no Thrombocytopenia, Disseminated intravascular coagulation. INR was 3 due to large dose of coumadin, and platelets were 180 and white count 6.8. Slight troponin increased at 0.37 at admittance, BNP 39. The patient started coughing up blood, having hemoxysis and bleeding on unspecified date. Laboratory test or diagnostic studies was reported that test for SARS-CoV-2 by PCR, or other commercial or public health assay. Xray showed vascular congestion with superimposed infiltrate which could represent pneumonia. Blood count was 11 and 36.7% at ER. Clinical chemistry: Sodium was 133; BUN was 68; Creatinine was 10. Evidence of hypoxemia: Pulse oO2 was 90 in ER.  CT scans: unknown results. Urinalysis: On dialysis so does not make urine. The patient had received Remdesivir, from 06Apr2021, Hydroxychloroquine/chloroquine, Azithromycin from 06Apr2021 and Corticosteroids from 06Apr2021 for COVID-19.  The outcome of event ""GI bleed"" was fatal, the event ""chest pain"" and ""body aches"" was recovered and other events was unknown. The patient died on 09Apr2021. An autopsy was not performed.  Information on the lot/batch number has been requested.; Sender's Comments: Based on temporal association, a contributory role of the suspect drug cannot be excluded for the events vaccination failure, COVID-19, COVID-19 pneumonia, and sepsis. However, the patient's multiple medical comborbidities including renal failure requiring dialysis, lupus, and morbid obesity along with the risk of COVID-19 infection in light of the current pandemic are the more likely explanations for the development of these infections. The events gastrointestinal hemorrhage, hemorrhage, hemolysis and troponin increased are attributed to intercurrent medical conditions, and are considered unrelated to the suspect drug. The patient is currently on warfarin which may increase the risk for bleeds. This case will be reassessed upon receipt of additional information. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate.; Reported Cause(s) of Death: GI bleed""
	"1235811-1"	"1235811-1"	"GASTROINTESTINAL HAEMORRHAGE"	"10017955"	"50-59 years"	"50-59"	""COVID pneumonia; Hematological; bleeding; having hemoxysis; slight troponin increase; GI bleed; headaches; COVID-19 test was positive; COVID-19 test was positive; nauseous; abdominal discomfort; body aches; This is a spontaneous report from a contactable physician. A 52-year-old female patient received her first dose of BNT162B2(PFIZER-BIONTECH COVID-19 VACCINE, Batch/Lot number was not reported), via an unspecified route of administration at the age 52-year-old on 12Mar2021 at single dose for COVID-19 immunisation. Medical history included hemodialysis for many years, adherent to medical care, multiple DVTs and Pes (On anticoagulants), morbid obesity, Patient was on dialysis for renal failure and had lupus anticoagulant (positive), Afib, allergic to shellfish. Family history included renal failure and had lupus anticoagulant. Concomitant medications included warfarin sodium (COUMADIN); metoprolol; amitriptyline; calcitriol; ergocalciferol (VIT D); calcium; calcium acetate (PHOSLO); amiodarone; albuterol. The patient previously allergic to Cipro, clindamycin, doxycyclin, Lyrica, tetracycline. The patient previously was non-responder to hepatitis B vaccine. The patient previously received first dose of BNT162B2(PFIZER-BIONTECH COVID-19 VACCINE) on 17Feb2021 for COVID-19 immunisation. The patient hasn't been treated with immunomodulating or immunosuppressing medications or received any other vaccines around the time of COVID-19 vaccination. The patient wasn't smoker/ former smoker. There was no any other vaccinations within four weeks prior to the first administration date of the suspect vaccine. A nephrologist who reported patient in her hemodialysis unit who were vaccinated with BNT162b2 but were recently diagnosed with COVID-19. More detail is below on each patient. The patient COVID results were sent to the local health department for genetic sequencing (pending) and SARS titers were drawn (pending). Unfortunately, the HD unit does not have B/L information (although the B/L # was put on the patient's COVID vaccine cards, a record was not kept in the HD unit). Day she came in for dialysis she was already short of breath she said she'd had body aches for 5 days, got short of breath on 05Apr2021. The day before, started getting cough, nauseous, chills, abdominal discomfort on 04Apr2021. The patient was sent to the ER from dialysis and was admitted for SOB on 05Apr2021 and passed away on 09Apr2021 due to a GI bleed. Patient is over 500lbs so was unable to fit into hospital imaging equiment for CT scans or weight measurements. COVID-19 test was positive on 05Apr2021; the patient experienced COVID pneumonia on 05Apr2021. The patient admitted on 05Apr2021 to regular floor. The patient was moved to an Intensive Care Unit on 06Apr2021. The patient experienced short of breath on 05Apr2021 and required much more O2 than normal. Sometimes required BP support while on Dialysis and BP was 113/61 in ER. Pressure dropped to 100/70 and required mitrodrine after fluid was removed. The patient needed 4 liters supplemental O2 vs. only needing 2 liters at home. The patient experienced tachypnea and hypoxemia and no Respiratory failure. Respiration was 22. After 5 litres of O2 improved. Pulse 93 in ER. Cardiovascular: There was no heart failure, cardiogenic shock, Acute myocardial infarction, arrhythmia and myocarditis. The patient Had chest pain which resolved when O2 was administered. Gastrointestinal/Hepatic: There was no Vomiting, Diarrhea. The patient experienced nausea but no vomiting or diarrhea and complained of abdominal pain. There was no Jaundice and acute liver failure. Neurological: There was no altered consciousness, altered consciousness, encephalopathy, meningitis and cerebrovascular accident. The patient had headaches a couple days before admitting to ER. Hematological: There was no Thrombocytopenia, Disseminated intravascular coagulation. INR was 3 due to large dose of coumadin, and platelets were 180 and white count 6.8. Slight troponin increased at 0.37 at admittance, BNP 39. The patient started coughing up blood, having hemoxysis and bleeding on unspecified date. Laboratory test or diagnostic studies was reported that test for SARS-CoV-2 by PCR, or other commercial or public health assay. Xray showed vascular congestion with superimposed infiltrate which could represent pneumonia. Blood count was 11 and 36.7% at ER. Clinical chemistry: Sodium was 133; BUN was 68; Creatinine was 10. Evidence of hypoxemia: Pulse oO2 was 90 in ER.  CT scans: unknown results. Urinalysis: On dialysis so does not make urine. The patient had received Remdesivir, from 06Apr2021, Hydroxychloroquine/chloroquine, Azithromycin from 06Apr2021 and Corticosteroids from 06Apr2021 for COVID-19.  The outcome of event ""GI bleed"" was fatal, the event ""chest pain"" and ""body aches"" was recovered and other events was unknown. The patient died on 09Apr2021. An autopsy was not performed.  Information on the lot/batch number has been requested.; Sender's Comments: Based on temporal association, a contributory role of the suspect drug cannot be excluded for the events vaccination failure, COVID-19, COVID-19 pneumonia, and sepsis. However, the patient's multiple medical comborbidities including renal failure requiring dialysis, lupus, and morbid obesity along with the risk of COVID-19 infection in light of the current pandemic are the more likely explanations for the development of these infections. The events gastrointestinal hemorrhage, hemorrhage, hemolysis and troponin increased are attributed to intercurrent medical conditions, and are considered unrelated to the suspect drug. The patient is currently on warfarin which may increase the risk for bleeds. This case will be reassessed upon receipt of additional information. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate.; Reported Cause(s) of Death: GI bleed""
	"1235811-1"	"1235811-1"	"HAEMOLYSIS"	"10018910"	"50-59 years"	"50-59"	""COVID pneumonia; Hematological; bleeding; having hemoxysis; slight troponin increase; GI bleed; headaches; COVID-19 test was positive; COVID-19 test was positive; nauseous; abdominal discomfort; body aches; This is a spontaneous report from a contactable physician. A 52-year-old female patient received her first dose of BNT162B2(PFIZER-BIONTECH COVID-19 VACCINE, Batch/Lot number was not reported), via an unspecified route of administration at the age 52-year-old on 12Mar2021 at single dose for COVID-19 immunisation. Medical history included hemodialysis for many years, adherent to medical care, multiple DVTs and Pes (On anticoagulants), morbid obesity, Patient was on dialysis for renal failure and had lupus anticoagulant (positive), Afib, allergic to shellfish. Family history included renal failure and had lupus anticoagulant. Concomitant medications included warfarin sodium (COUMADIN); metoprolol; amitriptyline; calcitriol; ergocalciferol (VIT D); calcium; calcium acetate (PHOSLO); amiodarone; albuterol. The patient previously allergic to Cipro, clindamycin, doxycyclin, Lyrica, tetracycline. The patient previously was non-responder to hepatitis B vaccine. The patient previously received first dose of BNT162B2(PFIZER-BIONTECH COVID-19 VACCINE) on 17Feb2021 for COVID-19 immunisation. The patient hasn't been treated with immunomodulating or immunosuppressing medications or received any other vaccines around the time of COVID-19 vaccination. The patient wasn't smoker/ former smoker. There was no any other vaccinations within four weeks prior to the first administration date of the suspect vaccine. A nephrologist who reported patient in her hemodialysis unit who were vaccinated with BNT162b2 but were recently diagnosed with COVID-19. More detail is below on each patient. The patient COVID results were sent to the local health department for genetic sequencing (pending) and SARS titers were drawn (pending). Unfortunately, the HD unit does not have B/L information (although the B/L # was put on the patient's COVID vaccine cards, a record was not kept in the HD unit). Day she came in for dialysis she was already short of breath she said she'd had body aches for 5 days, got short of breath on 05Apr2021. The day before, started getting cough, nauseous, chills, abdominal discomfort on 04Apr2021. The patient was sent to the ER from dialysis and was admitted for SOB on 05Apr2021 and passed away on 09Apr2021 due to a GI bleed. Patient is over 500lbs so was unable to fit into hospital imaging equiment for CT scans or weight measurements. COVID-19 test was positive on 05Apr2021; the patient experienced COVID pneumonia on 05Apr2021. The patient admitted on 05Apr2021 to regular floor. The patient was moved to an Intensive Care Unit on 06Apr2021. The patient experienced short of breath on 05Apr2021 and required much more O2 than normal. Sometimes required BP support while on Dialysis and BP was 113/61 in ER. Pressure dropped to 100/70 and required mitrodrine after fluid was removed. The patient needed 4 liters supplemental O2 vs. only needing 2 liters at home. The patient experienced tachypnea and hypoxemia and no Respiratory failure. Respiration was 22. After 5 litres of O2 improved. Pulse 93 in ER. Cardiovascular: There was no heart failure, cardiogenic shock, Acute myocardial infarction, arrhythmia and myocarditis. The patient Had chest pain which resolved when O2 was administered. Gastrointestinal/Hepatic: There was no Vomiting, Diarrhea. The patient experienced nausea but no vomiting or diarrhea and complained of abdominal pain. There was no Jaundice and acute liver failure. Neurological: There was no altered consciousness, altered consciousness, encephalopathy, meningitis and cerebrovascular accident. The patient had headaches a couple days before admitting to ER. Hematological: There was no Thrombocytopenia, Disseminated intravascular coagulation. INR was 3 due to large dose of coumadin, and platelets were 180 and white count 6.8. Slight troponin increased at 0.37 at admittance, BNP 39. The patient started coughing up blood, having hemoxysis and bleeding on unspecified date. Laboratory test or diagnostic studies was reported that test for SARS-CoV-2 by PCR, or other commercial or public health assay. Xray showed vascular congestion with superimposed infiltrate which could represent pneumonia. Blood count was 11 and 36.7% at ER. Clinical chemistry: Sodium was 133; BUN was 68; Creatinine was 10. Evidence of hypoxemia: Pulse oO2 was 90 in ER.  CT scans: unknown results. Urinalysis: On dialysis so does not make urine. The patient had received Remdesivir, from 06Apr2021, Hydroxychloroquine/chloroquine, Azithromycin from 06Apr2021 and Corticosteroids from 06Apr2021 for COVID-19.  The outcome of event ""GI bleed"" was fatal, the event ""chest pain"" and ""body aches"" was recovered and other events was unknown. The patient died on 09Apr2021. An autopsy was not performed.  Information on the lot/batch number has been requested.; Sender's Comments: Based on temporal association, a contributory role of the suspect drug cannot be excluded for the events vaccination failure, COVID-19, COVID-19 pneumonia, and sepsis. However, the patient's multiple medical comborbidities including renal failure requiring dialysis, lupus, and morbid obesity along with the risk of COVID-19 infection in light of the current pandemic are the more likely explanations for the development of these infections. The events gastrointestinal hemorrhage, hemorrhage, hemolysis and troponin increased are attributed to intercurrent medical conditions, and are considered unrelated to the suspect drug. The patient is currently on warfarin which may increase the risk for bleeds. This case will be reassessed upon receipt of additional information. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate.; Reported Cause(s) of Death: GI bleed""
	"1235811-1"	"1235811-1"	"HAEMORRHAGE"	"10055798"	"50-59 years"	"50-59"	""COVID pneumonia; Hematological; bleeding; having hemoxysis; slight troponin increase; GI bleed; headaches; COVID-19 test was positive; COVID-19 test was positive; nauseous; abdominal discomfort; body aches; This is a spontaneous report from a contactable physician. A 52-year-old female patient received her first dose of BNT162B2(PFIZER-BIONTECH COVID-19 VACCINE, Batch/Lot number was not reported), via an unspecified route of administration at the age 52-year-old on 12Mar2021 at single dose for COVID-19 immunisation. Medical history included hemodialysis for many years, adherent to medical care, multiple DVTs and Pes (On anticoagulants), morbid obesity, Patient was on dialysis for renal failure and had lupus anticoagulant (positive), Afib, allergic to shellfish. Family history included renal failure and had lupus anticoagulant. Concomitant medications included warfarin sodium (COUMADIN); metoprolol; amitriptyline; calcitriol; ergocalciferol (VIT D); calcium; calcium acetate (PHOSLO); amiodarone; albuterol. The patient previously allergic to Cipro, clindamycin, doxycyclin, Lyrica, tetracycline. The patient previously was non-responder to hepatitis B vaccine. The patient previously received first dose of BNT162B2(PFIZER-BIONTECH COVID-19 VACCINE) on 17Feb2021 for COVID-19 immunisation. The patient hasn't been treated with immunomodulating or immunosuppressing medications or received any other vaccines around the time of COVID-19 vaccination. The patient wasn't smoker/ former smoker. There was no any other vaccinations within four weeks prior to the first administration date of the suspect vaccine. A nephrologist who reported patient in her hemodialysis unit who were vaccinated with BNT162b2 but were recently diagnosed with COVID-19. More detail is below on each patient. The patient COVID results were sent to the local health department for genetic sequencing (pending) and SARS titers were drawn (pending). Unfortunately, the HD unit does not have B/L information (although the B/L # was put on the patient's COVID vaccine cards, a record was not kept in the HD unit). Day she came in for dialysis she was already short of breath she said she'd had body aches for 5 days, got short of breath on 05Apr2021. The day before, started getting cough, nauseous, chills, abdominal discomfort on 04Apr2021. The patient was sent to the ER from dialysis and was admitted for SOB on 05Apr2021 and passed away on 09Apr2021 due to a GI bleed. Patient is over 500lbs so was unable to fit into hospital imaging equiment for CT scans or weight measurements. COVID-19 test was positive on 05Apr2021; the patient experienced COVID pneumonia on 05Apr2021. The patient admitted on 05Apr2021 to regular floor. The patient was moved to an Intensive Care Unit on 06Apr2021. The patient experienced short of breath on 05Apr2021 and required much more O2 than normal. Sometimes required BP support while on Dialysis and BP was 113/61 in ER. Pressure dropped to 100/70 and required mitrodrine after fluid was removed. The patient needed 4 liters supplemental O2 vs. only needing 2 liters at home. The patient experienced tachypnea and hypoxemia and no Respiratory failure. Respiration was 22. After 5 litres of O2 improved. Pulse 93 in ER. Cardiovascular: There was no heart failure, cardiogenic shock, Acute myocardial infarction, arrhythmia and myocarditis. The patient Had chest pain which resolved when O2 was administered. Gastrointestinal/Hepatic: There was no Vomiting, Diarrhea. The patient experienced nausea but no vomiting or diarrhea and complained of abdominal pain. There was no Jaundice and acute liver failure. Neurological: There was no altered consciousness, altered consciousness, encephalopathy, meningitis and cerebrovascular accident. The patient had headaches a couple days before admitting to ER. Hematological: There was no Thrombocytopenia, Disseminated intravascular coagulation. INR was 3 due to large dose of coumadin, and platelets were 180 and white count 6.8. Slight troponin increased at 0.37 at admittance, BNP 39. The patient started coughing up blood, having hemoxysis and bleeding on unspecified date. Laboratory test or diagnostic studies was reported that test for SARS-CoV-2 by PCR, or other commercial or public health assay. Xray showed vascular congestion with superimposed infiltrate which could represent pneumonia. Blood count was 11 and 36.7% at ER. Clinical chemistry: Sodium was 133; BUN was 68; Creatinine was 10. Evidence of hypoxemia: Pulse oO2 was 90 in ER.  CT scans: unknown results. Urinalysis: On dialysis so does not make urine. The patient had received Remdesivir, from 06Apr2021, Hydroxychloroquine/chloroquine, Azithromycin from 06Apr2021 and Corticosteroids from 06Apr2021 for COVID-19.  The outcome of event ""GI bleed"" was fatal, the event ""chest pain"" and ""body aches"" was recovered and other events was unknown. The patient died on 09Apr2021. An autopsy was not performed.  Information on the lot/batch number has been requested.; Sender's Comments: Based on temporal association, a contributory role of the suspect drug cannot be excluded for the events vaccination failure, COVID-19, COVID-19 pneumonia, and sepsis. However, the patient's multiple medical comborbidities including renal failure requiring dialysis, lupus, and morbid obesity along with the risk of COVID-19 infection in light of the current pandemic are the more likely explanations for the development of these infections. The events gastrointestinal hemorrhage, hemorrhage, hemolysis and troponin increased are attributed to intercurrent medical conditions, and are considered unrelated to the suspect drug. The patient is currently on warfarin which may increase the risk for bleeds. This case will be reassessed upon receipt of additional information. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate.; Reported Cause(s) of Death: GI bleed""
	"1235811-1"	"1235811-1"	"HEADACHE"	"10019211"	"50-59 years"	"50-59"	""COVID pneumonia; Hematological; bleeding; having hemoxysis; slight troponin increase; GI bleed; headaches; COVID-19 test was positive; COVID-19 test was positive; nauseous; abdominal discomfort; body aches; This is a spontaneous report from a contactable physician. A 52-year-old female patient received her first dose of BNT162B2(PFIZER-BIONTECH COVID-19 VACCINE, Batch/Lot number was not reported), via an unspecified route of administration at the age 52-year-old on 12Mar2021 at single dose for COVID-19 immunisation. Medical history included hemodialysis for many years, adherent to medical care, multiple DVTs and Pes (On anticoagulants), morbid obesity, Patient was on dialysis for renal failure and had lupus anticoagulant (positive), Afib, allergic to shellfish. Family history included renal failure and had lupus anticoagulant. Concomitant medications included warfarin sodium (COUMADIN); metoprolol; amitriptyline; calcitriol; ergocalciferol (VIT D); calcium; calcium acetate (PHOSLO); amiodarone; albuterol. The patient previously allergic to Cipro, clindamycin, doxycyclin, Lyrica, tetracycline. The patient previously was non-responder to hepatitis B vaccine. The patient previously received first dose of BNT162B2(PFIZER-BIONTECH COVID-19 VACCINE) on 17Feb2021 for COVID-19 immunisation. The patient hasn't been treated with immunomodulating or immunosuppressing medications or received any other vaccines around the time of COVID-19 vaccination. The patient wasn't smoker/ former smoker. There was no any other vaccinations within four weeks prior to the first administration date of the suspect vaccine. A nephrologist who reported patient in her hemodialysis unit who were vaccinated with BNT162b2 but were recently diagnosed with COVID-19. More detail is below on each patient. The patient COVID results were sent to the local health department for genetic sequencing (pending) and SARS titers were drawn (pending). Unfortunately, the HD unit does not have B/L information (although the B/L # was put on the patient's COVID vaccine cards, a record was not kept in the HD unit). Day she came in for dialysis she was already short of breath she said she'd had body aches for 5 days, got short of breath on 05Apr2021. The day before, started getting cough, nauseous, chills, abdominal discomfort on 04Apr2021. The patient was sent to the ER from dialysis and was admitted for SOB on 05Apr2021 and passed away on 09Apr2021 due to a GI bleed. Patient is over 500lbs so was unable to fit into hospital imaging equiment for CT scans or weight measurements. COVID-19 test was positive on 05Apr2021; the patient experienced COVID pneumonia on 05Apr2021. The patient admitted on 05Apr2021 to regular floor. The patient was moved to an Intensive Care Unit on 06Apr2021. The patient experienced short of breath on 05Apr2021 and required much more O2 than normal. Sometimes required BP support while on Dialysis and BP was 113/61 in ER. Pressure dropped to 100/70 and required mitrodrine after fluid was removed. The patient needed 4 liters supplemental O2 vs. only needing 2 liters at home. The patient experienced tachypnea and hypoxemia and no Respiratory failure. Respiration was 22. After 5 litres of O2 improved. Pulse 93 in ER. Cardiovascular: There was no heart failure, cardiogenic shock, Acute myocardial infarction, arrhythmia and myocarditis. The patient Had chest pain which resolved when O2 was administered. Gastrointestinal/Hepatic: There was no Vomiting, Diarrhea. The patient experienced nausea but no vomiting or diarrhea and complained of abdominal pain. There was no Jaundice and acute liver failure. Neurological: There was no altered consciousness, altered consciousness, encephalopathy, meningitis and cerebrovascular accident. The patient had headaches a couple days before admitting to ER. Hematological: There was no Thrombocytopenia, Disseminated intravascular coagulation. INR was 3 due to large dose of coumadin, and platelets were 180 and white count 6.8. Slight troponin increased at 0.37 at admittance, BNP 39. The patient started coughing up blood, having hemoxysis and bleeding on unspecified date. Laboratory test or diagnostic studies was reported that test for SARS-CoV-2 by PCR, or other commercial or public health assay. Xray showed vascular congestion with superimposed infiltrate which could represent pneumonia. Blood count was 11 and 36.7% at ER. Clinical chemistry: Sodium was 133; BUN was 68; Creatinine was 10. Evidence of hypoxemia: Pulse oO2 was 90 in ER.  CT scans: unknown results. Urinalysis: On dialysis so does not make urine. The patient had received Remdesivir, from 06Apr2021, Hydroxychloroquine/chloroquine, Azithromycin from 06Apr2021 and Corticosteroids from 06Apr2021 for COVID-19.  The outcome of event ""GI bleed"" was fatal, the event ""chest pain"" and ""body aches"" was recovered and other events was unknown. The patient died on 09Apr2021. An autopsy was not performed.  Information on the lot/batch number has been requested.; Sender's Comments: Based on temporal association, a contributory role of the suspect drug cannot be excluded for the events vaccination failure, COVID-19, COVID-19 pneumonia, and sepsis. However, the patient's multiple medical comborbidities including renal failure requiring dialysis, lupus, and morbid obesity along with the risk of COVID-19 infection in light of the current pandemic are the more likely explanations for the development of these infections. The events gastrointestinal hemorrhage, hemorrhage, hemolysis and troponin increased are attributed to intercurrent medical conditions, and are considered unrelated to the suspect drug. The patient is currently on warfarin which may increase the risk for bleeds. This case will be reassessed upon receipt of additional information. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate.; Reported Cause(s) of Death: GI bleed""
	"1235811-1"	"1235811-1"	"HEART RATE"	"10019299"	"50-59 years"	"50-59"	""COVID pneumonia; Hematological; bleeding; having hemoxysis; slight troponin increase; GI bleed; headaches; COVID-19 test was positive; COVID-19 test was positive; nauseous; abdominal discomfort; body aches; This is a spontaneous report from a contactable physician. A 52-year-old female patient received her first dose of BNT162B2(PFIZER-BIONTECH COVID-19 VACCINE, Batch/Lot number was not reported), via an unspecified route of administration at the age 52-year-old on 12Mar2021 at single dose for COVID-19 immunisation. Medical history included hemodialysis for many years, adherent to medical care, multiple DVTs and Pes (On anticoagulants), morbid obesity, Patient was on dialysis for renal failure and had lupus anticoagulant (positive), Afib, allergic to shellfish. Family history included renal failure and had lupus anticoagulant. Concomitant medications included warfarin sodium (COUMADIN); metoprolol; amitriptyline; calcitriol; ergocalciferol (VIT D); calcium; calcium acetate (PHOSLO); amiodarone; albuterol. The patient previously allergic to Cipro, clindamycin, doxycyclin, Lyrica, tetracycline. The patient previously was non-responder to hepatitis B vaccine. The patient previously received first dose of BNT162B2(PFIZER-BIONTECH COVID-19 VACCINE) on 17Feb2021 for COVID-19 immunisation. The patient hasn't been treated with immunomodulating or immunosuppressing medications or received any other vaccines around the time of COVID-19 vaccination. The patient wasn't smoker/ former smoker. There was no any other vaccinations within four weeks prior to the first administration date of the suspect vaccine. A nephrologist who reported patient in her hemodialysis unit who were vaccinated with BNT162b2 but were recently diagnosed with COVID-19. More detail is below on each patient. The patient COVID results were sent to the local health department for genetic sequencing (pending) and SARS titers were drawn (pending). Unfortunately, the HD unit does not have B/L information (although the B/L # was put on the patient's COVID vaccine cards, a record was not kept in the HD unit). Day she came in for dialysis she was already short of breath she said she'd had body aches for 5 days, got short of breath on 05Apr2021. The day before, started getting cough, nauseous, chills, abdominal discomfort on 04Apr2021. The patient was sent to the ER from dialysis and was admitted for SOB on 05Apr2021 and passed away on 09Apr2021 due to a GI bleed. Patient is over 500lbs so was unable to fit into hospital imaging equiment for CT scans or weight measurements. COVID-19 test was positive on 05Apr2021; the patient experienced COVID pneumonia on 05Apr2021. The patient admitted on 05Apr2021 to regular floor. The patient was moved to an Intensive Care Unit on 06Apr2021. The patient experienced short of breath on 05Apr2021 and required much more O2 than normal. Sometimes required BP support while on Dialysis and BP was 113/61 in ER. Pressure dropped to 100/70 and required mitrodrine after fluid was removed. The patient needed 4 liters supplemental O2 vs. only needing 2 liters at home. The patient experienced tachypnea and hypoxemia and no Respiratory failure. Respiration was 22. After 5 litres of O2 improved. Pulse 93 in ER. Cardiovascular: There was no heart failure, cardiogenic shock, Acute myocardial infarction, arrhythmia and myocarditis. The patient Had chest pain which resolved when O2 was administered. Gastrointestinal/Hepatic: There was no Vomiting, Diarrhea. The patient experienced nausea but no vomiting or diarrhea and complained of abdominal pain. There was no Jaundice and acute liver failure. Neurological: There was no altered consciousness, altered consciousness, encephalopathy, meningitis and cerebrovascular accident. The patient had headaches a couple days before admitting to ER. Hematological: There was no Thrombocytopenia, Disseminated intravascular coagulation. INR was 3 due to large dose of coumadin, and platelets were 180 and white count 6.8. Slight troponin increased at 0.37 at admittance, BNP 39. The patient started coughing up blood, having hemoxysis and bleeding on unspecified date. Laboratory test or diagnostic studies was reported that test for SARS-CoV-2 by PCR, or other commercial or public health assay. Xray showed vascular congestion with superimposed infiltrate which could represent pneumonia. Blood count was 11 and 36.7% at ER. Clinical chemistry: Sodium was 133; BUN was 68; Creatinine was 10. Evidence of hypoxemia: Pulse oO2 was 90 in ER.  CT scans: unknown results. Urinalysis: On dialysis so does not make urine. The patient had received Remdesivir, from 06Apr2021, Hydroxychloroquine/chloroquine, Azithromycin from 06Apr2021 and Corticosteroids from 06Apr2021 for COVID-19.  The outcome of event ""GI bleed"" was fatal, the event ""chest pain"" and ""body aches"" was recovered and other events was unknown. The patient died on 09Apr2021. An autopsy was not performed.  Information on the lot/batch number has been requested.; Sender's Comments: Based on temporal association, a contributory role of the suspect drug cannot be excluded for the events vaccination failure, COVID-19, COVID-19 pneumonia, and sepsis. However, the patient's multiple medical comborbidities including renal failure requiring dialysis, lupus, and morbid obesity along with the risk of COVID-19 infection in light of the current pandemic are the more likely explanations for the development of these infections. The events gastrointestinal hemorrhage, hemorrhage, hemolysis and troponin increased are attributed to intercurrent medical conditions, and are considered unrelated to the suspect drug. The patient is currently on warfarin which may increase the risk for bleeds. This case will be reassessed upon receipt of additional information. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate.; Reported Cause(s) of Death: GI bleed""
	"1235811-1"	"1235811-1"	"INTERNATIONAL NORMALISED RATIO"	"10022591"	"50-59 years"	"50-59"	""COVID pneumonia; Hematological; bleeding; having hemoxysis; slight troponin increase; GI bleed; headaches; COVID-19 test was positive; COVID-19 test was positive; nauseous; abdominal discomfort; body aches; This is a spontaneous report from a contactable physician. A 52-year-old female patient received her first dose of BNT162B2(PFIZER-BIONTECH COVID-19 VACCINE, Batch/Lot number was not reported), via an unspecified route of administration at the age 52-year-old on 12Mar2021 at single dose for COVID-19 immunisation. Medical history included hemodialysis for many years, adherent to medical care, multiple DVTs and Pes (On anticoagulants), morbid obesity, Patient was on dialysis for renal failure and had lupus anticoagulant (positive), Afib, allergic to shellfish. Family history included renal failure and had lupus anticoagulant. Concomitant medications included warfarin sodium (COUMADIN); metoprolol; amitriptyline; calcitriol; ergocalciferol (VIT D); calcium; calcium acetate (PHOSLO); amiodarone; albuterol. The patient previously allergic to Cipro, clindamycin, doxycyclin, Lyrica, tetracycline. The patient previously was non-responder to hepatitis B vaccine. The patient previously received first dose of BNT162B2(PFIZER-BIONTECH COVID-19 VACCINE) on 17Feb2021 for COVID-19 immunisation. The patient hasn't been treated with immunomodulating or immunosuppressing medications or received any other vaccines around the time of COVID-19 vaccination. The patient wasn't smoker/ former smoker. There was no any other vaccinations within four weeks prior to the first administration date of the suspect vaccine. A nephrologist who reported patient in her hemodialysis unit who were vaccinated with BNT162b2 but were recently diagnosed with COVID-19. More detail is below on each patient. The patient COVID results were sent to the local health department for genetic sequencing (pending) and SARS titers were drawn (pending). Unfortunately, the HD unit does not have B/L information (although the B/L # was put on the patient's COVID vaccine cards, a record was not kept in the HD unit). Day she came in for dialysis she was already short of breath she said she'd had body aches for 5 days, got short of breath on 05Apr2021. The day before, started getting cough, nauseous, chills, abdominal discomfort on 04Apr2021. The patient was sent to the ER from dialysis and was admitted for SOB on 05Apr2021 and passed away on 09Apr2021 due to a GI bleed. Patient is over 500lbs so was unable to fit into hospital imaging equiment for CT scans or weight measurements. COVID-19 test was positive on 05Apr2021; the patient experienced COVID pneumonia on 05Apr2021. The patient admitted on 05Apr2021 to regular floor. The patient was moved to an Intensive Care Unit on 06Apr2021. The patient experienced short of breath on 05Apr2021 and required much more O2 than normal. Sometimes required BP support while on Dialysis and BP was 113/61 in ER. Pressure dropped to 100/70 and required mitrodrine after fluid was removed. The patient needed 4 liters supplemental O2 vs. only needing 2 liters at home. The patient experienced tachypnea and hypoxemia and no Respiratory failure. Respiration was 22. After 5 litres of O2 improved. Pulse 93 in ER. Cardiovascular: There was no heart failure, cardiogenic shock, Acute myocardial infarction, arrhythmia and myocarditis. The patient Had chest pain which resolved when O2 was administered. Gastrointestinal/Hepatic: There was no Vomiting, Diarrhea. The patient experienced nausea but no vomiting or diarrhea and complained of abdominal pain. There was no Jaundice and acute liver failure. Neurological: There was no altered consciousness, altered consciousness, encephalopathy, meningitis and cerebrovascular accident. The patient had headaches a couple days before admitting to ER. Hematological: There was no Thrombocytopenia, Disseminated intravascular coagulation. INR was 3 due to large dose of coumadin, and platelets were 180 and white count 6.8. Slight troponin increased at 0.37 at admittance, BNP 39. The patient started coughing up blood, having hemoxysis and bleeding on unspecified date. Laboratory test or diagnostic studies was reported that test for SARS-CoV-2 by PCR, or other commercial or public health assay. Xray showed vascular congestion with superimposed infiltrate which could represent pneumonia. Blood count was 11 and 36.7% at ER. Clinical chemistry: Sodium was 133; BUN was 68; Creatinine was 10. Evidence of hypoxemia: Pulse oO2 was 90 in ER.  CT scans: unknown results. Urinalysis: On dialysis so does not make urine. The patient had received Remdesivir, from 06Apr2021, Hydroxychloroquine/chloroquine, Azithromycin from 06Apr2021 and Corticosteroids from 06Apr2021 for COVID-19.  The outcome of event ""GI bleed"" was fatal, the event ""chest pain"" and ""body aches"" was recovered and other events was unknown. The patient died on 09Apr2021. An autopsy was not performed.  Information on the lot/batch number has been requested.; Sender's Comments: Based on temporal association, a contributory role of the suspect drug cannot be excluded for the events vaccination failure, COVID-19, COVID-19 pneumonia, and sepsis. However, the patient's multiple medical comborbidities including renal failure requiring dialysis, lupus, and morbid obesity along with the risk of COVID-19 infection in light of the current pandemic are the more likely explanations for the development of these infections. The events gastrointestinal hemorrhage, hemorrhage, hemolysis and troponin increased are attributed to intercurrent medical conditions, and are considered unrelated to the suspect drug. The patient is currently on warfarin which may increase the risk for bleeds. This case will be reassessed upon receipt of additional information. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate.; Reported Cause(s) of Death: GI bleed""
	"1235811-1"	"1235811-1"	"NAUSEA"	"10028813"	"50-59 years"	"50-59"	""COVID pneumonia; Hematological; bleeding; having hemoxysis; slight troponin increase; GI bleed; headaches; COVID-19 test was positive; COVID-19 test was positive; nauseous; abdominal discomfort; body aches; This is a spontaneous report from a contactable physician. A 52-year-old female patient received her first dose of BNT162B2(PFIZER-BIONTECH COVID-19 VACCINE, Batch/Lot number was not reported), via an unspecified route of administration at the age 52-year-old on 12Mar2021 at single dose for COVID-19 immunisation. Medical history included hemodialysis for many years, adherent to medical care, multiple DVTs and Pes (On anticoagulants), morbid obesity, Patient was on dialysis for renal failure and had lupus anticoagulant (positive), Afib, allergic to shellfish. Family history included renal failure and had lupus anticoagulant. Concomitant medications included warfarin sodium (COUMADIN); metoprolol; amitriptyline; calcitriol; ergocalciferol (VIT D); calcium; calcium acetate (PHOSLO); amiodarone; albuterol. The patient previously allergic to Cipro, clindamycin, doxycyclin, Lyrica, tetracycline. The patient previously was non-responder to hepatitis B vaccine. The patient previously received first dose of BNT162B2(PFIZER-BIONTECH COVID-19 VACCINE) on 17Feb2021 for COVID-19 immunisation. The patient hasn't been treated with immunomodulating or immunosuppressing medications or received any other vaccines around the time of COVID-19 vaccination. The patient wasn't smoker/ former smoker. There was no any other vaccinations within four weeks prior to the first administration date of the suspect vaccine. A nephrologist who reported patient in her hemodialysis unit who were vaccinated with BNT162b2 but were recently diagnosed with COVID-19. More detail is below on each patient. The patient COVID results were sent to the local health department for genetic sequencing (pending) and SARS titers were drawn (pending). Unfortunately, the HD unit does not have B/L information (although the B/L # was put on the patient's COVID vaccine cards, a record was not kept in the HD unit). Day she came in for dialysis she was already short of breath she said she'd had body aches for 5 days, got short of breath on 05Apr2021. The day before, started getting cough, nauseous, chills, abdominal discomfort on 04Apr2021. The patient was sent to the ER from dialysis and was admitted for SOB on 05Apr2021 and passed away on 09Apr2021 due to a GI bleed. Patient is over 500lbs so was unable to fit into hospital imaging equiment for CT scans or weight measurements. COVID-19 test was positive on 05Apr2021; the patient experienced COVID pneumonia on 05Apr2021. The patient admitted on 05Apr2021 to regular floor. The patient was moved to an Intensive Care Unit on 06Apr2021. The patient experienced short of breath on 05Apr2021 and required much more O2 than normal. Sometimes required BP support while on Dialysis and BP was 113/61 in ER. Pressure dropped to 100/70 and required mitrodrine after fluid was removed. The patient needed 4 liters supplemental O2 vs. only needing 2 liters at home. The patient experienced tachypnea and hypoxemia and no Respiratory failure. Respiration was 22. After 5 litres of O2 improved. Pulse 93 in ER. Cardiovascular: There was no heart failure, cardiogenic shock, Acute myocardial infarction, arrhythmia and myocarditis. The patient Had chest pain which resolved when O2 was administered. Gastrointestinal/Hepatic: There was no Vomiting, Diarrhea. The patient experienced nausea but no vomiting or diarrhea and complained of abdominal pain. There was no Jaundice and acute liver failure. Neurological: There was no altered consciousness, altered consciousness, encephalopathy, meningitis and cerebrovascular accident. The patient had headaches a couple days before admitting to ER. Hematological: There was no Thrombocytopenia, Disseminated intravascular coagulation. INR was 3 due to large dose of coumadin, and platelets were 180 and white count 6.8. Slight troponin increased at 0.37 at admittance, BNP 39. The patient started coughing up blood, having hemoxysis and bleeding on unspecified date. Laboratory test or diagnostic studies was reported that test for SARS-CoV-2 by PCR, or other commercial or public health assay. Xray showed vascular congestion with superimposed infiltrate which could represent pneumonia. Blood count was 11 and 36.7% at ER. Clinical chemistry: Sodium was 133; BUN was 68; Creatinine was 10. Evidence of hypoxemia: Pulse oO2 was 90 in ER.  CT scans: unknown results. Urinalysis: On dialysis so does not make urine. The patient had received Remdesivir, from 06Apr2021, Hydroxychloroquine/chloroquine, Azithromycin from 06Apr2021 and Corticosteroids from 06Apr2021 for COVID-19.  The outcome of event ""GI bleed"" was fatal, the event ""chest pain"" and ""body aches"" was recovered and other events was unknown. The patient died on 09Apr2021. An autopsy was not performed.  Information on the lot/batch number has been requested.; Sender's Comments: Based on temporal association, a contributory role of the suspect drug cannot be excluded for the events vaccination failure, COVID-19, COVID-19 pneumonia, and sepsis. However, the patient's multiple medical comborbidities including renal failure requiring dialysis, lupus, and morbid obesity along with the risk of COVID-19 infection in light of the current pandemic are the more likely explanations for the development of these infections. The events gastrointestinal hemorrhage, hemorrhage, hemolysis and troponin increased are attributed to intercurrent medical conditions, and are considered unrelated to the suspect drug. The patient is currently on warfarin which may increase the risk for bleeds. This case will be reassessed upon receipt of additional information. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate.; Reported Cause(s) of Death: GI bleed""
	"1235811-1"	"1235811-1"	"PAIN"	"10033371"	"50-59 years"	"50-59"	""COVID pneumonia; Hematological; bleeding; having hemoxysis; slight troponin increase; GI bleed; headaches; COVID-19 test was positive; COVID-19 test was positive; nauseous; abdominal discomfort; body aches; This is a spontaneous report from a contactable physician. A 52-year-old female patient received her first dose of BNT162B2(PFIZER-BIONTECH COVID-19 VACCINE, Batch/Lot number was not reported), via an unspecified route of administration at the age 52-year-old on 12Mar2021 at single dose for COVID-19 immunisation. Medical history included hemodialysis for many years, adherent to medical care, multiple DVTs and Pes (On anticoagulants), morbid obesity, Patient was on dialysis for renal failure and had lupus anticoagulant (positive), Afib, allergic to shellfish. Family history included renal failure and had lupus anticoagulant. Concomitant medications included warfarin sodium (COUMADIN); metoprolol; amitriptyline; calcitriol; ergocalciferol (VIT D); calcium; calcium acetate (PHOSLO); amiodarone; albuterol. The patient previously allergic to Cipro, clindamycin, doxycyclin, Lyrica, tetracycline. The patient previously was non-responder to hepatitis B vaccine. The patient previously received first dose of BNT162B2(PFIZER-BIONTECH COVID-19 VACCINE) on 17Feb2021 for COVID-19 immunisation. The patient hasn't been treated with immunomodulating or immunosuppressing medications or received any other vaccines around the time of COVID-19 vaccination. The patient wasn't smoker/ former smoker. There was no any other vaccinations within four weeks prior to the first administration date of the suspect vaccine. A nephrologist who reported patient in her hemodialysis unit who were vaccinated with BNT162b2 but were recently diagnosed with COVID-19. More detail is below on each patient. The patient COVID results were sent to the local health department for genetic sequencing (pending) and SARS titers were drawn (pending). Unfortunately, the HD unit does not have B/L information (although the B/L # was put on the patient's COVID vaccine cards, a record was not kept in the HD unit). Day she came in for dialysis she was already short of breath she said she'd had body aches for 5 days, got short of breath on 05Apr2021. The day before, started getting cough, nauseous, chills, abdominal discomfort on 04Apr2021. The patient was sent to the ER from dialysis and was admitted for SOB on 05Apr2021 and passed away on 09Apr2021 due to a GI bleed. Patient is over 500lbs so was unable to fit into hospital imaging equiment for CT scans or weight measurements. COVID-19 test was positive on 05Apr2021; the patient experienced COVID pneumonia on 05Apr2021. The patient admitted on 05Apr2021 to regular floor. The patient was moved to an Intensive Care Unit on 06Apr2021. The patient experienced short of breath on 05Apr2021 and required much more O2 than normal. Sometimes required BP support while on Dialysis and BP was 113/61 in ER. Pressure dropped to 100/70 and required mitrodrine after fluid was removed. The patient needed 4 liters supplemental O2 vs. only needing 2 liters at home. The patient experienced tachypnea and hypoxemia and no Respiratory failure. Respiration was 22. After 5 litres of O2 improved. Pulse 93 in ER. Cardiovascular: There was no heart failure, cardiogenic shock, Acute myocardial infarction, arrhythmia and myocarditis. The patient Had chest pain which resolved when O2 was administered. Gastrointestinal/Hepatic: There was no Vomiting, Diarrhea. The patient experienced nausea but no vomiting or diarrhea and complained of abdominal pain. There was no Jaundice and acute liver failure. Neurological: There was no altered consciousness, altered consciousness, encephalopathy, meningitis and cerebrovascular accident. The patient had headaches a couple days before admitting to ER. Hematological: There was no Thrombocytopenia, Disseminated intravascular coagulation. INR was 3 due to large dose of coumadin, and platelets were 180 and white count 6.8. Slight troponin increased at 0.37 at admittance, BNP 39. The patient started coughing up blood, having hemoxysis and bleeding on unspecified date. Laboratory test or diagnostic studies was reported that test for SARS-CoV-2 by PCR, or other commercial or public health assay. Xray showed vascular congestion with superimposed infiltrate which could represent pneumonia. Blood count was 11 and 36.7% at ER. Clinical chemistry: Sodium was 133; BUN was 68; Creatinine was 10. Evidence of hypoxemia: Pulse oO2 was 90 in ER.  CT scans: unknown results. Urinalysis: On dialysis so does not make urine. The patient had received Remdesivir, from 06Apr2021, Hydroxychloroquine/chloroquine, Azithromycin from 06Apr2021 and Corticosteroids from 06Apr2021 for COVID-19.  The outcome of event ""GI bleed"" was fatal, the event ""chest pain"" and ""body aches"" was recovered and other events was unknown. The patient died on 09Apr2021. An autopsy was not performed.  Information on the lot/batch number has been requested.; Sender's Comments: Based on temporal association, a contributory role of the suspect drug cannot be excluded for the events vaccination failure, COVID-19, COVID-19 pneumonia, and sepsis. However, the patient's multiple medical comborbidities including renal failure requiring dialysis, lupus, and morbid obesity along with the risk of COVID-19 infection in light of the current pandemic are the more likely explanations for the development of these infections. The events gastrointestinal hemorrhage, hemorrhage, hemolysis and troponin increased are attributed to intercurrent medical conditions, and are considered unrelated to the suspect drug. The patient is currently on warfarin which may increase the risk for bleeds. This case will be reassessed upon receipt of additional information. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate.; Reported Cause(s) of Death: GI bleed""
	"1235811-1"	"1235811-1"	"PLATELET DISORDER"	"10035532"	"50-59 years"	"50-59"	""COVID pneumonia; Hematological; bleeding; having hemoxysis; slight troponin increase; GI bleed; headaches; COVID-19 test was positive; COVID-19 test was positive; nauseous; abdominal discomfort; body aches; This is a spontaneous report from a contactable physician. A 52-year-old female patient received her first dose of BNT162B2(PFIZER-BIONTECH COVID-19 VACCINE, Batch/Lot number was not reported), via an unspecified route of administration at the age 52-year-old on 12Mar2021 at single dose for COVID-19 immunisation. Medical history included hemodialysis for many years, adherent to medical care, multiple DVTs and Pes (On anticoagulants), morbid obesity, Patient was on dialysis for renal failure and had lupus anticoagulant (positive), Afib, allergic to shellfish. Family history included renal failure and had lupus anticoagulant. Concomitant medications included warfarin sodium (COUMADIN); metoprolol; amitriptyline; calcitriol; ergocalciferol (VIT D); calcium; calcium acetate (PHOSLO); amiodarone; albuterol. The patient previously allergic to Cipro, clindamycin, doxycyclin, Lyrica, tetracycline. The patient previously was non-responder to hepatitis B vaccine. The patient previously received first dose of BNT162B2(PFIZER-BIONTECH COVID-19 VACCINE) on 17Feb2021 for COVID-19 immunisation. The patient hasn't been treated with immunomodulating or immunosuppressing medications or received any other vaccines around the time of COVID-19 vaccination. The patient wasn't smoker/ former smoker. There was no any other vaccinations within four weeks prior to the first administration date of the suspect vaccine. A nephrologist who reported patient in her hemodialysis unit who were vaccinated with BNT162b2 but were recently diagnosed with COVID-19. More detail is below on each patient. The patient COVID results were sent to the local health department for genetic sequencing (pending) and SARS titers were drawn (pending). Unfortunately, the HD unit does not have B/L information (although the B/L # was put on the patient's COVID vaccine cards, a record was not kept in the HD unit). Day she came in for dialysis she was already short of breath she said she'd had body aches for 5 days, got short of breath on 05Apr2021. The day before, started getting cough, nauseous, chills, abdominal discomfort on 04Apr2021. The patient was sent to the ER from dialysis and was admitted for SOB on 05Apr2021 and passed away on 09Apr2021 due to a GI bleed. Patient is over 500lbs so was unable to fit into hospital imaging equiment for CT scans or weight measurements. COVID-19 test was positive on 05Apr2021; the patient experienced COVID pneumonia on 05Apr2021. The patient admitted on 05Apr2021 to regular floor. The patient was moved to an Intensive Care Unit on 06Apr2021. The patient experienced short of breath on 05Apr2021 and required much more O2 than normal. Sometimes required BP support while on Dialysis and BP was 113/61 in ER. Pressure dropped to 100/70 and required mitrodrine after fluid was removed. The patient needed 4 liters supplemental O2 vs. only needing 2 liters at home. The patient experienced tachypnea and hypoxemia and no Respiratory failure. Respiration was 22. After 5 litres of O2 improved. Pulse 93 in ER. Cardiovascular: There was no heart failure, cardiogenic shock, Acute myocardial infarction, arrhythmia and myocarditis. The patient Had chest pain which resolved when O2 was administered. Gastrointestinal/Hepatic: There was no Vomiting, Diarrhea. The patient experienced nausea but no vomiting or diarrhea and complained of abdominal pain. There was no Jaundice and acute liver failure. Neurological: There was no altered consciousness, altered consciousness, encephalopathy, meningitis and cerebrovascular accident. The patient had headaches a couple days before admitting to ER. Hematological: There was no Thrombocytopenia, Disseminated intravascular coagulation. INR was 3 due to large dose of coumadin, and platelets were 180 and white count 6.8. Slight troponin increased at 0.37 at admittance, BNP 39. The patient started coughing up blood, having hemoxysis and bleeding on unspecified date. Laboratory test or diagnostic studies was reported that test for SARS-CoV-2 by PCR, or other commercial or public health assay. Xray showed vascular congestion with superimposed infiltrate which could represent pneumonia. Blood count was 11 and 36.7% at ER. Clinical chemistry: Sodium was 133; BUN was 68; Creatinine was 10. Evidence of hypoxemia: Pulse oO2 was 90 in ER.  CT scans: unknown results. Urinalysis: On dialysis so does not make urine. The patient had received Remdesivir, from 06Apr2021, Hydroxychloroquine/chloroquine, Azithromycin from 06Apr2021 and Corticosteroids from 06Apr2021 for COVID-19.  The outcome of event ""GI bleed"" was fatal, the event ""chest pain"" and ""body aches"" was recovered and other events was unknown. The patient died on 09Apr2021. An autopsy was not performed.  Information on the lot/batch number has been requested.; Sender's Comments: Based on temporal association, a contributory role of the suspect drug cannot be excluded for the events vaccination failure, COVID-19, COVID-19 pneumonia, and sepsis. However, the patient's multiple medical comborbidities including renal failure requiring dialysis, lupus, and morbid obesity along with the risk of COVID-19 infection in light of the current pandemic are the more likely explanations for the development of these infections. The events gastrointestinal hemorrhage, hemorrhage, hemolysis and troponin increased are attributed to intercurrent medical conditions, and are considered unrelated to the suspect drug. The patient is currently on warfarin which may increase the risk for bleeds. This case will be reassessed upon receipt of additional information. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate.; Reported Cause(s) of Death: GI bleed""
	"1235811-1"	"1235811-1"	"PULSE ABNORMAL"	"10037466"	"50-59 years"	"50-59"	""COVID pneumonia; Hematological; bleeding; having hemoxysis; slight troponin increase; GI bleed; headaches; COVID-19 test was positive; COVID-19 test was positive; nauseous; abdominal discomfort; body aches; This is a spontaneous report from a contactable physician. A 52-year-old female patient received her first dose of BNT162B2(PFIZER-BIONTECH COVID-19 VACCINE, Batch/Lot number was not reported), via an unspecified route of administration at the age 52-year-old on 12Mar2021 at single dose for COVID-19 immunisation. Medical history included hemodialysis for many years, adherent to medical care, multiple DVTs and Pes (On anticoagulants), morbid obesity, Patient was on dialysis for renal failure and had lupus anticoagulant (positive), Afib, allergic to shellfish. Family history included renal failure and had lupus anticoagulant. Concomitant medications included warfarin sodium (COUMADIN); metoprolol; amitriptyline; calcitriol; ergocalciferol (VIT D); calcium; calcium acetate (PHOSLO); amiodarone; albuterol. The patient previously allergic to Cipro, clindamycin, doxycyclin, Lyrica, tetracycline. The patient previously was non-responder to hepatitis B vaccine. The patient previously received first dose of BNT162B2(PFIZER-BIONTECH COVID-19 VACCINE) on 17Feb2021 for COVID-19 immunisation. The patient hasn't been treated with immunomodulating or immunosuppressing medications or received any other vaccines around the time of COVID-19 vaccination. The patient wasn't smoker/ former smoker. There was no any other vaccinations within four weeks prior to the first administration date of the suspect vaccine. A nephrologist who reported patient in her hemodialysis unit who were vaccinated with BNT162b2 but were recently diagnosed with COVID-19. More detail is below on each patient. The patient COVID results were sent to the local health department for genetic sequencing (pending) and SARS titers were drawn (pending). Unfortunately, the HD unit does not have B/L information (although the B/L # was put on the patient's COVID vaccine cards, a record was not kept in the HD unit). Day she came in for dialysis she was already short of breath she said she'd had body aches for 5 days, got short of breath on 05Apr2021. The day before, started getting cough, nauseous, chills, abdominal discomfort on 04Apr2021. The patient was sent to the ER from dialysis and was admitted for SOB on 05Apr2021 and passed away on 09Apr2021 due to a GI bleed. Patient is over 500lbs so was unable to fit into hospital imaging equiment for CT scans or weight measurements. COVID-19 test was positive on 05Apr2021; the patient experienced COVID pneumonia on 05Apr2021. The patient admitted on 05Apr2021 to regular floor. The patient was moved to an Intensive Care Unit on 06Apr2021. The patient experienced short of breath on 05Apr2021 and required much more O2 than normal. Sometimes required BP support while on Dialysis and BP was 113/61 in ER. Pressure dropped to 100/70 and required mitrodrine after fluid was removed. The patient needed 4 liters supplemental O2 vs. only needing 2 liters at home. The patient experienced tachypnea and hypoxemia and no Respiratory failure. Respiration was 22. After 5 litres of O2 improved. Pulse 93 in ER. Cardiovascular: There was no heart failure, cardiogenic shock, Acute myocardial infarction, arrhythmia and myocarditis. The patient Had chest pain which resolved when O2 was administered. Gastrointestinal/Hepatic: There was no Vomiting, Diarrhea. The patient experienced nausea but no vomiting or diarrhea and complained of abdominal pain. There was no Jaundice and acute liver failure. Neurological: There was no altered consciousness, altered consciousness, encephalopathy, meningitis and cerebrovascular accident. The patient had headaches a couple days before admitting to ER. Hematological: There was no Thrombocytopenia, Disseminated intravascular coagulation. INR was 3 due to large dose of coumadin, and platelets were 180 and white count 6.8. Slight troponin increased at 0.37 at admittance, BNP 39. The patient started coughing up blood, having hemoxysis and bleeding on unspecified date. Laboratory test or diagnostic studies was reported that test for SARS-CoV-2 by PCR, or other commercial or public health assay. Xray showed vascular congestion with superimposed infiltrate which could represent pneumonia. Blood count was 11 and 36.7% at ER. Clinical chemistry: Sodium was 133; BUN was 68; Creatinine was 10. Evidence of hypoxemia: Pulse oO2 was 90 in ER.  CT scans: unknown results. Urinalysis: On dialysis so does not make urine. The patient had received Remdesivir, from 06Apr2021, Hydroxychloroquine/chloroquine, Azithromycin from 06Apr2021 and Corticosteroids from 06Apr2021 for COVID-19.  The outcome of event ""GI bleed"" was fatal, the event ""chest pain"" and ""body aches"" was recovered and other events was unknown. The patient died on 09Apr2021. An autopsy was not performed.  Information on the lot/batch number has been requested.; Sender's Comments: Based on temporal association, a contributory role of the suspect drug cannot be excluded for the events vaccination failure, COVID-19, COVID-19 pneumonia, and sepsis. However, the patient's multiple medical comborbidities including renal failure requiring dialysis, lupus, and morbid obesity along with the risk of COVID-19 infection in light of the current pandemic are the more likely explanations for the development of these infections. The events gastrointestinal hemorrhage, hemorrhage, hemolysis and troponin increased are attributed to intercurrent medical conditions, and are considered unrelated to the suspect drug. The patient is currently on warfarin which may increase the risk for bleeds. This case will be reassessed upon receipt of additional information. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate.; Reported Cause(s) of Death: GI bleed""
	"1235811-1"	"1235811-1"	"RESPIRATION ABNORMAL"	"10038647"	"50-59 years"	"50-59"	""COVID pneumonia; Hematological; bleeding; having hemoxysis; slight troponin increase; GI bleed; headaches; COVID-19 test was positive; COVID-19 test was positive; nauseous; abdominal discomfort; body aches; This is a spontaneous report from a contactable physician. A 52-year-old female patient received her first dose of BNT162B2(PFIZER-BIONTECH COVID-19 VACCINE, Batch/Lot number was not reported), via an unspecified route of administration at the age 52-year-old on 12Mar2021 at single dose for COVID-19 immunisation. Medical history included hemodialysis for many years, adherent to medical care, multiple DVTs and Pes (On anticoagulants), morbid obesity, Patient was on dialysis for renal failure and had lupus anticoagulant (positive), Afib, allergic to shellfish. Family history included renal failure and had lupus anticoagulant. Concomitant medications included warfarin sodium (COUMADIN); metoprolol; amitriptyline; calcitriol; ergocalciferol (VIT D); calcium; calcium acetate (PHOSLO); amiodarone; albuterol. The patient previously allergic to Cipro, clindamycin, doxycyclin, Lyrica, tetracycline. The patient previously was non-responder to hepatitis B vaccine. The patient previously received first dose of BNT162B2(PFIZER-BIONTECH COVID-19 VACCINE) on 17Feb2021 for COVID-19 immunisation. The patient hasn't been treated with immunomodulating or immunosuppressing medications or received any other vaccines around the time of COVID-19 vaccination. The patient wasn't smoker/ former smoker. There was no any other vaccinations within four weeks prior to the first administration date of the suspect vaccine. A nephrologist who reported patient in her hemodialysis unit who were vaccinated with BNT162b2 but were recently diagnosed with COVID-19. More detail is below on each patient. The patient COVID results were sent to the local health department for genetic sequencing (pending) and SARS titers were drawn (pending). Unfortunately, the HD unit does not have B/L information (although the B/L # was put on the patient's COVID vaccine cards, a record was not kept in the HD unit). Day she came in for dialysis she was already short of breath she said she'd had body aches for 5 days, got short of breath on 05Apr2021. The day before, started getting cough, nauseous, chills, abdominal discomfort on 04Apr2021. The patient was sent to the ER from dialysis and was admitted for SOB on 05Apr2021 and passed away on 09Apr2021 due to a GI bleed. Patient is over 500lbs so was unable to fit into hospital imaging equiment for CT scans or weight measurements. COVID-19 test was positive on 05Apr2021; the patient experienced COVID pneumonia on 05Apr2021. The patient admitted on 05Apr2021 to regular floor. The patient was moved to an Intensive Care Unit on 06Apr2021. The patient experienced short of breath on 05Apr2021 and required much more O2 than normal. Sometimes required BP support while on Dialysis and BP was 113/61 in ER. Pressure dropped to 100/70 and required mitrodrine after fluid was removed. The patient needed 4 liters supplemental O2 vs. only needing 2 liters at home. The patient experienced tachypnea and hypoxemia and no Respiratory failure. Respiration was 22. After 5 litres of O2 improved. Pulse 93 in ER. Cardiovascular: There was no heart failure, cardiogenic shock, Acute myocardial infarction, arrhythmia and myocarditis. The patient Had chest pain which resolved when O2 was administered. Gastrointestinal/Hepatic: There was no Vomiting, Diarrhea. The patient experienced nausea but no vomiting or diarrhea and complained of abdominal pain. There was no Jaundice and acute liver failure. Neurological: There was no altered consciousness, altered consciousness, encephalopathy, meningitis and cerebrovascular accident. The patient had headaches a couple days before admitting to ER. Hematological: There was no Thrombocytopenia, Disseminated intravascular coagulation. INR was 3 due to large dose of coumadin, and platelets were 180 and white count 6.8. Slight troponin increased at 0.37 at admittance, BNP 39. The patient started coughing up blood, having hemoxysis and bleeding on unspecified date. Laboratory test or diagnostic studies was reported that test for SARS-CoV-2 by PCR, or other commercial or public health assay. Xray showed vascular congestion with superimposed infiltrate which could represent pneumonia. Blood count was 11 and 36.7% at ER. Clinical chemistry: Sodium was 133; BUN was 68; Creatinine was 10. Evidence of hypoxemia: Pulse oO2 was 90 in ER.  CT scans: unknown results. Urinalysis: On dialysis so does not make urine. The patient had received Remdesivir, from 06Apr2021, Hydroxychloroquine/chloroquine, Azithromycin from 06Apr2021 and Corticosteroids from 06Apr2021 for COVID-19.  The outcome of event ""GI bleed"" was fatal, the event ""chest pain"" and ""body aches"" was recovered and other events was unknown. The patient died on 09Apr2021. An autopsy was not performed.  Information on the lot/batch number has been requested.; Sender's Comments: Based on temporal association, a contributory role of the suspect drug cannot be excluded for the events vaccination failure, COVID-19, COVID-19 pneumonia, and sepsis. However, the patient's multiple medical comborbidities including renal failure requiring dialysis, lupus, and morbid obesity along with the risk of COVID-19 infection in light of the current pandemic are the more likely explanations for the development of these infections. The events gastrointestinal hemorrhage, hemorrhage, hemolysis and troponin increased are attributed to intercurrent medical conditions, and are considered unrelated to the suspect drug. The patient is currently on warfarin which may increase the risk for bleeds. This case will be reassessed upon receipt of additional information. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate.; Reported Cause(s) of Death: GI bleed""
	"1235811-1"	"1235811-1"	"SARS-COV-2 TEST"	"10084354"	"50-59 years"	"50-59"	""COVID pneumonia; Hematological; bleeding; having hemoxysis; slight troponin increase; GI bleed; headaches; COVID-19 test was positive; COVID-19 test was positive; nauseous; abdominal discomfort; body aches; This is a spontaneous report from a contactable physician. A 52-year-old female patient received her first dose of BNT162B2(PFIZER-BIONTECH COVID-19 VACCINE, Batch/Lot number was not reported), via an unspecified route of administration at the age 52-year-old on 12Mar2021 at single dose for COVID-19 immunisation. Medical history included hemodialysis for many years, adherent to medical care, multiple DVTs and Pes (On anticoagulants), morbid obesity, Patient was on dialysis for renal failure and had lupus anticoagulant (positive), Afib, allergic to shellfish. Family history included renal failure and had lupus anticoagulant. Concomitant medications included warfarin sodium (COUMADIN); metoprolol; amitriptyline; calcitriol; ergocalciferol (VIT D); calcium; calcium acetate (PHOSLO); amiodarone; albuterol. The patient previously allergic to Cipro, clindamycin, doxycyclin, Lyrica, tetracycline. The patient previously was non-responder to hepatitis B vaccine. The patient previously received first dose of BNT162B2(PFIZER-BIONTECH COVID-19 VACCINE) on 17Feb2021 for COVID-19 immunisation. The patient hasn't been treated with immunomodulating or immunosuppressing medications or received any other vaccines around the time of COVID-19 vaccination. The patient wasn't smoker/ former smoker. There was no any other vaccinations within four weeks prior to the first administration date of the suspect vaccine. A nephrologist who reported patient in her hemodialysis unit who were vaccinated with BNT162b2 but were recently diagnosed with COVID-19. More detail is below on each patient. The patient COVID results were sent to the local health department for genetic sequencing (pending) and SARS titers were drawn (pending). Unfortunately, the HD unit does not have B/L information (although the B/L # was put on the patient's COVID vaccine cards, a record was not kept in the HD unit). Day she came in for dialysis she was already short of breath she said she'd had body aches for 5 days, got short of breath on 05Apr2021. The day before, started getting cough, nauseous, chills, abdominal discomfort on 04Apr2021. The patient was sent to the ER from dialysis and was admitted for SOB on 05Apr2021 and passed away on 09Apr2021 due to a GI bleed. Patient is over 500lbs so was unable to fit into hospital imaging equiment for CT scans or weight measurements. COVID-19 test was positive on 05Apr2021; the patient experienced COVID pneumonia on 05Apr2021. The patient admitted on 05Apr2021 to regular floor. The patient was moved to an Intensive Care Unit on 06Apr2021. The patient experienced short of breath on 05Apr2021 and required much more O2 than normal. Sometimes required BP support while on Dialysis and BP was 113/61 in ER. Pressure dropped to 100/70 and required mitrodrine after fluid was removed. The patient needed 4 liters supplemental O2 vs. only needing 2 liters at home. The patient experienced tachypnea and hypoxemia and no Respiratory failure. Respiration was 22. After 5 litres of O2 improved. Pulse 93 in ER. Cardiovascular: There was no heart failure, cardiogenic shock, Acute myocardial infarction, arrhythmia and myocarditis. The patient Had chest pain which resolved when O2 was administered. Gastrointestinal/Hepatic: There was no Vomiting, Diarrhea. The patient experienced nausea but no vomiting or diarrhea and complained of abdominal pain. There was no Jaundice and acute liver failure. Neurological: There was no altered consciousness, altered consciousness, encephalopathy, meningitis and cerebrovascular accident. The patient had headaches a couple days before admitting to ER. Hematological: There was no Thrombocytopenia, Disseminated intravascular coagulation. INR was 3 due to large dose of coumadin, and platelets were 180 and white count 6.8. Slight troponin increased at 0.37 at admittance, BNP 39. The patient started coughing up blood, having hemoxysis and bleeding on unspecified date. Laboratory test or diagnostic studies was reported that test for SARS-CoV-2 by PCR, or other commercial or public health assay. Xray showed vascular congestion with superimposed infiltrate which could represent pneumonia. Blood count was 11 and 36.7% at ER. Clinical chemistry: Sodium was 133; BUN was 68; Creatinine was 10. Evidence of hypoxemia: Pulse oO2 was 90 in ER.  CT scans: unknown results. Urinalysis: On dialysis so does not make urine. The patient had received Remdesivir, from 06Apr2021, Hydroxychloroquine/chloroquine, Azithromycin from 06Apr2021 and Corticosteroids from 06Apr2021 for COVID-19.  The outcome of event ""GI bleed"" was fatal, the event ""chest pain"" and ""body aches"" was recovered and other events was unknown. The patient died on 09Apr2021. An autopsy was not performed.  Information on the lot/batch number has been requested.; Sender's Comments: Based on temporal association, a contributory role of the suspect drug cannot be excluded for the events vaccination failure, COVID-19, COVID-19 pneumonia, and sepsis. However, the patient's multiple medical comborbidities including renal failure requiring dialysis, lupus, and morbid obesity along with the risk of COVID-19 infection in light of the current pandemic are the more likely explanations for the development of these infections. The events gastrointestinal hemorrhage, hemorrhage, hemolysis and troponin increased are attributed to intercurrent medical conditions, and are considered unrelated to the suspect drug. The patient is currently on warfarin which may increase the risk for bleeds. This case will be reassessed upon receipt of additional information. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate.; Reported Cause(s) of Death: GI bleed""
	"1235811-1"	"1235811-1"	"SEPSIS"	"10040047"	"50-59 years"	"50-59"	""COVID pneumonia; Hematological; bleeding; having hemoxysis; slight troponin increase; GI bleed; headaches; COVID-19 test was positive; COVID-19 test was positive; nauseous; abdominal discomfort; body aches; This is a spontaneous report from a contactable physician. A 52-year-old female patient received her first dose of BNT162B2(PFIZER-BIONTECH COVID-19 VACCINE, Batch/Lot number was not reported), via an unspecified route of administration at the age 52-year-old on 12Mar2021 at single dose for COVID-19 immunisation. Medical history included hemodialysis for many years, adherent to medical care, multiple DVTs and Pes (On anticoagulants), morbid obesity, Patient was on dialysis for renal failure and had lupus anticoagulant (positive), Afib, allergic to shellfish. Family history included renal failure and had lupus anticoagulant. Concomitant medications included warfarin sodium (COUMADIN); metoprolol; amitriptyline; calcitriol; ergocalciferol (VIT D); calcium; calcium acetate (PHOSLO); amiodarone; albuterol. The patient previously allergic to Cipro, clindamycin, doxycyclin, Lyrica, tetracycline. The patient previously was non-responder to hepatitis B vaccine. The patient previously received first dose of BNT162B2(PFIZER-BIONTECH COVID-19 VACCINE) on 17Feb2021 for COVID-19 immunisation. The patient hasn't been treated with immunomodulating or immunosuppressing medications or received any other vaccines around the time of COVID-19 vaccination. The patient wasn't smoker/ former smoker. There was no any other vaccinations within four weeks prior to the first administration date of the suspect vaccine. A nephrologist who reported patient in her hemodialysis unit who were vaccinated with BNT162b2 but were recently diagnosed with COVID-19. More detail is below on each patient. The patient COVID results were sent to the local health department for genetic sequencing (pending) and SARS titers were drawn (pending). Unfortunately, the HD unit does not have B/L information (although the B/L # was put on the patient's COVID vaccine cards, a record was not kept in the HD unit). Day she came in for dialysis she was already short of breath she said she'd had body aches for 5 days, got short of breath on 05Apr2021. The day before, started getting cough, nauseous, chills, abdominal discomfort on 04Apr2021. The patient was sent to the ER from dialysis and was admitted for SOB on 05Apr2021 and passed away on 09Apr2021 due to a GI bleed. Patient is over 500lbs so was unable to fit into hospital imaging equiment for CT scans or weight measurements. COVID-19 test was positive on 05Apr2021; the patient experienced COVID pneumonia on 05Apr2021. The patient admitted on 05Apr2021 to regular floor. The patient was moved to an Intensive Care Unit on 06Apr2021. The patient experienced short of breath on 05Apr2021 and required much more O2 than normal. Sometimes required BP support while on Dialysis and BP was 113/61 in ER. Pressure dropped to 100/70 and required mitrodrine after fluid was removed. The patient needed 4 liters supplemental O2 vs. only needing 2 liters at home. The patient experienced tachypnea and hypoxemia and no Respiratory failure. Respiration was 22. After 5 litres of O2 improved. Pulse 93 in ER. Cardiovascular: There was no heart failure, cardiogenic shock, Acute myocardial infarction, arrhythmia and myocarditis. The patient Had chest pain which resolved when O2 was administered. Gastrointestinal/Hepatic: There was no Vomiting, Diarrhea. The patient experienced nausea but no vomiting or diarrhea and complained of abdominal pain. There was no Jaundice and acute liver failure. Neurological: There was no altered consciousness, altered consciousness, encephalopathy, meningitis and cerebrovascular accident. The patient had headaches a couple days before admitting to ER. Hematological: There was no Thrombocytopenia, Disseminated intravascular coagulation. INR was 3 due to large dose of coumadin, and platelets were 180 and white count 6.8. Slight troponin increased at 0.37 at admittance, BNP 39. The patient started coughing up blood, having hemoxysis and bleeding on unspecified date. Laboratory test or diagnostic studies was reported that test for SARS-CoV-2 by PCR, or other commercial or public health assay. Xray showed vascular congestion with superimposed infiltrate which could represent pneumonia. Blood count was 11 and 36.7% at ER. Clinical chemistry: Sodium was 133; BUN was 68; Creatinine was 10. Evidence of hypoxemia: Pulse oO2 was 90 in ER.  CT scans: unknown results. Urinalysis: On dialysis so does not make urine. The patient had received Remdesivir, from 06Apr2021, Hydroxychloroquine/chloroquine, Azithromycin from 06Apr2021 and Corticosteroids from 06Apr2021 for COVID-19.  The outcome of event ""GI bleed"" was fatal, the event ""chest pain"" and ""body aches"" was recovered and other events was unknown. The patient died on 09Apr2021. An autopsy was not performed.  Information on the lot/batch number has been requested.; Sender's Comments: Based on temporal association, a contributory role of the suspect drug cannot be excluded for the events vaccination failure, COVID-19, COVID-19 pneumonia, and sepsis. However, the patient's multiple medical comborbidities including renal failure requiring dialysis, lupus, and morbid obesity along with the risk of COVID-19 infection in light of the current pandemic are the more likely explanations for the development of these infections. The events gastrointestinal hemorrhage, hemorrhage, hemolysis and troponin increased are attributed to intercurrent medical conditions, and are considered unrelated to the suspect drug. The patient is currently on warfarin which may increase the risk for bleeds. This case will be reassessed upon receipt of additional information. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate.; Reported Cause(s) of Death: GI bleed""
	"1235811-1"	"1235811-1"	"TROPONIN INCREASED"	"10058267"	"50-59 years"	"50-59"	""COVID pneumonia; Hematological; bleeding; having hemoxysis; slight troponin increase; GI bleed; headaches; COVID-19 test was positive; COVID-19 test was positive; nauseous; abdominal discomfort; body aches; This is a spontaneous report from a contactable physician. A 52-year-old female patient received her first dose of BNT162B2(PFIZER-BIONTECH COVID-19 VACCINE, Batch/Lot number was not reported), via an unspecified route of administration at the age 52-year-old on 12Mar2021 at single dose for COVID-19 immunisation. Medical history included hemodialysis for many years, adherent to medical care, multiple DVTs and Pes (On anticoagulants), morbid obesity, Patient was on dialysis for renal failure and had lupus anticoagulant (positive), Afib, allergic to shellfish. Family history included renal failure and had lupus anticoagulant. Concomitant medications included warfarin sodium (COUMADIN); metoprolol; amitriptyline; calcitriol; ergocalciferol (VIT D); calcium; calcium acetate (PHOSLO); amiodarone; albuterol. The patient previously allergic to Cipro, clindamycin, doxycyclin, Lyrica, tetracycline. The patient previously was non-responder to hepatitis B vaccine. The patient previously received first dose of BNT162B2(PFIZER-BIONTECH COVID-19 VACCINE) on 17Feb2021 for COVID-19 immunisation. The patient hasn't been treated with immunomodulating or immunosuppressing medications or received any other vaccines around the time of COVID-19 vaccination. The patient wasn't smoker/ former smoker. There was no any other vaccinations within four weeks prior to the first administration date of the suspect vaccine. A nephrologist who reported patient in her hemodialysis unit who were vaccinated with BNT162b2 but were recently diagnosed with COVID-19. More detail is below on each patient. The patient COVID results were sent to the local health department for genetic sequencing (pending) and SARS titers were drawn (pending). Unfortunately, the HD unit does not have B/L information (although the B/L # was put on the patient's COVID vaccine cards, a record was not kept in the HD unit). Day she came in for dialysis she was already short of breath she said she'd had body aches for 5 days, got short of breath on 05Apr2021. The day before, started getting cough, nauseous, chills, abdominal discomfort on 04Apr2021. The patient was sent to the ER from dialysis and was admitted for SOB on 05Apr2021 and passed away on 09Apr2021 due to a GI bleed. Patient is over 500lbs so was unable to fit into hospital imaging equiment for CT scans or weight measurements. COVID-19 test was positive on 05Apr2021; the patient experienced COVID pneumonia on 05Apr2021. The patient admitted on 05Apr2021 to regular floor. The patient was moved to an Intensive Care Unit on 06Apr2021. The patient experienced short of breath on 05Apr2021 and required much more O2 than normal. Sometimes required BP support while on Dialysis and BP was 113/61 in ER. Pressure dropped to 100/70 and required mitrodrine after fluid was removed. The patient needed 4 liters supplemental O2 vs. only needing 2 liters at home. The patient experienced tachypnea and hypoxemia and no Respiratory failure. Respiration was 22. After 5 litres of O2 improved. Pulse 93 in ER. Cardiovascular: There was no heart failure, cardiogenic shock, Acute myocardial infarction, arrhythmia and myocarditis. The patient Had chest pain which resolved when O2 was administered. Gastrointestinal/Hepatic: There was no Vomiting, Diarrhea. The patient experienced nausea but no vomiting or diarrhea and complained of abdominal pain. There was no Jaundice and acute liver failure. Neurological: There was no altered consciousness, altered consciousness, encephalopathy, meningitis and cerebrovascular accident. The patient had headaches a couple days before admitting to ER. Hematological: There was no Thrombocytopenia, Disseminated intravascular coagulation. INR was 3 due to large dose of coumadin, and platelets were 180 and white count 6.8. Slight troponin increased at 0.37 at admittance, BNP 39. The patient started coughing up blood, having hemoxysis and bleeding on unspecified date. Laboratory test or diagnostic studies was reported that test for SARS-CoV-2 by PCR, or other commercial or public health assay. Xray showed vascular congestion with superimposed infiltrate which could represent pneumonia. Blood count was 11 and 36.7% at ER. Clinical chemistry: Sodium was 133; BUN was 68; Creatinine was 10. Evidence of hypoxemia: Pulse oO2 was 90 in ER.  CT scans: unknown results. Urinalysis: On dialysis so does not make urine. The patient had received Remdesivir, from 06Apr2021, Hydroxychloroquine/chloroquine, Azithromycin from 06Apr2021 and Corticosteroids from 06Apr2021 for COVID-19.  The outcome of event ""GI bleed"" was fatal, the event ""chest pain"" and ""body aches"" was recovered and other events was unknown. The patient died on 09Apr2021. An autopsy was not performed.  Information on the lot/batch number has been requested.; Sender's Comments: Based on temporal association, a contributory role of the suspect drug cannot be excluded for the events vaccination failure, COVID-19, COVID-19 pneumonia, and sepsis. However, the patient's multiple medical comborbidities including renal failure requiring dialysis, lupus, and morbid obesity along with the risk of COVID-19 infection in light of the current pandemic are the more likely explanations for the development of these infections. The events gastrointestinal hemorrhage, hemorrhage, hemolysis and troponin increased are attributed to intercurrent medical conditions, and are considered unrelated to the suspect drug. The patient is currently on warfarin which may increase the risk for bleeds. This case will be reassessed upon receipt of additional information. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate.; Reported Cause(s) of Death: GI bleed""
	"1235811-1"	"1235811-1"	"URINE ANALYSIS"	"10046614"	"50-59 years"	"50-59"	""COVID pneumonia; Hematological; bleeding; having hemoxysis; slight troponin increase; GI bleed; headaches; COVID-19 test was positive; COVID-19 test was positive; nauseous; abdominal discomfort; body aches; This is a spontaneous report from a contactable physician. A 52-year-old female patient received her first dose of BNT162B2(PFIZER-BIONTECH COVID-19 VACCINE, Batch/Lot number was not reported), via an unspecified route of administration at the age 52-year-old on 12Mar2021 at single dose for COVID-19 immunisation. Medical history included hemodialysis for many years, adherent to medical care, multiple DVTs and Pes (On anticoagulants), morbid obesity, Patient was on dialysis for renal failure and had lupus anticoagulant (positive), Afib, allergic to shellfish. Family history included renal failure and had lupus anticoagulant. Concomitant medications included warfarin sodium (COUMADIN); metoprolol; amitriptyline; calcitriol; ergocalciferol (VIT D); calcium; calcium acetate (PHOSLO); amiodarone; albuterol. The patient previously allergic to Cipro, clindamycin, doxycyclin, Lyrica, tetracycline. The patient previously was non-responder to hepatitis B vaccine. The patient previously received first dose of BNT162B2(PFIZER-BIONTECH COVID-19 VACCINE) on 17Feb2021 for COVID-19 immunisation. The patient hasn't been treated with immunomodulating or immunosuppressing medications or received any other vaccines around the time of COVID-19 vaccination. The patient wasn't smoker/ former smoker. There was no any other vaccinations within four weeks prior to the first administration date of the suspect vaccine. A nephrologist who reported patient in her hemodialysis unit who were vaccinated with BNT162b2 but were recently diagnosed with COVID-19. More detail is below on each patient. The patient COVID results were sent to the local health department for genetic sequencing (pending) and SARS titers were drawn (pending). Unfortunately, the HD unit does not have B/L information (although the B/L # was put on the patient's COVID vaccine cards, a record was not kept in the HD unit). Day she came in for dialysis she was already short of breath she said she'd had body aches for 5 days, got short of breath on 05Apr2021. The day before, started getting cough, nauseous, chills, abdominal discomfort on 04Apr2021. The patient was sent to the ER from dialysis and was admitted for SOB on 05Apr2021 and passed away on 09Apr2021 due to a GI bleed. Patient is over 500lbs so was unable to fit into hospital imaging equiment for CT scans or weight measurements. COVID-19 test was positive on 05Apr2021; the patient experienced COVID pneumonia on 05Apr2021. The patient admitted on 05Apr2021 to regular floor. The patient was moved to an Intensive Care Unit on 06Apr2021. The patient experienced short of breath on 05Apr2021 and required much more O2 than normal. Sometimes required BP support while on Dialysis and BP was 113/61 in ER. Pressure dropped to 100/70 and required mitrodrine after fluid was removed. The patient needed 4 liters supplemental O2 vs. only needing 2 liters at home. The patient experienced tachypnea and hypoxemia and no Respiratory failure. Respiration was 22. After 5 litres of O2 improved. Pulse 93 in ER. Cardiovascular: There was no heart failure, cardiogenic shock, Acute myocardial infarction, arrhythmia and myocarditis. The patient Had chest pain which resolved when O2 was administered. Gastrointestinal/Hepatic: There was no Vomiting, Diarrhea. The patient experienced nausea but no vomiting or diarrhea and complained of abdominal pain. There was no Jaundice and acute liver failure. Neurological: There was no altered consciousness, altered consciousness, encephalopathy, meningitis and cerebrovascular accident. The patient had headaches a couple days before admitting to ER. Hematological: There was no Thrombocytopenia, Disseminated intravascular coagulation. INR was 3 due to large dose of coumadin, and platelets were 180 and white count 6.8. Slight troponin increased at 0.37 at admittance, BNP 39. The patient started coughing up blood, having hemoxysis and bleeding on unspecified date. Laboratory test or diagnostic studies was reported that test for SARS-CoV-2 by PCR, or other commercial or public health assay. Xray showed vascular congestion with superimposed infiltrate which could represent pneumonia. Blood count was 11 and 36.7% at ER. Clinical chemistry: Sodium was 133; BUN was 68; Creatinine was 10. Evidence of hypoxemia: Pulse oO2 was 90 in ER.  CT scans: unknown results. Urinalysis: On dialysis so does not make urine. The patient had received Remdesivir, from 06Apr2021, Hydroxychloroquine/chloroquine, Azithromycin from 06Apr2021 and Corticosteroids from 06Apr2021 for COVID-19.  The outcome of event ""GI bleed"" was fatal, the event ""chest pain"" and ""body aches"" was recovered and other events was unknown. The patient died on 09Apr2021. An autopsy was not performed.  Information on the lot/batch number has been requested.; Sender's Comments: Based on temporal association, a contributory role of the suspect drug cannot be excluded for the events vaccination failure, COVID-19, COVID-19 pneumonia, and sepsis. However, the patient's multiple medical comborbidities including renal failure requiring dialysis, lupus, and morbid obesity along with the risk of COVID-19 infection in light of the current pandemic are the more likely explanations for the development of these infections. The events gastrointestinal hemorrhage, hemorrhage, hemolysis and troponin increased are attributed to intercurrent medical conditions, and are considered unrelated to the suspect drug. The patient is currently on warfarin which may increase the risk for bleeds. This case will be reassessed upon receipt of additional information. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate.; Reported Cause(s) of Death: GI bleed""
	"1235811-1"	"1235811-1"	"VACCINATION FAILURE"	"10046862"	"50-59 years"	"50-59"	""COVID pneumonia; Hematological; bleeding; having hemoxysis; slight troponin increase; GI bleed; headaches; COVID-19 test was positive; COVID-19 test was positive; nauseous; abdominal discomfort; body aches; This is a spontaneous report from a contactable physician. A 52-year-old female patient received her first dose of BNT162B2(PFIZER-BIONTECH COVID-19 VACCINE, Batch/Lot number was not reported), via an unspecified route of administration at the age 52-year-old on 12Mar2021 at single dose for COVID-19 immunisation. Medical history included hemodialysis for many years, adherent to medical care, multiple DVTs and Pes (On anticoagulants), morbid obesity, Patient was on dialysis for renal failure and had lupus anticoagulant (positive), Afib, allergic to shellfish. Family history included renal failure and had lupus anticoagulant. Concomitant medications included warfarin sodium (COUMADIN); metoprolol; amitriptyline; calcitriol; ergocalciferol (VIT D); calcium; calcium acetate (PHOSLO); amiodarone; albuterol. The patient previously allergic to Cipro, clindamycin, doxycyclin, Lyrica, tetracycline. The patient previously was non-responder to hepatitis B vaccine. The patient previously received first dose of BNT162B2(PFIZER-BIONTECH COVID-19 VACCINE) on 17Feb2021 for COVID-19 immunisation. The patient hasn't been treated with immunomodulating or immunosuppressing medications or received any other vaccines around the time of COVID-19 vaccination. The patient wasn't smoker/ former smoker. There was no any other vaccinations within four weeks prior to the first administration date of the suspect vaccine. A nephrologist who reported patient in her hemodialysis unit who were vaccinated with BNT162b2 but were recently diagnosed with COVID-19. More detail is below on each patient. The patient COVID results were sent to the local health department for genetic sequencing (pending) and SARS titers were drawn (pending). Unfortunately, the HD unit does not have B/L information (although the B/L # was put on the patient's COVID vaccine cards, a record was not kept in the HD unit). Day she came in for dialysis she was already short of breath she said she'd had body aches for 5 days, got short of breath on 05Apr2021. The day before, started getting cough, nauseous, chills, abdominal discomfort on 04Apr2021. The patient was sent to the ER from dialysis and was admitted for SOB on 05Apr2021 and passed away on 09Apr2021 due to a GI bleed. Patient is over 500lbs so was unable to fit into hospital imaging equiment for CT scans or weight measurements. COVID-19 test was positive on 05Apr2021; the patient experienced COVID pneumonia on 05Apr2021. The patient admitted on 05Apr2021 to regular floor. The patient was moved to an Intensive Care Unit on 06Apr2021. The patient experienced short of breath on 05Apr2021 and required much more O2 than normal. Sometimes required BP support while on Dialysis and BP was 113/61 in ER. Pressure dropped to 100/70 and required mitrodrine after fluid was removed. The patient needed 4 liters supplemental O2 vs. only needing 2 liters at home. The patient experienced tachypnea and hypoxemia and no Respiratory failure. Respiration was 22. After 5 litres of O2 improved. Pulse 93 in ER. Cardiovascular: There was no heart failure, cardiogenic shock, Acute myocardial infarction, arrhythmia and myocarditis. The patient Had chest pain which resolved when O2 was administered. Gastrointestinal/Hepatic: There was no Vomiting, Diarrhea. The patient experienced nausea but no vomiting or diarrhea and complained of abdominal pain. There was no Jaundice and acute liver failure. Neurological: There was no altered consciousness, altered consciousness, encephalopathy, meningitis and cerebrovascular accident. The patient had headaches a couple days before admitting to ER. Hematological: There was no Thrombocytopenia, Disseminated intravascular coagulation. INR was 3 due to large dose of coumadin, and platelets were 180 and white count 6.8. Slight troponin increased at 0.37 at admittance, BNP 39. The patient started coughing up blood, having hemoxysis and bleeding on unspecified date. Laboratory test or diagnostic studies was reported that test for SARS-CoV-2 by PCR, or other commercial or public health assay. Xray showed vascular congestion with superimposed infiltrate which could represent pneumonia. Blood count was 11 and 36.7% at ER. Clinical chemistry: Sodium was 133; BUN was 68; Creatinine was 10. Evidence of hypoxemia: Pulse oO2 was 90 in ER.  CT scans: unknown results. Urinalysis: On dialysis so does not make urine. The patient had received Remdesivir, from 06Apr2021, Hydroxychloroquine/chloroquine, Azithromycin from 06Apr2021 and Corticosteroids from 06Apr2021 for COVID-19.  The outcome of event ""GI bleed"" was fatal, the event ""chest pain"" and ""body aches"" was recovered and other events was unknown. The patient died on 09Apr2021. An autopsy was not performed.  Information on the lot/batch number has been requested.; Sender's Comments: Based on temporal association, a contributory role of the suspect drug cannot be excluded for the events vaccination failure, COVID-19, COVID-19 pneumonia, and sepsis. However, the patient's multiple medical comborbidities including renal failure requiring dialysis, lupus, and morbid obesity along with the risk of COVID-19 infection in light of the current pandemic are the more likely explanations for the development of these infections. The events gastrointestinal hemorrhage, hemorrhage, hemolysis and troponin increased are attributed to intercurrent medical conditions, and are considered unrelated to the suspect drug. The patient is currently on warfarin which may increase the risk for bleeds. This case will be reassessed upon receipt of additional information. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate.; Reported Cause(s) of Death: GI bleed""
	"1235811-1"	"1235811-1"	"WEIGHT"	"10047890"	"50-59 years"	"50-59"	""COVID pneumonia; Hematological; bleeding; having hemoxysis; slight troponin increase; GI bleed; headaches; COVID-19 test was positive; COVID-19 test was positive; nauseous; abdominal discomfort; body aches; This is a spontaneous report from a contactable physician. A 52-year-old female patient received her first dose of BNT162B2(PFIZER-BIONTECH COVID-19 VACCINE, Batch/Lot number was not reported), via an unspecified route of administration at the age 52-year-old on 12Mar2021 at single dose for COVID-19 immunisation. Medical history included hemodialysis for many years, adherent to medical care, multiple DVTs and Pes (On anticoagulants), morbid obesity, Patient was on dialysis for renal failure and had lupus anticoagulant (positive), Afib, allergic to shellfish. Family history included renal failure and had lupus anticoagulant. Concomitant medications included warfarin sodium (COUMADIN); metoprolol; amitriptyline; calcitriol; ergocalciferol (VIT D); calcium; calcium acetate (PHOSLO); amiodarone; albuterol. The patient previously allergic to Cipro, clindamycin, doxycyclin, Lyrica, tetracycline. The patient previously was non-responder to hepatitis B vaccine. The patient previously received first dose of BNT162B2(PFIZER-BIONTECH COVID-19 VACCINE) on 17Feb2021 for COVID-19 immunisation. The patient hasn't been treated with immunomodulating or immunosuppressing medications or received any other vaccines around the time of COVID-19 vaccination. The patient wasn't smoker/ former smoker. There was no any other vaccinations within four weeks prior to the first administration date of the suspect vaccine. A nephrologist who reported patient in her hemodialysis unit who were vaccinated with BNT162b2 but were recently diagnosed with COVID-19. More detail is below on each patient. The patient COVID results were sent to the local health department for genetic sequencing (pending) and SARS titers were drawn (pending). Unfortunately, the HD unit does not have B/L information (although the B/L # was put on the patient's COVID vaccine cards, a record was not kept in the HD unit). Day she came in for dialysis she was already short of breath she said she'd had body aches for 5 days, got short of breath on 05Apr2021. The day before, started getting cough, nauseous, chills, abdominal discomfort on 04Apr2021. The patient was sent to the ER from dialysis and was admitted for SOB on 05Apr2021 and passed away on 09Apr2021 due to a GI bleed. Patient is over 500lbs so was unable to fit into hospital imaging equiment for CT scans or weight measurements. COVID-19 test was positive on 05Apr2021; the patient experienced COVID pneumonia on 05Apr2021. The patient admitted on 05Apr2021 to regular floor. The patient was moved to an Intensive Care Unit on 06Apr2021. The patient experienced short of breath on 05Apr2021 and required much more O2 than normal. Sometimes required BP support while on Dialysis and BP was 113/61 in ER. Pressure dropped to 100/70 and required mitrodrine after fluid was removed. The patient needed 4 liters supplemental O2 vs. only needing 2 liters at home. The patient experienced tachypnea and hypoxemia and no Respiratory failure. Respiration was 22. After 5 litres of O2 improved. Pulse 93 in ER. Cardiovascular: There was no heart failure, cardiogenic shock, Acute myocardial infarction, arrhythmia and myocarditis. The patient Had chest pain which resolved when O2 was administered. Gastrointestinal/Hepatic: There was no Vomiting, Diarrhea. The patient experienced nausea but no vomiting or diarrhea and complained of abdominal pain. There was no Jaundice and acute liver failure. Neurological: There was no altered consciousness, altered consciousness, encephalopathy, meningitis and cerebrovascular accident. The patient had headaches a couple days before admitting to ER. Hematological: There was no Thrombocytopenia, Disseminated intravascular coagulation. INR was 3 due to large dose of coumadin, and platelets were 180 and white count 6.8. Slight troponin increased at 0.37 at admittance, BNP 39. The patient started coughing up blood, having hemoxysis and bleeding on unspecified date. Laboratory test or diagnostic studies was reported that test for SARS-CoV-2 by PCR, or other commercial or public health assay. Xray showed vascular congestion with superimposed infiltrate which could represent pneumonia. Blood count was 11 and 36.7% at ER. Clinical chemistry: Sodium was 133; BUN was 68; Creatinine was 10. Evidence of hypoxemia: Pulse oO2 was 90 in ER.  CT scans: unknown results. Urinalysis: On dialysis so does not make urine. The patient had received Remdesivir, from 06Apr2021, Hydroxychloroquine/chloroquine, Azithromycin from 06Apr2021 and Corticosteroids from 06Apr2021 for COVID-19.  The outcome of event ""GI bleed"" was fatal, the event ""chest pain"" and ""body aches"" was recovered and other events was unknown. The patient died on 09Apr2021. An autopsy was not performed.  Information on the lot/batch number has been requested.; Sender's Comments: Based on temporal association, a contributory role of the suspect drug cannot be excluded for the events vaccination failure, COVID-19, COVID-19 pneumonia, and sepsis. However, the patient's multiple medical comborbidities including renal failure requiring dialysis, lupus, and morbid obesity along with the risk of COVID-19 infection in light of the current pandemic are the more likely explanations for the development of these infections. The events gastrointestinal hemorrhage, hemorrhage, hemolysis and troponin increased are attributed to intercurrent medical conditions, and are considered unrelated to the suspect drug. The patient is currently on warfarin which may increase the risk for bleeds. This case will be reassessed upon receipt of additional information. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate.; Reported Cause(s) of Death: GI bleed""
	"1235811-1"	"1235811-1"	"WHITE BLOOD CELL COUNT"	"10047939"	"50-59 years"	"50-59"	""COVID pneumonia; Hematological; bleeding; having hemoxysis; slight troponin increase; GI bleed; headaches; COVID-19 test was positive; COVID-19 test was positive; nauseous; abdominal discomfort; body aches; This is a spontaneous report from a contactable physician. A 52-year-old female patient received her first dose of BNT162B2(PFIZER-BIONTECH COVID-19 VACCINE, Batch/Lot number was not reported), via an unspecified route of administration at the age 52-year-old on 12Mar2021 at single dose for COVID-19 immunisation. Medical history included hemodialysis for many years, adherent to medical care, multiple DVTs and Pes (On anticoagulants), morbid obesity, Patient was on dialysis for renal failure and had lupus anticoagulant (positive), Afib, allergic to shellfish. Family history included renal failure and had lupus anticoagulant. Concomitant medications included warfarin sodium (COUMADIN); metoprolol; amitriptyline; calcitriol; ergocalciferol (VIT D); calcium; calcium acetate (PHOSLO); amiodarone; albuterol. The patient previously allergic to Cipro, clindamycin, doxycyclin, Lyrica, tetracycline. The patient previously was non-responder to hepatitis B vaccine. The patient previously received first dose of BNT162B2(PFIZER-BIONTECH COVID-19 VACCINE) on 17Feb2021 for COVID-19 immunisation. The patient hasn't been treated with immunomodulating or immunosuppressing medications or received any other vaccines around the time of COVID-19 vaccination. The patient wasn't smoker/ former smoker. There was no any other vaccinations within four weeks prior to the first administration date of the suspect vaccine. A nephrologist who reported patient in her hemodialysis unit who were vaccinated with BNT162b2 but were recently diagnosed with COVID-19. More detail is below on each patient. The patient COVID results were sent to the local health department for genetic sequencing (pending) and SARS titers were drawn (pending). Unfortunately, the HD unit does not have B/L information (although the B/L # was put on the patient's COVID vaccine cards, a record was not kept in the HD unit). Day she came in for dialysis she was already short of breath she said she'd had body aches for 5 days, got short of breath on 05Apr2021. The day before, started getting cough, nauseous, chills, abdominal discomfort on 04Apr2021. The patient was sent to the ER from dialysis and was admitted for SOB on 05Apr2021 and passed away on 09Apr2021 due to a GI bleed. Patient is over 500lbs so was unable to fit into hospital imaging equiment for CT scans or weight measurements. COVID-19 test was positive on 05Apr2021; the patient experienced COVID pneumonia on 05Apr2021. The patient admitted on 05Apr2021 to regular floor. The patient was moved to an Intensive Care Unit on 06Apr2021. The patient experienced short of breath on 05Apr2021 and required much more O2 than normal. Sometimes required BP support while on Dialysis and BP was 113/61 in ER. Pressure dropped to 100/70 and required mitrodrine after fluid was removed. The patient needed 4 liters supplemental O2 vs. only needing 2 liters at home. The patient experienced tachypnea and hypoxemia and no Respiratory failure. Respiration was 22. After 5 litres of O2 improved. Pulse 93 in ER. Cardiovascular: There was no heart failure, cardiogenic shock, Acute myocardial infarction, arrhythmia and myocarditis. The patient Had chest pain which resolved when O2 was administered. Gastrointestinal/Hepatic: There was no Vomiting, Diarrhea. The patient experienced nausea but no vomiting or diarrhea and complained of abdominal pain. There was no Jaundice and acute liver failure. Neurological: There was no altered consciousness, altered consciousness, encephalopathy, meningitis and cerebrovascular accident. The patient had headaches a couple days before admitting to ER. Hematological: There was no Thrombocytopenia, Disseminated intravascular coagulation. INR was 3 due to large dose of coumadin, and platelets were 180 and white count 6.8. Slight troponin increased at 0.37 at admittance, BNP 39. The patient started coughing up blood, having hemoxysis and bleeding on unspecified date. Laboratory test or diagnostic studies was reported that test for SARS-CoV-2 by PCR, or other commercial or public health assay. Xray showed vascular congestion with superimposed infiltrate which could represent pneumonia. Blood count was 11 and 36.7% at ER. Clinical chemistry: Sodium was 133; BUN was 68; Creatinine was 10. Evidence of hypoxemia: Pulse oO2 was 90 in ER.  CT scans: unknown results. Urinalysis: On dialysis so does not make urine. The patient had received Remdesivir, from 06Apr2021, Hydroxychloroquine/chloroquine, Azithromycin from 06Apr2021 and Corticosteroids from 06Apr2021 for COVID-19.  The outcome of event ""GI bleed"" was fatal, the event ""chest pain"" and ""body aches"" was recovered and other events was unknown. The patient died on 09Apr2021. An autopsy was not performed.  Information on the lot/batch number has been requested.; Sender's Comments: Based on temporal association, a contributory role of the suspect drug cannot be excluded for the events vaccination failure, COVID-19, COVID-19 pneumonia, and sepsis. However, the patient's multiple medical comborbidities including renal failure requiring dialysis, lupus, and morbid obesity along with the risk of COVID-19 infection in light of the current pandemic are the more likely explanations for the development of these infections. The events gastrointestinal hemorrhage, hemorrhage, hemolysis and troponin increased are attributed to intercurrent medical conditions, and are considered unrelated to the suspect drug. The patient is currently on warfarin which may increase the risk for bleeds. This case will be reassessed upon receipt of additional information. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate.; Reported Cause(s) of Death: GI bleed""
	"1235811-1"	"1235811-1"	"X-RAY"	"10048064"	"50-59 years"	"50-59"	""COVID pneumonia; Hematological; bleeding; having hemoxysis; slight troponin increase; GI bleed; headaches; COVID-19 test was positive; COVID-19 test was positive; nauseous; abdominal discomfort; body aches; This is a spontaneous report from a contactable physician. A 52-year-old female patient received her first dose of BNT162B2(PFIZER-BIONTECH COVID-19 VACCINE, Batch/Lot number was not reported), via an unspecified route of administration at the age 52-year-old on 12Mar2021 at single dose for COVID-19 immunisation. Medical history included hemodialysis for many years, adherent to medical care, multiple DVTs and Pes (On anticoagulants), morbid obesity, Patient was on dialysis for renal failure and had lupus anticoagulant (positive), Afib, allergic to shellfish. Family history included renal failure and had lupus anticoagulant. Concomitant medications included warfarin sodium (COUMADIN); metoprolol; amitriptyline; calcitriol; ergocalciferol (VIT D); calcium; calcium acetate (PHOSLO); amiodarone; albuterol. The patient previously allergic to Cipro, clindamycin, doxycyclin, Lyrica, tetracycline. The patient previously was non-responder to hepatitis B vaccine. The patient previously received first dose of BNT162B2(PFIZER-BIONTECH COVID-19 VACCINE) on 17Feb2021 for COVID-19 immunisation. The patient hasn't been treated with immunomodulating or immunosuppressing medications or received any other vaccines around the time of COVID-19 vaccination. The patient wasn't smoker/ former smoker. There was no any other vaccinations within four weeks prior to the first administration date of the suspect vaccine. A nephrologist who reported patient in her hemodialysis unit who were vaccinated with BNT162b2 but were recently diagnosed with COVID-19. More detail is below on each patient. The patient COVID results were sent to the local health department for genetic sequencing (pending) and SARS titers were drawn (pending). Unfortunately, the HD unit does not have B/L information (although the B/L # was put on the patient's COVID vaccine cards, a record was not kept in the HD unit). Day she came in for dialysis she was already short of breath she said she'd had body aches for 5 days, got short of breath on 05Apr2021. The day before, started getting cough, nauseous, chills, abdominal discomfort on 04Apr2021. The patient was sent to the ER from dialysis and was admitted for SOB on 05Apr2021 and passed away on 09Apr2021 due to a GI bleed. Patient is over 500lbs so was unable to fit into hospital imaging equiment for CT scans or weight measurements. COVID-19 test was positive on 05Apr2021; the patient experienced COVID pneumonia on 05Apr2021. The patient admitted on 05Apr2021 to regular floor. The patient was moved to an Intensive Care Unit on 06Apr2021. The patient experienced short of breath on 05Apr2021 and required much more O2 than normal. Sometimes required BP support while on Dialysis and BP was 113/61 in ER. Pressure dropped to 100/70 and required mitrodrine after fluid was removed. The patient needed 4 liters supplemental O2 vs. only needing 2 liters at home. The patient experienced tachypnea and hypoxemia and no Respiratory failure. Respiration was 22. After 5 litres of O2 improved. Pulse 93 in ER. Cardiovascular: There was no heart failure, cardiogenic shock, Acute myocardial infarction, arrhythmia and myocarditis. The patient Had chest pain which resolved when O2 was administered. Gastrointestinal/Hepatic: There was no Vomiting, Diarrhea. The patient experienced nausea but no vomiting or diarrhea and complained of abdominal pain. There was no Jaundice and acute liver failure. Neurological: There was no altered consciousness, altered consciousness, encephalopathy, meningitis and cerebrovascular accident. The patient had headaches a couple days before admitting to ER. Hematological: There was no Thrombocytopenia, Disseminated intravascular coagulation. INR was 3 due to large dose of coumadin, and platelets were 180 and white count 6.8. Slight troponin increased at 0.37 at admittance, BNP 39. The patient started coughing up blood, having hemoxysis and bleeding on unspecified date. Laboratory test or diagnostic studies was reported that test for SARS-CoV-2 by PCR, or other commercial or public health assay. Xray showed vascular congestion with superimposed infiltrate which could represent pneumonia. Blood count was 11 and 36.7% at ER. Clinical chemistry: Sodium was 133; BUN was 68; Creatinine was 10. Evidence of hypoxemia: Pulse oO2 was 90 in ER.  CT scans: unknown results. Urinalysis: On dialysis so does not make urine. The patient had received Remdesivir, from 06Apr2021, Hydroxychloroquine/chloroquine, Azithromycin from 06Apr2021 and Corticosteroids from 06Apr2021 for COVID-19.  The outcome of event ""GI bleed"" was fatal, the event ""chest pain"" and ""body aches"" was recovered and other events was unknown. The patient died on 09Apr2021. An autopsy was not performed.  Information on the lot/batch number has been requested.; Sender's Comments: Based on temporal association, a contributory role of the suspect drug cannot be excluded for the events vaccination failure, COVID-19, COVID-19 pneumonia, and sepsis. However, the patient's multiple medical comborbidities including renal failure requiring dialysis, lupus, and morbid obesity along with the risk of COVID-19 infection in light of the current pandemic are the more likely explanations for the development of these infections. The events gastrointestinal hemorrhage, hemorrhage, hemolysis and troponin increased are attributed to intercurrent medical conditions, and are considered unrelated to the suspect drug. The patient is currently on warfarin which may increase the risk for bleeds. This case will be reassessed upon receipt of additional information. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate.; Reported Cause(s) of Death: GI bleed""
	"1235815-1"	"1235815-1"	"CEREBRAL HAEMORRHAGE"	"10008111"	"50-59 years"	"50-59"	"stroke; Brain bleed; Brain blood clot; This is a spontaneous report from a contactable consumer via a Pfizer sponsored program named Corporate (Pfizer) Social Media Platforms. A 53-years-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 1 via an unspecified route of administration, administered in Arm Left on 11Mar2021 13:15 as single dose for covid-19 immunisation.  Medical history reported as none.  The patient's concomitant medications were not reported.  The patient experienced brain blood clot on 25Mar2021 08:00 , stroke and brain bleed on an unspecified date.  The patient was hospitalized for brain blood clot, stroke, brain bleed for 7 days.  Therapeutic measures were taken as a result of brain blood clot, stroke, brain bleed included Ventillator.  The patient died on 02Apr2021.  An autopsy was not performed. The outcome of events was fatal. No other vaccine in four weeks; No covid prior vaccination.  Information on the lot/batch number has been requested.; Reported Cause(s) of Death: Brain blood clot; stroke; Brain bleed"
	"1235815-1"	"1235815-1"	"CEREBRAL THROMBOSIS"	"10008132"	"50-59 years"	"50-59"	"stroke; Brain bleed; Brain blood clot; This is a spontaneous report from a contactable consumer via a Pfizer sponsored program named Corporate (Pfizer) Social Media Platforms. A 53-years-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 1 via an unspecified route of administration, administered in Arm Left on 11Mar2021 13:15 as single dose for covid-19 immunisation.  Medical history reported as none.  The patient's concomitant medications were not reported.  The patient experienced brain blood clot on 25Mar2021 08:00 , stroke and brain bleed on an unspecified date.  The patient was hospitalized for brain blood clot, stroke, brain bleed for 7 days.  Therapeutic measures were taken as a result of brain blood clot, stroke, brain bleed included Ventillator.  The patient died on 02Apr2021.  An autopsy was not performed. The outcome of events was fatal. No other vaccine in four weeks; No covid prior vaccination.  Information on the lot/batch number has been requested.; Reported Cause(s) of Death: Brain blood clot; stroke; Brain bleed"
	"1235815-1"	"1235815-1"	"CEREBROVASCULAR ACCIDENT"	"10008190"	"50-59 years"	"50-59"	"stroke; Brain bleed; Brain blood clot; This is a spontaneous report from a contactable consumer via a Pfizer sponsored program named Corporate (Pfizer) Social Media Platforms. A 53-years-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 1 via an unspecified route of administration, administered in Arm Left on 11Mar2021 13:15 as single dose for covid-19 immunisation.  Medical history reported as none.  The patient's concomitant medications were not reported.  The patient experienced brain blood clot on 25Mar2021 08:00 , stroke and brain bleed on an unspecified date.  The patient was hospitalized for brain blood clot, stroke, brain bleed for 7 days.  Therapeutic measures were taken as a result of brain blood clot, stroke, brain bleed included Ventillator.  The patient died on 02Apr2021.  An autopsy was not performed. The outcome of events was fatal. No other vaccine in four weeks; No covid prior vaccination.  Information on the lot/batch number has been requested.; Reported Cause(s) of Death: Brain blood clot; stroke; Brain bleed"
	"1236417-1"	"1236417-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"death Narrative: Patient with noted history of ALS was given Moderna covid vaccine #1 on 2/27/21. On 3/5/21, notes were entered in system for family requesting a specialty bed as he was having difficulty sleeping as it was hard to breath when he laid down. He was sleeping sitting up in his wheelchair. On 3/8/21, a note was placed that he was planned to have a trach placed on 3/12/21 and that he was now under hospice care. No further notes entered and a date of death was recorded as 3/17/21. No autopsy results available. 18 days from date of vaccine to date of death."
	"1236417-1"	"1236417-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"death Narrative: Patient with noted history of ALS was given Moderna covid vaccine #1 on 2/27/21. On 3/5/21, notes were entered in system for family requesting a specialty bed as he was having difficulty sleeping as it was hard to breath when he laid down. He was sleeping sitting up in his wheelchair. On 3/8/21, a note was placed that he was planned to have a trach placed on 3/12/21 and that he was now under hospice care. No further notes entered and a date of death was recorded as 3/17/21. No autopsy results available. 18 days from date of vaccine to date of death."
	"1236417-1"	"1236417-1"	"INSOMNIA"	"10022437"	"50-59 years"	"50-59"	"death Narrative: Patient with noted history of ALS was given Moderna covid vaccine #1 on 2/27/21. On 3/5/21, notes were entered in system for family requesting a specialty bed as he was having difficulty sleeping as it was hard to breath when he laid down. He was sleeping sitting up in his wheelchair. On 3/8/21, a note was placed that he was planned to have a trach placed on 3/12/21 and that he was now under hospice care. No further notes entered and a date of death was recorded as 3/17/21. No autopsy results available. 18 days from date of vaccine to date of death."
	"1237427-1"	"1237427-1"	"BACK PAIN"	"10003988"	"50-59 years"	"50-59"	"Arm soreness  1-3 days post vaccine flu like symptoms 4-7 days post vaccine Severe back pain 4-10 days post vaccine Death 11 days post vaccine"
	"1237427-1"	"1237427-1"	"INFLUENZA LIKE ILLNESS"	"10022004"	"50-59 years"	"50-59"	"Arm soreness  1-3 days post vaccine flu like symptoms 4-7 days post vaccine Severe back pain 4-10 days post vaccine Death 11 days post vaccine"
	"1237427-1"	"1237427-1"	"LABORATORY TEST ABNORMAL"	"10023547"	"50-59 years"	"50-59"	"Arm soreness  1-3 days post vaccine flu like symptoms 4-7 days post vaccine Severe back pain 4-10 days post vaccine Death 11 days post vaccine"
	"1237427-1"	"1237427-1"	"PAIN IN EXTREMITY"	"10033425"	"50-59 years"	"50-59"	"Arm soreness  1-3 days post vaccine flu like symptoms 4-7 days post vaccine Severe back pain 4-10 days post vaccine Death 11 days post vaccine"
	"1238235-1"	"1238235-1"	"AUTOPSY"	"10050117"	"50-59 years"	"50-59"	"Information received by wife. Patient was fatigued 4/10/21 after vaccination. His wife stated that she talked with him and he seemed fine. When his wife went to bed early that evening, the patient was sitting in the recliner in the living room. On the morning of 4/11/21, patient's wife found him unresponsive in the recliner. She called an ambulance but patient was deceased. Patient's wife stated that she noted a trashcan next to the chair the patient was sitting in. The trashcan did not have emesis in it but patient's wife assumes he had been nauseated that evening before he passed away."
	"1238235-1"	"1238235-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Information received by wife. Patient was fatigued 4/10/21 after vaccination. His wife stated that she talked with him and he seemed fine. When his wife went to bed early that evening, the patient was sitting in the recliner in the living room. On the morning of 4/11/21, patient's wife found him unresponsive in the recliner. She called an ambulance but patient was deceased. Patient's wife stated that she noted a trashcan next to the chair the patient was sitting in. The trashcan did not have emesis in it but patient's wife assumes he had been nauseated that evening before he passed away."
	"1238235-1"	"1238235-1"	"FATIGUE"	"10016256"	"50-59 years"	"50-59"	"Information received by wife. Patient was fatigued 4/10/21 after vaccination. His wife stated that she talked with him and he seemed fine. When his wife went to bed early that evening, the patient was sitting in the recliner in the living room. On the morning of 4/11/21, patient's wife found him unresponsive in the recliner. She called an ambulance but patient was deceased. Patient's wife stated that she noted a trashcan next to the chair the patient was sitting in. The trashcan did not have emesis in it but patient's wife assumes he had been nauseated that evening before he passed away."
	"1238235-1"	"1238235-1"	"NAUSEA"	"10028813"	"50-59 years"	"50-59"	"Information received by wife. Patient was fatigued 4/10/21 after vaccination. His wife stated that she talked with him and he seemed fine. When his wife went to bed early that evening, the patient was sitting in the recliner in the living room. On the morning of 4/11/21, patient's wife found him unresponsive in the recliner. She called an ambulance but patient was deceased. Patient's wife stated that she noted a trashcan next to the chair the patient was sitting in. The trashcan did not have emesis in it but patient's wife assumes he had been nauseated that evening before he passed away."
	"1238235-1"	"1238235-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"50-59 years"	"50-59"	"Information received by wife. Patient was fatigued 4/10/21 after vaccination. His wife stated that she talked with him and he seemed fine. When his wife went to bed early that evening, the patient was sitting in the recliner in the living room. On the morning of 4/11/21, patient's wife found him unresponsive in the recliner. She called an ambulance but patient was deceased. Patient's wife stated that she noted a trashcan next to the chair the patient was sitting in. The trashcan did not have emesis in it but patient's wife assumes he had been nauseated that evening before he passed away."
	"1238276-1"	"1238276-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"This 58 year old white male hospice patient received the Covid shot on 3/22/21 and died on 4/15/21. Please refer to the other details submitted within this report and contact the person who submitted this report via email for additional follow up details and investigation."
	"1241587-1"	"1241587-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"She was a healthcare worker.  It was reported to me by her immediate supervisor that she tested positive for COVID-19 the day after her first vaccination.  She became symptomatic around January 21, 2021. She was scheduled to return to work on January 29, 2021 but did not come in. She died on February 2, 2021."
	"1241587-1"	"1241587-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"She was a healthcare worker.  It was reported to me by her immediate supervisor that she tested positive for COVID-19 the day after her first vaccination.  She became symptomatic around January 21, 2021. She was scheduled to return to work on January 29, 2021 but did not come in. She died on February 2, 2021."
	"1241587-1"	"1241587-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"She was a healthcare worker.  It was reported to me by her immediate supervisor that she tested positive for COVID-19 the day after her first vaccination.  She became symptomatic around January 21, 2021. She was scheduled to return to work on January 29, 2021 but did not come in. She died on February 2, 2021."
	"1242022-1"	"1242022-1"	"CHEST PAIN"	"10008479"	"50-59 years"	"50-59"	"Patient care coordinator on PCP team learned of patient death, as documented:  TC to pt family for a welfare ck d/t co-worker mentioned saw in social media pt had passed? PCC-spoke with pt daughter states father passed on 4/18/2021 in the PM unknown exact time of death at home. PCC gave family condolences for their loss. Patient reports father got covid-19 vaccine on 4/13/2021 and he started having severe HA's on this day. Sx increased for the next  few days, he had dry cough,sore throat,chest pain,SOB. States father declined for family to called an ambulance while sx were increasing. States ambulance was called on Sunday 4/18/2021 to take body to the morgue. States they are awaiting for autopsy results,and death certificate. States father's body will be taken to his family.   On what date did they pass away? 418/2021 unknown time, at home   Do you know what the cause was? Family is not sure of cause of death"
	"1242022-1"	"1242022-1"	"COUGH"	"10011224"	"50-59 years"	"50-59"	"Patient care coordinator on PCP team learned of patient death, as documented:  TC to pt family for a welfare ck d/t co-worker mentioned saw in social media pt had passed? PCC-spoke with pt daughter states father passed on 4/18/2021 in the PM unknown exact time of death at home. PCC gave family condolences for their loss. Patient reports father got covid-19 vaccine on 4/13/2021 and he started having severe HA's on this day. Sx increased for the next  few days, he had dry cough,sore throat,chest pain,SOB. States father declined for family to called an ambulance while sx were increasing. States ambulance was called on Sunday 4/18/2021 to take body to the morgue. States they are awaiting for autopsy results,and death certificate. States father's body will be taken to his family.   On what date did they pass away? 418/2021 unknown time, at home   Do you know what the cause was? Family is not sure of cause of death"
	"1242022-1"	"1242022-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient care coordinator on PCP team learned of patient death, as documented:  TC to pt family for a welfare ck d/t co-worker mentioned saw in social media pt had passed? PCC-spoke with pt daughter states father passed on 4/18/2021 in the PM unknown exact time of death at home. PCC gave family condolences for their loss. Patient reports father got covid-19 vaccine on 4/13/2021 and he started having severe HA's on this day. Sx increased for the next  few days, he had dry cough,sore throat,chest pain,SOB. States father declined for family to called an ambulance while sx were increasing. States ambulance was called on Sunday 4/18/2021 to take body to the morgue. States they are awaiting for autopsy results,and death certificate. States father's body will be taken to his family.   On what date did they pass away? 418/2021 unknown time, at home   Do you know what the cause was? Family is not sure of cause of death"
	"1242022-1"	"1242022-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"Patient care coordinator on PCP team learned of patient death, as documented:  TC to pt family for a welfare ck d/t co-worker mentioned saw in social media pt had passed? PCC-spoke with pt daughter states father passed on 4/18/2021 in the PM unknown exact time of death at home. PCC gave family condolences for their loss. Patient reports father got covid-19 vaccine on 4/13/2021 and he started having severe HA's on this day. Sx increased for the next  few days, he had dry cough,sore throat,chest pain,SOB. States father declined for family to called an ambulance while sx were increasing. States ambulance was called on Sunday 4/18/2021 to take body to the morgue. States they are awaiting for autopsy results,and death certificate. States father's body will be taken to his family.   On what date did they pass away? 418/2021 unknown time, at home   Do you know what the cause was? Family is not sure of cause of death"
	"1242022-1"	"1242022-1"	"HEADACHE"	"10019211"	"50-59 years"	"50-59"	"Patient care coordinator on PCP team learned of patient death, as documented:  TC to pt family for a welfare ck d/t co-worker mentioned saw in social media pt had passed? PCC-spoke with pt daughter states father passed on 4/18/2021 in the PM unknown exact time of death at home. PCC gave family condolences for their loss. Patient reports father got covid-19 vaccine on 4/13/2021 and he started having severe HA's on this day. Sx increased for the next  few days, he had dry cough,sore throat,chest pain,SOB. States father declined for family to called an ambulance while sx were increasing. States ambulance was called on Sunday 4/18/2021 to take body to the morgue. States they are awaiting for autopsy results,and death certificate. States father's body will be taken to his family.   On what date did they pass away? 418/2021 unknown time, at home   Do you know what the cause was? Family is not sure of cause of death"
	"1242022-1"	"1242022-1"	"OROPHARYNGEAL PAIN"	"10068319"	"50-59 years"	"50-59"	"Patient care coordinator on PCP team learned of patient death, as documented:  TC to pt family for a welfare ck d/t co-worker mentioned saw in social media pt had passed? PCC-spoke with pt daughter states father passed on 4/18/2021 in the PM unknown exact time of death at home. PCC gave family condolences for their loss. Patient reports father got covid-19 vaccine on 4/13/2021 and he started having severe HA's on this day. Sx increased for the next  few days, he had dry cough,sore throat,chest pain,SOB. States father declined for family to called an ambulance while sx were increasing. States ambulance was called on Sunday 4/18/2021 to take body to the morgue. States they are awaiting for autopsy results,and death certificate. States father's body will be taken to his family.   On what date did they pass away? 418/2021 unknown time, at home   Do you know what the cause was? Family is not sure of cause of death"
	"1243588-1"	"1243588-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"not sure if related, but he passed away on 4/18/2021"
	"1245370-1"	"1245370-1"	"CHEST PAIN"	"10008479"	"50-59 years"	"50-59"	"very tired and sleep 18 hours; passed away; severe flu-like symptoms; chest pain; Soreness at injection site; This spontaneous case was reported by a patient family member or friend and describes the occurrence of DEATH (passed away) in a 54-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 020B21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below.     Concurrent medical conditions included Dermatomyositis, Polymyositis, Osteoarthritis, Degenerative bone disease, Osteoporosis, Muscular dystrophy, Rheumatoid arthritis, Immune disorder (NOS) and Raynaud's phenomenon. Concomitant products included MONTELUKAST SODIUM (SINGULAIR) for Asthma, PILOCARPINE for Dry mouth, IRBESARTAN for Hypertension, DILTIAZEM HYDROCHLORIDE (CARDIZEM CD) for Hypertension and Chest pain, SUMATRIPTAN (IMITREX [SUMATRIPTAN]) for Migraine, TIZANIDINE for Muscle spasms, PROCHLORPERAZINE EDISYLATE (COMPAZINE [PROCHLORPERAZINE EDISYLATE]) and ONDANSETRON (ZOFRAN [ONDANSETRON]) for Nausea, GABAPENTIN (NEURONTIN) for Nerve pain, OXYCODONE for Pain, LEFLUNOMIDE and UPADACITINIB (RINVOQ) for Rheumatoid arthritis, ZOLPIDEM TARTRATE (AMBIEN CR), ACETYLSALICYLIC ACID (BAYER ASPIRIN), LANSOPRAZOLE (PREVACID), DIAZEPAM (VALIUM), CANNABIDIOL (CBD OIL) and IRON (IRON COMPLEX [IRON]) for an unknown indication.    On 30-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 30-Mar-2021, the patient experienced VACCINATION SITE PAIN (Soreness at injection site). On 31-Mar-2021, the patient experienced INFLUENZA LIKE ILLNESS (severe flu-like symptoms) and CHEST PAIN (chest pain). On an unknown date, the patient experienced FATIGUE (very tired and sleep 18 hours). On 02-Apr-2021, INFLUENZA LIKE ILLNESS (severe flu-like symptoms), CHEST PAIN (chest pain), FATIGUE (very tired and sleep 18 hours) and VACCINATION SITE PAIN (Soreness at injection site) outcome was unknown. The patient died on 02-Apr-2021. The cause of death was not reported. It is unknown if an autopsy was performed.            On 02-APR-2021 at 1: 30 AM mother found her daughter lying on the floor unresponsive. Paramedics and police came to the house. Paramedics tried to revive her and she was pronounced dead at the scene.  This is a 54 year-old, female patient who received mRNA-1273 Vaccine) (batch no. 020B21A) and died 3 days after receiving first dose of vaccine and experiencing Influenza like symptoms. Medical hx of several auto immune disorders were provided. Conmeds include Hypertensive and Chest pain meds. The fatal outcome may be related to the patient's pre-existing comorbidities Very limited information has been reported at this time. No further information is expected.; Sender's Comments: This is a 54 year-old, female patient who received mRNA-1273 Vaccine) (batch no. 020B21A) and died 3 days after receiving first dose of vaccine and experiencing Influenza like symptoms. Medical hx of several auto immune disorders were provided. Conmeds include Hypertensive and Chest pain meds. The fatal outcome may be related to the patient's pre-existing comorbidities Very limited information has been reported at this time. No further information is expected.; Reported Cause(s) of Death: Unknown cause of death"
	"1245370-1"	"1245370-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"very tired and sleep 18 hours; passed away; severe flu-like symptoms; chest pain; Soreness at injection site; This spontaneous case was reported by a patient family member or friend and describes the occurrence of DEATH (passed away) in a 54-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 020B21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below.     Concurrent medical conditions included Dermatomyositis, Polymyositis, Osteoarthritis, Degenerative bone disease, Osteoporosis, Muscular dystrophy, Rheumatoid arthritis, Immune disorder (NOS) and Raynaud's phenomenon. Concomitant products included MONTELUKAST SODIUM (SINGULAIR) for Asthma, PILOCARPINE for Dry mouth, IRBESARTAN for Hypertension, DILTIAZEM HYDROCHLORIDE (CARDIZEM CD) for Hypertension and Chest pain, SUMATRIPTAN (IMITREX [SUMATRIPTAN]) for Migraine, TIZANIDINE for Muscle spasms, PROCHLORPERAZINE EDISYLATE (COMPAZINE [PROCHLORPERAZINE EDISYLATE]) and ONDANSETRON (ZOFRAN [ONDANSETRON]) for Nausea, GABAPENTIN (NEURONTIN) for Nerve pain, OXYCODONE for Pain, LEFLUNOMIDE and UPADACITINIB (RINVOQ) for Rheumatoid arthritis, ZOLPIDEM TARTRATE (AMBIEN CR), ACETYLSALICYLIC ACID (BAYER ASPIRIN), LANSOPRAZOLE (PREVACID), DIAZEPAM (VALIUM), CANNABIDIOL (CBD OIL) and IRON (IRON COMPLEX [IRON]) for an unknown indication.    On 30-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 30-Mar-2021, the patient experienced VACCINATION SITE PAIN (Soreness at injection site). On 31-Mar-2021, the patient experienced INFLUENZA LIKE ILLNESS (severe flu-like symptoms) and CHEST PAIN (chest pain). On an unknown date, the patient experienced FATIGUE (very tired and sleep 18 hours). On 02-Apr-2021, INFLUENZA LIKE ILLNESS (severe flu-like symptoms), CHEST PAIN (chest pain), FATIGUE (very tired and sleep 18 hours) and VACCINATION SITE PAIN (Soreness at injection site) outcome was unknown. The patient died on 02-Apr-2021. The cause of death was not reported. It is unknown if an autopsy was performed.            On 02-APR-2021 at 1: 30 AM mother found her daughter lying on the floor unresponsive. Paramedics and police came to the house. Paramedics tried to revive her and she was pronounced dead at the scene.  This is a 54 year-old, female patient who received mRNA-1273 Vaccine) (batch no. 020B21A) and died 3 days after receiving first dose of vaccine and experiencing Influenza like symptoms. Medical hx of several auto immune disorders were provided. Conmeds include Hypertensive and Chest pain meds. The fatal outcome may be related to the patient's pre-existing comorbidities Very limited information has been reported at this time. No further information is expected.; Sender's Comments: This is a 54 year-old, female patient who received mRNA-1273 Vaccine) (batch no. 020B21A) and died 3 days after receiving first dose of vaccine and experiencing Influenza like symptoms. Medical hx of several auto immune disorders were provided. Conmeds include Hypertensive and Chest pain meds. The fatal outcome may be related to the patient's pre-existing comorbidities Very limited information has been reported at this time. No further information is expected.; Reported Cause(s) of Death: Unknown cause of death"
	"1245370-1"	"1245370-1"	"FATIGUE"	"10016256"	"50-59 years"	"50-59"	"very tired and sleep 18 hours; passed away; severe flu-like symptoms; chest pain; Soreness at injection site; This spontaneous case was reported by a patient family member or friend and describes the occurrence of DEATH (passed away) in a 54-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 020B21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below.     Concurrent medical conditions included Dermatomyositis, Polymyositis, Osteoarthritis, Degenerative bone disease, Osteoporosis, Muscular dystrophy, Rheumatoid arthritis, Immune disorder (NOS) and Raynaud's phenomenon. Concomitant products included MONTELUKAST SODIUM (SINGULAIR) for Asthma, PILOCARPINE for Dry mouth, IRBESARTAN for Hypertension, DILTIAZEM HYDROCHLORIDE (CARDIZEM CD) for Hypertension and Chest pain, SUMATRIPTAN (IMITREX [SUMATRIPTAN]) for Migraine, TIZANIDINE for Muscle spasms, PROCHLORPERAZINE EDISYLATE (COMPAZINE [PROCHLORPERAZINE EDISYLATE]) and ONDANSETRON (ZOFRAN [ONDANSETRON]) for Nausea, GABAPENTIN (NEURONTIN) for Nerve pain, OXYCODONE for Pain, LEFLUNOMIDE and UPADACITINIB (RINVOQ) for Rheumatoid arthritis, ZOLPIDEM TARTRATE (AMBIEN CR), ACETYLSALICYLIC ACID (BAYER ASPIRIN), LANSOPRAZOLE (PREVACID), DIAZEPAM (VALIUM), CANNABIDIOL (CBD OIL) and IRON (IRON COMPLEX [IRON]) for an unknown indication.    On 30-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 30-Mar-2021, the patient experienced VACCINATION SITE PAIN (Soreness at injection site). On 31-Mar-2021, the patient experienced INFLUENZA LIKE ILLNESS (severe flu-like symptoms) and CHEST PAIN (chest pain). On an unknown date, the patient experienced FATIGUE (very tired and sleep 18 hours). On 02-Apr-2021, INFLUENZA LIKE ILLNESS (severe flu-like symptoms), CHEST PAIN (chest pain), FATIGUE (very tired and sleep 18 hours) and VACCINATION SITE PAIN (Soreness at injection site) outcome was unknown. The patient died on 02-Apr-2021. The cause of death was not reported. It is unknown if an autopsy was performed.            On 02-APR-2021 at 1: 30 AM mother found her daughter lying on the floor unresponsive. Paramedics and police came to the house. Paramedics tried to revive her and she was pronounced dead at the scene.  This is a 54 year-old, female patient who received mRNA-1273 Vaccine) (batch no. 020B21A) and died 3 days after receiving first dose of vaccine and experiencing Influenza like symptoms. Medical hx of several auto immune disorders were provided. Conmeds include Hypertensive and Chest pain meds. The fatal outcome may be related to the patient's pre-existing comorbidities Very limited information has been reported at this time. No further information is expected.; Sender's Comments: This is a 54 year-old, female patient who received mRNA-1273 Vaccine) (batch no. 020B21A) and died 3 days after receiving first dose of vaccine and experiencing Influenza like symptoms. Medical hx of several auto immune disorders were provided. Conmeds include Hypertensive and Chest pain meds. The fatal outcome may be related to the patient's pre-existing comorbidities Very limited information has been reported at this time. No further information is expected.; Reported Cause(s) of Death: Unknown cause of death"
	"1245370-1"	"1245370-1"	"INFLUENZA LIKE ILLNESS"	"10022004"	"50-59 years"	"50-59"	"very tired and sleep 18 hours; passed away; severe flu-like symptoms; chest pain; Soreness at injection site; This spontaneous case was reported by a patient family member or friend and describes the occurrence of DEATH (passed away) in a 54-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 020B21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below.     Concurrent medical conditions included Dermatomyositis, Polymyositis, Osteoarthritis, Degenerative bone disease, Osteoporosis, Muscular dystrophy, Rheumatoid arthritis, Immune disorder (NOS) and Raynaud's phenomenon. Concomitant products included MONTELUKAST SODIUM (SINGULAIR) for Asthma, PILOCARPINE for Dry mouth, IRBESARTAN for Hypertension, DILTIAZEM HYDROCHLORIDE (CARDIZEM CD) for Hypertension and Chest pain, SUMATRIPTAN (IMITREX [SUMATRIPTAN]) for Migraine, TIZANIDINE for Muscle spasms, PROCHLORPERAZINE EDISYLATE (COMPAZINE [PROCHLORPERAZINE EDISYLATE]) and ONDANSETRON (ZOFRAN [ONDANSETRON]) for Nausea, GABAPENTIN (NEURONTIN) for Nerve pain, OXYCODONE for Pain, LEFLUNOMIDE and UPADACITINIB (RINVOQ) for Rheumatoid arthritis, ZOLPIDEM TARTRATE (AMBIEN CR), ACETYLSALICYLIC ACID (BAYER ASPIRIN), LANSOPRAZOLE (PREVACID), DIAZEPAM (VALIUM), CANNABIDIOL (CBD OIL) and IRON (IRON COMPLEX [IRON]) for an unknown indication.    On 30-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 30-Mar-2021, the patient experienced VACCINATION SITE PAIN (Soreness at injection site). On 31-Mar-2021, the patient experienced INFLUENZA LIKE ILLNESS (severe flu-like symptoms) and CHEST PAIN (chest pain). On an unknown date, the patient experienced FATIGUE (very tired and sleep 18 hours). On 02-Apr-2021, INFLUENZA LIKE ILLNESS (severe flu-like symptoms), CHEST PAIN (chest pain), FATIGUE (very tired and sleep 18 hours) and VACCINATION SITE PAIN (Soreness at injection site) outcome was unknown. The patient died on 02-Apr-2021. The cause of death was not reported. It is unknown if an autopsy was performed.            On 02-APR-2021 at 1: 30 AM mother found her daughter lying on the floor unresponsive. Paramedics and police came to the house. Paramedics tried to revive her and she was pronounced dead at the scene.  This is a 54 year-old, female patient who received mRNA-1273 Vaccine) (batch no. 020B21A) and died 3 days after receiving first dose of vaccine and experiencing Influenza like symptoms. Medical hx of several auto immune disorders were provided. Conmeds include Hypertensive and Chest pain meds. The fatal outcome may be related to the patient's pre-existing comorbidities Very limited information has been reported at this time. No further information is expected.; Sender's Comments: This is a 54 year-old, female patient who received mRNA-1273 Vaccine) (batch no. 020B21A) and died 3 days after receiving first dose of vaccine and experiencing Influenza like symptoms. Medical hx of several auto immune disorders were provided. Conmeds include Hypertensive and Chest pain meds. The fatal outcome may be related to the patient's pre-existing comorbidities Very limited information has been reported at this time. No further information is expected.; Reported Cause(s) of Death: Unknown cause of death"
	"1245370-1"	"1245370-1"	"VACCINATION SITE PAIN"	"10068879"	"50-59 years"	"50-59"	"very tired and sleep 18 hours; passed away; severe flu-like symptoms; chest pain; Soreness at injection site; This spontaneous case was reported by a patient family member or friend and describes the occurrence of DEATH (passed away) in a 54-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 020B21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below.     Concurrent medical conditions included Dermatomyositis, Polymyositis, Osteoarthritis, Degenerative bone disease, Osteoporosis, Muscular dystrophy, Rheumatoid arthritis, Immune disorder (NOS) and Raynaud's phenomenon. Concomitant products included MONTELUKAST SODIUM (SINGULAIR) for Asthma, PILOCARPINE for Dry mouth, IRBESARTAN for Hypertension, DILTIAZEM HYDROCHLORIDE (CARDIZEM CD) for Hypertension and Chest pain, SUMATRIPTAN (IMITREX [SUMATRIPTAN]) for Migraine, TIZANIDINE for Muscle spasms, PROCHLORPERAZINE EDISYLATE (COMPAZINE [PROCHLORPERAZINE EDISYLATE]) and ONDANSETRON (ZOFRAN [ONDANSETRON]) for Nausea, GABAPENTIN (NEURONTIN) for Nerve pain, OXYCODONE for Pain, LEFLUNOMIDE and UPADACITINIB (RINVOQ) for Rheumatoid arthritis, ZOLPIDEM TARTRATE (AMBIEN CR), ACETYLSALICYLIC ACID (BAYER ASPIRIN), LANSOPRAZOLE (PREVACID), DIAZEPAM (VALIUM), CANNABIDIOL (CBD OIL) and IRON (IRON COMPLEX [IRON]) for an unknown indication.    On 30-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 30-Mar-2021, the patient experienced VACCINATION SITE PAIN (Soreness at injection site). On 31-Mar-2021, the patient experienced INFLUENZA LIKE ILLNESS (severe flu-like symptoms) and CHEST PAIN (chest pain). On an unknown date, the patient experienced FATIGUE (very tired and sleep 18 hours). On 02-Apr-2021, INFLUENZA LIKE ILLNESS (severe flu-like symptoms), CHEST PAIN (chest pain), FATIGUE (very tired and sleep 18 hours) and VACCINATION SITE PAIN (Soreness at injection site) outcome was unknown. The patient died on 02-Apr-2021. The cause of death was not reported. It is unknown if an autopsy was performed.            On 02-APR-2021 at 1: 30 AM mother found her daughter lying on the floor unresponsive. Paramedics and police came to the house. Paramedics tried to revive her and she was pronounced dead at the scene.  This is a 54 year-old, female patient who received mRNA-1273 Vaccine) (batch no. 020B21A) and died 3 days after receiving first dose of vaccine and experiencing Influenza like symptoms. Medical hx of several auto immune disorders were provided. Conmeds include Hypertensive and Chest pain meds. The fatal outcome may be related to the patient's pre-existing comorbidities Very limited information has been reported at this time. No further information is expected.; Sender's Comments: This is a 54 year-old, female patient who received mRNA-1273 Vaccine) (batch no. 020B21A) and died 3 days after receiving first dose of vaccine and experiencing Influenza like symptoms. Medical hx of several auto immune disorders were provided. Conmeds include Hypertensive and Chest pain meds. The fatal outcome may be related to the patient's pre-existing comorbidities Very limited information has been reported at this time. No further information is expected.; Reported Cause(s) of Death: Unknown cause of death"
	"1246486-1"	"1246486-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"Patient reported to onsite health clinic to see nurse at 1930. Complaints of not feeling well. Vomited then dyspnea. Went into cardiac arrest, AED used x1. EMS called at 1945. CPR, intubation until 2055. Time of death 2055."
	"1246486-1"	"1246486-1"	"CARDIAC ASSISTANCE DEVICE USER"	"10053686"	"50-59 years"	"50-59"	"Patient reported to onsite health clinic to see nurse at 1930. Complaints of not feeling well. Vomited then dyspnea. Went into cardiac arrest, AED used x1. EMS called at 1945. CPR, intubation until 2055. Time of death 2055."
	"1246486-1"	"1246486-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient reported to onsite health clinic to see nurse at 1930. Complaints of not feeling well. Vomited then dyspnea. Went into cardiac arrest, AED used x1. EMS called at 1945. CPR, intubation until 2055. Time of death 2055."
	"1246486-1"	"1246486-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"Patient reported to onsite health clinic to see nurse at 1930. Complaints of not feeling well. Vomited then dyspnea. Went into cardiac arrest, AED used x1. EMS called at 1945. CPR, intubation until 2055. Time of death 2055."
	"1246486-1"	"1246486-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"50-59 years"	"50-59"	"Patient reported to onsite health clinic to see nurse at 1930. Complaints of not feeling well. Vomited then dyspnea. Went into cardiac arrest, AED used x1. EMS called at 1945. CPR, intubation until 2055. Time of death 2055."
	"1246486-1"	"1246486-1"	"MALAISE"	"10025482"	"50-59 years"	"50-59"	"Patient reported to onsite health clinic to see nurse at 1930. Complaints of not feeling well. Vomited then dyspnea. Went into cardiac arrest, AED used x1. EMS called at 1945. CPR, intubation until 2055. Time of death 2055."
	"1246486-1"	"1246486-1"	"RESUSCITATION"	"10038749"	"50-59 years"	"50-59"	"Patient reported to onsite health clinic to see nurse at 1930. Complaints of not feeling well. Vomited then dyspnea. Went into cardiac arrest, AED used x1. EMS called at 1945. CPR, intubation until 2055. Time of death 2055."
	"1246486-1"	"1246486-1"	"VOMITING"	"10047700"	"50-59 years"	"50-59"	"Patient reported to onsite health clinic to see nurse at 1930. Complaints of not feeling well. Vomited then dyspnea. Went into cardiac arrest, AED used x1. EMS called at 1945. CPR, intubation until 2055. Time of death 2055."
	"1247180-1"	"1247180-1"	"AUTOPSY"	"10050117"	"50-59 years"	"50-59"	"Patient passed away suddenly and unexpectedly at home the morning of April 4, 2021. The ER doctor was unable to ascertain a cause. The preliminary autopsy conducted by the medical examiner within 24 hours of death was inconclusive, but I'm told tests of samples are ongoing."
	"1247180-1"	"1247180-1"	"SUDDEN DEATH"	"10042434"	"50-59 years"	"50-59"	"Patient passed away suddenly and unexpectedly at home the morning of April 4, 2021. The ER doctor was unable to ascertain a cause. The preliminary autopsy conducted by the medical examiner within 24 hours of death was inconclusive, but I'm told tests of samples are ongoing."
	"1248862-1"	"1248862-1"	"ASTHENIA"	"10003549"	"50-59 years"	"50-59"	"Patient flew from city to city through another city on Tuesday 3/16/21.  He had a reaction on the flight where he coughed for 1.5 hrs and was hot in the airplane.  He could not go to work and was required to get Covid tested on 3/18.  Still coughing and having trouble sleeping (laying down).  Rapid Covid test negative on 3/18.  PCR test results negative on 3/21 from hospital.  He continued to grow weak and cough from 3/16-3/21.  At 3am on 3/22 he called and said that his feet were 2X their size and having difficulty breathing.  Taken to hospital via ambulance.  When transfered to ER bed, Dr said that he lost pulse.  They intubated and got his pulse back. Died at 5:15am. Autopsy said cardiac arrest.  Dr said that they could not maintain a heart beat.  He asked me if the patient had a history of blood clots?  No he did not ever has a blood clot that I know of.  He had a chest xray post mortem showing fluid in his lungs from low circulation of blood."
	"1248862-1"	"1248862-1"	"AUTOPSY"	"10050117"	"50-59 years"	"50-59"	"Patient flew from city to city through another city on Tuesday 3/16/21.  He had a reaction on the flight where he coughed for 1.5 hrs and was hot in the airplane.  He could not go to work and was required to get Covid tested on 3/18.  Still coughing and having trouble sleeping (laying down).  Rapid Covid test negative on 3/18.  PCR test results negative on 3/21 from hospital.  He continued to grow weak and cough from 3/16-3/21.  At 3am on 3/22 he called and said that his feet were 2X their size and having difficulty breathing.  Taken to hospital via ambulance.  When transfered to ER bed, Dr said that he lost pulse.  They intubated and got his pulse back. Died at 5:15am. Autopsy said cardiac arrest.  Dr said that they could not maintain a heart beat.  He asked me if the patient had a history of blood clots?  No he did not ever has a blood clot that I know of.  He had a chest xray post mortem showing fluid in his lungs from low circulation of blood."
	"1248862-1"	"1248862-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"Patient flew from city to city through another city on Tuesday 3/16/21.  He had a reaction on the flight where he coughed for 1.5 hrs and was hot in the airplane.  He could not go to work and was required to get Covid tested on 3/18.  Still coughing and having trouble sleeping (laying down).  Rapid Covid test negative on 3/18.  PCR test results negative on 3/21 from hospital.  He continued to grow weak and cough from 3/16-3/21.  At 3am on 3/22 he called and said that his feet were 2X their size and having difficulty breathing.  Taken to hospital via ambulance.  When transfered to ER bed, Dr said that he lost pulse.  They intubated and got his pulse back. Died at 5:15am. Autopsy said cardiac arrest.  Dr said that they could not maintain a heart beat.  He asked me if the patient had a history of blood clots?  No he did not ever has a blood clot that I know of.  He had a chest xray post mortem showing fluid in his lungs from low circulation of blood."
	"1248862-1"	"1248862-1"	"CHEST X-RAY ABNORMAL"	"10008499"	"50-59 years"	"50-59"	"Patient flew from city to city through another city on Tuesday 3/16/21.  He had a reaction on the flight where he coughed for 1.5 hrs and was hot in the airplane.  He could not go to work and was required to get Covid tested on 3/18.  Still coughing and having trouble sleeping (laying down).  Rapid Covid test negative on 3/18.  PCR test results negative on 3/21 from hospital.  He continued to grow weak and cough from 3/16-3/21.  At 3am on 3/22 he called and said that his feet were 2X their size and having difficulty breathing.  Taken to hospital via ambulance.  When transfered to ER bed, Dr said that he lost pulse.  They intubated and got his pulse back. Died at 5:15am. Autopsy said cardiac arrest.  Dr said that they could not maintain a heart beat.  He asked me if the patient had a history of blood clots?  No he did not ever has a blood clot that I know of.  He had a chest xray post mortem showing fluid in his lungs from low circulation of blood."
	"1248862-1"	"1248862-1"	"COUGH"	"10011224"	"50-59 years"	"50-59"	"Patient flew from city to city through another city on Tuesday 3/16/21.  He had a reaction on the flight where he coughed for 1.5 hrs and was hot in the airplane.  He could not go to work and was required to get Covid tested on 3/18.  Still coughing and having trouble sleeping (laying down).  Rapid Covid test negative on 3/18.  PCR test results negative on 3/21 from hospital.  He continued to grow weak and cough from 3/16-3/21.  At 3am on 3/22 he called and said that his feet were 2X their size and having difficulty breathing.  Taken to hospital via ambulance.  When transfered to ER bed, Dr said that he lost pulse.  They intubated and got his pulse back. Died at 5:15am. Autopsy said cardiac arrest.  Dr said that they could not maintain a heart beat.  He asked me if the patient had a history of blood clots?  No he did not ever has a blood clot that I know of.  He had a chest xray post mortem showing fluid in his lungs from low circulation of blood."
	"1248862-1"	"1248862-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient flew from city to city through another city on Tuesday 3/16/21.  He had a reaction on the flight where he coughed for 1.5 hrs and was hot in the airplane.  He could not go to work and was required to get Covid tested on 3/18.  Still coughing and having trouble sleeping (laying down).  Rapid Covid test negative on 3/18.  PCR test results negative on 3/21 from hospital.  He continued to grow weak and cough from 3/16-3/21.  At 3am on 3/22 he called and said that his feet were 2X their size and having difficulty breathing.  Taken to hospital via ambulance.  When transfered to ER bed, Dr said that he lost pulse.  They intubated and got his pulse back. Died at 5:15am. Autopsy said cardiac arrest.  Dr said that they could not maintain a heart beat.  He asked me if the patient had a history of blood clots?  No he did not ever has a blood clot that I know of.  He had a chest xray post mortem showing fluid in his lungs from low circulation of blood."
	"1248862-1"	"1248862-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"Patient flew from city to city through another city on Tuesday 3/16/21.  He had a reaction on the flight where he coughed for 1.5 hrs and was hot in the airplane.  He could not go to work and was required to get Covid tested on 3/18.  Still coughing and having trouble sleeping (laying down).  Rapid Covid test negative on 3/18.  PCR test results negative on 3/21 from hospital.  He continued to grow weak and cough from 3/16-3/21.  At 3am on 3/22 he called and said that his feet were 2X their size and having difficulty breathing.  Taken to hospital via ambulance.  When transfered to ER bed, Dr said that he lost pulse.  They intubated and got his pulse back. Died at 5:15am. Autopsy said cardiac arrest.  Dr said that they could not maintain a heart beat.  He asked me if the patient had a history of blood clots?  No he did not ever has a blood clot that I know of.  He had a chest xray post mortem showing fluid in his lungs from low circulation of blood."
	"1248862-1"	"1248862-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"50-59 years"	"50-59"	"Patient flew from city to city through another city on Tuesday 3/16/21.  He had a reaction on the flight where he coughed for 1.5 hrs and was hot in the airplane.  He could not go to work and was required to get Covid tested on 3/18.  Still coughing and having trouble sleeping (laying down).  Rapid Covid test negative on 3/18.  PCR test results negative on 3/21 from hospital.  He continued to grow weak and cough from 3/16-3/21.  At 3am on 3/22 he called and said that his feet were 2X their size and having difficulty breathing.  Taken to hospital via ambulance.  When transfered to ER bed, Dr said that he lost pulse.  They intubated and got his pulse back. Died at 5:15am. Autopsy said cardiac arrest.  Dr said that they could not maintain a heart beat.  He asked me if the patient had a history of blood clots?  No he did not ever has a blood clot that I know of.  He had a chest xray post mortem showing fluid in his lungs from low circulation of blood."
	"1248862-1"	"1248862-1"	"FEELING HOT"	"10016334"	"50-59 years"	"50-59"	"Patient flew from city to city through another city on Tuesday 3/16/21.  He had a reaction on the flight where he coughed for 1.5 hrs and was hot in the airplane.  He could not go to work and was required to get Covid tested on 3/18.  Still coughing and having trouble sleeping (laying down).  Rapid Covid test negative on 3/18.  PCR test results negative on 3/21 from hospital.  He continued to grow weak and cough from 3/16-3/21.  At 3am on 3/22 he called and said that his feet were 2X their size and having difficulty breathing.  Taken to hospital via ambulance.  When transfered to ER bed, Dr said that he lost pulse.  They intubated and got his pulse back. Died at 5:15am. Autopsy said cardiac arrest.  Dr said that they could not maintain a heart beat.  He asked me if the patient had a history of blood clots?  No he did not ever has a blood clot that I know of.  He had a chest xray post mortem showing fluid in his lungs from low circulation of blood."
	"1248862-1"	"1248862-1"	"IMPAIRED WORK ABILITY"	"10052302"	"50-59 years"	"50-59"	"Patient flew from city to city through another city on Tuesday 3/16/21.  He had a reaction on the flight where he coughed for 1.5 hrs and was hot in the airplane.  He could not go to work and was required to get Covid tested on 3/18.  Still coughing and having trouble sleeping (laying down).  Rapid Covid test negative on 3/18.  PCR test results negative on 3/21 from hospital.  He continued to grow weak and cough from 3/16-3/21.  At 3am on 3/22 he called and said that his feet were 2X their size and having difficulty breathing.  Taken to hospital via ambulance.  When transfered to ER bed, Dr said that he lost pulse.  They intubated and got his pulse back. Died at 5:15am. Autopsy said cardiac arrest.  Dr said that they could not maintain a heart beat.  He asked me if the patient had a history of blood clots?  No he did not ever has a blood clot that I know of.  He had a chest xray post mortem showing fluid in his lungs from low circulation of blood."
	"1248862-1"	"1248862-1"	"INSOMNIA"	"10022437"	"50-59 years"	"50-59"	"Patient flew from city to city through another city on Tuesday 3/16/21.  He had a reaction on the flight where he coughed for 1.5 hrs and was hot in the airplane.  He could not go to work and was required to get Covid tested on 3/18.  Still coughing and having trouble sleeping (laying down).  Rapid Covid test negative on 3/18.  PCR test results negative on 3/21 from hospital.  He continued to grow weak and cough from 3/16-3/21.  At 3am on 3/22 he called and said that his feet were 2X their size and having difficulty breathing.  Taken to hospital via ambulance.  When transfered to ER bed, Dr said that he lost pulse.  They intubated and got his pulse back. Died at 5:15am. Autopsy said cardiac arrest.  Dr said that they could not maintain a heart beat.  He asked me if the patient had a history of blood clots?  No he did not ever has a blood clot that I know of.  He had a chest xray post mortem showing fluid in his lungs from low circulation of blood."
	"1248862-1"	"1248862-1"	"MYOCARDIAL INFARCTION"	"10028596"	"50-59 years"	"50-59"	"Patient flew from city to city through another city on Tuesday 3/16/21.  He had a reaction on the flight where he coughed for 1.5 hrs and was hot in the airplane.  He could not go to work and was required to get Covid tested on 3/18.  Still coughing and having trouble sleeping (laying down).  Rapid Covid test negative on 3/18.  PCR test results negative on 3/21 from hospital.  He continued to grow weak and cough from 3/16-3/21.  At 3am on 3/22 he called and said that his feet were 2X their size and having difficulty breathing.  Taken to hospital via ambulance.  When transfered to ER bed, Dr said that he lost pulse.  They intubated and got his pulse back. Died at 5:15am. Autopsy said cardiac arrest.  Dr said that they could not maintain a heart beat.  He asked me if the patient had a history of blood clots?  No he did not ever has a blood clot that I know of.  He had a chest xray post mortem showing fluid in his lungs from low circulation of blood."
	"1248862-1"	"1248862-1"	"PERIPHERAL SWELLING"	"10048959"	"50-59 years"	"50-59"	"Patient flew from city to city through another city on Tuesday 3/16/21.  He had a reaction on the flight where he coughed for 1.5 hrs and was hot in the airplane.  He could not go to work and was required to get Covid tested on 3/18.  Still coughing and having trouble sleeping (laying down).  Rapid Covid test negative on 3/18.  PCR test results negative on 3/21 from hospital.  He continued to grow weak and cough from 3/16-3/21.  At 3am on 3/22 he called and said that his feet were 2X their size and having difficulty breathing.  Taken to hospital via ambulance.  When transfered to ER bed, Dr said that he lost pulse.  They intubated and got his pulse back. Died at 5:15am. Autopsy said cardiac arrest.  Dr said that they could not maintain a heart beat.  He asked me if the patient had a history of blood clots?  No he did not ever has a blood clot that I know of.  He had a chest xray post mortem showing fluid in his lungs from low circulation of blood."
	"1248862-1"	"1248862-1"	"POOR PERIPHERAL CIRCULATION"	"10036155"	"50-59 years"	"50-59"	"Patient flew from city to city through another city on Tuesday 3/16/21.  He had a reaction on the flight where he coughed for 1.5 hrs and was hot in the airplane.  He could not go to work and was required to get Covid tested on 3/18.  Still coughing and having trouble sleeping (laying down).  Rapid Covid test negative on 3/18.  PCR test results negative on 3/21 from hospital.  He continued to grow weak and cough from 3/16-3/21.  At 3am on 3/22 he called and said that his feet were 2X their size and having difficulty breathing.  Taken to hospital via ambulance.  When transfered to ER bed, Dr said that he lost pulse.  They intubated and got his pulse back. Died at 5:15am. Autopsy said cardiac arrest.  Dr said that they could not maintain a heart beat.  He asked me if the patient had a history of blood clots?  No he did not ever has a blood clot that I know of.  He had a chest xray post mortem showing fluid in his lungs from low circulation of blood."
	"1248862-1"	"1248862-1"	"PULMONARY OEDEMA"	"10037423"	"50-59 years"	"50-59"	"Patient flew from city to city through another city on Tuesday 3/16/21.  He had a reaction on the flight where he coughed for 1.5 hrs and was hot in the airplane.  He could not go to work and was required to get Covid tested on 3/18.  Still coughing and having trouble sleeping (laying down).  Rapid Covid test negative on 3/18.  PCR test results negative on 3/21 from hospital.  He continued to grow weak and cough from 3/16-3/21.  At 3am on 3/22 he called and said that his feet were 2X their size and having difficulty breathing.  Taken to hospital via ambulance.  When transfered to ER bed, Dr said that he lost pulse.  They intubated and got his pulse back. Died at 5:15am. Autopsy said cardiac arrest.  Dr said that they could not maintain a heart beat.  He asked me if the patient had a history of blood clots?  No he did not ever has a blood clot that I know of.  He had a chest xray post mortem showing fluid in his lungs from low circulation of blood."
	"1248862-1"	"1248862-1"	"PULSE ABSENT"	"10037469"	"50-59 years"	"50-59"	"Patient flew from city to city through another city on Tuesday 3/16/21.  He had a reaction on the flight where he coughed for 1.5 hrs and was hot in the airplane.  He could not go to work and was required to get Covid tested on 3/18.  Still coughing and having trouble sleeping (laying down).  Rapid Covid test negative on 3/18.  PCR test results negative on 3/21 from hospital.  He continued to grow weak and cough from 3/16-3/21.  At 3am on 3/22 he called and said that his feet were 2X their size and having difficulty breathing.  Taken to hospital via ambulance.  When transfered to ER bed, Dr said that he lost pulse.  They intubated and got his pulse back. Died at 5:15am. Autopsy said cardiac arrest.  Dr said that they could not maintain a heart beat.  He asked me if the patient had a history of blood clots?  No he did not ever has a blood clot that I know of.  He had a chest xray post mortem showing fluid in his lungs from low circulation of blood."
	"1248862-1"	"1248862-1"	"SARS-COV-2 TEST NEGATIVE"	"10084273"	"50-59 years"	"50-59"	"Patient flew from city to city through another city on Tuesday 3/16/21.  He had a reaction on the flight where he coughed for 1.5 hrs and was hot in the airplane.  He could not go to work and was required to get Covid tested on 3/18.  Still coughing and having trouble sleeping (laying down).  Rapid Covid test negative on 3/18.  PCR test results negative on 3/21 from hospital.  He continued to grow weak and cough from 3/16-3/21.  At 3am on 3/22 he called and said that his feet were 2X their size and having difficulty breathing.  Taken to hospital via ambulance.  When transfered to ER bed, Dr said that he lost pulse.  They intubated and got his pulse back. Died at 5:15am. Autopsy said cardiac arrest.  Dr said that they could not maintain a heart beat.  He asked me if the patient had a history of blood clots?  No he did not ever has a blood clot that I know of.  He had a chest xray post mortem showing fluid in his lungs from low circulation of blood."
	"1250851-1"	"1250851-1"	"CHILLS"	"10008531"	"50-59 years"	"50-59"	"She had a lymph tissue lumps fever chills muscle aches headache. She said she felt about 50% better the following day. She eventually succumbed and passed away."
	"1250851-1"	"1250851-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"She had a lymph tissue lumps fever chills muscle aches headache. She said she felt about 50% better the following day. She eventually succumbed and passed away."
	"1250851-1"	"1250851-1"	"HEADACHE"	"10019211"	"50-59 years"	"50-59"	"She had a lymph tissue lumps fever chills muscle aches headache. She said she felt about 50% better the following day. She eventually succumbed and passed away."
	"1250851-1"	"1250851-1"	"LYMPHADENOPATHY"	"10025197"	"50-59 years"	"50-59"	"She had a lymph tissue lumps fever chills muscle aches headache. She said she felt about 50% better the following day. She eventually succumbed and passed away."
	"1250851-1"	"1250851-1"	"MYALGIA"	"10028411"	"50-59 years"	"50-59"	"She had a lymph tissue lumps fever chills muscle aches headache. She said she felt about 50% better the following day. She eventually succumbed and passed away."
	"1250851-1"	"1250851-1"	"PYREXIA"	"10037660"	"50-59 years"	"50-59"	"She had a lymph tissue lumps fever chills muscle aches headache. She said she felt about 50% better the following day. She eventually succumbed and passed away."
	"1255708-1"	"1255708-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"SOB; Sepsis; aspiration pneumonia; This is a spontaneous report based on the information received by Pfizer. A contactable Other HCP reported that a 59-year-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection), dose 1 via an unspecified route of administration at the age of 59-year-old on 31Mar2021 (Batch/Lot number was not reported) as single dose for COVID-19 immunisation. Medical history included chronic UTI, and splenectomy for unknown reason, RMS (Rhabdomyosarcoma). Concomitant medication included ocrelizumab (OCREVUS). On 02Apr2021, it was reported that patient experienced: Went into hospital due to SOB (Shortness of breath) on 02Apr2021, died on 07Apr2021 related to aspiration pneumonia on an unspecified date. Patient developed Sepsis as well on an unspecified date. Patient became a DNR on 06Apr2021 then passed on 07Apr2021. The patient was hospitalized for SOB from 02Apr2021 to an unknown date. The patient died on 07Apr2021. It was not reported if an autopsy was performed. The outcome of event aspiration pneumonia was fatal. The outcome of events SOB and Sepsis was not recovered.   Information on the lot/batch number has been requested.; Sender's Comments: Based on the information currently available and known drug safety profile, the reported events more likely represented intercurrent illnesses, but not related to Bnt162b2.  The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to RAs, Ethics Committees, and investigators, as appropriate. ; Reported Cause(s) of Death: aspiration pneumonia"
	"1255708-1"	"1255708-1"	"PNEUMONIA ASPIRATION"	"10035669"	"50-59 years"	"50-59"	"SOB; Sepsis; aspiration pneumonia; This is a spontaneous report based on the information received by Pfizer. A contactable Other HCP reported that a 59-year-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection), dose 1 via an unspecified route of administration at the age of 59-year-old on 31Mar2021 (Batch/Lot number was not reported) as single dose for COVID-19 immunisation. Medical history included chronic UTI, and splenectomy for unknown reason, RMS (Rhabdomyosarcoma). Concomitant medication included ocrelizumab (OCREVUS). On 02Apr2021, it was reported that patient experienced: Went into hospital due to SOB (Shortness of breath) on 02Apr2021, died on 07Apr2021 related to aspiration pneumonia on an unspecified date. Patient developed Sepsis as well on an unspecified date. Patient became a DNR on 06Apr2021 then passed on 07Apr2021. The patient was hospitalized for SOB from 02Apr2021 to an unknown date. The patient died on 07Apr2021. It was not reported if an autopsy was performed. The outcome of event aspiration pneumonia was fatal. The outcome of events SOB and Sepsis was not recovered.   Information on the lot/batch number has been requested.; Sender's Comments: Based on the information currently available and known drug safety profile, the reported events more likely represented intercurrent illnesses, but not related to Bnt162b2.  The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to RAs, Ethics Committees, and investigators, as appropriate. ; Reported Cause(s) of Death: aspiration pneumonia"
	"1255708-1"	"1255708-1"	"SEPSIS"	"10040047"	"50-59 years"	"50-59"	"SOB; Sepsis; aspiration pneumonia; This is a spontaneous report based on the information received by Pfizer. A contactable Other HCP reported that a 59-year-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection), dose 1 via an unspecified route of administration at the age of 59-year-old on 31Mar2021 (Batch/Lot number was not reported) as single dose for COVID-19 immunisation. Medical history included chronic UTI, and splenectomy for unknown reason, RMS (Rhabdomyosarcoma). Concomitant medication included ocrelizumab (OCREVUS). On 02Apr2021, it was reported that patient experienced: Went into hospital due to SOB (Shortness of breath) on 02Apr2021, died on 07Apr2021 related to aspiration pneumonia on an unspecified date. Patient developed Sepsis as well on an unspecified date. Patient became a DNR on 06Apr2021 then passed on 07Apr2021. The patient was hospitalized for SOB from 02Apr2021 to an unknown date. The patient died on 07Apr2021. It was not reported if an autopsy was performed. The outcome of event aspiration pneumonia was fatal. The outcome of events SOB and Sepsis was not recovered.   Information on the lot/batch number has been requested.; Sender's Comments: Based on the information currently available and known drug safety profile, the reported events more likely represented intercurrent illnesses, but not related to Bnt162b2.  The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to RAs, Ethics Committees, and investigators, as appropriate. ; Reported Cause(s) of Death: aspiration pneumonia"
	"1256666-1"	"1256666-1"	"ASTHENIA"	"10003549"	"50-59 years"	"50-59"	"Patient started complaining of being short of breath, weak and dizzy a day or two after receiving the shot.  He started taking the asthma inhaler constantly rather than just once in months.  He lay down for a nap and never woke up exactly 3 weeks after getting the shot. (more exact details will need to come from his wife)."
	"1256666-1"	"1256666-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient started complaining of being short of breath, weak and dizzy a day or two after receiving the shot.  He started taking the asthma inhaler constantly rather than just once in months.  He lay down for a nap and never woke up exactly 3 weeks after getting the shot. (more exact details will need to come from his wife)."
	"1256666-1"	"1256666-1"	"DIZZINESS"	"10013573"	"50-59 years"	"50-59"	"Patient started complaining of being short of breath, weak and dizzy a day or two after receiving the shot.  He started taking the asthma inhaler constantly rather than just once in months.  He lay down for a nap and never woke up exactly 3 weeks after getting the shot. (more exact details will need to come from his wife)."
	"1256666-1"	"1256666-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"Patient started complaining of being short of breath, weak and dizzy a day or two after receiving the shot.  He started taking the asthma inhaler constantly rather than just once in months.  He lay down for a nap and never woke up exactly 3 weeks after getting the shot. (more exact details will need to come from his wife)."
	"1256806-1"	"1256806-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"My Sister was found dead on 4/27/2021. She had been dead aprx. 0ne week. She received her 1st Moderna shot on March 25th."
	"1256946-1"	"1256946-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Unknown if any immediate reaction. The patient passed away on 3/28/21 approximately 2 weeks from the first dose of the vaccine."
	"1258269-1"	"1258269-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"This pt came in to see me in her normal state of health and then received moderna #1 here on 4/1.  Developed SOB 2 hrs after vaccination. Presented to ER on 4/2 with hypoxia (80%) and was + for covid.  The ER triage notes states ?C/O SOB, Nausea, vomiting, diarrhea that started yesterday 2 hours after he first COVID Vaccine?.  Notes quote her saying ?I got my vaccine yesterday and I started to feel short of breath.? She died from covid respiratory failure on 4/23."
	"1258269-1"	"1258269-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"This pt came in to see me in her normal state of health and then received moderna #1 here on 4/1.  Developed SOB 2 hrs after vaccination. Presented to ER on 4/2 with hypoxia (80%) and was + for covid.  The ER triage notes states ?C/O SOB, Nausea, vomiting, diarrhea that started yesterday 2 hours after he first COVID Vaccine?.  Notes quote her saying ?I got my vaccine yesterday and I started to feel short of breath.? She died from covid respiratory failure on 4/23."
	"1258269-1"	"1258269-1"	"DIARRHOEA"	"10012735"	"50-59 years"	"50-59"	"This pt came in to see me in her normal state of health and then received moderna #1 here on 4/1.  Developed SOB 2 hrs after vaccination. Presented to ER on 4/2 with hypoxia (80%) and was + for covid.  The ER triage notes states ?C/O SOB, Nausea, vomiting, diarrhea that started yesterday 2 hours after he first COVID Vaccine?.  Notes quote her saying ?I got my vaccine yesterday and I started to feel short of breath.? She died from covid respiratory failure on 4/23."
	"1258269-1"	"1258269-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"This pt came in to see me in her normal state of health and then received moderna #1 here on 4/1.  Developed SOB 2 hrs after vaccination. Presented to ER on 4/2 with hypoxia (80%) and was + for covid.  The ER triage notes states ?C/O SOB, Nausea, vomiting, diarrhea that started yesterday 2 hours after he first COVID Vaccine?.  Notes quote her saying ?I got my vaccine yesterday and I started to feel short of breath.? She died from covid respiratory failure on 4/23."
	"1258269-1"	"1258269-1"	"HYPOXIA"	"10021143"	"50-59 years"	"50-59"	"This pt came in to see me in her normal state of health and then received moderna #1 here on 4/1.  Developed SOB 2 hrs after vaccination. Presented to ER on 4/2 with hypoxia (80%) and was + for covid.  The ER triage notes states ?C/O SOB, Nausea, vomiting, diarrhea that started yesterday 2 hours after he first COVID Vaccine?.  Notes quote her saying ?I got my vaccine yesterday and I started to feel short of breath.? She died from covid respiratory failure on 4/23."
	"1258269-1"	"1258269-1"	"NAUSEA"	"10028813"	"50-59 years"	"50-59"	"This pt came in to see me in her normal state of health and then received moderna #1 here on 4/1.  Developed SOB 2 hrs after vaccination. Presented to ER on 4/2 with hypoxia (80%) and was + for covid.  The ER triage notes states ?C/O SOB, Nausea, vomiting, diarrhea that started yesterday 2 hours after he first COVID Vaccine?.  Notes quote her saying ?I got my vaccine yesterday and I started to feel short of breath.? She died from covid respiratory failure on 4/23."
	"1258269-1"	"1258269-1"	"RESPIRATORY FAILURE"	"10038695"	"50-59 years"	"50-59"	"This pt came in to see me in her normal state of health and then received moderna #1 here on 4/1.  Developed SOB 2 hrs after vaccination. Presented to ER on 4/2 with hypoxia (80%) and was + for covid.  The ER triage notes states ?C/O SOB, Nausea, vomiting, diarrhea that started yesterday 2 hours after he first COVID Vaccine?.  Notes quote her saying ?I got my vaccine yesterday and I started to feel short of breath.? She died from covid respiratory failure on 4/23."
	"1258269-1"	"1258269-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"This pt came in to see me in her normal state of health and then received moderna #1 here on 4/1.  Developed SOB 2 hrs after vaccination. Presented to ER on 4/2 with hypoxia (80%) and was + for covid.  The ER triage notes states ?C/O SOB, Nausea, vomiting, diarrhea that started yesterday 2 hours after he first COVID Vaccine?.  Notes quote her saying ?I got my vaccine yesterday and I started to feel short of breath.? She died from covid respiratory failure on 4/23."
	"1258269-1"	"1258269-1"	"VOMITING"	"10047700"	"50-59 years"	"50-59"	"This pt came in to see me in her normal state of health and then received moderna #1 here on 4/1.  Developed SOB 2 hrs after vaccination. Presented to ER on 4/2 with hypoxia (80%) and was + for covid.  The ER triage notes states ?C/O SOB, Nausea, vomiting, diarrhea that started yesterday 2 hours after he first COVID Vaccine?.  Notes quote her saying ?I got my vaccine yesterday and I started to feel short of breath.? She died from covid respiratory failure on 4/23."
	"1258763-1"	"1258763-1"	"AUTOPSY"	"10050117"	"50-59 years"	"50-59"	"On April 23,2021 patient was at her home and started complaining of shortness of breath and chest pain. She called 911 and they responded to her residence at 0500 a.m. While being assessed, patient collapsed. She was asystolic. CPR was started but to no avail. She was transported to the coroner's office where an autopsy was performed. She had bilateral pulmonary thromboemboli. There were not deep vein thromboses found in her legs."
	"1258763-1"	"1258763-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"On April 23,2021 patient was at her home and started complaining of shortness of breath and chest pain. She called 911 and they responded to her residence at 0500 a.m. While being assessed, patient collapsed. She was asystolic. CPR was started but to no avail. She was transported to the coroner's office where an autopsy was performed. She had bilateral pulmonary thromboemboli. There were not deep vein thromboses found in her legs."
	"1258763-1"	"1258763-1"	"CHEST PAIN"	"10008479"	"50-59 years"	"50-59"	"On April 23,2021 patient was at her home and started complaining of shortness of breath and chest pain. She called 911 and they responded to her residence at 0500 a.m. While being assessed, patient collapsed. She was asystolic. CPR was started but to no avail. She was transported to the coroner's office where an autopsy was performed. She had bilateral pulmonary thromboemboli. There were not deep vein thromboses found in her legs."
	"1258763-1"	"1258763-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"On April 23,2021 patient was at her home and started complaining of shortness of breath and chest pain. She called 911 and they responded to her residence at 0500 a.m. While being assessed, patient collapsed. She was asystolic. CPR was started but to no avail. She was transported to the coroner's office where an autopsy was performed. She had bilateral pulmonary thromboemboli. There were not deep vein thromboses found in her legs."
	"1258763-1"	"1258763-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"On April 23,2021 patient was at her home and started complaining of shortness of breath and chest pain. She called 911 and they responded to her residence at 0500 a.m. While being assessed, patient collapsed. She was asystolic. CPR was started but to no avail. She was transported to the coroner's office where an autopsy was performed. She had bilateral pulmonary thromboemboli. There were not deep vein thromboses found in her legs."
	"1258763-1"	"1258763-1"	"PULMONARY EMBOLISM"	"10037377"	"50-59 years"	"50-59"	"On April 23,2021 patient was at her home and started complaining of shortness of breath and chest pain. She called 911 and they responded to her residence at 0500 a.m. While being assessed, patient collapsed. She was asystolic. CPR was started but to no avail. She was transported to the coroner's office where an autopsy was performed. She had bilateral pulmonary thromboemboli. There were not deep vein thromboses found in her legs."
	"1258763-1"	"1258763-1"	"RESUSCITATION"	"10038749"	"50-59 years"	"50-59"	"On April 23,2021 patient was at her home and started complaining of shortness of breath and chest pain. She called 911 and they responded to her residence at 0500 a.m. While being assessed, patient collapsed. She was asystolic. CPR was started but to no avail. She was transported to the coroner's office where an autopsy was performed. She had bilateral pulmonary thromboemboli. There were not deep vein thromboses found in her legs."
	"1258763-1"	"1258763-1"	"SYNCOPE"	"10042772"	"50-59 years"	"50-59"	"On April 23,2021 patient was at her home and started complaining of shortness of breath and chest pain. She called 911 and they responded to her residence at 0500 a.m. While being assessed, patient collapsed. She was asystolic. CPR was started but to no avail. She was transported to the coroner's office where an autopsy was performed. She had bilateral pulmonary thromboemboli. There were not deep vein thromboses found in her legs."
	"1258763-1"	"1258763-1"	"TOXICOLOGIC TEST"	"10061384"	"50-59 years"	"50-59"	"On April 23,2021 patient was at her home and started complaining of shortness of breath and chest pain. She called 911 and they responded to her residence at 0500 a.m. While being assessed, patient collapsed. She was asystolic. CPR was started but to no avail. She was transported to the coroner's office where an autopsy was performed. She had bilateral pulmonary thromboemboli. There were not deep vein thromboses found in her legs."
	"1260018-1"	"1260018-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Was sweaty, unresponsive, and breathing shallow a few mins after administration. BP 97/68. Within a few mins, patient became responsive and BP 146/81. Patient chose not to go with EMS and walked out of store after they were feeling better. Today (3 days later) received report from medical examiner that patient passed away."
	"1260018-1"	"1260018-1"	"HYPERHIDROSIS"	"10020642"	"50-59 years"	"50-59"	"Was sweaty, unresponsive, and breathing shallow a few mins after administration. BP 97/68. Within a few mins, patient became responsive and BP 146/81. Patient chose not to go with EMS and walked out of store after they were feeling better. Today (3 days later) received report from medical examiner that patient passed away."
	"1260018-1"	"1260018-1"	"HYPOPNOEA"	"10021079"	"50-59 years"	"50-59"	"Was sweaty, unresponsive, and breathing shallow a few mins after administration. BP 97/68. Within a few mins, patient became responsive and BP 146/81. Patient chose not to go with EMS and walked out of store after they were feeling better. Today (3 days later) received report from medical examiner that patient passed away."
	"1260018-1"	"1260018-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"50-59 years"	"50-59"	"Was sweaty, unresponsive, and breathing shallow a few mins after administration. BP 97/68. Within a few mins, patient became responsive and BP 146/81. Patient chose not to go with EMS and walked out of store after they were feeling better. Today (3 days later) received report from medical examiner that patient passed away."
	"1263713-1"	"1263713-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"3/30/2021  Patient received 1st dose of Moderna vaccine at 11:35AM and subsequently discontinued dialysis treatment 58 minutes early due to being cold.  3/31/2021 Patient went to hospital at 2:28PM with admitting diagnosis of acute encephalopathy due to intra-cranial hemorrhage. 4/1/2021  Patient expired at 3:35AM with cause of death reported as intra-cranial hemorrhage."
	"1263713-1"	"1263713-1"	"ENCEPHALOPATHY"	"10014625"	"50-59 years"	"50-59"	"3/30/2021  Patient received 1st dose of Moderna vaccine at 11:35AM and subsequently discontinued dialysis treatment 58 minutes early due to being cold.  3/31/2021 Patient went to hospital at 2:28PM with admitting diagnosis of acute encephalopathy due to intra-cranial hemorrhage. 4/1/2021  Patient expired at 3:35AM with cause of death reported as intra-cranial hemorrhage."
	"1263713-1"	"1263713-1"	"FEELING COLD"	"10016326"	"50-59 years"	"50-59"	"3/30/2021  Patient received 1st dose of Moderna vaccine at 11:35AM and subsequently discontinued dialysis treatment 58 minutes early due to being cold.  3/31/2021 Patient went to hospital at 2:28PM with admitting diagnosis of acute encephalopathy due to intra-cranial hemorrhage. 4/1/2021  Patient expired at 3:35AM with cause of death reported as intra-cranial hemorrhage."
	"1263713-1"	"1263713-1"	"HAEMORRHAGE INTRACRANIAL"	"10018985"	"50-59 years"	"50-59"	"3/30/2021  Patient received 1st dose of Moderna vaccine at 11:35AM and subsequently discontinued dialysis treatment 58 minutes early due to being cold.  3/31/2021 Patient went to hospital at 2:28PM with admitting diagnosis of acute encephalopathy due to intra-cranial hemorrhage. 4/1/2021  Patient expired at 3:35AM with cause of death reported as intra-cranial hemorrhage."
	"1264003-1"	"1264003-1"	"APNOEA"	"10002974"	"50-59 years"	"50-59"	"Patient received 1st COVID vaccine 4/12/2021 at medical center.  Per ER report: 4/14/2021 patient was in bed with significant other and was noted to not be responding.  EMS was called.  Patient was found without a pulse and apneic.  CPR began, PEA converted to Vtach, received 8 total epi and 1.5gm lidocaine by EMS.  Down 50-55 minutes prior to ER.  In ER given 2 additional epi, 2 sodium bicarb, intubated and was PEA then asystole.  Pronounced deceased in ER."
	"1264003-1"	"1264003-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"Patient received 1st COVID vaccine 4/12/2021 at medical center.  Per ER report: 4/14/2021 patient was in bed with significant other and was noted to not be responding.  EMS was called.  Patient was found without a pulse and apneic.  CPR began, PEA converted to Vtach, received 8 total epi and 1.5gm lidocaine by EMS.  Down 50-55 minutes prior to ER.  In ER given 2 additional epi, 2 sodium bicarb, intubated and was PEA then asystole.  Pronounced deceased in ER."
	"1264003-1"	"1264003-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient received 1st COVID vaccine 4/12/2021 at medical center.  Per ER report: 4/14/2021 patient was in bed with significant other and was noted to not be responding.  EMS was called.  Patient was found without a pulse and apneic.  CPR began, PEA converted to Vtach, received 8 total epi and 1.5gm lidocaine by EMS.  Down 50-55 minutes prior to ER.  In ER given 2 additional epi, 2 sodium bicarb, intubated and was PEA then asystole.  Pronounced deceased in ER."
	"1264003-1"	"1264003-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"50-59 years"	"50-59"	"Patient received 1st COVID vaccine 4/12/2021 at medical center.  Per ER report: 4/14/2021 patient was in bed with significant other and was noted to not be responding.  EMS was called.  Patient was found without a pulse and apneic.  CPR began, PEA converted to Vtach, received 8 total epi and 1.5gm lidocaine by EMS.  Down 50-55 minutes prior to ER.  In ER given 2 additional epi, 2 sodium bicarb, intubated and was PEA then asystole.  Pronounced deceased in ER."
	"1264003-1"	"1264003-1"	"PULSE ABSENT"	"10037469"	"50-59 years"	"50-59"	"Patient received 1st COVID vaccine 4/12/2021 at medical center.  Per ER report: 4/14/2021 patient was in bed with significant other and was noted to not be responding.  EMS was called.  Patient was found without a pulse and apneic.  CPR began, PEA converted to Vtach, received 8 total epi and 1.5gm lidocaine by EMS.  Down 50-55 minutes prior to ER.  In ER given 2 additional epi, 2 sodium bicarb, intubated and was PEA then asystole.  Pronounced deceased in ER."
	"1264003-1"	"1264003-1"	"PULSELESS ELECTRICAL ACTIVITY"	"10058151"	"50-59 years"	"50-59"	"Patient received 1st COVID vaccine 4/12/2021 at medical center.  Per ER report: 4/14/2021 patient was in bed with significant other and was noted to not be responding.  EMS was called.  Patient was found without a pulse and apneic.  CPR began, PEA converted to Vtach, received 8 total epi and 1.5gm lidocaine by EMS.  Down 50-55 minutes prior to ER.  In ER given 2 additional epi, 2 sodium bicarb, intubated and was PEA then asystole.  Pronounced deceased in ER."
	"1264003-1"	"1264003-1"	"RESUSCITATION"	"10038749"	"50-59 years"	"50-59"	"Patient received 1st COVID vaccine 4/12/2021 at medical center.  Per ER report: 4/14/2021 patient was in bed with significant other and was noted to not be responding.  EMS was called.  Patient was found without a pulse and apneic.  CPR began, PEA converted to Vtach, received 8 total epi and 1.5gm lidocaine by EMS.  Down 50-55 minutes prior to ER.  In ER given 2 additional epi, 2 sodium bicarb, intubated and was PEA then asystole.  Pronounced deceased in ER."
	"1264003-1"	"1264003-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"50-59 years"	"50-59"	"Patient received 1st COVID vaccine 4/12/2021 at medical center.  Per ER report: 4/14/2021 patient was in bed with significant other and was noted to not be responding.  EMS was called.  Patient was found without a pulse and apneic.  CPR began, PEA converted to Vtach, received 8 total epi and 1.5gm lidocaine by EMS.  Down 50-55 minutes prior to ER.  In ER given 2 additional epi, 2 sodium bicarb, intubated and was PEA then asystole.  Pronounced deceased in ER."
	"1264003-1"	"1264003-1"	"VENTRICULAR TACHYCARDIA"	"10047302"	"50-59 years"	"50-59"	"Patient received 1st COVID vaccine 4/12/2021 at medical center.  Per ER report: 4/14/2021 patient was in bed with significant other and was noted to not be responding.  EMS was called.  Patient was found without a pulse and apneic.  CPR began, PEA converted to Vtach, received 8 total epi and 1.5gm lidocaine by EMS.  Down 50-55 minutes prior to ER.  In ER given 2 additional epi, 2 sodium bicarb, intubated and was PEA then asystole.  Pronounced deceased in ER."
	"1264579-1"	"1264579-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"I was notified that patient passed away at Hospital 10:37 am today. Per message to medical office from Coroner, it was reported that patient collapsed this morning while walking his dog. Patient was brought in by ALS complaint of FULL ARREST to Hospital 10:10 am and pronounced at 10:37 am 4/24/2021  by Dr. at Hospital."
	"1264579-1"	"1264579-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"I was notified that patient passed away at Hospital 10:37 am today. Per message to medical office from Coroner, it was reported that patient collapsed this morning while walking his dog. Patient was brought in by ALS complaint of FULL ARREST to Hospital 10:10 am and pronounced at 10:37 am 4/24/2021  by Dr. at Hospital."
	"1264579-1"	"1264579-1"	"SYNCOPE"	"10042772"	"50-59 years"	"50-59"	"I was notified that patient passed away at Hospital 10:37 am today. Per message to medical office from Coroner, it was reported that patient collapsed this morning while walking his dog. Patient was brought in by ALS complaint of FULL ARREST to Hospital 10:10 am and pronounced at 10:37 am 4/24/2021  by Dr. at Hospital."
	"1266493-1"	"1266493-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Family friend of the wife, called our pharmacy on  04/28/2021 and reported that wife's appointment would need to be canceled for 04/29/2021 because her spouse passed away the previous night. This prompted our staff to look further and it was noted that her spouse, received his first Moderna vaccine on 4/26/2021 at our pharmacy. Friend was not reporting his death due to the belief that the injection was the cause. Only to report, so upcoming appointment for his wife could be canceled.  It was reported to our Medical staff that Patient n has Chronic COPD and had difficulty breathing on the evening of 4/27/2021 and was taken to the hospital where he later passed away.  Patient was on portable oxygen and resembled shortness of breath while ambulating at the time of his vaccination appointment on 4/26/2021. Patient immediately recovered from Shortness of Breath once seated in exam room for injection for a few minutes."
	"1266493-1"	"1266493-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"Family friend of the wife, called our pharmacy on  04/28/2021 and reported that wife's appointment would need to be canceled for 04/29/2021 because her spouse passed away the previous night. This prompted our staff to look further and it was noted that her spouse, received his first Moderna vaccine on 4/26/2021 at our pharmacy. Friend was not reporting his death due to the belief that the injection was the cause. Only to report, so upcoming appointment for his wife could be canceled.  It was reported to our Medical staff that Patient n has Chronic COPD and had difficulty breathing on the evening of 4/27/2021 and was taken to the hospital where he later passed away.  Patient was on portable oxygen and resembled shortness of breath while ambulating at the time of his vaccination appointment on 4/26/2021. Patient immediately recovered from Shortness of Breath once seated in exam room for injection for a few minutes."
	"1266953-1"	"1266953-1"	"AUTOPSY"	"10050117"	"50-59 years"	"50-59"	"It was reported that patient had been experiencing  difficulty breathing, walking and delusions as per his fiancT . Fiance notified Manger that they sought medical attention earlier in the morning on 1-Apr-21 at the Clinic and they refused to evaluate patient beyond performing a PCR swab test so, they went back to their apartment. An SMS notification was sent on 1-Apr-21 indicating that patient was COVID-19 positive which was not seen by patient or fiance who reported the result to Mgmt. on 6-Apr-21. He was contacted by patient's friend and advised him the patient was sick, not able to walk, and having difficulty."
	"1266953-1"	"1266953-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"It was reported that patient had been experiencing  difficulty breathing, walking and delusions as per his fiancT . Fiance notified Manger that they sought medical attention earlier in the morning on 1-Apr-21 at the Clinic and they refused to evaluate patient beyond performing a PCR swab test so, they went back to their apartment. An SMS notification was sent on 1-Apr-21 indicating that patient was COVID-19 positive which was not seen by patient or fiance who reported the result to Mgmt. on 6-Apr-21. He was contacted by patient's friend and advised him the patient was sick, not able to walk, and having difficulty."
	"1266953-1"	"1266953-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"It was reported that patient had been experiencing  difficulty breathing, walking and delusions as per his fiancT . Fiance notified Manger that they sought medical attention earlier in the morning on 1-Apr-21 at the Clinic and they refused to evaluate patient beyond performing a PCR swab test so, they went back to their apartment. An SMS notification was sent on 1-Apr-21 indicating that patient was COVID-19 positive which was not seen by patient or fiance who reported the result to Mgmt. on 6-Apr-21. He was contacted by patient's friend and advised him the patient was sick, not able to walk, and having difficulty."
	"1266953-1"	"1266953-1"	"DELUSION"	"10012239"	"50-59 years"	"50-59"	"It was reported that patient had been experiencing  difficulty breathing, walking and delusions as per his fiancT . Fiance notified Manger that they sought medical attention earlier in the morning on 1-Apr-21 at the Clinic and they refused to evaluate patient beyond performing a PCR swab test so, they went back to their apartment. An SMS notification was sent on 1-Apr-21 indicating that patient was COVID-19 positive which was not seen by patient or fiance who reported the result to Mgmt. on 6-Apr-21. He was contacted by patient's friend and advised him the patient was sick, not able to walk, and having difficulty."
	"1266953-1"	"1266953-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"It was reported that patient had been experiencing  difficulty breathing, walking and delusions as per his fiancT . Fiance notified Manger that they sought medical attention earlier in the morning on 1-Apr-21 at the Clinic and they refused to evaluate patient beyond performing a PCR swab test so, they went back to their apartment. An SMS notification was sent on 1-Apr-21 indicating that patient was COVID-19 positive which was not seen by patient or fiance who reported the result to Mgmt. on 6-Apr-21. He was contacted by patient's friend and advised him the patient was sick, not able to walk, and having difficulty."
	"1266953-1"	"1266953-1"	"GAIT DISTURBANCE"	"10017577"	"50-59 years"	"50-59"	"It was reported that patient had been experiencing  difficulty breathing, walking and delusions as per his fiancT . Fiance notified Manger that they sought medical attention earlier in the morning on 1-Apr-21 at the Clinic and they refused to evaluate patient beyond performing a PCR swab test so, they went back to their apartment. An SMS notification was sent on 1-Apr-21 indicating that patient was COVID-19 positive which was not seen by patient or fiance who reported the result to Mgmt. on 6-Apr-21. He was contacted by patient's friend and advised him the patient was sick, not able to walk, and having difficulty."
	"1266953-1"	"1266953-1"	"ILLNESS"	"10080284"	"50-59 years"	"50-59"	"It was reported that patient had been experiencing  difficulty breathing, walking and delusions as per his fiancT . Fiance notified Manger that they sought medical attention earlier in the morning on 1-Apr-21 at the Clinic and they refused to evaluate patient beyond performing a PCR swab test so, they went back to their apartment. An SMS notification was sent on 1-Apr-21 indicating that patient was COVID-19 positive which was not seen by patient or fiance who reported the result to Mgmt. on 6-Apr-21. He was contacted by patient's friend and advised him the patient was sick, not able to walk, and having difficulty."
	"1266953-1"	"1266953-1"	"INTESTINAL ISCHAEMIA"	"10022680"	"50-59 years"	"50-59"	"It was reported that patient had been experiencing  difficulty breathing, walking and delusions as per his fiancT . Fiance notified Manger that they sought medical attention earlier in the morning on 1-Apr-21 at the Clinic and they refused to evaluate patient beyond performing a PCR swab test so, they went back to their apartment. An SMS notification was sent on 1-Apr-21 indicating that patient was COVID-19 positive which was not seen by patient or fiance who reported the result to Mgmt. on 6-Apr-21. He was contacted by patient's friend and advised him the patient was sick, not able to walk, and having difficulty."
	"1266953-1"	"1266953-1"	"LOSS OF CONSCIOUSNESS"	"10024855"	"50-59 years"	"50-59"	"It was reported that patient had been experiencing  difficulty breathing, walking and delusions as per his fiancT . Fiance notified Manger that they sought medical attention earlier in the morning on 1-Apr-21 at the Clinic and they refused to evaluate patient beyond performing a PCR swab test so, they went back to their apartment. An SMS notification was sent on 1-Apr-21 indicating that patient was COVID-19 positive which was not seen by patient or fiance who reported the result to Mgmt. on 6-Apr-21. He was contacted by patient's friend and advised him the patient was sick, not able to walk, and having difficulty."
	"1266953-1"	"1266953-1"	"PNEUMONIA"	"10035664"	"50-59 years"	"50-59"	"It was reported that patient had been experiencing  difficulty breathing, walking and delusions as per his fiancT . Fiance notified Manger that they sought medical attention earlier in the morning on 1-Apr-21 at the Clinic and they refused to evaluate patient beyond performing a PCR swab test so, they went back to their apartment. An SMS notification was sent on 1-Apr-21 indicating that patient was COVID-19 positive which was not seen by patient or fiance who reported the result to Mgmt. on 6-Apr-21. He was contacted by patient's friend and advised him the patient was sick, not able to walk, and having difficulty."
	"1266953-1"	"1266953-1"	"RESPIRATORY ARREST"	"10038669"	"50-59 years"	"50-59"	"It was reported that patient had been experiencing  difficulty breathing, walking and delusions as per his fiancT . Fiance notified Manger that they sought medical attention earlier in the morning on 1-Apr-21 at the Clinic and they refused to evaluate patient beyond performing a PCR swab test so, they went back to their apartment. An SMS notification was sent on 1-Apr-21 indicating that patient was COVID-19 positive which was not seen by patient or fiance who reported the result to Mgmt. on 6-Apr-21. He was contacted by patient's friend and advised him the patient was sick, not able to walk, and having difficulty."
	"1266953-1"	"1266953-1"	"RESUSCITATION"	"10038749"	"50-59 years"	"50-59"	"It was reported that patient had been experiencing  difficulty breathing, walking and delusions as per his fiancT . Fiance notified Manger that they sought medical attention earlier in the morning on 1-Apr-21 at the Clinic and they refused to evaluate patient beyond performing a PCR swab test so, they went back to their apartment. An SMS notification was sent on 1-Apr-21 indicating that patient was COVID-19 positive which was not seen by patient or fiance who reported the result to Mgmt. on 6-Apr-21. He was contacted by patient's friend and advised him the patient was sick, not able to walk, and having difficulty."
	"1266953-1"	"1266953-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"It was reported that patient had been experiencing  difficulty breathing, walking and delusions as per his fiancT . Fiance notified Manger that they sought medical attention earlier in the morning on 1-Apr-21 at the Clinic and they refused to evaluate patient beyond performing a PCR swab test so, they went back to their apartment. An SMS notification was sent on 1-Apr-21 indicating that patient was COVID-19 positive which was not seen by patient or fiance who reported the result to Mgmt. on 6-Apr-21. He was contacted by patient's friend and advised him the patient was sick, not able to walk, and having difficulty."
	"1267641-1"	"1267641-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"Shortness of breath"
	"1268162-1"	"1268162-1"	"CHILLS"	"10008531"	"50-59 years"	"50-59"	"My mom received the first does of the shot on April 14, 2021 around 10:15 am. Her friend that took her told me that she was having a reaction to it when he took her home that day. He said she had the chills really bad that he had to turn the heat on in the car and give her a coat. He said later she was sweating. She didn't make any calls on her phone after 5:20 pm. Her sister found her dead inside her home the next day."
	"1268162-1"	"1268162-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"My mom received the first does of the shot on April 14, 2021 around 10:15 am. Her friend that took her told me that she was having a reaction to it when he took her home that day. He said she had the chills really bad that he had to turn the heat on in the car and give her a coat. He said later she was sweating. She didn't make any calls on her phone after 5:20 pm. Her sister found her dead inside her home the next day."
	"1268162-1"	"1268162-1"	"HYPERHIDROSIS"	"10020642"	"50-59 years"	"50-59"	"My mom received the first does of the shot on April 14, 2021 around 10:15 am. Her friend that took her told me that she was having a reaction to it when he took her home that day. He said she had the chills really bad that he had to turn the heat on in the car and give her a coat. He said later she was sweating. She didn't make any calls on her phone after 5:20 pm. Her sister found her dead inside her home the next day."
	"1268440-1"	"1268440-1"	"ACTIVATED PARTIAL THROMBOPLASTIN TIME SHORTENED"	"10000637"	"50-59 years"	"50-59"	"Death due to cardiac arrest on 4/26/2021"
	"1268440-1"	"1268440-1"	"BLOOD CREATINE PHOSPHOKINASE INCREASED"	"10005470"	"50-59 years"	"50-59"	"Death due to cardiac arrest on 4/26/2021"
	"1268440-1"	"1268440-1"	"BLOOD CREATINE PHOSPHOKINASE MB INCREASED"	"10005474"	"50-59 years"	"50-59"	"Death due to cardiac arrest on 4/26/2021"
	"1268440-1"	"1268440-1"	"BLOOD GLUCOSE NORMAL"	"10005558"	"50-59 years"	"50-59"	"Death due to cardiac arrest on 4/26/2021"
	"1268440-1"	"1268440-1"	"BLOOD PH DECREASED"	"10005706"	"50-59 years"	"50-59"	"Death due to cardiac arrest on 4/26/2021"
	"1268440-1"	"1268440-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"Death due to cardiac arrest on 4/26/2021"
	"1268440-1"	"1268440-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Death due to cardiac arrest on 4/26/2021"
	"1268440-1"	"1268440-1"	"FIBRIN D DIMER INCREASED"	"10016581"	"50-59 years"	"50-59"	"Death due to cardiac arrest on 4/26/2021"
	"1268440-1"	"1268440-1"	"INTERNATIONAL NORMALISED RATIO NORMAL"	"10022596"	"50-59 years"	"50-59"	"Death due to cardiac arrest on 4/26/2021"
	"1268440-1"	"1268440-1"	"PLATELET COUNT NORMAL"	"10035530"	"50-59 years"	"50-59"	"Death due to cardiac arrest on 4/26/2021"
	"1268440-1"	"1268440-1"	"SARS-COV-2 TEST NEGATIVE"	"10084273"	"50-59 years"	"50-59"	"Death due to cardiac arrest on 4/26/2021"
	"1268440-1"	"1268440-1"	"TROPONIN INCREASED"	"10058267"	"50-59 years"	"50-59"	"Death due to cardiac arrest on 4/26/2021"
	"1269282-1"	"1269282-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Death; This spontaneous case was reported by a consumer and describes the occurrence of DEATH (Death) in a 56-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination.     The patient's past medical history included COPD. Concurrent medical conditions included Immunocompromised. Concomitant products included OXYGEN for an unknown indication.    On 12-Apr-2021 at 12:45 PM, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. Death occurred on 12-Apr-2021 The patient died on 12-Apr-2021. The cause of death was not reported. It is unknown if an autopsy was performed.            No treatment information were reported.; Sender's Comments: Limited information regarding the event has been provided at this time and a causal relationship cannot be excluded; Reported Cause(s) of Death: Unknown cause of death"
	"1270749-1"	"1270749-1"	"ARTERIOSCLEROSIS CORONARY ARTERY"	"10003211"	"50-59 years"	"50-59"	"HYPOTENSION (SARASOTA EMS RESPONDED TO PHARMACY); CLAMMY/SOB, EXTREMITY TINGLES; DEATH WITHIN 6-7 HRS"
	"1270749-1"	"1270749-1"	"AUTOPSY"	"10050117"	"50-59 years"	"50-59"	"HYPOTENSION (SARASOTA EMS RESPONDED TO PHARMACY); CLAMMY/SOB, EXTREMITY TINGLES; DEATH WITHIN 6-7 HRS"
	"1270749-1"	"1270749-1"	"COLD SWEAT"	"10009866"	"50-59 years"	"50-59"	"HYPOTENSION (SARASOTA EMS RESPONDED TO PHARMACY); CLAMMY/SOB, EXTREMITY TINGLES; DEATH WITHIN 6-7 HRS"
	"1270749-1"	"1270749-1"	"CORONARY ARTERY OCCLUSION"	"10011086"	"50-59 years"	"50-59"	"HYPOTENSION (SARASOTA EMS RESPONDED TO PHARMACY); CLAMMY/SOB, EXTREMITY TINGLES; DEATH WITHIN 6-7 HRS"
	"1270749-1"	"1270749-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"HYPOTENSION (SARASOTA EMS RESPONDED TO PHARMACY); CLAMMY/SOB, EXTREMITY TINGLES; DEATH WITHIN 6-7 HRS"
	"1270749-1"	"1270749-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"HYPOTENSION (SARASOTA EMS RESPONDED TO PHARMACY); CLAMMY/SOB, EXTREMITY TINGLES; DEATH WITHIN 6-7 HRS"
	"1270749-1"	"1270749-1"	"HYPOTENSION"	"10021097"	"50-59 years"	"50-59"	"HYPOTENSION (SARASOTA EMS RESPONDED TO PHARMACY); CLAMMY/SOB, EXTREMITY TINGLES; DEATH WITHIN 6-7 HRS"
	"1270749-1"	"1270749-1"	"PARAESTHESIA"	"10033775"	"50-59 years"	"50-59"	"HYPOTENSION (SARASOTA EMS RESPONDED TO PHARMACY); CLAMMY/SOB, EXTREMITY TINGLES; DEATH WITHIN 6-7 HRS"
	"1271786-1"	"1271786-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient came to pharmacy for 1st Moderna Covid-19 vaccination on 4/21/21. Spouse reported she died on 4/25/21.  Our pharmacy does not have information about her medications or health conditions as she wasn't a regular customer of ours."
	"1271865-1"	"1271865-1"	"ANEURYSM RUPTURED"	"10048380"	"50-59 years"	"50-59"	""Patient spouse came to our clinic on 4/29/2021 to report that on 3/18/2021 patient had a ""brain bleed"" and required emergency treatment. Patient died on 3/20/2021. Death certificate list cause of death as subarachnoid hemorrhage due to ruptured aneurysm""
	"1271865-1"	"1271865-1"	"CEREBRAL HAEMORRHAGE"	"10008111"	"50-59 years"	"50-59"	""Patient spouse came to our clinic on 4/29/2021 to report that on 3/18/2021 patient had a ""brain bleed"" and required emergency treatment. Patient died on 3/20/2021. Death certificate list cause of death as subarachnoid hemorrhage due to ruptured aneurysm""
	"1271865-1"	"1271865-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	""Patient spouse came to our clinic on 4/29/2021 to report that on 3/18/2021 patient had a ""brain bleed"" and required emergency treatment. Patient died on 3/20/2021. Death certificate list cause of death as subarachnoid hemorrhage due to ruptured aneurysm""
	"1271865-1"	"1271865-1"	"SUBARACHNOID HAEMORRHAGE"	"10042316"	"50-59 years"	"50-59"	""Patient spouse came to our clinic on 4/29/2021 to report that on 3/18/2021 patient had a ""brain bleed"" and required emergency treatment. Patient died on 3/20/2021. Death certificate list cause of death as subarachnoid hemorrhage due to ruptured aneurysm""
	"1271898-1"	"1271898-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient was found unresponsive on 4/15/2021. Patient seemed to pass in his sleep per family member. The coroner deemed myocardial infarction. No autopsy completed."
	"1271898-1"	"1271898-1"	"MYOCARDIAL INFARCTION"	"10028596"	"50-59 years"	"50-59"	"Patient was found unresponsive on 4/15/2021. Patient seemed to pass in his sleep per family member. The coroner deemed myocardial infarction. No autopsy completed."
	"1271898-1"	"1271898-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"50-59 years"	"50-59"	"Patient was found unresponsive on 4/15/2021. Patient seemed to pass in his sleep per family member. The coroner deemed myocardial infarction. No autopsy completed."
	"1272058-1"	"1272058-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Death on April 28, 2021 1AM"
	"1273570-1"	"1273570-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient reported dyspnea that began about 1 week post 2nd shot in Covid vaccination series.  Patient deceased on 3/18/2021"
	"1273570-1"	"1273570-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"Patient reported dyspnea that began about 1 week post 2nd shot in Covid vaccination series.  Patient deceased on 3/18/2021"
	"1274185-1"	"1274185-1"	"ASTHENIA"	"10003549"	"50-59 years"	"50-59"	""This was a 58 year old female who received her 1st dose Pfizer on 4/6/21 (Lot# EW0175) and 2nd dose Pfizer on 4/27/21 (Lot# EW0151).  Of note, the patient was in a motor vehicle accident on 4/12/21 with a diagnosis of concussion and cervical/thoracic strain/sprain (see history under patient information).  On 4/29/21, the patient's sister contacted the patient's primary care clinic with the following documented concern:  ""Pt's sister calling to report that two days ago pt got 2nd dose Pfizer vaccine and has been sick. This morning they found her passed out against the her bedroom door. Pt reports that she can't remember much other than going to the bathroom.  Pt's sister states that patient totaled her car a week ago, and that it was determined she had a concussion.  ""She hasn't been herself since the wreck and I am very concerned."" This caller recommenced the Ed or UC but caller denied stating that either needs to see her today. This writer is reaching out to nurse to see if they can advise from here."" A RN assessed the patient virtually with the following documentation:  ""RN note:  Call transferred from patient's sister.  Pt noted to be found on her floor this morning. Pt unsure if she hit her head.  Spoke to patient.  She reports body aches, and feeling weak.  Pt is slow to answer questions, and had a lot of difficulty hearing me (sister did not have any difficulty hearing me).  Pt is noted to have more rapid breathing, and some slight wheezing.  Speech is clear when she is speaking.  Sister gave patient water to drink.  She drank out of bottle and was able to hold on her own (though had difficulty with this at first).  Sister noted some water dripping down face, but was able to swallow okay.  Sister also noted that patient's lips seem to be pursed. Plan: Given recent concussion, and patients change in behavior per sister (pt more irritable, speaking more slowly, moving slowly, breathing faster, and wheezing), recommended patient be taken to the ED today--recommended ambulance since it took 2 men to help patient back to bed this morning.  Sister states patient is not agreeable to going to ED at this time.  Advised to try to encourage her to drink more fluids, and continue to monitor her sxs, and if any worsening, to call for ambulance transport.  Sister agreeable to plan, and will discuss with sister, and recommend ED visit today."" On 4/30/21, the patient's sister contacted the clinic to inform them that the patient was found dead that morning.  The medical examiner is completing the further investigation. If additional information is needed from the primary care physician for this patient.""
	"1274185-1"	"1274185-1"	"BRADYKINESIA"	"10006100"	"50-59 years"	"50-59"	""This was a 58 year old female who received her 1st dose Pfizer on 4/6/21 (Lot# EW0175) and 2nd dose Pfizer on 4/27/21 (Lot# EW0151).  Of note, the patient was in a motor vehicle accident on 4/12/21 with a diagnosis of concussion and cervical/thoracic strain/sprain (see history under patient information).  On 4/29/21, the patient's sister contacted the patient's primary care clinic with the following documented concern:  ""Pt's sister calling to report that two days ago pt got 2nd dose Pfizer vaccine and has been sick. This morning they found her passed out against the her bedroom door. Pt reports that she can't remember much other than going to the bathroom.  Pt's sister states that patient totaled her car a week ago, and that it was determined she had a concussion.  ""She hasn't been herself since the wreck and I am very concerned."" This caller recommenced the Ed or UC but caller denied stating that either needs to see her today. This writer is reaching out to nurse to see if they can advise from here."" A RN assessed the patient virtually with the following documentation:  ""RN note:  Call transferred from patient's sister.  Pt noted to be found on her floor this morning. Pt unsure if she hit her head.  Spoke to patient.  She reports body aches, and feeling weak.  Pt is slow to answer questions, and had a lot of difficulty hearing me (sister did not have any difficulty hearing me).  Pt is noted to have more rapid breathing, and some slight wheezing.  Speech is clear when she is speaking.  Sister gave patient water to drink.  She drank out of bottle and was able to hold on her own (though had difficulty with this at first).  Sister noted some water dripping down face, but was able to swallow okay.  Sister also noted that patient's lips seem to be pursed. Plan: Given recent concussion, and patients change in behavior per sister (pt more irritable, speaking more slowly, moving slowly, breathing faster, and wheezing), recommended patient be taken to the ED today--recommended ambulance since it took 2 men to help patient back to bed this morning.  Sister states patient is not agreeable to going to ED at this time.  Advised to try to encourage her to drink more fluids, and continue to monitor her sxs, and if any worsening, to call for ambulance transport.  Sister agreeable to plan, and will discuss with sister, and recommend ED visit today."" On 4/30/21, the patient's sister contacted the clinic to inform them that the patient was found dead that morning.  The medical examiner is completing the further investigation. If additional information is needed from the primary care physician for this patient.""
	"1274185-1"	"1274185-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	""This was a 58 year old female who received her 1st dose Pfizer on 4/6/21 (Lot# EW0175) and 2nd dose Pfizer on 4/27/21 (Lot# EW0151).  Of note, the patient was in a motor vehicle accident on 4/12/21 with a diagnosis of concussion and cervical/thoracic strain/sprain (see history under patient information).  On 4/29/21, the patient's sister contacted the patient's primary care clinic with the following documented concern:  ""Pt's sister calling to report that two days ago pt got 2nd dose Pfizer vaccine and has been sick. This morning they found her passed out against the her bedroom door. Pt reports that she can't remember much other than going to the bathroom.  Pt's sister states that patient totaled her car a week ago, and that it was determined she had a concussion.  ""She hasn't been herself since the wreck and I am very concerned."" This caller recommenced the Ed or UC but caller denied stating that either needs to see her today. This writer is reaching out to nurse to see if they can advise from here."" A RN assessed the patient virtually with the following documentation:  ""RN note:  Call transferred from patient's sister.  Pt noted to be found on her floor this morning. Pt unsure if she hit her head.  Spoke to patient.  She reports body aches, and feeling weak.  Pt is slow to answer questions, and had a lot of difficulty hearing me (sister did not have any difficulty hearing me).  Pt is noted to have more rapid breathing, and some slight wheezing.  Speech is clear when she is speaking.  Sister gave patient water to drink.  She drank out of bottle and was able to hold on her own (though had difficulty with this at first).  Sister noted some water dripping down face, but was able to swallow okay.  Sister also noted that patient's lips seem to be pursed. Plan: Given recent concussion, and patients change in behavior per sister (pt more irritable, speaking more slowly, moving slowly, breathing faster, and wheezing), recommended patient be taken to the ED today--recommended ambulance since it took 2 men to help patient back to bed this morning.  Sister states patient is not agreeable to going to ED at this time.  Advised to try to encourage her to drink more fluids, and continue to monitor her sxs, and if any worsening, to call for ambulance transport.  Sister agreeable to plan, and will discuss with sister, and recommend ED visit today."" On 4/30/21, the patient's sister contacted the clinic to inform them that the patient was found dead that morning.  The medical examiner is completing the further investigation. If additional information is needed from the primary care physician for this patient.""
	"1274185-1"	"1274185-1"	"DISCOMFORT"	"10013082"	"50-59 years"	"50-59"	""This was a 58 year old female who received her 1st dose Pfizer on 4/6/21 (Lot# EW0175) and 2nd dose Pfizer on 4/27/21 (Lot# EW0151).  Of note, the patient was in a motor vehicle accident on 4/12/21 with a diagnosis of concussion and cervical/thoracic strain/sprain (see history under patient information).  On 4/29/21, the patient's sister contacted the patient's primary care clinic with the following documented concern:  ""Pt's sister calling to report that two days ago pt got 2nd dose Pfizer vaccine and has been sick. This morning they found her passed out against the her bedroom door. Pt reports that she can't remember much other than going to the bathroom.  Pt's sister states that patient totaled her car a week ago, and that it was determined she had a concussion.  ""She hasn't been herself since the wreck and I am very concerned."" This caller recommenced the Ed or UC but caller denied stating that either needs to see her today. This writer is reaching out to nurse to see if they can advise from here."" A RN assessed the patient virtually with the following documentation:  ""RN note:  Call transferred from patient's sister.  Pt noted to be found on her floor this morning. Pt unsure if she hit her head.  Spoke to patient.  She reports body aches, and feeling weak.  Pt is slow to answer questions, and had a lot of difficulty hearing me (sister did not have any difficulty hearing me).  Pt is noted to have more rapid breathing, and some slight wheezing.  Speech is clear when she is speaking.  Sister gave patient water to drink.  She drank out of bottle and was able to hold on her own (though had difficulty with this at first).  Sister noted some water dripping down face, but was able to swallow okay.  Sister also noted that patient's lips seem to be pursed. Plan: Given recent concussion, and patients change in behavior per sister (pt more irritable, speaking more slowly, moving slowly, breathing faster, and wheezing), recommended patient be taken to the ED today--recommended ambulance since it took 2 men to help patient back to bed this morning.  Sister states patient is not agreeable to going to ED at this time.  Advised to try to encourage her to drink more fluids, and continue to monitor her sxs, and if any worsening, to call for ambulance transport.  Sister agreeable to plan, and will discuss with sister, and recommend ED visit today."" On 4/30/21, the patient's sister contacted the clinic to inform them that the patient was found dead that morning.  The medical examiner is completing the further investigation. If additional information is needed from the primary care physician for this patient.""
	"1274185-1"	"1274185-1"	"HYPOACUSIS"	"10048865"	"50-59 years"	"50-59"	""This was a 58 year old female who received her 1st dose Pfizer on 4/6/21 (Lot# EW0175) and 2nd dose Pfizer on 4/27/21 (Lot# EW0151).  Of note, the patient was in a motor vehicle accident on 4/12/21 with a diagnosis of concussion and cervical/thoracic strain/sprain (see history under patient information).  On 4/29/21, the patient's sister contacted the patient's primary care clinic with the following documented concern:  ""Pt's sister calling to report that two days ago pt got 2nd dose Pfizer vaccine and has been sick. This morning they found her passed out against the her bedroom door. Pt reports that she can't remember much other than going to the bathroom.  Pt's sister states that patient totaled her car a week ago, and that it was determined she had a concussion.  ""She hasn't been herself since the wreck and I am very concerned."" This caller recommenced the Ed or UC but caller denied stating that either needs to see her today. This writer is reaching out to nurse to see if they can advise from here."" A RN assessed the patient virtually with the following documentation:  ""RN note:  Call transferred from patient's sister.  Pt noted to be found on her floor this morning. Pt unsure if she hit her head.  Spoke to patient.  She reports body aches, and feeling weak.  Pt is slow to answer questions, and had a lot of difficulty hearing me (sister did not have any difficulty hearing me).  Pt is noted to have more rapid breathing, and some slight wheezing.  Speech is clear when she is speaking.  Sister gave patient water to drink.  She drank out of bottle and was able to hold on her own (though had difficulty with this at first).  Sister noted some water dripping down face, but was able to swallow okay.  Sister also noted that patient's lips seem to be pursed. Plan: Given recent concussion, and patients change in behavior per sister (pt more irritable, speaking more slowly, moving slowly, breathing faster, and wheezing), recommended patient be taken to the ED today--recommended ambulance since it took 2 men to help patient back to bed this morning.  Sister states patient is not agreeable to going to ED at this time.  Advised to try to encourage her to drink more fluids, and continue to monitor her sxs, and if any worsening, to call for ambulance transport.  Sister agreeable to plan, and will discuss with sister, and recommend ED visit today."" On 4/30/21, the patient's sister contacted the clinic to inform them that the patient was found dead that morning.  The medical examiner is completing the further investigation. If additional information is needed from the primary care physician for this patient.""
	"1274185-1"	"1274185-1"	"IRRITABILITY"	"10022998"	"50-59 years"	"50-59"	""This was a 58 year old female who received her 1st dose Pfizer on 4/6/21 (Lot# EW0175) and 2nd dose Pfizer on 4/27/21 (Lot# EW0151).  Of note, the patient was in a motor vehicle accident on 4/12/21 with a diagnosis of concussion and cervical/thoracic strain/sprain (see history under patient information).  On 4/29/21, the patient's sister contacted the patient's primary care clinic with the following documented concern:  ""Pt's sister calling to report that two days ago pt got 2nd dose Pfizer vaccine and has been sick. This morning they found her passed out against the her bedroom door. Pt reports that she can't remember much other than going to the bathroom.  Pt's sister states that patient totaled her car a week ago, and that it was determined she had a concussion.  ""She hasn't been herself since the wreck and I am very concerned."" This caller recommenced the Ed or UC but caller denied stating that either needs to see her today. This writer is reaching out to nurse to see if they can advise from here."" A RN assessed the patient virtually with the following documentation:  ""RN note:  Call transferred from patient's sister.  Pt noted to be found on her floor this morning. Pt unsure if she hit her head.  Spoke to patient.  She reports body aches, and feeling weak.  Pt is slow to answer questions, and had a lot of difficulty hearing me (sister did not have any difficulty hearing me).  Pt is noted to have more rapid breathing, and some slight wheezing.  Speech is clear when she is speaking.  Sister gave patient water to drink.  She drank out of bottle and was able to hold on her own (though had difficulty with this at first).  Sister noted some water dripping down face, but was able to swallow okay.  Sister also noted that patient's lips seem to be pursed. Plan: Given recent concussion, and patients change in behavior per sister (pt more irritable, speaking more slowly, moving slowly, breathing faster, and wheezing), recommended patient be taken to the ED today--recommended ambulance since it took 2 men to help patient back to bed this morning.  Sister states patient is not agreeable to going to ED at this time.  Advised to try to encourage her to drink more fluids, and continue to monitor her sxs, and if any worsening, to call for ambulance transport.  Sister agreeable to plan, and will discuss with sister, and recommend ED visit today."" On 4/30/21, the patient's sister contacted the clinic to inform them that the patient was found dead that morning.  The medical examiner is completing the further investigation. If additional information is needed from the primary care physician for this patient.""
	"1274185-1"	"1274185-1"	"LOSS OF CONSCIOUSNESS"	"10024855"	"50-59 years"	"50-59"	""This was a 58 year old female who received her 1st dose Pfizer on 4/6/21 (Lot# EW0175) and 2nd dose Pfizer on 4/27/21 (Lot# EW0151).  Of note, the patient was in a motor vehicle accident on 4/12/21 with a diagnosis of concussion and cervical/thoracic strain/sprain (see history under patient information).  On 4/29/21, the patient's sister contacted the patient's primary care clinic with the following documented concern:  ""Pt's sister calling to report that two days ago pt got 2nd dose Pfizer vaccine and has been sick. This morning they found her passed out against the her bedroom door. Pt reports that she can't remember much other than going to the bathroom.  Pt's sister states that patient totaled her car a week ago, and that it was determined she had a concussion.  ""She hasn't been herself since the wreck and I am very concerned."" This caller recommenced the Ed or UC but caller denied stating that either needs to see her today. This writer is reaching out to nurse to see if they can advise from here."" A RN assessed the patient virtually with the following documentation:  ""RN note:  Call transferred from patient's sister.  Pt noted to be found on her floor this morning. Pt unsure if she hit her head.  Spoke to patient.  She reports body aches, and feeling weak.  Pt is slow to answer questions, and had a lot of difficulty hearing me (sister did not have any difficulty hearing me).  Pt is noted to have more rapid breathing, and some slight wheezing.  Speech is clear when she is speaking.  Sister gave patient water to drink.  She drank out of bottle and was able to hold on her own (though had difficulty with this at first).  Sister noted some water dripping down face, but was able to swallow okay.  Sister also noted that patient's lips seem to be pursed. Plan: Given recent concussion, and patients change in behavior per sister (pt more irritable, speaking more slowly, moving slowly, breathing faster, and wheezing), recommended patient be taken to the ED today--recommended ambulance since it took 2 men to help patient back to bed this morning.  Sister states patient is not agreeable to going to ED at this time.  Advised to try to encourage her to drink more fluids, and continue to monitor her sxs, and if any worsening, to call for ambulance transport.  Sister agreeable to plan, and will discuss with sister, and recommend ED visit today."" On 4/30/21, the patient's sister contacted the clinic to inform them that the patient was found dead that morning.  The medical examiner is completing the further investigation. If additional information is needed from the primary care physician for this patient.""
	"1274185-1"	"1274185-1"	"MALAISE"	"10025482"	"50-59 years"	"50-59"	""This was a 58 year old female who received her 1st dose Pfizer on 4/6/21 (Lot# EW0175) and 2nd dose Pfizer on 4/27/21 (Lot# EW0151).  Of note, the patient was in a motor vehicle accident on 4/12/21 with a diagnosis of concussion and cervical/thoracic strain/sprain (see history under patient information).  On 4/29/21, the patient's sister contacted the patient's primary care clinic with the following documented concern:  ""Pt's sister calling to report that two days ago pt got 2nd dose Pfizer vaccine and has been sick. This morning they found her passed out against the her bedroom door. Pt reports that she can't remember much other than going to the bathroom.  Pt's sister states that patient totaled her car a week ago, and that it was determined she had a concussion.  ""She hasn't been herself since the wreck and I am very concerned."" This caller recommenced the Ed or UC but caller denied stating that either needs to see her today. This writer is reaching out to nurse to see if they can advise from here."" A RN assessed the patient virtually with the following documentation:  ""RN note:  Call transferred from patient's sister.  Pt noted to be found on her floor this morning. Pt unsure if she hit her head.  Spoke to patient.  She reports body aches, and feeling weak.  Pt is slow to answer questions, and had a lot of difficulty hearing me (sister did not have any difficulty hearing me).  Pt is noted to have more rapid breathing, and some slight wheezing.  Speech is clear when she is speaking.  Sister gave patient water to drink.  She drank out of bottle and was able to hold on her own (though had difficulty with this at first).  Sister noted some water dripping down face, but was able to swallow okay.  Sister also noted that patient's lips seem to be pursed. Plan: Given recent concussion, and patients change in behavior per sister (pt more irritable, speaking more slowly, moving slowly, breathing faster, and wheezing), recommended patient be taken to the ED today--recommended ambulance since it took 2 men to help patient back to bed this morning.  Sister states patient is not agreeable to going to ED at this time.  Advised to try to encourage her to drink more fluids, and continue to monitor her sxs, and if any worsening, to call for ambulance transport.  Sister agreeable to plan, and will discuss with sister, and recommend ED visit today."" On 4/30/21, the patient's sister contacted the clinic to inform them that the patient was found dead that morning.  The medical examiner is completing the further investigation. If additional information is needed from the primary care physician for this patient.""
	"1274185-1"	"1274185-1"	"MEMORY IMPAIRMENT"	"10027175"	"50-59 years"	"50-59"	""This was a 58 year old female who received her 1st dose Pfizer on 4/6/21 (Lot# EW0175) and 2nd dose Pfizer on 4/27/21 (Lot# EW0151).  Of note, the patient was in a motor vehicle accident on 4/12/21 with a diagnosis of concussion and cervical/thoracic strain/sprain (see history under patient information).  On 4/29/21, the patient's sister contacted the patient's primary care clinic with the following documented concern:  ""Pt's sister calling to report that two days ago pt got 2nd dose Pfizer vaccine and has been sick. This morning they found her passed out against the her bedroom door. Pt reports that she can't remember much other than going to the bathroom.  Pt's sister states that patient totaled her car a week ago, and that it was determined she had a concussion.  ""She hasn't been herself since the wreck and I am very concerned."" This caller recommenced the Ed or UC but caller denied stating that either needs to see her today. This writer is reaching out to nurse to see if they can advise from here."" A RN assessed the patient virtually with the following documentation:  ""RN note:  Call transferred from patient's sister.  Pt noted to be found on her floor this morning. Pt unsure if she hit her head.  Spoke to patient.  She reports body aches, and feeling weak.  Pt is slow to answer questions, and had a lot of difficulty hearing me (sister did not have any difficulty hearing me).  Pt is noted to have more rapid breathing, and some slight wheezing.  Speech is clear when she is speaking.  Sister gave patient water to drink.  She drank out of bottle and was able to hold on her own (though had difficulty with this at first).  Sister noted some water dripping down face, but was able to swallow okay.  Sister also noted that patient's lips seem to be pursed. Plan: Given recent concussion, and patients change in behavior per sister (pt more irritable, speaking more slowly, moving slowly, breathing faster, and wheezing), recommended patient be taken to the ED today--recommended ambulance since it took 2 men to help patient back to bed this morning.  Sister states patient is not agreeable to going to ED at this time.  Advised to try to encourage her to drink more fluids, and continue to monitor her sxs, and if any worsening, to call for ambulance transport.  Sister agreeable to plan, and will discuss with sister, and recommend ED visit today."" On 4/30/21, the patient's sister contacted the clinic to inform them that the patient was found dead that morning.  The medical examiner is completing the further investigation. If additional information is needed from the primary care physician for this patient.""
	"1274185-1"	"1274185-1"	"PAIN"	"10033371"	"50-59 years"	"50-59"	""This was a 58 year old female who received her 1st dose Pfizer on 4/6/21 (Lot# EW0175) and 2nd dose Pfizer on 4/27/21 (Lot# EW0151).  Of note, the patient was in a motor vehicle accident on 4/12/21 with a diagnosis of concussion and cervical/thoracic strain/sprain (see history under patient information).  On 4/29/21, the patient's sister contacted the patient's primary care clinic with the following documented concern:  ""Pt's sister calling to report that two days ago pt got 2nd dose Pfizer vaccine and has been sick. This morning they found her passed out against the her bedroom door. Pt reports that she can't remember much other than going to the bathroom.  Pt's sister states that patient totaled her car a week ago, and that it was determined she had a concussion.  ""She hasn't been herself since the wreck and I am very concerned."" This caller recommenced the Ed or UC but caller denied stating that either needs to see her today. This writer is reaching out to nurse to see if they can advise from here."" A RN assessed the patient virtually with the following documentation:  ""RN note:  Call transferred from patient's sister.  Pt noted to be found on her floor this morning. Pt unsure if she hit her head.  Spoke to patient.  She reports body aches, and feeling weak.  Pt is slow to answer questions, and had a lot of difficulty hearing me (sister did not have any difficulty hearing me).  Pt is noted to have more rapid breathing, and some slight wheezing.  Speech is clear when she is speaking.  Sister gave patient water to drink.  She drank out of bottle and was able to hold on her own (though had difficulty with this at first).  Sister noted some water dripping down face, but was able to swallow okay.  Sister also noted that patient's lips seem to be pursed. Plan: Given recent concussion, and patients change in behavior per sister (pt more irritable, speaking more slowly, moving slowly, breathing faster, and wheezing), recommended patient be taken to the ED today--recommended ambulance since it took 2 men to help patient back to bed this morning.  Sister states patient is not agreeable to going to ED at this time.  Advised to try to encourage her to drink more fluids, and continue to monitor her sxs, and if any worsening, to call for ambulance transport.  Sister agreeable to plan, and will discuss with sister, and recommend ED visit today."" On 4/30/21, the patient's sister contacted the clinic to inform them that the patient was found dead that morning.  The medical examiner is completing the further investigation. If additional information is needed from the primary care physician for this patient.""
	"1274185-1"	"1274185-1"	"RESPIRATORY RATE INCREASED"	"10038712"	"50-59 years"	"50-59"	""This was a 58 year old female who received her 1st dose Pfizer on 4/6/21 (Lot# EW0175) and 2nd dose Pfizer on 4/27/21 (Lot# EW0151).  Of note, the patient was in a motor vehicle accident on 4/12/21 with a diagnosis of concussion and cervical/thoracic strain/sprain (see history under patient information).  On 4/29/21, the patient's sister contacted the patient's primary care clinic with the following documented concern:  ""Pt's sister calling to report that two days ago pt got 2nd dose Pfizer vaccine and has been sick. This morning they found her passed out against the her bedroom door. Pt reports that she can't remember much other than going to the bathroom.  Pt's sister states that patient totaled her car a week ago, and that it was determined she had a concussion.  ""She hasn't been herself since the wreck and I am very concerned."" This caller recommenced the Ed or UC but caller denied stating that either needs to see her today. This writer is reaching out to nurse to see if they can advise from here."" A RN assessed the patient virtually with the following documentation:  ""RN note:  Call transferred from patient's sister.  Pt noted to be found on her floor this morning. Pt unsure if she hit her head.  Spoke to patient.  She reports body aches, and feeling weak.  Pt is slow to answer questions, and had a lot of difficulty hearing me (sister did not have any difficulty hearing me).  Pt is noted to have more rapid breathing, and some slight wheezing.  Speech is clear when she is speaking.  Sister gave patient water to drink.  She drank out of bottle and was able to hold on her own (though had difficulty with this at first).  Sister noted some water dripping down face, but was able to swallow okay.  Sister also noted that patient's lips seem to be pursed. Plan: Given recent concussion, and patients change in behavior per sister (pt more irritable, speaking more slowly, moving slowly, breathing faster, and wheezing), recommended patient be taken to the ED today--recommended ambulance since it took 2 men to help patient back to bed this morning.  Sister states patient is not agreeable to going to ED at this time.  Advised to try to encourage her to drink more fluids, and continue to monitor her sxs, and if any worsening, to call for ambulance transport.  Sister agreeable to plan, and will discuss with sister, and recommend ED visit today."" On 4/30/21, the patient's sister contacted the clinic to inform them that the patient was found dead that morning.  The medical examiner is completing the further investigation. If additional information is needed from the primary care physician for this patient.""
	"1274185-1"	"1274185-1"	"SKIN ABRASION"	"10064990"	"50-59 years"	"50-59"	""This was a 58 year old female who received her 1st dose Pfizer on 4/6/21 (Lot# EW0175) and 2nd dose Pfizer on 4/27/21 (Lot# EW0151).  Of note, the patient was in a motor vehicle accident on 4/12/21 with a diagnosis of concussion and cervical/thoracic strain/sprain (see history under patient information).  On 4/29/21, the patient's sister contacted the patient's primary care clinic with the following documented concern:  ""Pt's sister calling to report that two days ago pt got 2nd dose Pfizer vaccine and has been sick. This morning they found her passed out against the her bedroom door. Pt reports that she can't remember much other than going to the bathroom.  Pt's sister states that patient totaled her car a week ago, and that it was determined she had a concussion.  ""She hasn't been herself since the wreck and I am very concerned."" This caller recommenced the Ed or UC but caller denied stating that either needs to see her today. This writer is reaching out to nurse to see if they can advise from here."" A RN assessed the patient virtually with the following documentation:  ""RN note:  Call transferred from patient's sister.  Pt noted to be found on her floor this morning. Pt unsure if she hit her head.  Spoke to patient.  She reports body aches, and feeling weak.  Pt is slow to answer questions, and had a lot of difficulty hearing me (sister did not have any difficulty hearing me).  Pt is noted to have more rapid breathing, and some slight wheezing.  Speech is clear when she is speaking.  Sister gave patient water to drink.  She drank out of bottle and was able to hold on her own (though had difficulty with this at first).  Sister noted some water dripping down face, but was able to swallow okay.  Sister also noted that patient's lips seem to be pursed. Plan: Given recent concussion, and patients change in behavior per sister (pt more irritable, speaking more slowly, moving slowly, breathing faster, and wheezing), recommended patient be taken to the ED today--recommended ambulance since it took 2 men to help patient back to bed this morning.  Sister states patient is not agreeable to going to ED at this time.  Advised to try to encourage her to drink more fluids, and continue to monitor her sxs, and if any worsening, to call for ambulance transport.  Sister agreeable to plan, and will discuss with sister, and recommend ED visit today."" On 4/30/21, the patient's sister contacted the clinic to inform them that the patient was found dead that morning.  The medical examiner is completing the further investigation. If additional information is needed from the primary care physician for this patient.""
	"1274185-1"	"1274185-1"	"SLOW RESPONSE TO STIMULI"	"10041045"	"50-59 years"	"50-59"	""This was a 58 year old female who received her 1st dose Pfizer on 4/6/21 (Lot# EW0175) and 2nd dose Pfizer on 4/27/21 (Lot# EW0151).  Of note, the patient was in a motor vehicle accident on 4/12/21 with a diagnosis of concussion and cervical/thoracic strain/sprain (see history under patient information).  On 4/29/21, the patient's sister contacted the patient's primary care clinic with the following documented concern:  ""Pt's sister calling to report that two days ago pt got 2nd dose Pfizer vaccine and has been sick. This morning they found her passed out against the her bedroom door. Pt reports that she can't remember much other than going to the bathroom.  Pt's sister states that patient totaled her car a week ago, and that it was determined she had a concussion.  ""She hasn't been herself since the wreck and I am very concerned."" This caller recommenced the Ed or UC but caller denied stating that either needs to see her today. This writer is reaching out to nurse to see if they can advise from here."" A RN assessed the patient virtually with the following documentation:  ""RN note:  Call transferred from patient's sister.  Pt noted to be found on her floor this morning. Pt unsure if she hit her head.  Spoke to patient.  She reports body aches, and feeling weak.  Pt is slow to answer questions, and had a lot of difficulty hearing me (sister did not have any difficulty hearing me).  Pt is noted to have more rapid breathing, and some slight wheezing.  Speech is clear when she is speaking.  Sister gave patient water to drink.  She drank out of bottle and was able to hold on her own (though had difficulty with this at first).  Sister noted some water dripping down face, but was able to swallow okay.  Sister also noted that patient's lips seem to be pursed. Plan: Given recent concussion, and patients change in behavior per sister (pt more irritable, speaking more slowly, moving slowly, breathing faster, and wheezing), recommended patient be taken to the ED today--recommended ambulance since it took 2 men to help patient back to bed this morning.  Sister states patient is not agreeable to going to ED at this time.  Advised to try to encourage her to drink more fluids, and continue to monitor her sxs, and if any worsening, to call for ambulance transport.  Sister agreeable to plan, and will discuss with sister, and recommend ED visit today."" On 4/30/21, the patient's sister contacted the clinic to inform them that the patient was found dead that morning.  The medical examiner is completing the further investigation. If additional information is needed from the primary care physician for this patient.""
	"1274185-1"	"1274185-1"	"SLOW SPEECH"	"10071299"	"50-59 years"	"50-59"	""This was a 58 year old female who received her 1st dose Pfizer on 4/6/21 (Lot# EW0175) and 2nd dose Pfizer on 4/27/21 (Lot# EW0151).  Of note, the patient was in a motor vehicle accident on 4/12/21 with a diagnosis of concussion and cervical/thoracic strain/sprain (see history under patient information).  On 4/29/21, the patient's sister contacted the patient's primary care clinic with the following documented concern:  ""Pt's sister calling to report that two days ago pt got 2nd dose Pfizer vaccine and has been sick. This morning they found her passed out against the her bedroom door. Pt reports that she can't remember much other than going to the bathroom.  Pt's sister states that patient totaled her car a week ago, and that it was determined she had a concussion.  ""She hasn't been herself since the wreck and I am very concerned."" This caller recommenced the Ed or UC but caller denied stating that either needs to see her today. This writer is reaching out to nurse to see if they can advise from here."" A RN assessed the patient virtually with the following documentation:  ""RN note:  Call transferred from patient's sister.  Pt noted to be found on her floor this morning. Pt unsure if she hit her head.  Spoke to patient.  She reports body aches, and feeling weak.  Pt is slow to answer questions, and had a lot of difficulty hearing me (sister did not have any difficulty hearing me).  Pt is noted to have more rapid breathing, and some slight wheezing.  Speech is clear when she is speaking.  Sister gave patient water to drink.  She drank out of bottle and was able to hold on her own (though had difficulty with this at first).  Sister noted some water dripping down face, but was able to swallow okay.  Sister also noted that patient's lips seem to be pursed. Plan: Given recent concussion, and patients change in behavior per sister (pt more irritable, speaking more slowly, moving slowly, breathing faster, and wheezing), recommended patient be taken to the ED today--recommended ambulance since it took 2 men to help patient back to bed this morning.  Sister states patient is not agreeable to going to ED at this time.  Advised to try to encourage her to drink more fluids, and continue to monitor her sxs, and if any worsening, to call for ambulance transport.  Sister agreeable to plan, and will discuss with sister, and recommend ED visit today."" On 4/30/21, the patient's sister contacted the clinic to inform them that the patient was found dead that morning.  The medical examiner is completing the further investigation. If additional information is needed from the primary care physician for this patient.""
	"1274185-1"	"1274185-1"	"SPINAL RETROLISTHESIS"	"10081602"	"50-59 years"	"50-59"	""This was a 58 year old female who received her 1st dose Pfizer on 4/6/21 (Lot# EW0175) and 2nd dose Pfizer on 4/27/21 (Lot# EW0151).  Of note, the patient was in a motor vehicle accident on 4/12/21 with a diagnosis of concussion and cervical/thoracic strain/sprain (see history under patient information).  On 4/29/21, the patient's sister contacted the patient's primary care clinic with the following documented concern:  ""Pt's sister calling to report that two days ago pt got 2nd dose Pfizer vaccine and has been sick. This morning they found her passed out against the her bedroom door. Pt reports that she can't remember much other than going to the bathroom.  Pt's sister states that patient totaled her car a week ago, and that it was determined she had a concussion.  ""She hasn't been herself since the wreck and I am very concerned."" This caller recommenced the Ed or UC but caller denied stating that either needs to see her today. This writer is reaching out to nurse to see if they can advise from here."" A RN assessed the patient virtually with the following documentation:  ""RN note:  Call transferred from patient's sister.  Pt noted to be found on her floor this morning. Pt unsure if she hit her head.  Spoke to patient.  She reports body aches, and feeling weak.  Pt is slow to answer questions, and had a lot of difficulty hearing me (sister did not have any difficulty hearing me).  Pt is noted to have more rapid breathing, and some slight wheezing.  Speech is clear when she is speaking.  Sister gave patient water to drink.  She drank out of bottle and was able to hold on her own (though had difficulty with this at first).  Sister noted some water dripping down face, but was able to swallow okay.  Sister also noted that patient's lips seem to be pursed. Plan: Given recent concussion, and patients change in behavior per sister (pt more irritable, speaking more slowly, moving slowly, breathing faster, and wheezing), recommended patient be taken to the ED today--recommended ambulance since it took 2 men to help patient back to bed this morning.  Sister states patient is not agreeable to going to ED at this time.  Advised to try to encourage her to drink more fluids, and continue to monitor her sxs, and if any worsening, to call for ambulance transport.  Sister agreeable to plan, and will discuss with sister, and recommend ED visit today."" On 4/30/21, the patient's sister contacted the clinic to inform them that the patient was found dead that morning.  The medical examiner is completing the further investigation. If additional information is needed from the primary care physician for this patient.""
	"1274185-1"	"1274185-1"	"TENDERNESS"	"10043224"	"50-59 years"	"50-59"	""This was a 58 year old female who received her 1st dose Pfizer on 4/6/21 (Lot# EW0175) and 2nd dose Pfizer on 4/27/21 (Lot# EW0151).  Of note, the patient was in a motor vehicle accident on 4/12/21 with a diagnosis of concussion and cervical/thoracic strain/sprain (see history under patient information).  On 4/29/21, the patient's sister contacted the patient's primary care clinic with the following documented concern:  ""Pt's sister calling to report that two days ago pt got 2nd dose Pfizer vaccine and has been sick. This morning they found her passed out against the her bedroom door. Pt reports that she can't remember much other than going to the bathroom.  Pt's sister states that patient totaled her car a week ago, and that it was determined she had a concussion.  ""She hasn't been herself since the wreck and I am very concerned."" This caller recommenced the Ed or UC but caller denied stating that either needs to see her today. This writer is reaching out to nurse to see if they can advise from here."" A RN assessed the patient virtually with the following documentation:  ""RN note:  Call transferred from patient's sister.  Pt noted to be found on her floor this morning. Pt unsure if she hit her head.  Spoke to patient.  She reports body aches, and feeling weak.  Pt is slow to answer questions, and had a lot of difficulty hearing me (sister did not have any difficulty hearing me).  Pt is noted to have more rapid breathing, and some slight wheezing.  Speech is clear when she is speaking.  Sister gave patient water to drink.  She drank out of bottle and was able to hold on her own (though had difficulty with this at first).  Sister noted some water dripping down face, but was able to swallow okay.  Sister also noted that patient's lips seem to be pursed. Plan: Given recent concussion, and patients change in behavior per sister (pt more irritable, speaking more slowly, moving slowly, breathing faster, and wheezing), recommended patient be taken to the ED today--recommended ambulance since it took 2 men to help patient back to bed this morning.  Sister states patient is not agreeable to going to ED at this time.  Advised to try to encourage her to drink more fluids, and continue to monitor her sxs, and if any worsening, to call for ambulance transport.  Sister agreeable to plan, and will discuss with sister, and recommend ED visit today."" On 4/30/21, the patient's sister contacted the clinic to inform them that the patient was found dead that morning.  The medical examiner is completing the further investigation. If additional information is needed from the primary care physician for this patient.""
	"1274185-1"	"1274185-1"	"WHEEZING"	"10047924"	"50-59 years"	"50-59"	""This was a 58 year old female who received her 1st dose Pfizer on 4/6/21 (Lot# EW0175) and 2nd dose Pfizer on 4/27/21 (Lot# EW0151).  Of note, the patient was in a motor vehicle accident on 4/12/21 with a diagnosis of concussion and cervical/thoracic strain/sprain (see history under patient information).  On 4/29/21, the patient's sister contacted the patient's primary care clinic with the following documented concern:  ""Pt's sister calling to report that two days ago pt got 2nd dose Pfizer vaccine and has been sick. This morning they found her passed out against the her bedroom door. Pt reports that she can't remember much other than going to the bathroom.  Pt's sister states that patient totaled her car a week ago, and that it was determined she had a concussion.  ""She hasn't been herself since the wreck and I am very concerned."" This caller recommenced the Ed or UC but caller denied stating that either needs to see her today. This writer is reaching out to nurse to see if they can advise from here."" A RN assessed the patient virtually with the following documentation:  ""RN note:  Call transferred from patient's sister.  Pt noted to be found on her floor this morning. Pt unsure if she hit her head.  Spoke to patient.  She reports body aches, and feeling weak.  Pt is slow to answer questions, and had a lot of difficulty hearing me (sister did not have any difficulty hearing me).  Pt is noted to have more rapid breathing, and some slight wheezing.  Speech is clear when she is speaking.  Sister gave patient water to drink.  She drank out of bottle and was able to hold on her own (though had difficulty with this at first).  Sister noted some water dripping down face, but was able to swallow okay.  Sister also noted that patient's lips seem to be pursed. Plan: Given recent concussion, and patients change in behavior per sister (pt more irritable, speaking more slowly, moving slowly, breathing faster, and wheezing), recommended patient be taken to the ED today--recommended ambulance since it took 2 men to help patient back to bed this morning.  Sister states patient is not agreeable to going to ED at this time.  Advised to try to encourage her to drink more fluids, and continue to monitor her sxs, and if any worsening, to call for ambulance transport.  Sister agreeable to plan, and will discuss with sister, and recommend ED visit today."" On 4/30/21, the patient's sister contacted the clinic to inform them that the patient was found dead that morning.  The medical examiner is completing the further investigation. If additional information is needed from the primary care physician for this patient.""
	"1280622-1"	"1280622-1"	"CHEST PAIN"	"10008479"	"50-59 years"	"50-59"	"On 4/13 Patient underwent aortic root replacement with saphenous vein graft reconstruction of the right coronary artery. He had no prior coronary disease. This operation was done for an enlarging aortic root aneurysm in the setting of Marfan syndrome. The right coronary was anomalous and needed vein extension for reimplantation. He recovered very well and was seen in our clinic on 4/23, with no unusual findings. He had a normal echo, EKG and DVT study performed.   On 4/28 he had his first Moderna COVID19 dose. on 5/1, he developed malaise, myalgias, painful lymph nodes, chills, and chest pain. He called my clinic and was instructed to go to the ER, but then felt better and didn't go. He was then found unresponsive later that afternoon and was pronounced dead on arrival of EMS."
	"1280622-1"	"1280622-1"	"CHILLS"	"10008531"	"50-59 years"	"50-59"	"On 4/13 Patient underwent aortic root replacement with saphenous vein graft reconstruction of the right coronary artery. He had no prior coronary disease. This operation was done for an enlarging aortic root aneurysm in the setting of Marfan syndrome. The right coronary was anomalous and needed vein extension for reimplantation. He recovered very well and was seen in our clinic on 4/23, with no unusual findings. He had a normal echo, EKG and DVT study performed.   On 4/28 he had his first Moderna COVID19 dose. on 5/1, he developed malaise, myalgias, painful lymph nodes, chills, and chest pain. He called my clinic and was instructed to go to the ER, but then felt better and didn't go. He was then found unresponsive later that afternoon and was pronounced dead on arrival of EMS."
	"1280622-1"	"1280622-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"On 4/13 Patient underwent aortic root replacement with saphenous vein graft reconstruction of the right coronary artery. He had no prior coronary disease. This operation was done for an enlarging aortic root aneurysm in the setting of Marfan syndrome. The right coronary was anomalous and needed vein extension for reimplantation. He recovered very well and was seen in our clinic on 4/23, with no unusual findings. He had a normal echo, EKG and DVT study performed.   On 4/28 he had his first Moderna COVID19 dose. on 5/1, he developed malaise, myalgias, painful lymph nodes, chills, and chest pain. He called my clinic and was instructed to go to the ER, but then felt better and didn't go. He was then found unresponsive later that afternoon and was pronounced dead on arrival of EMS."
	"1280622-1"	"1280622-1"	"LYMPH NODE PAIN"	"10025182"	"50-59 years"	"50-59"	"On 4/13 Patient underwent aortic root replacement with saphenous vein graft reconstruction of the right coronary artery. He had no prior coronary disease. This operation was done for an enlarging aortic root aneurysm in the setting of Marfan syndrome. The right coronary was anomalous and needed vein extension for reimplantation. He recovered very well and was seen in our clinic on 4/23, with no unusual findings. He had a normal echo, EKG and DVT study performed.   On 4/28 he had his first Moderna COVID19 dose. on 5/1, he developed malaise, myalgias, painful lymph nodes, chills, and chest pain. He called my clinic and was instructed to go to the ER, but then felt better and didn't go. He was then found unresponsive later that afternoon and was pronounced dead on arrival of EMS."
	"1280622-1"	"1280622-1"	"MALAISE"	"10025482"	"50-59 years"	"50-59"	"On 4/13 Patient underwent aortic root replacement with saphenous vein graft reconstruction of the right coronary artery. He had no prior coronary disease. This operation was done for an enlarging aortic root aneurysm in the setting of Marfan syndrome. The right coronary was anomalous and needed vein extension for reimplantation. He recovered very well and was seen in our clinic on 4/23, with no unusual findings. He had a normal echo, EKG and DVT study performed.   On 4/28 he had his first Moderna COVID19 dose. on 5/1, he developed malaise, myalgias, painful lymph nodes, chills, and chest pain. He called my clinic and was instructed to go to the ER, but then felt better and didn't go. He was then found unresponsive later that afternoon and was pronounced dead on arrival of EMS."
	"1280622-1"	"1280622-1"	"MYALGIA"	"10028411"	"50-59 years"	"50-59"	"On 4/13 Patient underwent aortic root replacement with saphenous vein graft reconstruction of the right coronary artery. He had no prior coronary disease. This operation was done for an enlarging aortic root aneurysm in the setting of Marfan syndrome. The right coronary was anomalous and needed vein extension for reimplantation. He recovered very well and was seen in our clinic on 4/23, with no unusual findings. He had a normal echo, EKG and DVT study performed.   On 4/28 he had his first Moderna COVID19 dose. on 5/1, he developed malaise, myalgias, painful lymph nodes, chills, and chest pain. He called my clinic and was instructed to go to the ER, but then felt better and didn't go. He was then found unresponsive later that afternoon and was pronounced dead on arrival of EMS."
	"1280622-1"	"1280622-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"50-59 years"	"50-59"	"On 4/13 Patient underwent aortic root replacement with saphenous vein graft reconstruction of the right coronary artery. He had no prior coronary disease. This operation was done for an enlarging aortic root aneurysm in the setting of Marfan syndrome. The right coronary was anomalous and needed vein extension for reimplantation. He recovered very well and was seen in our clinic on 4/23, with no unusual findings. He had a normal echo, EKG and DVT study performed.   On 4/28 he had his first Moderna COVID19 dose. on 5/1, he developed malaise, myalgias, painful lymph nodes, chills, and chest pain. He called my clinic and was instructed to go to the ER, but then felt better and didn't go. He was then found unresponsive later that afternoon and was pronounced dead on arrival of EMS."
	"1280718-1"	"1280718-1"	"BLOOD GLUCOSE INCREASED"	"10005557"	"50-59 years"	"50-59"	"Because patient had a severe adverse reaction to the first injection, he stated to me that he would not be getting the second injection.  Two workers (from the mental health day program, he went to before the covid lockdown) both advised him to get the second injection, however, and he complied.  After injection he had episodes of difficulty breathing and vomiting for several nights.  Soon after that, he started having to go to the emergency room for blood sugars over 500 (prior to injection his diabetes had been controllable at care home). When he went to ER (for high blood sugar) March 18th, his heart stopped and could not be re-started.  He died."
	"1280718-1"	"1280718-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"Because patient had a severe adverse reaction to the first injection, he stated to me that he would not be getting the second injection.  Two workers (from the mental health day program, he went to before the covid lockdown) both advised him to get the second injection, however, and he complied.  After injection he had episodes of difficulty breathing and vomiting for several nights.  Soon after that, he started having to go to the emergency room for blood sugars over 500 (prior to injection his diabetes had been controllable at care home). When he went to ER (for high blood sugar) March 18th, his heart stopped and could not be re-started.  He died."
	"1280718-1"	"1280718-1"	"CONDITION AGGRAVATED"	"10010264"	"50-59 years"	"50-59"	"Because patient had a severe adverse reaction to the first injection, he stated to me that he would not be getting the second injection.  Two workers (from the mental health day program, he went to before the covid lockdown) both advised him to get the second injection, however, and he complied.  After injection he had episodes of difficulty breathing and vomiting for several nights.  Soon after that, he started having to go to the emergency room for blood sugars over 500 (prior to injection his diabetes had been controllable at care home). When he went to ER (for high blood sugar) March 18th, his heart stopped and could not be re-started.  He died."
	"1280718-1"	"1280718-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Because patient had a severe adverse reaction to the first injection, he stated to me that he would not be getting the second injection.  Two workers (from the mental health day program, he went to before the covid lockdown) both advised him to get the second injection, however, and he complied.  After injection he had episodes of difficulty breathing and vomiting for several nights.  Soon after that, he started having to go to the emergency room for blood sugars over 500 (prior to injection his diabetes had been controllable at care home). When he went to ER (for high blood sugar) March 18th, his heart stopped and could not be re-started.  He died."
	"1280718-1"	"1280718-1"	"DIABETES MELLITUS"	"10012601"	"50-59 years"	"50-59"	"Because patient had a severe adverse reaction to the first injection, he stated to me that he would not be getting the second injection.  Two workers (from the mental health day program, he went to before the covid lockdown) both advised him to get the second injection, however, and he complied.  After injection he had episodes of difficulty breathing and vomiting for several nights.  Soon after that, he started having to go to the emergency room for blood sugars over 500 (prior to injection his diabetes had been controllable at care home). When he went to ER (for high blood sugar) March 18th, his heart stopped and could not be re-started.  He died."
	"1280718-1"	"1280718-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"Because patient had a severe adverse reaction to the first injection, he stated to me that he would not be getting the second injection.  Two workers (from the mental health day program, he went to before the covid lockdown) both advised him to get the second injection, however, and he complied.  After injection he had episodes of difficulty breathing and vomiting for several nights.  Soon after that, he started having to go to the emergency room for blood sugars over 500 (prior to injection his diabetes had been controllable at care home). When he went to ER (for high blood sugar) March 18th, his heart stopped and could not be re-started.  He died."
	"1280718-1"	"1280718-1"	"INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION"	"10081572"	"50-59 years"	"50-59"	"Because patient had a severe adverse reaction to the first injection, he stated to me that he would not be getting the second injection.  Two workers (from the mental health day program, he went to before the covid lockdown) both advised him to get the second injection, however, and he complied.  After injection he had episodes of difficulty breathing and vomiting for several nights.  Soon after that, he started having to go to the emergency room for blood sugars over 500 (prior to injection his diabetes had been controllable at care home). When he went to ER (for high blood sugar) March 18th, his heart stopped and could not be re-started.  He died."
	"1280718-1"	"1280718-1"	"VOMITING"	"10047700"	"50-59 years"	"50-59"	"Because patient had a severe adverse reaction to the first injection, he stated to me that he would not be getting the second injection.  Two workers (from the mental health day program, he went to before the covid lockdown) both advised him to get the second injection, however, and he complied.  After injection he had episodes of difficulty breathing and vomiting for several nights.  Soon after that, he started having to go to the emergency room for blood sugars over 500 (prior to injection his diabetes had been controllable at care home). When he went to ER (for high blood sugar) March 18th, his heart stopped and could not be re-started.  He died."
	"1281824-1"	"1281824-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"Pt. in cardiac arrest on 04/13/2021.  Pt.  was pronounced dead at  Hospital on 04/13/2021."
	"1281824-1"	"1281824-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Pt. in cardiac arrest on 04/13/2021.  Pt.  was pronounced dead at  Hospital on 04/13/2021."
	"1285361-1"	"1285361-1"	"CARDIAC FAILURE"	"10007554"	"50-59 years"	"50-59"	"I am unsure if this illness was related to his recent vaccination. However, after seeing reading this article about possible link between covid vaccination and the development of myocarditis, I felt compelled to report:  https://www.reuters.com/world/middle-east/israel-examining-heart-inflammation-cases-people-who-received-pfizer-covid-shot-2021-04-25/.  The patient in question is a 53 year old man with a history of previous carotid artery dissection and hyperlipidemia transferred to our hospital from an outside facility for presumed myocarditis. He rapidly decompensated, required intubation, multiple vasopressors, was initiated and ultimately expired."
	"1285361-1"	"1285361-1"	"COXSACKIE VIRUS TEST"	"10070394"	"50-59 years"	"50-59"	"I am unsure if this illness was related to his recent vaccination. However, after seeing reading this article about possible link between covid vaccination and the development of myocarditis, I felt compelled to report:  https://www.reuters.com/world/middle-east/israel-examining-heart-inflammation-cases-people-who-received-pfizer-covid-shot-2021-04-25/.  The patient in question is a 53 year old man with a history of previous carotid artery dissection and hyperlipidemia transferred to our hospital from an outside facility for presumed myocarditis. He rapidly decompensated, required intubation, multiple vasopressors, was initiated and ultimately expired."
	"1285361-1"	"1285361-1"	"COXSACKIE VIRUS TEST NEGATIVE"	"10070393"	"50-59 years"	"50-59"	"I am unsure if this illness was related to his recent vaccination. However, after seeing reading this article about possible link between covid vaccination and the development of myocarditis, I felt compelled to report:  https://www.reuters.com/world/middle-east/israel-examining-heart-inflammation-cases-people-who-received-pfizer-covid-shot-2021-04-25/.  The patient in question is a 53 year old man with a history of previous carotid artery dissection and hyperlipidemia transferred to our hospital from an outside facility for presumed myocarditis. He rapidly decompensated, required intubation, multiple vasopressors, was initiated and ultimately expired."
	"1285361-1"	"1285361-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"I am unsure if this illness was related to his recent vaccination. However, after seeing reading this article about possible link between covid vaccination and the development of myocarditis, I felt compelled to report:  https://www.reuters.com/world/middle-east/israel-examining-heart-inflammation-cases-people-who-received-pfizer-covid-shot-2021-04-25/.  The patient in question is a 53 year old man with a history of previous carotid artery dissection and hyperlipidemia transferred to our hospital from an outside facility for presumed myocarditis. He rapidly decompensated, required intubation, multiple vasopressors, was initiated and ultimately expired."
	"1285361-1"	"1285361-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"50-59 years"	"50-59"	"I am unsure if this illness was related to his recent vaccination. However, after seeing reading this article about possible link between covid vaccination and the development of myocarditis, I felt compelled to report:  https://www.reuters.com/world/middle-east/israel-examining-heart-inflammation-cases-people-who-received-pfizer-covid-shot-2021-04-25/.  The patient in question is a 53 year old man with a history of previous carotid artery dissection and hyperlipidemia transferred to our hospital from an outside facility for presumed myocarditis. He rapidly decompensated, required intubation, multiple vasopressors, was initiated and ultimately expired."
	"1285361-1"	"1285361-1"	"INFLUENZA VIRUS TEST NEGATIVE"	"10070718"	"50-59 years"	"50-59"	"I am unsure if this illness was related to his recent vaccination. However, after seeing reading this article about possible link between covid vaccination and the development of myocarditis, I felt compelled to report:  https://www.reuters.com/world/middle-east/israel-examining-heart-inflammation-cases-people-who-received-pfizer-covid-shot-2021-04-25/.  The patient in question is a 53 year old man with a history of previous carotid artery dissection and hyperlipidemia transferred to our hospital from an outside facility for presumed myocarditis. He rapidly decompensated, required intubation, multiple vasopressors, was initiated and ultimately expired."
	"1285361-1"	"1285361-1"	"LUNG ASSIST DEVICE THERAPY"	"10082527"	"50-59 years"	"50-59"	"I am unsure if this illness was related to his recent vaccination. However, after seeing reading this article about possible link between covid vaccination and the development of myocarditis, I felt compelled to report:  https://www.reuters.com/world/middle-east/israel-examining-heart-inflammation-cases-people-who-received-pfizer-covid-shot-2021-04-25/.  The patient in question is a 53 year old man with a history of previous carotid artery dissection and hyperlipidemia transferred to our hospital from an outside facility for presumed myocarditis. He rapidly decompensated, required intubation, multiple vasopressors, was initiated and ultimately expired."
	"1285361-1"	"1285361-1"	"MYOCARDITIS"	"10028606"	"50-59 years"	"50-59"	"I am unsure if this illness was related to his recent vaccination. However, after seeing reading this article about possible link between covid vaccination and the development of myocarditis, I felt compelled to report:  https://www.reuters.com/world/middle-east/israel-examining-heart-inflammation-cases-people-who-received-pfizer-covid-shot-2021-04-25/.  The patient in question is a 53 year old man with a history of previous carotid artery dissection and hyperlipidemia transferred to our hospital from an outside facility for presumed myocarditis. He rapidly decompensated, required intubation, multiple vasopressors, was initiated and ultimately expired."
	"1285361-1"	"1285361-1"	"SARS-COV-2 TEST NEGATIVE"	"10084273"	"50-59 years"	"50-59"	"I am unsure if this illness was related to his recent vaccination. However, after seeing reading this article about possible link between covid vaccination and the development of myocarditis, I felt compelled to report:  https://www.reuters.com/world/middle-east/israel-examining-heart-inflammation-cases-people-who-received-pfizer-covid-shot-2021-04-25/.  The patient in question is a 53 year old man with a history of previous carotid artery dissection and hyperlipidemia transferred to our hospital from an outside facility for presumed myocarditis. He rapidly decompensated, required intubation, multiple vasopressors, was initiated and ultimately expired."
	"1286074-1"	"1286074-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"We were notified by company on 4/28/21 that patient had died between the afternoon of 4/23 and Saturday morning 4/24/21. No other information was given to us."
	"1286760-1"	"1286760-1"	"ALANINE AMINOTRANSFERASE"	"10001546"	"50-59 years"	"50-59"	"fever, shortness of breath, respiratory distress, pneumonia, liver failure, death."
	"1286760-1"	"1286760-1"	"ASPARTATE AMINOTRANSFERASE"	"10003476"	"50-59 years"	"50-59"	"fever, shortness of breath, respiratory distress, pneumonia, liver failure, death."
	"1286760-1"	"1286760-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"fever, shortness of breath, respiratory distress, pneumonia, liver failure, death."
	"1286760-1"	"1286760-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"fever, shortness of breath, respiratory distress, pneumonia, liver failure, death."
	"1286760-1"	"1286760-1"	"FULL BLOOD COUNT"	"10017411"	"50-59 years"	"50-59"	"fever, shortness of breath, respiratory distress, pneumonia, liver failure, death."
	"1286760-1"	"1286760-1"	"HEPATIC FAILURE"	"10019663"	"50-59 years"	"50-59"	"fever, shortness of breath, respiratory distress, pneumonia, liver failure, death."
	"1286760-1"	"1286760-1"	"HIV TEST"	"10020185"	"50-59 years"	"50-59"	"fever, shortness of breath, respiratory distress, pneumonia, liver failure, death."
	"1286760-1"	"1286760-1"	"LIVER FUNCTION TEST"	"10060105"	"50-59 years"	"50-59"	"fever, shortness of breath, respiratory distress, pneumonia, liver failure, death."
	"1286760-1"	"1286760-1"	"METABOLIC FUNCTION TEST"	"10062191"	"50-59 years"	"50-59"	"fever, shortness of breath, respiratory distress, pneumonia, liver failure, death."
	"1286760-1"	"1286760-1"	"PNEUMONIA"	"10035664"	"50-59 years"	"50-59"	"fever, shortness of breath, respiratory distress, pneumonia, liver failure, death."
	"1286760-1"	"1286760-1"	"PYREXIA"	"10037660"	"50-59 years"	"50-59"	"fever, shortness of breath, respiratory distress, pneumonia, liver failure, death."
	"1286760-1"	"1286760-1"	"RESPIRATORY DISTRESS"	"10038687"	"50-59 years"	"50-59"	"fever, shortness of breath, respiratory distress, pneumonia, liver failure, death."
	"1286795-1"	"1286795-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	""Patient reported feeling ""shaky"" day of 2nd vaccine dose.   Patients family reports that patient wasn't feeling well the night of and called EMS to her home.  Patient passed away this morning around 5am.""
	"1286795-1"	"1286795-1"	"MALAISE"	"10025482"	"50-59 years"	"50-59"	""Patient reported feeling ""shaky"" day of 2nd vaccine dose.   Patients family reports that patient wasn't feeling well the night of and called EMS to her home.  Patient passed away this morning around 5am.""
	"1286795-1"	"1286795-1"	"TREMOR"	"10044565"	"50-59 years"	"50-59"	""Patient reported feeling ""shaky"" day of 2nd vaccine dose.   Patients family reports that patient wasn't feeling well the night of and called EMS to her home.  Patient passed away this morning around 5am.""
	"1289604-1"	"1289604-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient was found deceased in her home the next morning after getting  her vaccine the day before"
	"1290096-1"	"1290096-1"	"ACIDOSIS"	"10000486"	"50-59 years"	"50-59"	"4/20/21: patient arrived to ER per EMS status post PEA arrest. Per ER records, patient became unresponsive while sitting in bed witnessed by husband at home. According to husband, they had come home, she sat on the bed and complained she was not feeling good. She then fell back on the bed and began to seize. Subsequently she had intermittent episodes of alertness and was able to speak to the husband followed by unresponsiveness. At time of EMS arrival pt. was unresponsive. EMS noted BS 120s, SBP 50s. En route to hospital, pt. had a CP arrest for which epinephrine was given, CPR initiated with ROSC. Pt. arrived to the ER on a NRB mask attempting to speak. Subsequently, pt. had several CP arrests with asystole, and"
	"1290096-1"	"1290096-1"	"ACTIVATED PARTIAL THROMBOPLASTIN TIME PROLONGED"	"10000636"	"50-59 years"	"50-59"	"4/20/21: patient arrived to ER per EMS status post PEA arrest. Per ER records, patient became unresponsive while sitting in bed witnessed by husband at home. According to husband, they had come home, she sat on the bed and complained she was not feeling good. She then fell back on the bed and began to seize. Subsequently she had intermittent episodes of alertness and was able to speak to the husband followed by unresponsiveness. At time of EMS arrival pt. was unresponsive. EMS noted BS 120s, SBP 50s. En route to hospital, pt. had a CP arrest for which epinephrine was given, CPR initiated with ROSC. Pt. arrived to the ER on a NRB mask attempting to speak. Subsequently, pt. had several CP arrests with asystole, and"
	"1290096-1"	"1290096-1"	"ACUTE KIDNEY INJURY"	"10069339"	"50-59 years"	"50-59"	"4/20/21: patient arrived to ER per EMS status post PEA arrest. Per ER records, patient became unresponsive while sitting in bed witnessed by husband at home. According to husband, they had come home, she sat on the bed and complained she was not feeling good. She then fell back on the bed and began to seize. Subsequently she had intermittent episodes of alertness and was able to speak to the husband followed by unresponsiveness. At time of EMS arrival pt. was unresponsive. EMS noted BS 120s, SBP 50s. En route to hospital, pt. had a CP arrest for which epinephrine was given, CPR initiated with ROSC. Pt. arrived to the ER on a NRB mask attempting to speak. Subsequently, pt. had several CP arrests with asystole, and"
	"1290096-1"	"1290096-1"	"ALANINE AMINOTRANSFERASE INCREASED"	"10001551"	"50-59 years"	"50-59"	"4/20/21: patient arrived to ER per EMS status post PEA arrest. Per ER records, patient became unresponsive while sitting in bed witnessed by husband at home. According to husband, they had come home, she sat on the bed and complained she was not feeling good. She then fell back on the bed and began to seize. Subsequently she had intermittent episodes of alertness and was able to speak to the husband followed by unresponsiveness. At time of EMS arrival pt. was unresponsive. EMS noted BS 120s, SBP 50s. En route to hospital, pt. had a CP arrest for which epinephrine was given, CPR initiated with ROSC. Pt. arrived to the ER on a NRB mask attempting to speak. Subsequently, pt. had several CP arrests with asystole, and"
	"1290096-1"	"1290096-1"	"ANGIOGRAM PULMONARY ABNORMAL"	"10002441"	"50-59 years"	"50-59"	"4/20/21: patient arrived to ER per EMS status post PEA arrest. Per ER records, patient became unresponsive while sitting in bed witnessed by husband at home. According to husband, they had come home, she sat on the bed and complained she was not feeling good. She then fell back on the bed and began to seize. Subsequently she had intermittent episodes of alertness and was able to speak to the husband followed by unresponsiveness. At time of EMS arrival pt. was unresponsive. EMS noted BS 120s, SBP 50s. En route to hospital, pt. had a CP arrest for which epinephrine was given, CPR initiated with ROSC. Pt. arrived to the ER on a NRB mask attempting to speak. Subsequently, pt. had several CP arrests with asystole, and"
	"1290096-1"	"1290096-1"	"ASCITES"	"10003445"	"50-59 years"	"50-59"	"4/20/21: patient arrived to ER per EMS status post PEA arrest. Per ER records, patient became unresponsive while sitting in bed witnessed by husband at home. According to husband, they had come home, she sat on the bed and complained she was not feeling good. She then fell back on the bed and began to seize. Subsequently she had intermittent episodes of alertness and was able to speak to the husband followed by unresponsiveness. At time of EMS arrival pt. was unresponsive. EMS noted BS 120s, SBP 50s. En route to hospital, pt. had a CP arrest for which epinephrine was given, CPR initiated with ROSC. Pt. arrived to the ER on a NRB mask attempting to speak. Subsequently, pt. had several CP arrests with asystole, and"
	"1290096-1"	"1290096-1"	"ASPARTATE AMINOTRANSFERASE INCREASED"	"10003481"	"50-59 years"	"50-59"	"4/20/21: patient arrived to ER per EMS status post PEA arrest. Per ER records, patient became unresponsive while sitting in bed witnessed by husband at home. According to husband, they had come home, she sat on the bed and complained she was not feeling good. She then fell back on the bed and began to seize. Subsequently she had intermittent episodes of alertness and was able to speak to the husband followed by unresponsiveness. At time of EMS arrival pt. was unresponsive. EMS noted BS 120s, SBP 50s. En route to hospital, pt. had a CP arrest for which epinephrine was given, CPR initiated with ROSC. Pt. arrived to the ER on a NRB mask attempting to speak. Subsequently, pt. had several CP arrests with asystole, and"
	"1290096-1"	"1290096-1"	"BLOOD ALBUMIN DECREASED"	"10005287"	"50-59 years"	"50-59"	"4/20/21: patient arrived to ER per EMS status post PEA arrest. Per ER records, patient became unresponsive while sitting in bed witnessed by husband at home. According to husband, they had come home, she sat on the bed and complained she was not feeling good. She then fell back on the bed and began to seize. Subsequently she had intermittent episodes of alertness and was able to speak to the husband followed by unresponsiveness. At time of EMS arrival pt. was unresponsive. EMS noted BS 120s, SBP 50s. En route to hospital, pt. had a CP arrest for which epinephrine was given, CPR initiated with ROSC. Pt. arrived to the ER on a NRB mask attempting to speak. Subsequently, pt. had several CP arrests with asystole, and"
	"1290096-1"	"1290096-1"	"BLOOD ALKALINE PHOSPHATASE NORMAL"	"10005310"	"50-59 years"	"50-59"	"4/20/21: patient arrived to ER per EMS status post PEA arrest. Per ER records, patient became unresponsive while sitting in bed witnessed by husband at home. According to husband, they had come home, she sat on the bed and complained she was not feeling good. She then fell back on the bed and began to seize. Subsequently she had intermittent episodes of alertness and was able to speak to the husband followed by unresponsiveness. At time of EMS arrival pt. was unresponsive. EMS noted BS 120s, SBP 50s. En route to hospital, pt. had a CP arrest for which epinephrine was given, CPR initiated with ROSC. Pt. arrived to the ER on a NRB mask attempting to speak. Subsequently, pt. had several CP arrests with asystole, and"
	"1290096-1"	"1290096-1"	"BLOOD CALCIUM DECREASED"	"10005395"	"50-59 years"	"50-59"	"4/20/21: patient arrived to ER per EMS status post PEA arrest. Per ER records, patient became unresponsive while sitting in bed witnessed by husband at home. According to husband, they had come home, she sat on the bed and complained she was not feeling good. She then fell back on the bed and began to seize. Subsequently she had intermittent episodes of alertness and was able to speak to the husband followed by unresponsiveness. At time of EMS arrival pt. was unresponsive. EMS noted BS 120s, SBP 50s. En route to hospital, pt. had a CP arrest for which epinephrine was given, CPR initiated with ROSC. Pt. arrived to the ER on a NRB mask attempting to speak. Subsequently, pt. had several CP arrests with asystole, and"
	"1290096-1"	"1290096-1"	"BLOOD CHLORIDE INCREASED"	"10005420"	"50-59 years"	"50-59"	"4/20/21: patient arrived to ER per EMS status post PEA arrest. Per ER records, patient became unresponsive while sitting in bed witnessed by husband at home. According to husband, they had come home, she sat on the bed and complained she was not feeling good. She then fell back on the bed and began to seize. Subsequently she had intermittent episodes of alertness and was able to speak to the husband followed by unresponsiveness. At time of EMS arrival pt. was unresponsive. EMS noted BS 120s, SBP 50s. En route to hospital, pt. had a CP arrest for which epinephrine was given, CPR initiated with ROSC. Pt. arrived to the ER on a NRB mask attempting to speak. Subsequently, pt. had several CP arrests with asystole, and"
	"1290096-1"	"1290096-1"	"BLOOD GASES ABNORMAL"	"10005539"	"50-59 years"	"50-59"	"4/20/21: patient arrived to ER per EMS status post PEA arrest. Per ER records, patient became unresponsive while sitting in bed witnessed by husband at home. According to husband, they had come home, she sat on the bed and complained she was not feeling good. She then fell back on the bed and began to seize. Subsequently she had intermittent episodes of alertness and was able to speak to the husband followed by unresponsiveness. At time of EMS arrival pt. was unresponsive. EMS noted BS 120s, SBP 50s. En route to hospital, pt. had a CP arrest for which epinephrine was given, CPR initiated with ROSC. Pt. arrived to the ER on a NRB mask attempting to speak. Subsequently, pt. had several CP arrests with asystole, and"
	"1290096-1"	"1290096-1"	"BLOOD GLUCOSE INCREASED"	"10005557"	"50-59 years"	"50-59"	"4/20/21: patient arrived to ER per EMS status post PEA arrest. Per ER records, patient became unresponsive while sitting in bed witnessed by husband at home. According to husband, they had come home, she sat on the bed and complained she was not feeling good. She then fell back on the bed and began to seize. Subsequently she had intermittent episodes of alertness and was able to speak to the husband followed by unresponsiveness. At time of EMS arrival pt. was unresponsive. EMS noted BS 120s, SBP 50s. En route to hospital, pt. had a CP arrest for which epinephrine was given, CPR initiated with ROSC. Pt. arrived to the ER on a NRB mask attempting to speak. Subsequently, pt. had several CP arrests with asystole, and"
	"1290096-1"	"1290096-1"	"BLOOD LACTIC ACID INCREASED"	"10005635"	"50-59 years"	"50-59"	"4/20/21: patient arrived to ER per EMS status post PEA arrest. Per ER records, patient became unresponsive while sitting in bed witnessed by husband at home. According to husband, they had come home, she sat on the bed and complained she was not feeling good. She then fell back on the bed and began to seize. Subsequently she had intermittent episodes of alertness and was able to speak to the husband followed by unresponsiveness. At time of EMS arrival pt. was unresponsive. EMS noted BS 120s, SBP 50s. En route to hospital, pt. had a CP arrest for which epinephrine was given, CPR initiated with ROSC. Pt. arrived to the ER on a NRB mask attempting to speak. Subsequently, pt. had several CP arrests with asystole, and"
	"1290096-1"	"1290096-1"	"BLOOD POTASSIUM DECREASED"	"10005724"	"50-59 years"	"50-59"	"4/20/21: patient arrived to ER per EMS status post PEA arrest. Per ER records, patient became unresponsive while sitting in bed witnessed by husband at home. According to husband, they had come home, she sat on the bed and complained she was not feeling good. She then fell back on the bed and began to seize. Subsequently she had intermittent episodes of alertness and was able to speak to the husband followed by unresponsiveness. At time of EMS arrival pt. was unresponsive. EMS noted BS 120s, SBP 50s. En route to hospital, pt. had a CP arrest for which epinephrine was given, CPR initiated with ROSC. Pt. arrived to the ER on a NRB mask attempting to speak. Subsequently, pt. had several CP arrests with asystole, and"
	"1290096-1"	"1290096-1"	"BLOOD SODIUM INCREASED"	"10005803"	"50-59 years"	"50-59"	"4/20/21: patient arrived to ER per EMS status post PEA arrest. Per ER records, patient became unresponsive while sitting in bed witnessed by husband at home. According to husband, they had come home, she sat on the bed and complained she was not feeling good. She then fell back on the bed and began to seize. Subsequently she had intermittent episodes of alertness and was able to speak to the husband followed by unresponsiveness. At time of EMS arrival pt. was unresponsive. EMS noted BS 120s, SBP 50s. En route to hospital, pt. had a CP arrest for which epinephrine was given, CPR initiated with ROSC. Pt. arrived to the ER on a NRB mask attempting to speak. Subsequently, pt. had several CP arrests with asystole, and"
	"1290096-1"	"1290096-1"	"BRAIN INJURY"	"10067967"	"50-59 years"	"50-59"	"4/20/21: patient arrived to ER per EMS status post PEA arrest. Per ER records, patient became unresponsive while sitting in bed witnessed by husband at home. According to husband, they had come home, she sat on the bed and complained she was not feeling good. She then fell back on the bed and began to seize. Subsequently she had intermittent episodes of alertness and was able to speak to the husband followed by unresponsiveness. At time of EMS arrival pt. was unresponsive. EMS noted BS 120s, SBP 50s. En route to hospital, pt. had a CP arrest for which epinephrine was given, CPR initiated with ROSC. Pt. arrived to the ER on a NRB mask attempting to speak. Subsequently, pt. had several CP arrests with asystole, and"
	"1290096-1"	"1290096-1"	"CARBON DIOXIDE DECREASED"	"10007223"	"50-59 years"	"50-59"	"4/20/21: patient arrived to ER per EMS status post PEA arrest. Per ER records, patient became unresponsive while sitting in bed witnessed by husband at home. According to husband, they had come home, she sat on the bed and complained she was not feeling good. She then fell back on the bed and began to seize. Subsequently she had intermittent episodes of alertness and was able to speak to the husband followed by unresponsiveness. At time of EMS arrival pt. was unresponsive. EMS noted BS 120s, SBP 50s. En route to hospital, pt. had a CP arrest for which epinephrine was given, CPR initiated with ROSC. Pt. arrived to the ER on a NRB mask attempting to speak. Subsequently, pt. had several CP arrests with asystole, and"
	"1290096-1"	"1290096-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"4/20/21: patient arrived to ER per EMS status post PEA arrest. Per ER records, patient became unresponsive while sitting in bed witnessed by husband at home. According to husband, they had come home, she sat on the bed and complained she was not feeling good. She then fell back on the bed and began to seize. Subsequently she had intermittent episodes of alertness and was able to speak to the husband followed by unresponsiveness. At time of EMS arrival pt. was unresponsive. EMS noted BS 120s, SBP 50s. En route to hospital, pt. had a CP arrest for which epinephrine was given, CPR initiated with ROSC. Pt. arrived to the ER on a NRB mask attempting to speak. Subsequently, pt. had several CP arrests with asystole, and"
	"1290096-1"	"1290096-1"	"CARDIO-RESPIRATORY ARREST"	"10007617"	"50-59 years"	"50-59"	"4/20/21: patient arrived to ER per EMS status post PEA arrest. Per ER records, patient became unresponsive while sitting in bed witnessed by husband at home. According to husband, they had come home, she sat on the bed and complained she was not feeling good. She then fell back on the bed and began to seize. Subsequently she had intermittent episodes of alertness and was able to speak to the husband followed by unresponsiveness. At time of EMS arrival pt. was unresponsive. EMS noted BS 120s, SBP 50s. En route to hospital, pt. had a CP arrest for which epinephrine was given, CPR initiated with ROSC. Pt. arrived to the ER on a NRB mask attempting to speak. Subsequently, pt. had several CP arrests with asystole, and"
	"1290096-1"	"1290096-1"	"CENTRAL VENOUS CATHETERISATION"	"10053377"	"50-59 years"	"50-59"	"4/20/21: patient arrived to ER per EMS status post PEA arrest. Per ER records, patient became unresponsive while sitting in bed witnessed by husband at home. According to husband, they had come home, she sat on the bed and complained she was not feeling good. She then fell back on the bed and began to seize. Subsequently she had intermittent episodes of alertness and was able to speak to the husband followed by unresponsiveness. At time of EMS arrival pt. was unresponsive. EMS noted BS 120s, SBP 50s. En route to hospital, pt. had a CP arrest for which epinephrine was given, CPR initiated with ROSC. Pt. arrived to the ER on a NRB mask attempting to speak. Subsequently, pt. had several CP arrests with asystole, and"
	"1290096-1"	"1290096-1"	"COAGULOPATHY"	"10009802"	"50-59 years"	"50-59"	"4/20/21: patient arrived to ER per EMS status post PEA arrest. Per ER records, patient became unresponsive while sitting in bed witnessed by husband at home. According to husband, they had come home, she sat on the bed and complained she was not feeling good. She then fell back on the bed and began to seize. Subsequently she had intermittent episodes of alertness and was able to speak to the husband followed by unresponsiveness. At time of EMS arrival pt. was unresponsive. EMS noted BS 120s, SBP 50s. En route to hospital, pt. had a CP arrest for which epinephrine was given, CPR initiated with ROSC. Pt. arrived to the ER on a NRB mask attempting to speak. Subsequently, pt. had several CP arrests with asystole, and"
	"1290096-1"	"1290096-1"	"COMPUTERISED TOMOGRAM ABDOMEN"	"10053876"	"50-59 years"	"50-59"	"4/20/21: patient arrived to ER per EMS status post PEA arrest. Per ER records, patient became unresponsive while sitting in bed witnessed by husband at home. According to husband, they had come home, she sat on the bed and complained she was not feeling good. She then fell back on the bed and began to seize. Subsequently she had intermittent episodes of alertness and was able to speak to the husband followed by unresponsiveness. At time of EMS arrival pt. was unresponsive. EMS noted BS 120s, SBP 50s. En route to hospital, pt. had a CP arrest for which epinephrine was given, CPR initiated with ROSC. Pt. arrived to the ER on a NRB mask attempting to speak. Subsequently, pt. had several CP arrests with asystole, and"
	"1290096-1"	"1290096-1"	"COMPUTERISED TOMOGRAM HEAD NORMAL"	"10072167"	"50-59 years"	"50-59"	"4/20/21: patient arrived to ER per EMS status post PEA arrest. Per ER records, patient became unresponsive while sitting in bed witnessed by husband at home. According to husband, they had come home, she sat on the bed and complained she was not feeling good. She then fell back on the bed and began to seize. Subsequently she had intermittent episodes of alertness and was able to speak to the husband followed by unresponsiveness. At time of EMS arrival pt. was unresponsive. EMS noted BS 120s, SBP 50s. En route to hospital, pt. had a CP arrest for which epinephrine was given, CPR initiated with ROSC. Pt. arrived to the ER on a NRB mask attempting to speak. Subsequently, pt. had several CP arrests with asystole, and"
	"1290096-1"	"1290096-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"4/20/21: patient arrived to ER per EMS status post PEA arrest. Per ER records, patient became unresponsive while sitting in bed witnessed by husband at home. According to husband, they had come home, she sat on the bed and complained she was not feeling good. She then fell back on the bed and began to seize. Subsequently she had intermittent episodes of alertness and was able to speak to the husband followed by unresponsiveness. At time of EMS arrival pt. was unresponsive. EMS noted BS 120s, SBP 50s. En route to hospital, pt. had a CP arrest for which epinephrine was given, CPR initiated with ROSC. Pt. arrived to the ER on a NRB mask attempting to speak. Subsequently, pt. had several CP arrests with asystole, and"
	"1290096-1"	"1290096-1"	"DIALYSIS DEVICE INSERTION"	"10059015"	"50-59 years"	"50-59"	"4/20/21: patient arrived to ER per EMS status post PEA arrest. Per ER records, patient became unresponsive while sitting in bed witnessed by husband at home. According to husband, they had come home, she sat on the bed and complained she was not feeling good. She then fell back on the bed and began to seize. Subsequently she had intermittent episodes of alertness and was able to speak to the husband followed by unresponsiveness. At time of EMS arrival pt. was unresponsive. EMS noted BS 120s, SBP 50s. En route to hospital, pt. had a CP arrest for which epinephrine was given, CPR initiated with ROSC. Pt. arrived to the ER on a NRB mask attempting to speak. Subsequently, pt. had several CP arrests with asystole, and"
	"1290096-1"	"1290096-1"	"ECHOCARDIOGRAM ABNORMAL"	"10061593"	"50-59 years"	"50-59"	"4/20/21: patient arrived to ER per EMS status post PEA arrest. Per ER records, patient became unresponsive while sitting in bed witnessed by husband at home. According to husband, they had come home, she sat on the bed and complained she was not feeling good. She then fell back on the bed and began to seize. Subsequently she had intermittent episodes of alertness and was able to speak to the husband followed by unresponsiveness. At time of EMS arrival pt. was unresponsive. EMS noted BS 120s, SBP 50s. En route to hospital, pt. had a CP arrest for which epinephrine was given, CPR initiated with ROSC. Pt. arrived to the ER on a NRB mask attempting to speak. Subsequently, pt. had several CP arrests with asystole, and"
	"1290096-1"	"1290096-1"	"ELECTROENCEPHALOGRAM ABNORMAL"	"10014408"	"50-59 years"	"50-59"	"4/20/21: patient arrived to ER per EMS status post PEA arrest. Per ER records, patient became unresponsive while sitting in bed witnessed by husband at home. According to husband, they had come home, she sat on the bed and complained she was not feeling good. She then fell back on the bed and began to seize. Subsequently she had intermittent episodes of alertness and was able to speak to the husband followed by unresponsiveness. At time of EMS arrival pt. was unresponsive. EMS noted BS 120s, SBP 50s. En route to hospital, pt. had a CP arrest for which epinephrine was given, CPR initiated with ROSC. Pt. arrived to the ER on a NRB mask attempting to speak. Subsequently, pt. had several CP arrests with asystole, and"
	"1290096-1"	"1290096-1"	"ENCEPHALOPATHY"	"10014625"	"50-59 years"	"50-59"	"4/20/21: patient arrived to ER per EMS status post PEA arrest. Per ER records, patient became unresponsive while sitting in bed witnessed by husband at home. According to husband, they had come home, she sat on the bed and complained she was not feeling good. She then fell back on the bed and began to seize. Subsequently she had intermittent episodes of alertness and was able to speak to the husband followed by unresponsiveness. At time of EMS arrival pt. was unresponsive. EMS noted BS 120s, SBP 50s. En route to hospital, pt. had a CP arrest for which epinephrine was given, CPR initiated with ROSC. Pt. arrived to the ER on a NRB mask attempting to speak. Subsequently, pt. had several CP arrests with asystole, and"
	"1290096-1"	"1290096-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"50-59 years"	"50-59"	"4/20/21: patient arrived to ER per EMS status post PEA arrest. Per ER records, patient became unresponsive while sitting in bed witnessed by husband at home. According to husband, they had come home, she sat on the bed and complained she was not feeling good. She then fell back on the bed and began to seize. Subsequently she had intermittent episodes of alertness and was able to speak to the husband followed by unresponsiveness. At time of EMS arrival pt. was unresponsive. EMS noted BS 120s, SBP 50s. En route to hospital, pt. had a CP arrest for which epinephrine was given, CPR initiated with ROSC. Pt. arrived to the ER on a NRB mask attempting to speak. Subsequently, pt. had several CP arrests with asystole, and"
	"1290096-1"	"1290096-1"	"EPISTAXIS"	"10015090"	"50-59 years"	"50-59"	"4/20/21: patient arrived to ER per EMS status post PEA arrest. Per ER records, patient became unresponsive while sitting in bed witnessed by husband at home. According to husband, they had come home, she sat on the bed and complained she was not feeling good. She then fell back on the bed and began to seize. Subsequently she had intermittent episodes of alertness and was able to speak to the husband followed by unresponsiveness. At time of EMS arrival pt. was unresponsive. EMS noted BS 120s, SBP 50s. En route to hospital, pt. had a CP arrest for which epinephrine was given, CPR initiated with ROSC. Pt. arrived to the ER on a NRB mask attempting to speak. Subsequently, pt. had several CP arrests with asystole, and"
	"1290096-1"	"1290096-1"	"FEELING ABNORMAL"	"10016322"	"50-59 years"	"50-59"	"4/20/21: patient arrived to ER per EMS status post PEA arrest. Per ER records, patient became unresponsive while sitting in bed witnessed by husband at home. According to husband, they had come home, she sat on the bed and complained she was not feeling good. She then fell back on the bed and began to seize. Subsequently she had intermittent episodes of alertness and was able to speak to the husband followed by unresponsiveness. At time of EMS arrival pt. was unresponsive. EMS noted BS 120s, SBP 50s. En route to hospital, pt. had a CP arrest for which epinephrine was given, CPR initiated with ROSC. Pt. arrived to the ER on a NRB mask attempting to speak. Subsequently, pt. had several CP arrests with asystole, and"
	"1290096-1"	"1290096-1"	"FRACTION OF INSPIRED OXYGEN"	"10059883"	"50-59 years"	"50-59"	"4/20/21: patient arrived to ER per EMS status post PEA arrest. Per ER records, patient became unresponsive while sitting in bed witnessed by husband at home. According to husband, they had come home, she sat on the bed and complained she was not feeling good. She then fell back on the bed and began to seize. Subsequently she had intermittent episodes of alertness and was able to speak to the husband followed by unresponsiveness. At time of EMS arrival pt. was unresponsive. EMS noted BS 120s, SBP 50s. En route to hospital, pt. had a CP arrest for which epinephrine was given, CPR initiated with ROSC. Pt. arrived to the ER on a NRB mask attempting to speak. Subsequently, pt. had several CP arrests with asystole, and"
	"1290096-1"	"1290096-1"	"GASTROINTESTINAL HAEMORRHAGE"	"10017955"	"50-59 years"	"50-59"	"4/20/21: patient arrived to ER per EMS status post PEA arrest. Per ER records, patient became unresponsive while sitting in bed witnessed by husband at home. According to husband, they had come home, she sat on the bed and complained she was not feeling good. She then fell back on the bed and began to seize. Subsequently she had intermittent episodes of alertness and was able to speak to the husband followed by unresponsiveness. At time of EMS arrival pt. was unresponsive. EMS noted BS 120s, SBP 50s. En route to hospital, pt. had a CP arrest for which epinephrine was given, CPR initiated with ROSC. Pt. arrived to the ER on a NRB mask attempting to speak. Subsequently, pt. had several CP arrests with asystole, and"
	"1290096-1"	"1290096-1"	"GENERAL PHYSICAL HEALTH DETERIORATION"	"10049438"	"50-59 years"	"50-59"	"4/20/21: patient arrived to ER per EMS status post PEA arrest. Per ER records, patient became unresponsive while sitting in bed witnessed by husband at home. According to husband, they had come home, she sat on the bed and complained she was not feeling good. She then fell back on the bed and began to seize. Subsequently she had intermittent episodes of alertness and was able to speak to the husband followed by unresponsiveness. At time of EMS arrival pt. was unresponsive. EMS noted BS 120s, SBP 50s. En route to hospital, pt. had a CP arrest for which epinephrine was given, CPR initiated with ROSC. Pt. arrived to the ER on a NRB mask attempting to speak. Subsequently, pt. had several CP arrests with asystole, and"
	"1290096-1"	"1290096-1"	"HAEMODYNAMIC INSTABILITY"	"10052076"	"50-59 years"	"50-59"	"4/20/21: patient arrived to ER per EMS status post PEA arrest. Per ER records, patient became unresponsive while sitting in bed witnessed by husband at home. According to husband, they had come home, she sat on the bed and complained she was not feeling good. She then fell back on the bed and began to seize. Subsequently she had intermittent episodes of alertness and was able to speak to the husband followed by unresponsiveness. At time of EMS arrival pt. was unresponsive. EMS noted BS 120s, SBP 50s. En route to hospital, pt. had a CP arrest for which epinephrine was given, CPR initiated with ROSC. Pt. arrived to the ER on a NRB mask attempting to speak. Subsequently, pt. had several CP arrests with asystole, and"
	"1290096-1"	"1290096-1"	"HAEMOGLOBIN DECREASED"	"10018884"	"50-59 years"	"50-59"	"4/20/21: patient arrived to ER per EMS status post PEA arrest. Per ER records, patient became unresponsive while sitting in bed witnessed by husband at home. According to husband, they had come home, she sat on the bed and complained she was not feeling good. She then fell back on the bed and began to seize. Subsequently she had intermittent episodes of alertness and was able to speak to the husband followed by unresponsiveness. At time of EMS arrival pt. was unresponsive. EMS noted BS 120s, SBP 50s. En route to hospital, pt. had a CP arrest for which epinephrine was given, CPR initiated with ROSC. Pt. arrived to the ER on a NRB mask attempting to speak. Subsequently, pt. had several CP arrests with asystole, and"
	"1290096-1"	"1290096-1"	"HEPATIC FUNCTION ABNORMAL"	"10019670"	"50-59 years"	"50-59"	"4/20/21: patient arrived to ER per EMS status post PEA arrest. Per ER records, patient became unresponsive while sitting in bed witnessed by husband at home. According to husband, they had come home, she sat on the bed and complained she was not feeling good. She then fell back on the bed and began to seize. Subsequently she had intermittent episodes of alertness and was able to speak to the husband followed by unresponsiveness. At time of EMS arrival pt. was unresponsive. EMS noted BS 120s, SBP 50s. En route to hospital, pt. had a CP arrest for which epinephrine was given, CPR initiated with ROSC. Pt. arrived to the ER on a NRB mask attempting to speak. Subsequently, pt. had several CP arrests with asystole, and"
	"1290096-1"	"1290096-1"	"HEPATOMEGALY"	"10019842"	"50-59 years"	"50-59"	"4/20/21: patient arrived to ER per EMS status post PEA arrest. Per ER records, patient became unresponsive while sitting in bed witnessed by husband at home. According to husband, they had come home, she sat on the bed and complained she was not feeling good. She then fell back on the bed and began to seize. Subsequently she had intermittent episodes of alertness and was able to speak to the husband followed by unresponsiveness. At time of EMS arrival pt. was unresponsive. EMS noted BS 120s, SBP 50s. En route to hospital, pt. had a CP arrest for which epinephrine was given, CPR initiated with ROSC. Pt. arrived to the ER on a NRB mask attempting to speak. Subsequently, pt. had several CP arrests with asystole, and"
	"1290096-1"	"1290096-1"	"HYPOTENSION"	"10021097"	"50-59 years"	"50-59"	"4/20/21: patient arrived to ER per EMS status post PEA arrest. Per ER records, patient became unresponsive while sitting in bed witnessed by husband at home. According to husband, they had come home, she sat on the bed and complained she was not feeling good. She then fell back on the bed and began to seize. Subsequently she had intermittent episodes of alertness and was able to speak to the husband followed by unresponsiveness. At time of EMS arrival pt. was unresponsive. EMS noted BS 120s, SBP 50s. En route to hospital, pt. had a CP arrest for which epinephrine was given, CPR initiated with ROSC. Pt. arrived to the ER on a NRB mask attempting to speak. Subsequently, pt. had several CP arrests with asystole, and"
	"1290096-1"	"1290096-1"	"INTENSIVE CARE"	"10022519"	"50-59 years"	"50-59"	"4/20/21: patient arrived to ER per EMS status post PEA arrest. Per ER records, patient became unresponsive while sitting in bed witnessed by husband at home. According to husband, they had come home, she sat on the bed and complained she was not feeling good. She then fell back on the bed and began to seize. Subsequently she had intermittent episodes of alertness and was able to speak to the husband followed by unresponsiveness. At time of EMS arrival pt. was unresponsive. EMS noted BS 120s, SBP 50s. En route to hospital, pt. had a CP arrest for which epinephrine was given, CPR initiated with ROSC. Pt. arrived to the ER on a NRB mask attempting to speak. Subsequently, pt. had several CP arrests with asystole, and"
	"1290096-1"	"1290096-1"	"INTERNATIONAL NORMALISED RATIO INCREASED"	"10022595"	"50-59 years"	"50-59"	"4/20/21: patient arrived to ER per EMS status post PEA arrest. Per ER records, patient became unresponsive while sitting in bed witnessed by husband at home. According to husband, they had come home, she sat on the bed and complained she was not feeling good. She then fell back on the bed and began to seize. Subsequently she had intermittent episodes of alertness and was able to speak to the husband followed by unresponsiveness. At time of EMS arrival pt. was unresponsive. EMS noted BS 120s, SBP 50s. En route to hospital, pt. had a CP arrest for which epinephrine was given, CPR initiated with ROSC. Pt. arrived to the ER on a NRB mask attempting to speak. Subsequently, pt. had several CP arrests with asystole, and"
	"1290096-1"	"1290096-1"	"ISCHAEMIC HEPATITIS"	"10023025"	"50-59 years"	"50-59"	"4/20/21: patient arrived to ER per EMS status post PEA arrest. Per ER records, patient became unresponsive while sitting in bed witnessed by husband at home. According to husband, they had come home, she sat on the bed and complained she was not feeling good. She then fell back on the bed and began to seize. Subsequently she had intermittent episodes of alertness and was able to speak to the husband followed by unresponsiveness. At time of EMS arrival pt. was unresponsive. EMS noted BS 120s, SBP 50s. En route to hospital, pt. had a CP arrest for which epinephrine was given, CPR initiated with ROSC. Pt. arrived to the ER on a NRB mask attempting to speak. Subsequently, pt. had several CP arrests with asystole, and"
	"1290096-1"	"1290096-1"	"LIPASE NORMAL"	"10024575"	"50-59 years"	"50-59"	"4/20/21: patient arrived to ER per EMS status post PEA arrest. Per ER records, patient became unresponsive while sitting in bed witnessed by husband at home. According to husband, they had come home, she sat on the bed and complained she was not feeling good. She then fell back on the bed and began to seize. Subsequently she had intermittent episodes of alertness and was able to speak to the husband followed by unresponsiveness. At time of EMS arrival pt. was unresponsive. EMS noted BS 120s, SBP 50s. En route to hospital, pt. had a CP arrest for which epinephrine was given, CPR initiated with ROSC. Pt. arrived to the ER on a NRB mask attempting to speak. Subsequently, pt. had several CP arrests with asystole, and"
	"1290096-1"	"1290096-1"	"MECHANICAL VENTILATION"	"10067221"	"50-59 years"	"50-59"	"4/20/21: patient arrived to ER per EMS status post PEA arrest. Per ER records, patient became unresponsive while sitting in bed witnessed by husband at home. According to husband, they had come home, she sat on the bed and complained she was not feeling good. She then fell back on the bed and began to seize. Subsequently she had intermittent episodes of alertness and was able to speak to the husband followed by unresponsiveness. At time of EMS arrival pt. was unresponsive. EMS noted BS 120s, SBP 50s. En route to hospital, pt. had a CP arrest for which epinephrine was given, CPR initiated with ROSC. Pt. arrived to the ER on a NRB mask attempting to speak. Subsequently, pt. had several CP arrests with asystole, and"
	"1290096-1"	"1290096-1"	"MENTAL STATUS CHANGES"	"10048294"	"50-59 years"	"50-59"	"4/20/21: patient arrived to ER per EMS status post PEA arrest. Per ER records, patient became unresponsive while sitting in bed witnessed by husband at home. According to husband, they had come home, she sat on the bed and complained she was not feeling good. She then fell back on the bed and began to seize. Subsequently she had intermittent episodes of alertness and was able to speak to the husband followed by unresponsiveness. At time of EMS arrival pt. was unresponsive. EMS noted BS 120s, SBP 50s. En route to hospital, pt. had a CP arrest for which epinephrine was given, CPR initiated with ROSC. Pt. arrived to the ER on a NRB mask attempting to speak. Subsequently, pt. had several CP arrests with asystole, and"
	"1290096-1"	"1290096-1"	"MULTIPLE ORGAN DYSFUNCTION SYNDROME"	"10077361"	"50-59 years"	"50-59"	"4/20/21: patient arrived to ER per EMS status post PEA arrest. Per ER records, patient became unresponsive while sitting in bed witnessed by husband at home. According to husband, they had come home, she sat on the bed and complained she was not feeling good. She then fell back on the bed and began to seize. Subsequently she had intermittent episodes of alertness and was able to speak to the husband followed by unresponsiveness. At time of EMS arrival pt. was unresponsive. EMS noted BS 120s, SBP 50s. En route to hospital, pt. had a CP arrest for which epinephrine was given, CPR initiated with ROSC. Pt. arrived to the ER on a NRB mask attempting to speak. Subsequently, pt. had several CP arrests with asystole, and"
	"1290096-1"	"1290096-1"	"PACKED RED BLOOD CELL TRANSFUSION"	"10033359"	"50-59 years"	"50-59"	"4/20/21: patient arrived to ER per EMS status post PEA arrest. Per ER records, patient became unresponsive while sitting in bed witnessed by husband at home. According to husband, they had come home, she sat on the bed and complained she was not feeling good. She then fell back on the bed and began to seize. Subsequently she had intermittent episodes of alertness and was able to speak to the husband followed by unresponsiveness. At time of EMS arrival pt. was unresponsive. EMS noted BS 120s, SBP 50s. En route to hospital, pt. had a CP arrest for which epinephrine was given, CPR initiated with ROSC. Pt. arrived to the ER on a NRB mask attempting to speak. Subsequently, pt. had several CP arrests with asystole, and"
	"1290096-1"	"1290096-1"	"PERIPORTAL OEDEMA"	"10068821"	"50-59 years"	"50-59"	"4/20/21: patient arrived to ER per EMS status post PEA arrest. Per ER records, patient became unresponsive while sitting in bed witnessed by husband at home. According to husband, they had come home, she sat on the bed and complained she was not feeling good. She then fell back on the bed and began to seize. Subsequently she had intermittent episodes of alertness and was able to speak to the husband followed by unresponsiveness. At time of EMS arrival pt. was unresponsive. EMS noted BS 120s, SBP 50s. En route to hospital, pt. had a CP arrest for which epinephrine was given, CPR initiated with ROSC. Pt. arrived to the ER on a NRB mask attempting to speak. Subsequently, pt. had several CP arrests with asystole, and"
	"1290096-1"	"1290096-1"	"PLATELET COUNT DECREASED"	"10035528"	"50-59 years"	"50-59"	"4/20/21: patient arrived to ER per EMS status post PEA arrest. Per ER records, patient became unresponsive while sitting in bed witnessed by husband at home. According to husband, they had come home, she sat on the bed and complained she was not feeling good. She then fell back on the bed and began to seize. Subsequently she had intermittent episodes of alertness and was able to speak to the husband followed by unresponsiveness. At time of EMS arrival pt. was unresponsive. EMS noted BS 120s, SBP 50s. En route to hospital, pt. had a CP arrest for which epinephrine was given, CPR initiated with ROSC. Pt. arrived to the ER on a NRB mask attempting to speak. Subsequently, pt. had several CP arrests with asystole, and"
	"1290096-1"	"1290096-1"	"PLATELET TRANSFUSION"	"10035543"	"50-59 years"	"50-59"	"4/20/21: patient arrived to ER per EMS status post PEA arrest. Per ER records, patient became unresponsive while sitting in bed witnessed by husband at home. According to husband, they had come home, she sat on the bed and complained she was not feeling good. She then fell back on the bed and began to seize. Subsequently she had intermittent episodes of alertness and was able to speak to the husband followed by unresponsiveness. At time of EMS arrival pt. was unresponsive. EMS noted BS 120s, SBP 50s. En route to hospital, pt. had a CP arrest for which epinephrine was given, CPR initiated with ROSC. Pt. arrived to the ER on a NRB mask attempting to speak. Subsequently, pt. had several CP arrests with asystole, and"
	"1290096-1"	"1290096-1"	"POSITIVE END-EXPIRATORY PRESSURE"	"10059890"	"50-59 years"	"50-59"	"4/20/21: patient arrived to ER per EMS status post PEA arrest. Per ER records, patient became unresponsive while sitting in bed witnessed by husband at home. According to husband, they had come home, she sat on the bed and complained she was not feeling good. She then fell back on the bed and began to seize. Subsequently she had intermittent episodes of alertness and was able to speak to the husband followed by unresponsiveness. At time of EMS arrival pt. was unresponsive. EMS noted BS 120s, SBP 50s. En route to hospital, pt. had a CP arrest for which epinephrine was given, CPR initiated with ROSC. Pt. arrived to the ER on a NRB mask attempting to speak. Subsequently, pt. had several CP arrests with asystole, and"
	"1290096-1"	"1290096-1"	"PULMONARY EMBOLISM"	"10037377"	"50-59 years"	"50-59"	"4/20/21: patient arrived to ER per EMS status post PEA arrest. Per ER records, patient became unresponsive while sitting in bed witnessed by husband at home. According to husband, they had come home, she sat on the bed and complained she was not feeling good. She then fell back on the bed and began to seize. Subsequently she had intermittent episodes of alertness and was able to speak to the husband followed by unresponsiveness. At time of EMS arrival pt. was unresponsive. EMS noted BS 120s, SBP 50s. En route to hospital, pt. had a CP arrest for which epinephrine was given, CPR initiated with ROSC. Pt. arrived to the ER on a NRB mask attempting to speak. Subsequently, pt. had several CP arrests with asystole, and"
	"1290096-1"	"1290096-1"	"PULMONARY INFARCTION"	"10037410"	"50-59 years"	"50-59"	"4/20/21: patient arrived to ER per EMS status post PEA arrest. Per ER records, patient became unresponsive while sitting in bed witnessed by husband at home. According to husband, they had come home, she sat on the bed and complained she was not feeling good. She then fell back on the bed and began to seize. Subsequently she had intermittent episodes of alertness and was able to speak to the husband followed by unresponsiveness. At time of EMS arrival pt. was unresponsive. EMS noted BS 120s, SBP 50s. En route to hospital, pt. had a CP arrest for which epinephrine was given, CPR initiated with ROSC. Pt. arrived to the ER on a NRB mask attempting to speak. Subsequently, pt. had several CP arrests with asystole, and"
	"1290096-1"	"1290096-1"	"PULSELESS ELECTRICAL ACTIVITY"	"10058151"	"50-59 years"	"50-59"	"4/20/21: patient arrived to ER per EMS status post PEA arrest. Per ER records, patient became unresponsive while sitting in bed witnessed by husband at home. According to husband, they had come home, she sat on the bed and complained she was not feeling good. She then fell back on the bed and began to seize. Subsequently she had intermittent episodes of alertness and was able to speak to the husband followed by unresponsiveness. At time of EMS arrival pt. was unresponsive. EMS noted BS 120s, SBP 50s. En route to hospital, pt. had a CP arrest for which epinephrine was given, CPR initiated with ROSC. Pt. arrived to the ER on a NRB mask attempting to speak. Subsequently, pt. had several CP arrests with asystole, and"
	"1290096-1"	"1290096-1"	"RENAL IMPAIRMENT"	"10062237"	"50-59 years"	"50-59"	"4/20/21: patient arrived to ER per EMS status post PEA arrest. Per ER records, patient became unresponsive while sitting in bed witnessed by husband at home. According to husband, they had come home, she sat on the bed and complained she was not feeling good. She then fell back on the bed and began to seize. Subsequently she had intermittent episodes of alertness and was able to speak to the husband followed by unresponsiveness. At time of EMS arrival pt. was unresponsive. EMS noted BS 120s, SBP 50s. En route to hospital, pt. had a CP arrest for which epinephrine was given, CPR initiated with ROSC. Pt. arrived to the ER on a NRB mask attempting to speak. Subsequently, pt. had several CP arrests with asystole, and"
	"1290096-1"	"1290096-1"	"RENAL REPLACEMENT THERAPY"	"10074746"	"50-59 years"	"50-59"	"4/20/21: patient arrived to ER per EMS status post PEA arrest. Per ER records, patient became unresponsive while sitting in bed witnessed by husband at home. According to husband, they had come home, she sat on the bed and complained she was not feeling good. She then fell back on the bed and began to seize. Subsequently she had intermittent episodes of alertness and was able to speak to the husband followed by unresponsiveness. At time of EMS arrival pt. was unresponsive. EMS noted BS 120s, SBP 50s. En route to hospital, pt. had a CP arrest for which epinephrine was given, CPR initiated with ROSC. Pt. arrived to the ER on a NRB mask attempting to speak. Subsequently, pt. had several CP arrests with asystole, and"
	"1290096-1"	"1290096-1"	"RESPIRATORY FAILURE"	"10038695"	"50-59 years"	"50-59"	"4/20/21: patient arrived to ER per EMS status post PEA arrest. Per ER records, patient became unresponsive while sitting in bed witnessed by husband at home. According to husband, they had come home, she sat on the bed and complained she was not feeling good. She then fell back on the bed and began to seize. Subsequently she had intermittent episodes of alertness and was able to speak to the husband followed by unresponsiveness. At time of EMS arrival pt. was unresponsive. EMS noted BS 120s, SBP 50s. En route to hospital, pt. had a CP arrest for which epinephrine was given, CPR initiated with ROSC. Pt. arrived to the ER on a NRB mask attempting to speak. Subsequently, pt. had several CP arrests with asystole, and"
	"1290096-1"	"1290096-1"	"RESUSCITATION"	"10038749"	"50-59 years"	"50-59"	"4/20/21: patient arrived to ER per EMS status post PEA arrest. Per ER records, patient became unresponsive while sitting in bed witnessed by husband at home. According to husband, they had come home, she sat on the bed and complained she was not feeling good. She then fell back on the bed and began to seize. Subsequently she had intermittent episodes of alertness and was able to speak to the husband followed by unresponsiveness. At time of EMS arrival pt. was unresponsive. EMS noted BS 120s, SBP 50s. En route to hospital, pt. had a CP arrest for which epinephrine was given, CPR initiated with ROSC. Pt. arrived to the ER on a NRB mask attempting to speak. Subsequently, pt. had several CP arrests with asystole, and"
	"1290096-1"	"1290096-1"	"RIGHT VENTRICULAR DYSFUNCTION"	"10058597"	"50-59 years"	"50-59"	"4/20/21: patient arrived to ER per EMS status post PEA arrest. Per ER records, patient became unresponsive while sitting in bed witnessed by husband at home. According to husband, they had come home, she sat on the bed and complained she was not feeling good. She then fell back on the bed and began to seize. Subsequently she had intermittent episodes of alertness and was able to speak to the husband followed by unresponsiveness. At time of EMS arrival pt. was unresponsive. EMS noted BS 120s, SBP 50s. En route to hospital, pt. had a CP arrest for which epinephrine was given, CPR initiated with ROSC. Pt. arrived to the ER on a NRB mask attempting to speak. Subsequently, pt. had several CP arrests with asystole, and"
	"1290096-1"	"1290096-1"	"RIGHT VENTRICULAR FAILURE"	"10039163"	"50-59 years"	"50-59"	"4/20/21: patient arrived to ER per EMS status post PEA arrest. Per ER records, patient became unresponsive while sitting in bed witnessed by husband at home. According to husband, they had come home, she sat on the bed and complained she was not feeling good. She then fell back on the bed and began to seize. Subsequently she had intermittent episodes of alertness and was able to speak to the husband followed by unresponsiveness. At time of EMS arrival pt. was unresponsive. EMS noted BS 120s, SBP 50s. En route to hospital, pt. had a CP arrest for which epinephrine was given, CPR initiated with ROSC. Pt. arrived to the ER on a NRB mask attempting to speak. Subsequently, pt. had several CP arrests with asystole, and"
	"1290096-1"	"1290096-1"	"SEIZURE"	"10039906"	"50-59 years"	"50-59"	"4/20/21: patient arrived to ER per EMS status post PEA arrest. Per ER records, patient became unresponsive while sitting in bed witnessed by husband at home. According to husband, they had come home, she sat on the bed and complained she was not feeling good. She then fell back on the bed and began to seize. Subsequently she had intermittent episodes of alertness and was able to speak to the husband followed by unresponsiveness. At time of EMS arrival pt. was unresponsive. EMS noted BS 120s, SBP 50s. En route to hospital, pt. had a CP arrest for which epinephrine was given, CPR initiated with ROSC. Pt. arrived to the ER on a NRB mask attempting to speak. Subsequently, pt. had several CP arrests with asystole, and"
	"1290096-1"	"1290096-1"	"THERAPEUTIC HYPOTHERMIA"	"10059485"	"50-59 years"	"50-59"	"4/20/21: patient arrived to ER per EMS status post PEA arrest. Per ER records, patient became unresponsive while sitting in bed witnessed by husband at home. According to husband, they had come home, she sat on the bed and complained she was not feeling good. She then fell back on the bed and began to seize. Subsequently she had intermittent episodes of alertness and was able to speak to the husband followed by unresponsiveness. At time of EMS arrival pt. was unresponsive. EMS noted BS 120s, SBP 50s. En route to hospital, pt. had a CP arrest for which epinephrine was given, CPR initiated with ROSC. Pt. arrived to the ER on a NRB mask attempting to speak. Subsequently, pt. had several CP arrests with asystole, and"
	"1290096-1"	"1290096-1"	"THROMBOLYSIS"	"10043568"	"50-59 years"	"50-59"	"4/20/21: patient arrived to ER per EMS status post PEA arrest. Per ER records, patient became unresponsive while sitting in bed witnessed by husband at home. According to husband, they had come home, she sat on the bed and complained she was not feeling good. She then fell back on the bed and began to seize. Subsequently she had intermittent episodes of alertness and was able to speak to the husband followed by unresponsiveness. At time of EMS arrival pt. was unresponsive. EMS noted BS 120s, SBP 50s. En route to hospital, pt. had a CP arrest for which epinephrine was given, CPR initiated with ROSC. Pt. arrived to the ER on a NRB mask attempting to speak. Subsequently, pt. had several CP arrests with asystole, and"
	"1290096-1"	"1290096-1"	"TRANSFUSION"	"10066152"	"50-59 years"	"50-59"	"4/20/21: patient arrived to ER per EMS status post PEA arrest. Per ER records, patient became unresponsive while sitting in bed witnessed by husband at home. According to husband, they had come home, she sat on the bed and complained she was not feeling good. She then fell back on the bed and began to seize. Subsequently she had intermittent episodes of alertness and was able to speak to the husband followed by unresponsiveness. At time of EMS arrival pt. was unresponsive. EMS noted BS 120s, SBP 50s. En route to hospital, pt. had a CP arrest for which epinephrine was given, CPR initiated with ROSC. Pt. arrived to the ER on a NRB mask attempting to speak. Subsequently, pt. had several CP arrests with asystole, and"
	"1290096-1"	"1290096-1"	"TROPONIN"	"10061576"	"50-59 years"	"50-59"	"4/20/21: patient arrived to ER per EMS status post PEA arrest. Per ER records, patient became unresponsive while sitting in bed witnessed by husband at home. According to husband, they had come home, she sat on the bed and complained she was not feeling good. She then fell back on the bed and began to seize. Subsequently she had intermittent episodes of alertness and was able to speak to the husband followed by unresponsiveness. At time of EMS arrival pt. was unresponsive. EMS noted BS 120s, SBP 50s. En route to hospital, pt. had a CP arrest for which epinephrine was given, CPR initiated with ROSC. Pt. arrived to the ER on a NRB mask attempting to speak. Subsequently, pt. had several CP arrests with asystole, and"
	"1290096-1"	"1290096-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"50-59 years"	"50-59"	"4/20/21: patient arrived to ER per EMS status post PEA arrest. Per ER records, patient became unresponsive while sitting in bed witnessed by husband at home. According to husband, they had come home, she sat on the bed and complained she was not feeling good. She then fell back on the bed and began to seize. Subsequently she had intermittent episodes of alertness and was able to speak to the husband followed by unresponsiveness. At time of EMS arrival pt. was unresponsive. EMS noted BS 120s, SBP 50s. En route to hospital, pt. had a CP arrest for which epinephrine was given, CPR initiated with ROSC. Pt. arrived to the ER on a NRB mask attempting to speak. Subsequently, pt. had several CP arrests with asystole, and"
	"1290096-1"	"1290096-1"	"WHITE BLOOD CELL COUNT DECREASED"	"10047942"	"50-59 years"	"50-59"	"4/20/21: patient arrived to ER per EMS status post PEA arrest. Per ER records, patient became unresponsive while sitting in bed witnessed by husband at home. According to husband, they had come home, she sat on the bed and complained she was not feeling good. She then fell back on the bed and began to seize. Subsequently she had intermittent episodes of alertness and was able to speak to the husband followed by unresponsiveness. At time of EMS arrival pt. was unresponsive. EMS noted BS 120s, SBP 50s. En route to hospital, pt. had a CP arrest for which epinephrine was given, CPR initiated with ROSC. Pt. arrived to the ER on a NRB mask attempting to speak. Subsequently, pt. had several CP arrests with asystole, and"
	"1291811-1"	"1291811-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"day one  threw 3 dizziness, day 4 throwing up, diarrhea, then death"
	"1291811-1"	"1291811-1"	"DIARRHOEA"	"10012735"	"50-59 years"	"50-59"	"day one  threw 3 dizziness, day 4 throwing up, diarrhea, then death"
	"1291811-1"	"1291811-1"	"DIZZINESS"	"10013573"	"50-59 years"	"50-59"	"day one  threw 3 dizziness, day 4 throwing up, diarrhea, then death"
	"1291811-1"	"1291811-1"	"VOMITING"	"10047700"	"50-59 years"	"50-59"	"day one  threw 3 dizziness, day 4 throwing up, diarrhea, then death"
	"1291923-1"	"1291923-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"I had a patient come in at 10:05am for a Moderna Covid vaccine. Just before 11am we received a call from the patient's roommate that the patient arrived home and collapsed, it was also mentioned her blood pressure was high. We explained that they needed to call 911 but the patient did not want to go to the hospital. We explained that this patient must go to the hospital and get evaluated. They did end up calling 911.  Approximately 45 minutes later I received another call from the patient's roommate that EMS did not believe this was a reaction from the vaccine. The roommate mentioned that she was in fact mistaken about the blood pressure and it was actually low (92/54 mmHg). She also mentioned that the patient was vomiting.   Around 1:45pm I received a call from the roommate to tell me that the patient had died."
	"1291923-1"	"1291923-1"	"HYPOTENSION"	"10021097"	"50-59 years"	"50-59"	"I had a patient come in at 10:05am for a Moderna Covid vaccine. Just before 11am we received a call from the patient's roommate that the patient arrived home and collapsed, it was also mentioned her blood pressure was high. We explained that they needed to call 911 but the patient did not want to go to the hospital. We explained that this patient must go to the hospital and get evaluated. They did end up calling 911.  Approximately 45 minutes later I received another call from the patient's roommate that EMS did not believe this was a reaction from the vaccine. The roommate mentioned that she was in fact mistaken about the blood pressure and it was actually low (92/54 mmHg). She also mentioned that the patient was vomiting.   Around 1:45pm I received a call from the roommate to tell me that the patient had died."
	"1291923-1"	"1291923-1"	"SYNCOPE"	"10042772"	"50-59 years"	"50-59"	"I had a patient come in at 10:05am for a Moderna Covid vaccine. Just before 11am we received a call from the patient's roommate that the patient arrived home and collapsed, it was also mentioned her blood pressure was high. We explained that they needed to call 911 but the patient did not want to go to the hospital. We explained that this patient must go to the hospital and get evaluated. They did end up calling 911.  Approximately 45 minutes later I received another call from the patient's roommate that EMS did not believe this was a reaction from the vaccine. The roommate mentioned that she was in fact mistaken about the blood pressure and it was actually low (92/54 mmHg). She also mentioned that the patient was vomiting.   Around 1:45pm I received a call from the roommate to tell me that the patient had died."
	"1291923-1"	"1291923-1"	"VOMITING"	"10047700"	"50-59 years"	"50-59"	"I had a patient come in at 10:05am for a Moderna Covid vaccine. Just before 11am we received a call from the patient's roommate that the patient arrived home and collapsed, it was also mentioned her blood pressure was high. We explained that they needed to call 911 but the patient did not want to go to the hospital. We explained that this patient must go to the hospital and get evaluated. They did end up calling 911.  Approximately 45 minutes later I received another call from the patient's roommate that EMS did not believe this was a reaction from the vaccine. The roommate mentioned that she was in fact mistaken about the blood pressure and it was actually low (92/54 mmHg). She also mentioned that the patient was vomiting.   Around 1:45pm I received a call from the roommate to tell me that the patient had died."
	"1292213-1"	"1292213-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"DEATH.  My sister took the vaccine on April 28th and DIED on May 3rd."
	"1294116-1"	"1294116-1"	"CEREBRAL HAEMORRHAGE"	"10008111"	"50-59 years"	"50-59"	"Five days post vaccine patient had a massive cerebral hemorrhage resulting in death."
	"1294116-1"	"1294116-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Five days post vaccine patient had a massive cerebral hemorrhage resulting in death."
	"1296012-1"	"1296012-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	""Arrived to emergency department via ambulance from nursing home with complaints of ""looking like he was about to have a seizure"".   Patient became unresponsive and a code was called.  ACLS performed but the patient did not recover from cardiac arrest.""
	"1296012-1"	"1296012-1"	"CARDIO-RESPIRATORY ARREST"	"10007617"	"50-59 years"	"50-59"	""Arrived to emergency department via ambulance from nursing home with complaints of ""looking like he was about to have a seizure"".   Patient became unresponsive and a code was called.  ACLS performed but the patient did not recover from cardiac arrest.""
	"1296012-1"	"1296012-1"	"LIFE SUPPORT"	"10024447"	"50-59 years"	"50-59"	""Arrived to emergency department via ambulance from nursing home with complaints of ""looking like he was about to have a seizure"".   Patient became unresponsive and a code was called.  ACLS performed but the patient did not recover from cardiac arrest.""
	"1296012-1"	"1296012-1"	"SEIZURE LIKE PHENOMENA"	"10071048"	"50-59 years"	"50-59"	""Arrived to emergency department via ambulance from nursing home with complaints of ""looking like he was about to have a seizure"".   Patient became unresponsive and a code was called.  ACLS performed but the patient did not recover from cardiac arrest.""
	"1296012-1"	"1296012-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"50-59 years"	"50-59"	""Arrived to emergency department via ambulance from nursing home with complaints of ""looking like he was about to have a seizure"".   Patient became unresponsive and a code was called.  ACLS performed but the patient did not recover from cardiac arrest.""
	"1296284-1"	"1296284-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient had an ED visit and/or hospitalization within 6 weeks of receiving COVID vaccine."
	"1296304-1"	"1296304-1"	"ABDOMINAL PAIN"	"10000081"	"50-59 years"	"50-59"	"History 59-year young lady with history of COPD coronary artery disease CHF  was evaluated at a local hospital  and transferred  with diagnosis of pneumonia.  Patient O2 sat was in the 70s she was placed on CPAP.  In route patient complained of chest pain abdominal pain and back pain subsequently had a cardiorespiratory arrest.  Patient was being bagged after ET intubation in the field by EMS with chest compressions.  Breath sounds well equal on arrival.  Glucose was greater than 100 on fingerstick. Providers were initially able to obtain a pulse with return of spontaneous circulation but blood pressure was at best 50 systolic.  Patient was begun on an epinephrine infusion and norepinephrine ordered.  The patient then deteriorated into  V-tach,  All additional heroic measures failed and the patient expired."
	"1296304-1"	"1296304-1"	"BACK PAIN"	"10003988"	"50-59 years"	"50-59"	"History 59-year young lady with history of COPD coronary artery disease CHF  was evaluated at a local hospital  and transferred  with diagnosis of pneumonia.  Patient O2 sat was in the 70s she was placed on CPAP.  In route patient complained of chest pain abdominal pain and back pain subsequently had a cardiorespiratory arrest.  Patient was being bagged after ET intubation in the field by EMS with chest compressions.  Breath sounds well equal on arrival.  Glucose was greater than 100 on fingerstick. Providers were initially able to obtain a pulse with return of spontaneous circulation but blood pressure was at best 50 systolic.  Patient was begun on an epinephrine infusion and norepinephrine ordered.  The patient then deteriorated into  V-tach,  All additional heroic measures failed and the patient expired."
	"1296304-1"	"1296304-1"	"BLOOD GLUCOSE NORMAL"	"10005558"	"50-59 years"	"50-59"	"History 59-year young lady with history of COPD coronary artery disease CHF  was evaluated at a local hospital  and transferred  with diagnosis of pneumonia.  Patient O2 sat was in the 70s she was placed on CPAP.  In route patient complained of chest pain abdominal pain and back pain subsequently had a cardiorespiratory arrest.  Patient was being bagged after ET intubation in the field by EMS with chest compressions.  Breath sounds well equal on arrival.  Glucose was greater than 100 on fingerstick. Providers were initially able to obtain a pulse with return of spontaneous circulation but blood pressure was at best 50 systolic.  Patient was begun on an epinephrine infusion and norepinephrine ordered.  The patient then deteriorated into  V-tach,  All additional heroic measures failed and the patient expired."
	"1296304-1"	"1296304-1"	"BLOOD PRESSURE SYSTOLIC DECREASED"	"10005758"	"50-59 years"	"50-59"	"History 59-year young lady with history of COPD coronary artery disease CHF  was evaluated at a local hospital  and transferred  with diagnosis of pneumonia.  Patient O2 sat was in the 70s she was placed on CPAP.  In route patient complained of chest pain abdominal pain and back pain subsequently had a cardiorespiratory arrest.  Patient was being bagged after ET intubation in the field by EMS with chest compressions.  Breath sounds well equal on arrival.  Glucose was greater than 100 on fingerstick. Providers were initially able to obtain a pulse with return of spontaneous circulation but blood pressure was at best 50 systolic.  Patient was begun on an epinephrine infusion and norepinephrine ordered.  The patient then deteriorated into  V-tach,  All additional heroic measures failed and the patient expired."
	"1296304-1"	"1296304-1"	"CARDIO-RESPIRATORY ARREST"	"10007617"	"50-59 years"	"50-59"	"History 59-year young lady with history of COPD coronary artery disease CHF  was evaluated at a local hospital  and transferred  with diagnosis of pneumonia.  Patient O2 sat was in the 70s she was placed on CPAP.  In route patient complained of chest pain abdominal pain and back pain subsequently had a cardiorespiratory arrest.  Patient was being bagged after ET intubation in the field by EMS with chest compressions.  Breath sounds well equal on arrival.  Glucose was greater than 100 on fingerstick. Providers were initially able to obtain a pulse with return of spontaneous circulation but blood pressure was at best 50 systolic.  Patient was begun on an epinephrine infusion and norepinephrine ordered.  The patient then deteriorated into  V-tach,  All additional heroic measures failed and the patient expired."
	"1296304-1"	"1296304-1"	"CHEST PAIN"	"10008479"	"50-59 years"	"50-59"	"History 59-year young lady with history of COPD coronary artery disease CHF  was evaluated at a local hospital  and transferred  with diagnosis of pneumonia.  Patient O2 sat was in the 70s she was placed on CPAP.  In route patient complained of chest pain abdominal pain and back pain subsequently had a cardiorespiratory arrest.  Patient was being bagged after ET intubation in the field by EMS with chest compressions.  Breath sounds well equal on arrival.  Glucose was greater than 100 on fingerstick. Providers were initially able to obtain a pulse with return of spontaneous circulation but blood pressure was at best 50 systolic.  Patient was begun on an epinephrine infusion and norepinephrine ordered.  The patient then deteriorated into  V-tach,  All additional heroic measures failed and the patient expired."
	"1296304-1"	"1296304-1"	"CONTINUOUS POSITIVE AIRWAY PRESSURE"	"10052934"	"50-59 years"	"50-59"	"History 59-year young lady with history of COPD coronary artery disease CHF  was evaluated at a local hospital  and transferred  with diagnosis of pneumonia.  Patient O2 sat was in the 70s she was placed on CPAP.  In route patient complained of chest pain abdominal pain and back pain subsequently had a cardiorespiratory arrest.  Patient was being bagged after ET intubation in the field by EMS with chest compressions.  Breath sounds well equal on arrival.  Glucose was greater than 100 on fingerstick. Providers were initially able to obtain a pulse with return of spontaneous circulation but blood pressure was at best 50 systolic.  Patient was begun on an epinephrine infusion and norepinephrine ordered.  The patient then deteriorated into  V-tach,  All additional heroic measures failed and the patient expired."
	"1296304-1"	"1296304-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"History 59-year young lady with history of COPD coronary artery disease CHF  was evaluated at a local hospital  and transferred  with diagnosis of pneumonia.  Patient O2 sat was in the 70s she was placed on CPAP.  In route patient complained of chest pain abdominal pain and back pain subsequently had a cardiorespiratory arrest.  Patient was being bagged after ET intubation in the field by EMS with chest compressions.  Breath sounds well equal on arrival.  Glucose was greater than 100 on fingerstick. Providers were initially able to obtain a pulse with return of spontaneous circulation but blood pressure was at best 50 systolic.  Patient was begun on an epinephrine infusion and norepinephrine ordered.  The patient then deteriorated into  V-tach,  All additional heroic measures failed and the patient expired."
	"1296304-1"	"1296304-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"50-59 years"	"50-59"	"History 59-year young lady with history of COPD coronary artery disease CHF  was evaluated at a local hospital  and transferred  with diagnosis of pneumonia.  Patient O2 sat was in the 70s she was placed on CPAP.  In route patient complained of chest pain abdominal pain and back pain subsequently had a cardiorespiratory arrest.  Patient was being bagged after ET intubation in the field by EMS with chest compressions.  Breath sounds well equal on arrival.  Glucose was greater than 100 on fingerstick. Providers were initially able to obtain a pulse with return of spontaneous circulation but blood pressure was at best 50 systolic.  Patient was begun on an epinephrine infusion and norepinephrine ordered.  The patient then deteriorated into  V-tach,  All additional heroic measures failed and the patient expired."
	"1296304-1"	"1296304-1"	"OXYGEN SATURATION DECREASED"	"10033318"	"50-59 years"	"50-59"	"History 59-year young lady with history of COPD coronary artery disease CHF  was evaluated at a local hospital  and transferred  with diagnosis of pneumonia.  Patient O2 sat was in the 70s she was placed on CPAP.  In route patient complained of chest pain abdominal pain and back pain subsequently had a cardiorespiratory arrest.  Patient was being bagged after ET intubation in the field by EMS with chest compressions.  Breath sounds well equal on arrival.  Glucose was greater than 100 on fingerstick. Providers were initially able to obtain a pulse with return of spontaneous circulation but blood pressure was at best 50 systolic.  Patient was begun on an epinephrine infusion and norepinephrine ordered.  The patient then deteriorated into  V-tach,  All additional heroic measures failed and the patient expired."
	"1296304-1"	"1296304-1"	"PNEUMONIA"	"10035664"	"50-59 years"	"50-59"	"History 59-year young lady with history of COPD coronary artery disease CHF  was evaluated at a local hospital  and transferred  with diagnosis of pneumonia.  Patient O2 sat was in the 70s she was placed on CPAP.  In route patient complained of chest pain abdominal pain and back pain subsequently had a cardiorespiratory arrest.  Patient was being bagged after ET intubation in the field by EMS with chest compressions.  Breath sounds well equal on arrival.  Glucose was greater than 100 on fingerstick. Providers were initially able to obtain a pulse with return of spontaneous circulation but blood pressure was at best 50 systolic.  Patient was begun on an epinephrine infusion and norepinephrine ordered.  The patient then deteriorated into  V-tach,  All additional heroic measures failed and the patient expired."
	"1296304-1"	"1296304-1"	"RESUSCITATION"	"10038749"	"50-59 years"	"50-59"	"History 59-year young lady with history of COPD coronary artery disease CHF  was evaluated at a local hospital  and transferred  with diagnosis of pneumonia.  Patient O2 sat was in the 70s she was placed on CPAP.  In route patient complained of chest pain abdominal pain and back pain subsequently had a cardiorespiratory arrest.  Patient was being bagged after ET intubation in the field by EMS with chest compressions.  Breath sounds well equal on arrival.  Glucose was greater than 100 on fingerstick. Providers were initially able to obtain a pulse with return of spontaneous circulation but blood pressure was at best 50 systolic.  Patient was begun on an epinephrine infusion and norepinephrine ordered.  The patient then deteriorated into  V-tach,  All additional heroic measures failed and the patient expired."
	"1296304-1"	"1296304-1"	"VENTRICULAR TACHYCARDIA"	"10047302"	"50-59 years"	"50-59"	"History 59-year young lady with history of COPD coronary artery disease CHF  was evaluated at a local hospital  and transferred  with diagnosis of pneumonia.  Patient O2 sat was in the 70s she was placed on CPAP.  In route patient complained of chest pain abdominal pain and back pain subsequently had a cardiorespiratory arrest.  Patient was being bagged after ET intubation in the field by EMS with chest compressions.  Breath sounds well equal on arrival.  Glucose was greater than 100 on fingerstick. Providers were initially able to obtain a pulse with return of spontaneous circulation but blood pressure was at best 50 systolic.  Patient was begun on an epinephrine infusion and norepinephrine ordered.  The patient then deteriorated into  V-tach,  All additional heroic measures failed and the patient expired."
	"1296636-1"	"1296636-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Started getting achy and feverish. Diarrhea, vomiting.  Told me, I'm as sick as I've ever been in my life. Died. Just want to know if he died from Covid or an adverse reaction from Johnson and Johnson vaccine he received in jail. No one wants to test his blood. He's at the mortuary awaiting cremation, and I thought it best if some government entity drew some blood to determine if he's a Covid or vaccine reaction fatality.  Before they cremate his body."
	"1296636-1"	"1296636-1"	"DIARRHOEA"	"10012735"	"50-59 years"	"50-59"	"Started getting achy and feverish. Diarrhea, vomiting.  Told me, I'm as sick as I've ever been in my life. Died. Just want to know if he died from Covid or an adverse reaction from Johnson and Johnson vaccine he received in jail. No one wants to test his blood. He's at the mortuary awaiting cremation, and I thought it best if some government entity drew some blood to determine if he's a Covid or vaccine reaction fatality.  Before they cremate his body."
	"1296636-1"	"1296636-1"	"ILLNESS"	"10080284"	"50-59 years"	"50-59"	"Started getting achy and feverish. Diarrhea, vomiting.  Told me, I'm as sick as I've ever been in my life. Died. Just want to know if he died from Covid or an adverse reaction from Johnson and Johnson vaccine he received in jail. No one wants to test his blood. He's at the mortuary awaiting cremation, and I thought it best if some government entity drew some blood to determine if he's a Covid or vaccine reaction fatality.  Before they cremate his body."
	"1296636-1"	"1296636-1"	"PAIN"	"10033371"	"50-59 years"	"50-59"	"Started getting achy and feverish. Diarrhea, vomiting.  Told me, I'm as sick as I've ever been in my life. Died. Just want to know if he died from Covid or an adverse reaction from Johnson and Johnson vaccine he received in jail. No one wants to test his blood. He's at the mortuary awaiting cremation, and I thought it best if some government entity drew some blood to determine if he's a Covid or vaccine reaction fatality.  Before they cremate his body."
	"1296636-1"	"1296636-1"	"PYREXIA"	"10037660"	"50-59 years"	"50-59"	"Started getting achy and feverish. Diarrhea, vomiting.  Told me, I'm as sick as I've ever been in my life. Died. Just want to know if he died from Covid or an adverse reaction from Johnson and Johnson vaccine he received in jail. No one wants to test his blood. He's at the mortuary awaiting cremation, and I thought it best if some government entity drew some blood to determine if he's a Covid or vaccine reaction fatality.  Before they cremate his body."
	"1296636-1"	"1296636-1"	"VOMITING"	"10047700"	"50-59 years"	"50-59"	"Started getting achy and feverish. Diarrhea, vomiting.  Told me, I'm as sick as I've ever been in my life. Died. Just want to know if he died from Covid or an adverse reaction from Johnson and Johnson vaccine he received in jail. No one wants to test his blood. He's at the mortuary awaiting cremation, and I thought it best if some government entity drew some blood to determine if he's a Covid or vaccine reaction fatality.  Before they cremate his body."
	"1296823-1"	"1296823-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"According to facility representative on 1/27/2021 at approximately 7:15 am, pt was discovered not breathing with no pulse. Resident was pronounced dead at 7:44 am on 1/27/2021. Resident was previously tested positive for COVID-19 on 12/9/2020."
	"1296823-1"	"1296823-1"	"PULSE ABSENT"	"10037469"	"50-59 years"	"50-59"	"According to facility representative on 1/27/2021 at approximately 7:15 am, pt was discovered not breathing with no pulse. Resident was pronounced dead at 7:44 am on 1/27/2021. Resident was previously tested positive for COVID-19 on 12/9/2020."
	"1296823-1"	"1296823-1"	"RESPIRATORY ARREST"	"10038669"	"50-59 years"	"50-59"	"According to facility representative on 1/27/2021 at approximately 7:15 am, pt was discovered not breathing with no pulse. Resident was pronounced dead at 7:44 am on 1/27/2021. Resident was previously tested positive for COVID-19 on 12/9/2020."
	"1304689-1"	"1304689-1"	"THROMBOSIS"	"10043607"	"50-59 years"	"50-59"	"Blood clot"
	"1306337-1"	"1306337-1"	"CARDIO-RESPIRATORY ARREST"	"10007617"	"50-59 years"	"50-59"	""Patient death certificate lists ""natural"" causes, with the Immediate Cause of Death of Cardiopulmonary Arrest.""
	"1306337-1"	"1306337-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	""Patient death certificate lists ""natural"" causes, with the Immediate Cause of Death of Cardiopulmonary Arrest.""
	"1308208-1"	"1308208-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient died from methamphetamine/opiate overdose"
	"1308208-1"	"1308208-1"	"OVERDOSE"	"10033295"	"50-59 years"	"50-59"	"Patient died from methamphetamine/opiate overdose"
	"1310861-1"	"1310861-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"Cardiac Arrest, Death"
	"1310861-1"	"1310861-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Cardiac Arrest, Death"
	"1312219-1"	"1312219-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient was feeling fatigue, unwell the night after getting the vaccine. The next day he stayed home, did not go to work as he was not feeling well.  Two days after getting the vaccine,  he had trouble breathing, an ambulance was called  and he was pronounced deceased hours later. He had a heart attack."
	"1312219-1"	"1312219-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"Patient was feeling fatigue, unwell the night after getting the vaccine. The next day he stayed home, did not go to work as he was not feeling well.  Two days after getting the vaccine,  he had trouble breathing, an ambulance was called  and he was pronounced deceased hours later. He had a heart attack."
	"1312219-1"	"1312219-1"	"FATIGUE"	"10016256"	"50-59 years"	"50-59"	"Patient was feeling fatigue, unwell the night after getting the vaccine. The next day he stayed home, did not go to work as he was not feeling well.  Two days after getting the vaccine,  he had trouble breathing, an ambulance was called  and he was pronounced deceased hours later. He had a heart attack."
	"1312219-1"	"1312219-1"	"MALAISE"	"10025482"	"50-59 years"	"50-59"	"Patient was feeling fatigue, unwell the night after getting the vaccine. The next day he stayed home, did not go to work as he was not feeling well.  Two days after getting the vaccine,  he had trouble breathing, an ambulance was called  and he was pronounced deceased hours later. He had a heart attack."
	"1312219-1"	"1312219-1"	"MYOCARDIAL INFARCTION"	"10028596"	"50-59 years"	"50-59"	"Patient was feeling fatigue, unwell the night after getting the vaccine. The next day he stayed home, did not go to work as he was not feeling well.  Two days after getting the vaccine,  he had trouble breathing, an ambulance was called  and he was pronounced deceased hours later. He had a heart attack."
	"1312481-1"	"1312481-1"	"ACUTE CORONARY SYNDROME"	"10051592"	"50-59 years"	"50-59"	"My husband stated that he did not feel good after the vaccine the next morning, later he went to pick up hay and died on someone's property from the acute coronary syndrome."
	"1312481-1"	"1312481-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"My husband stated that he did not feel good after the vaccine the next morning, later he went to pick up hay and died on someone's property from the acute coronary syndrome."
	"1312481-1"	"1312481-1"	"MALAISE"	"10025482"	"50-59 years"	"50-59"	"My husband stated that he did not feel good after the vaccine the next morning, later he went to pick up hay and died on someone's property from the acute coronary syndrome."
	"1313560-1"	"1313560-1"	"ACUTE MYOCARDIAL INFARCTION"	"10000891"	"50-59 years"	"50-59"	"I21.3 - STEMI (ST elevation myocardial infarction) (CMS/HCC)"
	"1313691-1"	"1313691-1"	"ANEURYSM"	"10002329"	"50-59 years"	"50-59"	"Following the vaccination patient didn?t feel well. Fever, chills, cold symptoms, incredibly irritable. 5/1 she awake with a terrible headache which continued all day. Around  9:30 pm she laid down and shortly after was unable to move her body. 5/4/21 at 4:19pm her time of death was called. Cause; brain death due to aneurysm and stroke due to passing blood clot in brain."
	"1313691-1"	"1313691-1"	"BRAIN DEATH"	"10049054"	"50-59 years"	"50-59"	"Following the vaccination patient didn?t feel well. Fever, chills, cold symptoms, incredibly irritable. 5/1 she awake with a terrible headache which continued all day. Around  9:30 pm she laid down and shortly after was unable to move her body. 5/4/21 at 4:19pm her time of death was called. Cause; brain death due to aneurysm and stroke due to passing blood clot in brain."
	"1313691-1"	"1313691-1"	"CEREBRAL THROMBOSIS"	"10008132"	"50-59 years"	"50-59"	"Following the vaccination patient didn?t feel well. Fever, chills, cold symptoms, incredibly irritable. 5/1 she awake with a terrible headache which continued all day. Around  9:30 pm she laid down and shortly after was unable to move her body. 5/4/21 at 4:19pm her time of death was called. Cause; brain death due to aneurysm and stroke due to passing blood clot in brain."
	"1313691-1"	"1313691-1"	"CEREBROVASCULAR ACCIDENT"	"10008190"	"50-59 years"	"50-59"	"Following the vaccination patient didn?t feel well. Fever, chills, cold symptoms, incredibly irritable. 5/1 she awake with a terrible headache which continued all day. Around  9:30 pm she laid down and shortly after was unable to move her body. 5/4/21 at 4:19pm her time of death was called. Cause; brain death due to aneurysm and stroke due to passing blood clot in brain."
	"1313691-1"	"1313691-1"	"CHILLS"	"10008531"	"50-59 years"	"50-59"	"Following the vaccination patient didn?t feel well. Fever, chills, cold symptoms, incredibly irritable. 5/1 she awake with a terrible headache which continued all day. Around  9:30 pm she laid down and shortly after was unable to move her body. 5/4/21 at 4:19pm her time of death was called. Cause; brain death due to aneurysm and stroke due to passing blood clot in brain."
	"1313691-1"	"1313691-1"	"HEADACHE"	"10019211"	"50-59 years"	"50-59"	"Following the vaccination patient didn?t feel well. Fever, chills, cold symptoms, incredibly irritable. 5/1 she awake with a terrible headache which continued all day. Around  9:30 pm she laid down and shortly after was unable to move her body. 5/4/21 at 4:19pm her time of death was called. Cause; brain death due to aneurysm and stroke due to passing blood clot in brain."
	"1313691-1"	"1313691-1"	"IRRITABILITY"	"10022998"	"50-59 years"	"50-59"	"Following the vaccination patient didn?t feel well. Fever, chills, cold symptoms, incredibly irritable. 5/1 she awake with a terrible headache which continued all day. Around  9:30 pm she laid down and shortly after was unable to move her body. 5/4/21 at 4:19pm her time of death was called. Cause; brain death due to aneurysm and stroke due to passing blood clot in brain."
	"1313691-1"	"1313691-1"	"MALAISE"	"10025482"	"50-59 years"	"50-59"	"Following the vaccination patient didn?t feel well. Fever, chills, cold symptoms, incredibly irritable. 5/1 she awake with a terrible headache which continued all day. Around  9:30 pm she laid down and shortly after was unable to move her body. 5/4/21 at 4:19pm her time of death was called. Cause; brain death due to aneurysm and stroke due to passing blood clot in brain."
	"1313691-1"	"1313691-1"	"MOVEMENT DISORDER"	"10028035"	"50-59 years"	"50-59"	"Following the vaccination patient didn?t feel well. Fever, chills, cold symptoms, incredibly irritable. 5/1 she awake with a terrible headache which continued all day. Around  9:30 pm she laid down and shortly after was unable to move her body. 5/4/21 at 4:19pm her time of death was called. Cause; brain death due to aneurysm and stroke due to passing blood clot in brain."
	"1313691-1"	"1313691-1"	"NASOPHARYNGITIS"	"10028810"	"50-59 years"	"50-59"	"Following the vaccination patient didn?t feel well. Fever, chills, cold symptoms, incredibly irritable. 5/1 she awake with a terrible headache which continued all day. Around  9:30 pm she laid down and shortly after was unable to move her body. 5/4/21 at 4:19pm her time of death was called. Cause; brain death due to aneurysm and stroke due to passing blood clot in brain."
	"1313691-1"	"1313691-1"	"PYREXIA"	"10037660"	"50-59 years"	"50-59"	"Following the vaccination patient didn?t feel well. Fever, chills, cold symptoms, incredibly irritable. 5/1 she awake with a terrible headache which continued all day. Around  9:30 pm she laid down and shortly after was unable to move her body. 5/4/21 at 4:19pm her time of death was called. Cause; brain death due to aneurysm and stroke due to passing blood clot in brain."
	"1314135-1"	"1314135-1"	"ACUTE RESPIRATORY FAILURE"	"10001053"	"50-59 years"	"50-59"	"PATIENT'S SPOUSE REPORTS PATIENT WAS ADMITTED TO HOSPITAL ON 031421 FOR SEVERE SEPSIS WITH ACUTE ORGAN DYSFUNCTION, ACUTE METABOLIC ENCEPHALOPATHY, BILATERAL PNEUMONIA AND ACUTE HYPOXEMIC RESPIRATORY FAILURE THEN PASSED AWAY ON 3/27/21."
	"1314135-1"	"1314135-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"PATIENT'S SPOUSE REPORTS PATIENT WAS ADMITTED TO HOSPITAL ON 031421 FOR SEVERE SEPSIS WITH ACUTE ORGAN DYSFUNCTION, ACUTE METABOLIC ENCEPHALOPATHY, BILATERAL PNEUMONIA AND ACUTE HYPOXEMIC RESPIRATORY FAILURE THEN PASSED AWAY ON 3/27/21."
	"1314135-1"	"1314135-1"	"METABOLIC ENCEPHALOPATHY"	"10062190"	"50-59 years"	"50-59"	"PATIENT'S SPOUSE REPORTS PATIENT WAS ADMITTED TO HOSPITAL ON 031421 FOR SEVERE SEPSIS WITH ACUTE ORGAN DYSFUNCTION, ACUTE METABOLIC ENCEPHALOPATHY, BILATERAL PNEUMONIA AND ACUTE HYPOXEMIC RESPIRATORY FAILURE THEN PASSED AWAY ON 3/27/21."
	"1314135-1"	"1314135-1"	"ORGAN FAILURE"	"10053159"	"50-59 years"	"50-59"	"PATIENT'S SPOUSE REPORTS PATIENT WAS ADMITTED TO HOSPITAL ON 031421 FOR SEVERE SEPSIS WITH ACUTE ORGAN DYSFUNCTION, ACUTE METABOLIC ENCEPHALOPATHY, BILATERAL PNEUMONIA AND ACUTE HYPOXEMIC RESPIRATORY FAILURE THEN PASSED AWAY ON 3/27/21."
	"1314135-1"	"1314135-1"	"PNEUMONIA"	"10035664"	"50-59 years"	"50-59"	"PATIENT'S SPOUSE REPORTS PATIENT WAS ADMITTED TO HOSPITAL ON 031421 FOR SEVERE SEPSIS WITH ACUTE ORGAN DYSFUNCTION, ACUTE METABOLIC ENCEPHALOPATHY, BILATERAL PNEUMONIA AND ACUTE HYPOXEMIC RESPIRATORY FAILURE THEN PASSED AWAY ON 3/27/21."
	"1314135-1"	"1314135-1"	"SEPSIS"	"10040047"	"50-59 years"	"50-59"	"PATIENT'S SPOUSE REPORTS PATIENT WAS ADMITTED TO HOSPITAL ON 031421 FOR SEVERE SEPSIS WITH ACUTE ORGAN DYSFUNCTION, ACUTE METABOLIC ENCEPHALOPATHY, BILATERAL PNEUMONIA AND ACUTE HYPOXEMIC RESPIRATORY FAILURE THEN PASSED AWAY ON 3/27/21."
	"1314224-1"	"1314224-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient was vaccinated with Moderna Covid Vaccine on Thursday, May 6, 2021.  We were informed the following Monday that the patient had passed away unexpectedly on Friday, May 7, 2021.  Family members did not reach out to us to ask any questions or to let us know what had happened.  We do not know that this patient passed away due to vaccination with the Moderna Vaccine."
	"1314352-1"	"1314352-1"	"VOMITING"	"10047700"	"50-59 years"	"50-59"	"Vomiting."
	"1317744-1"	"1317744-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Death"
	"1321161-1"	"1321161-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient was vaccinated on May  6,2021.  On Friday May 14 ,2021 a  relative of the patient report that the patient died on May 9,2021..She report that the patient  doesn't take the prescriptions needed for a vascular condition he have and was suppose to received medicines by mail on tuesday before vaccination"
	"1323163-1"	"1323163-1"	"ACUTE KIDNEY INJURY"	"10069339"	"50-59 years"	"50-59"	"Patient was admitted to the hospital on 4/5/2021 for severe AKI with hyperkalemia. Patient had a prolonged hospital course due to kidney failure and AIDS. The patient developed acute respiratory failure on 5/1/21 and was transferred to the ICU, where he was found to be in septic shock. Patient passed away on 5/4/21 at 9:59am"
	"1323163-1"	"1323163-1"	"ACUTE RESPIRATORY FAILURE"	"10001053"	"50-59 years"	"50-59"	"Patient was admitted to the hospital on 4/5/2021 for severe AKI with hyperkalemia. Patient had a prolonged hospital course due to kidney failure and AIDS. The patient developed acute respiratory failure on 5/1/21 and was transferred to the ICU, where he was found to be in septic shock. Patient passed away on 5/4/21 at 9:59am"
	"1323163-1"	"1323163-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient was admitted to the hospital on 4/5/2021 for severe AKI with hyperkalemia. Patient had a prolonged hospital course due to kidney failure and AIDS. The patient developed acute respiratory failure on 5/1/21 and was transferred to the ICU, where he was found to be in septic shock. Patient passed away on 5/4/21 at 9:59am"
	"1323163-1"	"1323163-1"	"HYPERKALAEMIA"	"10020646"	"50-59 years"	"50-59"	"Patient was admitted to the hospital on 4/5/2021 for severe AKI with hyperkalemia. Patient had a prolonged hospital course due to kidney failure and AIDS. The patient developed acute respiratory failure on 5/1/21 and was transferred to the ICU, where he was found to be in septic shock. Patient passed away on 5/4/21 at 9:59am"
	"1323163-1"	"1323163-1"	"INTENSIVE CARE"	"10022519"	"50-59 years"	"50-59"	"Patient was admitted to the hospital on 4/5/2021 for severe AKI with hyperkalemia. Patient had a prolonged hospital course due to kidney failure and AIDS. The patient developed acute respiratory failure on 5/1/21 and was transferred to the ICU, where he was found to be in septic shock. Patient passed away on 5/4/21 at 9:59am"
	"1323163-1"	"1323163-1"	"SEPTIC SHOCK"	"10040070"	"50-59 years"	"50-59"	"Patient was admitted to the hospital on 4/5/2021 for severe AKI with hyperkalemia. Patient had a prolonged hospital course due to kidney failure and AIDS. The patient developed acute respiratory failure on 5/1/21 and was transferred to the ICU, where he was found to be in septic shock. Patient passed away on 5/4/21 at 9:59am"
	"1323260-1"	"1323260-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient did not show for 2nd dose appointment scheduled for 5/15/21.  Clinic staff contacted caregiver who notified that patient had expired 10 days after her first dose of Moderna."
	"1323514-1"	"1323514-1"	"COUGH"	"10011224"	"50-59 years"	"50-59"	"Son came into Health Dept this morning to report that his father began throwing up and having diarrhea Saturday morning(05/15/2021) which progressed through the day. States did not want to go to the Hospital but wanted to wait to see his MD at the Dialysis center on Monday (05/17/2021).   On Sunday(05/16/2021) nausea and vomiting  and diarrhea was worse and now with cough noted. States was washing his hands and fainted, EMS was called and he died that morning."
	"1323514-1"	"1323514-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Son came into Health Dept this morning to report that his father began throwing up and having diarrhea Saturday morning(05/15/2021) which progressed through the day. States did not want to go to the Hospital but wanted to wait to see his MD at the Dialysis center on Monday (05/17/2021).   On Sunday(05/16/2021) nausea and vomiting  and diarrhea was worse and now with cough noted. States was washing his hands and fainted, EMS was called and he died that morning."
	"1323514-1"	"1323514-1"	"DIARRHOEA"	"10012735"	"50-59 years"	"50-59"	"Son came into Health Dept this morning to report that his father began throwing up and having diarrhea Saturday morning(05/15/2021) which progressed through the day. States did not want to go to the Hospital but wanted to wait to see his MD at the Dialysis center on Monday (05/17/2021).   On Sunday(05/16/2021) nausea and vomiting  and diarrhea was worse and now with cough noted. States was washing his hands and fainted, EMS was called and he died that morning."
	"1323514-1"	"1323514-1"	"NAUSEA"	"10028813"	"50-59 years"	"50-59"	"Son came into Health Dept this morning to report that his father began throwing up and having diarrhea Saturday morning(05/15/2021) which progressed through the day. States did not want to go to the Hospital but wanted to wait to see his MD at the Dialysis center on Monday (05/17/2021).   On Sunday(05/16/2021) nausea and vomiting  and diarrhea was worse and now with cough noted. States was washing his hands and fainted, EMS was called and he died that morning."
	"1323514-1"	"1323514-1"	"SYNCOPE"	"10042772"	"50-59 years"	"50-59"	"Son came into Health Dept this morning to report that his father began throwing up and having diarrhea Saturday morning(05/15/2021) which progressed through the day. States did not want to go to the Hospital but wanted to wait to see his MD at the Dialysis center on Monday (05/17/2021).   On Sunday(05/16/2021) nausea and vomiting  and diarrhea was worse and now with cough noted. States was washing his hands and fainted, EMS was called and he died that morning."
	"1323514-1"	"1323514-1"	"VOMITING"	"10047700"	"50-59 years"	"50-59"	"Son came into Health Dept this morning to report that his father began throwing up and having diarrhea Saturday morning(05/15/2021) which progressed through the day. States did not want to go to the Hospital but wanted to wait to see his MD at the Dialysis center on Monday (05/17/2021).   On Sunday(05/16/2021) nausea and vomiting  and diarrhea was worse and now with cough noted. States was washing his hands and fainted, EMS was called and he died that morning."
	"1323673-1"	"1323673-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Subsequently developed respiratory distress and pneumonia after testing positive for COVID. Pt died due to illness."
	"1323673-1"	"1323673-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Subsequently developed respiratory distress and pneumonia after testing positive for COVID. Pt died due to illness."
	"1323673-1"	"1323673-1"	"ILLNESS"	"10080284"	"50-59 years"	"50-59"	"Subsequently developed respiratory distress and pneumonia after testing positive for COVID. Pt died due to illness."
	"1323673-1"	"1323673-1"	"PNEUMONIA"	"10035664"	"50-59 years"	"50-59"	"Subsequently developed respiratory distress and pneumonia after testing positive for COVID. Pt died due to illness."
	"1323673-1"	"1323673-1"	"RESPIRATORY DISTRESS"	"10038687"	"50-59 years"	"50-59"	"Subsequently developed respiratory distress and pneumonia after testing positive for COVID. Pt died due to illness."
	"1323673-1"	"1323673-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"Subsequently developed respiratory distress and pneumonia after testing positive for COVID. Pt died due to illness."
	"1324469-1"	"1324469-1"	"APHASIA"	"10002948"	"50-59 years"	"50-59"	"Pt received vaccination on 05/13.  The following day developed fever.  On 05/15 she developed sore throat and vomiting.  Her sore throat progressed where she could not speak or talk.  She was seen in the ER and in respiratory failure.  She was intubated and developed septic shock. Labs notable for WBC 0.1, platelets 32.  INR elevated at 2.2.  She had renal failure and shock liver and evidence of DIC.  Blood cultures grew gram negative rods.  She eventually died from septic shock."
	"1324469-1"	"1324469-1"	"BACTERIAL INFECTION"	"10060945"	"50-59 years"	"50-59"	"Pt received vaccination on 05/13.  The following day developed fever.  On 05/15 she developed sore throat and vomiting.  Her sore throat progressed where she could not speak or talk.  She was seen in the ER and in respiratory failure.  She was intubated and developed septic shock. Labs notable for WBC 0.1, platelets 32.  INR elevated at 2.2.  She had renal failure and shock liver and evidence of DIC.  Blood cultures grew gram negative rods.  She eventually died from septic shock."
	"1324469-1"	"1324469-1"	"BLOOD CREATININE INCREASED"	"10005483"	"50-59 years"	"50-59"	"Pt received vaccination on 05/13.  The following day developed fever.  On 05/15 she developed sore throat and vomiting.  Her sore throat progressed where she could not speak or talk.  She was seen in the ER and in respiratory failure.  She was intubated and developed septic shock. Labs notable for WBC 0.1, platelets 32.  INR elevated at 2.2.  She had renal failure and shock liver and evidence of DIC.  Blood cultures grew gram negative rods.  She eventually died from septic shock."
	"1324469-1"	"1324469-1"	"BLOOD CULTURE POSITIVE"	"10005488"	"50-59 years"	"50-59"	"Pt received vaccination on 05/13.  The following day developed fever.  On 05/15 she developed sore throat and vomiting.  Her sore throat progressed where she could not speak or talk.  She was seen in the ER and in respiratory failure.  She was intubated and developed septic shock. Labs notable for WBC 0.1, platelets 32.  INR elevated at 2.2.  She had renal failure and shock liver and evidence of DIC.  Blood cultures grew gram negative rods.  She eventually died from septic shock."
	"1324469-1"	"1324469-1"	"BLOOD LACTIC ACID"	"10005632"	"50-59 years"	"50-59"	"Pt received vaccination on 05/13.  The following day developed fever.  On 05/15 she developed sore throat and vomiting.  Her sore throat progressed where she could not speak or talk.  She was seen in the ER and in respiratory failure.  She was intubated and developed septic shock. Labs notable for WBC 0.1, platelets 32.  INR elevated at 2.2.  She had renal failure and shock liver and evidence of DIC.  Blood cultures grew gram negative rods.  She eventually died from septic shock."
	"1324469-1"	"1324469-1"	"COMPUTERISED TOMOGRAM ABNORMAL"	"10010235"	"50-59 years"	"50-59"	"Pt received vaccination on 05/13.  The following day developed fever.  On 05/15 she developed sore throat and vomiting.  Her sore throat progressed where she could not speak or talk.  She was seen in the ER and in respiratory failure.  She was intubated and developed septic shock. Labs notable for WBC 0.1, platelets 32.  INR elevated at 2.2.  She had renal failure and shock liver and evidence of DIC.  Blood cultures grew gram negative rods.  She eventually died from septic shock."
	"1324469-1"	"1324469-1"	"COMPUTERISED TOMOGRAM NECK"	"10082961"	"50-59 years"	"50-59"	"Pt received vaccination on 05/13.  The following day developed fever.  On 05/15 she developed sore throat and vomiting.  Her sore throat progressed where she could not speak or talk.  She was seen in the ER and in respiratory failure.  She was intubated and developed septic shock. Labs notable for WBC 0.1, platelets 32.  INR elevated at 2.2.  She had renal failure and shock liver and evidence of DIC.  Blood cultures grew gram negative rods.  She eventually died from septic shock."
	"1324469-1"	"1324469-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Pt received vaccination on 05/13.  The following day developed fever.  On 05/15 she developed sore throat and vomiting.  Her sore throat progressed where she could not speak or talk.  She was seen in the ER and in respiratory failure.  She was intubated and developed septic shock. Labs notable for WBC 0.1, platelets 32.  INR elevated at 2.2.  She had renal failure and shock liver and evidence of DIC.  Blood cultures grew gram negative rods.  She eventually died from septic shock."
	"1324469-1"	"1324469-1"	"DISSEMINATED INTRAVASCULAR COAGULATION"	"10013442"	"50-59 years"	"50-59"	"Pt received vaccination on 05/13.  The following day developed fever.  On 05/15 she developed sore throat and vomiting.  Her sore throat progressed where she could not speak or talk.  She was seen in the ER and in respiratory failure.  She was intubated and developed septic shock. Labs notable for WBC 0.1, platelets 32.  INR elevated at 2.2.  She had renal failure and shock liver and evidence of DIC.  Blood cultures grew gram negative rods.  She eventually died from septic shock."
	"1324469-1"	"1324469-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"50-59 years"	"50-59"	"Pt received vaccination on 05/13.  The following day developed fever.  On 05/15 she developed sore throat and vomiting.  Her sore throat progressed where she could not speak or talk.  She was seen in the ER and in respiratory failure.  She was intubated and developed septic shock. Labs notable for WBC 0.1, platelets 32.  INR elevated at 2.2.  She had renal failure and shock liver and evidence of DIC.  Blood cultures grew gram negative rods.  She eventually died from septic shock."
	"1324469-1"	"1324469-1"	"INTERNATIONAL NORMALISED RATIO INCREASED"	"10022595"	"50-59 years"	"50-59"	"Pt received vaccination on 05/13.  The following day developed fever.  On 05/15 she developed sore throat and vomiting.  Her sore throat progressed where she could not speak or talk.  She was seen in the ER and in respiratory failure.  She was intubated and developed septic shock. Labs notable for WBC 0.1, platelets 32.  INR elevated at 2.2.  She had renal failure and shock liver and evidence of DIC.  Blood cultures grew gram negative rods.  She eventually died from septic shock."
	"1324469-1"	"1324469-1"	"ISCHAEMIC HEPATITIS"	"10023025"	"50-59 years"	"50-59"	"Pt received vaccination on 05/13.  The following day developed fever.  On 05/15 she developed sore throat and vomiting.  Her sore throat progressed where she could not speak or talk.  She was seen in the ER and in respiratory failure.  She was intubated and developed septic shock. Labs notable for WBC 0.1, platelets 32.  INR elevated at 2.2.  She had renal failure and shock liver and evidence of DIC.  Blood cultures grew gram negative rods.  She eventually died from septic shock."
	"1324469-1"	"1324469-1"	"LOCALISED OEDEMA"	"10048961"	"50-59 years"	"50-59"	"Pt received vaccination on 05/13.  The following day developed fever.  On 05/15 she developed sore throat and vomiting.  Her sore throat progressed where she could not speak or talk.  She was seen in the ER and in respiratory failure.  She was intubated and developed septic shock. Labs notable for WBC 0.1, platelets 32.  INR elevated at 2.2.  She had renal failure and shock liver and evidence of DIC.  Blood cultures grew gram negative rods.  She eventually died from septic shock."
	"1324469-1"	"1324469-1"	"MEDIASTINAL MASS"	"10027076"	"50-59 years"	"50-59"	"Pt received vaccination on 05/13.  The following day developed fever.  On 05/15 she developed sore throat and vomiting.  Her sore throat progressed where she could not speak or talk.  She was seen in the ER and in respiratory failure.  She was intubated and developed septic shock. Labs notable for WBC 0.1, platelets 32.  INR elevated at 2.2.  She had renal failure and shock liver and evidence of DIC.  Blood cultures grew gram negative rods.  She eventually died from septic shock."
	"1324469-1"	"1324469-1"	"OROPHARYNGEAL PAIN"	"10068319"	"50-59 years"	"50-59"	"Pt received vaccination on 05/13.  The following day developed fever.  On 05/15 she developed sore throat and vomiting.  Her sore throat progressed where she could not speak or talk.  She was seen in the ER and in respiratory failure.  She was intubated and developed septic shock. Labs notable for WBC 0.1, platelets 32.  INR elevated at 2.2.  She had renal failure and shock liver and evidence of DIC.  Blood cultures grew gram negative rods.  She eventually died from septic shock."
	"1324469-1"	"1324469-1"	"PHARYNGEAL OEDEMA"	"10034829"	"50-59 years"	"50-59"	"Pt received vaccination on 05/13.  The following day developed fever.  On 05/15 she developed sore throat and vomiting.  Her sore throat progressed where she could not speak or talk.  She was seen in the ER and in respiratory failure.  She was intubated and developed septic shock. Labs notable for WBC 0.1, platelets 32.  INR elevated at 2.2.  She had renal failure and shock liver and evidence of DIC.  Blood cultures grew gram negative rods.  She eventually died from septic shock."
	"1324469-1"	"1324469-1"	"PLATELET COUNT DECREASED"	"10035528"	"50-59 years"	"50-59"	"Pt received vaccination on 05/13.  The following day developed fever.  On 05/15 she developed sore throat and vomiting.  Her sore throat progressed where she could not speak or talk.  She was seen in the ER and in respiratory failure.  She was intubated and developed septic shock. Labs notable for WBC 0.1, platelets 32.  INR elevated at 2.2.  She had renal failure and shock liver and evidence of DIC.  Blood cultures grew gram negative rods.  She eventually died from septic shock."
	"1324469-1"	"1324469-1"	"PYREXIA"	"10037660"	"50-59 years"	"50-59"	"Pt received vaccination on 05/13.  The following day developed fever.  On 05/15 she developed sore throat and vomiting.  Her sore throat progressed where she could not speak or talk.  She was seen in the ER and in respiratory failure.  She was intubated and developed septic shock. Labs notable for WBC 0.1, platelets 32.  INR elevated at 2.2.  She had renal failure and shock liver and evidence of DIC.  Blood cultures grew gram negative rods.  She eventually died from septic shock."
	"1324469-1"	"1324469-1"	"RENAL FAILURE"	"10038435"	"50-59 years"	"50-59"	"Pt received vaccination on 05/13.  The following day developed fever.  On 05/15 she developed sore throat and vomiting.  Her sore throat progressed where she could not speak or talk.  She was seen in the ER and in respiratory failure.  She was intubated and developed septic shock. Labs notable for WBC 0.1, platelets 32.  INR elevated at 2.2.  She had renal failure and shock liver and evidence of DIC.  Blood cultures grew gram negative rods.  She eventually died from septic shock."
	"1324469-1"	"1324469-1"	"RESPIRATORY FAILURE"	"10038695"	"50-59 years"	"50-59"	"Pt received vaccination on 05/13.  The following day developed fever.  On 05/15 she developed sore throat and vomiting.  Her sore throat progressed where she could not speak or talk.  She was seen in the ER and in respiratory failure.  She was intubated and developed septic shock. Labs notable for WBC 0.1, platelets 32.  INR elevated at 2.2.  She had renal failure and shock liver and evidence of DIC.  Blood cultures grew gram negative rods.  She eventually died from septic shock."
	"1324469-1"	"1324469-1"	"SEPTIC SHOCK"	"10040070"	"50-59 years"	"50-59"	"Pt received vaccination on 05/13.  The following day developed fever.  On 05/15 she developed sore throat and vomiting.  Her sore throat progressed where she could not speak or talk.  She was seen in the ER and in respiratory failure.  She was intubated and developed septic shock. Labs notable for WBC 0.1, platelets 32.  INR elevated at 2.2.  She had renal failure and shock liver and evidence of DIC.  Blood cultures grew gram negative rods.  She eventually died from septic shock."
	"1324469-1"	"1324469-1"	"VOMITING"	"10047700"	"50-59 years"	"50-59"	"Pt received vaccination on 05/13.  The following day developed fever.  On 05/15 she developed sore throat and vomiting.  Her sore throat progressed where she could not speak or talk.  She was seen in the ER and in respiratory failure.  She was intubated and developed septic shock. Labs notable for WBC 0.1, platelets 32.  INR elevated at 2.2.  She had renal failure and shock liver and evidence of DIC.  Blood cultures grew gram negative rods.  She eventually died from septic shock."
	"1324469-1"	"1324469-1"	"WHITE BLOOD CELL COUNT DECREASED"	"10047942"	"50-59 years"	"50-59"	"Pt received vaccination on 05/13.  The following day developed fever.  On 05/15 she developed sore throat and vomiting.  Her sore throat progressed where she could not speak or talk.  She was seen in the ER and in respiratory failure.  She was intubated and developed septic shock. Labs notable for WBC 0.1, platelets 32.  INR elevated at 2.2.  She had renal failure and shock liver and evidence of DIC.  Blood cultures grew gram negative rods.  She eventually died from septic shock."
	"1326284-1"	"1326284-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Pt. passed away 2 days after vaccination. At time of vaccination pt. already in moribund state related to long term diabetes mellitus1 with ESRD, chronic foot wound since 2017, severe osteoarthritis. In March 2021 pt. hospitalized d/t severe pain. Findings were acute encephalopathy likely multifactoral, abnormal EEG and NSTEMI. Pt. refused further diagnostic in the hospital and resumed home hemodiaysis with help of her spouse. Hospice care was considered by the couple shortly before the time of vaccination."
	"1326764-1"	"1326764-1"	"COMPUTERISED TOMOGRAM THORAX ABNORMAL"	"10057799"	"50-59 years"	"50-59"	"First vaccine dose administered on 4/20/21. Patient was admitted on 4/29/21 with shortness of breath and pleuritic chest pain. CT scan revealed pulmonary embolism and doppler showed vascular access (Hero graft) thrombosis. Patient was treated with heparin and warfarin, and was discharged on 5/5/2021 after being converted to apixaban.  Patient missed scheduled dialysis treatment (no call/no show) on 5/8/21 and 5/11/21. Subsequent welfare check found the patient expired at home."
	"1326764-1"	"1326764-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"First vaccine dose administered on 4/20/21. Patient was admitted on 4/29/21 with shortness of breath and pleuritic chest pain. CT scan revealed pulmonary embolism and doppler showed vascular access (Hero graft) thrombosis. Patient was treated with heparin and warfarin, and was discharged on 5/5/2021 after being converted to apixaban.  Patient missed scheduled dialysis treatment (no call/no show) on 5/8/21 and 5/11/21. Subsequent welfare check found the patient expired at home."
	"1326764-1"	"1326764-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"First vaccine dose administered on 4/20/21. Patient was admitted on 4/29/21 with shortness of breath and pleuritic chest pain. CT scan revealed pulmonary embolism and doppler showed vascular access (Hero graft) thrombosis. Patient was treated with heparin and warfarin, and was discharged on 5/5/2021 after being converted to apixaban.  Patient missed scheduled dialysis treatment (no call/no show) on 5/8/21 and 5/11/21. Subsequent welfare check found the patient expired at home."
	"1326764-1"	"1326764-1"	"ECHOCARDIOGRAM"	"10014113"	"50-59 years"	"50-59"	"First vaccine dose administered on 4/20/21. Patient was admitted on 4/29/21 with shortness of breath and pleuritic chest pain. CT scan revealed pulmonary embolism and doppler showed vascular access (Hero graft) thrombosis. Patient was treated with heparin and warfarin, and was discharged on 5/5/2021 after being converted to apixaban.  Patient missed scheduled dialysis treatment (no call/no show) on 5/8/21 and 5/11/21. Subsequent welfare check found the patient expired at home."
	"1326764-1"	"1326764-1"	"PLEURAL EFFUSION"	"10035598"	"50-59 years"	"50-59"	"First vaccine dose administered on 4/20/21. Patient was admitted on 4/29/21 with shortness of breath and pleuritic chest pain. CT scan revealed pulmonary embolism and doppler showed vascular access (Hero graft) thrombosis. Patient was treated with heparin and warfarin, and was discharged on 5/5/2021 after being converted to apixaban.  Patient missed scheduled dialysis treatment (no call/no show) on 5/8/21 and 5/11/21. Subsequent welfare check found the patient expired at home."
	"1326764-1"	"1326764-1"	"PLEURITIC PAIN"	"10035623"	"50-59 years"	"50-59"	"First vaccine dose administered on 4/20/21. Patient was admitted on 4/29/21 with shortness of breath and pleuritic chest pain. CT scan revealed pulmonary embolism and doppler showed vascular access (Hero graft) thrombosis. Patient was treated with heparin and warfarin, and was discharged on 5/5/2021 after being converted to apixaban.  Patient missed scheduled dialysis treatment (no call/no show) on 5/8/21 and 5/11/21. Subsequent welfare check found the patient expired at home."
	"1326764-1"	"1326764-1"	"PULMONARY EMBOLISM"	"10037377"	"50-59 years"	"50-59"	"First vaccine dose administered on 4/20/21. Patient was admitted on 4/29/21 with shortness of breath and pleuritic chest pain. CT scan revealed pulmonary embolism and doppler showed vascular access (Hero graft) thrombosis. Patient was treated with heparin and warfarin, and was discharged on 5/5/2021 after being converted to apixaban.  Patient missed scheduled dialysis treatment (no call/no show) on 5/8/21 and 5/11/21. Subsequent welfare check found the patient expired at home."
	"1326764-1"	"1326764-1"	"VASCULAR GRAFT THROMBOSIS"	"10069922"	"50-59 years"	"50-59"	"First vaccine dose administered on 4/20/21. Patient was admitted on 4/29/21 with shortness of breath and pleuritic chest pain. CT scan revealed pulmonary embolism and doppler showed vascular access (Hero graft) thrombosis. Patient was treated with heparin and warfarin, and was discharged on 5/5/2021 after being converted to apixaban.  Patient missed scheduled dialysis treatment (no call/no show) on 5/8/21 and 5/11/21. Subsequent welfare check found the patient expired at home."
	"1327652-1"	"1327652-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Approximately  48 - 72 hours after vaccine was administered, she was found deceased in am of 05/16/2021"
	"1331183-1"	"1331183-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Death occurred outside of pharmacy 22.5 hours post vaccination. Cause of death being the vaccine is unknown."
	"1331243-1"	"1331243-1"	"DIZZINESS"	"10013573"	"50-59 years"	"50-59"	"Lightheaded, nausea resulting in heart attack"
	"1331243-1"	"1331243-1"	"MYOCARDIAL INFARCTION"	"10028596"	"50-59 years"	"50-59"	"Lightheaded, nausea resulting in heart attack"
	"1331243-1"	"1331243-1"	"NAUSEA"	"10028813"	"50-59 years"	"50-59"	"Lightheaded, nausea resulting in heart attack"
	"1332656-1"	"1332656-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"bilateral leg pain, diarrhea, flu like symptoms, death"
	"1332656-1"	"1332656-1"	"DIARRHOEA"	"10012735"	"50-59 years"	"50-59"	"bilateral leg pain, diarrhea, flu like symptoms, death"
	"1332656-1"	"1332656-1"	"INFLUENZA LIKE ILLNESS"	"10022004"	"50-59 years"	"50-59"	"bilateral leg pain, diarrhea, flu like symptoms, death"
	"1332656-1"	"1332656-1"	"PAIN IN EXTREMITY"	"10033425"	"50-59 years"	"50-59"	"bilateral leg pain, diarrhea, flu like symptoms, death"
	"1333421-1"	"1333421-1"	"ACUTE RESPIRATORY FAILURE"	"10001053"	"50-59 years"	"50-59"	"3/18, admiteed 2 days after covic vaccine with SOB, rib pain, emesis. Patient had metastatic ovarian cancer on chemotherapy who was admitted to the intensive care unit with severe sepsis with septic shock and acute hypoxemic respiratory failure requiring intubation mechanical ventilation. She was started on broad-spectrum antibiotics, but did not have an obvious source of infection.  She remained on mechanical ventilation, with profound metabolic acidosis.  She required high doses of norepinephrine and vasopressin drips, but on arterial blood gas had a pH of 6.98.  The patient had a cardiopulmonary arrest in the intensive care unit.  1 round of ACLS protocol was performed, with return of spontaneous circulation.  After discussion with the patient's mother by phone, she opted for DNR status, comfort care, and to allow for natural death.  The patient was kept on mechanical ventilation, and she passed away."
	"1333421-1"	"1333421-1"	"BLOOD PH DECREASED"	"10005706"	"50-59 years"	"50-59"	"3/18, admiteed 2 days after covic vaccine with SOB, rib pain, emesis. Patient had metastatic ovarian cancer on chemotherapy who was admitted to the intensive care unit with severe sepsis with septic shock and acute hypoxemic respiratory failure requiring intubation mechanical ventilation. She was started on broad-spectrum antibiotics, but did not have an obvious source of infection.  She remained on mechanical ventilation, with profound metabolic acidosis.  She required high doses of norepinephrine and vasopressin drips, but on arterial blood gas had a pH of 6.98.  The patient had a cardiopulmonary arrest in the intensive care unit.  1 round of ACLS protocol was performed, with return of spontaneous circulation.  After discussion with the patient's mother by phone, she opted for DNR status, comfort care, and to allow for natural death.  The patient was kept on mechanical ventilation, and she passed away."
	"1333421-1"	"1333421-1"	"CARDIO-RESPIRATORY ARREST"	"10007617"	"50-59 years"	"50-59"	"3/18, admiteed 2 days after covic vaccine with SOB, rib pain, emesis. Patient had metastatic ovarian cancer on chemotherapy who was admitted to the intensive care unit with severe sepsis with septic shock and acute hypoxemic respiratory failure requiring intubation mechanical ventilation. She was started on broad-spectrum antibiotics, but did not have an obvious source of infection.  She remained on mechanical ventilation, with profound metabolic acidosis.  She required high doses of norepinephrine and vasopressin drips, but on arterial blood gas had a pH of 6.98.  The patient had a cardiopulmonary arrest in the intensive care unit.  1 round of ACLS protocol was performed, with return of spontaneous circulation.  After discussion with the patient's mother by phone, she opted for DNR status, comfort care, and to allow for natural death.  The patient was kept on mechanical ventilation, and she passed away."
	"1333421-1"	"1333421-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"3/18, admiteed 2 days after covic vaccine with SOB, rib pain, emesis. Patient had metastatic ovarian cancer on chemotherapy who was admitted to the intensive care unit with severe sepsis with septic shock and acute hypoxemic respiratory failure requiring intubation mechanical ventilation. She was started on broad-spectrum antibiotics, but did not have an obvious source of infection.  She remained on mechanical ventilation, with profound metabolic acidosis.  She required high doses of norepinephrine and vasopressin drips, but on arterial blood gas had a pH of 6.98.  The patient had a cardiopulmonary arrest in the intensive care unit.  1 round of ACLS protocol was performed, with return of spontaneous circulation.  After discussion with the patient's mother by phone, she opted for DNR status, comfort care, and to allow for natural death.  The patient was kept on mechanical ventilation, and she passed away."
	"1333421-1"	"1333421-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"3/18, admiteed 2 days after covic vaccine with SOB, rib pain, emesis. Patient had metastatic ovarian cancer on chemotherapy who was admitted to the intensive care unit with severe sepsis with septic shock and acute hypoxemic respiratory failure requiring intubation mechanical ventilation. She was started on broad-spectrum antibiotics, but did not have an obvious source of infection.  She remained on mechanical ventilation, with profound metabolic acidosis.  She required high doses of norepinephrine and vasopressin drips, but on arterial blood gas had a pH of 6.98.  The patient had a cardiopulmonary arrest in the intensive care unit.  1 round of ACLS protocol was performed, with return of spontaneous circulation.  After discussion with the patient's mother by phone, she opted for DNR status, comfort care, and to allow for natural death.  The patient was kept on mechanical ventilation, and she passed away."
	"1333421-1"	"1333421-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"50-59 years"	"50-59"	"3/18, admiteed 2 days after covic vaccine with SOB, rib pain, emesis. Patient had metastatic ovarian cancer on chemotherapy who was admitted to the intensive care unit with severe sepsis with septic shock and acute hypoxemic respiratory failure requiring intubation mechanical ventilation. She was started on broad-spectrum antibiotics, but did not have an obvious source of infection.  She remained on mechanical ventilation, with profound metabolic acidosis.  She required high doses of norepinephrine and vasopressin drips, but on arterial blood gas had a pH of 6.98.  The patient had a cardiopulmonary arrest in the intensive care unit.  1 round of ACLS protocol was performed, with return of spontaneous circulation.  After discussion with the patient's mother by phone, she opted for DNR status, comfort care, and to allow for natural death.  The patient was kept on mechanical ventilation, and she passed away."
	"1333421-1"	"1333421-1"	"INTENSIVE CARE"	"10022519"	"50-59 years"	"50-59"	"3/18, admiteed 2 days after covic vaccine with SOB, rib pain, emesis. Patient had metastatic ovarian cancer on chemotherapy who was admitted to the intensive care unit with severe sepsis with septic shock and acute hypoxemic respiratory failure requiring intubation mechanical ventilation. She was started on broad-spectrum antibiotics, but did not have an obvious source of infection.  She remained on mechanical ventilation, with profound metabolic acidosis.  She required high doses of norepinephrine and vasopressin drips, but on arterial blood gas had a pH of 6.98.  The patient had a cardiopulmonary arrest in the intensive care unit.  1 round of ACLS protocol was performed, with return of spontaneous circulation.  After discussion with the patient's mother by phone, she opted for DNR status, comfort care, and to allow for natural death.  The patient was kept on mechanical ventilation, and she passed away."
	"1333421-1"	"1333421-1"	"MECHANICAL VENTILATION"	"10067221"	"50-59 years"	"50-59"	"3/18, admiteed 2 days after covic vaccine with SOB, rib pain, emesis. Patient had metastatic ovarian cancer on chemotherapy who was admitted to the intensive care unit with severe sepsis with septic shock and acute hypoxemic respiratory failure requiring intubation mechanical ventilation. She was started on broad-spectrum antibiotics, but did not have an obvious source of infection.  She remained on mechanical ventilation, with profound metabolic acidosis.  She required high doses of norepinephrine and vasopressin drips, but on arterial blood gas had a pH of 6.98.  The patient had a cardiopulmonary arrest in the intensive care unit.  1 round of ACLS protocol was performed, with return of spontaneous circulation.  After discussion with the patient's mother by phone, she opted for DNR status, comfort care, and to allow for natural death.  The patient was kept on mechanical ventilation, and she passed away."
	"1333421-1"	"1333421-1"	"METABOLIC ACIDOSIS"	"10027417"	"50-59 years"	"50-59"	"3/18, admiteed 2 days after covic vaccine with SOB, rib pain, emesis. Patient had metastatic ovarian cancer on chemotherapy who was admitted to the intensive care unit with severe sepsis with septic shock and acute hypoxemic respiratory failure requiring intubation mechanical ventilation. She was started on broad-spectrum antibiotics, but did not have an obvious source of infection.  She remained on mechanical ventilation, with profound metabolic acidosis.  She required high doses of norepinephrine and vasopressin drips, but on arterial blood gas had a pH of 6.98.  The patient had a cardiopulmonary arrest in the intensive care unit.  1 round of ACLS protocol was performed, with return of spontaneous circulation.  After discussion with the patient's mother by phone, she opted for DNR status, comfort care, and to allow for natural death.  The patient was kept on mechanical ventilation, and she passed away."
	"1333421-1"	"1333421-1"	"MUSCULOSKELETAL CHEST PAIN"	"10050819"	"50-59 years"	"50-59"	"3/18, admiteed 2 days after covic vaccine with SOB, rib pain, emesis. Patient had metastatic ovarian cancer on chemotherapy who was admitted to the intensive care unit with severe sepsis with septic shock and acute hypoxemic respiratory failure requiring intubation mechanical ventilation. She was started on broad-spectrum antibiotics, but did not have an obvious source of infection.  She remained on mechanical ventilation, with profound metabolic acidosis.  She required high doses of norepinephrine and vasopressin drips, but on arterial blood gas had a pH of 6.98.  The patient had a cardiopulmonary arrest in the intensive care unit.  1 round of ACLS protocol was performed, with return of spontaneous circulation.  After discussion with the patient's mother by phone, she opted for DNR status, comfort care, and to allow for natural death.  The patient was kept on mechanical ventilation, and she passed away."
	"1333421-1"	"1333421-1"	"RESUSCITATION"	"10038749"	"50-59 years"	"50-59"	"3/18, admiteed 2 days after covic vaccine with SOB, rib pain, emesis. Patient had metastatic ovarian cancer on chemotherapy who was admitted to the intensive care unit with severe sepsis with septic shock and acute hypoxemic respiratory failure requiring intubation mechanical ventilation. She was started on broad-spectrum antibiotics, but did not have an obvious source of infection.  She remained on mechanical ventilation, with profound metabolic acidosis.  She required high doses of norepinephrine and vasopressin drips, but on arterial blood gas had a pH of 6.98.  The patient had a cardiopulmonary arrest in the intensive care unit.  1 round of ACLS protocol was performed, with return of spontaneous circulation.  After discussion with the patient's mother by phone, she opted for DNR status, comfort care, and to allow for natural death.  The patient was kept on mechanical ventilation, and she passed away."
	"1333421-1"	"1333421-1"	"SEPSIS"	"10040047"	"50-59 years"	"50-59"	"3/18, admiteed 2 days after covic vaccine with SOB, rib pain, emesis. Patient had metastatic ovarian cancer on chemotherapy who was admitted to the intensive care unit with severe sepsis with septic shock and acute hypoxemic respiratory failure requiring intubation mechanical ventilation. She was started on broad-spectrum antibiotics, but did not have an obvious source of infection.  She remained on mechanical ventilation, with profound metabolic acidosis.  She required high doses of norepinephrine and vasopressin drips, but on arterial blood gas had a pH of 6.98.  The patient had a cardiopulmonary arrest in the intensive care unit.  1 round of ACLS protocol was performed, with return of spontaneous circulation.  After discussion with the patient's mother by phone, she opted for DNR status, comfort care, and to allow for natural death.  The patient was kept on mechanical ventilation, and she passed away."
	"1333421-1"	"1333421-1"	"SEPTIC SHOCK"	"10040070"	"50-59 years"	"50-59"	"3/18, admiteed 2 days after covic vaccine with SOB, rib pain, emesis. Patient had metastatic ovarian cancer on chemotherapy who was admitted to the intensive care unit with severe sepsis with septic shock and acute hypoxemic respiratory failure requiring intubation mechanical ventilation. She was started on broad-spectrum antibiotics, but did not have an obvious source of infection.  She remained on mechanical ventilation, with profound metabolic acidosis.  She required high doses of norepinephrine and vasopressin drips, but on arterial blood gas had a pH of 6.98.  The patient had a cardiopulmonary arrest in the intensive care unit.  1 round of ACLS protocol was performed, with return of spontaneous circulation.  After discussion with the patient's mother by phone, she opted for DNR status, comfort care, and to allow for natural death.  The patient was kept on mechanical ventilation, and she passed away."
	"1333421-1"	"1333421-1"	"VOMITING"	"10047700"	"50-59 years"	"50-59"	"3/18, admiteed 2 days after covic vaccine with SOB, rib pain, emesis. Patient had metastatic ovarian cancer on chemotherapy who was admitted to the intensive care unit with severe sepsis with septic shock and acute hypoxemic respiratory failure requiring intubation mechanical ventilation. She was started on broad-spectrum antibiotics, but did not have an obvious source of infection.  She remained on mechanical ventilation, with profound metabolic acidosis.  She required high doses of norepinephrine and vasopressin drips, but on arterial blood gas had a pH of 6.98.  The patient had a cardiopulmonary arrest in the intensive care unit.  1 round of ACLS protocol was performed, with return of spontaneous circulation.  After discussion with the patient's mother by phone, she opted for DNR status, comfort care, and to allow for natural death.  The patient was kept on mechanical ventilation, and she passed away."
	"1334684-1"	"1334684-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Systemic: death (unknown cause)-Severe, Additional Details: Patient was found deceased roughly an hour and a half after receiving Moderna vaccine. He waited 20 minutes at the pharmacy and left however later died. Details are unknown. Sister may have more information."
	"1336097-1"	"1336097-1"	"ACUTE MYOCARDIAL INFARCTION"	"10000891"	"50-59 years"	"50-59"	"Vfib arrest"
	"1336097-1"	"1336097-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"Vfib arrest"
	"1336097-1"	"1336097-1"	"ELECTROCARDIOGRAM ABNORMAL"	"10014363"	"50-59 years"	"50-59"	"Vfib arrest"
	"1336097-1"	"1336097-1"	"VENTRICULAR FIBRILLATION"	"10047290"	"50-59 years"	"50-59"	"Vfib arrest"
	"1336774-1"	"1336774-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Patient developed fever, dyspnea and headache on 5/12/2021; tested positive for COVID-19 on 5/12/2021; patient died on 5/20/21"
	"1336774-1"	"1336774-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient developed fever, dyspnea and headache on 5/12/2021; tested positive for COVID-19 on 5/12/2021; patient died on 5/20/21"
	"1336774-1"	"1336774-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"Patient developed fever, dyspnea and headache on 5/12/2021; tested positive for COVID-19 on 5/12/2021; patient died on 5/20/21"
	"1336774-1"	"1336774-1"	"HEADACHE"	"10019211"	"50-59 years"	"50-59"	"Patient developed fever, dyspnea and headache on 5/12/2021; tested positive for COVID-19 on 5/12/2021; patient died on 5/20/21"
	"1336774-1"	"1336774-1"	"PYREXIA"	"10037660"	"50-59 years"	"50-59"	"Patient developed fever, dyspnea and headache on 5/12/2021; tested positive for COVID-19 on 5/12/2021; patient died on 5/20/21"
	"1336774-1"	"1336774-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"Patient developed fever, dyspnea and headache on 5/12/2021; tested positive for COVID-19 on 5/12/2021; patient died on 5/20/21"
	"1337058-1"	"1337058-1"	"APHASIA"	"10002948"	"50-59 years"	"50-59"	"The patient had Covid 19 from approximately January 28, 2021 through early February 2021. He received the first dose of the Pfizer Vaccine on March 26, 2021. On March 27, 2021 at approximately 7:30 PM, the patient suddenly became unable to speak clearly and walk normally.  The ambulance was called at approximately 7:45 PM. The patient was evaluated and placed in the ambulance by approximately 8:15 PM. He stopped breathing in the ambulance. He was resuscitated and placed on a ventilator at some point. After evaluation at the hospital, it was found that he had suffered a pontine hemorrhage. He was kept alive until his heart stopped on March 29, 2021."
	"1337058-1"	"1337058-1"	"BRAIN STEM HAEMORRHAGE"	"10006145"	"50-59 years"	"50-59"	"The patient had Covid 19 from approximately January 28, 2021 through early February 2021. He received the first dose of the Pfizer Vaccine on March 26, 2021. On March 27, 2021 at approximately 7:30 PM, the patient suddenly became unable to speak clearly and walk normally.  The ambulance was called at approximately 7:45 PM. The patient was evaluated and placed in the ambulance by approximately 8:15 PM. He stopped breathing in the ambulance. He was resuscitated and placed on a ventilator at some point. After evaluation at the hospital, it was found that he had suffered a pontine hemorrhage. He was kept alive until his heart stopped on March 29, 2021."
	"1337058-1"	"1337058-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"The patient had Covid 19 from approximately January 28, 2021 through early February 2021. He received the first dose of the Pfizer Vaccine on March 26, 2021. On March 27, 2021 at approximately 7:30 PM, the patient suddenly became unable to speak clearly and walk normally.  The ambulance was called at approximately 7:45 PM. The patient was evaluated and placed in the ambulance by approximately 8:15 PM. He stopped breathing in the ambulance. He was resuscitated and placed on a ventilator at some point. After evaluation at the hospital, it was found that he had suffered a pontine hemorrhage. He was kept alive until his heart stopped on March 29, 2021."
	"1337058-1"	"1337058-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"The patient had Covid 19 from approximately January 28, 2021 through early February 2021. He received the first dose of the Pfizer Vaccine on March 26, 2021. On March 27, 2021 at approximately 7:30 PM, the patient suddenly became unable to speak clearly and walk normally.  The ambulance was called at approximately 7:45 PM. The patient was evaluated and placed in the ambulance by approximately 8:15 PM. He stopped breathing in the ambulance. He was resuscitated and placed on a ventilator at some point. After evaluation at the hospital, it was found that he had suffered a pontine hemorrhage. He was kept alive until his heart stopped on March 29, 2021."
	"1337058-1"	"1337058-1"	"GAIT DISTURBANCE"	"10017577"	"50-59 years"	"50-59"	"The patient had Covid 19 from approximately January 28, 2021 through early February 2021. He received the first dose of the Pfizer Vaccine on March 26, 2021. On March 27, 2021 at approximately 7:30 PM, the patient suddenly became unable to speak clearly and walk normally.  The ambulance was called at approximately 7:45 PM. The patient was evaluated and placed in the ambulance by approximately 8:15 PM. He stopped breathing in the ambulance. He was resuscitated and placed on a ventilator at some point. After evaluation at the hospital, it was found that he had suffered a pontine hemorrhage. He was kept alive until his heart stopped on March 29, 2021."
	"1337058-1"	"1337058-1"	"MECHANICAL VENTILATION"	"10067221"	"50-59 years"	"50-59"	"The patient had Covid 19 from approximately January 28, 2021 through early February 2021. He received the first dose of the Pfizer Vaccine on March 26, 2021. On March 27, 2021 at approximately 7:30 PM, the patient suddenly became unable to speak clearly and walk normally.  The ambulance was called at approximately 7:45 PM. The patient was evaluated and placed in the ambulance by approximately 8:15 PM. He stopped breathing in the ambulance. He was resuscitated and placed on a ventilator at some point. After evaluation at the hospital, it was found that he had suffered a pontine hemorrhage. He was kept alive until his heart stopped on March 29, 2021."
	"1337058-1"	"1337058-1"	"RESPIRATORY ARREST"	"10038669"	"50-59 years"	"50-59"	"The patient had Covid 19 from approximately January 28, 2021 through early February 2021. He received the first dose of the Pfizer Vaccine on March 26, 2021. On March 27, 2021 at approximately 7:30 PM, the patient suddenly became unable to speak clearly and walk normally.  The ambulance was called at approximately 7:45 PM. The patient was evaluated and placed in the ambulance by approximately 8:15 PM. He stopped breathing in the ambulance. He was resuscitated and placed on a ventilator at some point. After evaluation at the hospital, it was found that he had suffered a pontine hemorrhage. He was kept alive until his heart stopped on March 29, 2021."
	"1337058-1"	"1337058-1"	"RESUSCITATION"	"10038749"	"50-59 years"	"50-59"	"The patient had Covid 19 from approximately January 28, 2021 through early February 2021. He received the first dose of the Pfizer Vaccine on March 26, 2021. On March 27, 2021 at approximately 7:30 PM, the patient suddenly became unable to speak clearly and walk normally.  The ambulance was called at approximately 7:45 PM. The patient was evaluated and placed in the ambulance by approximately 8:15 PM. He stopped breathing in the ambulance. He was resuscitated and placed on a ventilator at some point. After evaluation at the hospital, it was found that he had suffered a pontine hemorrhage. He was kept alive until his heart stopped on March 29, 2021."
	"1340500-1"	"1340500-1"	"ASPIRATION"	"10003504"	"50-59 years"	"50-59"	"She aspirated and she was dead within week on respirator; she aspirated and she had pulmonary problem to begin with; 3 convulsions within 24 hours of having her first Pfizer / three grand mal compulsive seizures; This is a spontaneous report from a contactable physician. A 55-years-old female patient received the first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 02Mar2021 (Batch/Lot number was not reported, vaccinated at the age of 55 years old) as single dose for covid-19 immunisation. Medical history included epilepsy, myocardial metabolism disorder. She has a myocardial metabolism disorder, very specific one and it is A467T mutation in the polymerase gamma gene and that is because of her epilepsy. It was because of that it's a progressive disease get involved with many part of the body that is all so causes seizure. Concomitant medications included clobazam; lamotrigine; escitalopram; amitriptyline; calcium folinate (LEUCOVORINE); lorazepam; mesalazine; butalbital, caffeine, paracetamol (FIORICET); vitamin b2 [riboflavin] (VITAMIN B2 [RIBOFLAVIN]); ubidecarenone (COQ10 [UBIDECARENONE]); l-carnitine [levocarnitine]; vitamin b complex (B COMPLEX [VITAMIN B COMPLEX]); vitamin a [retinol]; vitamin c [ascorbic acid], all taken for an unspecified indication, start and stop date were not reported. The patient previously took sulphur, nepatop, dilantin [phenytoin], prednisone, and lidocaine and all experienced hypersensitivity.  The patient had received 3 convulsions within 24 hours of having her first Pfizer and she had epilepsy like she has been suffering from years and she aspirated and she was dead within week on respirator. She had three grand mal compulsive seizures and because of the seizures; she aspirated and she had pulmonary problem to begin with. She was put on a respirator and she was on respirator from the day she was admitted and she probably died within about two days. when the vaccination was, precise 24 hours later she had three grand mal compulsive seizures and because of the seizures she aspirated and she had pulmonary problem to begin with. She had 3 convulsive seizures that stayed for about 10 minutes and she had not, she normally would have the focal seizure just in her left arm. She has not had it big seizure in probably 20 years. The physician stated that don't know what killed her was not seizure when she wasn't he hospital she was intubated and she was alive. What killed her was she was aspirated and they could not get her off the respirator and she did not have COVID. When she was admitted to the hospital they did a lot of blood test. Before that, her cortisone level usually runs about 200, with metabolize of 700, and her lamotrigine level runs about between 4 and 8.5 of all other routine her Full blood count (CBC) routine is quite normal. It was not reported if an autopsy was performed. Outcome of events Grand mal seizure and Pulmonary disorder was unknown.   Information on batch number has been requested.; Sender's Comments: Based on the available information and known product profile, the causal relationship between the reported seizures along with the consequent aspirations which lead to death  and the use of BNT162B2 cannot be fully excluded. However, it is noted that the patient has multiple comorbidities which confound the reported drug event pairs.  The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics Committees and Investigators, as appropriate.; Reported Cause(s) of Death: She aspirated and she was dead within week on respirator"
	"1340500-1"	"1340500-1"	"BLOOD CORTISOL"	"10005455"	"50-59 years"	"50-59"	"She aspirated and she was dead within week on respirator; she aspirated and she had pulmonary problem to begin with; 3 convulsions within 24 hours of having her first Pfizer / three grand mal compulsive seizures; This is a spontaneous report from a contactable physician. A 55-years-old female patient received the first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 02Mar2021 (Batch/Lot number was not reported, vaccinated at the age of 55 years old) as single dose for covid-19 immunisation. Medical history included epilepsy, myocardial metabolism disorder. She has a myocardial metabolism disorder, very specific one and it is A467T mutation in the polymerase gamma gene and that is because of her epilepsy. It was because of that it's a progressive disease get involved with many part of the body that is all so causes seizure. Concomitant medications included clobazam; lamotrigine; escitalopram; amitriptyline; calcium folinate (LEUCOVORINE); lorazepam; mesalazine; butalbital, caffeine, paracetamol (FIORICET); vitamin b2 [riboflavin] (VITAMIN B2 [RIBOFLAVIN]); ubidecarenone (COQ10 [UBIDECARENONE]); l-carnitine [levocarnitine]; vitamin b complex (B COMPLEX [VITAMIN B COMPLEX]); vitamin a [retinol]; vitamin c [ascorbic acid], all taken for an unspecified indication, start and stop date were not reported. The patient previously took sulphur, nepatop, dilantin [phenytoin], prednisone, and lidocaine and all experienced hypersensitivity.  The patient had received 3 convulsions within 24 hours of having her first Pfizer and she had epilepsy like she has been suffering from years and she aspirated and she was dead within week on respirator. She had three grand mal compulsive seizures and because of the seizures; she aspirated and she had pulmonary problem to begin with. She was put on a respirator and she was on respirator from the day she was admitted and she probably died within about two days. when the vaccination was, precise 24 hours later she had three grand mal compulsive seizures and because of the seizures she aspirated and she had pulmonary problem to begin with. She had 3 convulsive seizures that stayed for about 10 minutes and she had not, she normally would have the focal seizure just in her left arm. She has not had it big seizure in probably 20 years. The physician stated that don't know what killed her was not seizure when she wasn't he hospital she was intubated and she was alive. What killed her was she was aspirated and they could not get her off the respirator and she did not have COVID. When she was admitted to the hospital they did a lot of blood test. Before that, her cortisone level usually runs about 200, with metabolize of 700, and her lamotrigine level runs about between 4 and 8.5 of all other routine her Full blood count (CBC) routine is quite normal. It was not reported if an autopsy was performed. Outcome of events Grand mal seizure and Pulmonary disorder was unknown.   Information on batch number has been requested.; Sender's Comments: Based on the available information and known product profile, the causal relationship between the reported seizures along with the consequent aspirations which lead to death  and the use of BNT162B2 cannot be fully excluded. However, it is noted that the patient has multiple comorbidities which confound the reported drug event pairs.  The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics Committees and Investigators, as appropriate.; Reported Cause(s) of Death: She aspirated and she was dead within week on respirator"
	"1340500-1"	"1340500-1"	"BLOOD TEST"	"10061726"	"50-59 years"	"50-59"	"She aspirated and she was dead within week on respirator; she aspirated and she had pulmonary problem to begin with; 3 convulsions within 24 hours of having her first Pfizer / three grand mal compulsive seizures; This is a spontaneous report from a contactable physician. A 55-years-old female patient received the first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 02Mar2021 (Batch/Lot number was not reported, vaccinated at the age of 55 years old) as single dose for covid-19 immunisation. Medical history included epilepsy, myocardial metabolism disorder. She has a myocardial metabolism disorder, very specific one and it is A467T mutation in the polymerase gamma gene and that is because of her epilepsy. It was because of that it's a progressive disease get involved with many part of the body that is all so causes seizure. Concomitant medications included clobazam; lamotrigine; escitalopram; amitriptyline; calcium folinate (LEUCOVORINE); lorazepam; mesalazine; butalbital, caffeine, paracetamol (FIORICET); vitamin b2 [riboflavin] (VITAMIN B2 [RIBOFLAVIN]); ubidecarenone (COQ10 [UBIDECARENONE]); l-carnitine [levocarnitine]; vitamin b complex (B COMPLEX [VITAMIN B COMPLEX]); vitamin a [retinol]; vitamin c [ascorbic acid], all taken for an unspecified indication, start and stop date were not reported. The patient previously took sulphur, nepatop, dilantin [phenytoin], prednisone, and lidocaine and all experienced hypersensitivity.  The patient had received 3 convulsions within 24 hours of having her first Pfizer and she had epilepsy like she has been suffering from years and she aspirated and she was dead within week on respirator. She had three grand mal compulsive seizures and because of the seizures; she aspirated and she had pulmonary problem to begin with. She was put on a respirator and she was on respirator from the day she was admitted and she probably died within about two days. when the vaccination was, precise 24 hours later she had three grand mal compulsive seizures and because of the seizures she aspirated and she had pulmonary problem to begin with. She had 3 convulsive seizures that stayed for about 10 minutes and she had not, she normally would have the focal seizure just in her left arm. She has not had it big seizure in probably 20 years. The physician stated that don't know what killed her was not seizure when she wasn't he hospital she was intubated and she was alive. What killed her was she was aspirated and they could not get her off the respirator and she did not have COVID. When she was admitted to the hospital they did a lot of blood test. Before that, her cortisone level usually runs about 200, with metabolize of 700, and her lamotrigine level runs about between 4 and 8.5 of all other routine her Full blood count (CBC) routine is quite normal. It was not reported if an autopsy was performed. Outcome of events Grand mal seizure and Pulmonary disorder was unknown.   Information on batch number has been requested.; Sender's Comments: Based on the available information and known product profile, the causal relationship between the reported seizures along with the consequent aspirations which lead to death  and the use of BNT162B2 cannot be fully excluded. However, it is noted that the patient has multiple comorbidities which confound the reported drug event pairs.  The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics Committees and Investigators, as appropriate.; Reported Cause(s) of Death: She aspirated and she was dead within week on respirator"
	"1340500-1"	"1340500-1"	"FULL BLOOD COUNT"	"10017411"	"50-59 years"	"50-59"	"She aspirated and she was dead within week on respirator; she aspirated and she had pulmonary problem to begin with; 3 convulsions within 24 hours of having her first Pfizer / three grand mal compulsive seizures; This is a spontaneous report from a contactable physician. A 55-years-old female patient received the first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 02Mar2021 (Batch/Lot number was not reported, vaccinated at the age of 55 years old) as single dose for covid-19 immunisation. Medical history included epilepsy, myocardial metabolism disorder. She has a myocardial metabolism disorder, very specific one and it is A467T mutation in the polymerase gamma gene and that is because of her epilepsy. It was because of that it's a progressive disease get involved with many part of the body that is all so causes seizure. Concomitant medications included clobazam; lamotrigine; escitalopram; amitriptyline; calcium folinate (LEUCOVORINE); lorazepam; mesalazine; butalbital, caffeine, paracetamol (FIORICET); vitamin b2 [riboflavin] (VITAMIN B2 [RIBOFLAVIN]); ubidecarenone (COQ10 [UBIDECARENONE]); l-carnitine [levocarnitine]; vitamin b complex (B COMPLEX [VITAMIN B COMPLEX]); vitamin a [retinol]; vitamin c [ascorbic acid], all taken for an unspecified indication, start and stop date were not reported. The patient previously took sulphur, nepatop, dilantin [phenytoin], prednisone, and lidocaine and all experienced hypersensitivity.  The patient had received 3 convulsions within 24 hours of having her first Pfizer and she had epilepsy like she has been suffering from years and she aspirated and she was dead within week on respirator. She had three grand mal compulsive seizures and because of the seizures; she aspirated and she had pulmonary problem to begin with. She was put on a respirator and she was on respirator from the day she was admitted and she probably died within about two days. when the vaccination was, precise 24 hours later she had three grand mal compulsive seizures and because of the seizures she aspirated and she had pulmonary problem to begin with. She had 3 convulsive seizures that stayed for about 10 minutes and she had not, she normally would have the focal seizure just in her left arm. She has not had it big seizure in probably 20 years. The physician stated that don't know what killed her was not seizure when she wasn't he hospital she was intubated and she was alive. What killed her was she was aspirated and they could not get her off the respirator and she did not have COVID. When she was admitted to the hospital they did a lot of blood test. Before that, her cortisone level usually runs about 200, with metabolize of 700, and her lamotrigine level runs about between 4 and 8.5 of all other routine her Full blood count (CBC) routine is quite normal. It was not reported if an autopsy was performed. Outcome of events Grand mal seizure and Pulmonary disorder was unknown.   Information on batch number has been requested.; Sender's Comments: Based on the available information and known product profile, the causal relationship between the reported seizures along with the consequent aspirations which lead to death  and the use of BNT162B2 cannot be fully excluded. However, it is noted that the patient has multiple comorbidities which confound the reported drug event pairs.  The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics Committees and Investigators, as appropriate.; Reported Cause(s) of Death: She aspirated and she was dead within week on respirator"
	"1340500-1"	"1340500-1"	"GENERALISED TONIC-CLONIC SEIZURE"	"10018100"	"50-59 years"	"50-59"	"She aspirated and she was dead within week on respirator; she aspirated and she had pulmonary problem to begin with; 3 convulsions within 24 hours of having her first Pfizer / three grand mal compulsive seizures; This is a spontaneous report from a contactable physician. A 55-years-old female patient received the first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 02Mar2021 (Batch/Lot number was not reported, vaccinated at the age of 55 years old) as single dose for covid-19 immunisation. Medical history included epilepsy, myocardial metabolism disorder. She has a myocardial metabolism disorder, very specific one and it is A467T mutation in the polymerase gamma gene and that is because of her epilepsy. It was because of that it's a progressive disease get involved with many part of the body that is all so causes seizure. Concomitant medications included clobazam; lamotrigine; escitalopram; amitriptyline; calcium folinate (LEUCOVORINE); lorazepam; mesalazine; butalbital, caffeine, paracetamol (FIORICET); vitamin b2 [riboflavin] (VITAMIN B2 [RIBOFLAVIN]); ubidecarenone (COQ10 [UBIDECARENONE]); l-carnitine [levocarnitine]; vitamin b complex (B COMPLEX [VITAMIN B COMPLEX]); vitamin a [retinol]; vitamin c [ascorbic acid], all taken for an unspecified indication, start and stop date were not reported. The patient previously took sulphur, nepatop, dilantin [phenytoin], prednisone, and lidocaine and all experienced hypersensitivity.  The patient had received 3 convulsions within 24 hours of having her first Pfizer and she had epilepsy like she has been suffering from years and she aspirated and she was dead within week on respirator. She had three grand mal compulsive seizures and because of the seizures; she aspirated and she had pulmonary problem to begin with. She was put on a respirator and she was on respirator from the day she was admitted and she probably died within about two days. when the vaccination was, precise 24 hours later she had three grand mal compulsive seizures and because of the seizures she aspirated and she had pulmonary problem to begin with. She had 3 convulsive seizures that stayed for about 10 minutes and she had not, she normally would have the focal seizure just in her left arm. She has not had it big seizure in probably 20 years. The physician stated that don't know what killed her was not seizure when she wasn't he hospital she was intubated and she was alive. What killed her was she was aspirated and they could not get her off the respirator and she did not have COVID. When she was admitted to the hospital they did a lot of blood test. Before that, her cortisone level usually runs about 200, with metabolize of 700, and her lamotrigine level runs about between 4 and 8.5 of all other routine her Full blood count (CBC) routine is quite normal. It was not reported if an autopsy was performed. Outcome of events Grand mal seizure and Pulmonary disorder was unknown.   Information on batch number has been requested.; Sender's Comments: Based on the available information and known product profile, the causal relationship between the reported seizures along with the consequent aspirations which lead to death  and the use of BNT162B2 cannot be fully excluded. However, it is noted that the patient has multiple comorbidities which confound the reported drug event pairs.  The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics Committees and Investigators, as appropriate.; Reported Cause(s) of Death: She aspirated and she was dead within week on respirator"
	"1340500-1"	"1340500-1"	"INVESTIGATION"	"10062026"	"50-59 years"	"50-59"	"She aspirated and she was dead within week on respirator; she aspirated and she had pulmonary problem to begin with; 3 convulsions within 24 hours of having her first Pfizer / three grand mal compulsive seizures; This is a spontaneous report from a contactable physician. A 55-years-old female patient received the first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 02Mar2021 (Batch/Lot number was not reported, vaccinated at the age of 55 years old) as single dose for covid-19 immunisation. Medical history included epilepsy, myocardial metabolism disorder. She has a myocardial metabolism disorder, very specific one and it is A467T mutation in the polymerase gamma gene and that is because of her epilepsy. It was because of that it's a progressive disease get involved with many part of the body that is all so causes seizure. Concomitant medications included clobazam; lamotrigine; escitalopram; amitriptyline; calcium folinate (LEUCOVORINE); lorazepam; mesalazine; butalbital, caffeine, paracetamol (FIORICET); vitamin b2 [riboflavin] (VITAMIN B2 [RIBOFLAVIN]); ubidecarenone (COQ10 [UBIDECARENONE]); l-carnitine [levocarnitine]; vitamin b complex (B COMPLEX [VITAMIN B COMPLEX]); vitamin a [retinol]; vitamin c [ascorbic acid], all taken for an unspecified indication, start and stop date were not reported. The patient previously took sulphur, nepatop, dilantin [phenytoin], prednisone, and lidocaine and all experienced hypersensitivity.  The patient had received 3 convulsions within 24 hours of having her first Pfizer and she had epilepsy like she has been suffering from years and she aspirated and she was dead within week on respirator. She had three grand mal compulsive seizures and because of the seizures; she aspirated and she had pulmonary problem to begin with. She was put on a respirator and she was on respirator from the day she was admitted and she probably died within about two days. when the vaccination was, precise 24 hours later she had three grand mal compulsive seizures and because of the seizures she aspirated and she had pulmonary problem to begin with. She had 3 convulsive seizures that stayed for about 10 minutes and she had not, she normally would have the focal seizure just in her left arm. She has not had it big seizure in probably 20 years. The physician stated that don't know what killed her was not seizure when she wasn't he hospital she was intubated and she was alive. What killed her was she was aspirated and they could not get her off the respirator and she did not have COVID. When she was admitted to the hospital they did a lot of blood test. Before that, her cortisone level usually runs about 200, with metabolize of 700, and her lamotrigine level runs about between 4 and 8.5 of all other routine her Full blood count (CBC) routine is quite normal. It was not reported if an autopsy was performed. Outcome of events Grand mal seizure and Pulmonary disorder was unknown.   Information on batch number has been requested.; Sender's Comments: Based on the available information and known product profile, the causal relationship between the reported seizures along with the consequent aspirations which lead to death  and the use of BNT162B2 cannot be fully excluded. However, it is noted that the patient has multiple comorbidities which confound the reported drug event pairs.  The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics Committees and Investigators, as appropriate.; Reported Cause(s) of Death: She aspirated and she was dead within week on respirator"
	"1340500-1"	"1340500-1"	"LUNG DISORDER"	"10025082"	"50-59 years"	"50-59"	"She aspirated and she was dead within week on respirator; she aspirated and she had pulmonary problem to begin with; 3 convulsions within 24 hours of having her first Pfizer / three grand mal compulsive seizures; This is a spontaneous report from a contactable physician. A 55-years-old female patient received the first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 02Mar2021 (Batch/Lot number was not reported, vaccinated at the age of 55 years old) as single dose for covid-19 immunisation. Medical history included epilepsy, myocardial metabolism disorder. She has a myocardial metabolism disorder, very specific one and it is A467T mutation in the polymerase gamma gene and that is because of her epilepsy. It was because of that it's a progressive disease get involved with many part of the body that is all so causes seizure. Concomitant medications included clobazam; lamotrigine; escitalopram; amitriptyline; calcium folinate (LEUCOVORINE); lorazepam; mesalazine; butalbital, caffeine, paracetamol (FIORICET); vitamin b2 [riboflavin] (VITAMIN B2 [RIBOFLAVIN]); ubidecarenone (COQ10 [UBIDECARENONE]); l-carnitine [levocarnitine]; vitamin b complex (B COMPLEX [VITAMIN B COMPLEX]); vitamin a [retinol]; vitamin c [ascorbic acid], all taken for an unspecified indication, start and stop date were not reported. The patient previously took sulphur, nepatop, dilantin [phenytoin], prednisone, and lidocaine and all experienced hypersensitivity.  The patient had received 3 convulsions within 24 hours of having her first Pfizer and she had epilepsy like she has been suffering from years and she aspirated and she was dead within week on respirator. She had three grand mal compulsive seizures and because of the seizures; she aspirated and she had pulmonary problem to begin with. She was put on a respirator and she was on respirator from the day she was admitted and she probably died within about two days. when the vaccination was, precise 24 hours later she had three grand mal compulsive seizures and because of the seizures she aspirated and she had pulmonary problem to begin with. She had 3 convulsive seizures that stayed for about 10 minutes and she had not, she normally would have the focal seizure just in her left arm. She has not had it big seizure in probably 20 years. The physician stated that don't know what killed her was not seizure when she wasn't he hospital she was intubated and she was alive. What killed her was she was aspirated and they could not get her off the respirator and she did not have COVID. When she was admitted to the hospital they did a lot of blood test. Before that, her cortisone level usually runs about 200, with metabolize of 700, and her lamotrigine level runs about between 4 and 8.5 of all other routine her Full blood count (CBC) routine is quite normal. It was not reported if an autopsy was performed. Outcome of events Grand mal seizure and Pulmonary disorder was unknown.   Information on batch number has been requested.; Sender's Comments: Based on the available information and known product profile, the causal relationship between the reported seizures along with the consequent aspirations which lead to death  and the use of BNT162B2 cannot be fully excluded. However, it is noted that the patient has multiple comorbidities which confound the reported drug event pairs.  The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics Committees and Investigators, as appropriate.; Reported Cause(s) of Death: She aspirated and she was dead within week on respirator"
	"1343266-1"	"1343266-1"	"ABDOMINAL PAIN UPPER"	"10000087"	"50-59 years"	"50-59"	"On 4-18-21, 17 days after 1st dose of Moderna, he developed upper abdomen pain, chest discomfort. He thought it was indigestion and treated it as such. When he got no relief he went to Emergency room where a cardiac alert was initiated. After he died I was told he had developed myocarditis,/pericarditis and they had to remove a liter of blood from the sac around his heart, but that his heart had gone into cardiogenic shock and that he died. They were prepared to insert a stint thinking he had a blocked coronary artery, but his arteries were clear and they had no idea what had caused this to happen.  When he died so soon after the vaccine there were people who wanted to blame the vaccine but I checked into it and there were NO links between the vaccine and myocarditis, pericarditis or cardiogenic shock.  Within a few weeks of his death, there began to be possible links between the vaccine and myocarditis. I know 55 is older than what is being looked at, but he had absolutely no previous cardiac history prior to this and this case should e looked at as well"
	"1343266-1"	"1343266-1"	"BLOOD TEST"	"10061726"	"50-59 years"	"50-59"	"On 4-18-21, 17 days after 1st dose of Moderna, he developed upper abdomen pain, chest discomfort. He thought it was indigestion and treated it as such. When he got no relief he went to Emergency room where a cardiac alert was initiated. After he died I was told he had developed myocarditis,/pericarditis and they had to remove a liter of blood from the sac around his heart, but that his heart had gone into cardiogenic shock and that he died. They were prepared to insert a stint thinking he had a blocked coronary artery, but his arteries were clear and they had no idea what had caused this to happen.  When he died so soon after the vaccine there were people who wanted to blame the vaccine but I checked into it and there were NO links between the vaccine and myocarditis, pericarditis or cardiogenic shock.  Within a few weeks of his death, there began to be possible links between the vaccine and myocarditis. I know 55 is older than what is being looked at, but he had absolutely no previous cardiac history prior to this and this case should e looked at as well"
	"1343266-1"	"1343266-1"	"CARDIOGENIC SHOCK"	"10007625"	"50-59 years"	"50-59"	"On 4-18-21, 17 days after 1st dose of Moderna, he developed upper abdomen pain, chest discomfort. He thought it was indigestion and treated it as such. When he got no relief he went to Emergency room where a cardiac alert was initiated. After he died I was told he had developed myocarditis,/pericarditis and they had to remove a liter of blood from the sac around his heart, but that his heart had gone into cardiogenic shock and that he died. They were prepared to insert a stint thinking he had a blocked coronary artery, but his arteries were clear and they had no idea what had caused this to happen.  When he died so soon after the vaccine there were people who wanted to blame the vaccine but I checked into it and there were NO links between the vaccine and myocarditis, pericarditis or cardiogenic shock.  Within a few weeks of his death, there began to be possible links between the vaccine and myocarditis. I know 55 is older than what is being looked at, but he had absolutely no previous cardiac history prior to this and this case should e looked at as well"
	"1343266-1"	"1343266-1"	"CHEST DISCOMFORT"	"10008469"	"50-59 years"	"50-59"	"On 4-18-21, 17 days after 1st dose of Moderna, he developed upper abdomen pain, chest discomfort. He thought it was indigestion and treated it as such. When he got no relief he went to Emergency room where a cardiac alert was initiated. After he died I was told he had developed myocarditis,/pericarditis and they had to remove a liter of blood from the sac around his heart, but that his heart had gone into cardiogenic shock and that he died. They were prepared to insert a stint thinking he had a blocked coronary artery, but his arteries were clear and they had no idea what had caused this to happen.  When he died so soon after the vaccine there were people who wanted to blame the vaccine but I checked into it and there were NO links between the vaccine and myocarditis, pericarditis or cardiogenic shock.  Within a few weeks of his death, there began to be possible links between the vaccine and myocarditis. I know 55 is older than what is being looked at, but he had absolutely no previous cardiac history prior to this and this case should e looked at as well"
	"1343266-1"	"1343266-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"On 4-18-21, 17 days after 1st dose of Moderna, he developed upper abdomen pain, chest discomfort. He thought it was indigestion and treated it as such. When he got no relief he went to Emergency room where a cardiac alert was initiated. After he died I was told he had developed myocarditis,/pericarditis and they had to remove a liter of blood from the sac around his heart, but that his heart had gone into cardiogenic shock and that he died. They were prepared to insert a stint thinking he had a blocked coronary artery, but his arteries were clear and they had no idea what had caused this to happen.  When he died so soon after the vaccine there were people who wanted to blame the vaccine but I checked into it and there were NO links between the vaccine and myocarditis, pericarditis or cardiogenic shock.  Within a few weeks of his death, there began to be possible links between the vaccine and myocarditis. I know 55 is older than what is being looked at, but he had absolutely no previous cardiac history prior to this and this case should e looked at as well"
	"1343266-1"	"1343266-1"	"MYOCARDITIS"	"10028606"	"50-59 years"	"50-59"	"On 4-18-21, 17 days after 1st dose of Moderna, he developed upper abdomen pain, chest discomfort. He thought it was indigestion and treated it as such. When he got no relief he went to Emergency room where a cardiac alert was initiated. After he died I was told he had developed myocarditis,/pericarditis and they had to remove a liter of blood from the sac around his heart, but that his heart had gone into cardiogenic shock and that he died. They were prepared to insert a stint thinking he had a blocked coronary artery, but his arteries were clear and they had no idea what had caused this to happen.  When he died so soon after the vaccine there were people who wanted to blame the vaccine but I checked into it and there were NO links between the vaccine and myocarditis, pericarditis or cardiogenic shock.  Within a few weeks of his death, there began to be possible links between the vaccine and myocarditis. I know 55 is older than what is being looked at, but he had absolutely no previous cardiac history prior to this and this case should e looked at as well"
	"1343266-1"	"1343266-1"	"PERICARDIAL DRAINAGE"	"10034471"	"50-59 years"	"50-59"	"On 4-18-21, 17 days after 1st dose of Moderna, he developed upper abdomen pain, chest discomfort. He thought it was indigestion and treated it as such. When he got no relief he went to Emergency room where a cardiac alert was initiated. After he died I was told he had developed myocarditis,/pericarditis and they had to remove a liter of blood from the sac around his heart, but that his heart had gone into cardiogenic shock and that he died. They were prepared to insert a stint thinking he had a blocked coronary artery, but his arteries were clear and they had no idea what had caused this to happen.  When he died so soon after the vaccine there were people who wanted to blame the vaccine but I checked into it and there were NO links between the vaccine and myocarditis, pericarditis or cardiogenic shock.  Within a few weeks of his death, there began to be possible links between the vaccine and myocarditis. I know 55 is older than what is being looked at, but he had absolutely no previous cardiac history prior to this and this case should e looked at as well"
	"1343266-1"	"1343266-1"	"PERICARDITIS"	"10034484"	"50-59 years"	"50-59"	"On 4-18-21, 17 days after 1st dose of Moderna, he developed upper abdomen pain, chest discomfort. He thought it was indigestion and treated it as such. When he got no relief he went to Emergency room where a cardiac alert was initiated. After he died I was told he had developed myocarditis,/pericarditis and they had to remove a liter of blood from the sac around his heart, but that his heart had gone into cardiogenic shock and that he died. They were prepared to insert a stint thinking he had a blocked coronary artery, but his arteries were clear and they had no idea what had caused this to happen.  When he died so soon after the vaccine there were people who wanted to blame the vaccine but I checked into it and there were NO links between the vaccine and myocarditis, pericarditis or cardiogenic shock.  Within a few weeks of his death, there began to be possible links between the vaccine and myocarditis. I know 55 is older than what is being looked at, but he had absolutely no previous cardiac history prior to this and this case should e looked at as well"
	"1343315-1"	"1343315-1"	"CEREBRAL INFARCTION"	"10008118"	"50-59 years"	"50-59"	"left MCA infarct"
	"1344282-1"	"1344282-1"	"BLOOD CREATININE INCREASED"	"10005483"	"50-59 years"	"50-59"	"received the vaccine as an inpatient in our hospital on 5/21/21.  Patient went into cardiac arrest on 5/22/21 at approximately 9:00am"
	"1344282-1"	"1344282-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"received the vaccine as an inpatient in our hospital on 5/21/21.  Patient went into cardiac arrest on 5/22/21 at approximately 9:00am"
	"1347081-1"	"1347081-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient complained of exhaustion and malaise within 24 hours of receiving the dose.  This never resolved.  Three weeks later he complained of the same exhaustion and malaise.  Jaw pain was reported on 5/23/2021.  Patient found deceased 5/24/2021 at age of 53."
	"1347081-1"	"1347081-1"	"FATIGUE"	"10016256"	"50-59 years"	"50-59"	"Patient complained of exhaustion and malaise within 24 hours of receiving the dose.  This never resolved.  Three weeks later he complained of the same exhaustion and malaise.  Jaw pain was reported on 5/23/2021.  Patient found deceased 5/24/2021 at age of 53."
	"1347081-1"	"1347081-1"	"MALAISE"	"10025482"	"50-59 years"	"50-59"	"Patient complained of exhaustion and malaise within 24 hours of receiving the dose.  This never resolved.  Three weeks later he complained of the same exhaustion and malaise.  Jaw pain was reported on 5/23/2021.  Patient found deceased 5/24/2021 at age of 53."
	"1347081-1"	"1347081-1"	"PAIN IN JAW"	"10033433"	"50-59 years"	"50-59"	"Patient complained of exhaustion and malaise within 24 hours of receiving the dose.  This never resolved.  Three weeks later he complained of the same exhaustion and malaise.  Jaw pain was reported on 5/23/2021.  Patient found deceased 5/24/2021 at age of 53."
	"1347530-1"	"1347530-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"5 days after COVID-19 vaccine, patient had a sudden unexpected cardiac arrest and died at his home after long resuscitation attempts by EMS."
	"1347530-1"	"1347530-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"5 days after COVID-19 vaccine, patient had a sudden unexpected cardiac arrest and died at his home after long resuscitation attempts by EMS."
	"1347530-1"	"1347530-1"	"RESUSCITATION"	"10038749"	"50-59 years"	"50-59"	"5 days after COVID-19 vaccine, patient had a sudden unexpected cardiac arrest and died at his home after long resuscitation attempts by EMS."
	"1348060-1"	"1348060-1"	"CONDITION AGGRAVATED"	"10010264"	"50-59 years"	"50-59"	"My father in law suffered a heart attacked on the day he received his second shot. at the time of this he was staying in our house where he wasn't found until two days later when we received a call from his work saying he never showed up or called in to work. The medical examiner told us that prior to the second vaccine in the last few weeks he had suffered some sort of heart issue that damaged his heart, but wasn't big enough for him to notice or think anything of it. The timeline the medical examiner gave us would have been after receiving the first vaccine. He then received his second Vaccine on a Thursday which was the last time anyone heard from him and he didn't show up to work Friday and was found Saturday after we were notified he didn't show up to work and we called 911. The medical examiner said he suffered a heart attack. The medical examiner said they had to write the death date on Saturday because that was when he was found, but the last anyone heard of him was prior to getting the vaccine and then he missed work the very next day(which was Friday)."
	"1348060-1"	"1348060-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"My father in law suffered a heart attacked on the day he received his second shot. at the time of this he was staying in our house where he wasn't found until two days later when we received a call from his work saying he never showed up or called in to work. The medical examiner told us that prior to the second vaccine in the last few weeks he had suffered some sort of heart issue that damaged his heart, but wasn't big enough for him to notice or think anything of it. The timeline the medical examiner gave us would have been after receiving the first vaccine. He then received his second Vaccine on a Thursday which was the last time anyone heard from him and he didn't show up to work Friday and was found Saturday after we were notified he didn't show up to work and we called 911. The medical examiner said he suffered a heart attack. The medical examiner said they had to write the death date on Saturday because that was when he was found, but the last anyone heard of him was prior to getting the vaccine and then he missed work the very next day(which was Friday)."
	"1348060-1"	"1348060-1"	"MYOCARDIAL INFARCTION"	"10028596"	"50-59 years"	"50-59"	"My father in law suffered a heart attacked on the day he received his second shot. at the time of this he was staying in our house where he wasn't found until two days later when we received a call from his work saying he never showed up or called in to work. The medical examiner told us that prior to the second vaccine in the last few weeks he had suffered some sort of heart issue that damaged his heart, but wasn't big enough for him to notice or think anything of it. The timeline the medical examiner gave us would have been after receiving the first vaccine. He then received his second Vaccine on a Thursday which was the last time anyone heard from him and he didn't show up to work Friday and was found Saturday after we were notified he didn't show up to work and we called 911. The medical examiner said he suffered a heart attack. The medical examiner said they had to write the death date on Saturday because that was when he was found, but the last anyone heard of him was prior to getting the vaccine and then he missed work the very next day(which was Friday)."
	"1350433-1"	"1350433-1"	"ACUTE RESPIRATORY FAILURE"	"10001053"	"50-59 years"	"50-59"	"Presented 5/13 to Hospital.  Presented to Hospital on 5/13 with one week of symptoms including cough, dyspnea, diarrhea. COVID-19 testing was positive on 5/8.   Treatments prior to arrival included remdesivir and dexamethasone, started 5/13.  She was also placed on pulse dose steroids 1000 mg/day methylprednisolone given her history of ground glass lung opacities in 2018.  Progressed to high-flow nasal cannula, then BiPAP on 5/14, and was intubated on 5/17.   Paralysis and proning initiated.  Transferred to another hospital for possible VV ecmo candidacy. Patient with severe acute respiratory failure d/t covid who has failed treatment with the ventilator despite paralysis and proning.   CTS asked to place patient on VV ECMO.    5/20/21 1135am  initiated ECMO Patient is a 50yr old female with past medical history of hypertension, asthma, OSA and obesity BMI 41.5 who presented to hospital on 5/13 with progressive cough and shortness of breath for about a week.  Of note, patient also has a history of respiratory failure presenting with ground glass opacities on CT scan in 2018 with unclear etiology despite bronchoscopy and serologic studies which resolved with high dose corticosteroids.  Patient recently tested positive for COVID on 5/8 and received johnson and johnson vaccine in April. Patient was admitted on 5/13 and treated with decadron, remdesivir and tocilizumab.  Course complicated by progressive respiratory failure requiring HFNC followed by Bipap and ultimately intubation on 5/17.  Due to elevated d-dimer, lower extremity dopplers were obtained which were negative, however a heparin gtt was initiated. Course further complicated by cold left lower extremity; arterial duplex demonstrated distal popliteal artery thormbus extending into the peroneal, anterior tibial and dorsalis pedis arteries. therefore heparin was switched to argatroban and a HIT panel was sent.  On 5/19 patient continued to decline despite paralytic and pronning.  Patient transferred to ICU for further level of care and VV ECMO evaluation. On arrival patient was started on veletri; however due to continued respiratory decline a shock call was placed for VV ECMO and patient cannulated for VV @ 1200. Cannulation was difficult and patient was felt to have an IVC thrombus as clot was seen going into the ECMO circuit during cannulation. Post cannulation she developed worsening septic shock and DIC. She received 2uprbc, 1unit cryo, 1 platelet, 2 FFP, 5 liters crystalloid and 1L albumin. Blood cultures positive for GPC in clusters. Escalating vasopressors (Epi/NE/vaso) and ongoing hypoxia family opted to change code status to DNR. Patient then continue to have worsening hemodynamic instability and went into PEA and ultimately asystole. She was pronounced deceased at 1815. Family was en route already due to her instability thus will be notified of her passing once they arrive. Dr. was notified of patients death."
	"1350433-1"	"1350433-1"	"ANTICOAGULANT THERAPY"	"10053468"	"50-59 years"	"50-59"	"Presented 5/13 to Hospital.  Presented to Hospital on 5/13 with one week of symptoms including cough, dyspnea, diarrhea. COVID-19 testing was positive on 5/8.   Treatments prior to arrival included remdesivir and dexamethasone, started 5/13.  She was also placed on pulse dose steroids 1000 mg/day methylprednisolone given her history of ground glass lung opacities in 2018.  Progressed to high-flow nasal cannula, then BiPAP on 5/14, and was intubated on 5/17.   Paralysis and proning initiated.  Transferred to another hospital for possible VV ecmo candidacy. Patient with severe acute respiratory failure d/t covid who has failed treatment with the ventilator despite paralysis and proning.   CTS asked to place patient on VV ECMO.    5/20/21 1135am  initiated ECMO Patient is a 50yr old female with past medical history of hypertension, asthma, OSA and obesity BMI 41.5 who presented to hospital on 5/13 with progressive cough and shortness of breath for about a week.  Of note, patient also has a history of respiratory failure presenting with ground glass opacities on CT scan in 2018 with unclear etiology despite bronchoscopy and serologic studies which resolved with high dose corticosteroids.  Patient recently tested positive for COVID on 5/8 and received johnson and johnson vaccine in April. Patient was admitted on 5/13 and treated with decadron, remdesivir and tocilizumab.  Course complicated by progressive respiratory failure requiring HFNC followed by Bipap and ultimately intubation on 5/17.  Due to elevated d-dimer, lower extremity dopplers were obtained which were negative, however a heparin gtt was initiated. Course further complicated by cold left lower extremity; arterial duplex demonstrated distal popliteal artery thormbus extending into the peroneal, anterior tibial and dorsalis pedis arteries. therefore heparin was switched to argatroban and a HIT panel was sent.  On 5/19 patient continued to decline despite paralytic and pronning.  Patient transferred to ICU for further level of care and VV ECMO evaluation. On arrival patient was started on veletri; however due to continued respiratory decline a shock call was placed for VV ECMO and patient cannulated for VV @ 1200. Cannulation was difficult and patient was felt to have an IVC thrombus as clot was seen going into the ECMO circuit during cannulation. Post cannulation she developed worsening septic shock and DIC. She received 2uprbc, 1unit cryo, 1 platelet, 2 FFP, 5 liters crystalloid and 1L albumin. Blood cultures positive for GPC in clusters. Escalating vasopressors (Epi/NE/vaso) and ongoing hypoxia family opted to change code status to DNR. Patient then continue to have worsening hemodynamic instability and went into PEA and ultimately asystole. She was pronounced deceased at 1815. Family was en route already due to her instability thus will be notified of her passing once they arrive. Dr. was notified of patients death."
	"1350433-1"	"1350433-1"	"BACTERIAL INFECTION"	"10060945"	"50-59 years"	"50-59"	"Presented 5/13 to Hospital.  Presented to Hospital on 5/13 with one week of symptoms including cough, dyspnea, diarrhea. COVID-19 testing was positive on 5/8.   Treatments prior to arrival included remdesivir and dexamethasone, started 5/13.  She was also placed on pulse dose steroids 1000 mg/day methylprednisolone given her history of ground glass lung opacities in 2018.  Progressed to high-flow nasal cannula, then BiPAP on 5/14, and was intubated on 5/17.   Paralysis and proning initiated.  Transferred to another hospital for possible VV ecmo candidacy. Patient with severe acute respiratory failure d/t covid who has failed treatment with the ventilator despite paralysis and proning.   CTS asked to place patient on VV ECMO.    5/20/21 1135am  initiated ECMO Patient is a 50yr old female with past medical history of hypertension, asthma, OSA and obesity BMI 41.5 who presented to hospital on 5/13 with progressive cough and shortness of breath for about a week.  Of note, patient also has a history of respiratory failure presenting with ground glass opacities on CT scan in 2018 with unclear etiology despite bronchoscopy and serologic studies which resolved with high dose corticosteroids.  Patient recently tested positive for COVID on 5/8 and received johnson and johnson vaccine in April. Patient was admitted on 5/13 and treated with decadron, remdesivir and tocilizumab.  Course complicated by progressive respiratory failure requiring HFNC followed by Bipap and ultimately intubation on 5/17.  Due to elevated d-dimer, lower extremity dopplers were obtained which were negative, however a heparin gtt was initiated. Course further complicated by cold left lower extremity; arterial duplex demonstrated distal popliteal artery thormbus extending into the peroneal, anterior tibial and dorsalis pedis arteries. therefore heparin was switched to argatroban and a HIT panel was sent.  On 5/19 patient continued to decline despite paralytic and pronning.  Patient transferred to ICU for further level of care and VV ECMO evaluation. On arrival patient was started on veletri; however due to continued respiratory decline a shock call was placed for VV ECMO and patient cannulated for VV @ 1200. Cannulation was difficult and patient was felt to have an IVC thrombus as clot was seen going into the ECMO circuit during cannulation. Post cannulation she developed worsening septic shock and DIC. She received 2uprbc, 1unit cryo, 1 platelet, 2 FFP, 5 liters crystalloid and 1L albumin. Blood cultures positive for GPC in clusters. Escalating vasopressors (Epi/NE/vaso) and ongoing hypoxia family opted to change code status to DNR. Patient then continue to have worsening hemodynamic instability and went into PEA and ultimately asystole. She was pronounced deceased at 1815. Family was en route already due to her instability thus will be notified of her passing once they arrive. Dr. was notified of patients death."
	"1350433-1"	"1350433-1"	"BILEVEL POSITIVE AIRWAY PRESSURE"	"10064530"	"50-59 years"	"50-59"	"Presented 5/13 to Hospital.  Presented to Hospital on 5/13 with one week of symptoms including cough, dyspnea, diarrhea. COVID-19 testing was positive on 5/8.   Treatments prior to arrival included remdesivir and dexamethasone, started 5/13.  She was also placed on pulse dose steroids 1000 mg/day methylprednisolone given her history of ground glass lung opacities in 2018.  Progressed to high-flow nasal cannula, then BiPAP on 5/14, and was intubated on 5/17.   Paralysis and proning initiated.  Transferred to another hospital for possible VV ecmo candidacy. Patient with severe acute respiratory failure d/t covid who has failed treatment with the ventilator despite paralysis and proning.   CTS asked to place patient on VV ECMO.    5/20/21 1135am  initiated ECMO Patient is a 50yr old female with past medical history of hypertension, asthma, OSA and obesity BMI 41.5 who presented to hospital on 5/13 with progressive cough and shortness of breath for about a week.  Of note, patient also has a history of respiratory failure presenting with ground glass opacities on CT scan in 2018 with unclear etiology despite bronchoscopy and serologic studies which resolved with high dose corticosteroids.  Patient recently tested positive for COVID on 5/8 and received johnson and johnson vaccine in April. Patient was admitted on 5/13 and treated with decadron, remdesivir and tocilizumab.  Course complicated by progressive respiratory failure requiring HFNC followed by Bipap and ultimately intubation on 5/17.  Due to elevated d-dimer, lower extremity dopplers were obtained which were negative, however a heparin gtt was initiated. Course further complicated by cold left lower extremity; arterial duplex demonstrated distal popliteal artery thormbus extending into the peroneal, anterior tibial and dorsalis pedis arteries. therefore heparin was switched to argatroban and a HIT panel was sent.  On 5/19 patient continued to decline despite paralytic and pronning.  Patient transferred to ICU for further level of care and VV ECMO evaluation. On arrival patient was started on veletri; however due to continued respiratory decline a shock call was placed for VV ECMO and patient cannulated for VV @ 1200. Cannulation was difficult and patient was felt to have an IVC thrombus as clot was seen going into the ECMO circuit during cannulation. Post cannulation she developed worsening septic shock and DIC. She received 2uprbc, 1unit cryo, 1 platelet, 2 FFP, 5 liters crystalloid and 1L albumin. Blood cultures positive for GPC in clusters. Escalating vasopressors (Epi/NE/vaso) and ongoing hypoxia family opted to change code status to DNR. Patient then continue to have worsening hemodynamic instability and went into PEA and ultimately asystole. She was pronounced deceased at 1815. Family was en route already due to her instability thus will be notified of her passing once they arrive. Dr. was notified of patients death."
	"1350433-1"	"1350433-1"	"BLOOD CULTURE POSITIVE"	"10005488"	"50-59 years"	"50-59"	"Presented 5/13 to Hospital.  Presented to Hospital on 5/13 with one week of symptoms including cough, dyspnea, diarrhea. COVID-19 testing was positive on 5/8.   Treatments prior to arrival included remdesivir and dexamethasone, started 5/13.  She was also placed on pulse dose steroids 1000 mg/day methylprednisolone given her history of ground glass lung opacities in 2018.  Progressed to high-flow nasal cannula, then BiPAP on 5/14, and was intubated on 5/17.   Paralysis and proning initiated.  Transferred to another hospital for possible VV ecmo candidacy. Patient with severe acute respiratory failure d/t covid who has failed treatment with the ventilator despite paralysis and proning.   CTS asked to place patient on VV ECMO.    5/20/21 1135am  initiated ECMO Patient is a 50yr old female with past medical history of hypertension, asthma, OSA and obesity BMI 41.5 who presented to hospital on 5/13 with progressive cough and shortness of breath for about a week.  Of note, patient also has a history of respiratory failure presenting with ground glass opacities on CT scan in 2018 with unclear etiology despite bronchoscopy and serologic studies which resolved with high dose corticosteroids.  Patient recently tested positive for COVID on 5/8 and received johnson and johnson vaccine in April. Patient was admitted on 5/13 and treated with decadron, remdesivir and tocilizumab.  Course complicated by progressive respiratory failure requiring HFNC followed by Bipap and ultimately intubation on 5/17.  Due to elevated d-dimer, lower extremity dopplers were obtained which were negative, however a heparin gtt was initiated. Course further complicated by cold left lower extremity; arterial duplex demonstrated distal popliteal artery thormbus extending into the peroneal, anterior tibial and dorsalis pedis arteries. therefore heparin was switched to argatroban and a HIT panel was sent.  On 5/19 patient continued to decline despite paralytic and pronning.  Patient transferred to ICU for further level of care and VV ECMO evaluation. On arrival patient was started on veletri; however due to continued respiratory decline a shock call was placed for VV ECMO and patient cannulated for VV @ 1200. Cannulation was difficult and patient was felt to have an IVC thrombus as clot was seen going into the ECMO circuit during cannulation. Post cannulation she developed worsening septic shock and DIC. She received 2uprbc, 1unit cryo, 1 platelet, 2 FFP, 5 liters crystalloid and 1L albumin. Blood cultures positive for GPC in clusters. Escalating vasopressors (Epi/NE/vaso) and ongoing hypoxia family opted to change code status to DNR. Patient then continue to have worsening hemodynamic instability and went into PEA and ultimately asystole. She was pronounced deceased at 1815. Family was en route already due to her instability thus will be notified of her passing once they arrive. Dr. was notified of patients death."
	"1350433-1"	"1350433-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"Presented 5/13 to Hospital.  Presented to Hospital on 5/13 with one week of symptoms including cough, dyspnea, diarrhea. COVID-19 testing was positive on 5/8.   Treatments prior to arrival included remdesivir and dexamethasone, started 5/13.  She was also placed on pulse dose steroids 1000 mg/day methylprednisolone given her history of ground glass lung opacities in 2018.  Progressed to high-flow nasal cannula, then BiPAP on 5/14, and was intubated on 5/17.   Paralysis and proning initiated.  Transferred to another hospital for possible VV ecmo candidacy. Patient with severe acute respiratory failure d/t covid who has failed treatment with the ventilator despite paralysis and proning.   CTS asked to place patient on VV ECMO.    5/20/21 1135am  initiated ECMO Patient is a 50yr old female with past medical history of hypertension, asthma, OSA and obesity BMI 41.5 who presented to hospital on 5/13 with progressive cough and shortness of breath for about a week.  Of note, patient also has a history of respiratory failure presenting with ground glass opacities on CT scan in 2018 with unclear etiology despite bronchoscopy and serologic studies which resolved with high dose corticosteroids.  Patient recently tested positive for COVID on 5/8 and received johnson and johnson vaccine in April. Patient was admitted on 5/13 and treated with decadron, remdesivir and tocilizumab.  Course complicated by progressive respiratory failure requiring HFNC followed by Bipap and ultimately intubation on 5/17.  Due to elevated d-dimer, lower extremity dopplers were obtained which were negative, however a heparin gtt was initiated. Course further complicated by cold left lower extremity; arterial duplex demonstrated distal popliteal artery thormbus extending into the peroneal, anterior tibial and dorsalis pedis arteries. therefore heparin was switched to argatroban and a HIT panel was sent.  On 5/19 patient continued to decline despite paralytic and pronning.  Patient transferred to ICU for further level of care and VV ECMO evaluation. On arrival patient was started on veletri; however due to continued respiratory decline a shock call was placed for VV ECMO and patient cannulated for VV @ 1200. Cannulation was difficult and patient was felt to have an IVC thrombus as clot was seen going into the ECMO circuit during cannulation. Post cannulation she developed worsening septic shock and DIC. She received 2uprbc, 1unit cryo, 1 platelet, 2 FFP, 5 liters crystalloid and 1L albumin. Blood cultures positive for GPC in clusters. Escalating vasopressors (Epi/NE/vaso) and ongoing hypoxia family opted to change code status to DNR. Patient then continue to have worsening hemodynamic instability and went into PEA and ultimately asystole. She was pronounced deceased at 1815. Family was en route already due to her instability thus will be notified of her passing once they arrive. Dr. was notified of patients death."
	"1350433-1"	"1350433-1"	"CATHETER PLACEMENT"	"10052915"	"50-59 years"	"50-59"	"Presented 5/13 to Hospital.  Presented to Hospital on 5/13 with one week of symptoms including cough, dyspnea, diarrhea. COVID-19 testing was positive on 5/8.   Treatments prior to arrival included remdesivir and dexamethasone, started 5/13.  She was also placed on pulse dose steroids 1000 mg/day methylprednisolone given her history of ground glass lung opacities in 2018.  Progressed to high-flow nasal cannula, then BiPAP on 5/14, and was intubated on 5/17.   Paralysis and proning initiated.  Transferred to another hospital for possible VV ecmo candidacy. Patient with severe acute respiratory failure d/t covid who has failed treatment with the ventilator despite paralysis and proning.   CTS asked to place patient on VV ECMO.    5/20/21 1135am  initiated ECMO Patient is a 50yr old female with past medical history of hypertension, asthma, OSA and obesity BMI 41.5 who presented to hospital on 5/13 with progressive cough and shortness of breath for about a week.  Of note, patient also has a history of respiratory failure presenting with ground glass opacities on CT scan in 2018 with unclear etiology despite bronchoscopy and serologic studies which resolved with high dose corticosteroids.  Patient recently tested positive for COVID on 5/8 and received johnson and johnson vaccine in April. Patient was admitted on 5/13 and treated with decadron, remdesivir and tocilizumab.  Course complicated by progressive respiratory failure requiring HFNC followed by Bipap and ultimately intubation on 5/17.  Due to elevated d-dimer, lower extremity dopplers were obtained which were negative, however a heparin gtt was initiated. Course further complicated by cold left lower extremity; arterial duplex demonstrated distal popliteal artery thormbus extending into the peroneal, anterior tibial and dorsalis pedis arteries. therefore heparin was switched to argatroban and a HIT panel was sent.  On 5/19 patient continued to decline despite paralytic and pronning.  Patient transferred to ICU for further level of care and VV ECMO evaluation. On arrival patient was started on veletri; however due to continued respiratory decline a shock call was placed for VV ECMO and patient cannulated for VV @ 1200. Cannulation was difficult and patient was felt to have an IVC thrombus as clot was seen going into the ECMO circuit during cannulation. Post cannulation she developed worsening septic shock and DIC. She received 2uprbc, 1unit cryo, 1 platelet, 2 FFP, 5 liters crystalloid and 1L albumin. Blood cultures positive for GPC in clusters. Escalating vasopressors (Epi/NE/vaso) and ongoing hypoxia family opted to change code status to DNR. Patient then continue to have worsening hemodynamic instability and went into PEA and ultimately asystole. She was pronounced deceased at 1815. Family was en route already due to her instability thus will be notified of her passing once they arrive. Dr. was notified of patients death."
	"1350433-1"	"1350433-1"	"CONDITION AGGRAVATED"	"10010264"	"50-59 years"	"50-59"	"Presented 5/13 to Hospital.  Presented to Hospital on 5/13 with one week of symptoms including cough, dyspnea, diarrhea. COVID-19 testing was positive on 5/8.   Treatments prior to arrival included remdesivir and dexamethasone, started 5/13.  She was also placed on pulse dose steroids 1000 mg/day methylprednisolone given her history of ground glass lung opacities in 2018.  Progressed to high-flow nasal cannula, then BiPAP on 5/14, and was intubated on 5/17.   Paralysis and proning initiated.  Transferred to another hospital for possible VV ecmo candidacy. Patient with severe acute respiratory failure d/t covid who has failed treatment with the ventilator despite paralysis and proning.   CTS asked to place patient on VV ECMO.    5/20/21 1135am  initiated ECMO Patient is a 50yr old female with past medical history of hypertension, asthma, OSA and obesity BMI 41.5 who presented to hospital on 5/13 with progressive cough and shortness of breath for about a week.  Of note, patient also has a history of respiratory failure presenting with ground glass opacities on CT scan in 2018 with unclear etiology despite bronchoscopy and serologic studies which resolved with high dose corticosteroids.  Patient recently tested positive for COVID on 5/8 and received johnson and johnson vaccine in April. Patient was admitted on 5/13 and treated with decadron, remdesivir and tocilizumab.  Course complicated by progressive respiratory failure requiring HFNC followed by Bipap and ultimately intubation on 5/17.  Due to elevated d-dimer, lower extremity dopplers were obtained which were negative, however a heparin gtt was initiated. Course further complicated by cold left lower extremity; arterial duplex demonstrated distal popliteal artery thormbus extending into the peroneal, anterior tibial and dorsalis pedis arteries. therefore heparin was switched to argatroban and a HIT panel was sent.  On 5/19 patient continued to decline despite paralytic and pronning.  Patient transferred to ICU for further level of care and VV ECMO evaluation. On arrival patient was started on veletri; however due to continued respiratory decline a shock call was placed for VV ECMO and patient cannulated for VV @ 1200. Cannulation was difficult and patient was felt to have an IVC thrombus as clot was seen going into the ECMO circuit during cannulation. Post cannulation she developed worsening septic shock and DIC. She received 2uprbc, 1unit cryo, 1 platelet, 2 FFP, 5 liters crystalloid and 1L albumin. Blood cultures positive for GPC in clusters. Escalating vasopressors (Epi/NE/vaso) and ongoing hypoxia family opted to change code status to DNR. Patient then continue to have worsening hemodynamic instability and went into PEA and ultimately asystole. She was pronounced deceased at 1815. Family was en route already due to her instability thus will be notified of her passing once they arrive. Dr. was notified of patients death."
	"1350433-1"	"1350433-1"	"COUGH"	"10011224"	"50-59 years"	"50-59"	"Presented 5/13 to Hospital.  Presented to Hospital on 5/13 with one week of symptoms including cough, dyspnea, diarrhea. COVID-19 testing was positive on 5/8.   Treatments prior to arrival included remdesivir and dexamethasone, started 5/13.  She was also placed on pulse dose steroids 1000 mg/day methylprednisolone given her history of ground glass lung opacities in 2018.  Progressed to high-flow nasal cannula, then BiPAP on 5/14, and was intubated on 5/17.   Paralysis and proning initiated.  Transferred to another hospital for possible VV ecmo candidacy. Patient with severe acute respiratory failure d/t covid who has failed treatment with the ventilator despite paralysis and proning.   CTS asked to place patient on VV ECMO.    5/20/21 1135am  initiated ECMO Patient is a 50yr old female with past medical history of hypertension, asthma, OSA and obesity BMI 41.5 who presented to hospital on 5/13 with progressive cough and shortness of breath for about a week.  Of note, patient also has a history of respiratory failure presenting with ground glass opacities on CT scan in 2018 with unclear etiology despite bronchoscopy and serologic studies which resolved with high dose corticosteroids.  Patient recently tested positive for COVID on 5/8 and received johnson and johnson vaccine in April. Patient was admitted on 5/13 and treated with decadron, remdesivir and tocilizumab.  Course complicated by progressive respiratory failure requiring HFNC followed by Bipap and ultimately intubation on 5/17.  Due to elevated d-dimer, lower extremity dopplers were obtained which were negative, however a heparin gtt was initiated. Course further complicated by cold left lower extremity; arterial duplex demonstrated distal popliteal artery thormbus extending into the peroneal, anterior tibial and dorsalis pedis arteries. therefore heparin was switched to argatroban and a HIT panel was sent.  On 5/19 patient continued to decline despite paralytic and pronning.  Patient transferred to ICU for further level of care and VV ECMO evaluation. On arrival patient was started on veletri; however due to continued respiratory decline a shock call was placed for VV ECMO and patient cannulated for VV @ 1200. Cannulation was difficult and patient was felt to have an IVC thrombus as clot was seen going into the ECMO circuit during cannulation. Post cannulation she developed worsening septic shock and DIC. She received 2uprbc, 1unit cryo, 1 platelet, 2 FFP, 5 liters crystalloid and 1L albumin. Blood cultures positive for GPC in clusters. Escalating vasopressors (Epi/NE/vaso) and ongoing hypoxia family opted to change code status to DNR. Patient then continue to have worsening hemodynamic instability and went into PEA and ultimately asystole. She was pronounced deceased at 1815. Family was en route already due to her instability thus will be notified of her passing once they arrive. Dr. was notified of patients death."
	"1350433-1"	"1350433-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Presented 5/13 to Hospital.  Presented to Hospital on 5/13 with one week of symptoms including cough, dyspnea, diarrhea. COVID-19 testing was positive on 5/8.   Treatments prior to arrival included remdesivir and dexamethasone, started 5/13.  She was also placed on pulse dose steroids 1000 mg/day methylprednisolone given her history of ground glass lung opacities in 2018.  Progressed to high-flow nasal cannula, then BiPAP on 5/14, and was intubated on 5/17.   Paralysis and proning initiated.  Transferred to another hospital for possible VV ecmo candidacy. Patient with severe acute respiratory failure d/t covid who has failed treatment with the ventilator despite paralysis and proning.   CTS asked to place patient on VV ECMO.    5/20/21 1135am  initiated ECMO Patient is a 50yr old female with past medical history of hypertension, asthma, OSA and obesity BMI 41.5 who presented to hospital on 5/13 with progressive cough and shortness of breath for about a week.  Of note, patient also has a history of respiratory failure presenting with ground glass opacities on CT scan in 2018 with unclear etiology despite bronchoscopy and serologic studies which resolved with high dose corticosteroids.  Patient recently tested positive for COVID on 5/8 and received johnson and johnson vaccine in April. Patient was admitted on 5/13 and treated with decadron, remdesivir and tocilizumab.  Course complicated by progressive respiratory failure requiring HFNC followed by Bipap and ultimately intubation on 5/17.  Due to elevated d-dimer, lower extremity dopplers were obtained which were negative, however a heparin gtt was initiated. Course further complicated by cold left lower extremity; arterial duplex demonstrated distal popliteal artery thormbus extending into the peroneal, anterior tibial and dorsalis pedis arteries. therefore heparin was switched to argatroban and a HIT panel was sent.  On 5/19 patient continued to decline despite paralytic and pronning.  Patient transferred to ICU for further level of care and VV ECMO evaluation. On arrival patient was started on veletri; however due to continued respiratory decline a shock call was placed for VV ECMO and patient cannulated for VV @ 1200. Cannulation was difficult and patient was felt to have an IVC thrombus as clot was seen going into the ECMO circuit during cannulation. Post cannulation she developed worsening septic shock and DIC. She received 2uprbc, 1unit cryo, 1 platelet, 2 FFP, 5 liters crystalloid and 1L albumin. Blood cultures positive for GPC in clusters. Escalating vasopressors (Epi/NE/vaso) and ongoing hypoxia family opted to change code status to DNR. Patient then continue to have worsening hemodynamic instability and went into PEA and ultimately asystole. She was pronounced deceased at 1815. Family was en route already due to her instability thus will be notified of her passing once they arrive. Dr. was notified of patients death."
	"1350433-1"	"1350433-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Presented 5/13 to Hospital.  Presented to Hospital on 5/13 with one week of symptoms including cough, dyspnea, diarrhea. COVID-19 testing was positive on 5/8.   Treatments prior to arrival included remdesivir and dexamethasone, started 5/13.  She was also placed on pulse dose steroids 1000 mg/day methylprednisolone given her history of ground glass lung opacities in 2018.  Progressed to high-flow nasal cannula, then BiPAP on 5/14, and was intubated on 5/17.   Paralysis and proning initiated.  Transferred to another hospital for possible VV ecmo candidacy. Patient with severe acute respiratory failure d/t covid who has failed treatment with the ventilator despite paralysis and proning.   CTS asked to place patient on VV ECMO.    5/20/21 1135am  initiated ECMO Patient is a 50yr old female with past medical history of hypertension, asthma, OSA and obesity BMI 41.5 who presented to hospital on 5/13 with progressive cough and shortness of breath for about a week.  Of note, patient also has a history of respiratory failure presenting with ground glass opacities on CT scan in 2018 with unclear etiology despite bronchoscopy and serologic studies which resolved with high dose corticosteroids.  Patient recently tested positive for COVID on 5/8 and received johnson and johnson vaccine in April. Patient was admitted on 5/13 and treated with decadron, remdesivir and tocilizumab.  Course complicated by progressive respiratory failure requiring HFNC followed by Bipap and ultimately intubation on 5/17.  Due to elevated d-dimer, lower extremity dopplers were obtained which were negative, however a heparin gtt was initiated. Course further complicated by cold left lower extremity; arterial duplex demonstrated distal popliteal artery thormbus extending into the peroneal, anterior tibial and dorsalis pedis arteries. therefore heparin was switched to argatroban and a HIT panel was sent.  On 5/19 patient continued to decline despite paralytic and pronning.  Patient transferred to ICU for further level of care and VV ECMO evaluation. On arrival patient was started on veletri; however due to continued respiratory decline a shock call was placed for VV ECMO and patient cannulated for VV @ 1200. Cannulation was difficult and patient was felt to have an IVC thrombus as clot was seen going into the ECMO circuit during cannulation. Post cannulation she developed worsening septic shock and DIC. She received 2uprbc, 1unit cryo, 1 platelet, 2 FFP, 5 liters crystalloid and 1L albumin. Blood cultures positive for GPC in clusters. Escalating vasopressors (Epi/NE/vaso) and ongoing hypoxia family opted to change code status to DNR. Patient then continue to have worsening hemodynamic instability and went into PEA and ultimately asystole. She was pronounced deceased at 1815. Family was en route already due to her instability thus will be notified of her passing once they arrive. Dr. was notified of patients death."
	"1350433-1"	"1350433-1"	"DIARRHOEA"	"10012735"	"50-59 years"	"50-59"	"Presented 5/13 to Hospital.  Presented to Hospital on 5/13 with one week of symptoms including cough, dyspnea, diarrhea. COVID-19 testing was positive on 5/8.   Treatments prior to arrival included remdesivir and dexamethasone, started 5/13.  She was also placed on pulse dose steroids 1000 mg/day methylprednisolone given her history of ground glass lung opacities in 2018.  Progressed to high-flow nasal cannula, then BiPAP on 5/14, and was intubated on 5/17.   Paralysis and proning initiated.  Transferred to another hospital for possible VV ecmo candidacy. Patient with severe acute respiratory failure d/t covid who has failed treatment with the ventilator despite paralysis and proning.   CTS asked to place patient on VV ECMO.    5/20/21 1135am  initiated ECMO Patient is a 50yr old female with past medical history of hypertension, asthma, OSA and obesity BMI 41.5 who presented to hospital on 5/13 with progressive cough and shortness of breath for about a week.  Of note, patient also has a history of respiratory failure presenting with ground glass opacities on CT scan in 2018 with unclear etiology despite bronchoscopy and serologic studies which resolved with high dose corticosteroids.  Patient recently tested positive for COVID on 5/8 and received johnson and johnson vaccine in April. Patient was admitted on 5/13 and treated with decadron, remdesivir and tocilizumab.  Course complicated by progressive respiratory failure requiring HFNC followed by Bipap and ultimately intubation on 5/17.  Due to elevated d-dimer, lower extremity dopplers were obtained which were negative, however a heparin gtt was initiated. Course further complicated by cold left lower extremity; arterial duplex demonstrated distal popliteal artery thormbus extending into the peroneal, anterior tibial and dorsalis pedis arteries. therefore heparin was switched to argatroban and a HIT panel was sent.  On 5/19 patient continued to decline despite paralytic and pronning.  Patient transferred to ICU for further level of care and VV ECMO evaluation. On arrival patient was started on veletri; however due to continued respiratory decline a shock call was placed for VV ECMO and patient cannulated for VV @ 1200. Cannulation was difficult and patient was felt to have an IVC thrombus as clot was seen going into the ECMO circuit during cannulation. Post cannulation she developed worsening septic shock and DIC. She received 2uprbc, 1unit cryo, 1 platelet, 2 FFP, 5 liters crystalloid and 1L albumin. Blood cultures positive for GPC in clusters. Escalating vasopressors (Epi/NE/vaso) and ongoing hypoxia family opted to change code status to DNR. Patient then continue to have worsening hemodynamic instability and went into PEA and ultimately asystole. She was pronounced deceased at 1815. Family was en route already due to her instability thus will be notified of her passing once they arrive. Dr. was notified of patients death."
	"1350433-1"	"1350433-1"	"DISSEMINATED INTRAVASCULAR COAGULATION"	"10013442"	"50-59 years"	"50-59"	"Presented 5/13 to Hospital.  Presented to Hospital on 5/13 with one week of symptoms including cough, dyspnea, diarrhea. COVID-19 testing was positive on 5/8.   Treatments prior to arrival included remdesivir and dexamethasone, started 5/13.  She was also placed on pulse dose steroids 1000 mg/day methylprednisolone given her history of ground glass lung opacities in 2018.  Progressed to high-flow nasal cannula, then BiPAP on 5/14, and was intubated on 5/17.   Paralysis and proning initiated.  Transferred to another hospital for possible VV ecmo candidacy. Patient with severe acute respiratory failure d/t covid who has failed treatment with the ventilator despite paralysis and proning.   CTS asked to place patient on VV ECMO.    5/20/21 1135am  initiated ECMO Patient is a 50yr old female with past medical history of hypertension, asthma, OSA and obesity BMI 41.5 who presented to hospital on 5/13 with progressive cough and shortness of breath for about a week.  Of note, patient also has a history of respiratory failure presenting with ground glass opacities on CT scan in 2018 with unclear etiology despite bronchoscopy and serologic studies which resolved with high dose corticosteroids.  Patient recently tested positive for COVID on 5/8 and received johnson and johnson vaccine in April. Patient was admitted on 5/13 and treated with decadron, remdesivir and tocilizumab.  Course complicated by progressive respiratory failure requiring HFNC followed by Bipap and ultimately intubation on 5/17.  Due to elevated d-dimer, lower extremity dopplers were obtained which were negative, however a heparin gtt was initiated. Course further complicated by cold left lower extremity; arterial duplex demonstrated distal popliteal artery thormbus extending into the peroneal, anterior tibial and dorsalis pedis arteries. therefore heparin was switched to argatroban and a HIT panel was sent.  On 5/19 patient continued to decline despite paralytic and pronning.  Patient transferred to ICU for further level of care and VV ECMO evaluation. On arrival patient was started on veletri; however due to continued respiratory decline a shock call was placed for VV ECMO and patient cannulated for VV @ 1200. Cannulation was difficult and patient was felt to have an IVC thrombus as clot was seen going into the ECMO circuit during cannulation. Post cannulation she developed worsening septic shock and DIC. She received 2uprbc, 1unit cryo, 1 platelet, 2 FFP, 5 liters crystalloid and 1L albumin. Blood cultures positive for GPC in clusters. Escalating vasopressors (Epi/NE/vaso) and ongoing hypoxia family opted to change code status to DNR. Patient then continue to have worsening hemodynamic instability and went into PEA and ultimately asystole. She was pronounced deceased at 1815. Family was en route already due to her instability thus will be notified of her passing once they arrive. Dr. was notified of patients death."
	"1350433-1"	"1350433-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"Presented 5/13 to Hospital.  Presented to Hospital on 5/13 with one week of symptoms including cough, dyspnea, diarrhea. COVID-19 testing was positive on 5/8.   Treatments prior to arrival included remdesivir and dexamethasone, started 5/13.  She was also placed on pulse dose steroids 1000 mg/day methylprednisolone given her history of ground glass lung opacities in 2018.  Progressed to high-flow nasal cannula, then BiPAP on 5/14, and was intubated on 5/17.   Paralysis and proning initiated.  Transferred to another hospital for possible VV ecmo candidacy. Patient with severe acute respiratory failure d/t covid who has failed treatment with the ventilator despite paralysis and proning.   CTS asked to place patient on VV ECMO.    5/20/21 1135am  initiated ECMO Patient is a 50yr old female with past medical history of hypertension, asthma, OSA and obesity BMI 41.5 who presented to hospital on 5/13 with progressive cough and shortness of breath for about a week.  Of note, patient also has a history of respiratory failure presenting with ground glass opacities on CT scan in 2018 with unclear etiology despite bronchoscopy and serologic studies which resolved with high dose corticosteroids.  Patient recently tested positive for COVID on 5/8 and received johnson and johnson vaccine in April. Patient was admitted on 5/13 and treated with decadron, remdesivir and tocilizumab.  Course complicated by progressive respiratory failure requiring HFNC followed by Bipap and ultimately intubation on 5/17.  Due to elevated d-dimer, lower extremity dopplers were obtained which were negative, however a heparin gtt was initiated. Course further complicated by cold left lower extremity; arterial duplex demonstrated distal popliteal artery thormbus extending into the peroneal, anterior tibial and dorsalis pedis arteries. therefore heparin was switched to argatroban and a HIT panel was sent.  On 5/19 patient continued to decline despite paralytic and pronning.  Patient transferred to ICU for further level of care and VV ECMO evaluation. On arrival patient was started on veletri; however due to continued respiratory decline a shock call was placed for VV ECMO and patient cannulated for VV @ 1200. Cannulation was difficult and patient was felt to have an IVC thrombus as clot was seen going into the ECMO circuit during cannulation. Post cannulation she developed worsening septic shock and DIC. She received 2uprbc, 1unit cryo, 1 platelet, 2 FFP, 5 liters crystalloid and 1L albumin. Blood cultures positive for GPC in clusters. Escalating vasopressors (Epi/NE/vaso) and ongoing hypoxia family opted to change code status to DNR. Patient then continue to have worsening hemodynamic instability and went into PEA and ultimately asystole. She was pronounced deceased at 1815. Family was en route already due to her instability thus will be notified of her passing once they arrive. Dr. was notified of patients death."
	"1350433-1"	"1350433-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"50-59 years"	"50-59"	"Presented 5/13 to Hospital.  Presented to Hospital on 5/13 with one week of symptoms including cough, dyspnea, diarrhea. COVID-19 testing was positive on 5/8.   Treatments prior to arrival included remdesivir and dexamethasone, started 5/13.  She was also placed on pulse dose steroids 1000 mg/day methylprednisolone given her history of ground glass lung opacities in 2018.  Progressed to high-flow nasal cannula, then BiPAP on 5/14, and was intubated on 5/17.   Paralysis and proning initiated.  Transferred to another hospital for possible VV ecmo candidacy. Patient with severe acute respiratory failure d/t covid who has failed treatment with the ventilator despite paralysis and proning.   CTS asked to place patient on VV ECMO.    5/20/21 1135am  initiated ECMO Patient is a 50yr old female with past medical history of hypertension, asthma, OSA and obesity BMI 41.5 who presented to hospital on 5/13 with progressive cough and shortness of breath for about a week.  Of note, patient also has a history of respiratory failure presenting with ground glass opacities on CT scan in 2018 with unclear etiology despite bronchoscopy and serologic studies which resolved with high dose corticosteroids.  Patient recently tested positive for COVID on 5/8 and received johnson and johnson vaccine in April. Patient was admitted on 5/13 and treated with decadron, remdesivir and tocilizumab.  Course complicated by progressive respiratory failure requiring HFNC followed by Bipap and ultimately intubation on 5/17.  Due to elevated d-dimer, lower extremity dopplers were obtained which were negative, however a heparin gtt was initiated. Course further complicated by cold left lower extremity; arterial duplex demonstrated distal popliteal artery thormbus extending into the peroneal, anterior tibial and dorsalis pedis arteries. therefore heparin was switched to argatroban and a HIT panel was sent.  On 5/19 patient continued to decline despite paralytic and pronning.  Patient transferred to ICU for further level of care and VV ECMO evaluation. On arrival patient was started on veletri; however due to continued respiratory decline a shock call was placed for VV ECMO and patient cannulated for VV @ 1200. Cannulation was difficult and patient was felt to have an IVC thrombus as clot was seen going into the ECMO circuit during cannulation. Post cannulation she developed worsening septic shock and DIC. She received 2uprbc, 1unit cryo, 1 platelet, 2 FFP, 5 liters crystalloid and 1L albumin. Blood cultures positive for GPC in clusters. Escalating vasopressors (Epi/NE/vaso) and ongoing hypoxia family opted to change code status to DNR. Patient then continue to have worsening hemodynamic instability and went into PEA and ultimately asystole. She was pronounced deceased at 1815. Family was en route already due to her instability thus will be notified of her passing once they arrive. Dr. was notified of patients death."
	"1350433-1"	"1350433-1"	"FIBRIN D DIMER INCREASED"	"10016581"	"50-59 years"	"50-59"	"Presented 5/13 to Hospital.  Presented to Hospital on 5/13 with one week of symptoms including cough, dyspnea, diarrhea. COVID-19 testing was positive on 5/8.   Treatments prior to arrival included remdesivir and dexamethasone, started 5/13.  She was also placed on pulse dose steroids 1000 mg/day methylprednisolone given her history of ground glass lung opacities in 2018.  Progressed to high-flow nasal cannula, then BiPAP on 5/14, and was intubated on 5/17.   Paralysis and proning initiated.  Transferred to another hospital for possible VV ecmo candidacy. Patient with severe acute respiratory failure d/t covid who has failed treatment with the ventilator despite paralysis and proning.   CTS asked to place patient on VV ECMO.    5/20/21 1135am  initiated ECMO Patient is a 50yr old female with past medical history of hypertension, asthma, OSA and obesity BMI 41.5 who presented to hospital on 5/13 with progressive cough and shortness of breath for about a week.  Of note, patient also has a history of respiratory failure presenting with ground glass opacities on CT scan in 2018 with unclear etiology despite bronchoscopy and serologic studies which resolved with high dose corticosteroids.  Patient recently tested positive for COVID on 5/8 and received johnson and johnson vaccine in April. Patient was admitted on 5/13 and treated with decadron, remdesivir and tocilizumab.  Course complicated by progressive respiratory failure requiring HFNC followed by Bipap and ultimately intubation on 5/17.  Due to elevated d-dimer, lower extremity dopplers were obtained which were negative, however a heparin gtt was initiated. Course further complicated by cold left lower extremity; arterial duplex demonstrated distal popliteal artery thormbus extending into the peroneal, anterior tibial and dorsalis pedis arteries. therefore heparin was switched to argatroban and a HIT panel was sent.  On 5/19 patient continued to decline despite paralytic and pronning.  Patient transferred to ICU for further level of care and VV ECMO evaluation. On arrival patient was started on veletri; however due to continued respiratory decline a shock call was placed for VV ECMO and patient cannulated for VV @ 1200. Cannulation was difficult and patient was felt to have an IVC thrombus as clot was seen going into the ECMO circuit during cannulation. Post cannulation she developed worsening septic shock and DIC. She received 2uprbc, 1unit cryo, 1 platelet, 2 FFP, 5 liters crystalloid and 1L albumin. Blood cultures positive for GPC in clusters. Escalating vasopressors (Epi/NE/vaso) and ongoing hypoxia family opted to change code status to DNR. Patient then continue to have worsening hemodynamic instability and went into PEA and ultimately asystole. She was pronounced deceased at 1815. Family was en route already due to her instability thus will be notified of her passing once they arrive. Dr. was notified of patients death."
	"1350433-1"	"1350433-1"	"FLUID REPLACEMENT"	"10061858"	"50-59 years"	"50-59"	"Presented 5/13 to Hospital.  Presented to Hospital on 5/13 with one week of symptoms including cough, dyspnea, diarrhea. COVID-19 testing was positive on 5/8.   Treatments prior to arrival included remdesivir and dexamethasone, started 5/13.  She was also placed on pulse dose steroids 1000 mg/day methylprednisolone given her history of ground glass lung opacities in 2018.  Progressed to high-flow nasal cannula, then BiPAP on 5/14, and was intubated on 5/17.   Paralysis and proning initiated.  Transferred to another hospital for possible VV ecmo candidacy. Patient with severe acute respiratory failure d/t covid who has failed treatment with the ventilator despite paralysis and proning.   CTS asked to place patient on VV ECMO.    5/20/21 1135am  initiated ECMO Patient is a 50yr old female with past medical history of hypertension, asthma, OSA and obesity BMI 41.5 who presented to hospital on 5/13 with progressive cough and shortness of breath for about a week.  Of note, patient also has a history of respiratory failure presenting with ground glass opacities on CT scan in 2018 with unclear etiology despite bronchoscopy and serologic studies which resolved with high dose corticosteroids.  Patient recently tested positive for COVID on 5/8 and received johnson and johnson vaccine in April. Patient was admitted on 5/13 and treated with decadron, remdesivir and tocilizumab.  Course complicated by progressive respiratory failure requiring HFNC followed by Bipap and ultimately intubation on 5/17.  Due to elevated d-dimer, lower extremity dopplers were obtained which were negative, however a heparin gtt was initiated. Course further complicated by cold left lower extremity; arterial duplex demonstrated distal popliteal artery thormbus extending into the peroneal, anterior tibial and dorsalis pedis arteries. therefore heparin was switched to argatroban and a HIT panel was sent.  On 5/19 patient continued to decline despite paralytic and pronning.  Patient transferred to ICU for further level of care and VV ECMO evaluation. On arrival patient was started on veletri; however due to continued respiratory decline a shock call was placed for VV ECMO and patient cannulated for VV @ 1200. Cannulation was difficult and patient was felt to have an IVC thrombus as clot was seen going into the ECMO circuit during cannulation. Post cannulation she developed worsening septic shock and DIC. She received 2uprbc, 1unit cryo, 1 platelet, 2 FFP, 5 liters crystalloid and 1L albumin. Blood cultures positive for GPC in clusters. Escalating vasopressors (Epi/NE/vaso) and ongoing hypoxia family opted to change code status to DNR. Patient then continue to have worsening hemodynamic instability and went into PEA and ultimately asystole. She was pronounced deceased at 1815. Family was en route already due to her instability thus will be notified of her passing once they arrive. Dr. was notified of patients death."
	"1350433-1"	"1350433-1"	"GENERAL PHYSICAL HEALTH DETERIORATION"	"10049438"	"50-59 years"	"50-59"	"Presented 5/13 to Hospital.  Presented to Hospital on 5/13 with one week of symptoms including cough, dyspnea, diarrhea. COVID-19 testing was positive on 5/8.   Treatments prior to arrival included remdesivir and dexamethasone, started 5/13.  She was also placed on pulse dose steroids 1000 mg/day methylprednisolone given her history of ground glass lung opacities in 2018.  Progressed to high-flow nasal cannula, then BiPAP on 5/14, and was intubated on 5/17.   Paralysis and proning initiated.  Transferred to another hospital for possible VV ecmo candidacy. Patient with severe acute respiratory failure d/t covid who has failed treatment with the ventilator despite paralysis and proning.   CTS asked to place patient on VV ECMO.    5/20/21 1135am  initiated ECMO Patient is a 50yr old female with past medical history of hypertension, asthma, OSA and obesity BMI 41.5 who presented to hospital on 5/13 with progressive cough and shortness of breath for about a week.  Of note, patient also has a history of respiratory failure presenting with ground glass opacities on CT scan in 2018 with unclear etiology despite bronchoscopy and serologic studies which resolved with high dose corticosteroids.  Patient recently tested positive for COVID on 5/8 and received johnson and johnson vaccine in April. Patient was admitted on 5/13 and treated with decadron, remdesivir and tocilizumab.  Course complicated by progressive respiratory failure requiring HFNC followed by Bipap and ultimately intubation on 5/17.  Due to elevated d-dimer, lower extremity dopplers were obtained which were negative, however a heparin gtt was initiated. Course further complicated by cold left lower extremity; arterial duplex demonstrated distal popliteal artery thormbus extending into the peroneal, anterior tibial and dorsalis pedis arteries. therefore heparin was switched to argatroban and a HIT panel was sent.  On 5/19 patient continued to decline despite paralytic and pronning.  Patient transferred to ICU for further level of care and VV ECMO evaluation. On arrival patient was started on veletri; however due to continued respiratory decline a shock call was placed for VV ECMO and patient cannulated for VV @ 1200. Cannulation was difficult and patient was felt to have an IVC thrombus as clot was seen going into the ECMO circuit during cannulation. Post cannulation she developed worsening septic shock and DIC. She received 2uprbc, 1unit cryo, 1 platelet, 2 FFP, 5 liters crystalloid and 1L albumin. Blood cultures positive for GPC in clusters. Escalating vasopressors (Epi/NE/vaso) and ongoing hypoxia family opted to change code status to DNR. Patient then continue to have worsening hemodynamic instability and went into PEA and ultimately asystole. She was pronounced deceased at 1815. Family was en route already due to her instability thus will be notified of her passing once they arrive. Dr. was notified of patients death."
	"1350433-1"	"1350433-1"	"GRAM STAIN POSITIVE"	"10018656"	"50-59 years"	"50-59"	"Presented 5/13 to Hospital.  Presented to Hospital on 5/13 with one week of symptoms including cough, dyspnea, diarrhea. COVID-19 testing was positive on 5/8.   Treatments prior to arrival included remdesivir and dexamethasone, started 5/13.  She was also placed on pulse dose steroids 1000 mg/day methylprednisolone given her history of ground glass lung opacities in 2018.  Progressed to high-flow nasal cannula, then BiPAP on 5/14, and was intubated on 5/17.   Paralysis and proning initiated.  Transferred to another hospital for possible VV ecmo candidacy. Patient with severe acute respiratory failure d/t covid who has failed treatment with the ventilator despite paralysis and proning.   CTS asked to place patient on VV ECMO.    5/20/21 1135am  initiated ECMO Patient is a 50yr old female with past medical history of hypertension, asthma, OSA and obesity BMI 41.5 who presented to hospital on 5/13 with progressive cough and shortness of breath for about a week.  Of note, patient also has a history of respiratory failure presenting with ground glass opacities on CT scan in 2018 with unclear etiology despite bronchoscopy and serologic studies which resolved with high dose corticosteroids.  Patient recently tested positive for COVID on 5/8 and received johnson and johnson vaccine in April. Patient was admitted on 5/13 and treated with decadron, remdesivir and tocilizumab.  Course complicated by progressive respiratory failure requiring HFNC followed by Bipap and ultimately intubation on 5/17.  Due to elevated d-dimer, lower extremity dopplers were obtained which were negative, however a heparin gtt was initiated. Course further complicated by cold left lower extremity; arterial duplex demonstrated distal popliteal artery thormbus extending into the peroneal, anterior tibial and dorsalis pedis arteries. therefore heparin was switched to argatroban and a HIT panel was sent.  On 5/19 patient continued to decline despite paralytic and pronning.  Patient transferred to ICU for further level of care and VV ECMO evaluation. On arrival patient was started on veletri; however due to continued respiratory decline a shock call was placed for VV ECMO and patient cannulated for VV @ 1200. Cannulation was difficult and patient was felt to have an IVC thrombus as clot was seen going into the ECMO circuit during cannulation. Post cannulation she developed worsening septic shock and DIC. She received 2uprbc, 1unit cryo, 1 platelet, 2 FFP, 5 liters crystalloid and 1L albumin. Blood cultures positive for GPC in clusters. Escalating vasopressors (Epi/NE/vaso) and ongoing hypoxia family opted to change code status to DNR. Patient then continue to have worsening hemodynamic instability and went into PEA and ultimately asystole. She was pronounced deceased at 1815. Family was en route already due to her instability thus will be notified of her passing once they arrive. Dr. was notified of patients death."
	"1350433-1"	"1350433-1"	"HAEMODYNAMIC INSTABILITY"	"10052076"	"50-59 years"	"50-59"	"Presented 5/13 to Hospital.  Presented to Hospital on 5/13 with one week of symptoms including cough, dyspnea, diarrhea. COVID-19 testing was positive on 5/8.   Treatments prior to arrival included remdesivir and dexamethasone, started 5/13.  She was also placed on pulse dose steroids 1000 mg/day methylprednisolone given her history of ground glass lung opacities in 2018.  Progressed to high-flow nasal cannula, then BiPAP on 5/14, and was intubated on 5/17.   Paralysis and proning initiated.  Transferred to another hospital for possible VV ecmo candidacy. Patient with severe acute respiratory failure d/t covid who has failed treatment with the ventilator despite paralysis and proning.   CTS asked to place patient on VV ECMO.    5/20/21 1135am  initiated ECMO Patient is a 50yr old female with past medical history of hypertension, asthma, OSA and obesity BMI 41.5 who presented to hospital on 5/13 with progressive cough and shortness of breath for about a week.  Of note, patient also has a history of respiratory failure presenting with ground glass opacities on CT scan in 2018 with unclear etiology despite bronchoscopy and serologic studies which resolved with high dose corticosteroids.  Patient recently tested positive for COVID on 5/8 and received johnson and johnson vaccine in April. Patient was admitted on 5/13 and treated with decadron, remdesivir and tocilizumab.  Course complicated by progressive respiratory failure requiring HFNC followed by Bipap and ultimately intubation on 5/17.  Due to elevated d-dimer, lower extremity dopplers were obtained which were negative, however a heparin gtt was initiated. Course further complicated by cold left lower extremity; arterial duplex demonstrated distal popliteal artery thormbus extending into the peroneal, anterior tibial and dorsalis pedis arteries. therefore heparin was switched to argatroban and a HIT panel was sent.  On 5/19 patient continued to decline despite paralytic and pronning.  Patient transferred to ICU for further level of care and VV ECMO evaluation. On arrival patient was started on veletri; however due to continued respiratory decline a shock call was placed for VV ECMO and patient cannulated for VV @ 1200. Cannulation was difficult and patient was felt to have an IVC thrombus as clot was seen going into the ECMO circuit during cannulation. Post cannulation she developed worsening septic shock and DIC. She received 2uprbc, 1unit cryo, 1 platelet, 2 FFP, 5 liters crystalloid and 1L albumin. Blood cultures positive for GPC in clusters. Escalating vasopressors (Epi/NE/vaso) and ongoing hypoxia family opted to change code status to DNR. Patient then continue to have worsening hemodynamic instability and went into PEA and ultimately asystole. She was pronounced deceased at 1815. Family was en route already due to her instability thus will be notified of her passing once they arrive. Dr. was notified of patients death."
	"1350433-1"	"1350433-1"	"HEPARIN-INDUCED THROMBOCYTOPENIA TEST"	"10050829"	"50-59 years"	"50-59"	"Presented 5/13 to Hospital.  Presented to Hospital on 5/13 with one week of symptoms including cough, dyspnea, diarrhea. COVID-19 testing was positive on 5/8.   Treatments prior to arrival included remdesivir and dexamethasone, started 5/13.  She was also placed on pulse dose steroids 1000 mg/day methylprednisolone given her history of ground glass lung opacities in 2018.  Progressed to high-flow nasal cannula, then BiPAP on 5/14, and was intubated on 5/17.   Paralysis and proning initiated.  Transferred to another hospital for possible VV ecmo candidacy. Patient with severe acute respiratory failure d/t covid who has failed treatment with the ventilator despite paralysis and proning.   CTS asked to place patient on VV ECMO.    5/20/21 1135am  initiated ECMO Patient is a 50yr old female with past medical history of hypertension, asthma, OSA and obesity BMI 41.5 who presented to hospital on 5/13 with progressive cough and shortness of breath for about a week.  Of note, patient also has a history of respiratory failure presenting with ground glass opacities on CT scan in 2018 with unclear etiology despite bronchoscopy and serologic studies which resolved with high dose corticosteroids.  Patient recently tested positive for COVID on 5/8 and received johnson and johnson vaccine in April. Patient was admitted on 5/13 and treated with decadron, remdesivir and tocilizumab.  Course complicated by progressive respiratory failure requiring HFNC followed by Bipap and ultimately intubation on 5/17.  Due to elevated d-dimer, lower extremity dopplers were obtained which were negative, however a heparin gtt was initiated. Course further complicated by cold left lower extremity; arterial duplex demonstrated distal popliteal artery thormbus extending into the peroneal, anterior tibial and dorsalis pedis arteries. therefore heparin was switched to argatroban and a HIT panel was sent.  On 5/19 patient continued to decline despite paralytic and pronning.  Patient transferred to ICU for further level of care and VV ECMO evaluation. On arrival patient was started on veletri; however due to continued respiratory decline a shock call was placed for VV ECMO and patient cannulated for VV @ 1200. Cannulation was difficult and patient was felt to have an IVC thrombus as clot was seen going into the ECMO circuit during cannulation. Post cannulation she developed worsening septic shock and DIC. She received 2uprbc, 1unit cryo, 1 platelet, 2 FFP, 5 liters crystalloid and 1L albumin. Blood cultures positive for GPC in clusters. Escalating vasopressors (Epi/NE/vaso) and ongoing hypoxia family opted to change code status to DNR. Patient then continue to have worsening hemodynamic instability and went into PEA and ultimately asystole. She was pronounced deceased at 1815. Family was en route already due to her instability thus will be notified of her passing once they arrive. Dr. was notified of patients death."
	"1350433-1"	"1350433-1"	"HYPOXIA"	"10021143"	"50-59 years"	"50-59"	"Presented 5/13 to Hospital.  Presented to Hospital on 5/13 with one week of symptoms including cough, dyspnea, diarrhea. COVID-19 testing was positive on 5/8.   Treatments prior to arrival included remdesivir and dexamethasone, started 5/13.  She was also placed on pulse dose steroids 1000 mg/day methylprednisolone given her history of ground glass lung opacities in 2018.  Progressed to high-flow nasal cannula, then BiPAP on 5/14, and was intubated on 5/17.   Paralysis and proning initiated.  Transferred to another hospital for possible VV ecmo candidacy. Patient with severe acute respiratory failure d/t covid who has failed treatment with the ventilator despite paralysis and proning.   CTS asked to place patient on VV ECMO.    5/20/21 1135am  initiated ECMO Patient is a 50yr old female with past medical history of hypertension, asthma, OSA and obesity BMI 41.5 who presented to hospital on 5/13 with progressive cough and shortness of breath for about a week.  Of note, patient also has a history of respiratory failure presenting with ground glass opacities on CT scan in 2018 with unclear etiology despite bronchoscopy and serologic studies which resolved with high dose corticosteroids.  Patient recently tested positive for COVID on 5/8 and received johnson and johnson vaccine in April. Patient was admitted on 5/13 and treated with decadron, remdesivir and tocilizumab.  Course complicated by progressive respiratory failure requiring HFNC followed by Bipap and ultimately intubation on 5/17.  Due to elevated d-dimer, lower extremity dopplers were obtained which were negative, however a heparin gtt was initiated. Course further complicated by cold left lower extremity; arterial duplex demonstrated distal popliteal artery thormbus extending into the peroneal, anterior tibial and dorsalis pedis arteries. therefore heparin was switched to argatroban and a HIT panel was sent.  On 5/19 patient continued to decline despite paralytic and pronning.  Patient transferred to ICU for further level of care and VV ECMO evaluation. On arrival patient was started on veletri; however due to continued respiratory decline a shock call was placed for VV ECMO and patient cannulated for VV @ 1200. Cannulation was difficult and patient was felt to have an IVC thrombus as clot was seen going into the ECMO circuit during cannulation. Post cannulation she developed worsening septic shock and DIC. She received 2uprbc, 1unit cryo, 1 platelet, 2 FFP, 5 liters crystalloid and 1L albumin. Blood cultures positive for GPC in clusters. Escalating vasopressors (Epi/NE/vaso) and ongoing hypoxia family opted to change code status to DNR. Patient then continue to have worsening hemodynamic instability and went into PEA and ultimately asystole. She was pronounced deceased at 1815. Family was en route already due to her instability thus will be notified of her passing once they arrive. Dr. was notified of patients death."
	"1350433-1"	"1350433-1"	"INTENSIVE CARE"	"10022519"	"50-59 years"	"50-59"	"Presented 5/13 to Hospital.  Presented to Hospital on 5/13 with one week of symptoms including cough, dyspnea, diarrhea. COVID-19 testing was positive on 5/8.   Treatments prior to arrival included remdesivir and dexamethasone, started 5/13.  She was also placed on pulse dose steroids 1000 mg/day methylprednisolone given her history of ground glass lung opacities in 2018.  Progressed to high-flow nasal cannula, then BiPAP on 5/14, and was intubated on 5/17.   Paralysis and proning initiated.  Transferred to another hospital for possible VV ecmo candidacy. Patient with severe acute respiratory failure d/t covid who has failed treatment with the ventilator despite paralysis and proning.   CTS asked to place patient on VV ECMO.    5/20/21 1135am  initiated ECMO Patient is a 50yr old female with past medical history of hypertension, asthma, OSA and obesity BMI 41.5 who presented to hospital on 5/13 with progressive cough and shortness of breath for about a week.  Of note, patient also has a history of respiratory failure presenting with ground glass opacities on CT scan in 2018 with unclear etiology despite bronchoscopy and serologic studies which resolved with high dose corticosteroids.  Patient recently tested positive for COVID on 5/8 and received johnson and johnson vaccine in April. Patient was admitted on 5/13 and treated with decadron, remdesivir and tocilizumab.  Course complicated by progressive respiratory failure requiring HFNC followed by Bipap and ultimately intubation on 5/17.  Due to elevated d-dimer, lower extremity dopplers were obtained which were negative, however a heparin gtt was initiated. Course further complicated by cold left lower extremity; arterial duplex demonstrated distal popliteal artery thormbus extending into the peroneal, anterior tibial and dorsalis pedis arteries. therefore heparin was switched to argatroban and a HIT panel was sent.  On 5/19 patient continued to decline despite paralytic and pronning.  Patient transferred to ICU for further level of care and VV ECMO evaluation. On arrival patient was started on veletri; however due to continued respiratory decline a shock call was placed for VV ECMO and patient cannulated for VV @ 1200. Cannulation was difficult and patient was felt to have an IVC thrombus as clot was seen going into the ECMO circuit during cannulation. Post cannulation she developed worsening septic shock and DIC. She received 2uprbc, 1unit cryo, 1 platelet, 2 FFP, 5 liters crystalloid and 1L albumin. Blood cultures positive for GPC in clusters. Escalating vasopressors (Epi/NE/vaso) and ongoing hypoxia family opted to change code status to DNR. Patient then continue to have worsening hemodynamic instability and went into PEA and ultimately asystole. She was pronounced deceased at 1815. Family was en route already due to her instability thus will be notified of her passing once they arrive. Dr. was notified of patients death."
	"1350433-1"	"1350433-1"	"LUNG ASSIST DEVICE THERAPY"	"10082527"	"50-59 years"	"50-59"	"Presented 5/13 to Hospital.  Presented to Hospital on 5/13 with one week of symptoms including cough, dyspnea, diarrhea. COVID-19 testing was positive on 5/8.   Treatments prior to arrival included remdesivir and dexamethasone, started 5/13.  She was also placed on pulse dose steroids 1000 mg/day methylprednisolone given her history of ground glass lung opacities in 2018.  Progressed to high-flow nasal cannula, then BiPAP on 5/14, and was intubated on 5/17.   Paralysis and proning initiated.  Transferred to another hospital for possible VV ecmo candidacy. Patient with severe acute respiratory failure d/t covid who has failed treatment with the ventilator despite paralysis and proning.   CTS asked to place patient on VV ECMO.    5/20/21 1135am  initiated ECMO Patient is a 50yr old female with past medical history of hypertension, asthma, OSA and obesity BMI 41.5 who presented to hospital on 5/13 with progressive cough and shortness of breath for about a week.  Of note, patient also has a history of respiratory failure presenting with ground glass opacities on CT scan in 2018 with unclear etiology despite bronchoscopy and serologic studies which resolved with high dose corticosteroids.  Patient recently tested positive for COVID on 5/8 and received johnson and johnson vaccine in April. Patient was admitted on 5/13 and treated with decadron, remdesivir and tocilizumab.  Course complicated by progressive respiratory failure requiring HFNC followed by Bipap and ultimately intubation on 5/17.  Due to elevated d-dimer, lower extremity dopplers were obtained which were negative, however a heparin gtt was initiated. Course further complicated by cold left lower extremity; arterial duplex demonstrated distal popliteal artery thormbus extending into the peroneal, anterior tibial and dorsalis pedis arteries. therefore heparin was switched to argatroban and a HIT panel was sent.  On 5/19 patient continued to decline despite paralytic and pronning.  Patient transferred to ICU for further level of care and VV ECMO evaluation. On arrival patient was started on veletri; however due to continued respiratory decline a shock call was placed for VV ECMO and patient cannulated for VV @ 1200. Cannulation was difficult and patient was felt to have an IVC thrombus as clot was seen going into the ECMO circuit during cannulation. Post cannulation she developed worsening septic shock and DIC. She received 2uprbc, 1unit cryo, 1 platelet, 2 FFP, 5 liters crystalloid and 1L albumin. Blood cultures positive for GPC in clusters. Escalating vasopressors (Epi/NE/vaso) and ongoing hypoxia family opted to change code status to DNR. Patient then continue to have worsening hemodynamic instability and went into PEA and ultimately asystole. She was pronounced deceased at 1815. Family was en route already due to her instability thus will be notified of her passing once they arrive. Dr. was notified of patients death."
	"1350433-1"	"1350433-1"	"MECHANICAL VENTILATION"	"10067221"	"50-59 years"	"50-59"	"Presented 5/13 to Hospital.  Presented to Hospital on 5/13 with one week of symptoms including cough, dyspnea, diarrhea. COVID-19 testing was positive on 5/8.   Treatments prior to arrival included remdesivir and dexamethasone, started 5/13.  She was also placed on pulse dose steroids 1000 mg/day methylprednisolone given her history of ground glass lung opacities in 2018.  Progressed to high-flow nasal cannula, then BiPAP on 5/14, and was intubated on 5/17.   Paralysis and proning initiated.  Transferred to another hospital for possible VV ecmo candidacy. Patient with severe acute respiratory failure d/t covid who has failed treatment with the ventilator despite paralysis and proning.   CTS asked to place patient on VV ECMO.    5/20/21 1135am  initiated ECMO Patient is a 50yr old female with past medical history of hypertension, asthma, OSA and obesity BMI 41.5 who presented to hospital on 5/13 with progressive cough and shortness of breath for about a week.  Of note, patient also has a history of respiratory failure presenting with ground glass opacities on CT scan in 2018 with unclear etiology despite bronchoscopy and serologic studies which resolved with high dose corticosteroids.  Patient recently tested positive for COVID on 5/8 and received johnson and johnson vaccine in April. Patient was admitted on 5/13 and treated with decadron, remdesivir and tocilizumab.  Course complicated by progressive respiratory failure requiring HFNC followed by Bipap and ultimately intubation on 5/17.  Due to elevated d-dimer, lower extremity dopplers were obtained which were negative, however a heparin gtt was initiated. Course further complicated by cold left lower extremity; arterial duplex demonstrated distal popliteal artery thormbus extending into the peroneal, anterior tibial and dorsalis pedis arteries. therefore heparin was switched to argatroban and a HIT panel was sent.  On 5/19 patient continued to decline despite paralytic and pronning.  Patient transferred to ICU for further level of care and VV ECMO evaluation. On arrival patient was started on veletri; however due to continued respiratory decline a shock call was placed for VV ECMO and patient cannulated for VV @ 1200. Cannulation was difficult and patient was felt to have an IVC thrombus as clot was seen going into the ECMO circuit during cannulation. Post cannulation she developed worsening septic shock and DIC. She received 2uprbc, 1unit cryo, 1 platelet, 2 FFP, 5 liters crystalloid and 1L albumin. Blood cultures positive for GPC in clusters. Escalating vasopressors (Epi/NE/vaso) and ongoing hypoxia family opted to change code status to DNR. Patient then continue to have worsening hemodynamic instability and went into PEA and ultimately asystole. She was pronounced deceased at 1815. Family was en route already due to her instability thus will be notified of her passing once they arrive. Dr. was notified of patients death."
	"1350433-1"	"1350433-1"	"PACKED RED BLOOD CELL TRANSFUSION"	"10033359"	"50-59 years"	"50-59"	"Presented 5/13 to Hospital.  Presented to Hospital on 5/13 with one week of symptoms including cough, dyspnea, diarrhea. COVID-19 testing was positive on 5/8.   Treatments prior to arrival included remdesivir and dexamethasone, started 5/13.  She was also placed on pulse dose steroids 1000 mg/day methylprednisolone given her history of ground glass lung opacities in 2018.  Progressed to high-flow nasal cannula, then BiPAP on 5/14, and was intubated on 5/17.   Paralysis and proning initiated.  Transferred to another hospital for possible VV ecmo candidacy. Patient with severe acute respiratory failure d/t covid who has failed treatment with the ventilator despite paralysis and proning.   CTS asked to place patient on VV ECMO.    5/20/21 1135am  initiated ECMO Patient is a 50yr old female with past medical history of hypertension, asthma, OSA and obesity BMI 41.5 who presented to hospital on 5/13 with progressive cough and shortness of breath for about a week.  Of note, patient also has a history of respiratory failure presenting with ground glass opacities on CT scan in 2018 with unclear etiology despite bronchoscopy and serologic studies which resolved with high dose corticosteroids.  Patient recently tested positive for COVID on 5/8 and received johnson and johnson vaccine in April. Patient was admitted on 5/13 and treated with decadron, remdesivir and tocilizumab.  Course complicated by progressive respiratory failure requiring HFNC followed by Bipap and ultimately intubation on 5/17.  Due to elevated d-dimer, lower extremity dopplers were obtained which were negative, however a heparin gtt was initiated. Course further complicated by cold left lower extremity; arterial duplex demonstrated distal popliteal artery thormbus extending into the peroneal, anterior tibial and dorsalis pedis arteries. therefore heparin was switched to argatroban and a HIT panel was sent.  On 5/19 patient continued to decline despite paralytic and pronning.  Patient transferred to ICU for further level of care and VV ECMO evaluation. On arrival patient was started on veletri; however due to continued respiratory decline a shock call was placed for VV ECMO and patient cannulated for VV @ 1200. Cannulation was difficult and patient was felt to have an IVC thrombus as clot was seen going into the ECMO circuit during cannulation. Post cannulation she developed worsening septic shock and DIC. She received 2uprbc, 1unit cryo, 1 platelet, 2 FFP, 5 liters crystalloid and 1L albumin. Blood cultures positive for GPC in clusters. Escalating vasopressors (Epi/NE/vaso) and ongoing hypoxia family opted to change code status to DNR. Patient then continue to have worsening hemodynamic instability and went into PEA and ultimately asystole. She was pronounced deceased at 1815. Family was en route already due to her instability thus will be notified of her passing once they arrive. Dr. was notified of patients death."
	"1350433-1"	"1350433-1"	"PERIPHERAL ARTERY THROMBOSIS"	"10072564"	"50-59 years"	"50-59"	"Presented 5/13 to Hospital.  Presented to Hospital on 5/13 with one week of symptoms including cough, dyspnea, diarrhea. COVID-19 testing was positive on 5/8.   Treatments prior to arrival included remdesivir and dexamethasone, started 5/13.  She was also placed on pulse dose steroids 1000 mg/day methylprednisolone given her history of ground glass lung opacities in 2018.  Progressed to high-flow nasal cannula, then BiPAP on 5/14, and was intubated on 5/17.   Paralysis and proning initiated.  Transferred to another hospital for possible VV ecmo candidacy. Patient with severe acute respiratory failure d/t covid who has failed treatment with the ventilator despite paralysis and proning.   CTS asked to place patient on VV ECMO.    5/20/21 1135am  initiated ECMO Patient is a 50yr old female with past medical history of hypertension, asthma, OSA and obesity BMI 41.5 who presented to hospital on 5/13 with progressive cough and shortness of breath for about a week.  Of note, patient also has a history of respiratory failure presenting with ground glass opacities on CT scan in 2018 with unclear etiology despite bronchoscopy and serologic studies which resolved with high dose corticosteroids.  Patient recently tested positive for COVID on 5/8 and received johnson and johnson vaccine in April. Patient was admitted on 5/13 and treated with decadron, remdesivir and tocilizumab.  Course complicated by progressive respiratory failure requiring HFNC followed by Bipap and ultimately intubation on 5/17.  Due to elevated d-dimer, lower extremity dopplers were obtained which were negative, however a heparin gtt was initiated. Course further complicated by cold left lower extremity; arterial duplex demonstrated distal popliteal artery thormbus extending into the peroneal, anterior tibial and dorsalis pedis arteries. therefore heparin was switched to argatroban and a HIT panel was sent.  On 5/19 patient continued to decline despite paralytic and pronning.  Patient transferred to ICU for further level of care and VV ECMO evaluation. On arrival patient was started on veletri; however due to continued respiratory decline a shock call was placed for VV ECMO and patient cannulated for VV @ 1200. Cannulation was difficult and patient was felt to have an IVC thrombus as clot was seen going into the ECMO circuit during cannulation. Post cannulation she developed worsening septic shock and DIC. She received 2uprbc, 1unit cryo, 1 platelet, 2 FFP, 5 liters crystalloid and 1L albumin. Blood cultures positive for GPC in clusters. Escalating vasopressors (Epi/NE/vaso) and ongoing hypoxia family opted to change code status to DNR. Patient then continue to have worsening hemodynamic instability and went into PEA and ultimately asystole. She was pronounced deceased at 1815. Family was en route already due to her instability thus will be notified of her passing once they arrive. Dr. was notified of patients death."
	"1350433-1"	"1350433-1"	"PERIPHERAL COLDNESS"	"10034568"	"50-59 years"	"50-59"	"Presented 5/13 to Hospital.  Presented to Hospital on 5/13 with one week of symptoms including cough, dyspnea, diarrhea. COVID-19 testing was positive on 5/8.   Treatments prior to arrival included remdesivir and dexamethasone, started 5/13.  She was also placed on pulse dose steroids 1000 mg/day methylprednisolone given her history of ground glass lung opacities in 2018.  Progressed to high-flow nasal cannula, then BiPAP on 5/14, and was intubated on 5/17.   Paralysis and proning initiated.  Transferred to another hospital for possible VV ecmo candidacy. Patient with severe acute respiratory failure d/t covid who has failed treatment with the ventilator despite paralysis and proning.   CTS asked to place patient on VV ECMO.    5/20/21 1135am  initiated ECMO Patient is a 50yr old female with past medical history of hypertension, asthma, OSA and obesity BMI 41.5 who presented to hospital on 5/13 with progressive cough and shortness of breath for about a week.  Of note, patient also has a history of respiratory failure presenting with ground glass opacities on CT scan in 2018 with unclear etiology despite bronchoscopy and serologic studies which resolved with high dose corticosteroids.  Patient recently tested positive for COVID on 5/8 and received johnson and johnson vaccine in April. Patient was admitted on 5/13 and treated with decadron, remdesivir and tocilizumab.  Course complicated by progressive respiratory failure requiring HFNC followed by Bipap and ultimately intubation on 5/17.  Due to elevated d-dimer, lower extremity dopplers were obtained which were negative, however a heparin gtt was initiated. Course further complicated by cold left lower extremity; arterial duplex demonstrated distal popliteal artery thormbus extending into the peroneal, anterior tibial and dorsalis pedis arteries. therefore heparin was switched to argatroban and a HIT panel was sent.  On 5/19 patient continued to decline despite paralytic and pronning.  Patient transferred to ICU for further level of care and VV ECMO evaluation. On arrival patient was started on veletri; however due to continued respiratory decline a shock call was placed for VV ECMO and patient cannulated for VV @ 1200. Cannulation was difficult and patient was felt to have an IVC thrombus as clot was seen going into the ECMO circuit during cannulation. Post cannulation she developed worsening septic shock and DIC. She received 2uprbc, 1unit cryo, 1 platelet, 2 FFP, 5 liters crystalloid and 1L albumin. Blood cultures positive for GPC in clusters. Escalating vasopressors (Epi/NE/vaso) and ongoing hypoxia family opted to change code status to DNR. Patient then continue to have worsening hemodynamic instability and went into PEA and ultimately asystole. She was pronounced deceased at 1815. Family was en route already due to her instability thus will be notified of her passing once they arrive. Dr. was notified of patients death."
	"1350433-1"	"1350433-1"	"PLATELET TRANSFUSION"	"10035543"	"50-59 years"	"50-59"	"Presented 5/13 to Hospital.  Presented to Hospital on 5/13 with one week of symptoms including cough, dyspnea, diarrhea. COVID-19 testing was positive on 5/8.   Treatments prior to arrival included remdesivir and dexamethasone, started 5/13.  She was also placed on pulse dose steroids 1000 mg/day methylprednisolone given her history of ground glass lung opacities in 2018.  Progressed to high-flow nasal cannula, then BiPAP on 5/14, and was intubated on 5/17.   Paralysis and proning initiated.  Transferred to another hospital for possible VV ecmo candidacy. Patient with severe acute respiratory failure d/t covid who has failed treatment with the ventilator despite paralysis and proning.   CTS asked to place patient on VV ECMO.    5/20/21 1135am  initiated ECMO Patient is a 50yr old female with past medical history of hypertension, asthma, OSA and obesity BMI 41.5 who presented to hospital on 5/13 with progressive cough and shortness of breath for about a week.  Of note, patient also has a history of respiratory failure presenting with ground glass opacities on CT scan in 2018 with unclear etiology despite bronchoscopy and serologic studies which resolved with high dose corticosteroids.  Patient recently tested positive for COVID on 5/8 and received johnson and johnson vaccine in April. Patient was admitted on 5/13 and treated with decadron, remdesivir and tocilizumab.  Course complicated by progressive respiratory failure requiring HFNC followed by Bipap and ultimately intubation on 5/17.  Due to elevated d-dimer, lower extremity dopplers were obtained which were negative, however a heparin gtt was initiated. Course further complicated by cold left lower extremity; arterial duplex demonstrated distal popliteal artery thormbus extending into the peroneal, anterior tibial and dorsalis pedis arteries. therefore heparin was switched to argatroban and a HIT panel was sent.  On 5/19 patient continued to decline despite paralytic and pronning.  Patient transferred to ICU for further level of care and VV ECMO evaluation. On arrival patient was started on veletri; however due to continued respiratory decline a shock call was placed for VV ECMO and patient cannulated for VV @ 1200. Cannulation was difficult and patient was felt to have an IVC thrombus as clot was seen going into the ECMO circuit during cannulation. Post cannulation she developed worsening septic shock and DIC. She received 2uprbc, 1unit cryo, 1 platelet, 2 FFP, 5 liters crystalloid and 1L albumin. Blood cultures positive for GPC in clusters. Escalating vasopressors (Epi/NE/vaso) and ongoing hypoxia family opted to change code status to DNR. Patient then continue to have worsening hemodynamic instability and went into PEA and ultimately asystole. She was pronounced deceased at 1815. Family was en route already due to her instability thus will be notified of her passing once they arrive. Dr. was notified of patients death."
	"1350433-1"	"1350433-1"	"PRONE POSITION"	"10074744"	"50-59 years"	"50-59"	"Presented 5/13 to Hospital.  Presented to Hospital on 5/13 with one week of symptoms including cough, dyspnea, diarrhea. COVID-19 testing was positive on 5/8.   Treatments prior to arrival included remdesivir and dexamethasone, started 5/13.  She was also placed on pulse dose steroids 1000 mg/day methylprednisolone given her history of ground glass lung opacities in 2018.  Progressed to high-flow nasal cannula, then BiPAP on 5/14, and was intubated on 5/17.   Paralysis and proning initiated.  Transferred to another hospital for possible VV ecmo candidacy. Patient with severe acute respiratory failure d/t covid who has failed treatment with the ventilator despite paralysis and proning.   CTS asked to place patient on VV ECMO.    5/20/21 1135am  initiated ECMO Patient is a 50yr old female with past medical history of hypertension, asthma, OSA and obesity BMI 41.5 who presented to hospital on 5/13 with progressive cough and shortness of breath for about a week.  Of note, patient also has a history of respiratory failure presenting with ground glass opacities on CT scan in 2018 with unclear etiology despite bronchoscopy and serologic studies which resolved with high dose corticosteroids.  Patient recently tested positive for COVID on 5/8 and received johnson and johnson vaccine in April. Patient was admitted on 5/13 and treated with decadron, remdesivir and tocilizumab.  Course complicated by progressive respiratory failure requiring HFNC followed by Bipap and ultimately intubation on 5/17.  Due to elevated d-dimer, lower extremity dopplers were obtained which were negative, however a heparin gtt was initiated. Course further complicated by cold left lower extremity; arterial duplex demonstrated distal popliteal artery thormbus extending into the peroneal, anterior tibial and dorsalis pedis arteries. therefore heparin was switched to argatroban and a HIT panel was sent.  On 5/19 patient continued to decline despite paralytic and pronning.  Patient transferred to ICU for further level of care and VV ECMO evaluation. On arrival patient was started on veletri; however due to continued respiratory decline a shock call was placed for VV ECMO and patient cannulated for VV @ 1200. Cannulation was difficult and patient was felt to have an IVC thrombus as clot was seen going into the ECMO circuit during cannulation. Post cannulation she developed worsening septic shock and DIC. She received 2uprbc, 1unit cryo, 1 platelet, 2 FFP, 5 liters crystalloid and 1L albumin. Blood cultures positive for GPC in clusters. Escalating vasopressors (Epi/NE/vaso) and ongoing hypoxia family opted to change code status to DNR. Patient then continue to have worsening hemodynamic instability and went into PEA and ultimately asystole. She was pronounced deceased at 1815. Family was en route already due to her instability thus will be notified of her passing once they arrive. Dr. was notified of patients death."
	"1350433-1"	"1350433-1"	"PULSELESS ELECTRICAL ACTIVITY"	"10058151"	"50-59 years"	"50-59"	"Presented 5/13 to Hospital.  Presented to Hospital on 5/13 with one week of symptoms including cough, dyspnea, diarrhea. COVID-19 testing was positive on 5/8.   Treatments prior to arrival included remdesivir and dexamethasone, started 5/13.  She was also placed on pulse dose steroids 1000 mg/day methylprednisolone given her history of ground glass lung opacities in 2018.  Progressed to high-flow nasal cannula, then BiPAP on 5/14, and was intubated on 5/17.   Paralysis and proning initiated.  Transferred to another hospital for possible VV ecmo candidacy. Patient with severe acute respiratory failure d/t covid who has failed treatment with the ventilator despite paralysis and proning.   CTS asked to place patient on VV ECMO.    5/20/21 1135am  initiated ECMO Patient is a 50yr old female with past medical history of hypertension, asthma, OSA and obesity BMI 41.5 who presented to hospital on 5/13 with progressive cough and shortness of breath for about a week.  Of note, patient also has a history of respiratory failure presenting with ground glass opacities on CT scan in 2018 with unclear etiology despite bronchoscopy and serologic studies which resolved with high dose corticosteroids.  Patient recently tested positive for COVID on 5/8 and received johnson and johnson vaccine in April. Patient was admitted on 5/13 and treated with decadron, remdesivir and tocilizumab.  Course complicated by progressive respiratory failure requiring HFNC followed by Bipap and ultimately intubation on 5/17.  Due to elevated d-dimer, lower extremity dopplers were obtained which were negative, however a heparin gtt was initiated. Course further complicated by cold left lower extremity; arterial duplex demonstrated distal popliteal artery thormbus extending into the peroneal, anterior tibial and dorsalis pedis arteries. therefore heparin was switched to argatroban and a HIT panel was sent.  On 5/19 patient continued to decline despite paralytic and pronning.  Patient transferred to ICU for further level of care and VV ECMO evaluation. On arrival patient was started on veletri; however due to continued respiratory decline a shock call was placed for VV ECMO and patient cannulated for VV @ 1200. Cannulation was difficult and patient was felt to have an IVC thrombus as clot was seen going into the ECMO circuit during cannulation. Post cannulation she developed worsening septic shock and DIC. She received 2uprbc, 1unit cryo, 1 platelet, 2 FFP, 5 liters crystalloid and 1L albumin. Blood cultures positive for GPC in clusters. Escalating vasopressors (Epi/NE/vaso) and ongoing hypoxia family opted to change code status to DNR. Patient then continue to have worsening hemodynamic instability and went into PEA and ultimately asystole. She was pronounced deceased at 1815. Family was en route already due to her instability thus will be notified of her passing once they arrive. Dr. was notified of patients death."
	"1350433-1"	"1350433-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"Presented 5/13 to Hospital.  Presented to Hospital on 5/13 with one week of symptoms including cough, dyspnea, diarrhea. COVID-19 testing was positive on 5/8.   Treatments prior to arrival included remdesivir and dexamethasone, started 5/13.  She was also placed on pulse dose steroids 1000 mg/day methylprednisolone given her history of ground glass lung opacities in 2018.  Progressed to high-flow nasal cannula, then BiPAP on 5/14, and was intubated on 5/17.   Paralysis and proning initiated.  Transferred to another hospital for possible VV ecmo candidacy. Patient with severe acute respiratory failure d/t covid who has failed treatment with the ventilator despite paralysis and proning.   CTS asked to place patient on VV ECMO.    5/20/21 1135am  initiated ECMO Patient is a 50yr old female with past medical history of hypertension, asthma, OSA and obesity BMI 41.5 who presented to hospital on 5/13 with progressive cough and shortness of breath for about a week.  Of note, patient also has a history of respiratory failure presenting with ground glass opacities on CT scan in 2018 with unclear etiology despite bronchoscopy and serologic studies which resolved with high dose corticosteroids.  Patient recently tested positive for COVID on 5/8 and received johnson and johnson vaccine in April. Patient was admitted on 5/13 and treated with decadron, remdesivir and tocilizumab.  Course complicated by progressive respiratory failure requiring HFNC followed by Bipap and ultimately intubation on 5/17.  Due to elevated d-dimer, lower extremity dopplers were obtained which were negative, however a heparin gtt was initiated. Course further complicated by cold left lower extremity; arterial duplex demonstrated distal popliteal artery thormbus extending into the peroneal, anterior tibial and dorsalis pedis arteries. therefore heparin was switched to argatroban and a HIT panel was sent.  On 5/19 patient continued to decline despite paralytic and pronning.  Patient transferred to ICU for further level of care and VV ECMO evaluation. On arrival patient was started on veletri; however due to continued respiratory decline a shock call was placed for VV ECMO and patient cannulated for VV @ 1200. Cannulation was difficult and patient was felt to have an IVC thrombus as clot was seen going into the ECMO circuit during cannulation. Post cannulation she developed worsening septic shock and DIC. She received 2uprbc, 1unit cryo, 1 platelet, 2 FFP, 5 liters crystalloid and 1L albumin. Blood cultures positive for GPC in clusters. Escalating vasopressors (Epi/NE/vaso) and ongoing hypoxia family opted to change code status to DNR. Patient then continue to have worsening hemodynamic instability and went into PEA and ultimately asystole. She was pronounced deceased at 1815. Family was en route already due to her instability thus will be notified of her passing once they arrive. Dr. was notified of patients death."
	"1350433-1"	"1350433-1"	"SEPTIC SHOCK"	"10040070"	"50-59 years"	"50-59"	"Presented 5/13 to Hospital.  Presented to Hospital on 5/13 with one week of symptoms including cough, dyspnea, diarrhea. COVID-19 testing was positive on 5/8.   Treatments prior to arrival included remdesivir and dexamethasone, started 5/13.  She was also placed on pulse dose steroids 1000 mg/day methylprednisolone given her history of ground glass lung opacities in 2018.  Progressed to high-flow nasal cannula, then BiPAP on 5/14, and was intubated on 5/17.   Paralysis and proning initiated.  Transferred to another hospital for possible VV ecmo candidacy. Patient with severe acute respiratory failure d/t covid who has failed treatment with the ventilator despite paralysis and proning.   CTS asked to place patient on VV ECMO.    5/20/21 1135am  initiated ECMO Patient is a 50yr old female with past medical history of hypertension, asthma, OSA and obesity BMI 41.5 who presented to hospital on 5/13 with progressive cough and shortness of breath for about a week.  Of note, patient also has a history of respiratory failure presenting with ground glass opacities on CT scan in 2018 with unclear etiology despite bronchoscopy and serologic studies which resolved with high dose corticosteroids.  Patient recently tested positive for COVID on 5/8 and received johnson and johnson vaccine in April. Patient was admitted on 5/13 and treated with decadron, remdesivir and tocilizumab.  Course complicated by progressive respiratory failure requiring HFNC followed by Bipap and ultimately intubation on 5/17.  Due to elevated d-dimer, lower extremity dopplers were obtained which were negative, however a heparin gtt was initiated. Course further complicated by cold left lower extremity; arterial duplex demonstrated distal popliteal artery thormbus extending into the peroneal, anterior tibial and dorsalis pedis arteries. therefore heparin was switched to argatroban and a HIT panel was sent.  On 5/19 patient continued to decline despite paralytic and pronning.  Patient transferred to ICU for further level of care and VV ECMO evaluation. On arrival patient was started on veletri; however due to continued respiratory decline a shock call was placed for VV ECMO and patient cannulated for VV @ 1200. Cannulation was difficult and patient was felt to have an IVC thrombus as clot was seen going into the ECMO circuit during cannulation. Post cannulation she developed worsening septic shock and DIC. She received 2uprbc, 1unit cryo, 1 platelet, 2 FFP, 5 liters crystalloid and 1L albumin. Blood cultures positive for GPC in clusters. Escalating vasopressors (Epi/NE/vaso) and ongoing hypoxia family opted to change code status to DNR. Patient then continue to have worsening hemodynamic instability and went into PEA and ultimately asystole. She was pronounced deceased at 1815. Family was en route already due to her instability thus will be notified of her passing once they arrive. Dr. was notified of patients death."
	"1350433-1"	"1350433-1"	"TRANSFUSION"	"10066152"	"50-59 years"	"50-59"	"Presented 5/13 to Hospital.  Presented to Hospital on 5/13 with one week of symptoms including cough, dyspnea, diarrhea. COVID-19 testing was positive on 5/8.   Treatments prior to arrival included remdesivir and dexamethasone, started 5/13.  She was also placed on pulse dose steroids 1000 mg/day methylprednisolone given her history of ground glass lung opacities in 2018.  Progressed to high-flow nasal cannula, then BiPAP on 5/14, and was intubated on 5/17.   Paralysis and proning initiated.  Transferred to another hospital for possible VV ecmo candidacy. Patient with severe acute respiratory failure d/t covid who has failed treatment with the ventilator despite paralysis and proning.   CTS asked to place patient on VV ECMO.    5/20/21 1135am  initiated ECMO Patient is a 50yr old female with past medical history of hypertension, asthma, OSA and obesity BMI 41.5 who presented to hospital on 5/13 with progressive cough and shortness of breath for about a week.  Of note, patient also has a history of respiratory failure presenting with ground glass opacities on CT scan in 2018 with unclear etiology despite bronchoscopy and serologic studies which resolved with high dose corticosteroids.  Patient recently tested positive for COVID on 5/8 and received johnson and johnson vaccine in April. Patient was admitted on 5/13 and treated with decadron, remdesivir and tocilizumab.  Course complicated by progressive respiratory failure requiring HFNC followed by Bipap and ultimately intubation on 5/17.  Due to elevated d-dimer, lower extremity dopplers were obtained which were negative, however a heparin gtt was initiated. Course further complicated by cold left lower extremity; arterial duplex demonstrated distal popliteal artery thormbus extending into the peroneal, anterior tibial and dorsalis pedis arteries. therefore heparin was switched to argatroban and a HIT panel was sent.  On 5/19 patient continued to decline despite paralytic and pronning.  Patient transferred to ICU for further level of care and VV ECMO evaluation. On arrival patient was started on veletri; however due to continued respiratory decline a shock call was placed for VV ECMO and patient cannulated for VV @ 1200. Cannulation was difficult and patient was felt to have an IVC thrombus as clot was seen going into the ECMO circuit during cannulation. Post cannulation she developed worsening septic shock and DIC. She received 2uprbc, 1unit cryo, 1 platelet, 2 FFP, 5 liters crystalloid and 1L albumin. Blood cultures positive for GPC in clusters. Escalating vasopressors (Epi/NE/vaso) and ongoing hypoxia family opted to change code status to DNR. Patient then continue to have worsening hemodynamic instability and went into PEA and ultimately asystole. She was pronounced deceased at 1815. Family was en route already due to her instability thus will be notified of her passing once they arrive. Dr. was notified of patients death."
	"1350433-1"	"1350433-1"	"ULTRASOUND DOPPLER ABNORMAL"	"10045413"	"50-59 years"	"50-59"	"Presented 5/13 to Hospital.  Presented to Hospital on 5/13 with one week of symptoms including cough, dyspnea, diarrhea. COVID-19 testing was positive on 5/8.   Treatments prior to arrival included remdesivir and dexamethasone, started 5/13.  She was also placed on pulse dose steroids 1000 mg/day methylprednisolone given her history of ground glass lung opacities in 2018.  Progressed to high-flow nasal cannula, then BiPAP on 5/14, and was intubated on 5/17.   Paralysis and proning initiated.  Transferred to another hospital for possible VV ecmo candidacy. Patient with severe acute respiratory failure d/t covid who has failed treatment with the ventilator despite paralysis and proning.   CTS asked to place patient on VV ECMO.    5/20/21 1135am  initiated ECMO Patient is a 50yr old female with past medical history of hypertension, asthma, OSA and obesity BMI 41.5 who presented to hospital on 5/13 with progressive cough and shortness of breath for about a week.  Of note, patient also has a history of respiratory failure presenting with ground glass opacities on CT scan in 2018 with unclear etiology despite bronchoscopy and serologic studies which resolved with high dose corticosteroids.  Patient recently tested positive for COVID on 5/8 and received johnson and johnson vaccine in April. Patient was admitted on 5/13 and treated with decadron, remdesivir and tocilizumab.  Course complicated by progressive respiratory failure requiring HFNC followed by Bipap and ultimately intubation on 5/17.  Due to elevated d-dimer, lower extremity dopplers were obtained which were negative, however a heparin gtt was initiated. Course further complicated by cold left lower extremity; arterial duplex demonstrated distal popliteal artery thormbus extending into the peroneal, anterior tibial and dorsalis pedis arteries. therefore heparin was switched to argatroban and a HIT panel was sent.  On 5/19 patient continued to decline despite paralytic and pronning.  Patient transferred to ICU for further level of care and VV ECMO evaluation. On arrival patient was started on veletri; however due to continued respiratory decline a shock call was placed for VV ECMO and patient cannulated for VV @ 1200. Cannulation was difficult and patient was felt to have an IVC thrombus as clot was seen going into the ECMO circuit during cannulation. Post cannulation she developed worsening septic shock and DIC. She received 2uprbc, 1unit cryo, 1 platelet, 2 FFP, 5 liters crystalloid and 1L albumin. Blood cultures positive for GPC in clusters. Escalating vasopressors (Epi/NE/vaso) and ongoing hypoxia family opted to change code status to DNR. Patient then continue to have worsening hemodynamic instability and went into PEA and ultimately asystole. She was pronounced deceased at 1815. Family was en route already due to her instability thus will be notified of her passing once they arrive. Dr. was notified of patients death."
	"1350433-1"	"1350433-1"	"VASOPRESSIVE THERAPY"	"10064148"	"50-59 years"	"50-59"	"Presented 5/13 to Hospital.  Presented to Hospital on 5/13 with one week of symptoms including cough, dyspnea, diarrhea. COVID-19 testing was positive on 5/8.   Treatments prior to arrival included remdesivir and dexamethasone, started 5/13.  She was also placed on pulse dose steroids 1000 mg/day methylprednisolone given her history of ground glass lung opacities in 2018.  Progressed to high-flow nasal cannula, then BiPAP on 5/14, and was intubated on 5/17.   Paralysis and proning initiated.  Transferred to another hospital for possible VV ecmo candidacy. Patient with severe acute respiratory failure d/t covid who has failed treatment with the ventilator despite paralysis and proning.   CTS asked to place patient on VV ECMO.    5/20/21 1135am  initiated ECMO Patient is a 50yr old female with past medical history of hypertension, asthma, OSA and obesity BMI 41.5 who presented to hospital on 5/13 with progressive cough and shortness of breath for about a week.  Of note, patient also has a history of respiratory failure presenting with ground glass opacities on CT scan in 2018 with unclear etiology despite bronchoscopy and serologic studies which resolved with high dose corticosteroids.  Patient recently tested positive for COVID on 5/8 and received johnson and johnson vaccine in April. Patient was admitted on 5/13 and treated with decadron, remdesivir and tocilizumab.  Course complicated by progressive respiratory failure requiring HFNC followed by Bipap and ultimately intubation on 5/17.  Due to elevated d-dimer, lower extremity dopplers were obtained which were negative, however a heparin gtt was initiated. Course further complicated by cold left lower extremity; arterial duplex demonstrated distal popliteal artery thormbus extending into the peroneal, anterior tibial and dorsalis pedis arteries. therefore heparin was switched to argatroban and a HIT panel was sent.  On 5/19 patient continued to decline despite paralytic and pronning.  Patient transferred to ICU for further level of care and VV ECMO evaluation. On arrival patient was started on veletri; however due to continued respiratory decline a shock call was placed for VV ECMO and patient cannulated for VV @ 1200. Cannulation was difficult and patient was felt to have an IVC thrombus as clot was seen going into the ECMO circuit during cannulation. Post cannulation she developed worsening septic shock and DIC. She received 2uprbc, 1unit cryo, 1 platelet, 2 FFP, 5 liters crystalloid and 1L albumin. Blood cultures positive for GPC in clusters. Escalating vasopressors (Epi/NE/vaso) and ongoing hypoxia family opted to change code status to DNR. Patient then continue to have worsening hemodynamic instability and went into PEA and ultimately asystole. She was pronounced deceased at 1815. Family was en route already due to her instability thus will be notified of her passing once they arrive. Dr. was notified of patients death."
	"1350433-1"	"1350433-1"	"VENA CAVA THROMBOSIS"	"10047195"	"50-59 years"	"50-59"	"Presented 5/13 to Hospital.  Presented to Hospital on 5/13 with one week of symptoms including cough, dyspnea, diarrhea. COVID-19 testing was positive on 5/8.   Treatments prior to arrival included remdesivir and dexamethasone, started 5/13.  She was also placed on pulse dose steroids 1000 mg/day methylprednisolone given her history of ground glass lung opacities in 2018.  Progressed to high-flow nasal cannula, then BiPAP on 5/14, and was intubated on 5/17.   Paralysis and proning initiated.  Transferred to another hospital for possible VV ecmo candidacy. Patient with severe acute respiratory failure d/t covid who has failed treatment with the ventilator despite paralysis and proning.   CTS asked to place patient on VV ECMO.    5/20/21 1135am  initiated ECMO Patient is a 50yr old female with past medical history of hypertension, asthma, OSA and obesity BMI 41.5 who presented to hospital on 5/13 with progressive cough and shortness of breath for about a week.  Of note, patient also has a history of respiratory failure presenting with ground glass opacities on CT scan in 2018 with unclear etiology despite bronchoscopy and serologic studies which resolved with high dose corticosteroids.  Patient recently tested positive for COVID on 5/8 and received johnson and johnson vaccine in April. Patient was admitted on 5/13 and treated with decadron, remdesivir and tocilizumab.  Course complicated by progressive respiratory failure requiring HFNC followed by Bipap and ultimately intubation on 5/17.  Due to elevated d-dimer, lower extremity dopplers were obtained which were negative, however a heparin gtt was initiated. Course further complicated by cold left lower extremity; arterial duplex demonstrated distal popliteal artery thormbus extending into the peroneal, anterior tibial and dorsalis pedis arteries. therefore heparin was switched to argatroban and a HIT panel was sent.  On 5/19 patient continued to decline despite paralytic and pronning.  Patient transferred to ICU for further level of care and VV ECMO evaluation. On arrival patient was started on veletri; however due to continued respiratory decline a shock call was placed for VV ECMO and patient cannulated for VV @ 1200. Cannulation was difficult and patient was felt to have an IVC thrombus as clot was seen going into the ECMO circuit during cannulation. Post cannulation she developed worsening septic shock and DIC. She received 2uprbc, 1unit cryo, 1 platelet, 2 FFP, 5 liters crystalloid and 1L albumin. Blood cultures positive for GPC in clusters. Escalating vasopressors (Epi/NE/vaso) and ongoing hypoxia family opted to change code status to DNR. Patient then continue to have worsening hemodynamic instability and went into PEA and ultimately asystole. She was pronounced deceased at 1815. Family was en route already due to her instability thus will be notified of her passing once they arrive. Dr. was notified of patients death."
	"1351445-1"	"1351445-1"	"MALAISE"	"10025482"	"50-59 years"	"50-59"	"Slight malaise after first dose. After second dose, she complained of body aches throughout the rest of the day until she was transported to the hospital."
	"1351445-1"	"1351445-1"	"PAIN"	"10033371"	"50-59 years"	"50-59"	"Slight malaise after first dose. After second dose, she complained of body aches throughout the rest of the day until she was transported to the hospital."
	"1351907-1"	"1351907-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	""My mother described feeling ""off"" from the moment after the second vaccination of COVID19 (Pfizer-BioNTech). She Continued to feel strange weeks after the vaccine. My mother passed away at age 55 completely healthy and had a check-up with her primary care physician prior to any vaccinations. My mother did not die of natural causes at the time of her age and health.""
	"1351907-1"	"1351907-1"	"FEELING ABNORMAL"	"10016322"	"50-59 years"	"50-59"	""My mother described feeling ""off"" from the moment after the second vaccination of COVID19 (Pfizer-BioNTech). She Continued to feel strange weeks after the vaccine. My mother passed away at age 55 completely healthy and had a check-up with her primary care physician prior to any vaccinations. My mother did not die of natural causes at the time of her age and health.""
	"1354136-1"	"1354136-1"	"CONDITION AGGRAVATED"	"10010264"	"50-59 years"	"50-59"	"Patient had been complaining of worsening LE edema 3 days prior to event. She was seen at the clinic and given medication for it. Patient apparently developed high BP at home ( worsening HTN ?) and passed away at home 5 days after vaccination (05/11). No further info."
	"1354136-1"	"1354136-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient had been complaining of worsening LE edema 3 days prior to event. She was seen at the clinic and given medication for it. Patient apparently developed high BP at home ( worsening HTN ?) and passed away at home 5 days after vaccination (05/11). No further info."
	"1354136-1"	"1354136-1"	"HYPERTENSION"	"10020772"	"50-59 years"	"50-59"	"Patient had been complaining of worsening LE edema 3 days prior to event. She was seen at the clinic and given medication for it. Patient apparently developed high BP at home ( worsening HTN ?) and passed away at home 5 days after vaccination (05/11). No further info."
	"1354136-1"	"1354136-1"	"OEDEMA PERIPHERAL"	"10030124"	"50-59 years"	"50-59"	"Patient had been complaining of worsening LE edema 3 days prior to event. She was seen at the clinic and given medication for it. Patient apparently developed high BP at home ( worsening HTN ?) and passed away at home 5 days after vaccination (05/11). No further info."
	"1354548-1"	"1354548-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"No adverse symptoms reported.  Death following a fall while at home alone."
	"1354548-1"	"1354548-1"	"FALL"	"10016173"	"50-59 years"	"50-59"	"No adverse symptoms reported.  Death following a fall while at home alone."
	"1354957-1"	"1354957-1"	"CHEST DISCOMFORT"	"10008469"	"50-59 years"	"50-59"	"On 3/27/21 at around 9pm He felt tightness in chest which lead to heart attack and death"
	"1354957-1"	"1354957-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"On 3/27/21 at around 9pm He felt tightness in chest which lead to heart attack and death"
	"1354957-1"	"1354957-1"	"MYOCARDIAL INFARCTION"	"10028596"	"50-59 years"	"50-59"	"On 3/27/21 at around 9pm He felt tightness in chest which lead to heart attack and death"
	"1355174-1"	"1355174-1"	"ABDOMINAL PAIN"	"10000081"	"50-59 years"	"50-59"	""On 5/20/21 the patient was at home with his mother when he had acute nausea, light-headedness, and abdominal pain. He presented to the ED by ambulance. Excerpt from ED notes od MD follows: ""Initial ED interventions: iv fluids, low dose iv ativan, iv toradol, iv zofran.  ED course: patient arrives very anxious, writhing on bed, difficult to redirect. With chronic tonicity, not seizing. Mother arrives, and he recognizes her, seems to be consoled somewhat by her presence, but she is unable to direct him, and describes his behavior as irregular, and events acute this evening at her home.  Patient rests, and then HR decrease to 50s on monitior and patient found to be pulseless - I immediately start chest compressions, and achieve ROSC after PEA arrest with administration of EPI/compressions. Patient intubated per procedure note without complication. L femoral central attained per procedure note without complication. CPR performed over ED course intermittently (always PEA arrest) with ROSC achieved with administration of EPI, EPI drip started in addition to sedation meds, and iv fluids. No obvious STEMI on ECG to administer lytics, with suspicion of dissection and AAA prominent. I am able to stabilze and accompany patient to CT suite, where I recognize B/L massive PE immediately. I discuss with Dr. of Cardiology, who agrees with admininstration of alteplase. I disucss risks with mother who consents verbally. Patient without response to alteplase, and with continued pattern of PEA arrest following bradycardia. I discuss etiology of presentation with mother,and that patient is with very poor prognosis of survival, and likely poorer prognosis of neurological status, and patient is made comfort care, and fentanyl drip increased, patient is taken off of ventilation and drips. Pronounced deceased at 22:00.  MDM: Initial concern for but not limited to appendicitis, AAA, diverticulitis, renal stones, pyelonephritis, musculoskeletal pain, pancreatitis, toxic ingestion, ACS, obstruction, perforation, sepsis (2/2 PNA, UTI, meningitis, intra-abdominal infection), AAA, dissection, PE - as ED course progresses, differential narrows and consider more likely PEA arrest secondary to ACS, PE, dissection, AAA, necrotic pancreatitis, tension PNX (less likely). Considered but do not suspect seizures, stroke. Imaging studies reviewed - CXR with ETT in place, no acute pathology. CTA chest/A/P remarkable for massive proximal B/L PE. Labs reviewed. ECGs without STEMI, with sinus tach initially, LBBB after initial ROSC, and then AFib in RVR on subsequent ECG. Per above, patient suffered massive B/L PE, with subsequent cardiac arrest, despite heoric efforts including thrombolysis. Death called art 22:00.  Diagnosis: massive B/L PEs, PEA arrest.  Disposition: deceased.""""
	"1355174-1"	"1355174-1"	"ABNORMAL BEHAVIOUR"	"10061422"	"50-59 years"	"50-59"	""On 5/20/21 the patient was at home with his mother when he had acute nausea, light-headedness, and abdominal pain. He presented to the ED by ambulance. Excerpt from ED notes od MD follows: ""Initial ED interventions: iv fluids, low dose iv ativan, iv toradol, iv zofran.  ED course: patient arrives very anxious, writhing on bed, difficult to redirect. With chronic tonicity, not seizing. Mother arrives, and he recognizes her, seems to be consoled somewhat by her presence, but she is unable to direct him, and describes his behavior as irregular, and events acute this evening at her home.  Patient rests, and then HR decrease to 50s on monitior and patient found to be pulseless - I immediately start chest compressions, and achieve ROSC after PEA arrest with administration of EPI/compressions. Patient intubated per procedure note without complication. L femoral central attained per procedure note without complication. CPR performed over ED course intermittently (always PEA arrest) with ROSC achieved with administration of EPI, EPI drip started in addition to sedation meds, and iv fluids. No obvious STEMI on ECG to administer lytics, with suspicion of dissection and AAA prominent. I am able to stabilze and accompany patient to CT suite, where I recognize B/L massive PE immediately. I discuss with Dr. of Cardiology, who agrees with admininstration of alteplase. I disucss risks with mother who consents verbally. Patient without response to alteplase, and with continued pattern of PEA arrest following bradycardia. I discuss etiology of presentation with mother,and that patient is with very poor prognosis of survival, and likely poorer prognosis of neurological status, and patient is made comfort care, and fentanyl drip increased, patient is taken off of ventilation and drips. Pronounced deceased at 22:00.  MDM: Initial concern for but not limited to appendicitis, AAA, diverticulitis, renal stones, pyelonephritis, musculoskeletal pain, pancreatitis, toxic ingestion, ACS, obstruction, perforation, sepsis (2/2 PNA, UTI, meningitis, intra-abdominal infection), AAA, dissection, PE - as ED course progresses, differential narrows and consider more likely PEA arrest secondary to ACS, PE, dissection, AAA, necrotic pancreatitis, tension PNX (less likely). Considered but do not suspect seizures, stroke. Imaging studies reviewed - CXR with ETT in place, no acute pathology. CTA chest/A/P remarkable for massive proximal B/L PE. Labs reviewed. ECGs without STEMI, with sinus tach initially, LBBB after initial ROSC, and then AFib in RVR on subsequent ECG. Per above, patient suffered massive B/L PE, with subsequent cardiac arrest, despite heoric efforts including thrombolysis. Death called art 22:00.  Diagnosis: massive B/L PEs, PEA arrest.  Disposition: deceased.""""
	"1355174-1"	"1355174-1"	"ACUTE CORONARY SYNDROME"	"10051592"	"50-59 years"	"50-59"	""On 5/20/21 the patient was at home with his mother when he had acute nausea, light-headedness, and abdominal pain. He presented to the ED by ambulance. Excerpt from ED notes od MD follows: ""Initial ED interventions: iv fluids, low dose iv ativan, iv toradol, iv zofran.  ED course: patient arrives very anxious, writhing on bed, difficult to redirect. With chronic tonicity, not seizing. Mother arrives, and he recognizes her, seems to be consoled somewhat by her presence, but she is unable to direct him, and describes his behavior as irregular, and events acute this evening at her home.  Patient rests, and then HR decrease to 50s on monitior and patient found to be pulseless - I immediately start chest compressions, and achieve ROSC after PEA arrest with administration of EPI/compressions. Patient intubated per procedure note without complication. L femoral central attained per procedure note without complication. CPR performed over ED course intermittently (always PEA arrest) with ROSC achieved with administration of EPI, EPI drip started in addition to sedation meds, and iv fluids. No obvious STEMI on ECG to administer lytics, with suspicion of dissection and AAA prominent. I am able to stabilze and accompany patient to CT suite, where I recognize B/L massive PE immediately. I discuss with Dr. of Cardiology, who agrees with admininstration of alteplase. I disucss risks with mother who consents verbally. Patient without response to alteplase, and with continued pattern of PEA arrest following bradycardia. I discuss etiology of presentation with mother,and that patient is with very poor prognosis of survival, and likely poorer prognosis of neurological status, and patient is made comfort care, and fentanyl drip increased, patient is taken off of ventilation and drips. Pronounced deceased at 22:00.  MDM: Initial concern for but not limited to appendicitis, AAA, diverticulitis, renal stones, pyelonephritis, musculoskeletal pain, pancreatitis, toxic ingestion, ACS, obstruction, perforation, sepsis (2/2 PNA, UTI, meningitis, intra-abdominal infection), AAA, dissection, PE - as ED course progresses, differential narrows and consider more likely PEA arrest secondary to ACS, PE, dissection, AAA, necrotic pancreatitis, tension PNX (less likely). Considered but do not suspect seizures, stroke. Imaging studies reviewed - CXR with ETT in place, no acute pathology. CTA chest/A/P remarkable for massive proximal B/L PE. Labs reviewed. ECGs without STEMI, with sinus tach initially, LBBB after initial ROSC, and then AFib in RVR on subsequent ECG. Per above, patient suffered massive B/L PE, with subsequent cardiac arrest, despite heoric efforts including thrombolysis. Death called art 22:00.  Diagnosis: massive B/L PEs, PEA arrest.  Disposition: deceased.""""
	"1355174-1"	"1355174-1"	"ANGIOGRAM PULMONARY ABNORMAL"	"10002441"	"50-59 years"	"50-59"	""On 5/20/21 the patient was at home with his mother when he had acute nausea, light-headedness, and abdominal pain. He presented to the ED by ambulance. Excerpt from ED notes od MD follows: ""Initial ED interventions: iv fluids, low dose iv ativan, iv toradol, iv zofran.  ED course: patient arrives very anxious, writhing on bed, difficult to redirect. With chronic tonicity, not seizing. Mother arrives, and he recognizes her, seems to be consoled somewhat by her presence, but she is unable to direct him, and describes his behavior as irregular, and events acute this evening at her home.  Patient rests, and then HR decrease to 50s on monitior and patient found to be pulseless - I immediately start chest compressions, and achieve ROSC after PEA arrest with administration of EPI/compressions. Patient intubated per procedure note without complication. L femoral central attained per procedure note without complication. CPR performed over ED course intermittently (always PEA arrest) with ROSC achieved with administration of EPI, EPI drip started in addition to sedation meds, and iv fluids. No obvious STEMI on ECG to administer lytics, with suspicion of dissection and AAA prominent. I am able to stabilze and accompany patient to CT suite, where I recognize B/L massive PE immediately. I discuss with Dr. of Cardiology, who agrees with admininstration of alteplase. I disucss risks with mother who consents verbally. Patient without response to alteplase, and with continued pattern of PEA arrest following bradycardia. I discuss etiology of presentation with mother,and that patient is with very poor prognosis of survival, and likely poorer prognosis of neurological status, and patient is made comfort care, and fentanyl drip increased, patient is taken off of ventilation and drips. Pronounced deceased at 22:00.  MDM: Initial concern for but not limited to appendicitis, AAA, diverticulitis, renal stones, pyelonephritis, musculoskeletal pain, pancreatitis, toxic ingestion, ACS, obstruction, perforation, sepsis (2/2 PNA, UTI, meningitis, intra-abdominal infection), AAA, dissection, PE - as ED course progresses, differential narrows and consider more likely PEA arrest secondary to ACS, PE, dissection, AAA, necrotic pancreatitis, tension PNX (less likely). Considered but do not suspect seizures, stroke. Imaging studies reviewed - CXR with ETT in place, no acute pathology. CTA chest/A/P remarkable for massive proximal B/L PE. Labs reviewed. ECGs without STEMI, with sinus tach initially, LBBB after initial ROSC, and then AFib in RVR on subsequent ECG. Per above, patient suffered massive B/L PE, with subsequent cardiac arrest, despite heoric efforts including thrombolysis. Death called art 22:00.  Diagnosis: massive B/L PEs, PEA arrest.  Disposition: deceased.""""
	"1355174-1"	"1355174-1"	"ANXIETY"	"10002855"	"50-59 years"	"50-59"	""On 5/20/21 the patient was at home with his mother when he had acute nausea, light-headedness, and abdominal pain. He presented to the ED by ambulance. Excerpt from ED notes od MD follows: ""Initial ED interventions: iv fluids, low dose iv ativan, iv toradol, iv zofran.  ED course: patient arrives very anxious, writhing on bed, difficult to redirect. With chronic tonicity, not seizing. Mother arrives, and he recognizes her, seems to be consoled somewhat by her presence, but she is unable to direct him, and describes his behavior as irregular, and events acute this evening at her home.  Patient rests, and then HR decrease to 50s on monitior and patient found to be pulseless - I immediately start chest compressions, and achieve ROSC after PEA arrest with administration of EPI/compressions. Patient intubated per procedure note without complication. L femoral central attained per procedure note without complication. CPR performed over ED course intermittently (always PEA arrest) with ROSC achieved with administration of EPI, EPI drip started in addition to sedation meds, and iv fluids. No obvious STEMI on ECG to administer lytics, with suspicion of dissection and AAA prominent. I am able to stabilze and accompany patient to CT suite, where I recognize B/L massive PE immediately. I discuss with Dr. of Cardiology, who agrees with admininstration of alteplase. I disucss risks with mother who consents verbally. Patient without response to alteplase, and with continued pattern of PEA arrest following bradycardia. I discuss etiology of presentation with mother,and that patient is with very poor prognosis of survival, and likely poorer prognosis of neurological status, and patient is made comfort care, and fentanyl drip increased, patient is taken off of ventilation and drips. Pronounced deceased at 22:00.  MDM: Initial concern for but not limited to appendicitis, AAA, diverticulitis, renal stones, pyelonephritis, musculoskeletal pain, pancreatitis, toxic ingestion, ACS, obstruction, perforation, sepsis (2/2 PNA, UTI, meningitis, intra-abdominal infection), AAA, dissection, PE - as ED course progresses, differential narrows and consider more likely PEA arrest secondary to ACS, PE, dissection, AAA, necrotic pancreatitis, tension PNX (less likely). Considered but do not suspect seizures, stroke. Imaging studies reviewed - CXR with ETT in place, no acute pathology. CTA chest/A/P remarkable for massive proximal B/L PE. Labs reviewed. ECGs without STEMI, with sinus tach initially, LBBB after initial ROSC, and then AFib in RVR on subsequent ECG. Per above, patient suffered massive B/L PE, with subsequent cardiac arrest, despite heoric efforts including thrombolysis. Death called art 22:00.  Diagnosis: massive B/L PEs, PEA arrest.  Disposition: deceased.""""
	"1355174-1"	"1355174-1"	"AORTIC ANEURYSM"	"10002882"	"50-59 years"	"50-59"	""On 5/20/21 the patient was at home with his mother when he had acute nausea, light-headedness, and abdominal pain. He presented to the ED by ambulance. Excerpt from ED notes od MD follows: ""Initial ED interventions: iv fluids, low dose iv ativan, iv toradol, iv zofran.  ED course: patient arrives very anxious, writhing on bed, difficult to redirect. With chronic tonicity, not seizing. Mother arrives, and he recognizes her, seems to be consoled somewhat by her presence, but she is unable to direct him, and describes his behavior as irregular, and events acute this evening at her home.  Patient rests, and then HR decrease to 50s on monitior and patient found to be pulseless - I immediately start chest compressions, and achieve ROSC after PEA arrest with administration of EPI/compressions. Patient intubated per procedure note without complication. L femoral central attained per procedure note without complication. CPR performed over ED course intermittently (always PEA arrest) with ROSC achieved with administration of EPI, EPI drip started in addition to sedation meds, and iv fluids. No obvious STEMI on ECG to administer lytics, with suspicion of dissection and AAA prominent. I am able to stabilze and accompany patient to CT suite, where I recognize B/L massive PE immediately. I discuss with Dr. of Cardiology, who agrees with admininstration of alteplase. I disucss risks with mother who consents verbally. Patient without response to alteplase, and with continued pattern of PEA arrest following bradycardia. I discuss etiology of presentation with mother,and that patient is with very poor prognosis of survival, and likely poorer prognosis of neurological status, and patient is made comfort care, and fentanyl drip increased, patient is taken off of ventilation and drips. Pronounced deceased at 22:00.  MDM: Initial concern for but not limited to appendicitis, AAA, diverticulitis, renal stones, pyelonephritis, musculoskeletal pain, pancreatitis, toxic ingestion, ACS, obstruction, perforation, sepsis (2/2 PNA, UTI, meningitis, intra-abdominal infection), AAA, dissection, PE - as ED course progresses, differential narrows and consider more likely PEA arrest secondary to ACS, PE, dissection, AAA, necrotic pancreatitis, tension PNX (less likely). Considered but do not suspect seizures, stroke. Imaging studies reviewed - CXR with ETT in place, no acute pathology. CTA chest/A/P remarkable for massive proximal B/L PE. Labs reviewed. ECGs without STEMI, with sinus tach initially, LBBB after initial ROSC, and then AFib in RVR on subsequent ECG. Per above, patient suffered massive B/L PE, with subsequent cardiac arrest, despite heoric efforts including thrombolysis. Death called art 22:00.  Diagnosis: massive B/L PEs, PEA arrest.  Disposition: deceased.""""
	"1355174-1"	"1355174-1"	"AORTIC DISSECTION"	"10002895"	"50-59 years"	"50-59"	""On 5/20/21 the patient was at home with his mother when he had acute nausea, light-headedness, and abdominal pain. He presented to the ED by ambulance. Excerpt from ED notes od MD follows: ""Initial ED interventions: iv fluids, low dose iv ativan, iv toradol, iv zofran.  ED course: patient arrives very anxious, writhing on bed, difficult to redirect. With chronic tonicity, not seizing. Mother arrives, and he recognizes her, seems to be consoled somewhat by her presence, but she is unable to direct him, and describes his behavior as irregular, and events acute this evening at her home.  Patient rests, and then HR decrease to 50s on monitior and patient found to be pulseless - I immediately start chest compressions, and achieve ROSC after PEA arrest with administration of EPI/compressions. Patient intubated per procedure note without complication. L femoral central attained per procedure note without complication. CPR performed over ED course intermittently (always PEA arrest) with ROSC achieved with administration of EPI, EPI drip started in addition to sedation meds, and iv fluids. No obvious STEMI on ECG to administer lytics, with suspicion of dissection and AAA prominent. I am able to stabilze and accompany patient to CT suite, where I recognize B/L massive PE immediately. I discuss with Dr. of Cardiology, who agrees with admininstration of alteplase. I disucss risks with mother who consents verbally. Patient without response to alteplase, and with continued pattern of PEA arrest following bradycardia. I discuss etiology of presentation with mother,and that patient is with very poor prognosis of survival, and likely poorer prognosis of neurological status, and patient is made comfort care, and fentanyl drip increased, patient is taken off of ventilation and drips. Pronounced deceased at 22:00.  MDM: Initial concern for but not limited to appendicitis, AAA, diverticulitis, renal stones, pyelonephritis, musculoskeletal pain, pancreatitis, toxic ingestion, ACS, obstruction, perforation, sepsis (2/2 PNA, UTI, meningitis, intra-abdominal infection), AAA, dissection, PE - as ED course progresses, differential narrows and consider more likely PEA arrest secondary to ACS, PE, dissection, AAA, necrotic pancreatitis, tension PNX (less likely). Considered but do not suspect seizures, stroke. Imaging studies reviewed - CXR with ETT in place, no acute pathology. CTA chest/A/P remarkable for massive proximal B/L PE. Labs reviewed. ECGs without STEMI, with sinus tach initially, LBBB after initial ROSC, and then AFib in RVR on subsequent ECG. Per above, patient suffered massive B/L PE, with subsequent cardiac arrest, despite heoric efforts including thrombolysis. Death called art 22:00.  Diagnosis: massive B/L PEs, PEA arrest.  Disposition: deceased.""""
	"1355174-1"	"1355174-1"	"ATELECTASIS"	"10003598"	"50-59 years"	"50-59"	""On 5/20/21 the patient was at home with his mother when he had acute nausea, light-headedness, and abdominal pain. He presented to the ED by ambulance. Excerpt from ED notes od MD follows: ""Initial ED interventions: iv fluids, low dose iv ativan, iv toradol, iv zofran.  ED course: patient arrives very anxious, writhing on bed, difficult to redirect. With chronic tonicity, not seizing. Mother arrives, and he recognizes her, seems to be consoled somewhat by her presence, but she is unable to direct him, and describes his behavior as irregular, and events acute this evening at her home.  Patient rests, and then HR decrease to 50s on monitior and patient found to be pulseless - I immediately start chest compressions, and achieve ROSC after PEA arrest with administration of EPI/compressions. Patient intubated per procedure note without complication. L femoral central attained per procedure note without complication. CPR performed over ED course intermittently (always PEA arrest) with ROSC achieved with administration of EPI, EPI drip started in addition to sedation meds, and iv fluids. No obvious STEMI on ECG to administer lytics, with suspicion of dissection and AAA prominent. I am able to stabilze and accompany patient to CT suite, where I recognize B/L massive PE immediately. I discuss with Dr. of Cardiology, who agrees with admininstration of alteplase. I disucss risks with mother who consents verbally. Patient without response to alteplase, and with continued pattern of PEA arrest following bradycardia. I discuss etiology of presentation with mother,and that patient is with very poor prognosis of survival, and likely poorer prognosis of neurological status, and patient is made comfort care, and fentanyl drip increased, patient is taken off of ventilation and drips. Pronounced deceased at 22:00.  MDM: Initial concern for but not limited to appendicitis, AAA, diverticulitis, renal stones, pyelonephritis, musculoskeletal pain, pancreatitis, toxic ingestion, ACS, obstruction, perforation, sepsis (2/2 PNA, UTI, meningitis, intra-abdominal infection), AAA, dissection, PE - as ED course progresses, differential narrows and consider more likely PEA arrest secondary to ACS, PE, dissection, AAA, necrotic pancreatitis, tension PNX (less likely). Considered but do not suspect seizures, stroke. Imaging studies reviewed - CXR with ETT in place, no acute pathology. CTA chest/A/P remarkable for massive proximal B/L PE. Labs reviewed. ECGs without STEMI, with sinus tach initially, LBBB after initial ROSC, and then AFib in RVR on subsequent ECG. Per above, patient suffered massive B/L PE, with subsequent cardiac arrest, despite heoric efforts including thrombolysis. Death called art 22:00.  Diagnosis: massive B/L PEs, PEA arrest.  Disposition: deceased.""""
	"1355174-1"	"1355174-1"	"ATRIAL FIBRILLATION"	"10003658"	"50-59 years"	"50-59"	""On 5/20/21 the patient was at home with his mother when he had acute nausea, light-headedness, and abdominal pain. He presented to the ED by ambulance. Excerpt from ED notes od MD follows: ""Initial ED interventions: iv fluids, low dose iv ativan, iv toradol, iv zofran.  ED course: patient arrives very anxious, writhing on bed, difficult to redirect. With chronic tonicity, not seizing. Mother arrives, and he recognizes her, seems to be consoled somewhat by her presence, but she is unable to direct him, and describes his behavior as irregular, and events acute this evening at her home.  Patient rests, and then HR decrease to 50s on monitior and patient found to be pulseless - I immediately start chest compressions, and achieve ROSC after PEA arrest with administration of EPI/compressions. Patient intubated per procedure note without complication. L femoral central attained per procedure note without complication. CPR performed over ED course intermittently (always PEA arrest) with ROSC achieved with administration of EPI, EPI drip started in addition to sedation meds, and iv fluids. No obvious STEMI on ECG to administer lytics, with suspicion of dissection and AAA prominent. I am able to stabilze and accompany patient to CT suite, where I recognize B/L massive PE immediately. I discuss with Dr. of Cardiology, who agrees with admininstration of alteplase. I disucss risks with mother who consents verbally. Patient without response to alteplase, and with continued pattern of PEA arrest following bradycardia. I discuss etiology of presentation with mother,and that patient is with very poor prognosis of survival, and likely poorer prognosis of neurological status, and patient is made comfort care, and fentanyl drip increased, patient is taken off of ventilation and drips. Pronounced deceased at 22:00.  MDM: Initial concern for but not limited to appendicitis, AAA, diverticulitis, renal stones, pyelonephritis, musculoskeletal pain, pancreatitis, toxic ingestion, ACS, obstruction, perforation, sepsis (2/2 PNA, UTI, meningitis, intra-abdominal infection), AAA, dissection, PE - as ED course progresses, differential narrows and consider more likely PEA arrest secondary to ACS, PE, dissection, AAA, necrotic pancreatitis, tension PNX (less likely). Considered but do not suspect seizures, stroke. Imaging studies reviewed - CXR with ETT in place, no acute pathology. CTA chest/A/P remarkable for massive proximal B/L PE. Labs reviewed. ECGs without STEMI, with sinus tach initially, LBBB after initial ROSC, and then AFib in RVR on subsequent ECG. Per above, patient suffered massive B/L PE, with subsequent cardiac arrest, despite heoric efforts including thrombolysis. Death called art 22:00.  Diagnosis: massive B/L PEs, PEA arrest.  Disposition: deceased.""""
	"1355174-1"	"1355174-1"	"BRADYCARDIA"	"10006093"	"50-59 years"	"50-59"	""On 5/20/21 the patient was at home with his mother when he had acute nausea, light-headedness, and abdominal pain. He presented to the ED by ambulance. Excerpt from ED notes od MD follows: ""Initial ED interventions: iv fluids, low dose iv ativan, iv toradol, iv zofran.  ED course: patient arrives very anxious, writhing on bed, difficult to redirect. With chronic tonicity, not seizing. Mother arrives, and he recognizes her, seems to be consoled somewhat by her presence, but she is unable to direct him, and describes his behavior as irregular, and events acute this evening at her home.  Patient rests, and then HR decrease to 50s on monitior and patient found to be pulseless - I immediately start chest compressions, and achieve ROSC after PEA arrest with administration of EPI/compressions. Patient intubated per procedure note without complication. L femoral central attained per procedure note without complication. CPR performed over ED course intermittently (always PEA arrest) with ROSC achieved with administration of EPI, EPI drip started in addition to sedation meds, and iv fluids. No obvious STEMI on ECG to administer lytics, with suspicion of dissection and AAA prominent. I am able to stabilze and accompany patient to CT suite, where I recognize B/L massive PE immediately. I discuss with Dr. of Cardiology, who agrees with admininstration of alteplase. I disucss risks with mother who consents verbally. Patient without response to alteplase, and with continued pattern of PEA arrest following bradycardia. I discuss etiology of presentation with mother,and that patient is with very poor prognosis of survival, and likely poorer prognosis of neurological status, and patient is made comfort care, and fentanyl drip increased, patient is taken off of ventilation and drips. Pronounced deceased at 22:00.  MDM: Initial concern for but not limited to appendicitis, AAA, diverticulitis, renal stones, pyelonephritis, musculoskeletal pain, pancreatitis, toxic ingestion, ACS, obstruction, perforation, sepsis (2/2 PNA, UTI, meningitis, intra-abdominal infection), AAA, dissection, PE - as ED course progresses, differential narrows and consider more likely PEA arrest secondary to ACS, PE, dissection, AAA, necrotic pancreatitis, tension PNX (less likely). Considered but do not suspect seizures, stroke. Imaging studies reviewed - CXR with ETT in place, no acute pathology. CTA chest/A/P remarkable for massive proximal B/L PE. Labs reviewed. ECGs without STEMI, with sinus tach initially, LBBB after initial ROSC, and then AFib in RVR on subsequent ECG. Per above, patient suffered massive B/L PE, with subsequent cardiac arrest, despite heoric efforts including thrombolysis. Death called art 22:00.  Diagnosis: massive B/L PEs, PEA arrest.  Disposition: deceased.""""
	"1355174-1"	"1355174-1"	"BUNDLE BRANCH BLOCK LEFT"	"10006580"	"50-59 years"	"50-59"	""On 5/20/21 the patient was at home with his mother when he had acute nausea, light-headedness, and abdominal pain. He presented to the ED by ambulance. Excerpt from ED notes od MD follows: ""Initial ED interventions: iv fluids, low dose iv ativan, iv toradol, iv zofran.  ED course: patient arrives very anxious, writhing on bed, difficult to redirect. With chronic tonicity, not seizing. Mother arrives, and he recognizes her, seems to be consoled somewhat by her presence, but she is unable to direct him, and describes his behavior as irregular, and events acute this evening at her home.  Patient rests, and then HR decrease to 50s on monitior and patient found to be pulseless - I immediately start chest compressions, and achieve ROSC after PEA arrest with administration of EPI/compressions. Patient intubated per procedure note without complication. L femoral central attained per procedure note without complication. CPR performed over ED course intermittently (always PEA arrest) with ROSC achieved with administration of EPI, EPI drip started in addition to sedation meds, and iv fluids. No obvious STEMI on ECG to administer lytics, with suspicion of dissection and AAA prominent. I am able to stabilze and accompany patient to CT suite, where I recognize B/L massive PE immediately. I discuss with Dr. of Cardiology, who agrees with admininstration of alteplase. I disucss risks with mother who consents verbally. Patient without response to alteplase, and with continued pattern of PEA arrest following bradycardia. I discuss etiology of presentation with mother,and that patient is with very poor prognosis of survival, and likely poorer prognosis of neurological status, and patient is made comfort care, and fentanyl drip increased, patient is taken off of ventilation and drips. Pronounced deceased at 22:00.  MDM: Initial concern for but not limited to appendicitis, AAA, diverticulitis, renal stones, pyelonephritis, musculoskeletal pain, pancreatitis, toxic ingestion, ACS, obstruction, perforation, sepsis (2/2 PNA, UTI, meningitis, intra-abdominal infection), AAA, dissection, PE - as ED course progresses, differential narrows and consider more likely PEA arrest secondary to ACS, PE, dissection, AAA, necrotic pancreatitis, tension PNX (less likely). Considered but do not suspect seizures, stroke. Imaging studies reviewed - CXR with ETT in place, no acute pathology. CTA chest/A/P remarkable for massive proximal B/L PE. Labs reviewed. ECGs without STEMI, with sinus tach initially, LBBB after initial ROSC, and then AFib in RVR on subsequent ECG. Per above, patient suffered massive B/L PE, with subsequent cardiac arrest, despite heoric efforts including thrombolysis. Death called art 22:00.  Diagnosis: massive B/L PEs, PEA arrest.  Disposition: deceased.""""
	"1355174-1"	"1355174-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	""On 5/20/21 the patient was at home with his mother when he had acute nausea, light-headedness, and abdominal pain. He presented to the ED by ambulance. Excerpt from ED notes od MD follows: ""Initial ED interventions: iv fluids, low dose iv ativan, iv toradol, iv zofran.  ED course: patient arrives very anxious, writhing on bed, difficult to redirect. With chronic tonicity, not seizing. Mother arrives, and he recognizes her, seems to be consoled somewhat by her presence, but she is unable to direct him, and describes his behavior as irregular, and events acute this evening at her home.  Patient rests, and then HR decrease to 50s on monitior and patient found to be pulseless - I immediately start chest compressions, and achieve ROSC after PEA arrest with administration of EPI/compressions. Patient intubated per procedure note without complication. L femoral central attained per procedure note without complication. CPR performed over ED course intermittently (always PEA arrest) with ROSC achieved with administration of EPI, EPI drip started in addition to sedation meds, and iv fluids. No obvious STEMI on ECG to administer lytics, with suspicion of dissection and AAA prominent. I am able to stabilze and accompany patient to CT suite, where I recognize B/L massive PE immediately. I discuss with Dr. of Cardiology, who agrees with admininstration of alteplase. I disucss risks with mother who consents verbally. Patient without response to alteplase, and with continued pattern of PEA arrest following bradycardia. I discuss etiology of presentation with mother,and that patient is with very poor prognosis of survival, and likely poorer prognosis of neurological status, and patient is made comfort care, and fentanyl drip increased, patient is taken off of ventilation and drips. Pronounced deceased at 22:00.  MDM: Initial concern for but not limited to appendicitis, AAA, diverticulitis, renal stones, pyelonephritis, musculoskeletal pain, pancreatitis, toxic ingestion, ACS, obstruction, perforation, sepsis (2/2 PNA, UTI, meningitis, intra-abdominal infection), AAA, dissection, PE - as ED course progresses, differential narrows and consider more likely PEA arrest secondary to ACS, PE, dissection, AAA, necrotic pancreatitis, tension PNX (less likely). Considered but do not suspect seizures, stroke. Imaging studies reviewed - CXR with ETT in place, no acute pathology. CTA chest/A/P remarkable for massive proximal B/L PE. Labs reviewed. ECGs without STEMI, with sinus tach initially, LBBB after initial ROSC, and then AFib in RVR on subsequent ECG. Per above, patient suffered massive B/L PE, with subsequent cardiac arrest, despite heoric efforts including thrombolysis. Death called art 22:00.  Diagnosis: massive B/L PEs, PEA arrest.  Disposition: deceased.""""
	"1355174-1"	"1355174-1"	"CATHETER DIRECTED THROMBOLYSIS"	"10085325"	"50-59 years"	"50-59"	""On 5/20/21 the patient was at home with his mother when he had acute nausea, light-headedness, and abdominal pain. He presented to the ED by ambulance. Excerpt from ED notes od MD follows: ""Initial ED interventions: iv fluids, low dose iv ativan, iv toradol, iv zofran.  ED course: patient arrives very anxious, writhing on bed, difficult to redirect. With chronic tonicity, not seizing. Mother arrives, and he recognizes her, seems to be consoled somewhat by her presence, but she is unable to direct him, and describes his behavior as irregular, and events acute this evening at her home.  Patient rests, and then HR decrease to 50s on monitior and patient found to be pulseless - I immediately start chest compressions, and achieve ROSC after PEA arrest with administration of EPI/compressions. Patient intubated per procedure note without complication. L femoral central attained per procedure note without complication. CPR performed over ED course intermittently (always PEA arrest) with ROSC achieved with administration of EPI, EPI drip started in addition to sedation meds, and iv fluids. No obvious STEMI on ECG to administer lytics, with suspicion of dissection and AAA prominent. I am able to stabilze and accompany patient to CT suite, where I recognize B/L massive PE immediately. I discuss with Dr. of Cardiology, who agrees with admininstration of alteplase. I disucss risks with mother who consents verbally. Patient without response to alteplase, and with continued pattern of PEA arrest following bradycardia. I discuss etiology of presentation with mother,and that patient is with very poor prognosis of survival, and likely poorer prognosis of neurological status, and patient is made comfort care, and fentanyl drip increased, patient is taken off of ventilation and drips. Pronounced deceased at 22:00.  MDM: Initial concern for but not limited to appendicitis, AAA, diverticulitis, renal stones, pyelonephritis, musculoskeletal pain, pancreatitis, toxic ingestion, ACS, obstruction, perforation, sepsis (2/2 PNA, UTI, meningitis, intra-abdominal infection), AAA, dissection, PE - as ED course progresses, differential narrows and consider more likely PEA arrest secondary to ACS, PE, dissection, AAA, necrotic pancreatitis, tension PNX (less likely). Considered but do not suspect seizures, stroke. Imaging studies reviewed - CXR with ETT in place, no acute pathology. CTA chest/A/P remarkable for massive proximal B/L PE. Labs reviewed. ECGs without STEMI, with sinus tach initially, LBBB after initial ROSC, and then AFib in RVR on subsequent ECG. Per above, patient suffered massive B/L PE, with subsequent cardiac arrest, despite heoric efforts including thrombolysis. Death called art 22:00.  Diagnosis: massive B/L PEs, PEA arrest.  Disposition: deceased.""""
	"1355174-1"	"1355174-1"	"CENTRAL VENOUS CATHETERISATION"	"10053377"	"50-59 years"	"50-59"	""On 5/20/21 the patient was at home with his mother when he had acute nausea, light-headedness, and abdominal pain. He presented to the ED by ambulance. Excerpt from ED notes od MD follows: ""Initial ED interventions: iv fluids, low dose iv ativan, iv toradol, iv zofran.  ED course: patient arrives very anxious, writhing on bed, difficult to redirect. With chronic tonicity, not seizing. Mother arrives, and he recognizes her, seems to be consoled somewhat by her presence, but she is unable to direct him, and describes his behavior as irregular, and events acute this evening at her home.  Patient rests, and then HR decrease to 50s on monitior and patient found to be pulseless - I immediately start chest compressions, and achieve ROSC after PEA arrest with administration of EPI/compressions. Patient intubated per procedure note without complication. L femoral central attained per procedure note without complication. CPR performed over ED course intermittently (always PEA arrest) with ROSC achieved with administration of EPI, EPI drip started in addition to sedation meds, and iv fluids. No obvious STEMI on ECG to administer lytics, with suspicion of dissection and AAA prominent. I am able to stabilze and accompany patient to CT suite, where I recognize B/L massive PE immediately. I discuss with Dr. of Cardiology, who agrees with admininstration of alteplase. I disucss risks with mother who consents verbally. Patient without response to alteplase, and with continued pattern of PEA arrest following bradycardia. I discuss etiology of presentation with mother,and that patient is with very poor prognosis of survival, and likely poorer prognosis of neurological status, and patient is made comfort care, and fentanyl drip increased, patient is taken off of ventilation and drips. Pronounced deceased at 22:00.  MDM: Initial concern for but not limited to appendicitis, AAA, diverticulitis, renal stones, pyelonephritis, musculoskeletal pain, pancreatitis, toxic ingestion, ACS, obstruction, perforation, sepsis (2/2 PNA, UTI, meningitis, intra-abdominal infection), AAA, dissection, PE - as ED course progresses, differential narrows and consider more likely PEA arrest secondary to ACS, PE, dissection, AAA, necrotic pancreatitis, tension PNX (less likely). Considered but do not suspect seizures, stroke. Imaging studies reviewed - CXR with ETT in place, no acute pathology. CTA chest/A/P remarkable for massive proximal B/L PE. Labs reviewed. ECGs without STEMI, with sinus tach initially, LBBB after initial ROSC, and then AFib in RVR on subsequent ECG. Per above, patient suffered massive B/L PE, with subsequent cardiac arrest, despite heoric efforts including thrombolysis. Death called art 22:00.  Diagnosis: massive B/L PEs, PEA arrest.  Disposition: deceased.""""
	"1355174-1"	"1355174-1"	"CHEST X-RAY NORMAL"	"10008500"	"50-59 years"	"50-59"	""On 5/20/21 the patient was at home with his mother when he had acute nausea, light-headedness, and abdominal pain. He presented to the ED by ambulance. Excerpt from ED notes od MD follows: ""Initial ED interventions: iv fluids, low dose iv ativan, iv toradol, iv zofran.  ED course: patient arrives very anxious, writhing on bed, difficult to redirect. With chronic tonicity, not seizing. Mother arrives, and he recognizes her, seems to be consoled somewhat by her presence, but she is unable to direct him, and describes his behavior as irregular, and events acute this evening at her home.  Patient rests, and then HR decrease to 50s on monitior and patient found to be pulseless - I immediately start chest compressions, and achieve ROSC after PEA arrest with administration of EPI/compressions. Patient intubated per procedure note without complication. L femoral central attained per procedure note without complication. CPR performed over ED course intermittently (always PEA arrest) with ROSC achieved with administration of EPI, EPI drip started in addition to sedation meds, and iv fluids. No obvious STEMI on ECG to administer lytics, with suspicion of dissection and AAA prominent. I am able to stabilze and accompany patient to CT suite, where I recognize B/L massive PE immediately. I discuss with Dr. of Cardiology, who agrees with admininstration of alteplase. I disucss risks with mother who consents verbally. Patient without response to alteplase, and with continued pattern of PEA arrest following bradycardia. I discuss etiology of presentation with mother,and that patient is with very poor prognosis of survival, and likely poorer prognosis of neurological status, and patient is made comfort care, and fentanyl drip increased, patient is taken off of ventilation and drips. Pronounced deceased at 22:00.  MDM: Initial concern for but not limited to appendicitis, AAA, diverticulitis, renal stones, pyelonephritis, musculoskeletal pain, pancreatitis, toxic ingestion, ACS, obstruction, perforation, sepsis (2/2 PNA, UTI, meningitis, intra-abdominal infection), AAA, dissection, PE - as ED course progresses, differential narrows and consider more likely PEA arrest secondary to ACS, PE, dissection, AAA, necrotic pancreatitis, tension PNX (less likely). Considered but do not suspect seizures, stroke. Imaging studies reviewed - CXR with ETT in place, no acute pathology. CTA chest/A/P remarkable for massive proximal B/L PE. Labs reviewed. ECGs without STEMI, with sinus tach initially, LBBB after initial ROSC, and then AFib in RVR on subsequent ECG. Per above, patient suffered massive B/L PE, with subsequent cardiac arrest, despite heoric efforts including thrombolysis. Death called art 22:00.  Diagnosis: massive B/L PEs, PEA arrest.  Disposition: deceased.""""
	"1355174-1"	"1355174-1"	"COMPUTERISED TOMOGRAM ABDOMEN"	"10053876"	"50-59 years"	"50-59"	""On 5/20/21 the patient was at home with his mother when he had acute nausea, light-headedness, and abdominal pain. He presented to the ED by ambulance. Excerpt from ED notes od MD follows: ""Initial ED interventions: iv fluids, low dose iv ativan, iv toradol, iv zofran.  ED course: patient arrives very anxious, writhing on bed, difficult to redirect. With chronic tonicity, not seizing. Mother arrives, and he recognizes her, seems to be consoled somewhat by her presence, but she is unable to direct him, and describes his behavior as irregular, and events acute this evening at her home.  Patient rests, and then HR decrease to 50s on monitior and patient found to be pulseless - I immediately start chest compressions, and achieve ROSC after PEA arrest with administration of EPI/compressions. Patient intubated per procedure note without complication. L femoral central attained per procedure note without complication. CPR performed over ED course intermittently (always PEA arrest) with ROSC achieved with administration of EPI, EPI drip started in addition to sedation meds, and iv fluids. No obvious STEMI on ECG to administer lytics, with suspicion of dissection and AAA prominent. I am able to stabilze and accompany patient to CT suite, where I recognize B/L massive PE immediately. I discuss with Dr. of Cardiology, who agrees with admininstration of alteplase. I disucss risks with mother who consents verbally. Patient without response to alteplase, and with continued pattern of PEA arrest following bradycardia. I discuss etiology of presentation with mother,and that patient is with very poor prognosis of survival, and likely poorer prognosis of neurological status, and patient is made comfort care, and fentanyl drip increased, patient is taken off of ventilation and drips. Pronounced deceased at 22:00.  MDM: Initial concern for but not limited to appendicitis, AAA, diverticulitis, renal stones, pyelonephritis, musculoskeletal pain, pancreatitis, toxic ingestion, ACS, obstruction, perforation, sepsis (2/2 PNA, UTI, meningitis, intra-abdominal infection), AAA, dissection, PE - as ED course progresses, differential narrows and consider more likely PEA arrest secondary to ACS, PE, dissection, AAA, necrotic pancreatitis, tension PNX (less likely). Considered but do not suspect seizures, stroke. Imaging studies reviewed - CXR with ETT in place, no acute pathology. CTA chest/A/P remarkable for massive proximal B/L PE. Labs reviewed. ECGs without STEMI, with sinus tach initially, LBBB after initial ROSC, and then AFib in RVR on subsequent ECG. Per above, patient suffered massive B/L PE, with subsequent cardiac arrest, despite heoric efforts including thrombolysis. Death called art 22:00.  Diagnosis: massive B/L PEs, PEA arrest.  Disposition: deceased.""""
	"1355174-1"	"1355174-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	""On 5/20/21 the patient was at home with his mother when he had acute nausea, light-headedness, and abdominal pain. He presented to the ED by ambulance. Excerpt from ED notes od MD follows: ""Initial ED interventions: iv fluids, low dose iv ativan, iv toradol, iv zofran.  ED course: patient arrives very anxious, writhing on bed, difficult to redirect. With chronic tonicity, not seizing. Mother arrives, and he recognizes her, seems to be consoled somewhat by her presence, but she is unable to direct him, and describes his behavior as irregular, and events acute this evening at her home.  Patient rests, and then HR decrease to 50s on monitior and patient found to be pulseless - I immediately start chest compressions, and achieve ROSC after PEA arrest with administration of EPI/compressions. Patient intubated per procedure note without complication. L femoral central attained per procedure note without complication. CPR performed over ED course intermittently (always PEA arrest) with ROSC achieved with administration of EPI, EPI drip started in addition to sedation meds, and iv fluids. No obvious STEMI on ECG to administer lytics, with suspicion of dissection and AAA prominent. I am able to stabilze and accompany patient to CT suite, where I recognize B/L massive PE immediately. I discuss with Dr. of Cardiology, who agrees with admininstration of alteplase. I disucss risks with mother who consents verbally. Patient without response to alteplase, and with continued pattern of PEA arrest following bradycardia. I discuss etiology of presentation with mother,and that patient is with very poor prognosis of survival, and likely poorer prognosis of neurological status, and patient is made comfort care, and fentanyl drip increased, patient is taken off of ventilation and drips. Pronounced deceased at 22:00.  MDM: Initial concern for but not limited to appendicitis, AAA, diverticulitis, renal stones, pyelonephritis, musculoskeletal pain, pancreatitis, toxic ingestion, ACS, obstruction, perforation, sepsis (2/2 PNA, UTI, meningitis, intra-abdominal infection), AAA, dissection, PE - as ED course progresses, differential narrows and consider more likely PEA arrest secondary to ACS, PE, dissection, AAA, necrotic pancreatitis, tension PNX (less likely). Considered but do not suspect seizures, stroke. Imaging studies reviewed - CXR with ETT in place, no acute pathology. CTA chest/A/P remarkable for massive proximal B/L PE. Labs reviewed. ECGs without STEMI, with sinus tach initially, LBBB after initial ROSC, and then AFib in RVR on subsequent ECG. Per above, patient suffered massive B/L PE, with subsequent cardiac arrest, despite heoric efforts including thrombolysis. Death called art 22:00.  Diagnosis: massive B/L PEs, PEA arrest.  Disposition: deceased.""""
	"1355174-1"	"1355174-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	""On 5/20/21 the patient was at home with his mother when he had acute nausea, light-headedness, and abdominal pain. He presented to the ED by ambulance. Excerpt from ED notes od MD follows: ""Initial ED interventions: iv fluids, low dose iv ativan, iv toradol, iv zofran.  ED course: patient arrives very anxious, writhing on bed, difficult to redirect. With chronic tonicity, not seizing. Mother arrives, and he recognizes her, seems to be consoled somewhat by her presence, but she is unable to direct him, and describes his behavior as irregular, and events acute this evening at her home.  Patient rests, and then HR decrease to 50s on monitior and patient found to be pulseless - I immediately start chest compressions, and achieve ROSC after PEA arrest with administration of EPI/compressions. Patient intubated per procedure note without complication. L femoral central attained per procedure note without complication. CPR performed over ED course intermittently (always PEA arrest) with ROSC achieved with administration of EPI, EPI drip started in addition to sedation meds, and iv fluids. No obvious STEMI on ECG to administer lytics, with suspicion of dissection and AAA prominent. I am able to stabilze and accompany patient to CT suite, where I recognize B/L massive PE immediately. I discuss with Dr. of Cardiology, who agrees with admininstration of alteplase. I disucss risks with mother who consents verbally. Patient without response to alteplase, and with continued pattern of PEA arrest following bradycardia. I discuss etiology of presentation with mother,and that patient is with very poor prognosis of survival, and likely poorer prognosis of neurological status, and patient is made comfort care, and fentanyl drip increased, patient is taken off of ventilation and drips. Pronounced deceased at 22:00.  MDM: Initial concern for but not limited to appendicitis, AAA, diverticulitis, renal stones, pyelonephritis, musculoskeletal pain, pancreatitis, toxic ingestion, ACS, obstruction, perforation, sepsis (2/2 PNA, UTI, meningitis, intra-abdominal infection), AAA, dissection, PE - as ED course progresses, differential narrows and consider more likely PEA arrest secondary to ACS, PE, dissection, AAA, necrotic pancreatitis, tension PNX (less likely). Considered but do not suspect seizures, stroke. Imaging studies reviewed - CXR with ETT in place, no acute pathology. CTA chest/A/P remarkable for massive proximal B/L PE. Labs reviewed. ECGs without STEMI, with sinus tach initially, LBBB after initial ROSC, and then AFib in RVR on subsequent ECG. Per above, patient suffered massive B/L PE, with subsequent cardiac arrest, despite heoric efforts including thrombolysis. Death called art 22:00.  Diagnosis: massive B/L PEs, PEA arrest.  Disposition: deceased.""""
	"1355174-1"	"1355174-1"	"DIZZINESS"	"10013573"	"50-59 years"	"50-59"	""On 5/20/21 the patient was at home with his mother when he had acute nausea, light-headedness, and abdominal pain. He presented to the ED by ambulance. Excerpt from ED notes od MD follows: ""Initial ED interventions: iv fluids, low dose iv ativan, iv toradol, iv zofran.  ED course: patient arrives very anxious, writhing on bed, difficult to redirect. With chronic tonicity, not seizing. Mother arrives, and he recognizes her, seems to be consoled somewhat by her presence, but she is unable to direct him, and describes his behavior as irregular, and events acute this evening at her home.  Patient rests, and then HR decrease to 50s on monitior and patient found to be pulseless - I immediately start chest compressions, and achieve ROSC after PEA arrest with administration of EPI/compressions. Patient intubated per procedure note without complication. L femoral central attained per procedure note without complication. CPR performed over ED course intermittently (always PEA arrest) with ROSC achieved with administration of EPI, EPI drip started in addition to sedation meds, and iv fluids. No obvious STEMI on ECG to administer lytics, with suspicion of dissection and AAA prominent. I am able to stabilze and accompany patient to CT suite, where I recognize B/L massive PE immediately. I discuss with Dr. of Cardiology, who agrees with admininstration of alteplase. I disucss risks with mother who consents verbally. Patient without response to alteplase, and with continued pattern of PEA arrest following bradycardia. I discuss etiology of presentation with mother,and that patient is with very poor prognosis of survival, and likely poorer prognosis of neurological status, and patient is made comfort care, and fentanyl drip increased, patient is taken off of ventilation and drips. Pronounced deceased at 22:00.  MDM: Initial concern for but not limited to appendicitis, AAA, diverticulitis, renal stones, pyelonephritis, musculoskeletal pain, pancreatitis, toxic ingestion, ACS, obstruction, perforation, sepsis (2/2 PNA, UTI, meningitis, intra-abdominal infection), AAA, dissection, PE - as ED course progresses, differential narrows and consider more likely PEA arrest secondary to ACS, PE, dissection, AAA, necrotic pancreatitis, tension PNX (less likely). Considered but do not suspect seizures, stroke. Imaging studies reviewed - CXR with ETT in place, no acute pathology. CTA chest/A/P remarkable for massive proximal B/L PE. Labs reviewed. ECGs without STEMI, with sinus tach initially, LBBB after initial ROSC, and then AFib in RVR on subsequent ECG. Per above, patient suffered massive B/L PE, with subsequent cardiac arrest, despite heoric efforts including thrombolysis. Death called art 22:00.  Diagnosis: massive B/L PEs, PEA arrest.  Disposition: deceased.""""
	"1355174-1"	"1355174-1"	"DYSKINESIA"	"10013916"	"50-59 years"	"50-59"	""On 5/20/21 the patient was at home with his mother when he had acute nausea, light-headedness, and abdominal pain. He presented to the ED by ambulance. Excerpt from ED notes od MD follows: ""Initial ED interventions: iv fluids, low dose iv ativan, iv toradol, iv zofran.  ED course: patient arrives very anxious, writhing on bed, difficult to redirect. With chronic tonicity, not seizing. Mother arrives, and he recognizes her, seems to be consoled somewhat by her presence, but she is unable to direct him, and describes his behavior as irregular, and events acute this evening at her home.  Patient rests, and then HR decrease to 50s on monitior and patient found to be pulseless - I immediately start chest compressions, and achieve ROSC after PEA arrest with administration of EPI/compressions. Patient intubated per procedure note without complication. L femoral central attained per procedure note without complication. CPR performed over ED course intermittently (always PEA arrest) with ROSC achieved with administration of EPI, EPI drip started in addition to sedation meds, and iv fluids. No obvious STEMI on ECG to administer lytics, with suspicion of dissection and AAA prominent. I am able to stabilze and accompany patient to CT suite, where I recognize B/L massive PE immediately. I discuss with Dr. of Cardiology, who agrees with admininstration of alteplase. I disucss risks with mother who consents verbally. Patient without response to alteplase, and with continued pattern of PEA arrest following bradycardia. I discuss etiology of presentation with mother,and that patient is with very poor prognosis of survival, and likely poorer prognosis of neurological status, and patient is made comfort care, and fentanyl drip increased, patient is taken off of ventilation and drips. Pronounced deceased at 22:00.  MDM: Initial concern for but not limited to appendicitis, AAA, diverticulitis, renal stones, pyelonephritis, musculoskeletal pain, pancreatitis, toxic ingestion, ACS, obstruction, perforation, sepsis (2/2 PNA, UTI, meningitis, intra-abdominal infection), AAA, dissection, PE - as ED course progresses, differential narrows and consider more likely PEA arrest secondary to ACS, PE, dissection, AAA, necrotic pancreatitis, tension PNX (less likely). Considered but do not suspect seizures, stroke. Imaging studies reviewed - CXR with ETT in place, no acute pathology. CTA chest/A/P remarkable for massive proximal B/L PE. Labs reviewed. ECGs without STEMI, with sinus tach initially, LBBB after initial ROSC, and then AFib in RVR on subsequent ECG. Per above, patient suffered massive B/L PE, with subsequent cardiac arrest, despite heoric efforts including thrombolysis. Death called art 22:00.  Diagnosis: massive B/L PEs, PEA arrest.  Disposition: deceased.""""
	"1355174-1"	"1355174-1"	"ELECTROCARDIOGRAM ABNORMAL"	"10014363"	"50-59 years"	"50-59"	""On 5/20/21 the patient was at home with his mother when he had acute nausea, light-headedness, and abdominal pain. He presented to the ED by ambulance. Excerpt from ED notes od MD follows: ""Initial ED interventions: iv fluids, low dose iv ativan, iv toradol, iv zofran.  ED course: patient arrives very anxious, writhing on bed, difficult to redirect. With chronic tonicity, not seizing. Mother arrives, and he recognizes her, seems to be consoled somewhat by her presence, but she is unable to direct him, and describes his behavior as irregular, and events acute this evening at her home.  Patient rests, and then HR decrease to 50s on monitior and patient found to be pulseless - I immediately start chest compressions, and achieve ROSC after PEA arrest with administration of EPI/compressions. Patient intubated per procedure note without complication. L femoral central attained per procedure note without complication. CPR performed over ED course intermittently (always PEA arrest) with ROSC achieved with administration of EPI, EPI drip started in addition to sedation meds, and iv fluids. No obvious STEMI on ECG to administer lytics, with suspicion of dissection and AAA prominent. I am able to stabilze and accompany patient to CT suite, where I recognize B/L massive PE immediately. I discuss with Dr. of Cardiology, who agrees with admininstration of alteplase. I disucss risks with mother who consents verbally. Patient without response to alteplase, and with continued pattern of PEA arrest following bradycardia. I discuss etiology of presentation with mother,and that patient is with very poor prognosis of survival, and likely poorer prognosis of neurological status, and patient is made comfort care, and fentanyl drip increased, patient is taken off of ventilation and drips. Pronounced deceased at 22:00.  MDM: Initial concern for but not limited to appendicitis, AAA, diverticulitis, renal stones, pyelonephritis, musculoskeletal pain, pancreatitis, toxic ingestion, ACS, obstruction, perforation, sepsis (2/2 PNA, UTI, meningitis, intra-abdominal infection), AAA, dissection, PE - as ED course progresses, differential narrows and consider more likely PEA arrest secondary to ACS, PE, dissection, AAA, necrotic pancreatitis, tension PNX (less likely). Considered but do not suspect seizures, stroke. Imaging studies reviewed - CXR with ETT in place, no acute pathology. CTA chest/A/P remarkable for massive proximal B/L PE. Labs reviewed. ECGs without STEMI, with sinus tach initially, LBBB after initial ROSC, and then AFib in RVR on subsequent ECG. Per above, patient suffered massive B/L PE, with subsequent cardiac arrest, despite heoric efforts including thrombolysis. Death called art 22:00.  Diagnosis: massive B/L PEs, PEA arrest.  Disposition: deceased.""""
	"1355174-1"	"1355174-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"50-59 years"	"50-59"	""On 5/20/21 the patient was at home with his mother when he had acute nausea, light-headedness, and abdominal pain. He presented to the ED by ambulance. Excerpt from ED notes od MD follows: ""Initial ED interventions: iv fluids, low dose iv ativan, iv toradol, iv zofran.  ED course: patient arrives very anxious, writhing on bed, difficult to redirect. With chronic tonicity, not seizing. Mother arrives, and he recognizes her, seems to be consoled somewhat by her presence, but she is unable to direct him, and describes his behavior as irregular, and events acute this evening at her home.  Patient rests, and then HR decrease to 50s on monitior and patient found to be pulseless - I immediately start chest compressions, and achieve ROSC after PEA arrest with administration of EPI/compressions. Patient intubated per procedure note without complication. L femoral central attained per procedure note without complication. CPR performed over ED course intermittently (always PEA arrest) with ROSC achieved with administration of EPI, EPI drip started in addition to sedation meds, and iv fluids. No obvious STEMI on ECG to administer lytics, with suspicion of dissection and AAA prominent. I am able to stabilze and accompany patient to CT suite, where I recognize B/L massive PE immediately. I discuss with Dr. of Cardiology, who agrees with admininstration of alteplase. I disucss risks with mother who consents verbally. Patient without response to alteplase, and with continued pattern of PEA arrest following bradycardia. I discuss etiology of presentation with mother,and that patient is with very poor prognosis of survival, and likely poorer prognosis of neurological status, and patient is made comfort care, and fentanyl drip increased, patient is taken off of ventilation and drips. Pronounced deceased at 22:00.  MDM: Initial concern for but not limited to appendicitis, AAA, diverticulitis, renal stones, pyelonephritis, musculoskeletal pain, pancreatitis, toxic ingestion, ACS, obstruction, perforation, sepsis (2/2 PNA, UTI, meningitis, intra-abdominal infection), AAA, dissection, PE - as ED course progresses, differential narrows and consider more likely PEA arrest secondary to ACS, PE, dissection, AAA, necrotic pancreatitis, tension PNX (less likely). Considered but do not suspect seizures, stroke. Imaging studies reviewed - CXR with ETT in place, no acute pathology. CTA chest/A/P remarkable for massive proximal B/L PE. Labs reviewed. ECGs without STEMI, with sinus tach initially, LBBB after initial ROSC, and then AFib in RVR on subsequent ECG. Per above, patient suffered massive B/L PE, with subsequent cardiac arrest, despite heoric efforts including thrombolysis. Death called art 22:00.  Diagnosis: massive B/L PEs, PEA arrest.  Disposition: deceased.""""
	"1355174-1"	"1355174-1"	"HEART RATE DECREASED"	"10019301"	"50-59 years"	"50-59"	""On 5/20/21 the patient was at home with his mother when he had acute nausea, light-headedness, and abdominal pain. He presented to the ED by ambulance. Excerpt from ED notes od MD follows: ""Initial ED interventions: iv fluids, low dose iv ativan, iv toradol, iv zofran.  ED course: patient arrives very anxious, writhing on bed, difficult to redirect. With chronic tonicity, not seizing. Mother arrives, and he recognizes her, seems to be consoled somewhat by her presence, but she is unable to direct him, and describes his behavior as irregular, and events acute this evening at her home.  Patient rests, and then HR decrease to 50s on monitior and patient found to be pulseless - I immediately start chest compressions, and achieve ROSC after PEA arrest with administration of EPI/compressions. Patient intubated per procedure note without complication. L femoral central attained per procedure note without complication. CPR performed over ED course intermittently (always PEA arrest) with ROSC achieved with administration of EPI, EPI drip started in addition to sedation meds, and iv fluids. No obvious STEMI on ECG to administer lytics, with suspicion of dissection and AAA prominent. I am able to stabilze and accompany patient to CT suite, where I recognize B/L massive PE immediately. I discuss with Dr. of Cardiology, who agrees with admininstration of alteplase. I disucss risks with mother who consents verbally. Patient without response to alteplase, and with continued pattern of PEA arrest following bradycardia. I discuss etiology of presentation with mother,and that patient is with very poor prognosis of survival, and likely poorer prognosis of neurological status, and patient is made comfort care, and fentanyl drip increased, patient is taken off of ventilation and drips. Pronounced deceased at 22:00.  MDM: Initial concern for but not limited to appendicitis, AAA, diverticulitis, renal stones, pyelonephritis, musculoskeletal pain, pancreatitis, toxic ingestion, ACS, obstruction, perforation, sepsis (2/2 PNA, UTI, meningitis, intra-abdominal infection), AAA, dissection, PE - as ED course progresses, differential narrows and consider more likely PEA arrest secondary to ACS, PE, dissection, AAA, necrotic pancreatitis, tension PNX (less likely). Considered but do not suspect seizures, stroke. Imaging studies reviewed - CXR with ETT in place, no acute pathology. CTA chest/A/P remarkable for massive proximal B/L PE. Labs reviewed. ECGs without STEMI, with sinus tach initially, LBBB after initial ROSC, and then AFib in RVR on subsequent ECG. Per above, patient suffered massive B/L PE, with subsequent cardiac arrest, despite heoric efforts including thrombolysis. Death called art 22:00.  Diagnosis: massive B/L PEs, PEA arrest.  Disposition: deceased.""""
	"1355174-1"	"1355174-1"	"HYPERTONIA"	"10020852"	"50-59 years"	"50-59"	""On 5/20/21 the patient was at home with his mother when he had acute nausea, light-headedness, and abdominal pain. He presented to the ED by ambulance. Excerpt from ED notes od MD follows: ""Initial ED interventions: iv fluids, low dose iv ativan, iv toradol, iv zofran.  ED course: patient arrives very anxious, writhing on bed, difficult to redirect. With chronic tonicity, not seizing. Mother arrives, and he recognizes her, seems to be consoled somewhat by her presence, but she is unable to direct him, and describes his behavior as irregular, and events acute this evening at her home.  Patient rests, and then HR decrease to 50s on monitior and patient found to be pulseless - I immediately start chest compressions, and achieve ROSC after PEA arrest with administration of EPI/compressions. Patient intubated per procedure note without complication. L femoral central attained per procedure note without complication. CPR performed over ED course intermittently (always PEA arrest) with ROSC achieved with administration of EPI, EPI drip started in addition to sedation meds, and iv fluids. No obvious STEMI on ECG to administer lytics, with suspicion of dissection and AAA prominent. I am able to stabilze and accompany patient to CT suite, where I recognize B/L massive PE immediately. I discuss with Dr. of Cardiology, who agrees with admininstration of alteplase. I disucss risks with mother who consents verbally. Patient without response to alteplase, and with continued pattern of PEA arrest following bradycardia. I discuss etiology of presentation with mother,and that patient is with very poor prognosis of survival, and likely poorer prognosis of neurological status, and patient is made comfort care, and fentanyl drip increased, patient is taken off of ventilation and drips. Pronounced deceased at 22:00.  MDM: Initial concern for but not limited to appendicitis, AAA, diverticulitis, renal stones, pyelonephritis, musculoskeletal pain, pancreatitis, toxic ingestion, ACS, obstruction, perforation, sepsis (2/2 PNA, UTI, meningitis, intra-abdominal infection), AAA, dissection, PE - as ED course progresses, differential narrows and consider more likely PEA arrest secondary to ACS, PE, dissection, AAA, necrotic pancreatitis, tension PNX (less likely). Considered but do not suspect seizures, stroke. Imaging studies reviewed - CXR with ETT in place, no acute pathology. CTA chest/A/P remarkable for massive proximal B/L PE. Labs reviewed. ECGs without STEMI, with sinus tach initially, LBBB after initial ROSC, and then AFib in RVR on subsequent ECG. Per above, patient suffered massive B/L PE, with subsequent cardiac arrest, despite heoric efforts including thrombolysis. Death called art 22:00.  Diagnosis: massive B/L PEs, PEA arrest.  Disposition: deceased.""""
	"1355174-1"	"1355174-1"	"LUNG CONSOLIDATION"	"10025080"	"50-59 years"	"50-59"	""On 5/20/21 the patient was at home with his mother when he had acute nausea, light-headedness, and abdominal pain. He presented to the ED by ambulance. Excerpt from ED notes od MD follows: ""Initial ED interventions: iv fluids, low dose iv ativan, iv toradol, iv zofran.  ED course: patient arrives very anxious, writhing on bed, difficult to redirect. With chronic tonicity, not seizing. Mother arrives, and he recognizes her, seems to be consoled somewhat by her presence, but she is unable to direct him, and describes his behavior as irregular, and events acute this evening at her home.  Patient rests, and then HR decrease to 50s on monitior and patient found to be pulseless - I immediately start chest compressions, and achieve ROSC after PEA arrest with administration of EPI/compressions. Patient intubated per procedure note without complication. L femoral central attained per procedure note without complication. CPR performed over ED course intermittently (always PEA arrest) with ROSC achieved with administration of EPI, EPI drip started in addition to sedation meds, and iv fluids. No obvious STEMI on ECG to administer lytics, with suspicion of dissection and AAA prominent. I am able to stabilze and accompany patient to CT suite, where I recognize B/L massive PE immediately. I discuss with Dr. of Cardiology, who agrees with admininstration of alteplase. I disucss risks with mother who consents verbally. Patient without response to alteplase, and with continued pattern of PEA arrest following bradycardia. I discuss etiology of presentation with mother,and that patient is with very poor prognosis of survival, and likely poorer prognosis of neurological status, and patient is made comfort care, and fentanyl drip increased, patient is taken off of ventilation and drips. Pronounced deceased at 22:00.  MDM: Initial concern for but not limited to appendicitis, AAA, diverticulitis, renal stones, pyelonephritis, musculoskeletal pain, pancreatitis, toxic ingestion, ACS, obstruction, perforation, sepsis (2/2 PNA, UTI, meningitis, intra-abdominal infection), AAA, dissection, PE - as ED course progresses, differential narrows and consider more likely PEA arrest secondary to ACS, PE, dissection, AAA, necrotic pancreatitis, tension PNX (less likely). Considered but do not suspect seizures, stroke. Imaging studies reviewed - CXR with ETT in place, no acute pathology. CTA chest/A/P remarkable for massive proximal B/L PE. Labs reviewed. ECGs without STEMI, with sinus tach initially, LBBB after initial ROSC, and then AFib in RVR on subsequent ECG. Per above, patient suffered massive B/L PE, with subsequent cardiac arrest, despite heoric efforts including thrombolysis. Death called art 22:00.  Diagnosis: massive B/L PEs, PEA arrest.  Disposition: deceased.""""
	"1355174-1"	"1355174-1"	"MECHANICAL VENTILATION"	"10067221"	"50-59 years"	"50-59"	""On 5/20/21 the patient was at home with his mother when he had acute nausea, light-headedness, and abdominal pain. He presented to the ED by ambulance. Excerpt from ED notes od MD follows: ""Initial ED interventions: iv fluids, low dose iv ativan, iv toradol, iv zofran.  ED course: patient arrives very anxious, writhing on bed, difficult to redirect. With chronic tonicity, not seizing. Mother arrives, and he recognizes her, seems to be consoled somewhat by her presence, but she is unable to direct him, and describes his behavior as irregular, and events acute this evening at her home.  Patient rests, and then HR decrease to 50s on monitior and patient found to be pulseless - I immediately start chest compressions, and achieve ROSC after PEA arrest with administration of EPI/compressions. Patient intubated per procedure note without complication. L femoral central attained per procedure note without complication. CPR performed over ED course intermittently (always PEA arrest) with ROSC achieved with administration of EPI, EPI drip started in addition to sedation meds, and iv fluids. No obvious STEMI on ECG to administer lytics, with suspicion of dissection and AAA prominent. I am able to stabilze and accompany patient to CT suite, where I recognize B/L massive PE immediately. I discuss with Dr. of Cardiology, who agrees with admininstration of alteplase. I disucss risks with mother who consents verbally. Patient without response to alteplase, and with continued pattern of PEA arrest following bradycardia. I discuss etiology of presentation with mother,and that patient is with very poor prognosis of survival, and likely poorer prognosis of neurological status, and patient is made comfort care, and fentanyl drip increased, patient is taken off of ventilation and drips. Pronounced deceased at 22:00.  MDM: Initial concern for but not limited to appendicitis, AAA, diverticulitis, renal stones, pyelonephritis, musculoskeletal pain, pancreatitis, toxic ingestion, ACS, obstruction, perforation, sepsis (2/2 PNA, UTI, meningitis, intra-abdominal infection), AAA, dissection, PE - as ED course progresses, differential narrows and consider more likely PEA arrest secondary to ACS, PE, dissection, AAA, necrotic pancreatitis, tension PNX (less likely). Considered but do not suspect seizures, stroke. Imaging studies reviewed - CXR with ETT in place, no acute pathology. CTA chest/A/P remarkable for massive proximal B/L PE. Labs reviewed. ECGs without STEMI, with sinus tach initially, LBBB after initial ROSC, and then AFib in RVR on subsequent ECG. Per above, patient suffered massive B/L PE, with subsequent cardiac arrest, despite heoric efforts including thrombolysis. Death called art 22:00.  Diagnosis: massive B/L PEs, PEA arrest.  Disposition: deceased.""""
	"1355174-1"	"1355174-1"	"NAUSEA"	"10028813"	"50-59 years"	"50-59"	""On 5/20/21 the patient was at home with his mother when he had acute nausea, light-headedness, and abdominal pain. He presented to the ED by ambulance. Excerpt from ED notes od MD follows: ""Initial ED interventions: iv fluids, low dose iv ativan, iv toradol, iv zofran.  ED course: patient arrives very anxious, writhing on bed, difficult to redirect. With chronic tonicity, not seizing. Mother arrives, and he recognizes her, seems to be consoled somewhat by her presence, but she is unable to direct him, and describes his behavior as irregular, and events acute this evening at her home.  Patient rests, and then HR decrease to 50s on monitior and patient found to be pulseless - I immediately start chest compressions, and achieve ROSC after PEA arrest with administration of EPI/compressions. Patient intubated per procedure note without complication. L femoral central attained per procedure note without complication. CPR performed over ED course intermittently (always PEA arrest) with ROSC achieved with administration of EPI, EPI drip started in addition to sedation meds, and iv fluids. No obvious STEMI on ECG to administer lytics, with suspicion of dissection and AAA prominent. I am able to stabilze and accompany patient to CT suite, where I recognize B/L massive PE immediately. I discuss with Dr. of Cardiology, who agrees with admininstration of alteplase. I disucss risks with mother who consents verbally. Patient without response to alteplase, and with continued pattern of PEA arrest following bradycardia. I discuss etiology of presentation with mother,and that patient is with very poor prognosis of survival, and likely poorer prognosis of neurological status, and patient is made comfort care, and fentanyl drip increased, patient is taken off of ventilation and drips. Pronounced deceased at 22:00.  MDM: Initial concern for but not limited to appendicitis, AAA, diverticulitis, renal stones, pyelonephritis, musculoskeletal pain, pancreatitis, toxic ingestion, ACS, obstruction, perforation, sepsis (2/2 PNA, UTI, meningitis, intra-abdominal infection), AAA, dissection, PE - as ED course progresses, differential narrows and consider more likely PEA arrest secondary to ACS, PE, dissection, AAA, necrotic pancreatitis, tension PNX (less likely). Considered but do not suspect seizures, stroke. Imaging studies reviewed - CXR with ETT in place, no acute pathology. CTA chest/A/P remarkable for massive proximal B/L PE. Labs reviewed. ECGs without STEMI, with sinus tach initially, LBBB after initial ROSC, and then AFib in RVR on subsequent ECG. Per above, patient suffered massive B/L PE, with subsequent cardiac arrest, despite heoric efforts including thrombolysis. Death called art 22:00.  Diagnosis: massive B/L PEs, PEA arrest.  Disposition: deceased.""""
	"1355174-1"	"1355174-1"	"PANCREATITIS NECROTISING"	"10033654"	"50-59 years"	"50-59"	""On 5/20/21 the patient was at home with his mother when he had acute nausea, light-headedness, and abdominal pain. He presented to the ED by ambulance. Excerpt from ED notes od MD follows: ""Initial ED interventions: iv fluids, low dose iv ativan, iv toradol, iv zofran.  ED course: patient arrives very anxious, writhing on bed, difficult to redirect. With chronic tonicity, not seizing. Mother arrives, and he recognizes her, seems to be consoled somewhat by her presence, but she is unable to direct him, and describes his behavior as irregular, and events acute this evening at her home.  Patient rests, and then HR decrease to 50s on monitior and patient found to be pulseless - I immediately start chest compressions, and achieve ROSC after PEA arrest with administration of EPI/compressions. Patient intubated per procedure note without complication. L femoral central attained per procedure note without complication. CPR performed over ED course intermittently (always PEA arrest) with ROSC achieved with administration of EPI, EPI drip started in addition to sedation meds, and iv fluids. No obvious STEMI on ECG to administer lytics, with suspicion of dissection and AAA prominent. I am able to stabilze and accompany patient to CT suite, where I recognize B/L massive PE immediately. I discuss with Dr. of Cardiology, who agrees with admininstration of alteplase. I disucss risks with mother who consents verbally. Patient without response to alteplase, and with continued pattern of PEA arrest following bradycardia. I discuss etiology of presentation with mother,and that patient is with very poor prognosis of survival, and likely poorer prognosis of neurological status, and patient is made comfort care, and fentanyl drip increased, patient is taken off of ventilation and drips. Pronounced deceased at 22:00.  MDM: Initial concern for but not limited to appendicitis, AAA, diverticulitis, renal stones, pyelonephritis, musculoskeletal pain, pancreatitis, toxic ingestion, ACS, obstruction, perforation, sepsis (2/2 PNA, UTI, meningitis, intra-abdominal infection), AAA, dissection, PE - as ED course progresses, differential narrows and consider more likely PEA arrest secondary to ACS, PE, dissection, AAA, necrotic pancreatitis, tension PNX (less likely). Considered but do not suspect seizures, stroke. Imaging studies reviewed - CXR with ETT in place, no acute pathology. CTA chest/A/P remarkable for massive proximal B/L PE. Labs reviewed. ECGs without STEMI, with sinus tach initially, LBBB after initial ROSC, and then AFib in RVR on subsequent ECG. Per above, patient suffered massive B/L PE, with subsequent cardiac arrest, despite heoric efforts including thrombolysis. Death called art 22:00.  Diagnosis: massive B/L PEs, PEA arrest.  Disposition: deceased.""""
	"1355174-1"	"1355174-1"	"PNEUMOTHORAX"	"10035759"	"50-59 years"	"50-59"	""On 5/20/21 the patient was at home with his mother when he had acute nausea, light-headedness, and abdominal pain. He presented to the ED by ambulance. Excerpt from ED notes od MD follows: ""Initial ED interventions: iv fluids, low dose iv ativan, iv toradol, iv zofran.  ED course: patient arrives very anxious, writhing on bed, difficult to redirect. With chronic tonicity, not seizing. Mother arrives, and he recognizes her, seems to be consoled somewhat by her presence, but she is unable to direct him, and describes his behavior as irregular, and events acute this evening at her home.  Patient rests, and then HR decrease to 50s on monitior and patient found to be pulseless - I immediately start chest compressions, and achieve ROSC after PEA arrest with administration of EPI/compressions. Patient intubated per procedure note without complication. L femoral central attained per procedure note without complication. CPR performed over ED course intermittently (always PEA arrest) with ROSC achieved with administration of EPI, EPI drip started in addition to sedation meds, and iv fluids. No obvious STEMI on ECG to administer lytics, with suspicion of dissection and AAA prominent. I am able to stabilze and accompany patient to CT suite, where I recognize B/L massive PE immediately. I discuss with Dr. of Cardiology, who agrees with admininstration of alteplase. I disucss risks with mother who consents verbally. Patient without response to alteplase, and with continued pattern of PEA arrest following bradycardia. I discuss etiology of presentation with mother,and that patient is with very poor prognosis of survival, and likely poorer prognosis of neurological status, and patient is made comfort care, and fentanyl drip increased, patient is taken off of ventilation and drips. Pronounced deceased at 22:00.  MDM: Initial concern for but not limited to appendicitis, AAA, diverticulitis, renal stones, pyelonephritis, musculoskeletal pain, pancreatitis, toxic ingestion, ACS, obstruction, perforation, sepsis (2/2 PNA, UTI, meningitis, intra-abdominal infection), AAA, dissection, PE - as ED course progresses, differential narrows and consider more likely PEA arrest secondary to ACS, PE, dissection, AAA, necrotic pancreatitis, tension PNX (less likely). Considered but do not suspect seizures, stroke. Imaging studies reviewed - CXR with ETT in place, no acute pathology. CTA chest/A/P remarkable for massive proximal B/L PE. Labs reviewed. ECGs without STEMI, with sinus tach initially, LBBB after initial ROSC, and then AFib in RVR on subsequent ECG. Per above, patient suffered massive B/L PE, with subsequent cardiac arrest, despite heoric efforts including thrombolysis. Death called art 22:00.  Diagnosis: massive B/L PEs, PEA arrest.  Disposition: deceased.""""
	"1355174-1"	"1355174-1"	"PULMONARY EMBOLISM"	"10037377"	"50-59 years"	"50-59"	""On 5/20/21 the patient was at home with his mother when he had acute nausea, light-headedness, and abdominal pain. He presented to the ED by ambulance. Excerpt from ED notes od MD follows: ""Initial ED interventions: iv fluids, low dose iv ativan, iv toradol, iv zofran.  ED course: patient arrives very anxious, writhing on bed, difficult to redirect. With chronic tonicity, not seizing. Mother arrives, and he recognizes her, seems to be consoled somewhat by her presence, but she is unable to direct him, and describes his behavior as irregular, and events acute this evening at her home.  Patient rests, and then HR decrease to 50s on monitior and patient found to be pulseless - I immediately start chest compressions, and achieve ROSC after PEA arrest with administration of EPI/compressions. Patient intubated per procedure note without complication. L femoral central attained per procedure note without complication. CPR performed over ED course intermittently (always PEA arrest) with ROSC achieved with administration of EPI, EPI drip started in addition to sedation meds, and iv fluids. No obvious STEMI on ECG to administer lytics, with suspicion of dissection and AAA prominent. I am able to stabilze and accompany patient to CT suite, where I recognize B/L massive PE immediately. I discuss with Dr. of Cardiology, who agrees with admininstration of alteplase. I disucss risks with mother who consents verbally. Patient without response to alteplase, and with continued pattern of PEA arrest following bradycardia. I discuss etiology of presentation with mother,and that patient is with very poor prognosis of survival, and likely poorer prognosis of neurological status, and patient is made comfort care, and fentanyl drip increased, patient is taken off of ventilation and drips. Pronounced deceased at 22:00.  MDM: Initial concern for but not limited to appendicitis, AAA, diverticulitis, renal stones, pyelonephritis, musculoskeletal pain, pancreatitis, toxic ingestion, ACS, obstruction, perforation, sepsis (2/2 PNA, UTI, meningitis, intra-abdominal infection), AAA, dissection, PE - as ED course progresses, differential narrows and consider more likely PEA arrest secondary to ACS, PE, dissection, AAA, necrotic pancreatitis, tension PNX (less likely). Considered but do not suspect seizures, stroke. Imaging studies reviewed - CXR with ETT in place, no acute pathology. CTA chest/A/P remarkable for massive proximal B/L PE. Labs reviewed. ECGs without STEMI, with sinus tach initially, LBBB after initial ROSC, and then AFib in RVR on subsequent ECG. Per above, patient suffered massive B/L PE, with subsequent cardiac arrest, despite heoric efforts including thrombolysis. Death called art 22:00.  Diagnosis: massive B/L PEs, PEA arrest.  Disposition: deceased.""""
	"1355174-1"	"1355174-1"	"PULMONARY INFARCTION"	"10037410"	"50-59 years"	"50-59"	""On 5/20/21 the patient was at home with his mother when he had acute nausea, light-headedness, and abdominal pain. He presented to the ED by ambulance. Excerpt from ED notes od MD follows: ""Initial ED interventions: iv fluids, low dose iv ativan, iv toradol, iv zofran.  ED course: patient arrives very anxious, writhing on bed, difficult to redirect. With chronic tonicity, not seizing. Mother arrives, and he recognizes her, seems to be consoled somewhat by her presence, but she is unable to direct him, and describes his behavior as irregular, and events acute this evening at her home.  Patient rests, and then HR decrease to 50s on monitior and patient found to be pulseless - I immediately start chest compressions, and achieve ROSC after PEA arrest with administration of EPI/compressions. Patient intubated per procedure note without complication. L femoral central attained per procedure note without complication. CPR performed over ED course intermittently (always PEA arrest) with ROSC achieved with administration of EPI, EPI drip started in addition to sedation meds, and iv fluids. No obvious STEMI on ECG to administer lytics, with suspicion of dissection and AAA prominent. I am able to stabilze and accompany patient to CT suite, where I recognize B/L massive PE immediately. I discuss with Dr. of Cardiology, who agrees with admininstration of alteplase. I disucss risks with mother who consents verbally. Patient without response to alteplase, and with continued pattern of PEA arrest following bradycardia. I discuss etiology of presentation with mother,and that patient is with very poor prognosis of survival, and likely poorer prognosis of neurological status, and patient is made comfort care, and fentanyl drip increased, patient is taken off of ventilation and drips. Pronounced deceased at 22:00.  MDM: Initial concern for but not limited to appendicitis, AAA, diverticulitis, renal stones, pyelonephritis, musculoskeletal pain, pancreatitis, toxic ingestion, ACS, obstruction, perforation, sepsis (2/2 PNA, UTI, meningitis, intra-abdominal infection), AAA, dissection, PE - as ED course progresses, differential narrows and consider more likely PEA arrest secondary to ACS, PE, dissection, AAA, necrotic pancreatitis, tension PNX (less likely). Considered but do not suspect seizures, stroke. Imaging studies reviewed - CXR with ETT in place, no acute pathology. CTA chest/A/P remarkable for massive proximal B/L PE. Labs reviewed. ECGs without STEMI, with sinus tach initially, LBBB after initial ROSC, and then AFib in RVR on subsequent ECG. Per above, patient suffered massive B/L PE, with subsequent cardiac arrest, despite heoric efforts including thrombolysis. Death called art 22:00.  Diagnosis: massive B/L PEs, PEA arrest.  Disposition: deceased.""""
	"1355174-1"	"1355174-1"	"PULSE ABSENT"	"10037469"	"50-59 years"	"50-59"	""On 5/20/21 the patient was at home with his mother when he had acute nausea, light-headedness, and abdominal pain. He presented to the ED by ambulance. Excerpt from ED notes od MD follows: ""Initial ED interventions: iv fluids, low dose iv ativan, iv toradol, iv zofran.  ED course: patient arrives very anxious, writhing on bed, difficult to redirect. With chronic tonicity, not seizing. Mother arrives, and he recognizes her, seems to be consoled somewhat by her presence, but she is unable to direct him, and describes his behavior as irregular, and events acute this evening at her home.  Patient rests, and then HR decrease to 50s on monitior and patient found to be pulseless - I immediately start chest compressions, and achieve ROSC after PEA arrest with administration of EPI/compressions. Patient intubated per procedure note without complication. L femoral central attained per procedure note without complication. CPR performed over ED course intermittently (always PEA arrest) with ROSC achieved with administration of EPI, EPI drip started in addition to sedation meds, and iv fluids. No obvious STEMI on ECG to administer lytics, with suspicion of dissection and AAA prominent. I am able to stabilze and accompany patient to CT suite, where I recognize B/L massive PE immediately. I discuss with Dr. of Cardiology, who agrees with admininstration of alteplase. I disucss risks with mother who consents verbally. Patient without response to alteplase, and with continued pattern of PEA arrest following bradycardia. I discuss etiology of presentation with mother,and that patient is with very poor prognosis of survival, and likely poorer prognosis of neurological status, and patient is made comfort care, and fentanyl drip increased, patient is taken off of ventilation and drips. Pronounced deceased at 22:00.  MDM: Initial concern for but not limited to appendicitis, AAA, diverticulitis, renal stones, pyelonephritis, musculoskeletal pain, pancreatitis, toxic ingestion, ACS, obstruction, perforation, sepsis (2/2 PNA, UTI, meningitis, intra-abdominal infection), AAA, dissection, PE - as ED course progresses, differential narrows and consider more likely PEA arrest secondary to ACS, PE, dissection, AAA, necrotic pancreatitis, tension PNX (less likely). Considered but do not suspect seizures, stroke. Imaging studies reviewed - CXR with ETT in place, no acute pathology. CTA chest/A/P remarkable for massive proximal B/L PE. Labs reviewed. ECGs without STEMI, with sinus tach initially, LBBB after initial ROSC, and then AFib in RVR on subsequent ECG. Per above, patient suffered massive B/L PE, with subsequent cardiac arrest, despite heoric efforts including thrombolysis. Death called art 22:00.  Diagnosis: massive B/L PEs, PEA arrest.  Disposition: deceased.""""
	"1355174-1"	"1355174-1"	"PULSELESS ELECTRICAL ACTIVITY"	"10058151"	"50-59 years"	"50-59"	""On 5/20/21 the patient was at home with his mother when he had acute nausea, light-headedness, and abdominal pain. He presented to the ED by ambulance. Excerpt from ED notes od MD follows: ""Initial ED interventions: iv fluids, low dose iv ativan, iv toradol, iv zofran.  ED course: patient arrives very anxious, writhing on bed, difficult to redirect. With chronic tonicity, not seizing. Mother arrives, and he recognizes her, seems to be consoled somewhat by her presence, but she is unable to direct him, and describes his behavior as irregular, and events acute this evening at her home.  Patient rests, and then HR decrease to 50s on monitior and patient found to be pulseless - I immediately start chest compressions, and achieve ROSC after PEA arrest with administration of EPI/compressions. Patient intubated per procedure note without complication. L femoral central attained per procedure note without complication. CPR performed over ED course intermittently (always PEA arrest) with ROSC achieved with administration of EPI, EPI drip started in addition to sedation meds, and iv fluids. No obvious STEMI on ECG to administer lytics, with suspicion of dissection and AAA prominent. I am able to stabilze and accompany patient to CT suite, where I recognize B/L massive PE immediately. I discuss with Dr. of Cardiology, who agrees with admininstration of alteplase. I disucss risks with mother who consents verbally. Patient without response to alteplase, and with continued pattern of PEA arrest following bradycardia. I discuss etiology of presentation with mother,and that patient is with very poor prognosis of survival, and likely poorer prognosis of neurological status, and patient is made comfort care, and fentanyl drip increased, patient is taken off of ventilation and drips. Pronounced deceased at 22:00.  MDM: Initial concern for but not limited to appendicitis, AAA, diverticulitis, renal stones, pyelonephritis, musculoskeletal pain, pancreatitis, toxic ingestion, ACS, obstruction, perforation, sepsis (2/2 PNA, UTI, meningitis, intra-abdominal infection), AAA, dissection, PE - as ED course progresses, differential narrows and consider more likely PEA arrest secondary to ACS, PE, dissection, AAA, necrotic pancreatitis, tension PNX (less likely). Considered but do not suspect seizures, stroke. Imaging studies reviewed - CXR with ETT in place, no acute pathology. CTA chest/A/P remarkable for massive proximal B/L PE. Labs reviewed. ECGs without STEMI, with sinus tach initially, LBBB after initial ROSC, and then AFib in RVR on subsequent ECG. Per above, patient suffered massive B/L PE, with subsequent cardiac arrest, despite heoric efforts including thrombolysis. Death called art 22:00.  Diagnosis: massive B/L PEs, PEA arrest.  Disposition: deceased.""""
	"1355174-1"	"1355174-1"	"RESUSCITATION"	"10038749"	"50-59 years"	"50-59"	""On 5/20/21 the patient was at home with his mother when he had acute nausea, light-headedness, and abdominal pain. He presented to the ED by ambulance. Excerpt from ED notes od MD follows: ""Initial ED interventions: iv fluids, low dose iv ativan, iv toradol, iv zofran.  ED course: patient arrives very anxious, writhing on bed, difficult to redirect. With chronic tonicity, not seizing. Mother arrives, and he recognizes her, seems to be consoled somewhat by her presence, but she is unable to direct him, and describes his behavior as irregular, and events acute this evening at her home.  Patient rests, and then HR decrease to 50s on monitior and patient found to be pulseless - I immediately start chest compressions, and achieve ROSC after PEA arrest with administration of EPI/compressions. Patient intubated per procedure note without complication. L femoral central attained per procedure note without complication. CPR performed over ED course intermittently (always PEA arrest) with ROSC achieved with administration of EPI, EPI drip started in addition to sedation meds, and iv fluids. No obvious STEMI on ECG to administer lytics, with suspicion of dissection and AAA prominent. I am able to stabilze and accompany patient to CT suite, where I recognize B/L massive PE immediately. I discuss with Dr. of Cardiology, who agrees with admininstration of alteplase. I disucss risks with mother who consents verbally. Patient without response to alteplase, and with continued pattern of PEA arrest following bradycardia. I discuss etiology of presentation with mother,and that patient is with very poor prognosis of survival, and likely poorer prognosis of neurological status, and patient is made comfort care, and fentanyl drip increased, patient is taken off of ventilation and drips. Pronounced deceased at 22:00.  MDM: Initial concern for but not limited to appendicitis, AAA, diverticulitis, renal stones, pyelonephritis, musculoskeletal pain, pancreatitis, toxic ingestion, ACS, obstruction, perforation, sepsis (2/2 PNA, UTI, meningitis, intra-abdominal infection), AAA, dissection, PE - as ED course progresses, differential narrows and consider more likely PEA arrest secondary to ACS, PE, dissection, AAA, necrotic pancreatitis, tension PNX (less likely). Considered but do not suspect seizures, stroke. Imaging studies reviewed - CXR with ETT in place, no acute pathology. CTA chest/A/P remarkable for massive proximal B/L PE. Labs reviewed. ECGs without STEMI, with sinus tach initially, LBBB after initial ROSC, and then AFib in RVR on subsequent ECG. Per above, patient suffered massive B/L PE, with subsequent cardiac arrest, despite heoric efforts including thrombolysis. Death called art 22:00.  Diagnosis: massive B/L PEs, PEA arrest.  Disposition: deceased.""""
	"1355174-1"	"1355174-1"	"RIGHT VENTRICULAR DYSFUNCTION"	"10058597"	"50-59 years"	"50-59"	""On 5/20/21 the patient was at home with his mother when he had acute nausea, light-headedness, and abdominal pain. He presented to the ED by ambulance. Excerpt from ED notes od MD follows: ""Initial ED interventions: iv fluids, low dose iv ativan, iv toradol, iv zofran.  ED course: patient arrives very anxious, writhing on bed, difficult to redirect. With chronic tonicity, not seizing. Mother arrives, and he recognizes her, seems to be consoled somewhat by her presence, but she is unable to direct him, and describes his behavior as irregular, and events acute this evening at her home.  Patient rests, and then HR decrease to 50s on monitior and patient found to be pulseless - I immediately start chest compressions, and achieve ROSC after PEA arrest with administration of EPI/compressions. Patient intubated per procedure note without complication. L femoral central attained per procedure note without complication. CPR performed over ED course intermittently (always PEA arrest) with ROSC achieved with administration of EPI, EPI drip started in addition to sedation meds, and iv fluids. No obvious STEMI on ECG to administer lytics, with suspicion of dissection and AAA prominent. I am able to stabilze and accompany patient to CT suite, where I recognize B/L massive PE immediately. I discuss with Dr. of Cardiology, who agrees with admininstration of alteplase. I disucss risks with mother who consents verbally. Patient without response to alteplase, and with continued pattern of PEA arrest following bradycardia. I discuss etiology of presentation with mother,and that patient is with very poor prognosis of survival, and likely poorer prognosis of neurological status, and patient is made comfort care, and fentanyl drip increased, patient is taken off of ventilation and drips. Pronounced deceased at 22:00.  MDM: Initial concern for but not limited to appendicitis, AAA, diverticulitis, renal stones, pyelonephritis, musculoskeletal pain, pancreatitis, toxic ingestion, ACS, obstruction, perforation, sepsis (2/2 PNA, UTI, meningitis, intra-abdominal infection), AAA, dissection, PE - as ED course progresses, differential narrows and consider more likely PEA arrest secondary to ACS, PE, dissection, AAA, necrotic pancreatitis, tension PNX (less likely). Considered but do not suspect seizures, stroke. Imaging studies reviewed - CXR with ETT in place, no acute pathology. CTA chest/A/P remarkable for massive proximal B/L PE. Labs reviewed. ECGs without STEMI, with sinus tach initially, LBBB after initial ROSC, and then AFib in RVR on subsequent ECG. Per above, patient suffered massive B/L PE, with subsequent cardiac arrest, despite heoric efforts including thrombolysis. Death called art 22:00.  Diagnosis: massive B/L PEs, PEA arrest.  Disposition: deceased.""""
	"1355174-1"	"1355174-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	""On 5/20/21 the patient was at home with his mother when he had acute nausea, light-headedness, and abdominal pain. He presented to the ED by ambulance. Excerpt from ED notes od MD follows: ""Initial ED interventions: iv fluids, low dose iv ativan, iv toradol, iv zofran.  ED course: patient arrives very anxious, writhing on bed, difficult to redirect. With chronic tonicity, not seizing. Mother arrives, and he recognizes her, seems to be consoled somewhat by her presence, but she is unable to direct him, and describes his behavior as irregular, and events acute this evening at her home.  Patient rests, and then HR decrease to 50s on monitior and patient found to be pulseless - I immediately start chest compressions, and achieve ROSC after PEA arrest with administration of EPI/compressions. Patient intubated per procedure note without complication. L femoral central attained per procedure note without complication. CPR performed over ED course intermittently (always PEA arrest) with ROSC achieved with administration of EPI, EPI drip started in addition to sedation meds, and iv fluids. No obvious STEMI on ECG to administer lytics, with suspicion of dissection and AAA prominent. I am able to stabilze and accompany patient to CT suite, where I recognize B/L massive PE immediately. I discuss with Dr. of Cardiology, who agrees with admininstration of alteplase. I disucss risks with mother who consents verbally. Patient without response to alteplase, and with continued pattern of PEA arrest following bradycardia. I discuss etiology of presentation with mother,and that patient is with very poor prognosis of survival, and likely poorer prognosis of neurological status, and patient is made comfort care, and fentanyl drip increased, patient is taken off of ventilation and drips. Pronounced deceased at 22:00.  MDM: Initial concern for but not limited to appendicitis, AAA, diverticulitis, renal stones, pyelonephritis, musculoskeletal pain, pancreatitis, toxic ingestion, ACS, obstruction, perforation, sepsis (2/2 PNA, UTI, meningitis, intra-abdominal infection), AAA, dissection, PE - as ED course progresses, differential narrows and consider more likely PEA arrest secondary to ACS, PE, dissection, AAA, necrotic pancreatitis, tension PNX (less likely). Considered but do not suspect seizures, stroke. Imaging studies reviewed - CXR with ETT in place, no acute pathology. CTA chest/A/P remarkable for massive proximal B/L PE. Labs reviewed. ECGs without STEMI, with sinus tach initially, LBBB after initial ROSC, and then AFib in RVR on subsequent ECG. Per above, patient suffered massive B/L PE, with subsequent cardiac arrest, despite heoric efforts including thrombolysis. Death called art 22:00.  Diagnosis: massive B/L PEs, PEA arrest.  Disposition: deceased.""""
	"1355174-1"	"1355174-1"	"SCAN WITH CONTRAST ABNORMAL"	"10062152"	"50-59 years"	"50-59"	""On 5/20/21 the patient was at home with his mother when he had acute nausea, light-headedness, and abdominal pain. He presented to the ED by ambulance. Excerpt from ED notes od MD follows: ""Initial ED interventions: iv fluids, low dose iv ativan, iv toradol, iv zofran.  ED course: patient arrives very anxious, writhing on bed, difficult to redirect. With chronic tonicity, not seizing. Mother arrives, and he recognizes her, seems to be consoled somewhat by her presence, but she is unable to direct him, and describes his behavior as irregular, and events acute this evening at her home.  Patient rests, and then HR decrease to 50s on monitior and patient found to be pulseless - I immediately start chest compressions, and achieve ROSC after PEA arrest with administration of EPI/compressions. Patient intubated per procedure note without complication. L femoral central attained per procedure note without complication. CPR performed over ED course intermittently (always PEA arrest) with ROSC achieved with administration of EPI, EPI drip started in addition to sedation meds, and iv fluids. No obvious STEMI on ECG to administer lytics, with suspicion of dissection and AAA prominent. I am able to stabilze and accompany patient to CT suite, where I recognize B/L massive PE immediately. I discuss with Dr. of Cardiology, who agrees with admininstration of alteplase. I disucss risks with mother who consents verbally. Patient without response to alteplase, and with continued pattern of PEA arrest following bradycardia. I discuss etiology of presentation with mother,and that patient is with very poor prognosis of survival, and likely poorer prognosis of neurological status, and patient is made comfort care, and fentanyl drip increased, patient is taken off of ventilation and drips. Pronounced deceased at 22:00.  MDM: Initial concern for but not limited to appendicitis, AAA, diverticulitis, renal stones, pyelonephritis, musculoskeletal pain, pancreatitis, toxic ingestion, ACS, obstruction, perforation, sepsis (2/2 PNA, UTI, meningitis, intra-abdominal infection), AAA, dissection, PE - as ED course progresses, differential narrows and consider more likely PEA arrest secondary to ACS, PE, dissection, AAA, necrotic pancreatitis, tension PNX (less likely). Considered but do not suspect seizures, stroke. Imaging studies reviewed - CXR with ETT in place, no acute pathology. CTA chest/A/P remarkable for massive proximal B/L PE. Labs reviewed. ECGs without STEMI, with sinus tach initially, LBBB after initial ROSC, and then AFib in RVR on subsequent ECG. Per above, patient suffered massive B/L PE, with subsequent cardiac arrest, despite heoric efforts including thrombolysis. Death called art 22:00.  Diagnosis: massive B/L PEs, PEA arrest.  Disposition: deceased.""""
	"1355174-1"	"1355174-1"	"SEDATIVE THERAPY"	"10059283"	"50-59 years"	"50-59"	""On 5/20/21 the patient was at home with his mother when he had acute nausea, light-headedness, and abdominal pain. He presented to the ED by ambulance. Excerpt from ED notes od MD follows: ""Initial ED interventions: iv fluids, low dose iv ativan, iv toradol, iv zofran.  ED course: patient arrives very anxious, writhing on bed, difficult to redirect. With chronic tonicity, not seizing. Mother arrives, and he recognizes her, seems to be consoled somewhat by her presence, but she is unable to direct him, and describes his behavior as irregular, and events acute this evening at her home.  Patient rests, and then HR decrease to 50s on monitior and patient found to be pulseless - I immediately start chest compressions, and achieve ROSC after PEA arrest with administration of EPI/compressions. Patient intubated per procedure note without complication. L femoral central attained per procedure note without complication. CPR performed over ED course intermittently (always PEA arrest) with ROSC achieved with administration of EPI, EPI drip started in addition to sedation meds, and iv fluids. No obvious STEMI on ECG to administer lytics, with suspicion of dissection and AAA prominent. I am able to stabilze and accompany patient to CT suite, where I recognize B/L massive PE immediately. I discuss with Dr. of Cardiology, who agrees with admininstration of alteplase. I disucss risks with mother who consents verbally. Patient without response to alteplase, and with continued pattern of PEA arrest following bradycardia. I discuss etiology of presentation with mother,and that patient is with very poor prognosis of survival, and likely poorer prognosis of neurological status, and patient is made comfort care, and fentanyl drip increased, patient is taken off of ventilation and drips. Pronounced deceased at 22:00.  MDM: Initial concern for but not limited to appendicitis, AAA, diverticulitis, renal stones, pyelonephritis, musculoskeletal pain, pancreatitis, toxic ingestion, ACS, obstruction, perforation, sepsis (2/2 PNA, UTI, meningitis, intra-abdominal infection), AAA, dissection, PE - as ED course progresses, differential narrows and consider more likely PEA arrest secondary to ACS, PE, dissection, AAA, necrotic pancreatitis, tension PNX (less likely). Considered but do not suspect seizures, stroke. Imaging studies reviewed - CXR with ETT in place, no acute pathology. CTA chest/A/P remarkable for massive proximal B/L PE. Labs reviewed. ECGs without STEMI, with sinus tach initially, LBBB after initial ROSC, and then AFib in RVR on subsequent ECG. Per above, patient suffered massive B/L PE, with subsequent cardiac arrest, despite heoric efforts including thrombolysis. Death called art 22:00.  Diagnosis: massive B/L PEs, PEA arrest.  Disposition: deceased.""""
	"1355174-1"	"1355174-1"	"SINUS TACHYCARDIA"	"10040752"	"50-59 years"	"50-59"	""On 5/20/21 the patient was at home with his mother when he had acute nausea, light-headedness, and abdominal pain. He presented to the ED by ambulance. Excerpt from ED notes od MD follows: ""Initial ED interventions: iv fluids, low dose iv ativan, iv toradol, iv zofran.  ED course: patient arrives very anxious, writhing on bed, difficult to redirect. With chronic tonicity, not seizing. Mother arrives, and he recognizes her, seems to be consoled somewhat by her presence, but she is unable to direct him, and describes his behavior as irregular, and events acute this evening at her home.  Patient rests, and then HR decrease to 50s on monitior and patient found to be pulseless - I immediately start chest compressions, and achieve ROSC after PEA arrest with administration of EPI/compressions. Patient intubated per procedure note without complication. L femoral central attained per procedure note without complication. CPR performed over ED course intermittently (always PEA arrest) with ROSC achieved with administration of EPI, EPI drip started in addition to sedation meds, and iv fluids. No obvious STEMI on ECG to administer lytics, with suspicion of dissection and AAA prominent. I am able to stabilze and accompany patient to CT suite, where I recognize B/L massive PE immediately. I discuss with Dr. of Cardiology, who agrees with admininstration of alteplase. I disucss risks with mother who consents verbally. Patient without response to alteplase, and with continued pattern of PEA arrest following bradycardia. I discuss etiology of presentation with mother,and that patient is with very poor prognosis of survival, and likely poorer prognosis of neurological status, and patient is made comfort care, and fentanyl drip increased, patient is taken off of ventilation and drips. Pronounced deceased at 22:00.  MDM: Initial concern for but not limited to appendicitis, AAA, diverticulitis, renal stones, pyelonephritis, musculoskeletal pain, pancreatitis, toxic ingestion, ACS, obstruction, perforation, sepsis (2/2 PNA, UTI, meningitis, intra-abdominal infection), AAA, dissection, PE - as ED course progresses, differential narrows and consider more likely PEA arrest secondary to ACS, PE, dissection, AAA, necrotic pancreatitis, tension PNX (less likely). Considered but do not suspect seizures, stroke. Imaging studies reviewed - CXR with ETT in place, no acute pathology. CTA chest/A/P remarkable for massive proximal B/L PE. Labs reviewed. ECGs without STEMI, with sinus tach initially, LBBB after initial ROSC, and then AFib in RVR on subsequent ECG. Per above, patient suffered massive B/L PE, with subsequent cardiac arrest, despite heoric efforts including thrombolysis. Death called art 22:00.  Diagnosis: massive B/L PEs, PEA arrest.  Disposition: deceased.""""
	"1358087-1"	"1358087-1"	"ACUTE MYOCARDIAL INFARCTION"	"10000891"	"50-59 years"	"50-59"	"There were several serious GMO-associated injuries resulting into hospitalization: 90 (ninety) people, at least 2 (two) of whom died, but possibly even 25 (twenty-five) died (hospital/officials do not disclose the exact number)  - Non of the injured/dead had noticable  flu-like symptoms, but they had serious non-flu symptoms, e.g. transient  ischaemic attack, acute myocardial infarction, neuronal stroke/hemorrhage, autoimmunal petecchial thrombocytopenia etc."
	"1358087-1"	"1358087-1"	"CEREBROVASCULAR ACCIDENT"	"10008190"	"50-59 years"	"50-59"	"There were several serious GMO-associated injuries resulting into hospitalization: 90 (ninety) people, at least 2 (two) of whom died, but possibly even 25 (twenty-five) died (hospital/officials do not disclose the exact number)  - Non of the injured/dead had noticable  flu-like symptoms, but they had serious non-flu symptoms, e.g. transient  ischaemic attack, acute myocardial infarction, neuronal stroke/hemorrhage, autoimmunal petecchial thrombocytopenia etc."
	"1358087-1"	"1358087-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"There were several serious GMO-associated injuries resulting into hospitalization: 90 (ninety) people, at least 2 (two) of whom died, but possibly even 25 (twenty-five) died (hospital/officials do not disclose the exact number)  - Non of the injured/dead had noticable  flu-like symptoms, but they had serious non-flu symptoms, e.g. transient  ischaemic attack, acute myocardial infarction, neuronal stroke/hemorrhage, autoimmunal petecchial thrombocytopenia etc."
	"1358087-1"	"1358087-1"	"HAEMORRHAGE"	"10055798"	"50-59 years"	"50-59"	"There were several serious GMO-associated injuries resulting into hospitalization: 90 (ninety) people, at least 2 (two) of whom died, but possibly even 25 (twenty-five) died (hospital/officials do not disclose the exact number)  - Non of the injured/dead had noticable  flu-like symptoms, but they had serious non-flu symptoms, e.g. transient  ischaemic attack, acute myocardial infarction, neuronal stroke/hemorrhage, autoimmunal petecchial thrombocytopenia etc."
	"1358087-1"	"1358087-1"	"INJURY"	"10022116"	"50-59 years"	"50-59"	"There were several serious GMO-associated injuries resulting into hospitalization: 90 (ninety) people, at least 2 (two) of whom died, but possibly even 25 (twenty-five) died (hospital/officials do not disclose the exact number)  - Non of the injured/dead had noticable  flu-like symptoms, but they had serious non-flu symptoms, e.g. transient  ischaemic attack, acute myocardial infarction, neuronal stroke/hemorrhage, autoimmunal petecchial thrombocytopenia etc."
	"1358087-1"	"1358087-1"	"PETECHIAE"	"10034754"	"50-59 years"	"50-59"	"There were several serious GMO-associated injuries resulting into hospitalization: 90 (ninety) people, at least 2 (two) of whom died, but possibly even 25 (twenty-five) died (hospital/officials do not disclose the exact number)  - Non of the injured/dead had noticable  flu-like symptoms, but they had serious non-flu symptoms, e.g. transient  ischaemic attack, acute myocardial infarction, neuronal stroke/hemorrhage, autoimmunal petecchial thrombocytopenia etc."
	"1358087-1"	"1358087-1"	"THROMBOCYTOPENIA"	"10043554"	"50-59 years"	"50-59"	"There were several serious GMO-associated injuries resulting into hospitalization: 90 (ninety) people, at least 2 (two) of whom died, but possibly even 25 (twenty-five) died (hospital/officials do not disclose the exact number)  - Non of the injured/dead had noticable  flu-like symptoms, but they had serious non-flu symptoms, e.g. transient  ischaemic attack, acute myocardial infarction, neuronal stroke/hemorrhage, autoimmunal petecchial thrombocytopenia etc."
	"1358087-1"	"1358087-1"	"TRANSIENT ISCHAEMIC ATTACK"	"10044390"	"50-59 years"	"50-59"	"There were several serious GMO-associated injuries resulting into hospitalization: 90 (ninety) people, at least 2 (two) of whom died, but possibly even 25 (twenty-five) died (hospital/officials do not disclose the exact number)  - Non of the injured/dead had noticable  flu-like symptoms, but they had serious non-flu symptoms, e.g. transient  ischaemic attack, acute myocardial infarction, neuronal stroke/hemorrhage, autoimmunal petecchial thrombocytopenia etc."
	"1358345-1"	"1358345-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"My husband died May 1st, 3 weeks after his last vaccine April 10 .  He had a saddle pulmonary emboli. He did not have any symptoms that I knew of prior to May 1st. Entering info for research data."
	"1358345-1"	"1358345-1"	"PULMONARY EMBOLISM"	"10037377"	"50-59 years"	"50-59"	"My husband died May 1st, 3 weeks after his last vaccine April 10 .  He had a saddle pulmonary emboli. He did not have any symptoms that I knew of prior to May 1st. Entering info for research data."
	"1361131-1"	"1361131-1"	"ACUTE KIDNEY INJURY"	"10069339"	"50-59 years"	"50-59"	"s/p 2 doses of Covid-19 vaccine.  Pt presented for weakness, SOB, fatigue progressive over the past month prior to admission.  Found to be pancytopenic with bone marrow biopsy consistent with MDS.  He was started on chemo but stay was complicated by neutropenic fevers, epistaxis, retinal hemorrhage, AKI, fluid overload, hypoxic respiratory failure, atrial fibrillation with RVR, and shock.  He ultimately had a heart attack while admitted and was transitioned to comfort care after medical interventions could not stabilize hemodynamics."
	"1361131-1"	"1361131-1"	"ASTHENIA"	"10003549"	"50-59 years"	"50-59"	"s/p 2 doses of Covid-19 vaccine.  Pt presented for weakness, SOB, fatigue progressive over the past month prior to admission.  Found to be pancytopenic with bone marrow biopsy consistent with MDS.  He was started on chemo but stay was complicated by neutropenic fevers, epistaxis, retinal hemorrhage, AKI, fluid overload, hypoxic respiratory failure, atrial fibrillation with RVR, and shock.  He ultimately had a heart attack while admitted and was transitioned to comfort care after medical interventions could not stabilize hemodynamics."
	"1361131-1"	"1361131-1"	"ATRIAL FIBRILLATION"	"10003658"	"50-59 years"	"50-59"	"s/p 2 doses of Covid-19 vaccine.  Pt presented for weakness, SOB, fatigue progressive over the past month prior to admission.  Found to be pancytopenic with bone marrow biopsy consistent with MDS.  He was started on chemo but stay was complicated by neutropenic fevers, epistaxis, retinal hemorrhage, AKI, fluid overload, hypoxic respiratory failure, atrial fibrillation with RVR, and shock.  He ultimately had a heart attack while admitted and was transitioned to comfort care after medical interventions could not stabilize hemodynamics."
	"1361131-1"	"1361131-1"	"BIOPSY BONE MARROW ABNORMAL"	"10004738"	"50-59 years"	"50-59"	"s/p 2 doses of Covid-19 vaccine.  Pt presented for weakness, SOB, fatigue progressive over the past month prior to admission.  Found to be pancytopenic with bone marrow biopsy consistent with MDS.  He was started on chemo but stay was complicated by neutropenic fevers, epistaxis, retinal hemorrhage, AKI, fluid overload, hypoxic respiratory failure, atrial fibrillation with RVR, and shock.  He ultimately had a heart attack while admitted and was transitioned to comfort care after medical interventions could not stabilize hemodynamics."
	"1361131-1"	"1361131-1"	"CHEMOTHERAPY"	"10061758"	"50-59 years"	"50-59"	"s/p 2 doses of Covid-19 vaccine.  Pt presented for weakness, SOB, fatigue progressive over the past month prior to admission.  Found to be pancytopenic with bone marrow biopsy consistent with MDS.  He was started on chemo but stay was complicated by neutropenic fevers, epistaxis, retinal hemorrhage, AKI, fluid overload, hypoxic respiratory failure, atrial fibrillation with RVR, and shock.  He ultimately had a heart attack while admitted and was transitioned to comfort care after medical interventions could not stabilize hemodynamics."
	"1361131-1"	"1361131-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"s/p 2 doses of Covid-19 vaccine.  Pt presented for weakness, SOB, fatigue progressive over the past month prior to admission.  Found to be pancytopenic with bone marrow biopsy consistent with MDS.  He was started on chemo but stay was complicated by neutropenic fevers, epistaxis, retinal hemorrhage, AKI, fluid overload, hypoxic respiratory failure, atrial fibrillation with RVR, and shock.  He ultimately had a heart attack while admitted and was transitioned to comfort care after medical interventions could not stabilize hemodynamics."
	"1361131-1"	"1361131-1"	"EPISTAXIS"	"10015090"	"50-59 years"	"50-59"	"s/p 2 doses of Covid-19 vaccine.  Pt presented for weakness, SOB, fatigue progressive over the past month prior to admission.  Found to be pancytopenic with bone marrow biopsy consistent with MDS.  He was started on chemo but stay was complicated by neutropenic fevers, epistaxis, retinal hemorrhage, AKI, fluid overload, hypoxic respiratory failure, atrial fibrillation with RVR, and shock.  He ultimately had a heart attack while admitted and was transitioned to comfort care after medical interventions could not stabilize hemodynamics."
	"1361131-1"	"1361131-1"	"FATIGUE"	"10016256"	"50-59 years"	"50-59"	"s/p 2 doses of Covid-19 vaccine.  Pt presented for weakness, SOB, fatigue progressive over the past month prior to admission.  Found to be pancytopenic with bone marrow biopsy consistent with MDS.  He was started on chemo but stay was complicated by neutropenic fevers, epistaxis, retinal hemorrhage, AKI, fluid overload, hypoxic respiratory failure, atrial fibrillation with RVR, and shock.  He ultimately had a heart attack while admitted and was transitioned to comfort care after medical interventions could not stabilize hemodynamics."
	"1361131-1"	"1361131-1"	"FEBRILE NEUTROPENIA"	"10016288"	"50-59 years"	"50-59"	"s/p 2 doses of Covid-19 vaccine.  Pt presented for weakness, SOB, fatigue progressive over the past month prior to admission.  Found to be pancytopenic with bone marrow biopsy consistent with MDS.  He was started on chemo but stay was complicated by neutropenic fevers, epistaxis, retinal hemorrhage, AKI, fluid overload, hypoxic respiratory failure, atrial fibrillation with RVR, and shock.  He ultimately had a heart attack while admitted and was transitioned to comfort care after medical interventions could not stabilize hemodynamics."
	"1361131-1"	"1361131-1"	"FLUID OVERLOAD"	"10016803"	"50-59 years"	"50-59"	"s/p 2 doses of Covid-19 vaccine.  Pt presented for weakness, SOB, fatigue progressive over the past month prior to admission.  Found to be pancytopenic with bone marrow biopsy consistent with MDS.  He was started on chemo but stay was complicated by neutropenic fevers, epistaxis, retinal hemorrhage, AKI, fluid overload, hypoxic respiratory failure, atrial fibrillation with RVR, and shock.  He ultimately had a heart attack while admitted and was transitioned to comfort care after medical interventions could not stabilize hemodynamics."
	"1361131-1"	"1361131-1"	"FULL BLOOD COUNT ABNORMAL"	"10017412"	"50-59 years"	"50-59"	"s/p 2 doses of Covid-19 vaccine.  Pt presented for weakness, SOB, fatigue progressive over the past month prior to admission.  Found to be pancytopenic with bone marrow biopsy consistent with MDS.  He was started on chemo but stay was complicated by neutropenic fevers, epistaxis, retinal hemorrhage, AKI, fluid overload, hypoxic respiratory failure, atrial fibrillation with RVR, and shock.  He ultimately had a heart attack while admitted and was transitioned to comfort care after medical interventions could not stabilize hemodynamics."
	"1361131-1"	"1361131-1"	"HAEMODYNAMIC INSTABILITY"	"10052076"	"50-59 years"	"50-59"	"s/p 2 doses of Covid-19 vaccine.  Pt presented for weakness, SOB, fatigue progressive over the past month prior to admission.  Found to be pancytopenic with bone marrow biopsy consistent with MDS.  He was started on chemo but stay was complicated by neutropenic fevers, epistaxis, retinal hemorrhage, AKI, fluid overload, hypoxic respiratory failure, atrial fibrillation with RVR, and shock.  He ultimately had a heart attack while admitted and was transitioned to comfort care after medical interventions could not stabilize hemodynamics."
	"1361131-1"	"1361131-1"	"MARROW HYPERPLASIA"	"10026851"	"50-59 years"	"50-59"	"s/p 2 doses of Covid-19 vaccine.  Pt presented for weakness, SOB, fatigue progressive over the past month prior to admission.  Found to be pancytopenic with bone marrow biopsy consistent with MDS.  He was started on chemo but stay was complicated by neutropenic fevers, epistaxis, retinal hemorrhage, AKI, fluid overload, hypoxic respiratory failure, atrial fibrillation with RVR, and shock.  He ultimately had a heart attack while admitted and was transitioned to comfort care after medical interventions could not stabilize hemodynamics."
	"1361131-1"	"1361131-1"	"MEGALOBLASTS INCREASED"	"10027131"	"50-59 years"	"50-59"	"s/p 2 doses of Covid-19 vaccine.  Pt presented for weakness, SOB, fatigue progressive over the past month prior to admission.  Found to be pancytopenic with bone marrow biopsy consistent with MDS.  He was started on chemo but stay was complicated by neutropenic fevers, epistaxis, retinal hemorrhage, AKI, fluid overload, hypoxic respiratory failure, atrial fibrillation with RVR, and shock.  He ultimately had a heart attack while admitted and was transitioned to comfort care after medical interventions could not stabilize hemodynamics."
	"1361131-1"	"1361131-1"	"MYELODYSPLASTIC SYNDROME"	"10028533"	"50-59 years"	"50-59"	"s/p 2 doses of Covid-19 vaccine.  Pt presented for weakness, SOB, fatigue progressive over the past month prior to admission.  Found to be pancytopenic with bone marrow biopsy consistent with MDS.  He was started on chemo but stay was complicated by neutropenic fevers, epistaxis, retinal hemorrhage, AKI, fluid overload, hypoxic respiratory failure, atrial fibrillation with RVR, and shock.  He ultimately had a heart attack while admitted and was transitioned to comfort care after medical interventions could not stabilize hemodynamics."
	"1361131-1"	"1361131-1"	"MYOCARDIAL INFARCTION"	"10028596"	"50-59 years"	"50-59"	"s/p 2 doses of Covid-19 vaccine.  Pt presented for weakness, SOB, fatigue progressive over the past month prior to admission.  Found to be pancytopenic with bone marrow biopsy consistent with MDS.  He was started on chemo but stay was complicated by neutropenic fevers, epistaxis, retinal hemorrhage, AKI, fluid overload, hypoxic respiratory failure, atrial fibrillation with RVR, and shock.  He ultimately had a heart attack while admitted and was transitioned to comfort care after medical interventions could not stabilize hemodynamics."
	"1361131-1"	"1361131-1"	"PANCYTOPENIA"	"10033661"	"50-59 years"	"50-59"	"s/p 2 doses of Covid-19 vaccine.  Pt presented for weakness, SOB, fatigue progressive over the past month prior to admission.  Found to be pancytopenic with bone marrow biopsy consistent with MDS.  He was started on chemo but stay was complicated by neutropenic fevers, epistaxis, retinal hemorrhage, AKI, fluid overload, hypoxic respiratory failure, atrial fibrillation with RVR, and shock.  He ultimately had a heart attack while admitted and was transitioned to comfort care after medical interventions could not stabilize hemodynamics."
	"1361131-1"	"1361131-1"	"RESPIRATORY FAILURE"	"10038695"	"50-59 years"	"50-59"	"s/p 2 doses of Covid-19 vaccine.  Pt presented for weakness, SOB, fatigue progressive over the past month prior to admission.  Found to be pancytopenic with bone marrow biopsy consistent with MDS.  He was started on chemo but stay was complicated by neutropenic fevers, epistaxis, retinal hemorrhage, AKI, fluid overload, hypoxic respiratory failure, atrial fibrillation with RVR, and shock.  He ultimately had a heart attack while admitted and was transitioned to comfort care after medical interventions could not stabilize hemodynamics."
	"1361131-1"	"1361131-1"	"RETINAL HAEMORRHAGE"	"10038867"	"50-59 years"	"50-59"	"s/p 2 doses of Covid-19 vaccine.  Pt presented for weakness, SOB, fatigue progressive over the past month prior to admission.  Found to be pancytopenic with bone marrow biopsy consistent with MDS.  He was started on chemo but stay was complicated by neutropenic fevers, epistaxis, retinal hemorrhage, AKI, fluid overload, hypoxic respiratory failure, atrial fibrillation with RVR, and shock.  He ultimately had a heart attack while admitted and was transitioned to comfort care after medical interventions could not stabilize hemodynamics."
	"1361131-1"	"1361131-1"	"SHOCK"	"10040560"	"50-59 years"	"50-59"	"s/p 2 doses of Covid-19 vaccine.  Pt presented for weakness, SOB, fatigue progressive over the past month prior to admission.  Found to be pancytopenic with bone marrow biopsy consistent with MDS.  He was started on chemo but stay was complicated by neutropenic fevers, epistaxis, retinal hemorrhage, AKI, fluid overload, hypoxic respiratory failure, atrial fibrillation with RVR, and shock.  He ultimately had a heart attack while admitted and was transitioned to comfort care after medical interventions could not stabilize hemodynamics."
	"1361131-1"	"1361131-1"	"WHITE BLOOD CELL COUNT DECREASED"	"10047942"	"50-59 years"	"50-59"	"s/p 2 doses of Covid-19 vaccine.  Pt presented for weakness, SOB, fatigue progressive over the past month prior to admission.  Found to be pancytopenic with bone marrow biopsy consistent with MDS.  He was started on chemo but stay was complicated by neutropenic fevers, epistaxis, retinal hemorrhage, AKI, fluid overload, hypoxic respiratory failure, atrial fibrillation with RVR, and shock.  He ultimately had a heart attack while admitted and was transitioned to comfort care after medical interventions could not stabilize hemodynamics."
	"1361366-1"	"1361366-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Death - 03/26/2021"
	"1361818-1"	"1361818-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Death"
	"1362305-1"	"1362305-1"	"CEREBROVASCULAR ACCIDENT"	"10008190"	"50-59 years"	"50-59"	"Massive heart attack. He was in Icu with a ECCMO and Impella machine. The highest life support was going to get a heart transplant but hes life ended with a stroke while under sedation for 5 days"
	"1362305-1"	"1362305-1"	"COMPUTERISED TOMOGRAM"	"10010234"	"50-59 years"	"50-59"	"Massive heart attack. He was in Icu with a ECCMO and Impella machine. The highest life support was going to get a heart transplant but hes life ended with a stroke while under sedation for 5 days"
	"1362305-1"	"1362305-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Massive heart attack. He was in Icu with a ECCMO and Impella machine. The highest life support was going to get a heart transplant but hes life ended with a stroke while under sedation for 5 days"
	"1362305-1"	"1362305-1"	"ELECTROCARDIOGRAM ABNORMAL"	"10014363"	"50-59 years"	"50-59"	"Massive heart attack. He was in Icu with a ECCMO and Impella machine. The highest life support was going to get a heart transplant but hes life ended with a stroke while under sedation for 5 days"
	"1362305-1"	"1362305-1"	"INTENSIVE CARE"	"10022519"	"50-59 years"	"50-59"	"Massive heart attack. He was in Icu with a ECCMO and Impella machine. The highest life support was going to get a heart transplant but hes life ended with a stroke while under sedation for 5 days"
	"1362305-1"	"1362305-1"	"LIFE SUPPORT"	"10024447"	"50-59 years"	"50-59"	"Massive heart attack. He was in Icu with a ECCMO and Impella machine. The highest life support was going to get a heart transplant but hes life ended with a stroke while under sedation for 5 days"
	"1362305-1"	"1362305-1"	"LUNG ASSIST DEVICE THERAPY"	"10082527"	"50-59 years"	"50-59"	"Massive heart attack. He was in Icu with a ECCMO and Impella machine. The highest life support was going to get a heart transplant but hes life ended with a stroke while under sedation for 5 days"
	"1362305-1"	"1362305-1"	"MYOCARDIAL INFARCTION"	"10028596"	"50-59 years"	"50-59"	"Massive heart attack. He was in Icu with a ECCMO and Impella machine. The highest life support was going to get a heart transplant but hes life ended with a stroke while under sedation for 5 days"
	"1362305-1"	"1362305-1"	"SEDATIVE THERAPY"	"10059283"	"50-59 years"	"50-59"	"Massive heart attack. He was in Icu with a ECCMO and Impella machine. The highest life support was going to get a heart transplant but hes life ended with a stroke while under sedation for 5 days"
	"1362305-1"	"1362305-1"	"VENTRICULAR ASSIST DEVICE INSERTION"	"10052371"	"50-59 years"	"50-59"	"Massive heart attack. He was in Icu with a ECCMO and Impella machine. The highest life support was going to get a heart transplant but hes life ended with a stroke while under sedation for 5 days"
	"1362511-1"	"1362511-1"	"ANGIOGRAM PULMONARY ABNORMAL"	"10002441"	"50-59 years"	"50-59"	"Skin hurting/sensitivity (Day 1 forward), severe chills (day 2 forward), headache (day 1 forward), fatigue (day 1 forward), mild cough on/off, eye pain (? day 4 forward), achey (day 1 forward), chest rash (? day 3 forward), fever  (? day 5 forward 101.9 day 5), back pain (? day 5 forward), labored breathing (? day 5 forward), diarrhea (? day 5 forward), sore throat (? day 5 forward) vomit (day 7).  Symptoms of chills and miserable feeling increased day 4 on.  Tylenol, Albuterol on day 6, Day 8 hospitalized, antibiotics and oxygen, Sepsis and shock, less than one day in hospital - passed on 3/2/21 am."
	"1362511-1"	"1362511-1"	"BACK PAIN"	"10003988"	"50-59 years"	"50-59"	"Skin hurting/sensitivity (Day 1 forward), severe chills (day 2 forward), headache (day 1 forward), fatigue (day 1 forward), mild cough on/off, eye pain (? day 4 forward), achey (day 1 forward), chest rash (? day 3 forward), fever  (? day 5 forward 101.9 day 5), back pain (? day 5 forward), labored breathing (? day 5 forward), diarrhea (? day 5 forward), sore throat (? day 5 forward) vomit (day 7).  Symptoms of chills and miserable feeling increased day 4 on.  Tylenol, Albuterol on day 6, Day 8 hospitalized, antibiotics and oxygen, Sepsis and shock, less than one day in hospital - passed on 3/2/21 am."
	"1362511-1"	"1362511-1"	"BLOOD CALCIUM DECREASED"	"10005395"	"50-59 years"	"50-59"	"Skin hurting/sensitivity (Day 1 forward), severe chills (day 2 forward), headache (day 1 forward), fatigue (day 1 forward), mild cough on/off, eye pain (? day 4 forward), achey (day 1 forward), chest rash (? day 3 forward), fever  (? day 5 forward 101.9 day 5), back pain (? day 5 forward), labored breathing (? day 5 forward), diarrhea (? day 5 forward), sore throat (? day 5 forward) vomit (day 7).  Symptoms of chills and miserable feeling increased day 4 on.  Tylenol, Albuterol on day 6, Day 8 hospitalized, antibiotics and oxygen, Sepsis and shock, less than one day in hospital - passed on 3/2/21 am."
	"1362511-1"	"1362511-1"	"BLOOD CHLORIDE DECREASED"	"10005419"	"50-59 years"	"50-59"	"Skin hurting/sensitivity (Day 1 forward), severe chills (day 2 forward), headache (day 1 forward), fatigue (day 1 forward), mild cough on/off, eye pain (? day 4 forward), achey (day 1 forward), chest rash (? day 3 forward), fever  (? day 5 forward 101.9 day 5), back pain (? day 5 forward), labored breathing (? day 5 forward), diarrhea (? day 5 forward), sore throat (? day 5 forward) vomit (day 7).  Symptoms of chills and miserable feeling increased day 4 on.  Tylenol, Albuterol on day 6, Day 8 hospitalized, antibiotics and oxygen, Sepsis and shock, less than one day in hospital - passed on 3/2/21 am."
	"1362511-1"	"1362511-1"	"BLOOD GLUCOSE INCREASED"	"10005557"	"50-59 years"	"50-59"	"Skin hurting/sensitivity (Day 1 forward), severe chills (day 2 forward), headache (day 1 forward), fatigue (day 1 forward), mild cough on/off, eye pain (? day 4 forward), achey (day 1 forward), chest rash (? day 3 forward), fever  (? day 5 forward 101.9 day 5), back pain (? day 5 forward), labored breathing (? day 5 forward), diarrhea (? day 5 forward), sore throat (? day 5 forward) vomit (day 7).  Symptoms of chills and miserable feeling increased day 4 on.  Tylenol, Albuterol on day 6, Day 8 hospitalized, antibiotics and oxygen, Sepsis and shock, less than one day in hospital - passed on 3/2/21 am."
	"1362511-1"	"1362511-1"	"BLOOD SODIUM DECREASED"	"10005802"	"50-59 years"	"50-59"	"Skin hurting/sensitivity (Day 1 forward), severe chills (day 2 forward), headache (day 1 forward), fatigue (day 1 forward), mild cough on/off, eye pain (? day 4 forward), achey (day 1 forward), chest rash (? day 3 forward), fever  (? day 5 forward 101.9 day 5), back pain (? day 5 forward), labored breathing (? day 5 forward), diarrhea (? day 5 forward), sore throat (? day 5 forward) vomit (day 7).  Symptoms of chills and miserable feeling increased day 4 on.  Tylenol, Albuterol on day 6, Day 8 hospitalized, antibiotics and oxygen, Sepsis and shock, less than one day in hospital - passed on 3/2/21 am."
	"1362511-1"	"1362511-1"	"BRAIN NATRIURETIC PEPTIDE NORMAL"	"10053409"	"50-59 years"	"50-59"	"Skin hurting/sensitivity (Day 1 forward), severe chills (day 2 forward), headache (day 1 forward), fatigue (day 1 forward), mild cough on/off, eye pain (? day 4 forward), achey (day 1 forward), chest rash (? day 3 forward), fever  (? day 5 forward 101.9 day 5), back pain (? day 5 forward), labored breathing (? day 5 forward), diarrhea (? day 5 forward), sore throat (? day 5 forward) vomit (day 7).  Symptoms of chills and miserable feeling increased day 4 on.  Tylenol, Albuterol on day 6, Day 8 hospitalized, antibiotics and oxygen, Sepsis and shock, less than one day in hospital - passed on 3/2/21 am."
	"1362511-1"	"1362511-1"	"CHEST X-RAY ABNORMAL"	"10008499"	"50-59 years"	"50-59"	"Skin hurting/sensitivity (Day 1 forward), severe chills (day 2 forward), headache (day 1 forward), fatigue (day 1 forward), mild cough on/off, eye pain (? day 4 forward), achey (day 1 forward), chest rash (? day 3 forward), fever  (? day 5 forward 101.9 day 5), back pain (? day 5 forward), labored breathing (? day 5 forward), diarrhea (? day 5 forward), sore throat (? day 5 forward) vomit (day 7).  Symptoms of chills and miserable feeling increased day 4 on.  Tylenol, Albuterol on day 6, Day 8 hospitalized, antibiotics and oxygen, Sepsis and shock, less than one day in hospital - passed on 3/2/21 am."
	"1362511-1"	"1362511-1"	"CHILLS"	"10008531"	"50-59 years"	"50-59"	"Skin hurting/sensitivity (Day 1 forward), severe chills (day 2 forward), headache (day 1 forward), fatigue (day 1 forward), mild cough on/off, eye pain (? day 4 forward), achey (day 1 forward), chest rash (? day 3 forward), fever  (? day 5 forward 101.9 day 5), back pain (? day 5 forward), labored breathing (? day 5 forward), diarrhea (? day 5 forward), sore throat (? day 5 forward) vomit (day 7).  Symptoms of chills and miserable feeling increased day 4 on.  Tylenol, Albuterol on day 6, Day 8 hospitalized, antibiotics and oxygen, Sepsis and shock, less than one day in hospital - passed on 3/2/21 am."
	"1362511-1"	"1362511-1"	"CONDITION AGGRAVATED"	"10010264"	"50-59 years"	"50-59"	"Skin hurting/sensitivity (Day 1 forward), severe chills (day 2 forward), headache (day 1 forward), fatigue (day 1 forward), mild cough on/off, eye pain (? day 4 forward), achey (day 1 forward), chest rash (? day 3 forward), fever  (? day 5 forward 101.9 day 5), back pain (? day 5 forward), labored breathing (? day 5 forward), diarrhea (? day 5 forward), sore throat (? day 5 forward) vomit (day 7).  Symptoms of chills and miserable feeling increased day 4 on.  Tylenol, Albuterol on day 6, Day 8 hospitalized, antibiotics and oxygen, Sepsis and shock, less than one day in hospital - passed on 3/2/21 am."
	"1362511-1"	"1362511-1"	"COUGH"	"10011224"	"50-59 years"	"50-59"	"Skin hurting/sensitivity (Day 1 forward), severe chills (day 2 forward), headache (day 1 forward), fatigue (day 1 forward), mild cough on/off, eye pain (? day 4 forward), achey (day 1 forward), chest rash (? day 3 forward), fever  (? day 5 forward 101.9 day 5), back pain (? day 5 forward), labored breathing (? day 5 forward), diarrhea (? day 5 forward), sore throat (? day 5 forward) vomit (day 7).  Symptoms of chills and miserable feeling increased day 4 on.  Tylenol, Albuterol on day 6, Day 8 hospitalized, antibiotics and oxygen, Sepsis and shock, less than one day in hospital - passed on 3/2/21 am."
	"1362511-1"	"1362511-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Skin hurting/sensitivity (Day 1 forward), severe chills (day 2 forward), headache (day 1 forward), fatigue (day 1 forward), mild cough on/off, eye pain (? day 4 forward), achey (day 1 forward), chest rash (? day 3 forward), fever  (? day 5 forward 101.9 day 5), back pain (? day 5 forward), labored breathing (? day 5 forward), diarrhea (? day 5 forward), sore throat (? day 5 forward) vomit (day 7).  Symptoms of chills and miserable feeling increased day 4 on.  Tylenol, Albuterol on day 6, Day 8 hospitalized, antibiotics and oxygen, Sepsis and shock, less than one day in hospital - passed on 3/2/21 am."
	"1362511-1"	"1362511-1"	"DIARRHOEA"	"10012735"	"50-59 years"	"50-59"	"Skin hurting/sensitivity (Day 1 forward), severe chills (day 2 forward), headache (day 1 forward), fatigue (day 1 forward), mild cough on/off, eye pain (? day 4 forward), achey (day 1 forward), chest rash (? day 3 forward), fever  (? day 5 forward 101.9 day 5), back pain (? day 5 forward), labored breathing (? day 5 forward), diarrhea (? day 5 forward), sore throat (? day 5 forward) vomit (day 7).  Symptoms of chills and miserable feeling increased day 4 on.  Tylenol, Albuterol on day 6, Day 8 hospitalized, antibiotics and oxygen, Sepsis and shock, less than one day in hospital - passed on 3/2/21 am."
	"1362511-1"	"1362511-1"	"DIFFERENTIAL WHITE BLOOD CELL COUNT ABNORMAL"	"10012785"	"50-59 years"	"50-59"	"Skin hurting/sensitivity (Day 1 forward), severe chills (day 2 forward), headache (day 1 forward), fatigue (day 1 forward), mild cough on/off, eye pain (? day 4 forward), achey (day 1 forward), chest rash (? day 3 forward), fever  (? day 5 forward 101.9 day 5), back pain (? day 5 forward), labored breathing (? day 5 forward), diarrhea (? day 5 forward), sore throat (? day 5 forward) vomit (day 7).  Symptoms of chills and miserable feeling increased day 4 on.  Tylenol, Albuterol on day 6, Day 8 hospitalized, antibiotics and oxygen, Sepsis and shock, less than one day in hospital - passed on 3/2/21 am."
	"1362511-1"	"1362511-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"Skin hurting/sensitivity (Day 1 forward), severe chills (day 2 forward), headache (day 1 forward), fatigue (day 1 forward), mild cough on/off, eye pain (? day 4 forward), achey (day 1 forward), chest rash (? day 3 forward), fever  (? day 5 forward 101.9 day 5), back pain (? day 5 forward), labored breathing (? day 5 forward), diarrhea (? day 5 forward), sore throat (? day 5 forward) vomit (day 7).  Symptoms of chills and miserable feeling increased day 4 on.  Tylenol, Albuterol on day 6, Day 8 hospitalized, antibiotics and oxygen, Sepsis and shock, less than one day in hospital - passed on 3/2/21 am."
	"1362511-1"	"1362511-1"	"EYE PAIN"	"10015958"	"50-59 years"	"50-59"	"Skin hurting/sensitivity (Day 1 forward), severe chills (day 2 forward), headache (day 1 forward), fatigue (day 1 forward), mild cough on/off, eye pain (? day 4 forward), achey (day 1 forward), chest rash (? day 3 forward), fever  (? day 5 forward 101.9 day 5), back pain (? day 5 forward), labored breathing (? day 5 forward), diarrhea (? day 5 forward), sore throat (? day 5 forward) vomit (day 7).  Symptoms of chills and miserable feeling increased day 4 on.  Tylenol, Albuterol on day 6, Day 8 hospitalized, antibiotics and oxygen, Sepsis and shock, less than one day in hospital - passed on 3/2/21 am."
	"1362511-1"	"1362511-1"	"FATIGUE"	"10016256"	"50-59 years"	"50-59"	"Skin hurting/sensitivity (Day 1 forward), severe chills (day 2 forward), headache (day 1 forward), fatigue (day 1 forward), mild cough on/off, eye pain (? day 4 forward), achey (day 1 forward), chest rash (? day 3 forward), fever  (? day 5 forward 101.9 day 5), back pain (? day 5 forward), labored breathing (? day 5 forward), diarrhea (? day 5 forward), sore throat (? day 5 forward) vomit (day 7).  Symptoms of chills and miserable feeling increased day 4 on.  Tylenol, Albuterol on day 6, Day 8 hospitalized, antibiotics and oxygen, Sepsis and shock, less than one day in hospital - passed on 3/2/21 am."
	"1362511-1"	"1362511-1"	"FEELING ABNORMAL"	"10016322"	"50-59 years"	"50-59"	"Skin hurting/sensitivity (Day 1 forward), severe chills (day 2 forward), headache (day 1 forward), fatigue (day 1 forward), mild cough on/off, eye pain (? day 4 forward), achey (day 1 forward), chest rash (? day 3 forward), fever  (? day 5 forward 101.9 day 5), back pain (? day 5 forward), labored breathing (? day 5 forward), diarrhea (? day 5 forward), sore throat (? day 5 forward) vomit (day 7).  Symptoms of chills and miserable feeling increased day 4 on.  Tylenol, Albuterol on day 6, Day 8 hospitalized, antibiotics and oxygen, Sepsis and shock, less than one day in hospital - passed on 3/2/21 am."
	"1362511-1"	"1362511-1"	"FIBRIN D DIMER INCREASED"	"10016581"	"50-59 years"	"50-59"	"Skin hurting/sensitivity (Day 1 forward), severe chills (day 2 forward), headache (day 1 forward), fatigue (day 1 forward), mild cough on/off, eye pain (? day 4 forward), achey (day 1 forward), chest rash (? day 3 forward), fever  (? day 5 forward 101.9 day 5), back pain (? day 5 forward), labored breathing (? day 5 forward), diarrhea (? day 5 forward), sore throat (? day 5 forward) vomit (day 7).  Symptoms of chills and miserable feeling increased day 4 on.  Tylenol, Albuterol on day 6, Day 8 hospitalized, antibiotics and oxygen, Sepsis and shock, less than one day in hospital - passed on 3/2/21 am."
	"1362511-1"	"1362511-1"	"FULL BLOOD COUNT ABNORMAL"	"10017412"	"50-59 years"	"50-59"	"Skin hurting/sensitivity (Day 1 forward), severe chills (day 2 forward), headache (day 1 forward), fatigue (day 1 forward), mild cough on/off, eye pain (? day 4 forward), achey (day 1 forward), chest rash (? day 3 forward), fever  (? day 5 forward 101.9 day 5), back pain (? day 5 forward), labored breathing (? day 5 forward), diarrhea (? day 5 forward), sore throat (? day 5 forward) vomit (day 7).  Symptoms of chills and miserable feeling increased day 4 on.  Tylenol, Albuterol on day 6, Day 8 hospitalized, antibiotics and oxygen, Sepsis and shock, less than one day in hospital - passed on 3/2/21 am."
	"1362511-1"	"1362511-1"	"HAEMATOCRIT INCREASED"	"10018840"	"50-59 years"	"50-59"	"Skin hurting/sensitivity (Day 1 forward), severe chills (day 2 forward), headache (day 1 forward), fatigue (day 1 forward), mild cough on/off, eye pain (? day 4 forward), achey (day 1 forward), chest rash (? day 3 forward), fever  (? day 5 forward 101.9 day 5), back pain (? day 5 forward), labored breathing (? day 5 forward), diarrhea (? day 5 forward), sore throat (? day 5 forward) vomit (day 7).  Symptoms of chills and miserable feeling increased day 4 on.  Tylenol, Albuterol on day 6, Day 8 hospitalized, antibiotics and oxygen, Sepsis and shock, less than one day in hospital - passed on 3/2/21 am."
	"1362511-1"	"1362511-1"	"HAEMOGLOBIN INCREASED"	"10018888"	"50-59 years"	"50-59"	"Skin hurting/sensitivity (Day 1 forward), severe chills (day 2 forward), headache (day 1 forward), fatigue (day 1 forward), mild cough on/off, eye pain (? day 4 forward), achey (day 1 forward), chest rash (? day 3 forward), fever  (? day 5 forward 101.9 day 5), back pain (? day 5 forward), labored breathing (? day 5 forward), diarrhea (? day 5 forward), sore throat (? day 5 forward) vomit (day 7).  Symptoms of chills and miserable feeling increased day 4 on.  Tylenol, Albuterol on day 6, Day 8 hospitalized, antibiotics and oxygen, Sepsis and shock, less than one day in hospital - passed on 3/2/21 am."
	"1362511-1"	"1362511-1"	"HEADACHE"	"10019211"	"50-59 years"	"50-59"	"Skin hurting/sensitivity (Day 1 forward), severe chills (day 2 forward), headache (day 1 forward), fatigue (day 1 forward), mild cough on/off, eye pain (? day 4 forward), achey (day 1 forward), chest rash (? day 3 forward), fever  (? day 5 forward 101.9 day 5), back pain (? day 5 forward), labored breathing (? day 5 forward), diarrhea (? day 5 forward), sore throat (? day 5 forward) vomit (day 7).  Symptoms of chills and miserable feeling increased day 4 on.  Tylenol, Albuterol on day 6, Day 8 hospitalized, antibiotics and oxygen, Sepsis and shock, less than one day in hospital - passed on 3/2/21 am."
	"1362511-1"	"1362511-1"	"HYPERAESTHESIA"	"10020568"	"50-59 years"	"50-59"	"Skin hurting/sensitivity (Day 1 forward), severe chills (day 2 forward), headache (day 1 forward), fatigue (day 1 forward), mild cough on/off, eye pain (? day 4 forward), achey (day 1 forward), chest rash (? day 3 forward), fever  (? day 5 forward 101.9 day 5), back pain (? day 5 forward), labored breathing (? day 5 forward), diarrhea (? day 5 forward), sore throat (? day 5 forward) vomit (day 7).  Symptoms of chills and miserable feeling increased day 4 on.  Tylenol, Albuterol on day 6, Day 8 hospitalized, antibiotics and oxygen, Sepsis and shock, less than one day in hospital - passed on 3/2/21 am."
	"1362511-1"	"1362511-1"	"INFLUENZA VIRUS TEST NEGATIVE"	"10070718"	"50-59 years"	"50-59"	"Skin hurting/sensitivity (Day 1 forward), severe chills (day 2 forward), headache (day 1 forward), fatigue (day 1 forward), mild cough on/off, eye pain (? day 4 forward), achey (day 1 forward), chest rash (? day 3 forward), fever  (? day 5 forward 101.9 day 5), back pain (? day 5 forward), labored breathing (? day 5 forward), diarrhea (? day 5 forward), sore throat (? day 5 forward) vomit (day 7).  Symptoms of chills and miserable feeling increased day 4 on.  Tylenol, Albuterol on day 6, Day 8 hospitalized, antibiotics and oxygen, Sepsis and shock, less than one day in hospital - passed on 3/2/21 am."
	"1362511-1"	"1362511-1"	"LABORATORY TEST NORMAL"	"10054052"	"50-59 years"	"50-59"	"Skin hurting/sensitivity (Day 1 forward), severe chills (day 2 forward), headache (day 1 forward), fatigue (day 1 forward), mild cough on/off, eye pain (? day 4 forward), achey (day 1 forward), chest rash (? day 3 forward), fever  (? day 5 forward 101.9 day 5), back pain (? day 5 forward), labored breathing (? day 5 forward), diarrhea (? day 5 forward), sore throat (? day 5 forward) vomit (day 7).  Symptoms of chills and miserable feeling increased day 4 on.  Tylenol, Albuterol on day 6, Day 8 hospitalized, antibiotics and oxygen, Sepsis and shock, less than one day in hospital - passed on 3/2/21 am."
	"1362511-1"	"1362511-1"	"LEGIONELLA TEST"	"10070410"	"50-59 years"	"50-59"	"Skin hurting/sensitivity (Day 1 forward), severe chills (day 2 forward), headache (day 1 forward), fatigue (day 1 forward), mild cough on/off, eye pain (? day 4 forward), achey (day 1 forward), chest rash (? day 3 forward), fever  (? day 5 forward 101.9 day 5), back pain (? day 5 forward), labored breathing (? day 5 forward), diarrhea (? day 5 forward), sore throat (? day 5 forward) vomit (day 7).  Symptoms of chills and miserable feeling increased day 4 on.  Tylenol, Albuterol on day 6, Day 8 hospitalized, antibiotics and oxygen, Sepsis and shock, less than one day in hospital - passed on 3/2/21 am."
	"1362511-1"	"1362511-1"	"LUNG DISORDER"	"10025082"	"50-59 years"	"50-59"	"Skin hurting/sensitivity (Day 1 forward), severe chills (day 2 forward), headache (day 1 forward), fatigue (day 1 forward), mild cough on/off, eye pain (? day 4 forward), achey (day 1 forward), chest rash (? day 3 forward), fever  (? day 5 forward 101.9 day 5), back pain (? day 5 forward), labored breathing (? day 5 forward), diarrhea (? day 5 forward), sore throat (? day 5 forward) vomit (day 7).  Symptoms of chills and miserable feeling increased day 4 on.  Tylenol, Albuterol on day 6, Day 8 hospitalized, antibiotics and oxygen, Sepsis and shock, less than one day in hospital - passed on 3/2/21 am."
	"1362511-1"	"1362511-1"	"LUNG OPACITY"	"10081792"	"50-59 years"	"50-59"	"Skin hurting/sensitivity (Day 1 forward), severe chills (day 2 forward), headache (day 1 forward), fatigue (day 1 forward), mild cough on/off, eye pain (? day 4 forward), achey (day 1 forward), chest rash (? day 3 forward), fever  (? day 5 forward 101.9 day 5), back pain (? day 5 forward), labored breathing (? day 5 forward), diarrhea (? day 5 forward), sore throat (? day 5 forward) vomit (day 7).  Symptoms of chills and miserable feeling increased day 4 on.  Tylenol, Albuterol on day 6, Day 8 hospitalized, antibiotics and oxygen, Sepsis and shock, less than one day in hospital - passed on 3/2/21 am."
	"1362511-1"	"1362511-1"	"LYMPHADENOPATHY"	"10025197"	"50-59 years"	"50-59"	"Skin hurting/sensitivity (Day 1 forward), severe chills (day 2 forward), headache (day 1 forward), fatigue (day 1 forward), mild cough on/off, eye pain (? day 4 forward), achey (day 1 forward), chest rash (? day 3 forward), fever  (? day 5 forward 101.9 day 5), back pain (? day 5 forward), labored breathing (? day 5 forward), diarrhea (? day 5 forward), sore throat (? day 5 forward) vomit (day 7).  Symptoms of chills and miserable feeling increased day 4 on.  Tylenol, Albuterol on day 6, Day 8 hospitalized, antibiotics and oxygen, Sepsis and shock, less than one day in hospital - passed on 3/2/21 am."
	"1362511-1"	"1362511-1"	"LYMPHADENOPATHY MEDIASTINAL"	"10025205"	"50-59 years"	"50-59"	"Skin hurting/sensitivity (Day 1 forward), severe chills (day 2 forward), headache (day 1 forward), fatigue (day 1 forward), mild cough on/off, eye pain (? day 4 forward), achey (day 1 forward), chest rash (? day 3 forward), fever  (? day 5 forward 101.9 day 5), back pain (? day 5 forward), labored breathing (? day 5 forward), diarrhea (? day 5 forward), sore throat (? day 5 forward) vomit (day 7).  Symptoms of chills and miserable feeling increased day 4 on.  Tylenol, Albuterol on day 6, Day 8 hospitalized, antibiotics and oxygen, Sepsis and shock, less than one day in hospital - passed on 3/2/21 am."
	"1362511-1"	"1362511-1"	"METABOLIC FUNCTION TEST ABNORMAL"	"10061286"	"50-59 years"	"50-59"	"Skin hurting/sensitivity (Day 1 forward), severe chills (day 2 forward), headache (day 1 forward), fatigue (day 1 forward), mild cough on/off, eye pain (? day 4 forward), achey (day 1 forward), chest rash (? day 3 forward), fever  (? day 5 forward 101.9 day 5), back pain (? day 5 forward), labored breathing (? day 5 forward), diarrhea (? day 5 forward), sore throat (? day 5 forward) vomit (day 7).  Symptoms of chills and miserable feeling increased day 4 on.  Tylenol, Albuterol on day 6, Day 8 hospitalized, antibiotics and oxygen, Sepsis and shock, less than one day in hospital - passed on 3/2/21 am."
	"1362511-1"	"1362511-1"	"MONOCYTE COUNT INCREASED"	"10027880"	"50-59 years"	"50-59"	"Skin hurting/sensitivity (Day 1 forward), severe chills (day 2 forward), headache (day 1 forward), fatigue (day 1 forward), mild cough on/off, eye pain (? day 4 forward), achey (day 1 forward), chest rash (? day 3 forward), fever  (? day 5 forward 101.9 day 5), back pain (? day 5 forward), labored breathing (? day 5 forward), diarrhea (? day 5 forward), sore throat (? day 5 forward) vomit (day 7).  Symptoms of chills and miserable feeling increased day 4 on.  Tylenol, Albuterol on day 6, Day 8 hospitalized, antibiotics and oxygen, Sepsis and shock, less than one day in hospital - passed on 3/2/21 am."
	"1362511-1"	"1362511-1"	"OROPHARYNGEAL PAIN"	"10068319"	"50-59 years"	"50-59"	"Skin hurting/sensitivity (Day 1 forward), severe chills (day 2 forward), headache (day 1 forward), fatigue (day 1 forward), mild cough on/off, eye pain (? day 4 forward), achey (day 1 forward), chest rash (? day 3 forward), fever  (? day 5 forward 101.9 day 5), back pain (? day 5 forward), labored breathing (? day 5 forward), diarrhea (? day 5 forward), sore throat (? day 5 forward) vomit (day 7).  Symptoms of chills and miserable feeling increased day 4 on.  Tylenol, Albuterol on day 6, Day 8 hospitalized, antibiotics and oxygen, Sepsis and shock, less than one day in hospital - passed on 3/2/21 am."
	"1362511-1"	"1362511-1"	"PAIN"	"10033371"	"50-59 years"	"50-59"	"Skin hurting/sensitivity (Day 1 forward), severe chills (day 2 forward), headache (day 1 forward), fatigue (day 1 forward), mild cough on/off, eye pain (? day 4 forward), achey (day 1 forward), chest rash (? day 3 forward), fever  (? day 5 forward 101.9 day 5), back pain (? day 5 forward), labored breathing (? day 5 forward), diarrhea (? day 5 forward), sore throat (? day 5 forward) vomit (day 7).  Symptoms of chills and miserable feeling increased day 4 on.  Tylenol, Albuterol on day 6, Day 8 hospitalized, antibiotics and oxygen, Sepsis and shock, less than one day in hospital - passed on 3/2/21 am."
	"1362511-1"	"1362511-1"	"PAIN OF SKIN"	"10033474"	"50-59 years"	"50-59"	"Skin hurting/sensitivity (Day 1 forward), severe chills (day 2 forward), headache (day 1 forward), fatigue (day 1 forward), mild cough on/off, eye pain (? day 4 forward), achey (day 1 forward), chest rash (? day 3 forward), fever  (? day 5 forward 101.9 day 5), back pain (? day 5 forward), labored breathing (? day 5 forward), diarrhea (? day 5 forward), sore throat (? day 5 forward) vomit (day 7).  Symptoms of chills and miserable feeling increased day 4 on.  Tylenol, Albuterol on day 6, Day 8 hospitalized, antibiotics and oxygen, Sepsis and shock, less than one day in hospital - passed on 3/2/21 am."
	"1362511-1"	"1362511-1"	"PLATELET COUNT DECREASED"	"10035528"	"50-59 years"	"50-59"	"Skin hurting/sensitivity (Day 1 forward), severe chills (day 2 forward), headache (day 1 forward), fatigue (day 1 forward), mild cough on/off, eye pain (? day 4 forward), achey (day 1 forward), chest rash (? day 3 forward), fever  (? day 5 forward 101.9 day 5), back pain (? day 5 forward), labored breathing (? day 5 forward), diarrhea (? day 5 forward), sore throat (? day 5 forward) vomit (day 7).  Symptoms of chills and miserable feeling increased day 4 on.  Tylenol, Albuterol on day 6, Day 8 hospitalized, antibiotics and oxygen, Sepsis and shock, less than one day in hospital - passed on 3/2/21 am."
	"1362511-1"	"1362511-1"	"PLEURAL EFFUSION"	"10035598"	"50-59 years"	"50-59"	"Skin hurting/sensitivity (Day 1 forward), severe chills (day 2 forward), headache (day 1 forward), fatigue (day 1 forward), mild cough on/off, eye pain (? day 4 forward), achey (day 1 forward), chest rash (? day 3 forward), fever  (? day 5 forward 101.9 day 5), back pain (? day 5 forward), labored breathing (? day 5 forward), diarrhea (? day 5 forward), sore throat (? day 5 forward) vomit (day 7).  Symptoms of chills and miserable feeling increased day 4 on.  Tylenol, Albuterol on day 6, Day 8 hospitalized, antibiotics and oxygen, Sepsis and shock, less than one day in hospital - passed on 3/2/21 am."
	"1362511-1"	"1362511-1"	"PROCALCITONIN"	"10064051"	"50-59 years"	"50-59"	"Skin hurting/sensitivity (Day 1 forward), severe chills (day 2 forward), headache (day 1 forward), fatigue (day 1 forward), mild cough on/off, eye pain (? day 4 forward), achey (day 1 forward), chest rash (? day 3 forward), fever  (? day 5 forward 101.9 day 5), back pain (? day 5 forward), labored breathing (? day 5 forward), diarrhea (? day 5 forward), sore throat (? day 5 forward) vomit (day 7).  Symptoms of chills and miserable feeling increased day 4 on.  Tylenol, Albuterol on day 6, Day 8 hospitalized, antibiotics and oxygen, Sepsis and shock, less than one day in hospital - passed on 3/2/21 am."
	"1362511-1"	"1362511-1"	"PROTEIN URINE PRESENT"	"10053123"	"50-59 years"	"50-59"	"Skin hurting/sensitivity (Day 1 forward), severe chills (day 2 forward), headache (day 1 forward), fatigue (day 1 forward), mild cough on/off, eye pain (? day 4 forward), achey (day 1 forward), chest rash (? day 3 forward), fever  (? day 5 forward 101.9 day 5), back pain (? day 5 forward), labored breathing (? day 5 forward), diarrhea (? day 5 forward), sore throat (? day 5 forward) vomit (day 7).  Symptoms of chills and miserable feeling increased day 4 on.  Tylenol, Albuterol on day 6, Day 8 hospitalized, antibiotics and oxygen, Sepsis and shock, less than one day in hospital - passed on 3/2/21 am."
	"1362511-1"	"1362511-1"	"PYREXIA"	"10037660"	"50-59 years"	"50-59"	"Skin hurting/sensitivity (Day 1 forward), severe chills (day 2 forward), headache (day 1 forward), fatigue (day 1 forward), mild cough on/off, eye pain (? day 4 forward), achey (day 1 forward), chest rash (? day 3 forward), fever  (? day 5 forward 101.9 day 5), back pain (? day 5 forward), labored breathing (? day 5 forward), diarrhea (? day 5 forward), sore throat (? day 5 forward) vomit (day 7).  Symptoms of chills and miserable feeling increased day 4 on.  Tylenol, Albuterol on day 6, Day 8 hospitalized, antibiotics and oxygen, Sepsis and shock, less than one day in hospital - passed on 3/2/21 am."
	"1362511-1"	"1362511-1"	"RASH"	"10037844"	"50-59 years"	"50-59"	"Skin hurting/sensitivity (Day 1 forward), severe chills (day 2 forward), headache (day 1 forward), fatigue (day 1 forward), mild cough on/off, eye pain (? day 4 forward), achey (day 1 forward), chest rash (? day 3 forward), fever  (? day 5 forward 101.9 day 5), back pain (? day 5 forward), labored breathing (? day 5 forward), diarrhea (? day 5 forward), sore throat (? day 5 forward) vomit (day 7).  Symptoms of chills and miserable feeling increased day 4 on.  Tylenol, Albuterol on day 6, Day 8 hospitalized, antibiotics and oxygen, Sepsis and shock, less than one day in hospital - passed on 3/2/21 am."
	"1362511-1"	"1362511-1"	"RED BLOOD CELL COUNT INCREASED"	"10038155"	"50-59 years"	"50-59"	"Skin hurting/sensitivity (Day 1 forward), severe chills (day 2 forward), headache (day 1 forward), fatigue (day 1 forward), mild cough on/off, eye pain (? day 4 forward), achey (day 1 forward), chest rash (? day 3 forward), fever  (? day 5 forward 101.9 day 5), back pain (? day 5 forward), labored breathing (? day 5 forward), diarrhea (? day 5 forward), sore throat (? day 5 forward) vomit (day 7).  Symptoms of chills and miserable feeling increased day 4 on.  Tylenol, Albuterol on day 6, Day 8 hospitalized, antibiotics and oxygen, Sepsis and shock, less than one day in hospital - passed on 3/2/21 am."
	"1362511-1"	"1362511-1"	"SARS-COV-2 TEST NEGATIVE"	"10084273"	"50-59 years"	"50-59"	"Skin hurting/sensitivity (Day 1 forward), severe chills (day 2 forward), headache (day 1 forward), fatigue (day 1 forward), mild cough on/off, eye pain (? day 4 forward), achey (day 1 forward), chest rash (? day 3 forward), fever  (? day 5 forward 101.9 day 5), back pain (? day 5 forward), labored breathing (? day 5 forward), diarrhea (? day 5 forward), sore throat (? day 5 forward) vomit (day 7).  Symptoms of chills and miserable feeling increased day 4 on.  Tylenol, Albuterol on day 6, Day 8 hospitalized, antibiotics and oxygen, Sepsis and shock, less than one day in hospital - passed on 3/2/21 am."
	"1362511-1"	"1362511-1"	"SEPSIS"	"10040047"	"50-59 years"	"50-59"	"Skin hurting/sensitivity (Day 1 forward), severe chills (day 2 forward), headache (day 1 forward), fatigue (day 1 forward), mild cough on/off, eye pain (? day 4 forward), achey (day 1 forward), chest rash (? day 3 forward), fever  (? day 5 forward 101.9 day 5), back pain (? day 5 forward), labored breathing (? day 5 forward), diarrhea (? day 5 forward), sore throat (? day 5 forward) vomit (day 7).  Symptoms of chills and miserable feeling increased day 4 on.  Tylenol, Albuterol on day 6, Day 8 hospitalized, antibiotics and oxygen, Sepsis and shock, less than one day in hospital - passed on 3/2/21 am."
	"1362511-1"	"1362511-1"	"SHOCK"	"10040560"	"50-59 years"	"50-59"	"Skin hurting/sensitivity (Day 1 forward), severe chills (day 2 forward), headache (day 1 forward), fatigue (day 1 forward), mild cough on/off, eye pain (? day 4 forward), achey (day 1 forward), chest rash (? day 3 forward), fever  (? day 5 forward 101.9 day 5), back pain (? day 5 forward), labored breathing (? day 5 forward), diarrhea (? day 5 forward), sore throat (? day 5 forward) vomit (day 7).  Symptoms of chills and miserable feeling increased day 4 on.  Tylenol, Albuterol on day 6, Day 8 hospitalized, antibiotics and oxygen, Sepsis and shock, less than one day in hospital - passed on 3/2/21 am."
	"1362511-1"	"1362511-1"	"STREPTOCOCCUS TEST NEGATIVE"	"10070415"	"50-59 years"	"50-59"	"Skin hurting/sensitivity (Day 1 forward), severe chills (day 2 forward), headache (day 1 forward), fatigue (day 1 forward), mild cough on/off, eye pain (? day 4 forward), achey (day 1 forward), chest rash (? day 3 forward), fever  (? day 5 forward 101.9 day 5), back pain (? day 5 forward), labored breathing (? day 5 forward), diarrhea (? day 5 forward), sore throat (? day 5 forward) vomit (day 7).  Symptoms of chills and miserable feeling increased day 4 on.  Tylenol, Albuterol on day 6, Day 8 hospitalized, antibiotics and oxygen, Sepsis and shock, less than one day in hospital - passed on 3/2/21 am."
	"1362511-1"	"1362511-1"	"TROPONIN I NORMAL"	"10073406"	"50-59 years"	"50-59"	"Skin hurting/sensitivity (Day 1 forward), severe chills (day 2 forward), headache (day 1 forward), fatigue (day 1 forward), mild cough on/off, eye pain (? day 4 forward), achey (day 1 forward), chest rash (? day 3 forward), fever  (? day 5 forward 101.9 day 5), back pain (? day 5 forward), labored breathing (? day 5 forward), diarrhea (? day 5 forward), sore throat (? day 5 forward) vomit (day 7).  Symptoms of chills and miserable feeling increased day 4 on.  Tylenol, Albuterol on day 6, Day 8 hospitalized, antibiotics and oxygen, Sepsis and shock, less than one day in hospital - passed on 3/2/21 am."
	"1362511-1"	"1362511-1"	"URINE ANALYSIS ABNORMAL"	"10062226"	"50-59 years"	"50-59"	"Skin hurting/sensitivity (Day 1 forward), severe chills (day 2 forward), headache (day 1 forward), fatigue (day 1 forward), mild cough on/off, eye pain (? day 4 forward), achey (day 1 forward), chest rash (? day 3 forward), fever  (? day 5 forward 101.9 day 5), back pain (? day 5 forward), labored breathing (? day 5 forward), diarrhea (? day 5 forward), sore throat (? day 5 forward) vomit (day 7).  Symptoms of chills and miserable feeling increased day 4 on.  Tylenol, Albuterol on day 6, Day 8 hospitalized, antibiotics and oxygen, Sepsis and shock, less than one day in hospital - passed on 3/2/21 am."
	"1362511-1"	"1362511-1"	"VOMITING"	"10047700"	"50-59 years"	"50-59"	"Skin hurting/sensitivity (Day 1 forward), severe chills (day 2 forward), headache (day 1 forward), fatigue (day 1 forward), mild cough on/off, eye pain (? day 4 forward), achey (day 1 forward), chest rash (? day 3 forward), fever  (? day 5 forward 101.9 day 5), back pain (? day 5 forward), labored breathing (? day 5 forward), diarrhea (? day 5 forward), sore throat (? day 5 forward) vomit (day 7).  Symptoms of chills and miserable feeling increased day 4 on.  Tylenol, Albuterol on day 6, Day 8 hospitalized, antibiotics and oxygen, Sepsis and shock, less than one day in hospital - passed on 3/2/21 am."
	"1365365-1"	"1365365-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Resident  received Janssen Covid 19 vaccination on 5/25.  On 5/29, the resident died."
	"1365404-1"	"1365404-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"My husband past away"
	"1365410-1"	"1365410-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"ON 3/15/21 patient was found unresponsive by spouse. EMS was called.  Patient was found to have cardiac arrest Was given Epinephrine, Amiodarone and External Ventricular defibrillation Patient passed away on 3/15/21"
	"1365410-1"	"1365410-1"	"CARDIOVERSION"	"10007661"	"50-59 years"	"50-59"	"ON 3/15/21 patient was found unresponsive by spouse. EMS was called.  Patient was found to have cardiac arrest Was given Epinephrine, Amiodarone and External Ventricular defibrillation Patient passed away on 3/15/21"
	"1365410-1"	"1365410-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"ON 3/15/21 patient was found unresponsive by spouse. EMS was called.  Patient was found to have cardiac arrest Was given Epinephrine, Amiodarone and External Ventricular defibrillation Patient passed away on 3/15/21"
	"1365410-1"	"1365410-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"50-59 years"	"50-59"	"ON 3/15/21 patient was found unresponsive by spouse. EMS was called.  Patient was found to have cardiac arrest Was given Epinephrine, Amiodarone and External Ventricular defibrillation Patient passed away on 3/15/21"
	"1365516-1"	"1365516-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"my friend died from this vaccine"
	"1366154-1"	"1366154-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Death"
	"1369340-1"	"1369340-1"	"CARDIO-RESPIRATORY ARREST"	"10007617"	"50-59 years"	"50-59"	"My brother took the day off work on May 12, 2021 to receive his 2nd dose of the Moderna vaccine. He communicated with friends later that same day saying he was tired and needed to rest. On May 13, 2021, a work colleague followed up with a text message to see how he was doing to which my brother did not respond. This same colleague went to his house a few days later to find him dead lying on his couch."
	"1369340-1"	"1369340-1"	"CONDITION AGGRAVATED"	"10010264"	"50-59 years"	"50-59"	"My brother took the day off work on May 12, 2021 to receive his 2nd dose of the Moderna vaccine. He communicated with friends later that same day saying he was tired and needed to rest. On May 13, 2021, a work colleague followed up with a text message to see how he was doing to which my brother did not respond. This same colleague went to his house a few days later to find him dead lying on his couch."
	"1369340-1"	"1369340-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"My brother took the day off work on May 12, 2021 to receive his 2nd dose of the Moderna vaccine. He communicated with friends later that same day saying he was tired and needed to rest. On May 13, 2021, a work colleague followed up with a text message to see how he was doing to which my brother did not respond. This same colleague went to his house a few days later to find him dead lying on his couch."
	"1369340-1"	"1369340-1"	"EMBOLISM"	"10061169"	"50-59 years"	"50-59"	"My brother took the day off work on May 12, 2021 to receive his 2nd dose of the Moderna vaccine. He communicated with friends later that same day saying he was tired and needed to rest. On May 13, 2021, a work colleague followed up with a text message to see how he was doing to which my brother did not respond. This same colleague went to his house a few days later to find him dead lying on his couch."
	"1369340-1"	"1369340-1"	"FATIGUE"	"10016256"	"50-59 years"	"50-59"	"My brother took the day off work on May 12, 2021 to receive his 2nd dose of the Moderna vaccine. He communicated with friends later that same day saying he was tired and needed to rest. On May 13, 2021, a work colleague followed up with a text message to see how he was doing to which my brother did not respond. This same colleague went to his house a few days later to find him dead lying on his couch."
	"1369340-1"	"1369340-1"	"HYPERTENSION"	"10020772"	"50-59 years"	"50-59"	"My brother took the day off work on May 12, 2021 to receive his 2nd dose of the Moderna vaccine. He communicated with friends later that same day saying he was tired and needed to rest. On May 13, 2021, a work colleague followed up with a text message to see how he was doing to which my brother did not respond. This same colleague went to his house a few days later to find him dead lying on his couch."
	"1369811-1"	"1369811-1"	"ARRHYTHMIA"	"10003119"	"50-59 years"	"50-59"	"Patient went swimming at a fitness center the day after he had his 2nd COVID-19 vaccine and was found unresponsive at the bottom of the shallow 4.5 deep pool while exercising.  He was not able to be revived.  The death certificate says that the immediate cause of death was Arrhythmia resulting from Hypertensive Atherosclerotic Cardiovascular Disease."
	"1369811-1"	"1369811-1"	"ARTERIOSCLEROSIS"	"10003210"	"50-59 years"	"50-59"	"Patient went swimming at a fitness center the day after he had his 2nd COVID-19 vaccine and was found unresponsive at the bottom of the shallow 4.5 deep pool while exercising.  He was not able to be revived.  The death certificate says that the immediate cause of death was Arrhythmia resulting from Hypertensive Atherosclerotic Cardiovascular Disease."
	"1369811-1"	"1369811-1"	"AUTOPSY"	"10050117"	"50-59 years"	"50-59"	"Patient went swimming at a fitness center the day after he had his 2nd COVID-19 vaccine and was found unresponsive at the bottom of the shallow 4.5 deep pool while exercising.  He was not able to be revived.  The death certificate says that the immediate cause of death was Arrhythmia resulting from Hypertensive Atherosclerotic Cardiovascular Disease."
	"1369811-1"	"1369811-1"	"CARDIAC DISORDER"	"10061024"	"50-59 years"	"50-59"	"Patient went swimming at a fitness center the day after he had his 2nd COVID-19 vaccine and was found unresponsive at the bottom of the shallow 4.5 deep pool while exercising.  He was not able to be revived.  The death certificate says that the immediate cause of death was Arrhythmia resulting from Hypertensive Atherosclerotic Cardiovascular Disease."
	"1369811-1"	"1369811-1"	"CONDITION AGGRAVATED"	"10010264"	"50-59 years"	"50-59"	"Patient went swimming at a fitness center the day after he had his 2nd COVID-19 vaccine and was found unresponsive at the bottom of the shallow 4.5 deep pool while exercising.  He was not able to be revived.  The death certificate says that the immediate cause of death was Arrhythmia resulting from Hypertensive Atherosclerotic Cardiovascular Disease."
	"1369811-1"	"1369811-1"	"HYPERTENSIVE HEART DISEASE"	"10020823"	"50-59 years"	"50-59"	"Patient went swimming at a fitness center the day after he had his 2nd COVID-19 vaccine and was found unresponsive at the bottom of the shallow 4.5 deep pool while exercising.  He was not able to be revived.  The death certificate says that the immediate cause of death was Arrhythmia resulting from Hypertensive Atherosclerotic Cardiovascular Disease."
	"1369811-1"	"1369811-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"50-59 years"	"50-59"	"Patient went swimming at a fitness center the day after he had his 2nd COVID-19 vaccine and was found unresponsive at the bottom of the shallow 4.5 deep pool while exercising.  He was not able to be revived.  The death certificate says that the immediate cause of death was Arrhythmia resulting from Hypertensive Atherosclerotic Cardiovascular Disease."
	"1371354-1"	"1371354-1"	"CHILLS"	"10008531"	"50-59 years"	"50-59"	"Patient developed  dizziness, chills, fever, body ache, sore throat, difficulty breathing, and stopped eating beginning April 26,    The adverse effect is the belief that a breakthrough case of Covid-19 will be less severe if you had the shots.  A false sense of security."
	"1371354-1"	"1371354-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient developed  dizziness, chills, fever, body ache, sore throat, difficulty breathing, and stopped eating beginning April 26,    The adverse effect is the belief that a breakthrough case of Covid-19 will be less severe if you had the shots.  A false sense of security."
	"1371354-1"	"1371354-1"	"DECREASED APPETITE"	"10061428"	"50-59 years"	"50-59"	"Patient developed  dizziness, chills, fever, body ache, sore throat, difficulty breathing, and stopped eating beginning April 26,    The adverse effect is the belief that a breakthrough case of Covid-19 will be less severe if you had the shots.  A false sense of security."
	"1371354-1"	"1371354-1"	"DIZZINESS"	"10013573"	"50-59 years"	"50-59"	"Patient developed  dizziness, chills, fever, body ache, sore throat, difficulty breathing, and stopped eating beginning April 26,    The adverse effect is the belief that a breakthrough case of Covid-19 will be less severe if you had the shots.  A false sense of security."
	"1371354-1"	"1371354-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"Patient developed  dizziness, chills, fever, body ache, sore throat, difficulty breathing, and stopped eating beginning April 26,    The adverse effect is the belief that a breakthrough case of Covid-19 will be less severe if you had the shots.  A false sense of security."
	"1371354-1"	"1371354-1"	"OROPHARYNGEAL PAIN"	"10068319"	"50-59 years"	"50-59"	"Patient developed  dizziness, chills, fever, body ache, sore throat, difficulty breathing, and stopped eating beginning April 26,    The adverse effect is the belief that a breakthrough case of Covid-19 will be less severe if you had the shots.  A false sense of security."
	"1371354-1"	"1371354-1"	"PAIN"	"10033371"	"50-59 years"	"50-59"	"Patient developed  dizziness, chills, fever, body ache, sore throat, difficulty breathing, and stopped eating beginning April 26,    The adverse effect is the belief that a breakthrough case of Covid-19 will be less severe if you had the shots.  A false sense of security."
	"1371354-1"	"1371354-1"	"PYREXIA"	"10037660"	"50-59 years"	"50-59"	"Patient developed  dizziness, chills, fever, body ache, sore throat, difficulty breathing, and stopped eating beginning April 26,    The adverse effect is the belief that a breakthrough case of Covid-19 will be less severe if you had the shots.  A false sense of security."
	"1371420-1"	"1371420-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"patient expired 3 days after first vaccination.  Did not present to our facility for care after vaccination; did not have any adverse reactions during vaccination waiting period.  Per the Medical examiner, patient passed away at his residence, and his death was not related to the COVID vaccine."
	"1371537-1"	"1371537-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Received shot Tuesday afternoon  Died Friday Mourning"
	"1371720-1"	"1371720-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"Death, cardiac arrest.  Patient was found deceased in home, no hospitalization, no autopsy"
	"1371720-1"	"1371720-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Death, cardiac arrest.  Patient was found deceased in home, no hospitalization, no autopsy"
	"1371905-1"	"1371905-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Adverse Event was Death within 48 hours of vaccine."
	"1374138-1"	"1374138-1"	"ACUTE MYOCARDIAL INFARCTION"	"10000891"	"50-59 years"	"50-59"	"death - Non-ST elevation (NSTEMI) myocardial infarction"
	"1374138-1"	"1374138-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"death - Non-ST elevation (NSTEMI) myocardial infarction"
	"1375926-1"	"1375926-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patients wife stated he was found  dead on floor the morning of 6/1/21 and exact time of death was unknown.  It sounded like cause was unknown."
	"1377674-1"	"1377674-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"Sudden Cardiac Arrest . Resuscitated and transferred to the hospital. Never regained consciousness and died on 5/11/21."
	"1377674-1"	"1377674-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Sudden Cardiac Arrest . Resuscitated and transferred to the hospital. Never regained consciousness and died on 5/11/21."
	"1377674-1"	"1377674-1"	"LOSS OF CONSCIOUSNESS"	"10024855"	"50-59 years"	"50-59"	"Sudden Cardiac Arrest . Resuscitated and transferred to the hospital. Never regained consciousness and died on 5/11/21."
	"1377674-1"	"1377674-1"	"RESUSCITATION"	"10038749"	"50-59 years"	"50-59"	"Sudden Cardiac Arrest . Resuscitated and transferred to the hospital. Never regained consciousness and died on 5/11/21."
	"1378531-1"	"1378531-1"	"ATRIAL FIBRILLATION"	"10003658"	"50-59 years"	"50-59"	"Ventricular tachycardia with a pulse.  Cardioversion x 3, Amiodarone 300mg IVP, Lidocaine 100mg IVP, Amiodarone drip & Levophed drip started."
	"1378531-1"	"1378531-1"	"CARDIOVERSION"	"10007661"	"50-59 years"	"50-59"	"Ventricular tachycardia with a pulse.  Cardioversion x 3, Amiodarone 300mg IVP, Lidocaine 100mg IVP, Amiodarone drip & Levophed drip started."
	"1378531-1"	"1378531-1"	"HYPOTENSION"	"10021097"	"50-59 years"	"50-59"	"Ventricular tachycardia with a pulse.  Cardioversion x 3, Amiodarone 300mg IVP, Lidocaine 100mg IVP, Amiodarone drip & Levophed drip started."
	"1378531-1"	"1378531-1"	"VENTRICULAR TACHYCARDIA"	"10047302"	"50-59 years"	"50-59"	"Ventricular tachycardia with a pulse.  Cardioversion x 3, Amiodarone 300mg IVP, Lidocaine 100mg IVP, Amiodarone drip & Levophed drip started."
	"1381998-1"	"1381998-1"	"BLOOD OSMOLARITY DECREASED"	"10005696"	"50-59 years"	"50-59"	"death J18.9 - Pneumonia, unspecified organism E87.1 - Hypo-osmolality and hyponatremia"
	"1381998-1"	"1381998-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"death J18.9 - Pneumonia, unspecified organism E87.1 - Hypo-osmolality and hyponatremia"
	"1381998-1"	"1381998-1"	"HYPONATRAEMIA"	"10021036"	"50-59 years"	"50-59"	"death J18.9 - Pneumonia, unspecified organism E87.1 - Hypo-osmolality and hyponatremia"
	"1381998-1"	"1381998-1"	"PNEUMONIA"	"10035664"	"50-59 years"	"50-59"	"death J18.9 - Pneumonia, unspecified organism E87.1 - Hypo-osmolality and hyponatremia"
	"1382262-1"	"1382262-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Patient received first dose of Moderna on 4/15/2021.  Patient tested positive on 4/19/2021 for Covid.  Patient admitted to hospital on 4/25/2021.  Patient expired 5/14/2021"
	"1382262-1"	"1382262-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient received first dose of Moderna on 4/15/2021.  Patient tested positive on 4/19/2021 for Covid.  Patient admitted to hospital on 4/25/2021.  Patient expired 5/14/2021"
	"1382262-1"	"1382262-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"Patient received first dose of Moderna on 4/15/2021.  Patient tested positive on 4/19/2021 for Covid.  Patient admitted to hospital on 4/25/2021.  Patient expired 5/14/2021"
	"1385311-1"	"1385311-1"	"COVID-19 PNEUMONIA"	"10084380"	"50-59 years"	"50-59"	"Initially sore arm; severe headache. positive COVID test on 1/21/2021 - doctors assume he was positive at time of vaccination but we didn't know it yet; severe covid pneumonia; supraventricular tachycardia; diabetes; iron deficiency anemia"
	"1385311-1"	"1385311-1"	"DIABETES MELLITUS"	"10012601"	"50-59 years"	"50-59"	"Initially sore arm; severe headache. positive COVID test on 1/21/2021 - doctors assume he was positive at time of vaccination but we didn't know it yet; severe covid pneumonia; supraventricular tachycardia; diabetes; iron deficiency anemia"
	"1385311-1"	"1385311-1"	"HEADACHE"	"10019211"	"50-59 years"	"50-59"	"Initially sore arm; severe headache. positive COVID test on 1/21/2021 - doctors assume he was positive at time of vaccination but we didn't know it yet; severe covid pneumonia; supraventricular tachycardia; diabetes; iron deficiency anemia"
	"1385311-1"	"1385311-1"	"IRON DEFICIENCY ANAEMIA"	"10022972"	"50-59 years"	"50-59"	"Initially sore arm; severe headache. positive COVID test on 1/21/2021 - doctors assume he was positive at time of vaccination but we didn't know it yet; severe covid pneumonia; supraventricular tachycardia; diabetes; iron deficiency anemia"
	"1385311-1"	"1385311-1"	"PAIN IN EXTREMITY"	"10033425"	"50-59 years"	"50-59"	"Initially sore arm; severe headache. positive COVID test on 1/21/2021 - doctors assume he was positive at time of vaccination but we didn't know it yet; severe covid pneumonia; supraventricular tachycardia; diabetes; iron deficiency anemia"
	"1385311-1"	"1385311-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"Initially sore arm; severe headache. positive COVID test on 1/21/2021 - doctors assume he was positive at time of vaccination but we didn't know it yet; severe covid pneumonia; supraventricular tachycardia; diabetes; iron deficiency anemia"
	"1385311-1"	"1385311-1"	"SUPRAVENTRICULAR TACHYCARDIA"	"10042604"	"50-59 years"	"50-59"	"Initially sore arm; severe headache. positive COVID test on 1/21/2021 - doctors assume he was positive at time of vaccination but we didn't know it yet; severe covid pneumonia; supraventricular tachycardia; diabetes; iron deficiency anemia"
	"1386585-1"	"1386585-1"	"ACUTE MYOCARDIAL INFARCTION"	"10000891"	"50-59 years"	"50-59"	"06/08/2021-Received  vaccine at Urgent Clinic. Pt found down at home. Brought to Hospital ED, with cardiac arrest (STEMI), where she later died."
	"1386585-1"	"1386585-1"	"ALANINE AMINOTRANSFERASE INCREASED"	"10001551"	"50-59 years"	"50-59"	"06/08/2021-Received  vaccine at Urgent Clinic. Pt found down at home. Brought to Hospital ED, with cardiac arrest (STEMI), where she later died."
	"1386585-1"	"1386585-1"	"ASPARTATE AMINOTRANSFERASE INCREASED"	"10003481"	"50-59 years"	"50-59"	"06/08/2021-Received  vaccine at Urgent Clinic. Pt found down at home. Brought to Hospital ED, with cardiac arrest (STEMI), where she later died."
	"1386585-1"	"1386585-1"	"BLOOD ALBUMIN DECREASED"	"10005287"	"50-59 years"	"50-59"	"06/08/2021-Received  vaccine at Urgent Clinic. Pt found down at home. Brought to Hospital ED, with cardiac arrest (STEMI), where she later died."
	"1386585-1"	"1386585-1"	"BLOOD ALKALINE PHOSPHATASE INCREASED"	"10059570"	"50-59 years"	"50-59"	"06/08/2021-Received  vaccine at Urgent Clinic. Pt found down at home. Brought to Hospital ED, with cardiac arrest (STEMI), where she later died."
	"1386585-1"	"1386585-1"	"BLOOD CHLORIDE NORMAL"	"10005421"	"50-59 years"	"50-59"	"06/08/2021-Received  vaccine at Urgent Clinic. Pt found down at home. Brought to Hospital ED, with cardiac arrest (STEMI), where she later died."
	"1386585-1"	"1386585-1"	"BLOOD CREATINE INCREASED"	"10005464"	"50-59 years"	"50-59"	"06/08/2021-Received  vaccine at Urgent Clinic. Pt found down at home. Brought to Hospital ED, with cardiac arrest (STEMI), where she later died."
	"1386585-1"	"1386585-1"	"BLOOD GLUCOSE INCREASED"	"10005557"	"50-59 years"	"50-59"	"06/08/2021-Received  vaccine at Urgent Clinic. Pt found down at home. Brought to Hospital ED, with cardiac arrest (STEMI), where she later died."
	"1386585-1"	"1386585-1"	"BLOOD POTASSIUM DECREASED"	"10005724"	"50-59 years"	"50-59"	"06/08/2021-Received  vaccine at Urgent Clinic. Pt found down at home. Brought to Hospital ED, with cardiac arrest (STEMI), where she later died."
	"1386585-1"	"1386585-1"	"CARBON DIOXIDE DECREASED"	"10007223"	"50-59 years"	"50-59"	"06/08/2021-Received  vaccine at Urgent Clinic. Pt found down at home. Brought to Hospital ED, with cardiac arrest (STEMI), where she later died."
	"1386585-1"	"1386585-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"06/08/2021-Received  vaccine at Urgent Clinic. Pt found down at home. Brought to Hospital ED, with cardiac arrest (STEMI), where she later died."
	"1386585-1"	"1386585-1"	"CHEST X-RAY ABNORMAL"	"10008499"	"50-59 years"	"50-59"	"06/08/2021-Received  vaccine at Urgent Clinic. Pt found down at home. Brought to Hospital ED, with cardiac arrest (STEMI), where she later died."
	"1386585-1"	"1386585-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"06/08/2021-Received  vaccine at Urgent Clinic. Pt found down at home. Brought to Hospital ED, with cardiac arrest (STEMI), where she later died."
	"1386585-1"	"1386585-1"	"EOSINOPHIL PERCENTAGE DECREASED"	"10052221"	"50-59 years"	"50-59"	"06/08/2021-Received  vaccine at Urgent Clinic. Pt found down at home. Brought to Hospital ED, with cardiac arrest (STEMI), where she later died."
	"1386585-1"	"1386585-1"	"GLYCOSYLATED HAEMOGLOBIN INCREASED"	"10018484"	"50-59 years"	"50-59"	"06/08/2021-Received  vaccine at Urgent Clinic. Pt found down at home. Brought to Hospital ED, with cardiac arrest (STEMI), where she later died."
	"1386585-1"	"1386585-1"	"HAEMATOCRIT NORMAL"	"10018842"	"50-59 years"	"50-59"	"06/08/2021-Received  vaccine at Urgent Clinic. Pt found down at home. Brought to Hospital ED, with cardiac arrest (STEMI), where she later died."
	"1386585-1"	"1386585-1"	"HAEMOGLOBIN NORMAL"	"10018890"	"50-59 years"	"50-59"	"06/08/2021-Received  vaccine at Urgent Clinic. Pt found down at home. Brought to Hospital ED, with cardiac arrest (STEMI), where she later died."
	"1386585-1"	"1386585-1"	"HIGH DENSITY LIPOPROTEIN DECREASED"	"10020060"	"50-59 years"	"50-59"	"06/08/2021-Received  vaccine at Urgent Clinic. Pt found down at home. Brought to Hospital ED, with cardiac arrest (STEMI), where she later died."
	"1386585-1"	"1386585-1"	"LUNG OPACITY"	"10081792"	"50-59 years"	"50-59"	"06/08/2021-Received  vaccine at Urgent Clinic. Pt found down at home. Brought to Hospital ED, with cardiac arrest (STEMI), where she later died."
	"1386585-1"	"1386585-1"	"LYMPHOCYTE PERCENTAGE DECREASED"	"10052231"	"50-59 years"	"50-59"	"06/08/2021-Received  vaccine at Urgent Clinic. Pt found down at home. Brought to Hospital ED, with cardiac arrest (STEMI), where she later died."
	"1386585-1"	"1386585-1"	"MONOCYTE PERCENTAGE INCREASED"	"10052230"	"50-59 years"	"50-59"	"06/08/2021-Received  vaccine at Urgent Clinic. Pt found down at home. Brought to Hospital ED, with cardiac arrest (STEMI), where she later died."
	"1386585-1"	"1386585-1"	"NEUTROPHIL PERCENTAGE INCREASED"	"10052224"	"50-59 years"	"50-59"	"06/08/2021-Received  vaccine at Urgent Clinic. Pt found down at home. Brought to Hospital ED, with cardiac arrest (STEMI), where she later died."
	"1386585-1"	"1386585-1"	"PLATELET COUNT DECREASED"	"10035528"	"50-59 years"	"50-59"	"06/08/2021-Received  vaccine at Urgent Clinic. Pt found down at home. Brought to Hospital ED, with cardiac arrest (STEMI), where she later died."
	"1386585-1"	"1386585-1"	"TROPONIN I INCREASED"	"10058268"	"50-59 years"	"50-59"	"06/08/2021-Received  vaccine at Urgent Clinic. Pt found down at home. Brought to Hospital ED, with cardiac arrest (STEMI), where she later died."
	"1386585-1"	"1386585-1"	"WHITE BLOOD CELL COUNT INCREASED"	"10047943"	"50-59 years"	"50-59"	"06/08/2021-Received  vaccine at Urgent Clinic. Pt found down at home. Brought to Hospital ED, with cardiac arrest (STEMI), where she later died."
	"1391500-1"	"1391500-1"	"CARDIAC FAILURE CONGESTIVE"	"10007559"	"50-59 years"	"50-59"	"Patient had his 2nd Moderna vaccine at pharmacy at 2:00 and was struggling to breathe a few hours later. We were at the emergency room around 6:00pm and he was placed on a ventilator between midnight and 1:00am. He died 10 days later after experiencing clots that led to seizures and congestive heart failure. I have a death certificate if needed."
	"1391500-1"	"1391500-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient had his 2nd Moderna vaccine at pharmacy at 2:00 and was struggling to breathe a few hours later. We were at the emergency room around 6:00pm and he was placed on a ventilator between midnight and 1:00am. He died 10 days later after experiencing clots that led to seizures and congestive heart failure. I have a death certificate if needed."
	"1391500-1"	"1391500-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"Patient had his 2nd Moderna vaccine at pharmacy at 2:00 and was struggling to breathe a few hours later. We were at the emergency room around 6:00pm and he was placed on a ventilator between midnight and 1:00am. He died 10 days later after experiencing clots that led to seizures and congestive heart failure. I have a death certificate if needed."
	"1391500-1"	"1391500-1"	"LABORATORY TEST"	"10059938"	"50-59 years"	"50-59"	"Patient had his 2nd Moderna vaccine at pharmacy at 2:00 and was struggling to breathe a few hours later. We were at the emergency room around 6:00pm and he was placed on a ventilator between midnight and 1:00am. He died 10 days later after experiencing clots that led to seizures and congestive heart failure. I have a death certificate if needed."
	"1391500-1"	"1391500-1"	"MECHANICAL VENTILATION"	"10067221"	"50-59 years"	"50-59"	"Patient had his 2nd Moderna vaccine at pharmacy at 2:00 and was struggling to breathe a few hours later. We were at the emergency room around 6:00pm and he was placed on a ventilator between midnight and 1:00am. He died 10 days later after experiencing clots that led to seizures and congestive heart failure. I have a death certificate if needed."
	"1391500-1"	"1391500-1"	"SARS-COV-2 ANTIBODY TEST NEGATIVE"	"10084509"	"50-59 years"	"50-59"	"Patient had his 2nd Moderna vaccine at pharmacy at 2:00 and was struggling to breathe a few hours later. We were at the emergency room around 6:00pm and he was placed on a ventilator between midnight and 1:00am. He died 10 days later after experiencing clots that led to seizures and congestive heart failure. I have a death certificate if needed."
	"1391500-1"	"1391500-1"	"SARS-COV-2 TEST NEGATIVE"	"10084273"	"50-59 years"	"50-59"	"Patient had his 2nd Moderna vaccine at pharmacy at 2:00 and was struggling to breathe a few hours later. We were at the emergency room around 6:00pm and he was placed on a ventilator between midnight and 1:00am. He died 10 days later after experiencing clots that led to seizures and congestive heart failure. I have a death certificate if needed."
	"1391500-1"	"1391500-1"	"SEIZURE"	"10039906"	"50-59 years"	"50-59"	"Patient had his 2nd Moderna vaccine at pharmacy at 2:00 and was struggling to breathe a few hours later. We were at the emergency room around 6:00pm and he was placed on a ventilator between midnight and 1:00am. He died 10 days later after experiencing clots that led to seizures and congestive heart failure. I have a death certificate if needed."
	"1391500-1"	"1391500-1"	"THROMBOSIS"	"10043607"	"50-59 years"	"50-59"	"Patient had his 2nd Moderna vaccine at pharmacy at 2:00 and was struggling to breathe a few hours later. We were at the emergency room around 6:00pm and he was placed on a ventilator between midnight and 1:00am. He died 10 days later after experiencing clots that led to seizures and congestive heart failure. I have a death certificate if needed."
	"1391711-1"	"1391711-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Death Certificate 4/22/2021  Cause of Death - Hypertensive Cardiovascular Disease"
	"1391711-1"	"1391711-1"	"HYPERTENSIVE HEART DISEASE"	"10020823"	"50-59 years"	"50-59"	"Death Certificate 4/22/2021  Cause of Death - Hypertensive Cardiovascular Disease"
	"1391995-1"	"1391995-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Died of unknown cause 2 weeks after receiving vaccine."
	"1394137-1"	"1394137-1"	"ACUTE RESPIRATORY DISTRESS SYNDROME"	"10001052"	"50-59 years"	"50-59"	"Her husband passed away; Sepsis; Shock due to bilateral pulmonary acute disease syndrome; Shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage; misery and feeling horrible; Severe chills; Headache; Shortness of breath; Fever; Fatigue; Diarrhea; Muscle aches; Skin sensitivity and rash; Skin sensitivity and rash; Sore throat; This is a spontaneous report from a contactable consumer. A 57-year-old male patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in arm on 22Feb2021 at 10:00 (Lot Number: EN6202) (at the age of 57-year-old) as single dose for COVID-19 immunisation.  Medical history included high cholesterol from 2017 to an unknown date, seasonal allergy from an unknown date and unknown if ongoing and arteriosclerosis from 2017 to an unknown date. The patient's concomitant medications were not reported.  The patient previously received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 01Feb2021 (Lot Number: EL9264) (at the age of 57-year-old) as single dose for COVID-19 immunisation; the patient previously received ZYRTEC (10mg almost daily) for seasonal allergy, ibuprofen (ADVIL, 200 mg) and TYLENOL both for pain. Caller stated that the patient passed away on 02Mar2021 which was 8 days after the 2nd dose of the Pfizer COVID Vaccine. On 26Feb2021 the patient went to urgent care and then on 01Mar2021 he went to the hospital emergency room (ER).  It was reported that an autopsy was performed on 06Mar2021 and the cause of death listed sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.  The manner of death was natural and the lung presentation is highly suggestive of diffuse alveolar damage due to COVID-19 although the patient had several negative tests for COVID. The patient tested negative for influenza AB, negative for valley fever, negative for Legionnaire's disease and was in the hospital for less than 24 hours. The patient went back to urgent care on 28Feb2021 and was feeling miserable and asking for blood tests and urine tests, stated at that time his platelets were low at 122, glucose was high at 105, sodium was low at 134, calcium was low at 8.3, urine was negative and the patient did not get these labs til Monday when he was on the way to the emergency room and it was all different when he got to the hospital. The test for strep was negative, the oxygen was low at 86 percent when he got to the hospital on Monday and they just had to keep increasing his oxygen, stated a culture, no further details provided about the culture. A CTA done on the chest on Monday which was bad and stated the patient was symptomatic and they did not treat him for COVID but had a clinical suspicion for COVID. Adenovirus was not detected, metapneumonia virus was not detected, respiratory syncytial virus was not detected, parainfluenza was not detected, his platelets kept dropping and he had two tests for valley fever which is Cocci IGG and IGM and those were negative, the sodium level on 02Mar2021 was 126, all of these things were low: chloride 92, CO2 18, calcium 7.8, glucose was high at 222, bun was high at 21, creatinine was high at 1.4, EGFR was low at 52, WBC was high at 18.6, RBC was high at 7.39, HGB was 22.6, HCT was 66.4, RDW was high at 15, RDWFD was 45.5, and platelets were low at 61. The patient came into the emergency room those labs were when he was failing completely and on 01Mar2021 was when he arrived in the ER; at that time his WBC were normal, RBC was high at 6.16, HGB was high at 18.5, HCT was high at 54.9, platelets were low at 73, monocytes absolute were high at 0.96, sodium was low at 129, chloride was low at 95, calcium was low at 8.3, glucose was high at 150 and this was 7 days past the Pfizer COVID Vaccine. The patient was negative for strep pneumonia antigen and negative for Legionnaires Urinary antigen. The chest X-ray was done on 26Feb2021 and the patient was in misery and feeling horrible and they sent him home with albuterol and possible antibiotic to start that Monday and he had severe chills, headache, shortness of breath, fever, fatigue, diarrhea, muscle aches, skin sensitivity and rash, sore throat. Chest X-ray says normal; states the albuterol was PROAIR HFA 90mcg and he tested negative for influenza AB and he never got to the antibiotic because they said to wait til Monday and by that time this was an emergency. The patient outcome of sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage was fatal and unknown for the other events. The patient died on 02Mar2021.  An autopsy was performed that revealed the cause of death was sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.; Reported Cause(s) of Death: Sepsis; Autopsy-determined Cause(s) of Death: Shock due to bilateral pulmonary acute disease syndrome; Diffuse alveolar damage"
	"1394137-1"	"1394137-1"	"ADENOVIRUS TEST"	"10050991"	"50-59 years"	"50-59"	"Her husband passed away; Sepsis; Shock due to bilateral pulmonary acute disease syndrome; Shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage; misery and feeling horrible; Severe chills; Headache; Shortness of breath; Fever; Fatigue; Diarrhea; Muscle aches; Skin sensitivity and rash; Skin sensitivity and rash; Sore throat; This is a spontaneous report from a contactable consumer. A 57-year-old male patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in arm on 22Feb2021 at 10:00 (Lot Number: EN6202) (at the age of 57-year-old) as single dose for COVID-19 immunisation.  Medical history included high cholesterol from 2017 to an unknown date, seasonal allergy from an unknown date and unknown if ongoing and arteriosclerosis from 2017 to an unknown date. The patient's concomitant medications were not reported.  The patient previously received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 01Feb2021 (Lot Number: EL9264) (at the age of 57-year-old) as single dose for COVID-19 immunisation; the patient previously received ZYRTEC (10mg almost daily) for seasonal allergy, ibuprofen (ADVIL, 200 mg) and TYLENOL both for pain. Caller stated that the patient passed away on 02Mar2021 which was 8 days after the 2nd dose of the Pfizer COVID Vaccine. On 26Feb2021 the patient went to urgent care and then on 01Mar2021 he went to the hospital emergency room (ER).  It was reported that an autopsy was performed on 06Mar2021 and the cause of death listed sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.  The manner of death was natural and the lung presentation is highly suggestive of diffuse alveolar damage due to COVID-19 although the patient had several negative tests for COVID. The patient tested negative for influenza AB, negative for valley fever, negative for Legionnaire's disease and was in the hospital for less than 24 hours. The patient went back to urgent care on 28Feb2021 and was feeling miserable and asking for blood tests and urine tests, stated at that time his platelets were low at 122, glucose was high at 105, sodium was low at 134, calcium was low at 8.3, urine was negative and the patient did not get these labs til Monday when he was on the way to the emergency room and it was all different when he got to the hospital. The test for strep was negative, the oxygen was low at 86 percent when he got to the hospital on Monday and they just had to keep increasing his oxygen, stated a culture, no further details provided about the culture. A CTA done on the chest on Monday which was bad and stated the patient was symptomatic and they did not treat him for COVID but had a clinical suspicion for COVID. Adenovirus was not detected, metapneumonia virus was not detected, respiratory syncytial virus was not detected, parainfluenza was not detected, his platelets kept dropping and he had two tests for valley fever which is Cocci IGG and IGM and those were negative, the sodium level on 02Mar2021 was 126, all of these things were low: chloride 92, CO2 18, calcium 7.8, glucose was high at 222, bun was high at 21, creatinine was high at 1.4, EGFR was low at 52, WBC was high at 18.6, RBC was high at 7.39, HGB was 22.6, HCT was 66.4, RDW was high at 15, RDWFD was 45.5, and platelets were low at 61. The patient came into the emergency room those labs were when he was failing completely and on 01Mar2021 was when he arrived in the ER; at that time his WBC were normal, RBC was high at 6.16, HGB was high at 18.5, HCT was high at 54.9, platelets were low at 73, monocytes absolute were high at 0.96, sodium was low at 129, chloride was low at 95, calcium was low at 8.3, glucose was high at 150 and this was 7 days past the Pfizer COVID Vaccine. The patient was negative for strep pneumonia antigen and negative for Legionnaires Urinary antigen. The chest X-ray was done on 26Feb2021 and the patient was in misery and feeling horrible and they sent him home with albuterol and possible antibiotic to start that Monday and he had severe chills, headache, shortness of breath, fever, fatigue, diarrhea, muscle aches, skin sensitivity and rash, sore throat. Chest X-ray says normal; states the albuterol was PROAIR HFA 90mcg and he tested negative for influenza AB and he never got to the antibiotic because they said to wait til Monday and by that time this was an emergency. The patient outcome of sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage was fatal and unknown for the other events. The patient died on 02Mar2021.  An autopsy was performed that revealed the cause of death was sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.; Reported Cause(s) of Death: Sepsis; Autopsy-determined Cause(s) of Death: Shock due to bilateral pulmonary acute disease syndrome; Diffuse alveolar damage"
	"1394137-1"	"1394137-1"	"BLOOD CALCIUM"	"10005392"	"50-59 years"	"50-59"	"Her husband passed away; Sepsis; Shock due to bilateral pulmonary acute disease syndrome; Shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage; misery and feeling horrible; Severe chills; Headache; Shortness of breath; Fever; Fatigue; Diarrhea; Muscle aches; Skin sensitivity and rash; Skin sensitivity and rash; Sore throat; This is a spontaneous report from a contactable consumer. A 57-year-old male patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in arm on 22Feb2021 at 10:00 (Lot Number: EN6202) (at the age of 57-year-old) as single dose for COVID-19 immunisation.  Medical history included high cholesterol from 2017 to an unknown date, seasonal allergy from an unknown date and unknown if ongoing and arteriosclerosis from 2017 to an unknown date. The patient's concomitant medications were not reported.  The patient previously received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 01Feb2021 (Lot Number: EL9264) (at the age of 57-year-old) as single dose for COVID-19 immunisation; the patient previously received ZYRTEC (10mg almost daily) for seasonal allergy, ibuprofen (ADVIL, 200 mg) and TYLENOL both for pain. Caller stated that the patient passed away on 02Mar2021 which was 8 days after the 2nd dose of the Pfizer COVID Vaccine. On 26Feb2021 the patient went to urgent care and then on 01Mar2021 he went to the hospital emergency room (ER).  It was reported that an autopsy was performed on 06Mar2021 and the cause of death listed sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.  The manner of death was natural and the lung presentation is highly suggestive of diffuse alveolar damage due to COVID-19 although the patient had several negative tests for COVID. The patient tested negative for influenza AB, negative for valley fever, negative for Legionnaire's disease and was in the hospital for less than 24 hours. The patient went back to urgent care on 28Feb2021 and was feeling miserable and asking for blood tests and urine tests, stated at that time his platelets were low at 122, glucose was high at 105, sodium was low at 134, calcium was low at 8.3, urine was negative and the patient did not get these labs til Monday when he was on the way to the emergency room and it was all different when he got to the hospital. The test for strep was negative, the oxygen was low at 86 percent when he got to the hospital on Monday and they just had to keep increasing his oxygen, stated a culture, no further details provided about the culture. A CTA done on the chest on Monday which was bad and stated the patient was symptomatic and they did not treat him for COVID but had a clinical suspicion for COVID. Adenovirus was not detected, metapneumonia virus was not detected, respiratory syncytial virus was not detected, parainfluenza was not detected, his platelets kept dropping and he had two tests for valley fever which is Cocci IGG and IGM and those were negative, the sodium level on 02Mar2021 was 126, all of these things were low: chloride 92, CO2 18, calcium 7.8, glucose was high at 222, bun was high at 21, creatinine was high at 1.4, EGFR was low at 52, WBC was high at 18.6, RBC was high at 7.39, HGB was 22.6, HCT was 66.4, RDW was high at 15, RDWFD was 45.5, and platelets were low at 61. The patient came into the emergency room those labs were when he was failing completely and on 01Mar2021 was when he arrived in the ER; at that time his WBC were normal, RBC was high at 6.16, HGB was high at 18.5, HCT was high at 54.9, platelets were low at 73, monocytes absolute were high at 0.96, sodium was low at 129, chloride was low at 95, calcium was low at 8.3, glucose was high at 150 and this was 7 days past the Pfizer COVID Vaccine. The patient was negative for strep pneumonia antigen and negative for Legionnaires Urinary antigen. The chest X-ray was done on 26Feb2021 and the patient was in misery and feeling horrible and they sent him home with albuterol and possible antibiotic to start that Monday and he had severe chills, headache, shortness of breath, fever, fatigue, diarrhea, muscle aches, skin sensitivity and rash, sore throat. Chest X-ray says normal; states the albuterol was PROAIR HFA 90mcg and he tested negative for influenza AB and he never got to the antibiotic because they said to wait til Monday and by that time this was an emergency. The patient outcome of sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage was fatal and unknown for the other events. The patient died on 02Mar2021.  An autopsy was performed that revealed the cause of death was sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.; Reported Cause(s) of Death: Sepsis; Autopsy-determined Cause(s) of Death: Shock due to bilateral pulmonary acute disease syndrome; Diffuse alveolar damage"
	"1394137-1"	"1394137-1"	"BLOOD CHLORIDE"	"10005416"	"50-59 years"	"50-59"	"Her husband passed away; Sepsis; Shock due to bilateral pulmonary acute disease syndrome; Shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage; misery and feeling horrible; Severe chills; Headache; Shortness of breath; Fever; Fatigue; Diarrhea; Muscle aches; Skin sensitivity and rash; Skin sensitivity and rash; Sore throat; This is a spontaneous report from a contactable consumer. A 57-year-old male patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in arm on 22Feb2021 at 10:00 (Lot Number: EN6202) (at the age of 57-year-old) as single dose for COVID-19 immunisation.  Medical history included high cholesterol from 2017 to an unknown date, seasonal allergy from an unknown date and unknown if ongoing and arteriosclerosis from 2017 to an unknown date. The patient's concomitant medications were not reported.  The patient previously received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 01Feb2021 (Lot Number: EL9264) (at the age of 57-year-old) as single dose for COVID-19 immunisation; the patient previously received ZYRTEC (10mg almost daily) for seasonal allergy, ibuprofen (ADVIL, 200 mg) and TYLENOL both for pain. Caller stated that the patient passed away on 02Mar2021 which was 8 days after the 2nd dose of the Pfizer COVID Vaccine. On 26Feb2021 the patient went to urgent care and then on 01Mar2021 he went to the hospital emergency room (ER).  It was reported that an autopsy was performed on 06Mar2021 and the cause of death listed sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.  The manner of death was natural and the lung presentation is highly suggestive of diffuse alveolar damage due to COVID-19 although the patient had several negative tests for COVID. The patient tested negative for influenza AB, negative for valley fever, negative for Legionnaire's disease and was in the hospital for less than 24 hours. The patient went back to urgent care on 28Feb2021 and was feeling miserable and asking for blood tests and urine tests, stated at that time his platelets were low at 122, glucose was high at 105, sodium was low at 134, calcium was low at 8.3, urine was negative and the patient did not get these labs til Monday when he was on the way to the emergency room and it was all different when he got to the hospital. The test for strep was negative, the oxygen was low at 86 percent when he got to the hospital on Monday and they just had to keep increasing his oxygen, stated a culture, no further details provided about the culture. A CTA done on the chest on Monday which was bad and stated the patient was symptomatic and they did not treat him for COVID but had a clinical suspicion for COVID. Adenovirus was not detected, metapneumonia virus was not detected, respiratory syncytial virus was not detected, parainfluenza was not detected, his platelets kept dropping and he had two tests for valley fever which is Cocci IGG and IGM and those were negative, the sodium level on 02Mar2021 was 126, all of these things were low: chloride 92, CO2 18, calcium 7.8, glucose was high at 222, bun was high at 21, creatinine was high at 1.4, EGFR was low at 52, WBC was high at 18.6, RBC was high at 7.39, HGB was 22.6, HCT was 66.4, RDW was high at 15, RDWFD was 45.5, and platelets were low at 61. The patient came into the emergency room those labs were when he was failing completely and on 01Mar2021 was when he arrived in the ER; at that time his WBC were normal, RBC was high at 6.16, HGB was high at 18.5, HCT was high at 54.9, platelets were low at 73, monocytes absolute were high at 0.96, sodium was low at 129, chloride was low at 95, calcium was low at 8.3, glucose was high at 150 and this was 7 days past the Pfizer COVID Vaccine. The patient was negative for strep pneumonia antigen and negative for Legionnaires Urinary antigen. The chest X-ray was done on 26Feb2021 and the patient was in misery and feeling horrible and they sent him home with albuterol and possible antibiotic to start that Monday and he had severe chills, headache, shortness of breath, fever, fatigue, diarrhea, muscle aches, skin sensitivity and rash, sore throat. Chest X-ray says normal; states the albuterol was PROAIR HFA 90mcg and he tested negative for influenza AB and he never got to the antibiotic because they said to wait til Monday and by that time this was an emergency. The patient outcome of sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage was fatal and unknown for the other events. The patient died on 02Mar2021.  An autopsy was performed that revealed the cause of death was sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.; Reported Cause(s) of Death: Sepsis; Autopsy-determined Cause(s) of Death: Shock due to bilateral pulmonary acute disease syndrome; Diffuse alveolar damage"
	"1394137-1"	"1394137-1"	"BLOOD CREATININE"	"10005480"	"50-59 years"	"50-59"	"Her husband passed away; Sepsis; Shock due to bilateral pulmonary acute disease syndrome; Shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage; misery and feeling horrible; Severe chills; Headache; Shortness of breath; Fever; Fatigue; Diarrhea; Muscle aches; Skin sensitivity and rash; Skin sensitivity and rash; Sore throat; This is a spontaneous report from a contactable consumer. A 57-year-old male patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in arm on 22Feb2021 at 10:00 (Lot Number: EN6202) (at the age of 57-year-old) as single dose for COVID-19 immunisation.  Medical history included high cholesterol from 2017 to an unknown date, seasonal allergy from an unknown date and unknown if ongoing and arteriosclerosis from 2017 to an unknown date. The patient's concomitant medications were not reported.  The patient previously received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 01Feb2021 (Lot Number: EL9264) (at the age of 57-year-old) as single dose for COVID-19 immunisation; the patient previously received ZYRTEC (10mg almost daily) for seasonal allergy, ibuprofen (ADVIL, 200 mg) and TYLENOL both for pain. Caller stated that the patient passed away on 02Mar2021 which was 8 days after the 2nd dose of the Pfizer COVID Vaccine. On 26Feb2021 the patient went to urgent care and then on 01Mar2021 he went to the hospital emergency room (ER).  It was reported that an autopsy was performed on 06Mar2021 and the cause of death listed sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.  The manner of death was natural and the lung presentation is highly suggestive of diffuse alveolar damage due to COVID-19 although the patient had several negative tests for COVID. The patient tested negative for influenza AB, negative for valley fever, negative for Legionnaire's disease and was in the hospital for less than 24 hours. The patient went back to urgent care on 28Feb2021 and was feeling miserable and asking for blood tests and urine tests, stated at that time his platelets were low at 122, glucose was high at 105, sodium was low at 134, calcium was low at 8.3, urine was negative and the patient did not get these labs til Monday when he was on the way to the emergency room and it was all different when he got to the hospital. The test for strep was negative, the oxygen was low at 86 percent when he got to the hospital on Monday and they just had to keep increasing his oxygen, stated a culture, no further details provided about the culture. A CTA done on the chest on Monday which was bad and stated the patient was symptomatic and they did not treat him for COVID but had a clinical suspicion for COVID. Adenovirus was not detected, metapneumonia virus was not detected, respiratory syncytial virus was not detected, parainfluenza was not detected, his platelets kept dropping and he had two tests for valley fever which is Cocci IGG and IGM and those were negative, the sodium level on 02Mar2021 was 126, all of these things were low: chloride 92, CO2 18, calcium 7.8, glucose was high at 222, bun was high at 21, creatinine was high at 1.4, EGFR was low at 52, WBC was high at 18.6, RBC was high at 7.39, HGB was 22.6, HCT was 66.4, RDW was high at 15, RDWFD was 45.5, and platelets were low at 61. The patient came into the emergency room those labs were when he was failing completely and on 01Mar2021 was when he arrived in the ER; at that time his WBC were normal, RBC was high at 6.16, HGB was high at 18.5, HCT was high at 54.9, platelets were low at 73, monocytes absolute were high at 0.96, sodium was low at 129, chloride was low at 95, calcium was low at 8.3, glucose was high at 150 and this was 7 days past the Pfizer COVID Vaccine. The patient was negative for strep pneumonia antigen and negative for Legionnaires Urinary antigen. The chest X-ray was done on 26Feb2021 and the patient was in misery and feeling horrible and they sent him home with albuterol and possible antibiotic to start that Monday and he had severe chills, headache, shortness of breath, fever, fatigue, diarrhea, muscle aches, skin sensitivity and rash, sore throat. Chest X-ray says normal; states the albuterol was PROAIR HFA 90mcg and he tested negative for influenza AB and he never got to the antibiotic because they said to wait til Monday and by that time this was an emergency. The patient outcome of sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage was fatal and unknown for the other events. The patient died on 02Mar2021.  An autopsy was performed that revealed the cause of death was sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.; Reported Cause(s) of Death: Sepsis; Autopsy-determined Cause(s) of Death: Shock due to bilateral pulmonary acute disease syndrome; Diffuse alveolar damage"
	"1394137-1"	"1394137-1"	"BLOOD GLUCOSE"	"10005553"	"50-59 years"	"50-59"	"Her husband passed away; Sepsis; Shock due to bilateral pulmonary acute disease syndrome; Shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage; misery and feeling horrible; Severe chills; Headache; Shortness of breath; Fever; Fatigue; Diarrhea; Muscle aches; Skin sensitivity and rash; Skin sensitivity and rash; Sore throat; This is a spontaneous report from a contactable consumer. A 57-year-old male patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in arm on 22Feb2021 at 10:00 (Lot Number: EN6202) (at the age of 57-year-old) as single dose for COVID-19 immunisation.  Medical history included high cholesterol from 2017 to an unknown date, seasonal allergy from an unknown date and unknown if ongoing and arteriosclerosis from 2017 to an unknown date. The patient's concomitant medications were not reported.  The patient previously received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 01Feb2021 (Lot Number: EL9264) (at the age of 57-year-old) as single dose for COVID-19 immunisation; the patient previously received ZYRTEC (10mg almost daily) for seasonal allergy, ibuprofen (ADVIL, 200 mg) and TYLENOL both for pain. Caller stated that the patient passed away on 02Mar2021 which was 8 days after the 2nd dose of the Pfizer COVID Vaccine. On 26Feb2021 the patient went to urgent care and then on 01Mar2021 he went to the hospital emergency room (ER).  It was reported that an autopsy was performed on 06Mar2021 and the cause of death listed sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.  The manner of death was natural and the lung presentation is highly suggestive of diffuse alveolar damage due to COVID-19 although the patient had several negative tests for COVID. The patient tested negative for influenza AB, negative for valley fever, negative for Legionnaire's disease and was in the hospital for less than 24 hours. The patient went back to urgent care on 28Feb2021 and was feeling miserable and asking for blood tests and urine tests, stated at that time his platelets were low at 122, glucose was high at 105, sodium was low at 134, calcium was low at 8.3, urine was negative and the patient did not get these labs til Monday when he was on the way to the emergency room and it was all different when he got to the hospital. The test for strep was negative, the oxygen was low at 86 percent when he got to the hospital on Monday and they just had to keep increasing his oxygen, stated a culture, no further details provided about the culture. A CTA done on the chest on Monday which was bad and stated the patient was symptomatic and they did not treat him for COVID but had a clinical suspicion for COVID. Adenovirus was not detected, metapneumonia virus was not detected, respiratory syncytial virus was not detected, parainfluenza was not detected, his platelets kept dropping and he had two tests for valley fever which is Cocci IGG and IGM and those were negative, the sodium level on 02Mar2021 was 126, all of these things were low: chloride 92, CO2 18, calcium 7.8, glucose was high at 222, bun was high at 21, creatinine was high at 1.4, EGFR was low at 52, WBC was high at 18.6, RBC was high at 7.39, HGB was 22.6, HCT was 66.4, RDW was high at 15, RDWFD was 45.5, and platelets were low at 61. The patient came into the emergency room those labs were when he was failing completely and on 01Mar2021 was when he arrived in the ER; at that time his WBC were normal, RBC was high at 6.16, HGB was high at 18.5, HCT was high at 54.9, platelets were low at 73, monocytes absolute were high at 0.96, sodium was low at 129, chloride was low at 95, calcium was low at 8.3, glucose was high at 150 and this was 7 days past the Pfizer COVID Vaccine. The patient was negative for strep pneumonia antigen and negative for Legionnaires Urinary antigen. The chest X-ray was done on 26Feb2021 and the patient was in misery and feeling horrible and they sent him home with albuterol and possible antibiotic to start that Monday and he had severe chills, headache, shortness of breath, fever, fatigue, diarrhea, muscle aches, skin sensitivity and rash, sore throat. Chest X-ray says normal; states the albuterol was PROAIR HFA 90mcg and he tested negative for influenza AB and he never got to the antibiotic because they said to wait til Monday and by that time this was an emergency. The patient outcome of sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage was fatal and unknown for the other events. The patient died on 02Mar2021.  An autopsy was performed that revealed the cause of death was sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.; Reported Cause(s) of Death: Sepsis; Autopsy-determined Cause(s) of Death: Shock due to bilateral pulmonary acute disease syndrome; Diffuse alveolar damage"
	"1394137-1"	"1394137-1"	"BLOOD SODIUM"	"10005799"	"50-59 years"	"50-59"	"Her husband passed away; Sepsis; Shock due to bilateral pulmonary acute disease syndrome; Shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage; misery and feeling horrible; Severe chills; Headache; Shortness of breath; Fever; Fatigue; Diarrhea; Muscle aches; Skin sensitivity and rash; Skin sensitivity and rash; Sore throat; This is a spontaneous report from a contactable consumer. A 57-year-old male patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in arm on 22Feb2021 at 10:00 (Lot Number: EN6202) (at the age of 57-year-old) as single dose for COVID-19 immunisation.  Medical history included high cholesterol from 2017 to an unknown date, seasonal allergy from an unknown date and unknown if ongoing and arteriosclerosis from 2017 to an unknown date. The patient's concomitant medications were not reported.  The patient previously received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 01Feb2021 (Lot Number: EL9264) (at the age of 57-year-old) as single dose for COVID-19 immunisation; the patient previously received ZYRTEC (10mg almost daily) for seasonal allergy, ibuprofen (ADVIL, 200 mg) and TYLENOL both for pain. Caller stated that the patient passed away on 02Mar2021 which was 8 days after the 2nd dose of the Pfizer COVID Vaccine. On 26Feb2021 the patient went to urgent care and then on 01Mar2021 he went to the hospital emergency room (ER).  It was reported that an autopsy was performed on 06Mar2021 and the cause of death listed sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.  The manner of death was natural and the lung presentation is highly suggestive of diffuse alveolar damage due to COVID-19 although the patient had several negative tests for COVID. The patient tested negative for influenza AB, negative for valley fever, negative for Legionnaire's disease and was in the hospital for less than 24 hours. The patient went back to urgent care on 28Feb2021 and was feeling miserable and asking for blood tests and urine tests, stated at that time his platelets were low at 122, glucose was high at 105, sodium was low at 134, calcium was low at 8.3, urine was negative and the patient did not get these labs til Monday when he was on the way to the emergency room and it was all different when he got to the hospital. The test for strep was negative, the oxygen was low at 86 percent when he got to the hospital on Monday and they just had to keep increasing his oxygen, stated a culture, no further details provided about the culture. A CTA done on the chest on Monday which was bad and stated the patient was symptomatic and they did not treat him for COVID but had a clinical suspicion for COVID. Adenovirus was not detected, metapneumonia virus was not detected, respiratory syncytial virus was not detected, parainfluenza was not detected, his platelets kept dropping and he had two tests for valley fever which is Cocci IGG and IGM and those were negative, the sodium level on 02Mar2021 was 126, all of these things were low: chloride 92, CO2 18, calcium 7.8, glucose was high at 222, bun was high at 21, creatinine was high at 1.4, EGFR was low at 52, WBC was high at 18.6, RBC was high at 7.39, HGB was 22.6, HCT was 66.4, RDW was high at 15, RDWFD was 45.5, and platelets were low at 61. The patient came into the emergency room those labs were when he was failing completely and on 01Mar2021 was when he arrived in the ER; at that time his WBC were normal, RBC was high at 6.16, HGB was high at 18.5, HCT was high at 54.9, platelets were low at 73, monocytes absolute were high at 0.96, sodium was low at 129, chloride was low at 95, calcium was low at 8.3, glucose was high at 150 and this was 7 days past the Pfizer COVID Vaccine. The patient was negative for strep pneumonia antigen and negative for Legionnaires Urinary antigen. The chest X-ray was done on 26Feb2021 and the patient was in misery and feeling horrible and they sent him home with albuterol and possible antibiotic to start that Monday and he had severe chills, headache, shortness of breath, fever, fatigue, diarrhea, muscle aches, skin sensitivity and rash, sore throat. Chest X-ray says normal; states the albuterol was PROAIR HFA 90mcg and he tested negative for influenza AB and he never got to the antibiotic because they said to wait til Monday and by that time this was an emergency. The patient outcome of sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage was fatal and unknown for the other events. The patient died on 02Mar2021.  An autopsy was performed that revealed the cause of death was sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.; Reported Cause(s) of Death: Sepsis; Autopsy-determined Cause(s) of Death: Shock due to bilateral pulmonary acute disease syndrome; Diffuse alveolar damage"
	"1394137-1"	"1394137-1"	"BLOOD UREA"	"10005845"	"50-59 years"	"50-59"	"Her husband passed away; Sepsis; Shock due to bilateral pulmonary acute disease syndrome; Shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage; misery and feeling horrible; Severe chills; Headache; Shortness of breath; Fever; Fatigue; Diarrhea; Muscle aches; Skin sensitivity and rash; Skin sensitivity and rash; Sore throat; This is a spontaneous report from a contactable consumer. A 57-year-old male patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in arm on 22Feb2021 at 10:00 (Lot Number: EN6202) (at the age of 57-year-old) as single dose for COVID-19 immunisation.  Medical history included high cholesterol from 2017 to an unknown date, seasonal allergy from an unknown date and unknown if ongoing and arteriosclerosis from 2017 to an unknown date. The patient's concomitant medications were not reported.  The patient previously received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 01Feb2021 (Lot Number: EL9264) (at the age of 57-year-old) as single dose for COVID-19 immunisation; the patient previously received ZYRTEC (10mg almost daily) for seasonal allergy, ibuprofen (ADVIL, 200 mg) and TYLENOL both for pain. Caller stated that the patient passed away on 02Mar2021 which was 8 days after the 2nd dose of the Pfizer COVID Vaccine. On 26Feb2021 the patient went to urgent care and then on 01Mar2021 he went to the hospital emergency room (ER).  It was reported that an autopsy was performed on 06Mar2021 and the cause of death listed sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.  The manner of death was natural and the lung presentation is highly suggestive of diffuse alveolar damage due to COVID-19 although the patient had several negative tests for COVID. The patient tested negative for influenza AB, negative for valley fever, negative for Legionnaire's disease and was in the hospital for less than 24 hours. The patient went back to urgent care on 28Feb2021 and was feeling miserable and asking for blood tests and urine tests, stated at that time his platelets were low at 122, glucose was high at 105, sodium was low at 134, calcium was low at 8.3, urine was negative and the patient did not get these labs til Monday when he was on the way to the emergency room and it was all different when he got to the hospital. The test for strep was negative, the oxygen was low at 86 percent when he got to the hospital on Monday and they just had to keep increasing his oxygen, stated a culture, no further details provided about the culture. A CTA done on the chest on Monday which was bad and stated the patient was symptomatic and they did not treat him for COVID but had a clinical suspicion for COVID. Adenovirus was not detected, metapneumonia virus was not detected, respiratory syncytial virus was not detected, parainfluenza was not detected, his platelets kept dropping and he had two tests for valley fever which is Cocci IGG and IGM and those were negative, the sodium level on 02Mar2021 was 126, all of these things were low: chloride 92, CO2 18, calcium 7.8, glucose was high at 222, bun was high at 21, creatinine was high at 1.4, EGFR was low at 52, WBC was high at 18.6, RBC was high at 7.39, HGB was 22.6, HCT was 66.4, RDW was high at 15, RDWFD was 45.5, and platelets were low at 61. The patient came into the emergency room those labs were when he was failing completely and on 01Mar2021 was when he arrived in the ER; at that time his WBC were normal, RBC was high at 6.16, HGB was high at 18.5, HCT was high at 54.9, platelets were low at 73, monocytes absolute were high at 0.96, sodium was low at 129, chloride was low at 95, calcium was low at 8.3, glucose was high at 150 and this was 7 days past the Pfizer COVID Vaccine. The patient was negative for strep pneumonia antigen and negative for Legionnaires Urinary antigen. The chest X-ray was done on 26Feb2021 and the patient was in misery and feeling horrible and they sent him home with albuterol and possible antibiotic to start that Monday and he had severe chills, headache, shortness of breath, fever, fatigue, diarrhea, muscle aches, skin sensitivity and rash, sore throat. Chest X-ray says normal; states the albuterol was PROAIR HFA 90mcg and he tested negative for influenza AB and he never got to the antibiotic because they said to wait til Monday and by that time this was an emergency. The patient outcome of sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage was fatal and unknown for the other events. The patient died on 02Mar2021.  An autopsy was performed that revealed the cause of death was sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.; Reported Cause(s) of Death: Sepsis; Autopsy-determined Cause(s) of Death: Shock due to bilateral pulmonary acute disease syndrome; Diffuse alveolar damage"
	"1394137-1"	"1394137-1"	"CARBON DIOXIDE"	"10007220"	"50-59 years"	"50-59"	"Her husband passed away; Sepsis; Shock due to bilateral pulmonary acute disease syndrome; Shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage; misery and feeling horrible; Severe chills; Headache; Shortness of breath; Fever; Fatigue; Diarrhea; Muscle aches; Skin sensitivity and rash; Skin sensitivity and rash; Sore throat; This is a spontaneous report from a contactable consumer. A 57-year-old male patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in arm on 22Feb2021 at 10:00 (Lot Number: EN6202) (at the age of 57-year-old) as single dose for COVID-19 immunisation.  Medical history included high cholesterol from 2017 to an unknown date, seasonal allergy from an unknown date and unknown if ongoing and arteriosclerosis from 2017 to an unknown date. The patient's concomitant medications were not reported.  The patient previously received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 01Feb2021 (Lot Number: EL9264) (at the age of 57-year-old) as single dose for COVID-19 immunisation; the patient previously received ZYRTEC (10mg almost daily) for seasonal allergy, ibuprofen (ADVIL, 200 mg) and TYLENOL both for pain. Caller stated that the patient passed away on 02Mar2021 which was 8 days after the 2nd dose of the Pfizer COVID Vaccine. On 26Feb2021 the patient went to urgent care and then on 01Mar2021 he went to the hospital emergency room (ER).  It was reported that an autopsy was performed on 06Mar2021 and the cause of death listed sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.  The manner of death was natural and the lung presentation is highly suggestive of diffuse alveolar damage due to COVID-19 although the patient had several negative tests for COVID. The patient tested negative for influenza AB, negative for valley fever, negative for Legionnaire's disease and was in the hospital for less than 24 hours. The patient went back to urgent care on 28Feb2021 and was feeling miserable and asking for blood tests and urine tests, stated at that time his platelets were low at 122, glucose was high at 105, sodium was low at 134, calcium was low at 8.3, urine was negative and the patient did not get these labs til Monday when he was on the way to the emergency room and it was all different when he got to the hospital. The test for strep was negative, the oxygen was low at 86 percent when he got to the hospital on Monday and they just had to keep increasing his oxygen, stated a culture, no further details provided about the culture. A CTA done on the chest on Monday which was bad and stated the patient was symptomatic and they did not treat him for COVID but had a clinical suspicion for COVID. Adenovirus was not detected, metapneumonia virus was not detected, respiratory syncytial virus was not detected, parainfluenza was not detected, his platelets kept dropping and he had two tests for valley fever which is Cocci IGG and IGM and those were negative, the sodium level on 02Mar2021 was 126, all of these things were low: chloride 92, CO2 18, calcium 7.8, glucose was high at 222, bun was high at 21, creatinine was high at 1.4, EGFR was low at 52, WBC was high at 18.6, RBC was high at 7.39, HGB was 22.6, HCT was 66.4, RDW was high at 15, RDWFD was 45.5, and platelets were low at 61. The patient came into the emergency room those labs were when he was failing completely and on 01Mar2021 was when he arrived in the ER; at that time his WBC were normal, RBC was high at 6.16, HGB was high at 18.5, HCT was high at 54.9, platelets were low at 73, monocytes absolute were high at 0.96, sodium was low at 129, chloride was low at 95, calcium was low at 8.3, glucose was high at 150 and this was 7 days past the Pfizer COVID Vaccine. The patient was negative for strep pneumonia antigen and negative for Legionnaires Urinary antigen. The chest X-ray was done on 26Feb2021 and the patient was in misery and feeling horrible and they sent him home with albuterol and possible antibiotic to start that Monday and he had severe chills, headache, shortness of breath, fever, fatigue, diarrhea, muscle aches, skin sensitivity and rash, sore throat. Chest X-ray says normal; states the albuterol was PROAIR HFA 90mcg and he tested negative for influenza AB and he never got to the antibiotic because they said to wait til Monday and by that time this was an emergency. The patient outcome of sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage was fatal and unknown for the other events. The patient died on 02Mar2021.  An autopsy was performed that revealed the cause of death was sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.; Reported Cause(s) of Death: Sepsis; Autopsy-determined Cause(s) of Death: Shock due to bilateral pulmonary acute disease syndrome; Diffuse alveolar damage"
	"1394137-1"	"1394137-1"	"CHEST X-RAY"	"10008498"	"50-59 years"	"50-59"	"Her husband passed away; Sepsis; Shock due to bilateral pulmonary acute disease syndrome; Shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage; misery and feeling horrible; Severe chills; Headache; Shortness of breath; Fever; Fatigue; Diarrhea; Muscle aches; Skin sensitivity and rash; Skin sensitivity and rash; Sore throat; This is a spontaneous report from a contactable consumer. A 57-year-old male patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in arm on 22Feb2021 at 10:00 (Lot Number: EN6202) (at the age of 57-year-old) as single dose for COVID-19 immunisation.  Medical history included high cholesterol from 2017 to an unknown date, seasonal allergy from an unknown date and unknown if ongoing and arteriosclerosis from 2017 to an unknown date. The patient's concomitant medications were not reported.  The patient previously received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 01Feb2021 (Lot Number: EL9264) (at the age of 57-year-old) as single dose for COVID-19 immunisation; the patient previously received ZYRTEC (10mg almost daily) for seasonal allergy, ibuprofen (ADVIL, 200 mg) and TYLENOL both for pain. Caller stated that the patient passed away on 02Mar2021 which was 8 days after the 2nd dose of the Pfizer COVID Vaccine. On 26Feb2021 the patient went to urgent care and then on 01Mar2021 he went to the hospital emergency room (ER).  It was reported that an autopsy was performed on 06Mar2021 and the cause of death listed sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.  The manner of death was natural and the lung presentation is highly suggestive of diffuse alveolar damage due to COVID-19 although the patient had several negative tests for COVID. The patient tested negative for influenza AB, negative for valley fever, negative for Legionnaire's disease and was in the hospital for less than 24 hours. The patient went back to urgent care on 28Feb2021 and was feeling miserable and asking for blood tests and urine tests, stated at that time his platelets were low at 122, glucose was high at 105, sodium was low at 134, calcium was low at 8.3, urine was negative and the patient did not get these labs til Monday when he was on the way to the emergency room and it was all different when he got to the hospital. The test for strep was negative, the oxygen was low at 86 percent when he got to the hospital on Monday and they just had to keep increasing his oxygen, stated a culture, no further details provided about the culture. A CTA done on the chest on Monday which was bad and stated the patient was symptomatic and they did not treat him for COVID but had a clinical suspicion for COVID. Adenovirus was not detected, metapneumonia virus was not detected, respiratory syncytial virus was not detected, parainfluenza was not detected, his platelets kept dropping and he had two tests for valley fever which is Cocci IGG and IGM and those were negative, the sodium level on 02Mar2021 was 126, all of these things were low: chloride 92, CO2 18, calcium 7.8, glucose was high at 222, bun was high at 21, creatinine was high at 1.4, EGFR was low at 52, WBC was high at 18.6, RBC was high at 7.39, HGB was 22.6, HCT was 66.4, RDW was high at 15, RDWFD was 45.5, and platelets were low at 61. The patient came into the emergency room those labs were when he was failing completely and on 01Mar2021 was when he arrived in the ER; at that time his WBC were normal, RBC was high at 6.16, HGB was high at 18.5, HCT was high at 54.9, platelets were low at 73, monocytes absolute were high at 0.96, sodium was low at 129, chloride was low at 95, calcium was low at 8.3, glucose was high at 150 and this was 7 days past the Pfizer COVID Vaccine. The patient was negative for strep pneumonia antigen and negative for Legionnaires Urinary antigen. The chest X-ray was done on 26Feb2021 and the patient was in misery and feeling horrible and they sent him home with albuterol and possible antibiotic to start that Monday and he had severe chills, headache, shortness of breath, fever, fatigue, diarrhea, muscle aches, skin sensitivity and rash, sore throat. Chest X-ray says normal; states the albuterol was PROAIR HFA 90mcg and he tested negative for influenza AB and he never got to the antibiotic because they said to wait til Monday and by that time this was an emergency. The patient outcome of sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage was fatal and unknown for the other events. The patient died on 02Mar2021.  An autopsy was performed that revealed the cause of death was sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.; Reported Cause(s) of Death: Sepsis; Autopsy-determined Cause(s) of Death: Shock due to bilateral pulmonary acute disease syndrome; Diffuse alveolar damage"
	"1394137-1"	"1394137-1"	"CHILLS"	"10008531"	"50-59 years"	"50-59"	"Her husband passed away; Sepsis; Shock due to bilateral pulmonary acute disease syndrome; Shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage; misery and feeling horrible; Severe chills; Headache; Shortness of breath; Fever; Fatigue; Diarrhea; Muscle aches; Skin sensitivity and rash; Skin sensitivity and rash; Sore throat; This is a spontaneous report from a contactable consumer. A 57-year-old male patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in arm on 22Feb2021 at 10:00 (Lot Number: EN6202) (at the age of 57-year-old) as single dose for COVID-19 immunisation.  Medical history included high cholesterol from 2017 to an unknown date, seasonal allergy from an unknown date and unknown if ongoing and arteriosclerosis from 2017 to an unknown date. The patient's concomitant medications were not reported.  The patient previously received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 01Feb2021 (Lot Number: EL9264) (at the age of 57-year-old) as single dose for COVID-19 immunisation; the patient previously received ZYRTEC (10mg almost daily) for seasonal allergy, ibuprofen (ADVIL, 200 mg) and TYLENOL both for pain. Caller stated that the patient passed away on 02Mar2021 which was 8 days after the 2nd dose of the Pfizer COVID Vaccine. On 26Feb2021 the patient went to urgent care and then on 01Mar2021 he went to the hospital emergency room (ER).  It was reported that an autopsy was performed on 06Mar2021 and the cause of death listed sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.  The manner of death was natural and the lung presentation is highly suggestive of diffuse alveolar damage due to COVID-19 although the patient had several negative tests for COVID. The patient tested negative for influenza AB, negative for valley fever, negative for Legionnaire's disease and was in the hospital for less than 24 hours. The patient went back to urgent care on 28Feb2021 and was feeling miserable and asking for blood tests and urine tests, stated at that time his platelets were low at 122, glucose was high at 105, sodium was low at 134, calcium was low at 8.3, urine was negative and the patient did not get these labs til Monday when he was on the way to the emergency room and it was all different when he got to the hospital. The test for strep was negative, the oxygen was low at 86 percent when he got to the hospital on Monday and they just had to keep increasing his oxygen, stated a culture, no further details provided about the culture. A CTA done on the chest on Monday which was bad and stated the patient was symptomatic and they did not treat him for COVID but had a clinical suspicion for COVID. Adenovirus was not detected, metapneumonia virus was not detected, respiratory syncytial virus was not detected, parainfluenza was not detected, his platelets kept dropping and he had two tests for valley fever which is Cocci IGG and IGM and those were negative, the sodium level on 02Mar2021 was 126, all of these things were low: chloride 92, CO2 18, calcium 7.8, glucose was high at 222, bun was high at 21, creatinine was high at 1.4, EGFR was low at 52, WBC was high at 18.6, RBC was high at 7.39, HGB was 22.6, HCT was 66.4, RDW was high at 15, RDWFD was 45.5, and platelets were low at 61. The patient came into the emergency room those labs were when he was failing completely and on 01Mar2021 was when he arrived in the ER; at that time his WBC were normal, RBC was high at 6.16, HGB was high at 18.5, HCT was high at 54.9, platelets were low at 73, monocytes absolute were high at 0.96, sodium was low at 129, chloride was low at 95, calcium was low at 8.3, glucose was high at 150 and this was 7 days past the Pfizer COVID Vaccine. The patient was negative for strep pneumonia antigen and negative for Legionnaires Urinary antigen. The chest X-ray was done on 26Feb2021 and the patient was in misery and feeling horrible and they sent him home with albuterol and possible antibiotic to start that Monday and he had severe chills, headache, shortness of breath, fever, fatigue, diarrhea, muscle aches, skin sensitivity and rash, sore throat. Chest X-ray says normal; states the albuterol was PROAIR HFA 90mcg and he tested negative for influenza AB and he never got to the antibiotic because they said to wait til Monday and by that time this was an emergency. The patient outcome of sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage was fatal and unknown for the other events. The patient died on 02Mar2021.  An autopsy was performed that revealed the cause of death was sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.; Reported Cause(s) of Death: Sepsis; Autopsy-determined Cause(s) of Death: Shock due to bilateral pulmonary acute disease syndrome; Diffuse alveolar damage"
	"1394137-1"	"1394137-1"	"COCCIDIOIDOMYCOSIS"	"10009825"	"50-59 years"	"50-59"	"Her husband passed away; Sepsis; Shock due to bilateral pulmonary acute disease syndrome; Shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage; misery and feeling horrible; Severe chills; Headache; Shortness of breath; Fever; Fatigue; Diarrhea; Muscle aches; Skin sensitivity and rash; Skin sensitivity and rash; Sore throat; This is a spontaneous report from a contactable consumer. A 57-year-old male patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in arm on 22Feb2021 at 10:00 (Lot Number: EN6202) (at the age of 57-year-old) as single dose for COVID-19 immunisation.  Medical history included high cholesterol from 2017 to an unknown date, seasonal allergy from an unknown date and unknown if ongoing and arteriosclerosis from 2017 to an unknown date. The patient's concomitant medications were not reported.  The patient previously received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 01Feb2021 (Lot Number: EL9264) (at the age of 57-year-old) as single dose for COVID-19 immunisation; the patient previously received ZYRTEC (10mg almost daily) for seasonal allergy, ibuprofen (ADVIL, 200 mg) and TYLENOL both for pain. Caller stated that the patient passed away on 02Mar2021 which was 8 days after the 2nd dose of the Pfizer COVID Vaccine. On 26Feb2021 the patient went to urgent care and then on 01Mar2021 he went to the hospital emergency room (ER).  It was reported that an autopsy was performed on 06Mar2021 and the cause of death listed sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.  The manner of death was natural and the lung presentation is highly suggestive of diffuse alveolar damage due to COVID-19 although the patient had several negative tests for COVID. The patient tested negative for influenza AB, negative for valley fever, negative for Legionnaire's disease and was in the hospital for less than 24 hours. The patient went back to urgent care on 28Feb2021 and was feeling miserable and asking for blood tests and urine tests, stated at that time his platelets were low at 122, glucose was high at 105, sodium was low at 134, calcium was low at 8.3, urine was negative and the patient did not get these labs til Monday when he was on the way to the emergency room and it was all different when he got to the hospital. The test for strep was negative, the oxygen was low at 86 percent when he got to the hospital on Monday and they just had to keep increasing his oxygen, stated a culture, no further details provided about the culture. A CTA done on the chest on Monday which was bad and stated the patient was symptomatic and they did not treat him for COVID but had a clinical suspicion for COVID. Adenovirus was not detected, metapneumonia virus was not detected, respiratory syncytial virus was not detected, parainfluenza was not detected, his platelets kept dropping and he had two tests for valley fever which is Cocci IGG and IGM and those were negative, the sodium level on 02Mar2021 was 126, all of these things were low: chloride 92, CO2 18, calcium 7.8, glucose was high at 222, bun was high at 21, creatinine was high at 1.4, EGFR was low at 52, WBC was high at 18.6, RBC was high at 7.39, HGB was 22.6, HCT was 66.4, RDW was high at 15, RDWFD was 45.5, and platelets were low at 61. The patient came into the emergency room those labs were when he was failing completely and on 01Mar2021 was when he arrived in the ER; at that time his WBC were normal, RBC was high at 6.16, HGB was high at 18.5, HCT was high at 54.9, platelets were low at 73, monocytes absolute were high at 0.96, sodium was low at 129, chloride was low at 95, calcium was low at 8.3, glucose was high at 150 and this was 7 days past the Pfizer COVID Vaccine. The patient was negative for strep pneumonia antigen and negative for Legionnaires Urinary antigen. The chest X-ray was done on 26Feb2021 and the patient was in misery and feeling horrible and they sent him home with albuterol and possible antibiotic to start that Monday and he had severe chills, headache, shortness of breath, fever, fatigue, diarrhea, muscle aches, skin sensitivity and rash, sore throat. Chest X-ray says normal; states the albuterol was PROAIR HFA 90mcg and he tested negative for influenza AB and he never got to the antibiotic because they said to wait til Monday and by that time this was an emergency. The patient outcome of sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage was fatal and unknown for the other events. The patient died on 02Mar2021.  An autopsy was performed that revealed the cause of death was sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.; Reported Cause(s) of Death: Sepsis; Autopsy-determined Cause(s) of Death: Shock due to bilateral pulmonary acute disease syndrome; Diffuse alveolar damage"
	"1394137-1"	"1394137-1"	"COMPUTED TOMOGRAPHIC ABSCESSOGRAM"	"10076045"	"50-59 years"	"50-59"	"Her husband passed away; Sepsis; Shock due to bilateral pulmonary acute disease syndrome; Shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage; misery and feeling horrible; Severe chills; Headache; Shortness of breath; Fever; Fatigue; Diarrhea; Muscle aches; Skin sensitivity and rash; Skin sensitivity and rash; Sore throat; This is a spontaneous report from a contactable consumer. A 57-year-old male patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in arm on 22Feb2021 at 10:00 (Lot Number: EN6202) (at the age of 57-year-old) as single dose for COVID-19 immunisation.  Medical history included high cholesterol from 2017 to an unknown date, seasonal allergy from an unknown date and unknown if ongoing and arteriosclerosis from 2017 to an unknown date. The patient's concomitant medications were not reported.  The patient previously received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 01Feb2021 (Lot Number: EL9264) (at the age of 57-year-old) as single dose for COVID-19 immunisation; the patient previously received ZYRTEC (10mg almost daily) for seasonal allergy, ibuprofen (ADVIL, 200 mg) and TYLENOL both for pain. Caller stated that the patient passed away on 02Mar2021 which was 8 days after the 2nd dose of the Pfizer COVID Vaccine. On 26Feb2021 the patient went to urgent care and then on 01Mar2021 he went to the hospital emergency room (ER).  It was reported that an autopsy was performed on 06Mar2021 and the cause of death listed sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.  The manner of death was natural and the lung presentation is highly suggestive of diffuse alveolar damage due to COVID-19 although the patient had several negative tests for COVID. The patient tested negative for influenza AB, negative for valley fever, negative for Legionnaire's disease and was in the hospital for less than 24 hours. The patient went back to urgent care on 28Feb2021 and was feeling miserable and asking for blood tests and urine tests, stated at that time his platelets were low at 122, glucose was high at 105, sodium was low at 134, calcium was low at 8.3, urine was negative and the patient did not get these labs til Monday when he was on the way to the emergency room and it was all different when he got to the hospital. The test for strep was negative, the oxygen was low at 86 percent when he got to the hospital on Monday and they just had to keep increasing his oxygen, stated a culture, no further details provided about the culture. A CTA done on the chest on Monday which was bad and stated the patient was symptomatic and they did not treat him for COVID but had a clinical suspicion for COVID. Adenovirus was not detected, metapneumonia virus was not detected, respiratory syncytial virus was not detected, parainfluenza was not detected, his platelets kept dropping and he had two tests for valley fever which is Cocci IGG and IGM and those were negative, the sodium level on 02Mar2021 was 126, all of these things were low: chloride 92, CO2 18, calcium 7.8, glucose was high at 222, bun was high at 21, creatinine was high at 1.4, EGFR was low at 52, WBC was high at 18.6, RBC was high at 7.39, HGB was 22.6, HCT was 66.4, RDW was high at 15, RDWFD was 45.5, and platelets were low at 61. The patient came into the emergency room those labs were when he was failing completely and on 01Mar2021 was when he arrived in the ER; at that time his WBC were normal, RBC was high at 6.16, HGB was high at 18.5, HCT was high at 54.9, platelets were low at 73, monocytes absolute were high at 0.96, sodium was low at 129, chloride was low at 95, calcium was low at 8.3, glucose was high at 150 and this was 7 days past the Pfizer COVID Vaccine. The patient was negative for strep pneumonia antigen and negative for Legionnaires Urinary antigen. The chest X-ray was done on 26Feb2021 and the patient was in misery and feeling horrible and they sent him home with albuterol and possible antibiotic to start that Monday and he had severe chills, headache, shortness of breath, fever, fatigue, diarrhea, muscle aches, skin sensitivity and rash, sore throat. Chest X-ray says normal; states the albuterol was PROAIR HFA 90mcg and he tested negative for influenza AB and he never got to the antibiotic because they said to wait til Monday and by that time this was an emergency. The patient outcome of sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage was fatal and unknown for the other events. The patient died on 02Mar2021.  An autopsy was performed that revealed the cause of death was sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.; Reported Cause(s) of Death: Sepsis; Autopsy-determined Cause(s) of Death: Shock due to bilateral pulmonary acute disease syndrome; Diffuse alveolar damage"
	"1394137-1"	"1394137-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Her husband passed away; Sepsis; Shock due to bilateral pulmonary acute disease syndrome; Shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage; misery and feeling horrible; Severe chills; Headache; Shortness of breath; Fever; Fatigue; Diarrhea; Muscle aches; Skin sensitivity and rash; Skin sensitivity and rash; Sore throat; This is a spontaneous report from a contactable consumer. A 57-year-old male patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in arm on 22Feb2021 at 10:00 (Lot Number: EN6202) (at the age of 57-year-old) as single dose for COVID-19 immunisation.  Medical history included high cholesterol from 2017 to an unknown date, seasonal allergy from an unknown date and unknown if ongoing and arteriosclerosis from 2017 to an unknown date. The patient's concomitant medications were not reported.  The patient previously received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 01Feb2021 (Lot Number: EL9264) (at the age of 57-year-old) as single dose for COVID-19 immunisation; the patient previously received ZYRTEC (10mg almost daily) for seasonal allergy, ibuprofen (ADVIL, 200 mg) and TYLENOL both for pain. Caller stated that the patient passed away on 02Mar2021 which was 8 days after the 2nd dose of the Pfizer COVID Vaccine. On 26Feb2021 the patient went to urgent care and then on 01Mar2021 he went to the hospital emergency room (ER).  It was reported that an autopsy was performed on 06Mar2021 and the cause of death listed sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.  The manner of death was natural and the lung presentation is highly suggestive of diffuse alveolar damage due to COVID-19 although the patient had several negative tests for COVID. The patient tested negative for influenza AB, negative for valley fever, negative for Legionnaire's disease and was in the hospital for less than 24 hours. The patient went back to urgent care on 28Feb2021 and was feeling miserable and asking for blood tests and urine tests, stated at that time his platelets were low at 122, glucose was high at 105, sodium was low at 134, calcium was low at 8.3, urine was negative and the patient did not get these labs til Monday when he was on the way to the emergency room and it was all different when he got to the hospital. The test for strep was negative, the oxygen was low at 86 percent when he got to the hospital on Monday and they just had to keep increasing his oxygen, stated a culture, no further details provided about the culture. A CTA done on the chest on Monday which was bad and stated the patient was symptomatic and they did not treat him for COVID but had a clinical suspicion for COVID. Adenovirus was not detected, metapneumonia virus was not detected, respiratory syncytial virus was not detected, parainfluenza was not detected, his platelets kept dropping and he had two tests for valley fever which is Cocci IGG and IGM and those were negative, the sodium level on 02Mar2021 was 126, all of these things were low: chloride 92, CO2 18, calcium 7.8, glucose was high at 222, bun was high at 21, creatinine was high at 1.4, EGFR was low at 52, WBC was high at 18.6, RBC was high at 7.39, HGB was 22.6, HCT was 66.4, RDW was high at 15, RDWFD was 45.5, and platelets were low at 61. The patient came into the emergency room those labs were when he was failing completely and on 01Mar2021 was when he arrived in the ER; at that time his WBC were normal, RBC was high at 6.16, HGB was high at 18.5, HCT was high at 54.9, platelets were low at 73, monocytes absolute were high at 0.96, sodium was low at 129, chloride was low at 95, calcium was low at 8.3, glucose was high at 150 and this was 7 days past the Pfizer COVID Vaccine. The patient was negative for strep pneumonia antigen and negative for Legionnaires Urinary antigen. The chest X-ray was done on 26Feb2021 and the patient was in misery and feeling horrible and they sent him home with albuterol and possible antibiotic to start that Monday and he had severe chills, headache, shortness of breath, fever, fatigue, diarrhea, muscle aches, skin sensitivity and rash, sore throat. Chest X-ray says normal; states the albuterol was PROAIR HFA 90mcg and he tested negative for influenza AB and he never got to the antibiotic because they said to wait til Monday and by that time this was an emergency. The patient outcome of sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage was fatal and unknown for the other events. The patient died on 02Mar2021.  An autopsy was performed that revealed the cause of death was sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.; Reported Cause(s) of Death: Sepsis; Autopsy-determined Cause(s) of Death: Shock due to bilateral pulmonary acute disease syndrome; Diffuse alveolar damage"
	"1394137-1"	"1394137-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Her husband passed away; Sepsis; Shock due to bilateral pulmonary acute disease syndrome; Shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage; misery and feeling horrible; Severe chills; Headache; Shortness of breath; Fever; Fatigue; Diarrhea; Muscle aches; Skin sensitivity and rash; Skin sensitivity and rash; Sore throat; This is a spontaneous report from a contactable consumer. A 57-year-old male patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in arm on 22Feb2021 at 10:00 (Lot Number: EN6202) (at the age of 57-year-old) as single dose for COVID-19 immunisation.  Medical history included high cholesterol from 2017 to an unknown date, seasonal allergy from an unknown date and unknown if ongoing and arteriosclerosis from 2017 to an unknown date. The patient's concomitant medications were not reported.  The patient previously received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 01Feb2021 (Lot Number: EL9264) (at the age of 57-year-old) as single dose for COVID-19 immunisation; the patient previously received ZYRTEC (10mg almost daily) for seasonal allergy, ibuprofen (ADVIL, 200 mg) and TYLENOL both for pain. Caller stated that the patient passed away on 02Mar2021 which was 8 days after the 2nd dose of the Pfizer COVID Vaccine. On 26Feb2021 the patient went to urgent care and then on 01Mar2021 he went to the hospital emergency room (ER).  It was reported that an autopsy was performed on 06Mar2021 and the cause of death listed sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.  The manner of death was natural and the lung presentation is highly suggestive of diffuse alveolar damage due to COVID-19 although the patient had several negative tests for COVID. The patient tested negative for influenza AB, negative for valley fever, negative for Legionnaire's disease and was in the hospital for less than 24 hours. The patient went back to urgent care on 28Feb2021 and was feeling miserable and asking for blood tests and urine tests, stated at that time his platelets were low at 122, glucose was high at 105, sodium was low at 134, calcium was low at 8.3, urine was negative and the patient did not get these labs til Monday when he was on the way to the emergency room and it was all different when he got to the hospital. The test for strep was negative, the oxygen was low at 86 percent when he got to the hospital on Monday and they just had to keep increasing his oxygen, stated a culture, no further details provided about the culture. A CTA done on the chest on Monday which was bad and stated the patient was symptomatic and they did not treat him for COVID but had a clinical suspicion for COVID. Adenovirus was not detected, metapneumonia virus was not detected, respiratory syncytial virus was not detected, parainfluenza was not detected, his platelets kept dropping and he had two tests for valley fever which is Cocci IGG and IGM and those were negative, the sodium level on 02Mar2021 was 126, all of these things were low: chloride 92, CO2 18, calcium 7.8, glucose was high at 222, bun was high at 21, creatinine was high at 1.4, EGFR was low at 52, WBC was high at 18.6, RBC was high at 7.39, HGB was 22.6, HCT was 66.4, RDW was high at 15, RDWFD was 45.5, and platelets were low at 61. The patient came into the emergency room those labs were when he was failing completely and on 01Mar2021 was when he arrived in the ER; at that time his WBC were normal, RBC was high at 6.16, HGB was high at 18.5, HCT was high at 54.9, platelets were low at 73, monocytes absolute were high at 0.96, sodium was low at 129, chloride was low at 95, calcium was low at 8.3, glucose was high at 150 and this was 7 days past the Pfizer COVID Vaccine. The patient was negative for strep pneumonia antigen and negative for Legionnaires Urinary antigen. The chest X-ray was done on 26Feb2021 and the patient was in misery and feeling horrible and they sent him home with albuterol and possible antibiotic to start that Monday and he had severe chills, headache, shortness of breath, fever, fatigue, diarrhea, muscle aches, skin sensitivity and rash, sore throat. Chest X-ray says normal; states the albuterol was PROAIR HFA 90mcg and he tested negative for influenza AB and he never got to the antibiotic because they said to wait til Monday and by that time this was an emergency. The patient outcome of sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage was fatal and unknown for the other events. The patient died on 02Mar2021.  An autopsy was performed that revealed the cause of death was sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.; Reported Cause(s) of Death: Sepsis; Autopsy-determined Cause(s) of Death: Shock due to bilateral pulmonary acute disease syndrome; Diffuse alveolar damage"
	"1394137-1"	"1394137-1"	"DIARRHOEA"	"10012735"	"50-59 years"	"50-59"	"Her husband passed away; Sepsis; Shock due to bilateral pulmonary acute disease syndrome; Shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage; misery and feeling horrible; Severe chills; Headache; Shortness of breath; Fever; Fatigue; Diarrhea; Muscle aches; Skin sensitivity and rash; Skin sensitivity and rash; Sore throat; This is a spontaneous report from a contactable consumer. A 57-year-old male patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in arm on 22Feb2021 at 10:00 (Lot Number: EN6202) (at the age of 57-year-old) as single dose for COVID-19 immunisation.  Medical history included high cholesterol from 2017 to an unknown date, seasonal allergy from an unknown date and unknown if ongoing and arteriosclerosis from 2017 to an unknown date. The patient's concomitant medications were not reported.  The patient previously received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 01Feb2021 (Lot Number: EL9264) (at the age of 57-year-old) as single dose for COVID-19 immunisation; the patient previously received ZYRTEC (10mg almost daily) for seasonal allergy, ibuprofen (ADVIL, 200 mg) and TYLENOL both for pain. Caller stated that the patient passed away on 02Mar2021 which was 8 days after the 2nd dose of the Pfizer COVID Vaccine. On 26Feb2021 the patient went to urgent care and then on 01Mar2021 he went to the hospital emergency room (ER).  It was reported that an autopsy was performed on 06Mar2021 and the cause of death listed sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.  The manner of death was natural and the lung presentation is highly suggestive of diffuse alveolar damage due to COVID-19 although the patient had several negative tests for COVID. The patient tested negative for influenza AB, negative for valley fever, negative for Legionnaire's disease and was in the hospital for less than 24 hours. The patient went back to urgent care on 28Feb2021 and was feeling miserable and asking for blood tests and urine tests, stated at that time his platelets were low at 122, glucose was high at 105, sodium was low at 134, calcium was low at 8.3, urine was negative and the patient did not get these labs til Monday when he was on the way to the emergency room and it was all different when he got to the hospital. The test for strep was negative, the oxygen was low at 86 percent when he got to the hospital on Monday and they just had to keep increasing his oxygen, stated a culture, no further details provided about the culture. A CTA done on the chest on Monday which was bad and stated the patient was symptomatic and they did not treat him for COVID but had a clinical suspicion for COVID. Adenovirus was not detected, metapneumonia virus was not detected, respiratory syncytial virus was not detected, parainfluenza was not detected, his platelets kept dropping and he had two tests for valley fever which is Cocci IGG and IGM and those were negative, the sodium level on 02Mar2021 was 126, all of these things were low: chloride 92, CO2 18, calcium 7.8, glucose was high at 222, bun was high at 21, creatinine was high at 1.4, EGFR was low at 52, WBC was high at 18.6, RBC was high at 7.39, HGB was 22.6, HCT was 66.4, RDW was high at 15, RDWFD was 45.5, and platelets were low at 61. The patient came into the emergency room those labs were when he was failing completely and on 01Mar2021 was when he arrived in the ER; at that time his WBC were normal, RBC was high at 6.16, HGB was high at 18.5, HCT was high at 54.9, platelets were low at 73, monocytes absolute were high at 0.96, sodium was low at 129, chloride was low at 95, calcium was low at 8.3, glucose was high at 150 and this was 7 days past the Pfizer COVID Vaccine. The patient was negative for strep pneumonia antigen and negative for Legionnaires Urinary antigen. The chest X-ray was done on 26Feb2021 and the patient was in misery and feeling horrible and they sent him home with albuterol and possible antibiotic to start that Monday and he had severe chills, headache, shortness of breath, fever, fatigue, diarrhea, muscle aches, skin sensitivity and rash, sore throat. Chest X-ray says normal; states the albuterol was PROAIR HFA 90mcg and he tested negative for influenza AB and he never got to the antibiotic because they said to wait til Monday and by that time this was an emergency. The patient outcome of sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage was fatal and unknown for the other events. The patient died on 02Mar2021.  An autopsy was performed that revealed the cause of death was sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.; Reported Cause(s) of Death: Sepsis; Autopsy-determined Cause(s) of Death: Shock due to bilateral pulmonary acute disease syndrome; Diffuse alveolar damage"
	"1394137-1"	"1394137-1"	"DIFFUSE ALVEOLAR DAMAGE"	"10060902"	"50-59 years"	"50-59"	"Her husband passed away; Sepsis; Shock due to bilateral pulmonary acute disease syndrome; Shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage; misery and feeling horrible; Severe chills; Headache; Shortness of breath; Fever; Fatigue; Diarrhea; Muscle aches; Skin sensitivity and rash; Skin sensitivity and rash; Sore throat; This is a spontaneous report from a contactable consumer. A 57-year-old male patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in arm on 22Feb2021 at 10:00 (Lot Number: EN6202) (at the age of 57-year-old) as single dose for COVID-19 immunisation.  Medical history included high cholesterol from 2017 to an unknown date, seasonal allergy from an unknown date and unknown if ongoing and arteriosclerosis from 2017 to an unknown date. The patient's concomitant medications were not reported.  The patient previously received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 01Feb2021 (Lot Number: EL9264) (at the age of 57-year-old) as single dose for COVID-19 immunisation; the patient previously received ZYRTEC (10mg almost daily) for seasonal allergy, ibuprofen (ADVIL, 200 mg) and TYLENOL both for pain. Caller stated that the patient passed away on 02Mar2021 which was 8 days after the 2nd dose of the Pfizer COVID Vaccine. On 26Feb2021 the patient went to urgent care and then on 01Mar2021 he went to the hospital emergency room (ER).  It was reported that an autopsy was performed on 06Mar2021 and the cause of death listed sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.  The manner of death was natural and the lung presentation is highly suggestive of diffuse alveolar damage due to COVID-19 although the patient had several negative tests for COVID. The patient tested negative for influenza AB, negative for valley fever, negative for Legionnaire's disease and was in the hospital for less than 24 hours. The patient went back to urgent care on 28Feb2021 and was feeling miserable and asking for blood tests and urine tests, stated at that time his platelets were low at 122, glucose was high at 105, sodium was low at 134, calcium was low at 8.3, urine was negative and the patient did not get these labs til Monday when he was on the way to the emergency room and it was all different when he got to the hospital. The test for strep was negative, the oxygen was low at 86 percent when he got to the hospital on Monday and they just had to keep increasing his oxygen, stated a culture, no further details provided about the culture. A CTA done on the chest on Monday which was bad and stated the patient was symptomatic and they did not treat him for COVID but had a clinical suspicion for COVID. Adenovirus was not detected, metapneumonia virus was not detected, respiratory syncytial virus was not detected, parainfluenza was not detected, his platelets kept dropping and he had two tests for valley fever which is Cocci IGG and IGM and those were negative, the sodium level on 02Mar2021 was 126, all of these things were low: chloride 92, CO2 18, calcium 7.8, glucose was high at 222, bun was high at 21, creatinine was high at 1.4, EGFR was low at 52, WBC was high at 18.6, RBC was high at 7.39, HGB was 22.6, HCT was 66.4, RDW was high at 15, RDWFD was 45.5, and platelets were low at 61. The patient came into the emergency room those labs were when he was failing completely and on 01Mar2021 was when he arrived in the ER; at that time his WBC were normal, RBC was high at 6.16, HGB was high at 18.5, HCT was high at 54.9, platelets were low at 73, monocytes absolute were high at 0.96, sodium was low at 129, chloride was low at 95, calcium was low at 8.3, glucose was high at 150 and this was 7 days past the Pfizer COVID Vaccine. The patient was negative for strep pneumonia antigen and negative for Legionnaires Urinary antigen. The chest X-ray was done on 26Feb2021 and the patient was in misery and feeling horrible and they sent him home with albuterol and possible antibiotic to start that Monday and he had severe chills, headache, shortness of breath, fever, fatigue, diarrhea, muscle aches, skin sensitivity and rash, sore throat. Chest X-ray says normal; states the albuterol was PROAIR HFA 90mcg and he tested negative for influenza AB and he never got to the antibiotic because they said to wait til Monday and by that time this was an emergency. The patient outcome of sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage was fatal and unknown for the other events. The patient died on 02Mar2021.  An autopsy was performed that revealed the cause of death was sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.; Reported Cause(s) of Death: Sepsis; Autopsy-determined Cause(s) of Death: Shock due to bilateral pulmonary acute disease syndrome; Diffuse alveolar damage"
	"1394137-1"	"1394137-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"Her husband passed away; Sepsis; Shock due to bilateral pulmonary acute disease syndrome; Shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage; misery and feeling horrible; Severe chills; Headache; Shortness of breath; Fever; Fatigue; Diarrhea; Muscle aches; Skin sensitivity and rash; Skin sensitivity and rash; Sore throat; This is a spontaneous report from a contactable consumer. A 57-year-old male patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in arm on 22Feb2021 at 10:00 (Lot Number: EN6202) (at the age of 57-year-old) as single dose for COVID-19 immunisation.  Medical history included high cholesterol from 2017 to an unknown date, seasonal allergy from an unknown date and unknown if ongoing and arteriosclerosis from 2017 to an unknown date. The patient's concomitant medications were not reported.  The patient previously received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 01Feb2021 (Lot Number: EL9264) (at the age of 57-year-old) as single dose for COVID-19 immunisation; the patient previously received ZYRTEC (10mg almost daily) for seasonal allergy, ibuprofen (ADVIL, 200 mg) and TYLENOL both for pain. Caller stated that the patient passed away on 02Mar2021 which was 8 days after the 2nd dose of the Pfizer COVID Vaccine. On 26Feb2021 the patient went to urgent care and then on 01Mar2021 he went to the hospital emergency room (ER).  It was reported that an autopsy was performed on 06Mar2021 and the cause of death listed sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.  The manner of death was natural and the lung presentation is highly suggestive of diffuse alveolar damage due to COVID-19 although the patient had several negative tests for COVID. The patient tested negative for influenza AB, negative for valley fever, negative for Legionnaire's disease and was in the hospital for less than 24 hours. The patient went back to urgent care on 28Feb2021 and was feeling miserable and asking for blood tests and urine tests, stated at that time his platelets were low at 122, glucose was high at 105, sodium was low at 134, calcium was low at 8.3, urine was negative and the patient did not get these labs til Monday when he was on the way to the emergency room and it was all different when he got to the hospital. The test for strep was negative, the oxygen was low at 86 percent when he got to the hospital on Monday and they just had to keep increasing his oxygen, stated a culture, no further details provided about the culture. A CTA done on the chest on Monday which was bad and stated the patient was symptomatic and they did not treat him for COVID but had a clinical suspicion for COVID. Adenovirus was not detected, metapneumonia virus was not detected, respiratory syncytial virus was not detected, parainfluenza was not detected, his platelets kept dropping and he had two tests for valley fever which is Cocci IGG and IGM and those were negative, the sodium level on 02Mar2021 was 126, all of these things were low: chloride 92, CO2 18, calcium 7.8, glucose was high at 222, bun was high at 21, creatinine was high at 1.4, EGFR was low at 52, WBC was high at 18.6, RBC was high at 7.39, HGB was 22.6, HCT was 66.4, RDW was high at 15, RDWFD was 45.5, and platelets were low at 61. The patient came into the emergency room those labs were when he was failing completely and on 01Mar2021 was when he arrived in the ER; at that time his WBC were normal, RBC was high at 6.16, HGB was high at 18.5, HCT was high at 54.9, platelets were low at 73, monocytes absolute were high at 0.96, sodium was low at 129, chloride was low at 95, calcium was low at 8.3, glucose was high at 150 and this was 7 days past the Pfizer COVID Vaccine. The patient was negative for strep pneumonia antigen and negative for Legionnaires Urinary antigen. The chest X-ray was done on 26Feb2021 and the patient was in misery and feeling horrible and they sent him home with albuterol and possible antibiotic to start that Monday and he had severe chills, headache, shortness of breath, fever, fatigue, diarrhea, muscle aches, skin sensitivity and rash, sore throat. Chest X-ray says normal; states the albuterol was PROAIR HFA 90mcg and he tested negative for influenza AB and he never got to the antibiotic because they said to wait til Monday and by that time this was an emergency. The patient outcome of sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage was fatal and unknown for the other events. The patient died on 02Mar2021.  An autopsy was performed that revealed the cause of death was sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.; Reported Cause(s) of Death: Sepsis; Autopsy-determined Cause(s) of Death: Shock due to bilateral pulmonary acute disease syndrome; Diffuse alveolar damage"
	"1394137-1"	"1394137-1"	"FATIGUE"	"10016256"	"50-59 years"	"50-59"	"Her husband passed away; Sepsis; Shock due to bilateral pulmonary acute disease syndrome; Shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage; misery and feeling horrible; Severe chills; Headache; Shortness of breath; Fever; Fatigue; Diarrhea; Muscle aches; Skin sensitivity and rash; Skin sensitivity and rash; Sore throat; This is a spontaneous report from a contactable consumer. A 57-year-old male patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in arm on 22Feb2021 at 10:00 (Lot Number: EN6202) (at the age of 57-year-old) as single dose for COVID-19 immunisation.  Medical history included high cholesterol from 2017 to an unknown date, seasonal allergy from an unknown date and unknown if ongoing and arteriosclerosis from 2017 to an unknown date. The patient's concomitant medications were not reported.  The patient previously received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 01Feb2021 (Lot Number: EL9264) (at the age of 57-year-old) as single dose for COVID-19 immunisation; the patient previously received ZYRTEC (10mg almost daily) for seasonal allergy, ibuprofen (ADVIL, 200 mg) and TYLENOL both for pain. Caller stated that the patient passed away on 02Mar2021 which was 8 days after the 2nd dose of the Pfizer COVID Vaccine. On 26Feb2021 the patient went to urgent care and then on 01Mar2021 he went to the hospital emergency room (ER).  It was reported that an autopsy was performed on 06Mar2021 and the cause of death listed sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.  The manner of death was natural and the lung presentation is highly suggestive of diffuse alveolar damage due to COVID-19 although the patient had several negative tests for COVID. The patient tested negative for influenza AB, negative for valley fever, negative for Legionnaire's disease and was in the hospital for less than 24 hours. The patient went back to urgent care on 28Feb2021 and was feeling miserable and asking for blood tests and urine tests, stated at that time his platelets were low at 122, glucose was high at 105, sodium was low at 134, calcium was low at 8.3, urine was negative and the patient did not get these labs til Monday when he was on the way to the emergency room and it was all different when he got to the hospital. The test for strep was negative, the oxygen was low at 86 percent when he got to the hospital on Monday and they just had to keep increasing his oxygen, stated a culture, no further details provided about the culture. A CTA done on the chest on Monday which was bad and stated the patient was symptomatic and they did not treat him for COVID but had a clinical suspicion for COVID. Adenovirus was not detected, metapneumonia virus was not detected, respiratory syncytial virus was not detected, parainfluenza was not detected, his platelets kept dropping and he had two tests for valley fever which is Cocci IGG and IGM and those were negative, the sodium level on 02Mar2021 was 126, all of these things were low: chloride 92, CO2 18, calcium 7.8, glucose was high at 222, bun was high at 21, creatinine was high at 1.4, EGFR was low at 52, WBC was high at 18.6, RBC was high at 7.39, HGB was 22.6, HCT was 66.4, RDW was high at 15, RDWFD was 45.5, and platelets were low at 61. The patient came into the emergency room those labs were when he was failing completely and on 01Mar2021 was when he arrived in the ER; at that time his WBC were normal, RBC was high at 6.16, HGB was high at 18.5, HCT was high at 54.9, platelets were low at 73, monocytes absolute were high at 0.96, sodium was low at 129, chloride was low at 95, calcium was low at 8.3, glucose was high at 150 and this was 7 days past the Pfizer COVID Vaccine. The patient was negative for strep pneumonia antigen and negative for Legionnaires Urinary antigen. The chest X-ray was done on 26Feb2021 and the patient was in misery and feeling horrible and they sent him home with albuterol and possible antibiotic to start that Monday and he had severe chills, headache, shortness of breath, fever, fatigue, diarrhea, muscle aches, skin sensitivity and rash, sore throat. Chest X-ray says normal; states the albuterol was PROAIR HFA 90mcg and he tested negative for influenza AB and he never got to the antibiotic because they said to wait til Monday and by that time this was an emergency. The patient outcome of sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage was fatal and unknown for the other events. The patient died on 02Mar2021.  An autopsy was performed that revealed the cause of death was sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.; Reported Cause(s) of Death: Sepsis; Autopsy-determined Cause(s) of Death: Shock due to bilateral pulmonary acute disease syndrome; Diffuse alveolar damage"
	"1394137-1"	"1394137-1"	"GLOMERULAR FILTRATION RATE"	"10018355"	"50-59 years"	"50-59"	"Her husband passed away; Sepsis; Shock due to bilateral pulmonary acute disease syndrome; Shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage; misery and feeling horrible; Severe chills; Headache; Shortness of breath; Fever; Fatigue; Diarrhea; Muscle aches; Skin sensitivity and rash; Skin sensitivity and rash; Sore throat; This is a spontaneous report from a contactable consumer. A 57-year-old male patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in arm on 22Feb2021 at 10:00 (Lot Number: EN6202) (at the age of 57-year-old) as single dose for COVID-19 immunisation.  Medical history included high cholesterol from 2017 to an unknown date, seasonal allergy from an unknown date and unknown if ongoing and arteriosclerosis from 2017 to an unknown date. The patient's concomitant medications were not reported.  The patient previously received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 01Feb2021 (Lot Number: EL9264) (at the age of 57-year-old) as single dose for COVID-19 immunisation; the patient previously received ZYRTEC (10mg almost daily) for seasonal allergy, ibuprofen (ADVIL, 200 mg) and TYLENOL both for pain. Caller stated that the patient passed away on 02Mar2021 which was 8 days after the 2nd dose of the Pfizer COVID Vaccine. On 26Feb2021 the patient went to urgent care and then on 01Mar2021 he went to the hospital emergency room (ER).  It was reported that an autopsy was performed on 06Mar2021 and the cause of death listed sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.  The manner of death was natural and the lung presentation is highly suggestive of diffuse alveolar damage due to COVID-19 although the patient had several negative tests for COVID. The patient tested negative for influenza AB, negative for valley fever, negative for Legionnaire's disease and was in the hospital for less than 24 hours. The patient went back to urgent care on 28Feb2021 and was feeling miserable and asking for blood tests and urine tests, stated at that time his platelets were low at 122, glucose was high at 105, sodium was low at 134, calcium was low at 8.3, urine was negative and the patient did not get these labs til Monday when he was on the way to the emergency room and it was all different when he got to the hospital. The test for strep was negative, the oxygen was low at 86 percent when he got to the hospital on Monday and they just had to keep increasing his oxygen, stated a culture, no further details provided about the culture. A CTA done on the chest on Monday which was bad and stated the patient was symptomatic and they did not treat him for COVID but had a clinical suspicion for COVID. Adenovirus was not detected, metapneumonia virus was not detected, respiratory syncytial virus was not detected, parainfluenza was not detected, his platelets kept dropping and he had two tests for valley fever which is Cocci IGG and IGM and those were negative, the sodium level on 02Mar2021 was 126, all of these things were low: chloride 92, CO2 18, calcium 7.8, glucose was high at 222, bun was high at 21, creatinine was high at 1.4, EGFR was low at 52, WBC was high at 18.6, RBC was high at 7.39, HGB was 22.6, HCT was 66.4, RDW was high at 15, RDWFD was 45.5, and platelets were low at 61. The patient came into the emergency room those labs were when he was failing completely and on 01Mar2021 was when he arrived in the ER; at that time his WBC were normal, RBC was high at 6.16, HGB was high at 18.5, HCT was high at 54.9, platelets were low at 73, monocytes absolute were high at 0.96, sodium was low at 129, chloride was low at 95, calcium was low at 8.3, glucose was high at 150 and this was 7 days past the Pfizer COVID Vaccine. The patient was negative for strep pneumonia antigen and negative for Legionnaires Urinary antigen. The chest X-ray was done on 26Feb2021 and the patient was in misery and feeling horrible and they sent him home with albuterol and possible antibiotic to start that Monday and he had severe chills, headache, shortness of breath, fever, fatigue, diarrhea, muscle aches, skin sensitivity and rash, sore throat. Chest X-ray says normal; states the albuterol was PROAIR HFA 90mcg and he tested negative for influenza AB and he never got to the antibiotic because they said to wait til Monday and by that time this was an emergency. The patient outcome of sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage was fatal and unknown for the other events. The patient died on 02Mar2021.  An autopsy was performed that revealed the cause of death was sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.; Reported Cause(s) of Death: Sepsis; Autopsy-determined Cause(s) of Death: Shock due to bilateral pulmonary acute disease syndrome; Diffuse alveolar damage"
	"1394137-1"	"1394137-1"	"HAEMATOCRIT"	"10018837"	"50-59 years"	"50-59"	"Her husband passed away; Sepsis; Shock due to bilateral pulmonary acute disease syndrome; Shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage; misery and feeling horrible; Severe chills; Headache; Shortness of breath; Fever; Fatigue; Diarrhea; Muscle aches; Skin sensitivity and rash; Skin sensitivity and rash; Sore throat; This is a spontaneous report from a contactable consumer. A 57-year-old male patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in arm on 22Feb2021 at 10:00 (Lot Number: EN6202) (at the age of 57-year-old) as single dose for COVID-19 immunisation.  Medical history included high cholesterol from 2017 to an unknown date, seasonal allergy from an unknown date and unknown if ongoing and arteriosclerosis from 2017 to an unknown date. The patient's concomitant medications were not reported.  The patient previously received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 01Feb2021 (Lot Number: EL9264) (at the age of 57-year-old) as single dose for COVID-19 immunisation; the patient previously received ZYRTEC (10mg almost daily) for seasonal allergy, ibuprofen (ADVIL, 200 mg) and TYLENOL both for pain. Caller stated that the patient passed away on 02Mar2021 which was 8 days after the 2nd dose of the Pfizer COVID Vaccine. On 26Feb2021 the patient went to urgent care and then on 01Mar2021 he went to the hospital emergency room (ER).  It was reported that an autopsy was performed on 06Mar2021 and the cause of death listed sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.  The manner of death was natural and the lung presentation is highly suggestive of diffuse alveolar damage due to COVID-19 although the patient had several negative tests for COVID. The patient tested negative for influenza AB, negative for valley fever, negative for Legionnaire's disease and was in the hospital for less than 24 hours. The patient went back to urgent care on 28Feb2021 and was feeling miserable and asking for blood tests and urine tests, stated at that time his platelets were low at 122, glucose was high at 105, sodium was low at 134, calcium was low at 8.3, urine was negative and the patient did not get these labs til Monday when he was on the way to the emergency room and it was all different when he got to the hospital. The test for strep was negative, the oxygen was low at 86 percent when he got to the hospital on Monday and they just had to keep increasing his oxygen, stated a culture, no further details provided about the culture. A CTA done on the chest on Monday which was bad and stated the patient was symptomatic and they did not treat him for COVID but had a clinical suspicion for COVID. Adenovirus was not detected, metapneumonia virus was not detected, respiratory syncytial virus was not detected, parainfluenza was not detected, his platelets kept dropping and he had two tests for valley fever which is Cocci IGG and IGM and those were negative, the sodium level on 02Mar2021 was 126, all of these things were low: chloride 92, CO2 18, calcium 7.8, glucose was high at 222, bun was high at 21, creatinine was high at 1.4, EGFR was low at 52, WBC was high at 18.6, RBC was high at 7.39, HGB was 22.6, HCT was 66.4, RDW was high at 15, RDWFD was 45.5, and platelets were low at 61. The patient came into the emergency room those labs were when he was failing completely and on 01Mar2021 was when he arrived in the ER; at that time his WBC were normal, RBC was high at 6.16, HGB was high at 18.5, HCT was high at 54.9, platelets were low at 73, monocytes absolute were high at 0.96, sodium was low at 129, chloride was low at 95, calcium was low at 8.3, glucose was high at 150 and this was 7 days past the Pfizer COVID Vaccine. The patient was negative for strep pneumonia antigen and negative for Legionnaires Urinary antigen. The chest X-ray was done on 26Feb2021 and the patient was in misery and feeling horrible and they sent him home with albuterol and possible antibiotic to start that Monday and he had severe chills, headache, shortness of breath, fever, fatigue, diarrhea, muscle aches, skin sensitivity and rash, sore throat. Chest X-ray says normal; states the albuterol was PROAIR HFA 90mcg and he tested negative for influenza AB and he never got to the antibiotic because they said to wait til Monday and by that time this was an emergency. The patient outcome of sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage was fatal and unknown for the other events. The patient died on 02Mar2021.  An autopsy was performed that revealed the cause of death was sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.; Reported Cause(s) of Death: Sepsis; Autopsy-determined Cause(s) of Death: Shock due to bilateral pulmonary acute disease syndrome; Diffuse alveolar damage"
	"1394137-1"	"1394137-1"	"HAEMOGLOBIN"	"10018876"	"50-59 years"	"50-59"	"Her husband passed away; Sepsis; Shock due to bilateral pulmonary acute disease syndrome; Shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage; misery and feeling horrible; Severe chills; Headache; Shortness of breath; Fever; Fatigue; Diarrhea; Muscle aches; Skin sensitivity and rash; Skin sensitivity and rash; Sore throat; This is a spontaneous report from a contactable consumer. A 57-year-old male patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in arm on 22Feb2021 at 10:00 (Lot Number: EN6202) (at the age of 57-year-old) as single dose for COVID-19 immunisation.  Medical history included high cholesterol from 2017 to an unknown date, seasonal allergy from an unknown date and unknown if ongoing and arteriosclerosis from 2017 to an unknown date. The patient's concomitant medications were not reported.  The patient previously received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 01Feb2021 (Lot Number: EL9264) (at the age of 57-year-old) as single dose for COVID-19 immunisation; the patient previously received ZYRTEC (10mg almost daily) for seasonal allergy, ibuprofen (ADVIL, 200 mg) and TYLENOL both for pain. Caller stated that the patient passed away on 02Mar2021 which was 8 days after the 2nd dose of the Pfizer COVID Vaccine. On 26Feb2021 the patient went to urgent care and then on 01Mar2021 he went to the hospital emergency room (ER).  It was reported that an autopsy was performed on 06Mar2021 and the cause of death listed sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.  The manner of death was natural and the lung presentation is highly suggestive of diffuse alveolar damage due to COVID-19 although the patient had several negative tests for COVID. The patient tested negative for influenza AB, negative for valley fever, negative for Legionnaire's disease and was in the hospital for less than 24 hours. The patient went back to urgent care on 28Feb2021 and was feeling miserable and asking for blood tests and urine tests, stated at that time his platelets were low at 122, glucose was high at 105, sodium was low at 134, calcium was low at 8.3, urine was negative and the patient did not get these labs til Monday when he was on the way to the emergency room and it was all different when he got to the hospital. The test for strep was negative, the oxygen was low at 86 percent when he got to the hospital on Monday and they just had to keep increasing his oxygen, stated a culture, no further details provided about the culture. A CTA done on the chest on Monday which was bad and stated the patient was symptomatic and they did not treat him for COVID but had a clinical suspicion for COVID. Adenovirus was not detected, metapneumonia virus was not detected, respiratory syncytial virus was not detected, parainfluenza was not detected, his platelets kept dropping and he had two tests for valley fever which is Cocci IGG and IGM and those were negative, the sodium level on 02Mar2021 was 126, all of these things were low: chloride 92, CO2 18, calcium 7.8, glucose was high at 222, bun was high at 21, creatinine was high at 1.4, EGFR was low at 52, WBC was high at 18.6, RBC was high at 7.39, HGB was 22.6, HCT was 66.4, RDW was high at 15, RDWFD was 45.5, and platelets were low at 61. The patient came into the emergency room those labs were when he was failing completely and on 01Mar2021 was when he arrived in the ER; at that time his WBC were normal, RBC was high at 6.16, HGB was high at 18.5, HCT was high at 54.9, platelets were low at 73, monocytes absolute were high at 0.96, sodium was low at 129, chloride was low at 95, calcium was low at 8.3, glucose was high at 150 and this was 7 days past the Pfizer COVID Vaccine. The patient was negative for strep pneumonia antigen and negative for Legionnaires Urinary antigen. The chest X-ray was done on 26Feb2021 and the patient was in misery and feeling horrible and they sent him home with albuterol and possible antibiotic to start that Monday and he had severe chills, headache, shortness of breath, fever, fatigue, diarrhea, muscle aches, skin sensitivity and rash, sore throat. Chest X-ray says normal; states the albuterol was PROAIR HFA 90mcg and he tested negative for influenza AB and he never got to the antibiotic because they said to wait til Monday and by that time this was an emergency. The patient outcome of sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage was fatal and unknown for the other events. The patient died on 02Mar2021.  An autopsy was performed that revealed the cause of death was sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.; Reported Cause(s) of Death: Sepsis; Autopsy-determined Cause(s) of Death: Shock due to bilateral pulmonary acute disease syndrome; Diffuse alveolar damage"
	"1394137-1"	"1394137-1"	"HEADACHE"	"10019211"	"50-59 years"	"50-59"	"Her husband passed away; Sepsis; Shock due to bilateral pulmonary acute disease syndrome; Shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage; misery and feeling horrible; Severe chills; Headache; Shortness of breath; Fever; Fatigue; Diarrhea; Muscle aches; Skin sensitivity and rash; Skin sensitivity and rash; Sore throat; This is a spontaneous report from a contactable consumer. A 57-year-old male patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in arm on 22Feb2021 at 10:00 (Lot Number: EN6202) (at the age of 57-year-old) as single dose for COVID-19 immunisation.  Medical history included high cholesterol from 2017 to an unknown date, seasonal allergy from an unknown date and unknown if ongoing and arteriosclerosis from 2017 to an unknown date. The patient's concomitant medications were not reported.  The patient previously received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 01Feb2021 (Lot Number: EL9264) (at the age of 57-year-old) as single dose for COVID-19 immunisation; the patient previously received ZYRTEC (10mg almost daily) for seasonal allergy, ibuprofen (ADVIL, 200 mg) and TYLENOL both for pain. Caller stated that the patient passed away on 02Mar2021 which was 8 days after the 2nd dose of the Pfizer COVID Vaccine. On 26Feb2021 the patient went to urgent care and then on 01Mar2021 he went to the hospital emergency room (ER).  It was reported that an autopsy was performed on 06Mar2021 and the cause of death listed sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.  The manner of death was natural and the lung presentation is highly suggestive of diffuse alveolar damage due to COVID-19 although the patient had several negative tests for COVID. The patient tested negative for influenza AB, negative for valley fever, negative for Legionnaire's disease and was in the hospital for less than 24 hours. The patient went back to urgent care on 28Feb2021 and was feeling miserable and asking for blood tests and urine tests, stated at that time his platelets were low at 122, glucose was high at 105, sodium was low at 134, calcium was low at 8.3, urine was negative and the patient did not get these labs til Monday when he was on the way to the emergency room and it was all different when he got to the hospital. The test for strep was negative, the oxygen was low at 86 percent when he got to the hospital on Monday and they just had to keep increasing his oxygen, stated a culture, no further details provided about the culture. A CTA done on the chest on Monday which was bad and stated the patient was symptomatic and they did not treat him for COVID but had a clinical suspicion for COVID. Adenovirus was not detected, metapneumonia virus was not detected, respiratory syncytial virus was not detected, parainfluenza was not detected, his platelets kept dropping and he had two tests for valley fever which is Cocci IGG and IGM and those were negative, the sodium level on 02Mar2021 was 126, all of these things were low: chloride 92, CO2 18, calcium 7.8, glucose was high at 222, bun was high at 21, creatinine was high at 1.4, EGFR was low at 52, WBC was high at 18.6, RBC was high at 7.39, HGB was 22.6, HCT was 66.4, RDW was high at 15, RDWFD was 45.5, and platelets were low at 61. The patient came into the emergency room those labs were when he was failing completely and on 01Mar2021 was when he arrived in the ER; at that time his WBC were normal, RBC was high at 6.16, HGB was high at 18.5, HCT was high at 54.9, platelets were low at 73, monocytes absolute were high at 0.96, sodium was low at 129, chloride was low at 95, calcium was low at 8.3, glucose was high at 150 and this was 7 days past the Pfizer COVID Vaccine. The patient was negative for strep pneumonia antigen and negative for Legionnaires Urinary antigen. The chest X-ray was done on 26Feb2021 and the patient was in misery and feeling horrible and they sent him home with albuterol and possible antibiotic to start that Monday and he had severe chills, headache, shortness of breath, fever, fatigue, diarrhea, muscle aches, skin sensitivity and rash, sore throat. Chest X-ray says normal; states the albuterol was PROAIR HFA 90mcg and he tested negative for influenza AB and he never got to the antibiotic because they said to wait til Monday and by that time this was an emergency. The patient outcome of sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage was fatal and unknown for the other events. The patient died on 02Mar2021.  An autopsy was performed that revealed the cause of death was sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.; Reported Cause(s) of Death: Sepsis; Autopsy-determined Cause(s) of Death: Shock due to bilateral pulmonary acute disease syndrome; Diffuse alveolar damage"
	"1394137-1"	"1394137-1"	"INFLUENZA A VIRUS TEST"	"10070416"	"50-59 years"	"50-59"	"Her husband passed away; Sepsis; Shock due to bilateral pulmonary acute disease syndrome; Shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage; misery and feeling horrible; Severe chills; Headache; Shortness of breath; Fever; Fatigue; Diarrhea; Muscle aches; Skin sensitivity and rash; Skin sensitivity and rash; Sore throat; This is a spontaneous report from a contactable consumer. A 57-year-old male patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in arm on 22Feb2021 at 10:00 (Lot Number: EN6202) (at the age of 57-year-old) as single dose for COVID-19 immunisation.  Medical history included high cholesterol from 2017 to an unknown date, seasonal allergy from an unknown date and unknown if ongoing and arteriosclerosis from 2017 to an unknown date. The patient's concomitant medications were not reported.  The patient previously received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 01Feb2021 (Lot Number: EL9264) (at the age of 57-year-old) as single dose for COVID-19 immunisation; the patient previously received ZYRTEC (10mg almost daily) for seasonal allergy, ibuprofen (ADVIL, 200 mg) and TYLENOL both for pain. Caller stated that the patient passed away on 02Mar2021 which was 8 days after the 2nd dose of the Pfizer COVID Vaccine. On 26Feb2021 the patient went to urgent care and then on 01Mar2021 he went to the hospital emergency room (ER).  It was reported that an autopsy was performed on 06Mar2021 and the cause of death listed sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.  The manner of death was natural and the lung presentation is highly suggestive of diffuse alveolar damage due to COVID-19 although the patient had several negative tests for COVID. The patient tested negative for influenza AB, negative for valley fever, negative for Legionnaire's disease and was in the hospital for less than 24 hours. The patient went back to urgent care on 28Feb2021 and was feeling miserable and asking for blood tests and urine tests, stated at that time his platelets were low at 122, glucose was high at 105, sodium was low at 134, calcium was low at 8.3, urine was negative and the patient did not get these labs til Monday when he was on the way to the emergency room and it was all different when he got to the hospital. The test for strep was negative, the oxygen was low at 86 percent when he got to the hospital on Monday and they just had to keep increasing his oxygen, stated a culture, no further details provided about the culture. A CTA done on the chest on Monday which was bad and stated the patient was symptomatic and they did not treat him for COVID but had a clinical suspicion for COVID. Adenovirus was not detected, metapneumonia virus was not detected, respiratory syncytial virus was not detected, parainfluenza was not detected, his platelets kept dropping and he had two tests for valley fever which is Cocci IGG and IGM and those were negative, the sodium level on 02Mar2021 was 126, all of these things were low: chloride 92, CO2 18, calcium 7.8, glucose was high at 222, bun was high at 21, creatinine was high at 1.4, EGFR was low at 52, WBC was high at 18.6, RBC was high at 7.39, HGB was 22.6, HCT was 66.4, RDW was high at 15, RDWFD was 45.5, and platelets were low at 61. The patient came into the emergency room those labs were when he was failing completely and on 01Mar2021 was when he arrived in the ER; at that time his WBC were normal, RBC was high at 6.16, HGB was high at 18.5, HCT was high at 54.9, platelets were low at 73, monocytes absolute were high at 0.96, sodium was low at 129, chloride was low at 95, calcium was low at 8.3, glucose was high at 150 and this was 7 days past the Pfizer COVID Vaccine. The patient was negative for strep pneumonia antigen and negative for Legionnaires Urinary antigen. The chest X-ray was done on 26Feb2021 and the patient was in misery and feeling horrible and they sent him home with albuterol and possible antibiotic to start that Monday and he had severe chills, headache, shortness of breath, fever, fatigue, diarrhea, muscle aches, skin sensitivity and rash, sore throat. Chest X-ray says normal; states the albuterol was PROAIR HFA 90mcg and he tested negative for influenza AB and he never got to the antibiotic because they said to wait til Monday and by that time this was an emergency. The patient outcome of sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage was fatal and unknown for the other events. The patient died on 02Mar2021.  An autopsy was performed that revealed the cause of death was sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.; Reported Cause(s) of Death: Sepsis; Autopsy-determined Cause(s) of Death: Shock due to bilateral pulmonary acute disease syndrome; Diffuse alveolar damage"
	"1394137-1"	"1394137-1"	"INFLUENZA B VIRUS TEST"	"10071544"	"50-59 years"	"50-59"	"Her husband passed away; Sepsis; Shock due to bilateral pulmonary acute disease syndrome; Shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage; misery and feeling horrible; Severe chills; Headache; Shortness of breath; Fever; Fatigue; Diarrhea; Muscle aches; Skin sensitivity and rash; Skin sensitivity and rash; Sore throat; This is a spontaneous report from a contactable consumer. A 57-year-old male patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in arm on 22Feb2021 at 10:00 (Lot Number: EN6202) (at the age of 57-year-old) as single dose for COVID-19 immunisation.  Medical history included high cholesterol from 2017 to an unknown date, seasonal allergy from an unknown date and unknown if ongoing and arteriosclerosis from 2017 to an unknown date. The patient's concomitant medications were not reported.  The patient previously received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 01Feb2021 (Lot Number: EL9264) (at the age of 57-year-old) as single dose for COVID-19 immunisation; the patient previously received ZYRTEC (10mg almost daily) for seasonal allergy, ibuprofen (ADVIL, 200 mg) and TYLENOL both for pain. Caller stated that the patient passed away on 02Mar2021 which was 8 days after the 2nd dose of the Pfizer COVID Vaccine. On 26Feb2021 the patient went to urgent care and then on 01Mar2021 he went to the hospital emergency room (ER).  It was reported that an autopsy was performed on 06Mar2021 and the cause of death listed sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.  The manner of death was natural and the lung presentation is highly suggestive of diffuse alveolar damage due to COVID-19 although the patient had several negative tests for COVID. The patient tested negative for influenza AB, negative for valley fever, negative for Legionnaire's disease and was in the hospital for less than 24 hours. The patient went back to urgent care on 28Feb2021 and was feeling miserable and asking for blood tests and urine tests, stated at that time his platelets were low at 122, glucose was high at 105, sodium was low at 134, calcium was low at 8.3, urine was negative and the patient did not get these labs til Monday when he was on the way to the emergency room and it was all different when he got to the hospital. The test for strep was negative, the oxygen was low at 86 percent when he got to the hospital on Monday and they just had to keep increasing his oxygen, stated a culture, no further details provided about the culture. A CTA done on the chest on Monday which was bad and stated the patient was symptomatic and they did not treat him for COVID but had a clinical suspicion for COVID. Adenovirus was not detected, metapneumonia virus was not detected, respiratory syncytial virus was not detected, parainfluenza was not detected, his platelets kept dropping and he had two tests for valley fever which is Cocci IGG and IGM and those were negative, the sodium level on 02Mar2021 was 126, all of these things were low: chloride 92, CO2 18, calcium 7.8, glucose was high at 222, bun was high at 21, creatinine was high at 1.4, EGFR was low at 52, WBC was high at 18.6, RBC was high at 7.39, HGB was 22.6, HCT was 66.4, RDW was high at 15, RDWFD was 45.5, and platelets were low at 61. The patient came into the emergency room those labs were when he was failing completely and on 01Mar2021 was when he arrived in the ER; at that time his WBC were normal, RBC was high at 6.16, HGB was high at 18.5, HCT was high at 54.9, platelets were low at 73, monocytes absolute were high at 0.96, sodium was low at 129, chloride was low at 95, calcium was low at 8.3, glucose was high at 150 and this was 7 days past the Pfizer COVID Vaccine. The patient was negative for strep pneumonia antigen and negative for Legionnaires Urinary antigen. The chest X-ray was done on 26Feb2021 and the patient was in misery and feeling horrible and they sent him home with albuterol and possible antibiotic to start that Monday and he had severe chills, headache, shortness of breath, fever, fatigue, diarrhea, muscle aches, skin sensitivity and rash, sore throat. Chest X-ray says normal; states the albuterol was PROAIR HFA 90mcg and he tested negative for influenza AB and he never got to the antibiotic because they said to wait til Monday and by that time this was an emergency. The patient outcome of sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage was fatal and unknown for the other events. The patient died on 02Mar2021.  An autopsy was performed that revealed the cause of death was sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.; Reported Cause(s) of Death: Sepsis; Autopsy-determined Cause(s) of Death: Shock due to bilateral pulmonary acute disease syndrome; Diffuse alveolar damage"
	"1394137-1"	"1394137-1"	"MALAISE"	"10025482"	"50-59 years"	"50-59"	"Her husband passed away; Sepsis; Shock due to bilateral pulmonary acute disease syndrome; Shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage; misery and feeling horrible; Severe chills; Headache; Shortness of breath; Fever; Fatigue; Diarrhea; Muscle aches; Skin sensitivity and rash; Skin sensitivity and rash; Sore throat; This is a spontaneous report from a contactable consumer. A 57-year-old male patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in arm on 22Feb2021 at 10:00 (Lot Number: EN6202) (at the age of 57-year-old) as single dose for COVID-19 immunisation.  Medical history included high cholesterol from 2017 to an unknown date, seasonal allergy from an unknown date and unknown if ongoing and arteriosclerosis from 2017 to an unknown date. The patient's concomitant medications were not reported.  The patient previously received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 01Feb2021 (Lot Number: EL9264) (at the age of 57-year-old) as single dose for COVID-19 immunisation; the patient previously received ZYRTEC (10mg almost daily) for seasonal allergy, ibuprofen (ADVIL, 200 mg) and TYLENOL both for pain. Caller stated that the patient passed away on 02Mar2021 which was 8 days after the 2nd dose of the Pfizer COVID Vaccine. On 26Feb2021 the patient went to urgent care and then on 01Mar2021 he went to the hospital emergency room (ER).  It was reported that an autopsy was performed on 06Mar2021 and the cause of death listed sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.  The manner of death was natural and the lung presentation is highly suggestive of diffuse alveolar damage due to COVID-19 although the patient had several negative tests for COVID. The patient tested negative for influenza AB, negative for valley fever, negative for Legionnaire's disease and was in the hospital for less than 24 hours. The patient went back to urgent care on 28Feb2021 and was feeling miserable and asking for blood tests and urine tests, stated at that time his platelets were low at 122, glucose was high at 105, sodium was low at 134, calcium was low at 8.3, urine was negative and the patient did not get these labs til Monday when he was on the way to the emergency room and it was all different when he got to the hospital. The test for strep was negative, the oxygen was low at 86 percent when he got to the hospital on Monday and they just had to keep increasing his oxygen, stated a culture, no further details provided about the culture. A CTA done on the chest on Monday which was bad and stated the patient was symptomatic and they did not treat him for COVID but had a clinical suspicion for COVID. Adenovirus was not detected, metapneumonia virus was not detected, respiratory syncytial virus was not detected, parainfluenza was not detected, his platelets kept dropping and he had two tests for valley fever which is Cocci IGG and IGM and those were negative, the sodium level on 02Mar2021 was 126, all of these things were low: chloride 92, CO2 18, calcium 7.8, glucose was high at 222, bun was high at 21, creatinine was high at 1.4, EGFR was low at 52, WBC was high at 18.6, RBC was high at 7.39, HGB was 22.6, HCT was 66.4, RDW was high at 15, RDWFD was 45.5, and platelets were low at 61. The patient came into the emergency room those labs were when he was failing completely and on 01Mar2021 was when he arrived in the ER; at that time his WBC were normal, RBC was high at 6.16, HGB was high at 18.5, HCT was high at 54.9, platelets were low at 73, monocytes absolute were high at 0.96, sodium was low at 129, chloride was low at 95, calcium was low at 8.3, glucose was high at 150 and this was 7 days past the Pfizer COVID Vaccine. The patient was negative for strep pneumonia antigen and negative for Legionnaires Urinary antigen. The chest X-ray was done on 26Feb2021 and the patient was in misery and feeling horrible and they sent him home with albuterol and possible antibiotic to start that Monday and he had severe chills, headache, shortness of breath, fever, fatigue, diarrhea, muscle aches, skin sensitivity and rash, sore throat. Chest X-ray says normal; states the albuterol was PROAIR HFA 90mcg and he tested negative for influenza AB and he never got to the antibiotic because they said to wait til Monday and by that time this was an emergency. The patient outcome of sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage was fatal and unknown for the other events. The patient died on 02Mar2021.  An autopsy was performed that revealed the cause of death was sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.; Reported Cause(s) of Death: Sepsis; Autopsy-determined Cause(s) of Death: Shock due to bilateral pulmonary acute disease syndrome; Diffuse alveolar damage"
	"1394137-1"	"1394137-1"	"METAPNEUMOVIRUS INFECTION"	"10066226"	"50-59 years"	"50-59"	"Her husband passed away; Sepsis; Shock due to bilateral pulmonary acute disease syndrome; Shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage; misery and feeling horrible; Severe chills; Headache; Shortness of breath; Fever; Fatigue; Diarrhea; Muscle aches; Skin sensitivity and rash; Skin sensitivity and rash; Sore throat; This is a spontaneous report from a contactable consumer. A 57-year-old male patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in arm on 22Feb2021 at 10:00 (Lot Number: EN6202) (at the age of 57-year-old) as single dose for COVID-19 immunisation.  Medical history included high cholesterol from 2017 to an unknown date, seasonal allergy from an unknown date and unknown if ongoing and arteriosclerosis from 2017 to an unknown date. The patient's concomitant medications were not reported.  The patient previously received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 01Feb2021 (Lot Number: EL9264) (at the age of 57-year-old) as single dose for COVID-19 immunisation; the patient previously received ZYRTEC (10mg almost daily) for seasonal allergy, ibuprofen (ADVIL, 200 mg) and TYLENOL both for pain. Caller stated that the patient passed away on 02Mar2021 which was 8 days after the 2nd dose of the Pfizer COVID Vaccine. On 26Feb2021 the patient went to urgent care and then on 01Mar2021 he went to the hospital emergency room (ER).  It was reported that an autopsy was performed on 06Mar2021 and the cause of death listed sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.  The manner of death was natural and the lung presentation is highly suggestive of diffuse alveolar damage due to COVID-19 although the patient had several negative tests for COVID. The patient tested negative for influenza AB, negative for valley fever, negative for Legionnaire's disease and was in the hospital for less than 24 hours. The patient went back to urgent care on 28Feb2021 and was feeling miserable and asking for blood tests and urine tests, stated at that time his platelets were low at 122, glucose was high at 105, sodium was low at 134, calcium was low at 8.3, urine was negative and the patient did not get these labs til Monday when he was on the way to the emergency room and it was all different when he got to the hospital. The test for strep was negative, the oxygen was low at 86 percent when he got to the hospital on Monday and they just had to keep increasing his oxygen, stated a culture, no further details provided about the culture. A CTA done on the chest on Monday which was bad and stated the patient was symptomatic and they did not treat him for COVID but had a clinical suspicion for COVID. Adenovirus was not detected, metapneumonia virus was not detected, respiratory syncytial virus was not detected, parainfluenza was not detected, his platelets kept dropping and he had two tests for valley fever which is Cocci IGG and IGM and those were negative, the sodium level on 02Mar2021 was 126, all of these things were low: chloride 92, CO2 18, calcium 7.8, glucose was high at 222, bun was high at 21, creatinine was high at 1.4, EGFR was low at 52, WBC was high at 18.6, RBC was high at 7.39, HGB was 22.6, HCT was 66.4, RDW was high at 15, RDWFD was 45.5, and platelets were low at 61. The patient came into the emergency room those labs were when he was failing completely and on 01Mar2021 was when he arrived in the ER; at that time his WBC were normal, RBC was high at 6.16, HGB was high at 18.5, HCT was high at 54.9, platelets were low at 73, monocytes absolute were high at 0.96, sodium was low at 129, chloride was low at 95, calcium was low at 8.3, glucose was high at 150 and this was 7 days past the Pfizer COVID Vaccine. The patient was negative for strep pneumonia antigen and negative for Legionnaires Urinary antigen. The chest X-ray was done on 26Feb2021 and the patient was in misery and feeling horrible and they sent him home with albuterol and possible antibiotic to start that Monday and he had severe chills, headache, shortness of breath, fever, fatigue, diarrhea, muscle aches, skin sensitivity and rash, sore throat. Chest X-ray says normal; states the albuterol was PROAIR HFA 90mcg and he tested negative for influenza AB and he never got to the antibiotic because they said to wait til Monday and by that time this was an emergency. The patient outcome of sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage was fatal and unknown for the other events. The patient died on 02Mar2021.  An autopsy was performed that revealed the cause of death was sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.; Reported Cause(s) of Death: Sepsis; Autopsy-determined Cause(s) of Death: Shock due to bilateral pulmonary acute disease syndrome; Diffuse alveolar damage"
	"1394137-1"	"1394137-1"	"MONOCYTE COUNT"	"10027876"	"50-59 years"	"50-59"	"Her husband passed away; Sepsis; Shock due to bilateral pulmonary acute disease syndrome; Shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage; misery and feeling horrible; Severe chills; Headache; Shortness of breath; Fever; Fatigue; Diarrhea; Muscle aches; Skin sensitivity and rash; Skin sensitivity and rash; Sore throat; This is a spontaneous report from a contactable consumer. A 57-year-old male patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in arm on 22Feb2021 at 10:00 (Lot Number: EN6202) (at the age of 57-year-old) as single dose for COVID-19 immunisation.  Medical history included high cholesterol from 2017 to an unknown date, seasonal allergy from an unknown date and unknown if ongoing and arteriosclerosis from 2017 to an unknown date. The patient's concomitant medications were not reported.  The patient previously received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 01Feb2021 (Lot Number: EL9264) (at the age of 57-year-old) as single dose for COVID-19 immunisation; the patient previously received ZYRTEC (10mg almost daily) for seasonal allergy, ibuprofen (ADVIL, 200 mg) and TYLENOL both for pain. Caller stated that the patient passed away on 02Mar2021 which was 8 days after the 2nd dose of the Pfizer COVID Vaccine. On 26Feb2021 the patient went to urgent care and then on 01Mar2021 he went to the hospital emergency room (ER).  It was reported that an autopsy was performed on 06Mar2021 and the cause of death listed sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.  The manner of death was natural and the lung presentation is highly suggestive of diffuse alveolar damage due to COVID-19 although the patient had several negative tests for COVID. The patient tested negative for influenza AB, negative for valley fever, negative for Legionnaire's disease and was in the hospital for less than 24 hours. The patient went back to urgent care on 28Feb2021 and was feeling miserable and asking for blood tests and urine tests, stated at that time his platelets were low at 122, glucose was high at 105, sodium was low at 134, calcium was low at 8.3, urine was negative and the patient did not get these labs til Monday when he was on the way to the emergency room and it was all different when he got to the hospital. The test for strep was negative, the oxygen was low at 86 percent when he got to the hospital on Monday and they just had to keep increasing his oxygen, stated a culture, no further details provided about the culture. A CTA done on the chest on Monday which was bad and stated the patient was symptomatic and they did not treat him for COVID but had a clinical suspicion for COVID. Adenovirus was not detected, metapneumonia virus was not detected, respiratory syncytial virus was not detected, parainfluenza was not detected, his platelets kept dropping and he had two tests for valley fever which is Cocci IGG and IGM and those were negative, the sodium level on 02Mar2021 was 126, all of these things were low: chloride 92, CO2 18, calcium 7.8, glucose was high at 222, bun was high at 21, creatinine was high at 1.4, EGFR was low at 52, WBC was high at 18.6, RBC was high at 7.39, HGB was 22.6, HCT was 66.4, RDW was high at 15, RDWFD was 45.5, and platelets were low at 61. The patient came into the emergency room those labs were when he was failing completely and on 01Mar2021 was when he arrived in the ER; at that time his WBC were normal, RBC was high at 6.16, HGB was high at 18.5, HCT was high at 54.9, platelets were low at 73, monocytes absolute were high at 0.96, sodium was low at 129, chloride was low at 95, calcium was low at 8.3, glucose was high at 150 and this was 7 days past the Pfizer COVID Vaccine. The patient was negative for strep pneumonia antigen and negative for Legionnaires Urinary antigen. The chest X-ray was done on 26Feb2021 and the patient was in misery and feeling horrible and they sent him home with albuterol and possible antibiotic to start that Monday and he had severe chills, headache, shortness of breath, fever, fatigue, diarrhea, muscle aches, skin sensitivity and rash, sore throat. Chest X-ray says normal; states the albuterol was PROAIR HFA 90mcg and he tested negative for influenza AB and he never got to the antibiotic because they said to wait til Monday and by that time this was an emergency. The patient outcome of sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage was fatal and unknown for the other events. The patient died on 02Mar2021.  An autopsy was performed that revealed the cause of death was sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.; Reported Cause(s) of Death: Sepsis; Autopsy-determined Cause(s) of Death: Shock due to bilateral pulmonary acute disease syndrome; Diffuse alveolar damage"
	"1394137-1"	"1394137-1"	"MYALGIA"	"10028411"	"50-59 years"	"50-59"	"Her husband passed away; Sepsis; Shock due to bilateral pulmonary acute disease syndrome; Shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage; misery and feeling horrible; Severe chills; Headache; Shortness of breath; Fever; Fatigue; Diarrhea; Muscle aches; Skin sensitivity and rash; Skin sensitivity and rash; Sore throat; This is a spontaneous report from a contactable consumer. A 57-year-old male patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in arm on 22Feb2021 at 10:00 (Lot Number: EN6202) (at the age of 57-year-old) as single dose for COVID-19 immunisation.  Medical history included high cholesterol from 2017 to an unknown date, seasonal allergy from an unknown date and unknown if ongoing and arteriosclerosis from 2017 to an unknown date. The patient's concomitant medications were not reported.  The patient previously received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 01Feb2021 (Lot Number: EL9264) (at the age of 57-year-old) as single dose for COVID-19 immunisation; the patient previously received ZYRTEC (10mg almost daily) for seasonal allergy, ibuprofen (ADVIL, 200 mg) and TYLENOL both for pain. Caller stated that the patient passed away on 02Mar2021 which was 8 days after the 2nd dose of the Pfizer COVID Vaccine. On 26Feb2021 the patient went to urgent care and then on 01Mar2021 he went to the hospital emergency room (ER).  It was reported that an autopsy was performed on 06Mar2021 and the cause of death listed sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.  The manner of death was natural and the lung presentation is highly suggestive of diffuse alveolar damage due to COVID-19 although the patient had several negative tests for COVID. The patient tested negative for influenza AB, negative for valley fever, negative for Legionnaire's disease and was in the hospital for less than 24 hours. The patient went back to urgent care on 28Feb2021 and was feeling miserable and asking for blood tests and urine tests, stated at that time his platelets were low at 122, glucose was high at 105, sodium was low at 134, calcium was low at 8.3, urine was negative and the patient did not get these labs til Monday when he was on the way to the emergency room and it was all different when he got to the hospital. The test for strep was negative, the oxygen was low at 86 percent when he got to the hospital on Monday and they just had to keep increasing his oxygen, stated a culture, no further details provided about the culture. A CTA done on the chest on Monday which was bad and stated the patient was symptomatic and they did not treat him for COVID but had a clinical suspicion for COVID. Adenovirus was not detected, metapneumonia virus was not detected, respiratory syncytial virus was not detected, parainfluenza was not detected, his platelets kept dropping and he had two tests for valley fever which is Cocci IGG and IGM and those were negative, the sodium level on 02Mar2021 was 126, all of these things were low: chloride 92, CO2 18, calcium 7.8, glucose was high at 222, bun was high at 21, creatinine was high at 1.4, EGFR was low at 52, WBC was high at 18.6, RBC was high at 7.39, HGB was 22.6, HCT was 66.4, RDW was high at 15, RDWFD was 45.5, and platelets were low at 61. The patient came into the emergency room those labs were when he was failing completely and on 01Mar2021 was when he arrived in the ER; at that time his WBC were normal, RBC was high at 6.16, HGB was high at 18.5, HCT was high at 54.9, platelets were low at 73, monocytes absolute were high at 0.96, sodium was low at 129, chloride was low at 95, calcium was low at 8.3, glucose was high at 150 and this was 7 days past the Pfizer COVID Vaccine. The patient was negative for strep pneumonia antigen and negative for Legionnaires Urinary antigen. The chest X-ray was done on 26Feb2021 and the patient was in misery and feeling horrible and they sent him home with albuterol and possible antibiotic to start that Monday and he had severe chills, headache, shortness of breath, fever, fatigue, diarrhea, muscle aches, skin sensitivity and rash, sore throat. Chest X-ray says normal; states the albuterol was PROAIR HFA 90mcg and he tested negative for influenza AB and he never got to the antibiotic because they said to wait til Monday and by that time this was an emergency. The patient outcome of sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage was fatal and unknown for the other events. The patient died on 02Mar2021.  An autopsy was performed that revealed the cause of death was sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.; Reported Cause(s) of Death: Sepsis; Autopsy-determined Cause(s) of Death: Shock due to bilateral pulmonary acute disease syndrome; Diffuse alveolar damage"
	"1394137-1"	"1394137-1"	"OROPHARYNGEAL PAIN"	"10068319"	"50-59 years"	"50-59"	"Her husband passed away; Sepsis; Shock due to bilateral pulmonary acute disease syndrome; Shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage; misery and feeling horrible; Severe chills; Headache; Shortness of breath; Fever; Fatigue; Diarrhea; Muscle aches; Skin sensitivity and rash; Skin sensitivity and rash; Sore throat; This is a spontaneous report from a contactable consumer. A 57-year-old male patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in arm on 22Feb2021 at 10:00 (Lot Number: EN6202) (at the age of 57-year-old) as single dose for COVID-19 immunisation.  Medical history included high cholesterol from 2017 to an unknown date, seasonal allergy from an unknown date and unknown if ongoing and arteriosclerosis from 2017 to an unknown date. The patient's concomitant medications were not reported.  The patient previously received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 01Feb2021 (Lot Number: EL9264) (at the age of 57-year-old) as single dose for COVID-19 immunisation; the patient previously received ZYRTEC (10mg almost daily) for seasonal allergy, ibuprofen (ADVIL, 200 mg) and TYLENOL both for pain. Caller stated that the patient passed away on 02Mar2021 which was 8 days after the 2nd dose of the Pfizer COVID Vaccine. On 26Feb2021 the patient went to urgent care and then on 01Mar2021 he went to the hospital emergency room (ER).  It was reported that an autopsy was performed on 06Mar2021 and the cause of death listed sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.  The manner of death was natural and the lung presentation is highly suggestive of diffuse alveolar damage due to COVID-19 although the patient had several negative tests for COVID. The patient tested negative for influenza AB, negative for valley fever, negative for Legionnaire's disease and was in the hospital for less than 24 hours. The patient went back to urgent care on 28Feb2021 and was feeling miserable and asking for blood tests and urine tests, stated at that time his platelets were low at 122, glucose was high at 105, sodium was low at 134, calcium was low at 8.3, urine was negative and the patient did not get these labs til Monday when he was on the way to the emergency room and it was all different when he got to the hospital. The test for strep was negative, the oxygen was low at 86 percent when he got to the hospital on Monday and they just had to keep increasing his oxygen, stated a culture, no further details provided about the culture. A CTA done on the chest on Monday which was bad and stated the patient was symptomatic and they did not treat him for COVID but had a clinical suspicion for COVID. Adenovirus was not detected, metapneumonia virus was not detected, respiratory syncytial virus was not detected, parainfluenza was not detected, his platelets kept dropping and he had two tests for valley fever which is Cocci IGG and IGM and those were negative, the sodium level on 02Mar2021 was 126, all of these things were low: chloride 92, CO2 18, calcium 7.8, glucose was high at 222, bun was high at 21, creatinine was high at 1.4, EGFR was low at 52, WBC was high at 18.6, RBC was high at 7.39, HGB was 22.6, HCT was 66.4, RDW was high at 15, RDWFD was 45.5, and platelets were low at 61. The patient came into the emergency room those labs were when he was failing completely and on 01Mar2021 was when he arrived in the ER; at that time his WBC were normal, RBC was high at 6.16, HGB was high at 18.5, HCT was high at 54.9, platelets were low at 73, monocytes absolute were high at 0.96, sodium was low at 129, chloride was low at 95, calcium was low at 8.3, glucose was high at 150 and this was 7 days past the Pfizer COVID Vaccine. The patient was negative for strep pneumonia antigen and negative for Legionnaires Urinary antigen. The chest X-ray was done on 26Feb2021 and the patient was in misery and feeling horrible and they sent him home with albuterol and possible antibiotic to start that Monday and he had severe chills, headache, shortness of breath, fever, fatigue, diarrhea, muscle aches, skin sensitivity and rash, sore throat. Chest X-ray says normal; states the albuterol was PROAIR HFA 90mcg and he tested negative for influenza AB and he never got to the antibiotic because they said to wait til Monday and by that time this was an emergency. The patient outcome of sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage was fatal and unknown for the other events. The patient died on 02Mar2021.  An autopsy was performed that revealed the cause of death was sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.; Reported Cause(s) of Death: Sepsis; Autopsy-determined Cause(s) of Death: Shock due to bilateral pulmonary acute disease syndrome; Diffuse alveolar damage"
	"1394137-1"	"1394137-1"	"OXYGEN SATURATION"	"10033316"	"50-59 years"	"50-59"	"Her husband passed away; Sepsis; Shock due to bilateral pulmonary acute disease syndrome; Shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage; misery and feeling horrible; Severe chills; Headache; Shortness of breath; Fever; Fatigue; Diarrhea; Muscle aches; Skin sensitivity and rash; Skin sensitivity and rash; Sore throat; This is a spontaneous report from a contactable consumer. A 57-year-old male patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in arm on 22Feb2021 at 10:00 (Lot Number: EN6202) (at the age of 57-year-old) as single dose for COVID-19 immunisation.  Medical history included high cholesterol from 2017 to an unknown date, seasonal allergy from an unknown date and unknown if ongoing and arteriosclerosis from 2017 to an unknown date. The patient's concomitant medications were not reported.  The patient previously received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 01Feb2021 (Lot Number: EL9264) (at the age of 57-year-old) as single dose for COVID-19 immunisation; the patient previously received ZYRTEC (10mg almost daily) for seasonal allergy, ibuprofen (ADVIL, 200 mg) and TYLENOL both for pain. Caller stated that the patient passed away on 02Mar2021 which was 8 days after the 2nd dose of the Pfizer COVID Vaccine. On 26Feb2021 the patient went to urgent care and then on 01Mar2021 he went to the hospital emergency room (ER).  It was reported that an autopsy was performed on 06Mar2021 and the cause of death listed sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.  The manner of death was natural and the lung presentation is highly suggestive of diffuse alveolar damage due to COVID-19 although the patient had several negative tests for COVID. The patient tested negative for influenza AB, negative for valley fever, negative for Legionnaire's disease and was in the hospital for less than 24 hours. The patient went back to urgent care on 28Feb2021 and was feeling miserable and asking for blood tests and urine tests, stated at that time his platelets were low at 122, glucose was high at 105, sodium was low at 134, calcium was low at 8.3, urine was negative and the patient did not get these labs til Monday when he was on the way to the emergency room and it was all different when he got to the hospital. The test for strep was negative, the oxygen was low at 86 percent when he got to the hospital on Monday and they just had to keep increasing his oxygen, stated a culture, no further details provided about the culture. A CTA done on the chest on Monday which was bad and stated the patient was symptomatic and they did not treat him for COVID but had a clinical suspicion for COVID. Adenovirus was not detected, metapneumonia virus was not detected, respiratory syncytial virus was not detected, parainfluenza was not detected, his platelets kept dropping and he had two tests for valley fever which is Cocci IGG and IGM and those were negative, the sodium level on 02Mar2021 was 126, all of these things were low: chloride 92, CO2 18, calcium 7.8, glucose was high at 222, bun was high at 21, creatinine was high at 1.4, EGFR was low at 52, WBC was high at 18.6, RBC was high at 7.39, HGB was 22.6, HCT was 66.4, RDW was high at 15, RDWFD was 45.5, and platelets were low at 61. The patient came into the emergency room those labs were when he was failing completely and on 01Mar2021 was when he arrived in the ER; at that time his WBC were normal, RBC was high at 6.16, HGB was high at 18.5, HCT was high at 54.9, platelets were low at 73, monocytes absolute were high at 0.96, sodium was low at 129, chloride was low at 95, calcium was low at 8.3, glucose was high at 150 and this was 7 days past the Pfizer COVID Vaccine. The patient was negative for strep pneumonia antigen and negative for Legionnaires Urinary antigen. The chest X-ray was done on 26Feb2021 and the patient was in misery and feeling horrible and they sent him home with albuterol and possible antibiotic to start that Monday and he had severe chills, headache, shortness of breath, fever, fatigue, diarrhea, muscle aches, skin sensitivity and rash, sore throat. Chest X-ray says normal; states the albuterol was PROAIR HFA 90mcg and he tested negative for influenza AB and he never got to the antibiotic because they said to wait til Monday and by that time this was an emergency. The patient outcome of sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage was fatal and unknown for the other events. The patient died on 02Mar2021.  An autopsy was performed that revealed the cause of death was sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.; Reported Cause(s) of Death: Sepsis; Autopsy-determined Cause(s) of Death: Shock due to bilateral pulmonary acute disease syndrome; Diffuse alveolar damage"
	"1394137-1"	"1394137-1"	"PARAINFLUENZAE VIRUS INFECTION"	"10061907"	"50-59 years"	"50-59"	"Her husband passed away; Sepsis; Shock due to bilateral pulmonary acute disease syndrome; Shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage; misery and feeling horrible; Severe chills; Headache; Shortness of breath; Fever; Fatigue; Diarrhea; Muscle aches; Skin sensitivity and rash; Skin sensitivity and rash; Sore throat; This is a spontaneous report from a contactable consumer. A 57-year-old male patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in arm on 22Feb2021 at 10:00 (Lot Number: EN6202) (at the age of 57-year-old) as single dose for COVID-19 immunisation.  Medical history included high cholesterol from 2017 to an unknown date, seasonal allergy from an unknown date and unknown if ongoing and arteriosclerosis from 2017 to an unknown date. The patient's concomitant medications were not reported.  The patient previously received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 01Feb2021 (Lot Number: EL9264) (at the age of 57-year-old) as single dose for COVID-19 immunisation; the patient previously received ZYRTEC (10mg almost daily) for seasonal allergy, ibuprofen (ADVIL, 200 mg) and TYLENOL both for pain. Caller stated that the patient passed away on 02Mar2021 which was 8 days after the 2nd dose of the Pfizer COVID Vaccine. On 26Feb2021 the patient went to urgent care and then on 01Mar2021 he went to the hospital emergency room (ER).  It was reported that an autopsy was performed on 06Mar2021 and the cause of death listed sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.  The manner of death was natural and the lung presentation is highly suggestive of diffuse alveolar damage due to COVID-19 although the patient had several negative tests for COVID. The patient tested negative for influenza AB, negative for valley fever, negative for Legionnaire's disease and was in the hospital for less than 24 hours. The patient went back to urgent care on 28Feb2021 and was feeling miserable and asking for blood tests and urine tests, stated at that time his platelets were low at 122, glucose was high at 105, sodium was low at 134, calcium was low at 8.3, urine was negative and the patient did not get these labs til Monday when he was on the way to the emergency room and it was all different when he got to the hospital. The test for strep was negative, the oxygen was low at 86 percent when he got to the hospital on Monday and they just had to keep increasing his oxygen, stated a culture, no further details provided about the culture. A CTA done on the chest on Monday which was bad and stated the patient was symptomatic and they did not treat him for COVID but had a clinical suspicion for COVID. Adenovirus was not detected, metapneumonia virus was not detected, respiratory syncytial virus was not detected, parainfluenza was not detected, his platelets kept dropping and he had two tests for valley fever which is Cocci IGG and IGM and those were negative, the sodium level on 02Mar2021 was 126, all of these things were low: chloride 92, CO2 18, calcium 7.8, glucose was high at 222, bun was high at 21, creatinine was high at 1.4, EGFR was low at 52, WBC was high at 18.6, RBC was high at 7.39, HGB was 22.6, HCT was 66.4, RDW was high at 15, RDWFD was 45.5, and platelets were low at 61. The patient came into the emergency room those labs were when he was failing completely and on 01Mar2021 was when he arrived in the ER; at that time his WBC were normal, RBC was high at 6.16, HGB was high at 18.5, HCT was high at 54.9, platelets were low at 73, monocytes absolute were high at 0.96, sodium was low at 129, chloride was low at 95, calcium was low at 8.3, glucose was high at 150 and this was 7 days past the Pfizer COVID Vaccine. The patient was negative for strep pneumonia antigen and negative for Legionnaires Urinary antigen. The chest X-ray was done on 26Feb2021 and the patient was in misery and feeling horrible and they sent him home with albuterol and possible antibiotic to start that Monday and he had severe chills, headache, shortness of breath, fever, fatigue, diarrhea, muscle aches, skin sensitivity and rash, sore throat. Chest X-ray says normal; states the albuterol was PROAIR HFA 90mcg and he tested negative for influenza AB and he never got to the antibiotic because they said to wait til Monday and by that time this was an emergency. The patient outcome of sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage was fatal and unknown for the other events. The patient died on 02Mar2021.  An autopsy was performed that revealed the cause of death was sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.; Reported Cause(s) of Death: Sepsis; Autopsy-determined Cause(s) of Death: Shock due to bilateral pulmonary acute disease syndrome; Diffuse alveolar damage"
	"1394137-1"	"1394137-1"	"PLATELET COUNT DECREASED"	"10035528"	"50-59 years"	"50-59"	"Her husband passed away; Sepsis; Shock due to bilateral pulmonary acute disease syndrome; Shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage; misery and feeling horrible; Severe chills; Headache; Shortness of breath; Fever; Fatigue; Diarrhea; Muscle aches; Skin sensitivity and rash; Skin sensitivity and rash; Sore throat; This is a spontaneous report from a contactable consumer. A 57-year-old male patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in arm on 22Feb2021 at 10:00 (Lot Number: EN6202) (at the age of 57-year-old) as single dose for COVID-19 immunisation.  Medical history included high cholesterol from 2017 to an unknown date, seasonal allergy from an unknown date and unknown if ongoing and arteriosclerosis from 2017 to an unknown date. The patient's concomitant medications were not reported.  The patient previously received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 01Feb2021 (Lot Number: EL9264) (at the age of 57-year-old) as single dose for COVID-19 immunisation; the patient previously received ZYRTEC (10mg almost daily) for seasonal allergy, ibuprofen (ADVIL, 200 mg) and TYLENOL both for pain. Caller stated that the patient passed away on 02Mar2021 which was 8 days after the 2nd dose of the Pfizer COVID Vaccine. On 26Feb2021 the patient went to urgent care and then on 01Mar2021 he went to the hospital emergency room (ER).  It was reported that an autopsy was performed on 06Mar2021 and the cause of death listed sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.  The manner of death was natural and the lung presentation is highly suggestive of diffuse alveolar damage due to COVID-19 although the patient had several negative tests for COVID. The patient tested negative for influenza AB, negative for valley fever, negative for Legionnaire's disease and was in the hospital for less than 24 hours. The patient went back to urgent care on 28Feb2021 and was feeling miserable and asking for blood tests and urine tests, stated at that time his platelets were low at 122, glucose was high at 105, sodium was low at 134, calcium was low at 8.3, urine was negative and the patient did not get these labs til Monday when he was on the way to the emergency room and it was all different when he got to the hospital. The test for strep was negative, the oxygen was low at 86 percent when he got to the hospital on Monday and they just had to keep increasing his oxygen, stated a culture, no further details provided about the culture. A CTA done on the chest on Monday which was bad and stated the patient was symptomatic and they did not treat him for COVID but had a clinical suspicion for COVID. Adenovirus was not detected, metapneumonia virus was not detected, respiratory syncytial virus was not detected, parainfluenza was not detected, his platelets kept dropping and he had two tests for valley fever which is Cocci IGG and IGM and those were negative, the sodium level on 02Mar2021 was 126, all of these things were low: chloride 92, CO2 18, calcium 7.8, glucose was high at 222, bun was high at 21, creatinine was high at 1.4, EGFR was low at 52, WBC was high at 18.6, RBC was high at 7.39, HGB was 22.6, HCT was 66.4, RDW was high at 15, RDWFD was 45.5, and platelets were low at 61. The patient came into the emergency room those labs were when he was failing completely and on 01Mar2021 was when he arrived in the ER; at that time his WBC were normal, RBC was high at 6.16, HGB was high at 18.5, HCT was high at 54.9, platelets were low at 73, monocytes absolute were high at 0.96, sodium was low at 129, chloride was low at 95, calcium was low at 8.3, glucose was high at 150 and this was 7 days past the Pfizer COVID Vaccine. The patient was negative for strep pneumonia antigen and negative for Legionnaires Urinary antigen. The chest X-ray was done on 26Feb2021 and the patient was in misery and feeling horrible and they sent him home with albuterol and possible antibiotic to start that Monday and he had severe chills, headache, shortness of breath, fever, fatigue, diarrhea, muscle aches, skin sensitivity and rash, sore throat. Chest X-ray says normal; states the albuterol was PROAIR HFA 90mcg and he tested negative for influenza AB and he never got to the antibiotic because they said to wait til Monday and by that time this was an emergency. The patient outcome of sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage was fatal and unknown for the other events. The patient died on 02Mar2021.  An autopsy was performed that revealed the cause of death was sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.; Reported Cause(s) of Death: Sepsis; Autopsy-determined Cause(s) of Death: Shock due to bilateral pulmonary acute disease syndrome; Diffuse alveolar damage"
	"1394137-1"	"1394137-1"	"PNEUMONIA LEGIONELLA"	"10035718"	"50-59 years"	"50-59"	"Her husband passed away; Sepsis; Shock due to bilateral pulmonary acute disease syndrome; Shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage; misery and feeling horrible; Severe chills; Headache; Shortness of breath; Fever; Fatigue; Diarrhea; Muscle aches; Skin sensitivity and rash; Skin sensitivity and rash; Sore throat; This is a spontaneous report from a contactable consumer. A 57-year-old male patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in arm on 22Feb2021 at 10:00 (Lot Number: EN6202) (at the age of 57-year-old) as single dose for COVID-19 immunisation.  Medical history included high cholesterol from 2017 to an unknown date, seasonal allergy from an unknown date and unknown if ongoing and arteriosclerosis from 2017 to an unknown date. The patient's concomitant medications were not reported.  The patient previously received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 01Feb2021 (Lot Number: EL9264) (at the age of 57-year-old) as single dose for COVID-19 immunisation; the patient previously received ZYRTEC (10mg almost daily) for seasonal allergy, ibuprofen (ADVIL, 200 mg) and TYLENOL both for pain. Caller stated that the patient passed away on 02Mar2021 which was 8 days after the 2nd dose of the Pfizer COVID Vaccine. On 26Feb2021 the patient went to urgent care and then on 01Mar2021 he went to the hospital emergency room (ER).  It was reported that an autopsy was performed on 06Mar2021 and the cause of death listed sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.  The manner of death was natural and the lung presentation is highly suggestive of diffuse alveolar damage due to COVID-19 although the patient had several negative tests for COVID. The patient tested negative for influenza AB, negative for valley fever, negative for Legionnaire's disease and was in the hospital for less than 24 hours. The patient went back to urgent care on 28Feb2021 and was feeling miserable and asking for blood tests and urine tests, stated at that time his platelets were low at 122, glucose was high at 105, sodium was low at 134, calcium was low at 8.3, urine was negative and the patient did not get these labs til Monday when he was on the way to the emergency room and it was all different when he got to the hospital. The test for strep was negative, the oxygen was low at 86 percent when he got to the hospital on Monday and they just had to keep increasing his oxygen, stated a culture, no further details provided about the culture. A CTA done on the chest on Monday which was bad and stated the patient was symptomatic and they did not treat him for COVID but had a clinical suspicion for COVID. Adenovirus was not detected, metapneumonia virus was not detected, respiratory syncytial virus was not detected, parainfluenza was not detected, his platelets kept dropping and he had two tests for valley fever which is Cocci IGG and IGM and those were negative, the sodium level on 02Mar2021 was 126, all of these things were low: chloride 92, CO2 18, calcium 7.8, glucose was high at 222, bun was high at 21, creatinine was high at 1.4, EGFR was low at 52, WBC was high at 18.6, RBC was high at 7.39, HGB was 22.6, HCT was 66.4, RDW was high at 15, RDWFD was 45.5, and platelets were low at 61. The patient came into the emergency room those labs were when he was failing completely and on 01Mar2021 was when he arrived in the ER; at that time his WBC were normal, RBC was high at 6.16, HGB was high at 18.5, HCT was high at 54.9, platelets were low at 73, monocytes absolute were high at 0.96, sodium was low at 129, chloride was low at 95, calcium was low at 8.3, glucose was high at 150 and this was 7 days past the Pfizer COVID Vaccine. The patient was negative for strep pneumonia antigen and negative for Legionnaires Urinary antigen. The chest X-ray was done on 26Feb2021 and the patient was in misery and feeling horrible and they sent him home with albuterol and possible antibiotic to start that Monday and he had severe chills, headache, shortness of breath, fever, fatigue, diarrhea, muscle aches, skin sensitivity and rash, sore throat. Chest X-ray says normal; states the albuterol was PROAIR HFA 90mcg and he tested negative for influenza AB and he never got to the antibiotic because they said to wait til Monday and by that time this was an emergency. The patient outcome of sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage was fatal and unknown for the other events. The patient died on 02Mar2021.  An autopsy was performed that revealed the cause of death was sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.; Reported Cause(s) of Death: Sepsis; Autopsy-determined Cause(s) of Death: Shock due to bilateral pulmonary acute disease syndrome; Diffuse alveolar damage"
	"1394137-1"	"1394137-1"	"PYREXIA"	"10037660"	"50-59 years"	"50-59"	"Her husband passed away; Sepsis; Shock due to bilateral pulmonary acute disease syndrome; Shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage; misery and feeling horrible; Severe chills; Headache; Shortness of breath; Fever; Fatigue; Diarrhea; Muscle aches; Skin sensitivity and rash; Skin sensitivity and rash; Sore throat; This is a spontaneous report from a contactable consumer. A 57-year-old male patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in arm on 22Feb2021 at 10:00 (Lot Number: EN6202) (at the age of 57-year-old) as single dose for COVID-19 immunisation.  Medical history included high cholesterol from 2017 to an unknown date, seasonal allergy from an unknown date and unknown if ongoing and arteriosclerosis from 2017 to an unknown date. The patient's concomitant medications were not reported.  The patient previously received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 01Feb2021 (Lot Number: EL9264) (at the age of 57-year-old) as single dose for COVID-19 immunisation; the patient previously received ZYRTEC (10mg almost daily) for seasonal allergy, ibuprofen (ADVIL, 200 mg) and TYLENOL both for pain. Caller stated that the patient passed away on 02Mar2021 which was 8 days after the 2nd dose of the Pfizer COVID Vaccine. On 26Feb2021 the patient went to urgent care and then on 01Mar2021 he went to the hospital emergency room (ER).  It was reported that an autopsy was performed on 06Mar2021 and the cause of death listed sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.  The manner of death was natural and the lung presentation is highly suggestive of diffuse alveolar damage due to COVID-19 although the patient had several negative tests for COVID. The patient tested negative for influenza AB, negative for valley fever, negative for Legionnaire's disease and was in the hospital for less than 24 hours. The patient went back to urgent care on 28Feb2021 and was feeling miserable and asking for blood tests and urine tests, stated at that time his platelets were low at 122, glucose was high at 105, sodium was low at 134, calcium was low at 8.3, urine was negative and the patient did not get these labs til Monday when he was on the way to the emergency room and it was all different when he got to the hospital. The test for strep was negative, the oxygen was low at 86 percent when he got to the hospital on Monday and they just had to keep increasing his oxygen, stated a culture, no further details provided about the culture. A CTA done on the chest on Monday which was bad and stated the patient was symptomatic and they did not treat him for COVID but had a clinical suspicion for COVID. Adenovirus was not detected, metapneumonia virus was not detected, respiratory syncytial virus was not detected, parainfluenza was not detected, his platelets kept dropping and he had two tests for valley fever which is Cocci IGG and IGM and those were negative, the sodium level on 02Mar2021 was 126, all of these things were low: chloride 92, CO2 18, calcium 7.8, glucose was high at 222, bun was high at 21, creatinine was high at 1.4, EGFR was low at 52, WBC was high at 18.6, RBC was high at 7.39, HGB was 22.6, HCT was 66.4, RDW was high at 15, RDWFD was 45.5, and platelets were low at 61. The patient came into the emergency room those labs were when he was failing completely and on 01Mar2021 was when he arrived in the ER; at that time his WBC were normal, RBC was high at 6.16, HGB was high at 18.5, HCT was high at 54.9, platelets were low at 73, monocytes absolute were high at 0.96, sodium was low at 129, chloride was low at 95, calcium was low at 8.3, glucose was high at 150 and this was 7 days past the Pfizer COVID Vaccine. The patient was negative for strep pneumonia antigen and negative for Legionnaires Urinary antigen. The chest X-ray was done on 26Feb2021 and the patient was in misery and feeling horrible and they sent him home with albuterol and possible antibiotic to start that Monday and he had severe chills, headache, shortness of breath, fever, fatigue, diarrhea, muscle aches, skin sensitivity and rash, sore throat. Chest X-ray says normal; states the albuterol was PROAIR HFA 90mcg and he tested negative for influenza AB and he never got to the antibiotic because they said to wait til Monday and by that time this was an emergency. The patient outcome of sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage was fatal and unknown for the other events. The patient died on 02Mar2021.  An autopsy was performed that revealed the cause of death was sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.; Reported Cause(s) of Death: Sepsis; Autopsy-determined Cause(s) of Death: Shock due to bilateral pulmonary acute disease syndrome; Diffuse alveolar damage"
	"1394137-1"	"1394137-1"	"RASH"	"10037844"	"50-59 years"	"50-59"	"Her husband passed away; Sepsis; Shock due to bilateral pulmonary acute disease syndrome; Shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage; misery and feeling horrible; Severe chills; Headache; Shortness of breath; Fever; Fatigue; Diarrhea; Muscle aches; Skin sensitivity and rash; Skin sensitivity and rash; Sore throat; This is a spontaneous report from a contactable consumer. A 57-year-old male patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in arm on 22Feb2021 at 10:00 (Lot Number: EN6202) (at the age of 57-year-old) as single dose for COVID-19 immunisation.  Medical history included high cholesterol from 2017 to an unknown date, seasonal allergy from an unknown date and unknown if ongoing and arteriosclerosis from 2017 to an unknown date. The patient's concomitant medications were not reported.  The patient previously received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 01Feb2021 (Lot Number: EL9264) (at the age of 57-year-old) as single dose for COVID-19 immunisation; the patient previously received ZYRTEC (10mg almost daily) for seasonal allergy, ibuprofen (ADVIL, 200 mg) and TYLENOL both for pain. Caller stated that the patient passed away on 02Mar2021 which was 8 days after the 2nd dose of the Pfizer COVID Vaccine. On 26Feb2021 the patient went to urgent care and then on 01Mar2021 he went to the hospital emergency room (ER).  It was reported that an autopsy was performed on 06Mar2021 and the cause of death listed sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.  The manner of death was natural and the lung presentation is highly suggestive of diffuse alveolar damage due to COVID-19 although the patient had several negative tests for COVID. The patient tested negative for influenza AB, negative for valley fever, negative for Legionnaire's disease and was in the hospital for less than 24 hours. The patient went back to urgent care on 28Feb2021 and was feeling miserable and asking for blood tests and urine tests, stated at that time his platelets were low at 122, glucose was high at 105, sodium was low at 134, calcium was low at 8.3, urine was negative and the patient did not get these labs til Monday when he was on the way to the emergency room and it was all different when he got to the hospital. The test for strep was negative, the oxygen was low at 86 percent when he got to the hospital on Monday and they just had to keep increasing his oxygen, stated a culture, no further details provided about the culture. A CTA done on the chest on Monday which was bad and stated the patient was symptomatic and they did not treat him for COVID but had a clinical suspicion for COVID. Adenovirus was not detected, metapneumonia virus was not detected, respiratory syncytial virus was not detected, parainfluenza was not detected, his platelets kept dropping and he had two tests for valley fever which is Cocci IGG and IGM and those were negative, the sodium level on 02Mar2021 was 126, all of these things were low: chloride 92, CO2 18, calcium 7.8, glucose was high at 222, bun was high at 21, creatinine was high at 1.4, EGFR was low at 52, WBC was high at 18.6, RBC was high at 7.39, HGB was 22.6, HCT was 66.4, RDW was high at 15, RDWFD was 45.5, and platelets were low at 61. The patient came into the emergency room those labs were when he was failing completely and on 01Mar2021 was when he arrived in the ER; at that time his WBC were normal, RBC was high at 6.16, HGB was high at 18.5, HCT was high at 54.9, platelets were low at 73, monocytes absolute were high at 0.96, sodium was low at 129, chloride was low at 95, calcium was low at 8.3, glucose was high at 150 and this was 7 days past the Pfizer COVID Vaccine. The patient was negative for strep pneumonia antigen and negative for Legionnaires Urinary antigen. The chest X-ray was done on 26Feb2021 and the patient was in misery and feeling horrible and they sent him home with albuterol and possible antibiotic to start that Monday and he had severe chills, headache, shortness of breath, fever, fatigue, diarrhea, muscle aches, skin sensitivity and rash, sore throat. Chest X-ray says normal; states the albuterol was PROAIR HFA 90mcg and he tested negative for influenza AB and he never got to the antibiotic because they said to wait til Monday and by that time this was an emergency. The patient outcome of sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage was fatal and unknown for the other events. The patient died on 02Mar2021.  An autopsy was performed that revealed the cause of death was sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.; Reported Cause(s) of Death: Sepsis; Autopsy-determined Cause(s) of Death: Shock due to bilateral pulmonary acute disease syndrome; Diffuse alveolar damage"
	"1394137-1"	"1394137-1"	"RED BLOOD CELL COUNT"	"10038150"	"50-59 years"	"50-59"	"Her husband passed away; Sepsis; Shock due to bilateral pulmonary acute disease syndrome; Shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage; misery and feeling horrible; Severe chills; Headache; Shortness of breath; Fever; Fatigue; Diarrhea; Muscle aches; Skin sensitivity and rash; Skin sensitivity and rash; Sore throat; This is a spontaneous report from a contactable consumer. A 57-year-old male patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in arm on 22Feb2021 at 10:00 (Lot Number: EN6202) (at the age of 57-year-old) as single dose for COVID-19 immunisation.  Medical history included high cholesterol from 2017 to an unknown date, seasonal allergy from an unknown date and unknown if ongoing and arteriosclerosis from 2017 to an unknown date. The patient's concomitant medications were not reported.  The patient previously received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 01Feb2021 (Lot Number: EL9264) (at the age of 57-year-old) as single dose for COVID-19 immunisation; the patient previously received ZYRTEC (10mg almost daily) for seasonal allergy, ibuprofen (ADVIL, 200 mg) and TYLENOL both for pain. Caller stated that the patient passed away on 02Mar2021 which was 8 days after the 2nd dose of the Pfizer COVID Vaccine. On 26Feb2021 the patient went to urgent care and then on 01Mar2021 he went to the hospital emergency room (ER).  It was reported that an autopsy was performed on 06Mar2021 and the cause of death listed sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.  The manner of death was natural and the lung presentation is highly suggestive of diffuse alveolar damage due to COVID-19 although the patient had several negative tests for COVID. The patient tested negative for influenza AB, negative for valley fever, negative for Legionnaire's disease and was in the hospital for less than 24 hours. The patient went back to urgent care on 28Feb2021 and was feeling miserable and asking for blood tests and urine tests, stated at that time his platelets were low at 122, glucose was high at 105, sodium was low at 134, calcium was low at 8.3, urine was negative and the patient did not get these labs til Monday when he was on the way to the emergency room and it was all different when he got to the hospital. The test for strep was negative, the oxygen was low at 86 percent when he got to the hospital on Monday and they just had to keep increasing his oxygen, stated a culture, no further details provided about the culture. A CTA done on the chest on Monday which was bad and stated the patient was symptomatic and they did not treat him for COVID but had a clinical suspicion for COVID. Adenovirus was not detected, metapneumonia virus was not detected, respiratory syncytial virus was not detected, parainfluenza was not detected, his platelets kept dropping and he had two tests for valley fever which is Cocci IGG and IGM and those were negative, the sodium level on 02Mar2021 was 126, all of these things were low: chloride 92, CO2 18, calcium 7.8, glucose was high at 222, bun was high at 21, creatinine was high at 1.4, EGFR was low at 52, WBC was high at 18.6, RBC was high at 7.39, HGB was 22.6, HCT was 66.4, RDW was high at 15, RDWFD was 45.5, and platelets were low at 61. The patient came into the emergency room those labs were when he was failing completely and on 01Mar2021 was when he arrived in the ER; at that time his WBC were normal, RBC was high at 6.16, HGB was high at 18.5, HCT was high at 54.9, platelets were low at 73, monocytes absolute were high at 0.96, sodium was low at 129, chloride was low at 95, calcium was low at 8.3, glucose was high at 150 and this was 7 days past the Pfizer COVID Vaccine. The patient was negative for strep pneumonia antigen and negative for Legionnaires Urinary antigen. The chest X-ray was done on 26Feb2021 and the patient was in misery and feeling horrible and they sent him home with albuterol and possible antibiotic to start that Monday and he had severe chills, headache, shortness of breath, fever, fatigue, diarrhea, muscle aches, skin sensitivity and rash, sore throat. Chest X-ray says normal; states the albuterol was PROAIR HFA 90mcg and he tested negative for influenza AB and he never got to the antibiotic because they said to wait til Monday and by that time this was an emergency. The patient outcome of sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage was fatal and unknown for the other events. The patient died on 02Mar2021.  An autopsy was performed that revealed the cause of death was sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.; Reported Cause(s) of Death: Sepsis; Autopsy-determined Cause(s) of Death: Shock due to bilateral pulmonary acute disease syndrome; Diffuse alveolar damage"
	"1394137-1"	"1394137-1"	"RED CELL DISTRIBUTION WIDTH INCREASED"	"10053920"	"50-59 years"	"50-59"	"Her husband passed away; Sepsis; Shock due to bilateral pulmonary acute disease syndrome; Shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage; misery and feeling horrible; Severe chills; Headache; Shortness of breath; Fever; Fatigue; Diarrhea; Muscle aches; Skin sensitivity and rash; Skin sensitivity and rash; Sore throat; This is a spontaneous report from a contactable consumer. A 57-year-old male patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in arm on 22Feb2021 at 10:00 (Lot Number: EN6202) (at the age of 57-year-old) as single dose for COVID-19 immunisation.  Medical history included high cholesterol from 2017 to an unknown date, seasonal allergy from an unknown date and unknown if ongoing and arteriosclerosis from 2017 to an unknown date. The patient's concomitant medications were not reported.  The patient previously received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 01Feb2021 (Lot Number: EL9264) (at the age of 57-year-old) as single dose for COVID-19 immunisation; the patient previously received ZYRTEC (10mg almost daily) for seasonal allergy, ibuprofen (ADVIL, 200 mg) and TYLENOL both for pain. Caller stated that the patient passed away on 02Mar2021 which was 8 days after the 2nd dose of the Pfizer COVID Vaccine. On 26Feb2021 the patient went to urgent care and then on 01Mar2021 he went to the hospital emergency room (ER).  It was reported that an autopsy was performed on 06Mar2021 and the cause of death listed sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.  The manner of death was natural and the lung presentation is highly suggestive of diffuse alveolar damage due to COVID-19 although the patient had several negative tests for COVID. The patient tested negative for influenza AB, negative for valley fever, negative for Legionnaire's disease and was in the hospital for less than 24 hours. The patient went back to urgent care on 28Feb2021 and was feeling miserable and asking for blood tests and urine tests, stated at that time his platelets were low at 122, glucose was high at 105, sodium was low at 134, calcium was low at 8.3, urine was negative and the patient did not get these labs til Monday when he was on the way to the emergency room and it was all different when he got to the hospital. The test for strep was negative, the oxygen was low at 86 percent when he got to the hospital on Monday and they just had to keep increasing his oxygen, stated a culture, no further details provided about the culture. A CTA done on the chest on Monday which was bad and stated the patient was symptomatic and they did not treat him for COVID but had a clinical suspicion for COVID. Adenovirus was not detected, metapneumonia virus was not detected, respiratory syncytial virus was not detected, parainfluenza was not detected, his platelets kept dropping and he had two tests for valley fever which is Cocci IGG and IGM and those were negative, the sodium level on 02Mar2021 was 126, all of these things were low: chloride 92, CO2 18, calcium 7.8, glucose was high at 222, bun was high at 21, creatinine was high at 1.4, EGFR was low at 52, WBC was high at 18.6, RBC was high at 7.39, HGB was 22.6, HCT was 66.4, RDW was high at 15, RDWFD was 45.5, and platelets were low at 61. The patient came into the emergency room those labs were when he was failing completely and on 01Mar2021 was when he arrived in the ER; at that time his WBC were normal, RBC was high at 6.16, HGB was high at 18.5, HCT was high at 54.9, platelets were low at 73, monocytes absolute were high at 0.96, sodium was low at 129, chloride was low at 95, calcium was low at 8.3, glucose was high at 150 and this was 7 days past the Pfizer COVID Vaccine. The patient was negative for strep pneumonia antigen and negative for Legionnaires Urinary antigen. The chest X-ray was done on 26Feb2021 and the patient was in misery and feeling horrible and they sent him home with albuterol and possible antibiotic to start that Monday and he had severe chills, headache, shortness of breath, fever, fatigue, diarrhea, muscle aches, skin sensitivity and rash, sore throat. Chest X-ray says normal; states the albuterol was PROAIR HFA 90mcg and he tested negative for influenza AB and he never got to the antibiotic because they said to wait til Monday and by that time this was an emergency. The patient outcome of sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage was fatal and unknown for the other events. The patient died on 02Mar2021.  An autopsy was performed that revealed the cause of death was sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.; Reported Cause(s) of Death: Sepsis; Autopsy-determined Cause(s) of Death: Shock due to bilateral pulmonary acute disease syndrome; Diffuse alveolar damage"
	"1394137-1"	"1394137-1"	"RESPIRATORY SYNCYTIAL VIRUS INFECTION"	"10061603"	"50-59 years"	"50-59"	"Her husband passed away; Sepsis; Shock due to bilateral pulmonary acute disease syndrome; Shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage; misery and feeling horrible; Severe chills; Headache; Shortness of breath; Fever; Fatigue; Diarrhea; Muscle aches; Skin sensitivity and rash; Skin sensitivity and rash; Sore throat; This is a spontaneous report from a contactable consumer. A 57-year-old male patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in arm on 22Feb2021 at 10:00 (Lot Number: EN6202) (at the age of 57-year-old) as single dose for COVID-19 immunisation.  Medical history included high cholesterol from 2017 to an unknown date, seasonal allergy from an unknown date and unknown if ongoing and arteriosclerosis from 2017 to an unknown date. The patient's concomitant medications were not reported.  The patient previously received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 01Feb2021 (Lot Number: EL9264) (at the age of 57-year-old) as single dose for COVID-19 immunisation; the patient previously received ZYRTEC (10mg almost daily) for seasonal allergy, ibuprofen (ADVIL, 200 mg) and TYLENOL both for pain. Caller stated that the patient passed away on 02Mar2021 which was 8 days after the 2nd dose of the Pfizer COVID Vaccine. On 26Feb2021 the patient went to urgent care and then on 01Mar2021 he went to the hospital emergency room (ER).  It was reported that an autopsy was performed on 06Mar2021 and the cause of death listed sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.  The manner of death was natural and the lung presentation is highly suggestive of diffuse alveolar damage due to COVID-19 although the patient had several negative tests for COVID. The patient tested negative for influenza AB, negative for valley fever, negative for Legionnaire's disease and was in the hospital for less than 24 hours. The patient went back to urgent care on 28Feb2021 and was feeling miserable and asking for blood tests and urine tests, stated at that time his platelets were low at 122, glucose was high at 105, sodium was low at 134, calcium was low at 8.3, urine was negative and the patient did not get these labs til Monday when he was on the way to the emergency room and it was all different when he got to the hospital. The test for strep was negative, the oxygen was low at 86 percent when he got to the hospital on Monday and they just had to keep increasing his oxygen, stated a culture, no further details provided about the culture. A CTA done on the chest on Monday which was bad and stated the patient was symptomatic and they did not treat him for COVID but had a clinical suspicion for COVID. Adenovirus was not detected, metapneumonia virus was not detected, respiratory syncytial virus was not detected, parainfluenza was not detected, his platelets kept dropping and he had two tests for valley fever which is Cocci IGG and IGM and those were negative, the sodium level on 02Mar2021 was 126, all of these things were low: chloride 92, CO2 18, calcium 7.8, glucose was high at 222, bun was high at 21, creatinine was high at 1.4, EGFR was low at 52, WBC was high at 18.6, RBC was high at 7.39, HGB was 22.6, HCT was 66.4, RDW was high at 15, RDWFD was 45.5, and platelets were low at 61. The patient came into the emergency room those labs were when he was failing completely and on 01Mar2021 was when he arrived in the ER; at that time his WBC were normal, RBC was high at 6.16, HGB was high at 18.5, HCT was high at 54.9, platelets were low at 73, monocytes absolute were high at 0.96, sodium was low at 129, chloride was low at 95, calcium was low at 8.3, glucose was high at 150 and this was 7 days past the Pfizer COVID Vaccine. The patient was negative for strep pneumonia antigen and negative for Legionnaires Urinary antigen. The chest X-ray was done on 26Feb2021 and the patient was in misery and feeling horrible and they sent him home with albuterol and possible antibiotic to start that Monday and he had severe chills, headache, shortness of breath, fever, fatigue, diarrhea, muscle aches, skin sensitivity and rash, sore throat. Chest X-ray says normal; states the albuterol was PROAIR HFA 90mcg and he tested negative for influenza AB and he never got to the antibiotic because they said to wait til Monday and by that time this was an emergency. The patient outcome of sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage was fatal and unknown for the other events. The patient died on 02Mar2021.  An autopsy was performed that revealed the cause of death was sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.; Reported Cause(s) of Death: Sepsis; Autopsy-determined Cause(s) of Death: Shock due to bilateral pulmonary acute disease syndrome; Diffuse alveolar damage"
	"1394137-1"	"1394137-1"	"SENSITIVE SKIN"	"10081765"	"50-59 years"	"50-59"	"Her husband passed away; Sepsis; Shock due to bilateral pulmonary acute disease syndrome; Shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage; misery and feeling horrible; Severe chills; Headache; Shortness of breath; Fever; Fatigue; Diarrhea; Muscle aches; Skin sensitivity and rash; Skin sensitivity and rash; Sore throat; This is a spontaneous report from a contactable consumer. A 57-year-old male patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in arm on 22Feb2021 at 10:00 (Lot Number: EN6202) (at the age of 57-year-old) as single dose for COVID-19 immunisation.  Medical history included high cholesterol from 2017 to an unknown date, seasonal allergy from an unknown date and unknown if ongoing and arteriosclerosis from 2017 to an unknown date. The patient's concomitant medications were not reported.  The patient previously received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 01Feb2021 (Lot Number: EL9264) (at the age of 57-year-old) as single dose for COVID-19 immunisation; the patient previously received ZYRTEC (10mg almost daily) for seasonal allergy, ibuprofen (ADVIL, 200 mg) and TYLENOL both for pain. Caller stated that the patient passed away on 02Mar2021 which was 8 days after the 2nd dose of the Pfizer COVID Vaccine. On 26Feb2021 the patient went to urgent care and then on 01Mar2021 he went to the hospital emergency room (ER).  It was reported that an autopsy was performed on 06Mar2021 and the cause of death listed sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.  The manner of death was natural and the lung presentation is highly suggestive of diffuse alveolar damage due to COVID-19 although the patient had several negative tests for COVID. The patient tested negative for influenza AB, negative for valley fever, negative for Legionnaire's disease and was in the hospital for less than 24 hours. The patient went back to urgent care on 28Feb2021 and was feeling miserable and asking for blood tests and urine tests, stated at that time his platelets were low at 122, glucose was high at 105, sodium was low at 134, calcium was low at 8.3, urine was negative and the patient did not get these labs til Monday when he was on the way to the emergency room and it was all different when he got to the hospital. The test for strep was negative, the oxygen was low at 86 percent when he got to the hospital on Monday and they just had to keep increasing his oxygen, stated a culture, no further details provided about the culture. A CTA done on the chest on Monday which was bad and stated the patient was symptomatic and they did not treat him for COVID but had a clinical suspicion for COVID. Adenovirus was not detected, metapneumonia virus was not detected, respiratory syncytial virus was not detected, parainfluenza was not detected, his platelets kept dropping and he had two tests for valley fever which is Cocci IGG and IGM and those were negative, the sodium level on 02Mar2021 was 126, all of these things were low: chloride 92, CO2 18, calcium 7.8, glucose was high at 222, bun was high at 21, creatinine was high at 1.4, EGFR was low at 52, WBC was high at 18.6, RBC was high at 7.39, HGB was 22.6, HCT was 66.4, RDW was high at 15, RDWFD was 45.5, and platelets were low at 61. The patient came into the emergency room those labs were when he was failing completely and on 01Mar2021 was when he arrived in the ER; at that time his WBC were normal, RBC was high at 6.16, HGB was high at 18.5, HCT was high at 54.9, platelets were low at 73, monocytes absolute were high at 0.96, sodium was low at 129, chloride was low at 95, calcium was low at 8.3, glucose was high at 150 and this was 7 days past the Pfizer COVID Vaccine. The patient was negative for strep pneumonia antigen and negative for Legionnaires Urinary antigen. The chest X-ray was done on 26Feb2021 and the patient was in misery and feeling horrible and they sent him home with albuterol and possible antibiotic to start that Monday and he had severe chills, headache, shortness of breath, fever, fatigue, diarrhea, muscle aches, skin sensitivity and rash, sore throat. Chest X-ray says normal; states the albuterol was PROAIR HFA 90mcg and he tested negative for influenza AB and he never got to the antibiotic because they said to wait til Monday and by that time this was an emergency. The patient outcome of sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage was fatal and unknown for the other events. The patient died on 02Mar2021.  An autopsy was performed that revealed the cause of death was sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.; Reported Cause(s) of Death: Sepsis; Autopsy-determined Cause(s) of Death: Shock due to bilateral pulmonary acute disease syndrome; Diffuse alveolar damage"
	"1394137-1"	"1394137-1"	"SEPSIS"	"10040047"	"50-59 years"	"50-59"	"Her husband passed away; Sepsis; Shock due to bilateral pulmonary acute disease syndrome; Shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage; misery and feeling horrible; Severe chills; Headache; Shortness of breath; Fever; Fatigue; Diarrhea; Muscle aches; Skin sensitivity and rash; Skin sensitivity and rash; Sore throat; This is a spontaneous report from a contactable consumer. A 57-year-old male patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in arm on 22Feb2021 at 10:00 (Lot Number: EN6202) (at the age of 57-year-old) as single dose for COVID-19 immunisation.  Medical history included high cholesterol from 2017 to an unknown date, seasonal allergy from an unknown date and unknown if ongoing and arteriosclerosis from 2017 to an unknown date. The patient's concomitant medications were not reported.  The patient previously received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 01Feb2021 (Lot Number: EL9264) (at the age of 57-year-old) as single dose for COVID-19 immunisation; the patient previously received ZYRTEC (10mg almost daily) for seasonal allergy, ibuprofen (ADVIL, 200 mg) and TYLENOL both for pain. Caller stated that the patient passed away on 02Mar2021 which was 8 days after the 2nd dose of the Pfizer COVID Vaccine. On 26Feb2021 the patient went to urgent care and then on 01Mar2021 he went to the hospital emergency room (ER).  It was reported that an autopsy was performed on 06Mar2021 and the cause of death listed sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.  The manner of death was natural and the lung presentation is highly suggestive of diffuse alveolar damage due to COVID-19 although the patient had several negative tests for COVID. The patient tested negative for influenza AB, negative for valley fever, negative for Legionnaire's disease and was in the hospital for less than 24 hours. The patient went back to urgent care on 28Feb2021 and was feeling miserable and asking for blood tests and urine tests, stated at that time his platelets were low at 122, glucose was high at 105, sodium was low at 134, calcium was low at 8.3, urine was negative and the patient did not get these labs til Monday when he was on the way to the emergency room and it was all different when he got to the hospital. The test for strep was negative, the oxygen was low at 86 percent when he got to the hospital on Monday and they just had to keep increasing his oxygen, stated a culture, no further details provided about the culture. A CTA done on the chest on Monday which was bad and stated the patient was symptomatic and they did not treat him for COVID but had a clinical suspicion for COVID. Adenovirus was not detected, metapneumonia virus was not detected, respiratory syncytial virus was not detected, parainfluenza was not detected, his platelets kept dropping and he had two tests for valley fever which is Cocci IGG and IGM and those were negative, the sodium level on 02Mar2021 was 126, all of these things were low: chloride 92, CO2 18, calcium 7.8, glucose was high at 222, bun was high at 21, creatinine was high at 1.4, EGFR was low at 52, WBC was high at 18.6, RBC was high at 7.39, HGB was 22.6, HCT was 66.4, RDW was high at 15, RDWFD was 45.5, and platelets were low at 61. The patient came into the emergency room those labs were when he was failing completely and on 01Mar2021 was when he arrived in the ER; at that time his WBC were normal, RBC was high at 6.16, HGB was high at 18.5, HCT was high at 54.9, platelets were low at 73, monocytes absolute were high at 0.96, sodium was low at 129, chloride was low at 95, calcium was low at 8.3, glucose was high at 150 and this was 7 days past the Pfizer COVID Vaccine. The patient was negative for strep pneumonia antigen and negative for Legionnaires Urinary antigen. The chest X-ray was done on 26Feb2021 and the patient was in misery and feeling horrible and they sent him home with albuterol and possible antibiotic to start that Monday and he had severe chills, headache, shortness of breath, fever, fatigue, diarrhea, muscle aches, skin sensitivity and rash, sore throat. Chest X-ray says normal; states the albuterol was PROAIR HFA 90mcg and he tested negative for influenza AB and he never got to the antibiotic because they said to wait til Monday and by that time this was an emergency. The patient outcome of sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage was fatal and unknown for the other events. The patient died on 02Mar2021.  An autopsy was performed that revealed the cause of death was sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.; Reported Cause(s) of Death: Sepsis; Autopsy-determined Cause(s) of Death: Shock due to bilateral pulmonary acute disease syndrome; Diffuse alveolar damage"
	"1394137-1"	"1394137-1"	"STREPTOBACILLUS INFECTION"	"10062118"	"50-59 years"	"50-59"	"Her husband passed away; Sepsis; Shock due to bilateral pulmonary acute disease syndrome; Shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage; misery and feeling horrible; Severe chills; Headache; Shortness of breath; Fever; Fatigue; Diarrhea; Muscle aches; Skin sensitivity and rash; Skin sensitivity and rash; Sore throat; This is a spontaneous report from a contactable consumer. A 57-year-old male patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in arm on 22Feb2021 at 10:00 (Lot Number: EN6202) (at the age of 57-year-old) as single dose for COVID-19 immunisation.  Medical history included high cholesterol from 2017 to an unknown date, seasonal allergy from an unknown date and unknown if ongoing and arteriosclerosis from 2017 to an unknown date. The patient's concomitant medications were not reported.  The patient previously received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 01Feb2021 (Lot Number: EL9264) (at the age of 57-year-old) as single dose for COVID-19 immunisation; the patient previously received ZYRTEC (10mg almost daily) for seasonal allergy, ibuprofen (ADVIL, 200 mg) and TYLENOL both for pain. Caller stated that the patient passed away on 02Mar2021 which was 8 days after the 2nd dose of the Pfizer COVID Vaccine. On 26Feb2021 the patient went to urgent care and then on 01Mar2021 he went to the hospital emergency room (ER).  It was reported that an autopsy was performed on 06Mar2021 and the cause of death listed sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.  The manner of death was natural and the lung presentation is highly suggestive of diffuse alveolar damage due to COVID-19 although the patient had several negative tests for COVID. The patient tested negative for influenza AB, negative for valley fever, negative for Legionnaire's disease and was in the hospital for less than 24 hours. The patient went back to urgent care on 28Feb2021 and was feeling miserable and asking for blood tests and urine tests, stated at that time his platelets were low at 122, glucose was high at 105, sodium was low at 134, calcium was low at 8.3, urine was negative and the patient did not get these labs til Monday when he was on the way to the emergency room and it was all different when he got to the hospital. The test for strep was negative, the oxygen was low at 86 percent when he got to the hospital on Monday and they just had to keep increasing his oxygen, stated a culture, no further details provided about the culture. A CTA done on the chest on Monday which was bad and stated the patient was symptomatic and they did not treat him for COVID but had a clinical suspicion for COVID. Adenovirus was not detected, metapneumonia virus was not detected, respiratory syncytial virus was not detected, parainfluenza was not detected, his platelets kept dropping and he had two tests for valley fever which is Cocci IGG and IGM and those were negative, the sodium level on 02Mar2021 was 126, all of these things were low: chloride 92, CO2 18, calcium 7.8, glucose was high at 222, bun was high at 21, creatinine was high at 1.4, EGFR was low at 52, WBC was high at 18.6, RBC was high at 7.39, HGB was 22.6, HCT was 66.4, RDW was high at 15, RDWFD was 45.5, and platelets were low at 61. The patient came into the emergency room those labs were when he was failing completely and on 01Mar2021 was when he arrived in the ER; at that time his WBC were normal, RBC was high at 6.16, HGB was high at 18.5, HCT was high at 54.9, platelets were low at 73, monocytes absolute were high at 0.96, sodium was low at 129, chloride was low at 95, calcium was low at 8.3, glucose was high at 150 and this was 7 days past the Pfizer COVID Vaccine. The patient was negative for strep pneumonia antigen and negative for Legionnaires Urinary antigen. The chest X-ray was done on 26Feb2021 and the patient was in misery and feeling horrible and they sent him home with albuterol and possible antibiotic to start that Monday and he had severe chills, headache, shortness of breath, fever, fatigue, diarrhea, muscle aches, skin sensitivity and rash, sore throat. Chest X-ray says normal; states the albuterol was PROAIR HFA 90mcg and he tested negative for influenza AB and he never got to the antibiotic because they said to wait til Monday and by that time this was an emergency. The patient outcome of sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage was fatal and unknown for the other events. The patient died on 02Mar2021.  An autopsy was performed that revealed the cause of death was sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.; Reported Cause(s) of Death: Sepsis; Autopsy-determined Cause(s) of Death: Shock due to bilateral pulmonary acute disease syndrome; Diffuse alveolar damage"
	"1394137-1"	"1394137-1"	"WHITE BLOOD CELL COUNT"	"10047939"	"50-59 years"	"50-59"	"Her husband passed away; Sepsis; Shock due to bilateral pulmonary acute disease syndrome; Shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage; misery and feeling horrible; Severe chills; Headache; Shortness of breath; Fever; Fatigue; Diarrhea; Muscle aches; Skin sensitivity and rash; Skin sensitivity and rash; Sore throat; This is a spontaneous report from a contactable consumer. A 57-year-old male patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in arm on 22Feb2021 at 10:00 (Lot Number: EN6202) (at the age of 57-year-old) as single dose for COVID-19 immunisation.  Medical history included high cholesterol from 2017 to an unknown date, seasonal allergy from an unknown date and unknown if ongoing and arteriosclerosis from 2017 to an unknown date. The patient's concomitant medications were not reported.  The patient previously received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 01Feb2021 (Lot Number: EL9264) (at the age of 57-year-old) as single dose for COVID-19 immunisation; the patient previously received ZYRTEC (10mg almost daily) for seasonal allergy, ibuprofen (ADVIL, 200 mg) and TYLENOL both for pain. Caller stated that the patient passed away on 02Mar2021 which was 8 days after the 2nd dose of the Pfizer COVID Vaccine. On 26Feb2021 the patient went to urgent care and then on 01Mar2021 he went to the hospital emergency room (ER).  It was reported that an autopsy was performed on 06Mar2021 and the cause of death listed sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.  The manner of death was natural and the lung presentation is highly suggestive of diffuse alveolar damage due to COVID-19 although the patient had several negative tests for COVID. The patient tested negative for influenza AB, negative for valley fever, negative for Legionnaire's disease and was in the hospital for less than 24 hours. The patient went back to urgent care on 28Feb2021 and was feeling miserable and asking for blood tests and urine tests, stated at that time his platelets were low at 122, glucose was high at 105, sodium was low at 134, calcium was low at 8.3, urine was negative and the patient did not get these labs til Monday when he was on the way to the emergency room and it was all different when he got to the hospital. The test for strep was negative, the oxygen was low at 86 percent when he got to the hospital on Monday and they just had to keep increasing his oxygen, stated a culture, no further details provided about the culture. A CTA done on the chest on Monday which was bad and stated the patient was symptomatic and they did not treat him for COVID but had a clinical suspicion for COVID. Adenovirus was not detected, metapneumonia virus was not detected, respiratory syncytial virus was not detected, parainfluenza was not detected, his platelets kept dropping and he had two tests for valley fever which is Cocci IGG and IGM and those were negative, the sodium level on 02Mar2021 was 126, all of these things were low: chloride 92, CO2 18, calcium 7.8, glucose was high at 222, bun was high at 21, creatinine was high at 1.4, EGFR was low at 52, WBC was high at 18.6, RBC was high at 7.39, HGB was 22.6, HCT was 66.4, RDW was high at 15, RDWFD was 45.5, and platelets were low at 61. The patient came into the emergency room those labs were when he was failing completely and on 01Mar2021 was when he arrived in the ER; at that time his WBC were normal, RBC was high at 6.16, HGB was high at 18.5, HCT was high at 54.9, platelets were low at 73, monocytes absolute were high at 0.96, sodium was low at 129, chloride was low at 95, calcium was low at 8.3, glucose was high at 150 and this was 7 days past the Pfizer COVID Vaccine. The patient was negative for strep pneumonia antigen and negative for Legionnaires Urinary antigen. The chest X-ray was done on 26Feb2021 and the patient was in misery and feeling horrible and they sent him home with albuterol and possible antibiotic to start that Monday and he had severe chills, headache, shortness of breath, fever, fatigue, diarrhea, muscle aches, skin sensitivity and rash, sore throat. Chest X-ray says normal; states the albuterol was PROAIR HFA 90mcg and he tested negative for influenza AB and he never got to the antibiotic because they said to wait til Monday and by that time this was an emergency. The patient outcome of sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage was fatal and unknown for the other events. The patient died on 02Mar2021.  An autopsy was performed that revealed the cause of death was sepsis and complications from sepsis and shock due to bilateral pulmonary acute disease syndrome due to diffuse alveolar damage.; Reported Cause(s) of Death: Sepsis; Autopsy-determined Cause(s) of Death: Shock due to bilateral pulmonary acute disease syndrome; Diffuse alveolar damage"
	"1395203-1"	"1395203-1"	"APHASIA"	"10002948"	"50-59 years"	"50-59"	"Was feeling sick and in bed all day on 6/6, could barely walk or talk on 6/7. Collapsed and stopped breathing/ passed away in the middle of the night late 6/7 or early 6/8."
	"1395203-1"	"1395203-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Was feeling sick and in bed all day on 6/6, could barely walk or talk on 6/7. Collapsed and stopped breathing/ passed away in the middle of the night late 6/7 or early 6/8."
	"1395203-1"	"1395203-1"	"GAIT DISTURBANCE"	"10017577"	"50-59 years"	"50-59"	"Was feeling sick and in bed all day on 6/6, could barely walk or talk on 6/7. Collapsed and stopped breathing/ passed away in the middle of the night late 6/7 or early 6/8."
	"1395203-1"	"1395203-1"	"MALAISE"	"10025482"	"50-59 years"	"50-59"	"Was feeling sick and in bed all day on 6/6, could barely walk or talk on 6/7. Collapsed and stopped breathing/ passed away in the middle of the night late 6/7 or early 6/8."
	"1395203-1"	"1395203-1"	"MOBILITY DECREASED"	"10048334"	"50-59 years"	"50-59"	"Was feeling sick and in bed all day on 6/6, could barely walk or talk on 6/7. Collapsed and stopped breathing/ passed away in the middle of the night late 6/7 or early 6/8."
	"1395203-1"	"1395203-1"	"RESPIRATORY ARREST"	"10038669"	"50-59 years"	"50-59"	"Was feeling sick and in bed all day on 6/6, could barely walk or talk on 6/7. Collapsed and stopped breathing/ passed away in the middle of the night late 6/7 or early 6/8."
	"1395203-1"	"1395203-1"	"SYNCOPE"	"10042772"	"50-59 years"	"50-59"	"Was feeling sick and in bed all day on 6/6, could barely walk or talk on 6/7. Collapsed and stopped breathing/ passed away in the middle of the night late 6/7 or early 6/8."
	"1395556-1"	"1395556-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Death.  Ischemic and Hypertensive Heart Disease. No signs.  Active and athletic middle age man.  Was riding bicycle on a trail, stopped pedaling and dropped dead.  Died instantly. CPR was performed.  No vitals upon arrival."
	"1395556-1"	"1395556-1"	"HYPERTENSIVE HEART DISEASE"	"10020823"	"50-59 years"	"50-59"	"Death.  Ischemic and Hypertensive Heart Disease. No signs.  Active and athletic middle age man.  Was riding bicycle on a trail, stopped pedaling and dropped dead.  Died instantly. CPR was performed.  No vitals upon arrival."
	"1395556-1"	"1395556-1"	"MYOCARDIAL ISCHAEMIA"	"10028600"	"50-59 years"	"50-59"	"Death.  Ischemic and Hypertensive Heart Disease. No signs.  Active and athletic middle age man.  Was riding bicycle on a trail, stopped pedaling and dropped dead.  Died instantly. CPR was performed.  No vitals upon arrival."
	"1395556-1"	"1395556-1"	"RESUSCITATION"	"10038749"	"50-59 years"	"50-59"	"Death.  Ischemic and Hypertensive Heart Disease. No signs.  Active and athletic middle age man.  Was riding bicycle on a trail, stopped pedaling and dropped dead.  Died instantly. CPR was performed.  No vitals upon arrival."
	"1396672-1"	"1396672-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"4/27/2021 nausea, on 4/28/2021 nausea, vomiting, diarrhea, 4/30/2021 chest pain, 5/1/2021 cardiac arrest"
	"1396672-1"	"1396672-1"	"CHEST PAIN"	"10008479"	"50-59 years"	"50-59"	"4/27/2021 nausea, on 4/28/2021 nausea, vomiting, diarrhea, 4/30/2021 chest pain, 5/1/2021 cardiac arrest"
	"1396672-1"	"1396672-1"	"DIARRHOEA"	"10012735"	"50-59 years"	"50-59"	"4/27/2021 nausea, on 4/28/2021 nausea, vomiting, diarrhea, 4/30/2021 chest pain, 5/1/2021 cardiac arrest"
	"1396672-1"	"1396672-1"	"NAUSEA"	"10028813"	"50-59 years"	"50-59"	"4/27/2021 nausea, on 4/28/2021 nausea, vomiting, diarrhea, 4/30/2021 chest pain, 5/1/2021 cardiac arrest"
	"1396672-1"	"1396672-1"	"VOMITING"	"10047700"	"50-59 years"	"50-59"	"4/27/2021 nausea, on 4/28/2021 nausea, vomiting, diarrhea, 4/30/2021 chest pain, 5/1/2021 cardiac arrest"
	"1397724-1"	"1397724-1"	"CORONARY ARTERY THROMBOSIS"	"10011091"	"50-59 years"	"50-59"	"Thrombosis of LAD, death"
	"1397724-1"	"1397724-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Thrombosis of LAD, death"
	"1400020-1"	"1400020-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Death"
	"1400093-1"	"1400093-1"	"SUDDEN DEATH"	"10042434"	"50-59 years"	"50-59"	"Died suddenly, autopsy pending"
	"1401722-1"	"1401722-1"	"CONDITION AGGRAVATED"	"10010264"	"50-59 years"	"50-59"	"Died on the night of 05Jun2021 or Morning 06Jun2021 not Sure; Gastritis; The reaction came back with a vengeance; was doubling over; This spontaneous case was reported by an other health care professional (subsequently medically confirmed) and describes the occurrence of DEATH (Died on the night of 05Jun2021 or Morning 06Jun2021 not Sure) in a 53-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 007C21A and 028A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below.     The patient's past medical history included Heart disease, unspecified.   On 25-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 22-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 28-May-2021, the patient experienced DISEASE RECURRENCE (The reaction came back with a vengeance) and CONDITION AGGRAVATED (was doubling over). On 01-Jun-2021, the patient experienced GASTRITIS (Gastritis). The patient died on 05-Jun-2021. The cause of death was not reported. It is unknown if an autopsy was performed. At the time of death, GASTRITIS (Gastritis), DISEASE RECURRENCE (The reaction came back with a vengeance) and CONDITION AGGRAVATED (was doubling over) outcome was unknown.      DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 01-Jun-2021, Ultrasound scan: abnormal (abnormal) confirmed gastritis..     For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments.   Concomitant medications were not provided.  Labs included electrocardiogram (EKG) whose results were not provided.  It was reported that on 01-jun-2021 at Emergency room, gastritis was diagnosed and patient was sent home. Treatment information was not provided.  Company comment: This is a case of sudden death in a 53-year-old male patient with a history of Heart disease, who died 1 month 14 days after receiving last dose of vaccine. Very limited information has been provided at this time.   This case was linked to MOD-2021-211580 (Patient Link).; Sender's Comments: This is a case of sudden death in a 53-year-old male patient with a history of Heart disease, who died 1 month 14 days after receiving last dose of vaccine. Very limited information has been provided at this time.; Reported Cause(s) of Death: Unknown cause of death"
	"1401722-1"	"1401722-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Died on the night of 05Jun2021 or Morning 06Jun2021 not Sure; Gastritis; The reaction came back with a vengeance; was doubling over; This spontaneous case was reported by an other health care professional (subsequently medically confirmed) and describes the occurrence of DEATH (Died on the night of 05Jun2021 or Morning 06Jun2021 not Sure) in a 53-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 007C21A and 028A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below.     The patient's past medical history included Heart disease, unspecified.   On 25-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 22-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 28-May-2021, the patient experienced DISEASE RECURRENCE (The reaction came back with a vengeance) and CONDITION AGGRAVATED (was doubling over). On 01-Jun-2021, the patient experienced GASTRITIS (Gastritis). The patient died on 05-Jun-2021. The cause of death was not reported. It is unknown if an autopsy was performed. At the time of death, GASTRITIS (Gastritis), DISEASE RECURRENCE (The reaction came back with a vengeance) and CONDITION AGGRAVATED (was doubling over) outcome was unknown.      DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 01-Jun-2021, Ultrasound scan: abnormal (abnormal) confirmed gastritis..     For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments.   Concomitant medications were not provided.  Labs included electrocardiogram (EKG) whose results were not provided.  It was reported that on 01-jun-2021 at Emergency room, gastritis was diagnosed and patient was sent home. Treatment information was not provided.  Company comment: This is a case of sudden death in a 53-year-old male patient with a history of Heart disease, who died 1 month 14 days after receiving last dose of vaccine. Very limited information has been provided at this time.   This case was linked to MOD-2021-211580 (Patient Link).; Sender's Comments: This is a case of sudden death in a 53-year-old male patient with a history of Heart disease, who died 1 month 14 days after receiving last dose of vaccine. Very limited information has been provided at this time.; Reported Cause(s) of Death: Unknown cause of death"
	"1401722-1"	"1401722-1"	"DISEASE RECURRENCE"	"10061819"	"50-59 years"	"50-59"	"Died on the night of 05Jun2021 or Morning 06Jun2021 not Sure; Gastritis; The reaction came back with a vengeance; was doubling over; This spontaneous case was reported by an other health care professional (subsequently medically confirmed) and describes the occurrence of DEATH (Died on the night of 05Jun2021 or Morning 06Jun2021 not Sure) in a 53-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 007C21A and 028A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below.     The patient's past medical history included Heart disease, unspecified.   On 25-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 22-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 28-May-2021, the patient experienced DISEASE RECURRENCE (The reaction came back with a vengeance) and CONDITION AGGRAVATED (was doubling over). On 01-Jun-2021, the patient experienced GASTRITIS (Gastritis). The patient died on 05-Jun-2021. The cause of death was not reported. It is unknown if an autopsy was performed. At the time of death, GASTRITIS (Gastritis), DISEASE RECURRENCE (The reaction came back with a vengeance) and CONDITION AGGRAVATED (was doubling over) outcome was unknown.      DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 01-Jun-2021, Ultrasound scan: abnormal (abnormal) confirmed gastritis..     For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments.   Concomitant medications were not provided.  Labs included electrocardiogram (EKG) whose results were not provided.  It was reported that on 01-jun-2021 at Emergency room, gastritis was diagnosed and patient was sent home. Treatment information was not provided.  Company comment: This is a case of sudden death in a 53-year-old male patient with a history of Heart disease, who died 1 month 14 days after receiving last dose of vaccine. Very limited information has been provided at this time.   This case was linked to MOD-2021-211580 (Patient Link).; Sender's Comments: This is a case of sudden death in a 53-year-old male patient with a history of Heart disease, who died 1 month 14 days after receiving last dose of vaccine. Very limited information has been provided at this time.; Reported Cause(s) of Death: Unknown cause of death"
	"1401722-1"	"1401722-1"	"GASTRITIS"	"10017853"	"50-59 years"	"50-59"	"Died on the night of 05Jun2021 or Morning 06Jun2021 not Sure; Gastritis; The reaction came back with a vengeance; was doubling over; This spontaneous case was reported by an other health care professional (subsequently medically confirmed) and describes the occurrence of DEATH (Died on the night of 05Jun2021 or Morning 06Jun2021 not Sure) in a 53-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 007C21A and 028A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below.     The patient's past medical history included Heart disease, unspecified.   On 25-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 22-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 28-May-2021, the patient experienced DISEASE RECURRENCE (The reaction came back with a vengeance) and CONDITION AGGRAVATED (was doubling over). On 01-Jun-2021, the patient experienced GASTRITIS (Gastritis). The patient died on 05-Jun-2021. The cause of death was not reported. It is unknown if an autopsy was performed. At the time of death, GASTRITIS (Gastritis), DISEASE RECURRENCE (The reaction came back with a vengeance) and CONDITION AGGRAVATED (was doubling over) outcome was unknown.      DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 01-Jun-2021, Ultrasound scan: abnormal (abnormal) confirmed gastritis..     For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments.   Concomitant medications were not provided.  Labs included electrocardiogram (EKG) whose results were not provided.  It was reported that on 01-jun-2021 at Emergency room, gastritis was diagnosed and patient was sent home. Treatment information was not provided.  Company comment: This is a case of sudden death in a 53-year-old male patient with a history of Heart disease, who died 1 month 14 days after receiving last dose of vaccine. Very limited information has been provided at this time.   This case was linked to MOD-2021-211580 (Patient Link).; Sender's Comments: This is a case of sudden death in a 53-year-old male patient with a history of Heart disease, who died 1 month 14 days after receiving last dose of vaccine. Very limited information has been provided at this time.; Reported Cause(s) of Death: Unknown cause of death"
	"1401722-1"	"1401722-1"	"ULTRASOUND SCAN"	"10045434"	"50-59 years"	"50-59"	"Died on the night of 05Jun2021 or Morning 06Jun2021 not Sure; Gastritis; The reaction came back with a vengeance; was doubling over; This spontaneous case was reported by an other health care professional (subsequently medically confirmed) and describes the occurrence of DEATH (Died on the night of 05Jun2021 or Morning 06Jun2021 not Sure) in a 53-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 007C21A and 028A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below.     The patient's past medical history included Heart disease, unspecified.   On 25-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 22-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 28-May-2021, the patient experienced DISEASE RECURRENCE (The reaction came back with a vengeance) and CONDITION AGGRAVATED (was doubling over). On 01-Jun-2021, the patient experienced GASTRITIS (Gastritis). The patient died on 05-Jun-2021. The cause of death was not reported. It is unknown if an autopsy was performed. At the time of death, GASTRITIS (Gastritis), DISEASE RECURRENCE (The reaction came back with a vengeance) and CONDITION AGGRAVATED (was doubling over) outcome was unknown.      DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 01-Jun-2021, Ultrasound scan: abnormal (abnormal) confirmed gastritis..     For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments.   Concomitant medications were not provided.  Labs included electrocardiogram (EKG) whose results were not provided.  It was reported that on 01-jun-2021 at Emergency room, gastritis was diagnosed and patient was sent home. Treatment information was not provided.  Company comment: This is a case of sudden death in a 53-year-old male patient with a history of Heart disease, who died 1 month 14 days after receiving last dose of vaccine. Very limited information has been provided at this time.   This case was linked to MOD-2021-211580 (Patient Link).; Sender's Comments: This is a case of sudden death in a 53-year-old male patient with a history of Heart disease, who died 1 month 14 days after receiving last dose of vaccine. Very limited information has been provided at this time.; Reported Cause(s) of Death: Unknown cause of death"
	"1401732-1"	"1401732-1"	"ACUTE RESPIRATORY DISTRESS SYNDROME"	"10001052"	"50-59 years"	"50-59"	"Seizures; Bood clots; Stuggling to breathe; Struggling to walk; ARDS; Acute hypoxic respiratory failure; Acute exacerbation of heart failure and sepsis; Acute exacerbation of heart failure and sepsis; Cardiac arrest; Blood infection; Fever; This spontaneous case was reported by a patient family member or friend (subsequently medically confirmed) and describes the occurrence of ACUTE RESPIRATORY DISTRESS SYNDROME (ARDS), ACUTE RESPIRATORY FAILURE (Acute hypoxic respiratory failure), SEPSIS (Acute exacerbation of heart failure and sepsis), CARDIAC FAILURE ACUTE (Acute exacerbation of heart failure and sepsis), CARDIAC ARREST (Cardiac arrest), SEIZURE (Seizures), THROMBOSIS (Bood clots), DYSPNOEA (Stuggling to breathe) and GAIT DISTURBANCE (Struggling to walk) in a 53-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below.     Concurrent medical conditions included Obesity.   On 16-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 15-May-2021 at 2:00 PM, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 15-May-2021, the patient experienced ACUTE RESPIRATORY DISTRESS SYNDROME (ARDS) (seriousness criteria death and medically significant), ACUTE RESPIRATORY FAILURE (Acute hypoxic respiratory failure) (seriousness criteria death and medically significant), DYSPNOEA (Stuggling to breathe) (seriousness criterion hospitalization prolonged) and GAIT DISTURBANCE (Struggling to walk) (seriousness criterion hospitalization prolonged). In May 2021, the patient experienced SEPSIS (Acute exacerbation of heart failure and sepsis) (seriousness criteria death and medically significant), CARDIAC FAILURE ACUTE (Acute exacerbation of heart failure and sepsis) (seriousness criteria death and medically significant), CARDIAC ARREST (Cardiac arrest) (seriousness criteria death and medically significant), INFECTION (Blood infection) and PYREXIA (Fever). On 17-May-2021, the patient experienced SEIZURE (Seizures) (seriousness criteria hospitalization prolonged and medically significant) and THROMBOSIS (Bood clots) (seriousness criteria hospitalization prolonged and medically significant). The patient was hospitalized from 15-May-2021 to 25-May-2021 due to DYSPNOEA, GAIT DISTURBANCE, SEIZURE and THROMBOSIS. The patient died on 25-May-2021. The reported cause of death was Cardiac arrest, Acute hypoxic respiratory failure, ards and acute exacerbation of heart failure and sepsis. It is unknown if an autopsy was performed. At the time of death, SEIZURE (Seizures), THROMBOSIS (Bood clots), DYSPNOEA (Stuggling to breathe), GAIT DISTURBANCE (Struggling to walk), INFECTION (Blood infection) and PYREXIA (Fever) outcome was unknown.      DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 15-May-2021, Blood pressure measurement: elevated (High) Twice normal. On 15-May-2021, Glycosylated haemoglobin: elevated (High) High. On 15-May-2021, Oxygen saturation: low (Low) Required intubation and was placed on ventilator.. On 15-May-2021, SARS-CoV-2 antibody test: negative (Negative) 1 negative COVID antibody test. On 15-May-2021, SARS-CoV-2 test: negatie (Negative) 3 negative COVID antigen tests.         No concomitant medications were provided.  It was reported that within few hours after second dose of vaccine patient was struggling to walk and to breathe. The reporter and her husband went to see the patient and took him to an emergency room (ER). In the ER his blood pressure was markedly elevated (twice normal) and his oxygen level was low and by midnight he required intubation and was placed on a ventilator. His HbgA1c was noted to be elevated. Two days after admission (17-May-2021), he developed seizures which the medical team believed to be due to blood clots and he was anti-coagulated. It was determined that he did not have blood clots on his heart valves as the source of the clots. The source of the blood clots was never identified. He later developed fever and was diagnosed with a blood infection and treated with antibiotics. At one point his oxygen requirement on the ventilator went down to 65% but later returned and remained at 100%. He ultimately died on 25-May-2021 and as per copy of his death certificate he had 4 causes of death as cardiac arrest, acute hypoxic respiratory failure, acute respiratory distress syndrome (ARDS) and acute exacerbation of heart failure and sepsis.  Treatment included, anticoagulants, antibiotics, intubation and ventilator.  Very limited information regarding these events has been provided at this time.  Further information has been requested.   This case was linked to MOD-2021-219410 (Patient Link).; Sender's Comments: Very limited information regarding these events has been provided at this time.  Further information has been requested.; Reported Cause(s) of Death: Cardiac arrest; Acute hypoxic respiratory failure; ARDS; Acute exacerbation of heart failure and sepsis"
	"1401732-1"	"1401732-1"	"ACUTE RESPIRATORY FAILURE"	"10001053"	"50-59 years"	"50-59"	"Seizures; Bood clots; Stuggling to breathe; Struggling to walk; ARDS; Acute hypoxic respiratory failure; Acute exacerbation of heart failure and sepsis; Acute exacerbation of heart failure and sepsis; Cardiac arrest; Blood infection; Fever; This spontaneous case was reported by a patient family member or friend (subsequently medically confirmed) and describes the occurrence of ACUTE RESPIRATORY DISTRESS SYNDROME (ARDS), ACUTE RESPIRATORY FAILURE (Acute hypoxic respiratory failure), SEPSIS (Acute exacerbation of heart failure and sepsis), CARDIAC FAILURE ACUTE (Acute exacerbation of heart failure and sepsis), CARDIAC ARREST (Cardiac arrest), SEIZURE (Seizures), THROMBOSIS (Bood clots), DYSPNOEA (Stuggling to breathe) and GAIT DISTURBANCE (Struggling to walk) in a 53-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below.     Concurrent medical conditions included Obesity.   On 16-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 15-May-2021 at 2:00 PM, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 15-May-2021, the patient experienced ACUTE RESPIRATORY DISTRESS SYNDROME (ARDS) (seriousness criteria death and medically significant), ACUTE RESPIRATORY FAILURE (Acute hypoxic respiratory failure) (seriousness criteria death and medically significant), DYSPNOEA (Stuggling to breathe) (seriousness criterion hospitalization prolonged) and GAIT DISTURBANCE (Struggling to walk) (seriousness criterion hospitalization prolonged). In May 2021, the patient experienced SEPSIS (Acute exacerbation of heart failure and sepsis) (seriousness criteria death and medically significant), CARDIAC FAILURE ACUTE (Acute exacerbation of heart failure and sepsis) (seriousness criteria death and medically significant), CARDIAC ARREST (Cardiac arrest) (seriousness criteria death and medically significant), INFECTION (Blood infection) and PYREXIA (Fever). On 17-May-2021, the patient experienced SEIZURE (Seizures) (seriousness criteria hospitalization prolonged and medically significant) and THROMBOSIS (Bood clots) (seriousness criteria hospitalization prolonged and medically significant). The patient was hospitalized from 15-May-2021 to 25-May-2021 due to DYSPNOEA, GAIT DISTURBANCE, SEIZURE and THROMBOSIS. The patient died on 25-May-2021. The reported cause of death was Cardiac arrest, Acute hypoxic respiratory failure, ards and acute exacerbation of heart failure and sepsis. It is unknown if an autopsy was performed. At the time of death, SEIZURE (Seizures), THROMBOSIS (Bood clots), DYSPNOEA (Stuggling to breathe), GAIT DISTURBANCE (Struggling to walk), INFECTION (Blood infection) and PYREXIA (Fever) outcome was unknown.      DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 15-May-2021, Blood pressure measurement: elevated (High) Twice normal. On 15-May-2021, Glycosylated haemoglobin: elevated (High) High. On 15-May-2021, Oxygen saturation: low (Low) Required intubation and was placed on ventilator.. On 15-May-2021, SARS-CoV-2 antibody test: negative (Negative) 1 negative COVID antibody test. On 15-May-2021, SARS-CoV-2 test: negatie (Negative) 3 negative COVID antigen tests.         No concomitant medications were provided.  It was reported that within few hours after second dose of vaccine patient was struggling to walk and to breathe. The reporter and her husband went to see the patient and took him to an emergency room (ER). In the ER his blood pressure was markedly elevated (twice normal) and his oxygen level was low and by midnight he required intubation and was placed on a ventilator. His HbgA1c was noted to be elevated. Two days after admission (17-May-2021), he developed seizures which the medical team believed to be due to blood clots and he was anti-coagulated. It was determined that he did not have blood clots on his heart valves as the source of the clots. The source of the blood clots was never identified. He later developed fever and was diagnosed with a blood infection and treated with antibiotics. At one point his oxygen requirement on the ventilator went down to 65% but later returned and remained at 100%. He ultimately died on 25-May-2021 and as per copy of his death certificate he had 4 causes of death as cardiac arrest, acute hypoxic respiratory failure, acute respiratory distress syndrome (ARDS) and acute exacerbation of heart failure and sepsis.  Treatment included, anticoagulants, antibiotics, intubation and ventilator.  Very limited information regarding these events has been provided at this time.  Further information has been requested.   This case was linked to MOD-2021-219410 (Patient Link).; Sender's Comments: Very limited information regarding these events has been provided at this time.  Further information has been requested.; Reported Cause(s) of Death: Cardiac arrest; Acute hypoxic respiratory failure; ARDS; Acute exacerbation of heart failure and sepsis"
	"1401732-1"	"1401732-1"	"BLOOD PRESSURE MEASUREMENT"	"10076581"	"50-59 years"	"50-59"	"Seizures; Bood clots; Stuggling to breathe; Struggling to walk; ARDS; Acute hypoxic respiratory failure; Acute exacerbation of heart failure and sepsis; Acute exacerbation of heart failure and sepsis; Cardiac arrest; Blood infection; Fever; This spontaneous case was reported by a patient family member or friend (subsequently medically confirmed) and describes the occurrence of ACUTE RESPIRATORY DISTRESS SYNDROME (ARDS), ACUTE RESPIRATORY FAILURE (Acute hypoxic respiratory failure), SEPSIS (Acute exacerbation of heart failure and sepsis), CARDIAC FAILURE ACUTE (Acute exacerbation of heart failure and sepsis), CARDIAC ARREST (Cardiac arrest), SEIZURE (Seizures), THROMBOSIS (Bood clots), DYSPNOEA (Stuggling to breathe) and GAIT DISTURBANCE (Struggling to walk) in a 53-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below.     Concurrent medical conditions included Obesity.   On 16-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 15-May-2021 at 2:00 PM, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 15-May-2021, the patient experienced ACUTE RESPIRATORY DISTRESS SYNDROME (ARDS) (seriousness criteria death and medically significant), ACUTE RESPIRATORY FAILURE (Acute hypoxic respiratory failure) (seriousness criteria death and medically significant), DYSPNOEA (Stuggling to breathe) (seriousness criterion hospitalization prolonged) and GAIT DISTURBANCE (Struggling to walk) (seriousness criterion hospitalization prolonged). In May 2021, the patient experienced SEPSIS (Acute exacerbation of heart failure and sepsis) (seriousness criteria death and medically significant), CARDIAC FAILURE ACUTE (Acute exacerbation of heart failure and sepsis) (seriousness criteria death and medically significant), CARDIAC ARREST (Cardiac arrest) (seriousness criteria death and medically significant), INFECTION (Blood infection) and PYREXIA (Fever). On 17-May-2021, the patient experienced SEIZURE (Seizures) (seriousness criteria hospitalization prolonged and medically significant) and THROMBOSIS (Bood clots) (seriousness criteria hospitalization prolonged and medically significant). The patient was hospitalized from 15-May-2021 to 25-May-2021 due to DYSPNOEA, GAIT DISTURBANCE, SEIZURE and THROMBOSIS. The patient died on 25-May-2021. The reported cause of death was Cardiac arrest, Acute hypoxic respiratory failure, ards and acute exacerbation of heart failure and sepsis. It is unknown if an autopsy was performed. At the time of death, SEIZURE (Seizures), THROMBOSIS (Bood clots), DYSPNOEA (Stuggling to breathe), GAIT DISTURBANCE (Struggling to walk), INFECTION (Blood infection) and PYREXIA (Fever) outcome was unknown.      DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 15-May-2021, Blood pressure measurement: elevated (High) Twice normal. On 15-May-2021, Glycosylated haemoglobin: elevated (High) High. On 15-May-2021, Oxygen saturation: low (Low) Required intubation and was placed on ventilator.. On 15-May-2021, SARS-CoV-2 antibody test: negative (Negative) 1 negative COVID antibody test. On 15-May-2021, SARS-CoV-2 test: negatie (Negative) 3 negative COVID antigen tests.         No concomitant medications were provided.  It was reported that within few hours after second dose of vaccine patient was struggling to walk and to breathe. The reporter and her husband went to see the patient and took him to an emergency room (ER). In the ER his blood pressure was markedly elevated (twice normal) and his oxygen level was low and by midnight he required intubation and was placed on a ventilator. His HbgA1c was noted to be elevated. Two days after admission (17-May-2021), he developed seizures which the medical team believed to be due to blood clots and he was anti-coagulated. It was determined that he did not have blood clots on his heart valves as the source of the clots. The source of the blood clots was never identified. He later developed fever and was diagnosed with a blood infection and treated with antibiotics. At one point his oxygen requirement on the ventilator went down to 65% but later returned and remained at 100%. He ultimately died on 25-May-2021 and as per copy of his death certificate he had 4 causes of death as cardiac arrest, acute hypoxic respiratory failure, acute respiratory distress syndrome (ARDS) and acute exacerbation of heart failure and sepsis.  Treatment included, anticoagulants, antibiotics, intubation and ventilator.  Very limited information regarding these events has been provided at this time.  Further information has been requested.   This case was linked to MOD-2021-219410 (Patient Link).; Sender's Comments: Very limited information regarding these events has been provided at this time.  Further information has been requested.; Reported Cause(s) of Death: Cardiac arrest; Acute hypoxic respiratory failure; ARDS; Acute exacerbation of heart failure and sepsis"
	"1401732-1"	"1401732-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"Seizures; Bood clots; Stuggling to breathe; Struggling to walk; ARDS; Acute hypoxic respiratory failure; Acute exacerbation of heart failure and sepsis; Acute exacerbation of heart failure and sepsis; Cardiac arrest; Blood infection; Fever; This spontaneous case was reported by a patient family member or friend (subsequently medically confirmed) and describes the occurrence of ACUTE RESPIRATORY DISTRESS SYNDROME (ARDS), ACUTE RESPIRATORY FAILURE (Acute hypoxic respiratory failure), SEPSIS (Acute exacerbation of heart failure and sepsis), CARDIAC FAILURE ACUTE (Acute exacerbation of heart failure and sepsis), CARDIAC ARREST (Cardiac arrest), SEIZURE (Seizures), THROMBOSIS (Bood clots), DYSPNOEA (Stuggling to breathe) and GAIT DISTURBANCE (Struggling to walk) in a 53-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below.     Concurrent medical conditions included Obesity.   On 16-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 15-May-2021 at 2:00 PM, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 15-May-2021, the patient experienced ACUTE RESPIRATORY DISTRESS SYNDROME (ARDS) (seriousness criteria death and medically significant), ACUTE RESPIRATORY FAILURE (Acute hypoxic respiratory failure) (seriousness criteria death and medically significant), DYSPNOEA (Stuggling to breathe) (seriousness criterion hospitalization prolonged) and GAIT DISTURBANCE (Struggling to walk) (seriousness criterion hospitalization prolonged). In May 2021, the patient experienced SEPSIS (Acute exacerbation of heart failure and sepsis) (seriousness criteria death and medically significant), CARDIAC FAILURE ACUTE (Acute exacerbation of heart failure and sepsis) (seriousness criteria death and medically significant), CARDIAC ARREST (Cardiac arrest) (seriousness criteria death and medically significant), INFECTION (Blood infection) and PYREXIA (Fever). On 17-May-2021, the patient experienced SEIZURE (Seizures) (seriousness criteria hospitalization prolonged and medically significant) and THROMBOSIS (Bood clots) (seriousness criteria hospitalization prolonged and medically significant). The patient was hospitalized from 15-May-2021 to 25-May-2021 due to DYSPNOEA, GAIT DISTURBANCE, SEIZURE and THROMBOSIS. The patient died on 25-May-2021. The reported cause of death was Cardiac arrest, Acute hypoxic respiratory failure, ards and acute exacerbation of heart failure and sepsis. It is unknown if an autopsy was performed. At the time of death, SEIZURE (Seizures), THROMBOSIS (Bood clots), DYSPNOEA (Stuggling to breathe), GAIT DISTURBANCE (Struggling to walk), INFECTION (Blood infection) and PYREXIA (Fever) outcome was unknown.      DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 15-May-2021, Blood pressure measurement: elevated (High) Twice normal. On 15-May-2021, Glycosylated haemoglobin: elevated (High) High. On 15-May-2021, Oxygen saturation: low (Low) Required intubation and was placed on ventilator.. On 15-May-2021, SARS-CoV-2 antibody test: negative (Negative) 1 negative COVID antibody test. On 15-May-2021, SARS-CoV-2 test: negatie (Negative) 3 negative COVID antigen tests.         No concomitant medications were provided.  It was reported that within few hours after second dose of vaccine patient was struggling to walk and to breathe. The reporter and her husband went to see the patient and took him to an emergency room (ER). In the ER his blood pressure was markedly elevated (twice normal) and his oxygen level was low and by midnight he required intubation and was placed on a ventilator. His HbgA1c was noted to be elevated. Two days after admission (17-May-2021), he developed seizures which the medical team believed to be due to blood clots and he was anti-coagulated. It was determined that he did not have blood clots on his heart valves as the source of the clots. The source of the blood clots was never identified. He later developed fever and was diagnosed with a blood infection and treated with antibiotics. At one point his oxygen requirement on the ventilator went down to 65% but later returned and remained at 100%. He ultimately died on 25-May-2021 and as per copy of his death certificate he had 4 causes of death as cardiac arrest, acute hypoxic respiratory failure, acute respiratory distress syndrome (ARDS) and acute exacerbation of heart failure and sepsis.  Treatment included, anticoagulants, antibiotics, intubation and ventilator.  Very limited information regarding these events has been provided at this time.  Further information has been requested.   This case was linked to MOD-2021-219410 (Patient Link).; Sender's Comments: Very limited information regarding these events has been provided at this time.  Further information has been requested.; Reported Cause(s) of Death: Cardiac arrest; Acute hypoxic respiratory failure; ARDS; Acute exacerbation of heart failure and sepsis"
	"1401732-1"	"1401732-1"	"CARDIAC FAILURE ACUTE"	"10007556"	"50-59 years"	"50-59"	"Seizures; Bood clots; Stuggling to breathe; Struggling to walk; ARDS; Acute hypoxic respiratory failure; Acute exacerbation of heart failure and sepsis; Acute exacerbation of heart failure and sepsis; Cardiac arrest; Blood infection; Fever; This spontaneous case was reported by a patient family member or friend (subsequently medically confirmed) and describes the occurrence of ACUTE RESPIRATORY DISTRESS SYNDROME (ARDS), ACUTE RESPIRATORY FAILURE (Acute hypoxic respiratory failure), SEPSIS (Acute exacerbation of heart failure and sepsis), CARDIAC FAILURE ACUTE (Acute exacerbation of heart failure and sepsis), CARDIAC ARREST (Cardiac arrest), SEIZURE (Seizures), THROMBOSIS (Bood clots), DYSPNOEA (Stuggling to breathe) and GAIT DISTURBANCE (Struggling to walk) in a 53-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below.     Concurrent medical conditions included Obesity.   On 16-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 15-May-2021 at 2:00 PM, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 15-May-2021, the patient experienced ACUTE RESPIRATORY DISTRESS SYNDROME (ARDS) (seriousness criteria death and medically significant), ACUTE RESPIRATORY FAILURE (Acute hypoxic respiratory failure) (seriousness criteria death and medically significant), DYSPNOEA (Stuggling to breathe) (seriousness criterion hospitalization prolonged) and GAIT DISTURBANCE (Struggling to walk) (seriousness criterion hospitalization prolonged). In May 2021, the patient experienced SEPSIS (Acute exacerbation of heart failure and sepsis) (seriousness criteria death and medically significant), CARDIAC FAILURE ACUTE (Acute exacerbation of heart failure and sepsis) (seriousness criteria death and medically significant), CARDIAC ARREST (Cardiac arrest) (seriousness criteria death and medically significant), INFECTION (Blood infection) and PYREXIA (Fever). On 17-May-2021, the patient experienced SEIZURE (Seizures) (seriousness criteria hospitalization prolonged and medically significant) and THROMBOSIS (Bood clots) (seriousness criteria hospitalization prolonged and medically significant). The patient was hospitalized from 15-May-2021 to 25-May-2021 due to DYSPNOEA, GAIT DISTURBANCE, SEIZURE and THROMBOSIS. The patient died on 25-May-2021. The reported cause of death was Cardiac arrest, Acute hypoxic respiratory failure, ards and acute exacerbation of heart failure and sepsis. It is unknown if an autopsy was performed. At the time of death, SEIZURE (Seizures), THROMBOSIS (Bood clots), DYSPNOEA (Stuggling to breathe), GAIT DISTURBANCE (Struggling to walk), INFECTION (Blood infection) and PYREXIA (Fever) outcome was unknown.      DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 15-May-2021, Blood pressure measurement: elevated (High) Twice normal. On 15-May-2021, Glycosylated haemoglobin: elevated (High) High. On 15-May-2021, Oxygen saturation: low (Low) Required intubation and was placed on ventilator.. On 15-May-2021, SARS-CoV-2 antibody test: negative (Negative) 1 negative COVID antibody test. On 15-May-2021, SARS-CoV-2 test: negatie (Negative) 3 negative COVID antigen tests.         No concomitant medications were provided.  It was reported that within few hours after second dose of vaccine patient was struggling to walk and to breathe. The reporter and her husband went to see the patient and took him to an emergency room (ER). In the ER his blood pressure was markedly elevated (twice normal) and his oxygen level was low and by midnight he required intubation and was placed on a ventilator. His HbgA1c was noted to be elevated. Two days after admission (17-May-2021), he developed seizures which the medical team believed to be due to blood clots and he was anti-coagulated. It was determined that he did not have blood clots on his heart valves as the source of the clots. The source of the blood clots was never identified. He later developed fever and was diagnosed with a blood infection and treated with antibiotics. At one point his oxygen requirement on the ventilator went down to 65% but later returned and remained at 100%. He ultimately died on 25-May-2021 and as per copy of his death certificate he had 4 causes of death as cardiac arrest, acute hypoxic respiratory failure, acute respiratory distress syndrome (ARDS) and acute exacerbation of heart failure and sepsis.  Treatment included, anticoagulants, antibiotics, intubation and ventilator.  Very limited information regarding these events has been provided at this time.  Further information has been requested.   This case was linked to MOD-2021-219410 (Patient Link).; Sender's Comments: Very limited information regarding these events has been provided at this time.  Further information has been requested.; Reported Cause(s) of Death: Cardiac arrest; Acute hypoxic respiratory failure; ARDS; Acute exacerbation of heart failure and sepsis"
	"1401732-1"	"1401732-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"Seizures; Bood clots; Stuggling to breathe; Struggling to walk; ARDS; Acute hypoxic respiratory failure; Acute exacerbation of heart failure and sepsis; Acute exacerbation of heart failure and sepsis; Cardiac arrest; Blood infection; Fever; This spontaneous case was reported by a patient family member or friend (subsequently medically confirmed) and describes the occurrence of ACUTE RESPIRATORY DISTRESS SYNDROME (ARDS), ACUTE RESPIRATORY FAILURE (Acute hypoxic respiratory failure), SEPSIS (Acute exacerbation of heart failure and sepsis), CARDIAC FAILURE ACUTE (Acute exacerbation of heart failure and sepsis), CARDIAC ARREST (Cardiac arrest), SEIZURE (Seizures), THROMBOSIS (Bood clots), DYSPNOEA (Stuggling to breathe) and GAIT DISTURBANCE (Struggling to walk) in a 53-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below.     Concurrent medical conditions included Obesity.   On 16-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 15-May-2021 at 2:00 PM, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 15-May-2021, the patient experienced ACUTE RESPIRATORY DISTRESS SYNDROME (ARDS) (seriousness criteria death and medically significant), ACUTE RESPIRATORY FAILURE (Acute hypoxic respiratory failure) (seriousness criteria death and medically significant), DYSPNOEA (Stuggling to breathe) (seriousness criterion hospitalization prolonged) and GAIT DISTURBANCE (Struggling to walk) (seriousness criterion hospitalization prolonged). In May 2021, the patient experienced SEPSIS (Acute exacerbation of heart failure and sepsis) (seriousness criteria death and medically significant), CARDIAC FAILURE ACUTE (Acute exacerbation of heart failure and sepsis) (seriousness criteria death and medically significant), CARDIAC ARREST (Cardiac arrest) (seriousness criteria death and medically significant), INFECTION (Blood infection) and PYREXIA (Fever). On 17-May-2021, the patient experienced SEIZURE (Seizures) (seriousness criteria hospitalization prolonged and medically significant) and THROMBOSIS (Bood clots) (seriousness criteria hospitalization prolonged and medically significant). The patient was hospitalized from 15-May-2021 to 25-May-2021 due to DYSPNOEA, GAIT DISTURBANCE, SEIZURE and THROMBOSIS. The patient died on 25-May-2021. The reported cause of death was Cardiac arrest, Acute hypoxic respiratory failure, ards and acute exacerbation of heart failure and sepsis. It is unknown if an autopsy was performed. At the time of death, SEIZURE (Seizures), THROMBOSIS (Bood clots), DYSPNOEA (Stuggling to breathe), GAIT DISTURBANCE (Struggling to walk), INFECTION (Blood infection) and PYREXIA (Fever) outcome was unknown.      DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 15-May-2021, Blood pressure measurement: elevated (High) Twice normal. On 15-May-2021, Glycosylated haemoglobin: elevated (High) High. On 15-May-2021, Oxygen saturation: low (Low) Required intubation and was placed on ventilator.. On 15-May-2021, SARS-CoV-2 antibody test: negative (Negative) 1 negative COVID antibody test. On 15-May-2021, SARS-CoV-2 test: negatie (Negative) 3 negative COVID antigen tests.         No concomitant medications were provided.  It was reported that within few hours after second dose of vaccine patient was struggling to walk and to breathe. The reporter and her husband went to see the patient and took him to an emergency room (ER). In the ER his blood pressure was markedly elevated (twice normal) and his oxygen level was low and by midnight he required intubation and was placed on a ventilator. His HbgA1c was noted to be elevated. Two days after admission (17-May-2021), he developed seizures which the medical team believed to be due to blood clots and he was anti-coagulated. It was determined that he did not have blood clots on his heart valves as the source of the clots. The source of the blood clots was never identified. He later developed fever and was diagnosed with a blood infection and treated with antibiotics. At one point his oxygen requirement on the ventilator went down to 65% but later returned and remained at 100%. He ultimately died on 25-May-2021 and as per copy of his death certificate he had 4 causes of death as cardiac arrest, acute hypoxic respiratory failure, acute respiratory distress syndrome (ARDS) and acute exacerbation of heart failure and sepsis.  Treatment included, anticoagulants, antibiotics, intubation and ventilator.  Very limited information regarding these events has been provided at this time.  Further information has been requested.   This case was linked to MOD-2021-219410 (Patient Link).; Sender's Comments: Very limited information regarding these events has been provided at this time.  Further information has been requested.; Reported Cause(s) of Death: Cardiac arrest; Acute hypoxic respiratory failure; ARDS; Acute exacerbation of heart failure and sepsis"
	"1401732-1"	"1401732-1"	"GAIT DISTURBANCE"	"10017577"	"50-59 years"	"50-59"	"Seizures; Bood clots; Stuggling to breathe; Struggling to walk; ARDS; Acute hypoxic respiratory failure; Acute exacerbation of heart failure and sepsis; Acute exacerbation of heart failure and sepsis; Cardiac arrest; Blood infection; Fever; This spontaneous case was reported by a patient family member or friend (subsequently medically confirmed) and describes the occurrence of ACUTE RESPIRATORY DISTRESS SYNDROME (ARDS), ACUTE RESPIRATORY FAILURE (Acute hypoxic respiratory failure), SEPSIS (Acute exacerbation of heart failure and sepsis), CARDIAC FAILURE ACUTE (Acute exacerbation of heart failure and sepsis), CARDIAC ARREST (Cardiac arrest), SEIZURE (Seizures), THROMBOSIS (Bood clots), DYSPNOEA (Stuggling to breathe) and GAIT DISTURBANCE (Struggling to walk) in a 53-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below.     Concurrent medical conditions included Obesity.   On 16-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 15-May-2021 at 2:00 PM, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 15-May-2021, the patient experienced ACUTE RESPIRATORY DISTRESS SYNDROME (ARDS) (seriousness criteria death and medically significant), ACUTE RESPIRATORY FAILURE (Acute hypoxic respiratory failure) (seriousness criteria death and medically significant), DYSPNOEA (Stuggling to breathe) (seriousness criterion hospitalization prolonged) and GAIT DISTURBANCE (Struggling to walk) (seriousness criterion hospitalization prolonged). In May 2021, the patient experienced SEPSIS (Acute exacerbation of heart failure and sepsis) (seriousness criteria death and medically significant), CARDIAC FAILURE ACUTE (Acute exacerbation of heart failure and sepsis) (seriousness criteria death and medically significant), CARDIAC ARREST (Cardiac arrest) (seriousness criteria death and medically significant), INFECTION (Blood infection) and PYREXIA (Fever). On 17-May-2021, the patient experienced SEIZURE (Seizures) (seriousness criteria hospitalization prolonged and medically significant) and THROMBOSIS (Bood clots) (seriousness criteria hospitalization prolonged and medically significant). The patient was hospitalized from 15-May-2021 to 25-May-2021 due to DYSPNOEA, GAIT DISTURBANCE, SEIZURE and THROMBOSIS. The patient died on 25-May-2021. The reported cause of death was Cardiac arrest, Acute hypoxic respiratory failure, ards and acute exacerbation of heart failure and sepsis. It is unknown if an autopsy was performed. At the time of death, SEIZURE (Seizures), THROMBOSIS (Bood clots), DYSPNOEA (Stuggling to breathe), GAIT DISTURBANCE (Struggling to walk), INFECTION (Blood infection) and PYREXIA (Fever) outcome was unknown.      DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 15-May-2021, Blood pressure measurement: elevated (High) Twice normal. On 15-May-2021, Glycosylated haemoglobin: elevated (High) High. On 15-May-2021, Oxygen saturation: low (Low) Required intubation and was placed on ventilator.. On 15-May-2021, SARS-CoV-2 antibody test: negative (Negative) 1 negative COVID antibody test. On 15-May-2021, SARS-CoV-2 test: negatie (Negative) 3 negative COVID antigen tests.         No concomitant medications were provided.  It was reported that within few hours after second dose of vaccine patient was struggling to walk and to breathe. The reporter and her husband went to see the patient and took him to an emergency room (ER). In the ER his blood pressure was markedly elevated (twice normal) and his oxygen level was low and by midnight he required intubation and was placed on a ventilator. His HbgA1c was noted to be elevated. Two days after admission (17-May-2021), he developed seizures which the medical team believed to be due to blood clots and he was anti-coagulated. It was determined that he did not have blood clots on his heart valves as the source of the clots. The source of the blood clots was never identified. He later developed fever and was diagnosed with a blood infection and treated with antibiotics. At one point his oxygen requirement on the ventilator went down to 65% but later returned and remained at 100%. He ultimately died on 25-May-2021 and as per copy of his death certificate he had 4 causes of death as cardiac arrest, acute hypoxic respiratory failure, acute respiratory distress syndrome (ARDS) and acute exacerbation of heart failure and sepsis.  Treatment included, anticoagulants, antibiotics, intubation and ventilator.  Very limited information regarding these events has been provided at this time.  Further information has been requested.   This case was linked to MOD-2021-219410 (Patient Link).; Sender's Comments: Very limited information regarding these events has been provided at this time.  Further information has been requested.; Reported Cause(s) of Death: Cardiac arrest; Acute hypoxic respiratory failure; ARDS; Acute exacerbation of heart failure and sepsis"
	"1401732-1"	"1401732-1"	"GLYCOSYLATED HAEMOGLOBIN"	"10018480"	"50-59 years"	"50-59"	"Seizures; Bood clots; Stuggling to breathe; Struggling to walk; ARDS; Acute hypoxic respiratory failure; Acute exacerbation of heart failure and sepsis; Acute exacerbation of heart failure and sepsis; Cardiac arrest; Blood infection; Fever; This spontaneous case was reported by a patient family member or friend (subsequently medically confirmed) and describes the occurrence of ACUTE RESPIRATORY DISTRESS SYNDROME (ARDS), ACUTE RESPIRATORY FAILURE (Acute hypoxic respiratory failure), SEPSIS (Acute exacerbation of heart failure and sepsis), CARDIAC FAILURE ACUTE (Acute exacerbation of heart failure and sepsis), CARDIAC ARREST (Cardiac arrest), SEIZURE (Seizures), THROMBOSIS (Bood clots), DYSPNOEA (Stuggling to breathe) and GAIT DISTURBANCE (Struggling to walk) in a 53-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below.     Concurrent medical conditions included Obesity.   On 16-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 15-May-2021 at 2:00 PM, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 15-May-2021, the patient experienced ACUTE RESPIRATORY DISTRESS SYNDROME (ARDS) (seriousness criteria death and medically significant), ACUTE RESPIRATORY FAILURE (Acute hypoxic respiratory failure) (seriousness criteria death and medically significant), DYSPNOEA (Stuggling to breathe) (seriousness criterion hospitalization prolonged) and GAIT DISTURBANCE (Struggling to walk) (seriousness criterion hospitalization prolonged). In May 2021, the patient experienced SEPSIS (Acute exacerbation of heart failure and sepsis) (seriousness criteria death and medically significant), CARDIAC FAILURE ACUTE (Acute exacerbation of heart failure and sepsis) (seriousness criteria death and medically significant), CARDIAC ARREST (Cardiac arrest) (seriousness criteria death and medically significant), INFECTION (Blood infection) and PYREXIA (Fever). On 17-May-2021, the patient experienced SEIZURE (Seizures) (seriousness criteria hospitalization prolonged and medically significant) and THROMBOSIS (Bood clots) (seriousness criteria hospitalization prolonged and medically significant). The patient was hospitalized from 15-May-2021 to 25-May-2021 due to DYSPNOEA, GAIT DISTURBANCE, SEIZURE and THROMBOSIS. The patient died on 25-May-2021. The reported cause of death was Cardiac arrest, Acute hypoxic respiratory failure, ards and acute exacerbation of heart failure and sepsis. It is unknown if an autopsy was performed. At the time of death, SEIZURE (Seizures), THROMBOSIS (Bood clots), DYSPNOEA (Stuggling to breathe), GAIT DISTURBANCE (Struggling to walk), INFECTION (Blood infection) and PYREXIA (Fever) outcome was unknown.      DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 15-May-2021, Blood pressure measurement: elevated (High) Twice normal. On 15-May-2021, Glycosylated haemoglobin: elevated (High) High. On 15-May-2021, Oxygen saturation: low (Low) Required intubation and was placed on ventilator.. On 15-May-2021, SARS-CoV-2 antibody test: negative (Negative) 1 negative COVID antibody test. On 15-May-2021, SARS-CoV-2 test: negatie (Negative) 3 negative COVID antigen tests.         No concomitant medications were provided.  It was reported that within few hours after second dose of vaccine patient was struggling to walk and to breathe. The reporter and her husband went to see the patient and took him to an emergency room (ER). In the ER his blood pressure was markedly elevated (twice normal) and his oxygen level was low and by midnight he required intubation and was placed on a ventilator. His HbgA1c was noted to be elevated. Two days after admission (17-May-2021), he developed seizures which the medical team believed to be due to blood clots and he was anti-coagulated. It was determined that he did not have blood clots on his heart valves as the source of the clots. The source of the blood clots was never identified. He later developed fever and was diagnosed with a blood infection and treated with antibiotics. At one point his oxygen requirement on the ventilator went down to 65% but later returned and remained at 100%. He ultimately died on 25-May-2021 and as per copy of his death certificate he had 4 causes of death as cardiac arrest, acute hypoxic respiratory failure, acute respiratory distress syndrome (ARDS) and acute exacerbation of heart failure and sepsis.  Treatment included, anticoagulants, antibiotics, intubation and ventilator.  Very limited information regarding these events has been provided at this time.  Further information has been requested.   This case was linked to MOD-2021-219410 (Patient Link).; Sender's Comments: Very limited information regarding these events has been provided at this time.  Further information has been requested.; Reported Cause(s) of Death: Cardiac arrest; Acute hypoxic respiratory failure; ARDS; Acute exacerbation of heart failure and sepsis"
	"1401732-1"	"1401732-1"	"INFECTION"	"10021789"	"50-59 years"	"50-59"	"Seizures; Bood clots; Stuggling to breathe; Struggling to walk; ARDS; Acute hypoxic respiratory failure; Acute exacerbation of heart failure and sepsis; Acute exacerbation of heart failure and sepsis; Cardiac arrest; Blood infection; Fever; This spontaneous case was reported by a patient family member or friend (subsequently medically confirmed) and describes the occurrence of ACUTE RESPIRATORY DISTRESS SYNDROME (ARDS), ACUTE RESPIRATORY FAILURE (Acute hypoxic respiratory failure), SEPSIS (Acute exacerbation of heart failure and sepsis), CARDIAC FAILURE ACUTE (Acute exacerbation of heart failure and sepsis), CARDIAC ARREST (Cardiac arrest), SEIZURE (Seizures), THROMBOSIS (Bood clots), DYSPNOEA (Stuggling to breathe) and GAIT DISTURBANCE (Struggling to walk) in a 53-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below.     Concurrent medical conditions included Obesity.   On 16-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 15-May-2021 at 2:00 PM, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 15-May-2021, the patient experienced ACUTE RESPIRATORY DISTRESS SYNDROME (ARDS) (seriousness criteria death and medically significant), ACUTE RESPIRATORY FAILURE (Acute hypoxic respiratory failure) (seriousness criteria death and medically significant), DYSPNOEA (Stuggling to breathe) (seriousness criterion hospitalization prolonged) and GAIT DISTURBANCE (Struggling to walk) (seriousness criterion hospitalization prolonged). In May 2021, the patient experienced SEPSIS (Acute exacerbation of heart failure and sepsis) (seriousness criteria death and medically significant), CARDIAC FAILURE ACUTE (Acute exacerbation of heart failure and sepsis) (seriousness criteria death and medically significant), CARDIAC ARREST (Cardiac arrest) (seriousness criteria death and medically significant), INFECTION (Blood infection) and PYREXIA (Fever). On 17-May-2021, the patient experienced SEIZURE (Seizures) (seriousness criteria hospitalization prolonged and medically significant) and THROMBOSIS (Bood clots) (seriousness criteria hospitalization prolonged and medically significant). The patient was hospitalized from 15-May-2021 to 25-May-2021 due to DYSPNOEA, GAIT DISTURBANCE, SEIZURE and THROMBOSIS. The patient died on 25-May-2021. The reported cause of death was Cardiac arrest, Acute hypoxic respiratory failure, ards and acute exacerbation of heart failure and sepsis. It is unknown if an autopsy was performed. At the time of death, SEIZURE (Seizures), THROMBOSIS (Bood clots), DYSPNOEA (Stuggling to breathe), GAIT DISTURBANCE (Struggling to walk), INFECTION (Blood infection) and PYREXIA (Fever) outcome was unknown.      DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 15-May-2021, Blood pressure measurement: elevated (High) Twice normal. On 15-May-2021, Glycosylated haemoglobin: elevated (High) High. On 15-May-2021, Oxygen saturation: low (Low) Required intubation and was placed on ventilator.. On 15-May-2021, SARS-CoV-2 antibody test: negative (Negative) 1 negative COVID antibody test. On 15-May-2021, SARS-CoV-2 test: negatie (Negative) 3 negative COVID antigen tests.         No concomitant medications were provided.  It was reported that within few hours after second dose of vaccine patient was struggling to walk and to breathe. The reporter and her husband went to see the patient and took him to an emergency room (ER). In the ER his blood pressure was markedly elevated (twice normal) and his oxygen level was low and by midnight he required intubation and was placed on a ventilator. His HbgA1c was noted to be elevated. Two days after admission (17-May-2021), he developed seizures which the medical team believed to be due to blood clots and he was anti-coagulated. It was determined that he did not have blood clots on his heart valves as the source of the clots. The source of the blood clots was never identified. He later developed fever and was diagnosed with a blood infection and treated with antibiotics. At one point his oxygen requirement on the ventilator went down to 65% but later returned and remained at 100%. He ultimately died on 25-May-2021 and as per copy of his death certificate he had 4 causes of death as cardiac arrest, acute hypoxic respiratory failure, acute respiratory distress syndrome (ARDS) and acute exacerbation of heart failure and sepsis.  Treatment included, anticoagulants, antibiotics, intubation and ventilator.  Very limited information regarding these events has been provided at this time.  Further information has been requested.   This case was linked to MOD-2021-219410 (Patient Link).; Sender's Comments: Very limited information regarding these events has been provided at this time.  Further information has been requested.; Reported Cause(s) of Death: Cardiac arrest; Acute hypoxic respiratory failure; ARDS; Acute exacerbation of heart failure and sepsis"
	"1401732-1"	"1401732-1"	"OXYGEN SATURATION"	"10033316"	"50-59 years"	"50-59"	"Seizures; Bood clots; Stuggling to breathe; Struggling to walk; ARDS; Acute hypoxic respiratory failure; Acute exacerbation of heart failure and sepsis; Acute exacerbation of heart failure and sepsis; Cardiac arrest; Blood infection; Fever; This spontaneous case was reported by a patient family member or friend (subsequently medically confirmed) and describes the occurrence of ACUTE RESPIRATORY DISTRESS SYNDROME (ARDS), ACUTE RESPIRATORY FAILURE (Acute hypoxic respiratory failure), SEPSIS (Acute exacerbation of heart failure and sepsis), CARDIAC FAILURE ACUTE (Acute exacerbation of heart failure and sepsis), CARDIAC ARREST (Cardiac arrest), SEIZURE (Seizures), THROMBOSIS (Bood clots), DYSPNOEA (Stuggling to breathe) and GAIT DISTURBANCE (Struggling to walk) in a 53-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below.     Concurrent medical conditions included Obesity.   On 16-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 15-May-2021 at 2:00 PM, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 15-May-2021, the patient experienced ACUTE RESPIRATORY DISTRESS SYNDROME (ARDS) (seriousness criteria death and medically significant), ACUTE RESPIRATORY FAILURE (Acute hypoxic respiratory failure) (seriousness criteria death and medically significant), DYSPNOEA (Stuggling to breathe) (seriousness criterion hospitalization prolonged) and GAIT DISTURBANCE (Struggling to walk) (seriousness criterion hospitalization prolonged). In May 2021, the patient experienced SEPSIS (Acute exacerbation of heart failure and sepsis) (seriousness criteria death and medically significant), CARDIAC FAILURE ACUTE (Acute exacerbation of heart failure and sepsis) (seriousness criteria death and medically significant), CARDIAC ARREST (Cardiac arrest) (seriousness criteria death and medically significant), INFECTION (Blood infection) and PYREXIA (Fever). On 17-May-2021, the patient experienced SEIZURE (Seizures) (seriousness criteria hospitalization prolonged and medically significant) and THROMBOSIS (Bood clots) (seriousness criteria hospitalization prolonged and medically significant). The patient was hospitalized from 15-May-2021 to 25-May-2021 due to DYSPNOEA, GAIT DISTURBANCE, SEIZURE and THROMBOSIS. The patient died on 25-May-2021. The reported cause of death was Cardiac arrest, Acute hypoxic respiratory failure, ards and acute exacerbation of heart failure and sepsis. It is unknown if an autopsy was performed. At the time of death, SEIZURE (Seizures), THROMBOSIS (Bood clots), DYSPNOEA (Stuggling to breathe), GAIT DISTURBANCE (Struggling to walk), INFECTION (Blood infection) and PYREXIA (Fever) outcome was unknown.      DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 15-May-2021, Blood pressure measurement: elevated (High) Twice normal. On 15-May-2021, Glycosylated haemoglobin: elevated (High) High. On 15-May-2021, Oxygen saturation: low (Low) Required intubation and was placed on ventilator.. On 15-May-2021, SARS-CoV-2 antibody test: negative (Negative) 1 negative COVID antibody test. On 15-May-2021, SARS-CoV-2 test: negatie (Negative) 3 negative COVID antigen tests.         No concomitant medications were provided.  It was reported that within few hours after second dose of vaccine patient was struggling to walk and to breathe. The reporter and her husband went to see the patient and took him to an emergency room (ER). In the ER his blood pressure was markedly elevated (twice normal) and his oxygen level was low and by midnight he required intubation and was placed on a ventilator. His HbgA1c was noted to be elevated. Two days after admission (17-May-2021), he developed seizures which the medical team believed to be due to blood clots and he was anti-coagulated. It was determined that he did not have blood clots on his heart valves as the source of the clots. The source of the blood clots was never identified. He later developed fever and was diagnosed with a blood infection and treated with antibiotics. At one point his oxygen requirement on the ventilator went down to 65% but later returned and remained at 100%. He ultimately died on 25-May-2021 and as per copy of his death certificate he had 4 causes of death as cardiac arrest, acute hypoxic respiratory failure, acute respiratory distress syndrome (ARDS) and acute exacerbation of heart failure and sepsis.  Treatment included, anticoagulants, antibiotics, intubation and ventilator.  Very limited information regarding these events has been provided at this time.  Further information has been requested.   This case was linked to MOD-2021-219410 (Patient Link).; Sender's Comments: Very limited information regarding these events has been provided at this time.  Further information has been requested.; Reported Cause(s) of Death: Cardiac arrest; Acute hypoxic respiratory failure; ARDS; Acute exacerbation of heart failure and sepsis"
	"1401732-1"	"1401732-1"	"PYREXIA"	"10037660"	"50-59 years"	"50-59"	"Seizures; Bood clots; Stuggling to breathe; Struggling to walk; ARDS; Acute hypoxic respiratory failure; Acute exacerbation of heart failure and sepsis; Acute exacerbation of heart failure and sepsis; Cardiac arrest; Blood infection; Fever; This spontaneous case was reported by a patient family member or friend (subsequently medically confirmed) and describes the occurrence of ACUTE RESPIRATORY DISTRESS SYNDROME (ARDS), ACUTE RESPIRATORY FAILURE (Acute hypoxic respiratory failure), SEPSIS (Acute exacerbation of heart failure and sepsis), CARDIAC FAILURE ACUTE (Acute exacerbation of heart failure and sepsis), CARDIAC ARREST (Cardiac arrest), SEIZURE (Seizures), THROMBOSIS (Bood clots), DYSPNOEA (Stuggling to breathe) and GAIT DISTURBANCE (Struggling to walk) in a 53-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below.     Concurrent medical conditions included Obesity.   On 16-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 15-May-2021 at 2:00 PM, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 15-May-2021, the patient experienced ACUTE RESPIRATORY DISTRESS SYNDROME (ARDS) (seriousness criteria death and medically significant), ACUTE RESPIRATORY FAILURE (Acute hypoxic respiratory failure) (seriousness criteria death and medically significant), DYSPNOEA (Stuggling to breathe) (seriousness criterion hospitalization prolonged) and GAIT DISTURBANCE (Struggling to walk) (seriousness criterion hospitalization prolonged). In May 2021, the patient experienced SEPSIS (Acute exacerbation of heart failure and sepsis) (seriousness criteria death and medically significant), CARDIAC FAILURE ACUTE (Acute exacerbation of heart failure and sepsis) (seriousness criteria death and medically significant), CARDIAC ARREST (Cardiac arrest) (seriousness criteria death and medically significant), INFECTION (Blood infection) and PYREXIA (Fever). On 17-May-2021, the patient experienced SEIZURE (Seizures) (seriousness criteria hospitalization prolonged and medically significant) and THROMBOSIS (Bood clots) (seriousness criteria hospitalization prolonged and medically significant). The patient was hospitalized from 15-May-2021 to 25-May-2021 due to DYSPNOEA, GAIT DISTURBANCE, SEIZURE and THROMBOSIS. The patient died on 25-May-2021. The reported cause of death was Cardiac arrest, Acute hypoxic respiratory failure, ards and acute exacerbation of heart failure and sepsis. It is unknown if an autopsy was performed. At the time of death, SEIZURE (Seizures), THROMBOSIS (Bood clots), DYSPNOEA (Stuggling to breathe), GAIT DISTURBANCE (Struggling to walk), INFECTION (Blood infection) and PYREXIA (Fever) outcome was unknown.      DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 15-May-2021, Blood pressure measurement: elevated (High) Twice normal. On 15-May-2021, Glycosylated haemoglobin: elevated (High) High. On 15-May-2021, Oxygen saturation: low (Low) Required intubation and was placed on ventilator.. On 15-May-2021, SARS-CoV-2 antibody test: negative (Negative) 1 negative COVID antibody test. On 15-May-2021, SARS-CoV-2 test: negatie (Negative) 3 negative COVID antigen tests.         No concomitant medications were provided.  It was reported that within few hours after second dose of vaccine patient was struggling to walk and to breathe. The reporter and her husband went to see the patient and took him to an emergency room (ER). In the ER his blood pressure was markedly elevated (twice normal) and his oxygen level was low and by midnight he required intubation and was placed on a ventilator. His HbgA1c was noted to be elevated. Two days after admission (17-May-2021), he developed seizures which the medical team believed to be due to blood clots and he was anti-coagulated. It was determined that he did not have blood clots on his heart valves as the source of the clots. The source of the blood clots was never identified. He later developed fever and was diagnosed with a blood infection and treated with antibiotics. At one point his oxygen requirement on the ventilator went down to 65% but later returned and remained at 100%. He ultimately died on 25-May-2021 and as per copy of his death certificate he had 4 causes of death as cardiac arrest, acute hypoxic respiratory failure, acute respiratory distress syndrome (ARDS) and acute exacerbation of heart failure and sepsis.  Treatment included, anticoagulants, antibiotics, intubation and ventilator.  Very limited information regarding these events has been provided at this time.  Further information has been requested.   This case was linked to MOD-2021-219410 (Patient Link).; Sender's Comments: Very limited information regarding these events has been provided at this time.  Further information has been requested.; Reported Cause(s) of Death: Cardiac arrest; Acute hypoxic respiratory failure; ARDS; Acute exacerbation of heart failure and sepsis"
	"1401732-1"	"1401732-1"	"SARS-COV-2 ANTIBODY TEST"	"10084501"	"50-59 years"	"50-59"	"Seizures; Bood clots; Stuggling to breathe; Struggling to walk; ARDS; Acute hypoxic respiratory failure; Acute exacerbation of heart failure and sepsis; Acute exacerbation of heart failure and sepsis; Cardiac arrest; Blood infection; Fever; This spontaneous case was reported by a patient family member or friend (subsequently medically confirmed) and describes the occurrence of ACUTE RESPIRATORY DISTRESS SYNDROME (ARDS), ACUTE RESPIRATORY FAILURE (Acute hypoxic respiratory failure), SEPSIS (Acute exacerbation of heart failure and sepsis), CARDIAC FAILURE ACUTE (Acute exacerbation of heart failure and sepsis), CARDIAC ARREST (Cardiac arrest), SEIZURE (Seizures), THROMBOSIS (Bood clots), DYSPNOEA (Stuggling to breathe) and GAIT DISTURBANCE (Struggling to walk) in a 53-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below.     Concurrent medical conditions included Obesity.   On 16-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 15-May-2021 at 2:00 PM, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 15-May-2021, the patient experienced ACUTE RESPIRATORY DISTRESS SYNDROME (ARDS) (seriousness criteria death and medically significant), ACUTE RESPIRATORY FAILURE (Acute hypoxic respiratory failure) (seriousness criteria death and medically significant), DYSPNOEA (Stuggling to breathe) (seriousness criterion hospitalization prolonged) and GAIT DISTURBANCE (Struggling to walk) (seriousness criterion hospitalization prolonged). In May 2021, the patient experienced SEPSIS (Acute exacerbation of heart failure and sepsis) (seriousness criteria death and medically significant), CARDIAC FAILURE ACUTE (Acute exacerbation of heart failure and sepsis) (seriousness criteria death and medically significant), CARDIAC ARREST (Cardiac arrest) (seriousness criteria death and medically significant), INFECTION (Blood infection) and PYREXIA (Fever). On 17-May-2021, the patient experienced SEIZURE (Seizures) (seriousness criteria hospitalization prolonged and medically significant) and THROMBOSIS (Bood clots) (seriousness criteria hospitalization prolonged and medically significant). The patient was hospitalized from 15-May-2021 to 25-May-2021 due to DYSPNOEA, GAIT DISTURBANCE, SEIZURE and THROMBOSIS. The patient died on 25-May-2021. The reported cause of death was Cardiac arrest, Acute hypoxic respiratory failure, ards and acute exacerbation of heart failure and sepsis. It is unknown if an autopsy was performed. At the time of death, SEIZURE (Seizures), THROMBOSIS (Bood clots), DYSPNOEA (Stuggling to breathe), GAIT DISTURBANCE (Struggling to walk), INFECTION (Blood infection) and PYREXIA (Fever) outcome was unknown.      DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 15-May-2021, Blood pressure measurement: elevated (High) Twice normal. On 15-May-2021, Glycosylated haemoglobin: elevated (High) High. On 15-May-2021, Oxygen saturation: low (Low) Required intubation and was placed on ventilator.. On 15-May-2021, SARS-CoV-2 antibody test: negative (Negative) 1 negative COVID antibody test. On 15-May-2021, SARS-CoV-2 test: negatie (Negative) 3 negative COVID antigen tests.         No concomitant medications were provided.  It was reported that within few hours after second dose of vaccine patient was struggling to walk and to breathe. The reporter and her husband went to see the patient and took him to an emergency room (ER). In the ER his blood pressure was markedly elevated (twice normal) and his oxygen level was low and by midnight he required intubation and was placed on a ventilator. His HbgA1c was noted to be elevated. Two days after admission (17-May-2021), he developed seizures which the medical team believed to be due to blood clots and he was anti-coagulated. It was determined that he did not have blood clots on his heart valves as the source of the clots. The source of the blood clots was never identified. He later developed fever and was diagnosed with a blood infection and treated with antibiotics. At one point his oxygen requirement on the ventilator went down to 65% but later returned and remained at 100%. He ultimately died on 25-May-2021 and as per copy of his death certificate he had 4 causes of death as cardiac arrest, acute hypoxic respiratory failure, acute respiratory distress syndrome (ARDS) and acute exacerbation of heart failure and sepsis.  Treatment included, anticoagulants, antibiotics, intubation and ventilator.  Very limited information regarding these events has been provided at this time.  Further information has been requested.   This case was linked to MOD-2021-219410 (Patient Link).; Sender's Comments: Very limited information regarding these events has been provided at this time.  Further information has been requested.; Reported Cause(s) of Death: Cardiac arrest; Acute hypoxic respiratory failure; ARDS; Acute exacerbation of heart failure and sepsis"
	"1401732-1"	"1401732-1"	"SARS-COV-2 TEST"	"10084354"	"50-59 years"	"50-59"	"Seizures; Bood clots; Stuggling to breathe; Struggling to walk; ARDS; Acute hypoxic respiratory failure; Acute exacerbation of heart failure and sepsis; Acute exacerbation of heart failure and sepsis; Cardiac arrest; Blood infection; Fever; This spontaneous case was reported by a patient family member or friend (subsequently medically confirmed) and describes the occurrence of ACUTE RESPIRATORY DISTRESS SYNDROME (ARDS), ACUTE RESPIRATORY FAILURE (Acute hypoxic respiratory failure), SEPSIS (Acute exacerbation of heart failure and sepsis), CARDIAC FAILURE ACUTE (Acute exacerbation of heart failure and sepsis), CARDIAC ARREST (Cardiac arrest), SEIZURE (Seizures), THROMBOSIS (Bood clots), DYSPNOEA (Stuggling to breathe) and GAIT DISTURBANCE (Struggling to walk) in a 53-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below.     Concurrent medical conditions included Obesity.   On 16-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 15-May-2021 at 2:00 PM, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 15-May-2021, the patient experienced ACUTE RESPIRATORY DISTRESS SYNDROME (ARDS) (seriousness criteria death and medically significant), ACUTE RESPIRATORY FAILURE (Acute hypoxic respiratory failure) (seriousness criteria death and medically significant), DYSPNOEA (Stuggling to breathe) (seriousness criterion hospitalization prolonged) and GAIT DISTURBANCE (Struggling to walk) (seriousness criterion hospitalization prolonged). In May 2021, the patient experienced SEPSIS (Acute exacerbation of heart failure and sepsis) (seriousness criteria death and medically significant), CARDIAC FAILURE ACUTE (Acute exacerbation of heart failure and sepsis) (seriousness criteria death and medically significant), CARDIAC ARREST (Cardiac arrest) (seriousness criteria death and medically significant), INFECTION (Blood infection) and PYREXIA (Fever). On 17-May-2021, the patient experienced SEIZURE (Seizures) (seriousness criteria hospitalization prolonged and medically significant) and THROMBOSIS (Bood clots) (seriousness criteria hospitalization prolonged and medically significant). The patient was hospitalized from 15-May-2021 to 25-May-2021 due to DYSPNOEA, GAIT DISTURBANCE, SEIZURE and THROMBOSIS. The patient died on 25-May-2021. The reported cause of death was Cardiac arrest, Acute hypoxic respiratory failure, ards and acute exacerbation of heart failure and sepsis. It is unknown if an autopsy was performed. At the time of death, SEIZURE (Seizures), THROMBOSIS (Bood clots), DYSPNOEA (Stuggling to breathe), GAIT DISTURBANCE (Struggling to walk), INFECTION (Blood infection) and PYREXIA (Fever) outcome was unknown.      DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 15-May-2021, Blood pressure measurement: elevated (High) Twice normal. On 15-May-2021, Glycosylated haemoglobin: elevated (High) High. On 15-May-2021, Oxygen saturation: low (Low) Required intubation and was placed on ventilator.. On 15-May-2021, SARS-CoV-2 antibody test: negative (Negative) 1 negative COVID antibody test. On 15-May-2021, SARS-CoV-2 test: negatie (Negative) 3 negative COVID antigen tests.         No concomitant medications were provided.  It was reported that within few hours after second dose of vaccine patient was struggling to walk and to breathe. The reporter and her husband went to see the patient and took him to an emergency room (ER). In the ER his blood pressure was markedly elevated (twice normal) and his oxygen level was low and by midnight he required intubation and was placed on a ventilator. His HbgA1c was noted to be elevated. Two days after admission (17-May-2021), he developed seizures which the medical team believed to be due to blood clots and he was anti-coagulated. It was determined that he did not have blood clots on his heart valves as the source of the clots. The source of the blood clots was never identified. He later developed fever and was diagnosed with a blood infection and treated with antibiotics. At one point his oxygen requirement on the ventilator went down to 65% but later returned and remained at 100%. He ultimately died on 25-May-2021 and as per copy of his death certificate he had 4 causes of death as cardiac arrest, acute hypoxic respiratory failure, acute respiratory distress syndrome (ARDS) and acute exacerbation of heart failure and sepsis.  Treatment included, anticoagulants, antibiotics, intubation and ventilator.  Very limited information regarding these events has been provided at this time.  Further information has been requested.   This case was linked to MOD-2021-219410 (Patient Link).; Sender's Comments: Very limited information regarding these events has been provided at this time.  Further information has been requested.; Reported Cause(s) of Death: Cardiac arrest; Acute hypoxic respiratory failure; ARDS; Acute exacerbation of heart failure and sepsis"
	"1401732-1"	"1401732-1"	"SEIZURE"	"10039906"	"50-59 years"	"50-59"	"Seizures; Bood clots; Stuggling to breathe; Struggling to walk; ARDS; Acute hypoxic respiratory failure; Acute exacerbation of heart failure and sepsis; Acute exacerbation of heart failure and sepsis; Cardiac arrest; Blood infection; Fever; This spontaneous case was reported by a patient family member or friend (subsequently medically confirmed) and describes the occurrence of ACUTE RESPIRATORY DISTRESS SYNDROME (ARDS), ACUTE RESPIRATORY FAILURE (Acute hypoxic respiratory failure), SEPSIS (Acute exacerbation of heart failure and sepsis), CARDIAC FAILURE ACUTE (Acute exacerbation of heart failure and sepsis), CARDIAC ARREST (Cardiac arrest), SEIZURE (Seizures), THROMBOSIS (Bood clots), DYSPNOEA (Stuggling to breathe) and GAIT DISTURBANCE (Struggling to walk) in a 53-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below.     Concurrent medical conditions included Obesity.   On 16-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 15-May-2021 at 2:00 PM, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 15-May-2021, the patient experienced ACUTE RESPIRATORY DISTRESS SYNDROME (ARDS) (seriousness criteria death and medically significant), ACUTE RESPIRATORY FAILURE (Acute hypoxic respiratory failure) (seriousness criteria death and medically significant), DYSPNOEA (Stuggling to breathe) (seriousness criterion hospitalization prolonged) and GAIT DISTURBANCE (Struggling to walk) (seriousness criterion hospitalization prolonged). In May 2021, the patient experienced SEPSIS (Acute exacerbation of heart failure and sepsis) (seriousness criteria death and medically significant), CARDIAC FAILURE ACUTE (Acute exacerbation of heart failure and sepsis) (seriousness criteria death and medically significant), CARDIAC ARREST (Cardiac arrest) (seriousness criteria death and medically significant), INFECTION (Blood infection) and PYREXIA (Fever). On 17-May-2021, the patient experienced SEIZURE (Seizures) (seriousness criteria hospitalization prolonged and medically significant) and THROMBOSIS (Bood clots) (seriousness criteria hospitalization prolonged and medically significant). The patient was hospitalized from 15-May-2021 to 25-May-2021 due to DYSPNOEA, GAIT DISTURBANCE, SEIZURE and THROMBOSIS. The patient died on 25-May-2021. The reported cause of death was Cardiac arrest, Acute hypoxic respiratory failure, ards and acute exacerbation of heart failure and sepsis. It is unknown if an autopsy was performed. At the time of death, SEIZURE (Seizures), THROMBOSIS (Bood clots), DYSPNOEA (Stuggling to breathe), GAIT DISTURBANCE (Struggling to walk), INFECTION (Blood infection) and PYREXIA (Fever) outcome was unknown.      DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 15-May-2021, Blood pressure measurement: elevated (High) Twice normal. On 15-May-2021, Glycosylated haemoglobin: elevated (High) High. On 15-May-2021, Oxygen saturation: low (Low) Required intubation and was placed on ventilator.. On 15-May-2021, SARS-CoV-2 antibody test: negative (Negative) 1 negative COVID antibody test. On 15-May-2021, SARS-CoV-2 test: negatie (Negative) 3 negative COVID antigen tests.         No concomitant medications were provided.  It was reported that within few hours after second dose of vaccine patient was struggling to walk and to breathe. The reporter and her husband went to see the patient and took him to an emergency room (ER). In the ER his blood pressure was markedly elevated (twice normal) and his oxygen level was low and by midnight he required intubation and was placed on a ventilator. His HbgA1c was noted to be elevated. Two days after admission (17-May-2021), he developed seizures which the medical team believed to be due to blood clots and he was anti-coagulated. It was determined that he did not have blood clots on his heart valves as the source of the clots. The source of the blood clots was never identified. He later developed fever and was diagnosed with a blood infection and treated with antibiotics. At one point his oxygen requirement on the ventilator went down to 65% but later returned and remained at 100%. He ultimately died on 25-May-2021 and as per copy of his death certificate he had 4 causes of death as cardiac arrest, acute hypoxic respiratory failure, acute respiratory distress syndrome (ARDS) and acute exacerbation of heart failure and sepsis.  Treatment included, anticoagulants, antibiotics, intubation and ventilator.  Very limited information regarding these events has been provided at this time.  Further information has been requested.   This case was linked to MOD-2021-219410 (Patient Link).; Sender's Comments: Very limited information regarding these events has been provided at this time.  Further information has been requested.; Reported Cause(s) of Death: Cardiac arrest; Acute hypoxic respiratory failure; ARDS; Acute exacerbation of heart failure and sepsis"
	"1401732-1"	"1401732-1"	"SEPSIS"	"10040047"	"50-59 years"	"50-59"	"Seizures; Bood clots; Stuggling to breathe; Struggling to walk; ARDS; Acute hypoxic respiratory failure; Acute exacerbation of heart failure and sepsis; Acute exacerbation of heart failure and sepsis; Cardiac arrest; Blood infection; Fever; This spontaneous case was reported by a patient family member or friend (subsequently medically confirmed) and describes the occurrence of ACUTE RESPIRATORY DISTRESS SYNDROME (ARDS), ACUTE RESPIRATORY FAILURE (Acute hypoxic respiratory failure), SEPSIS (Acute exacerbation of heart failure and sepsis), CARDIAC FAILURE ACUTE (Acute exacerbation of heart failure and sepsis), CARDIAC ARREST (Cardiac arrest), SEIZURE (Seizures), THROMBOSIS (Bood clots), DYSPNOEA (Stuggling to breathe) and GAIT DISTURBANCE (Struggling to walk) in a 53-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below.     Concurrent medical conditions included Obesity.   On 16-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 15-May-2021 at 2:00 PM, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 15-May-2021, the patient experienced ACUTE RESPIRATORY DISTRESS SYNDROME (ARDS) (seriousness criteria death and medically significant), ACUTE RESPIRATORY FAILURE (Acute hypoxic respiratory failure) (seriousness criteria death and medically significant), DYSPNOEA (Stuggling to breathe) (seriousness criterion hospitalization prolonged) and GAIT DISTURBANCE (Struggling to walk) (seriousness criterion hospitalization prolonged). In May 2021, the patient experienced SEPSIS (Acute exacerbation of heart failure and sepsis) (seriousness criteria death and medically significant), CARDIAC FAILURE ACUTE (Acute exacerbation of heart failure and sepsis) (seriousness criteria death and medically significant), CARDIAC ARREST (Cardiac arrest) (seriousness criteria death and medically significant), INFECTION (Blood infection) and PYREXIA (Fever). On 17-May-2021, the patient experienced SEIZURE (Seizures) (seriousness criteria hospitalization prolonged and medically significant) and THROMBOSIS (Bood clots) (seriousness criteria hospitalization prolonged and medically significant). The patient was hospitalized from 15-May-2021 to 25-May-2021 due to DYSPNOEA, GAIT DISTURBANCE, SEIZURE and THROMBOSIS. The patient died on 25-May-2021. The reported cause of death was Cardiac arrest, Acute hypoxic respiratory failure, ards and acute exacerbation of heart failure and sepsis. It is unknown if an autopsy was performed. At the time of death, SEIZURE (Seizures), THROMBOSIS (Bood clots), DYSPNOEA (Stuggling to breathe), GAIT DISTURBANCE (Struggling to walk), INFECTION (Blood infection) and PYREXIA (Fever) outcome was unknown.      DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 15-May-2021, Blood pressure measurement: elevated (High) Twice normal. On 15-May-2021, Glycosylated haemoglobin: elevated (High) High. On 15-May-2021, Oxygen saturation: low (Low) Required intubation and was placed on ventilator.. On 15-May-2021, SARS-CoV-2 antibody test: negative (Negative) 1 negative COVID antibody test. On 15-May-2021, SARS-CoV-2 test: negatie (Negative) 3 negative COVID antigen tests.         No concomitant medications were provided.  It was reported that within few hours after second dose of vaccine patient was struggling to walk and to breathe. The reporter and her husband went to see the patient and took him to an emergency room (ER). In the ER his blood pressure was markedly elevated (twice normal) and his oxygen level was low and by midnight he required intubation and was placed on a ventilator. His HbgA1c was noted to be elevated. Two days after admission (17-May-2021), he developed seizures which the medical team believed to be due to blood clots and he was anti-coagulated. It was determined that he did not have blood clots on his heart valves as the source of the clots. The source of the blood clots was never identified. He later developed fever and was diagnosed with a blood infection and treated with antibiotics. At one point his oxygen requirement on the ventilator went down to 65% but later returned and remained at 100%. He ultimately died on 25-May-2021 and as per copy of his death certificate he had 4 causes of death as cardiac arrest, acute hypoxic respiratory failure, acute respiratory distress syndrome (ARDS) and acute exacerbation of heart failure and sepsis.  Treatment included, anticoagulants, antibiotics, intubation and ventilator.  Very limited information regarding these events has been provided at this time.  Further information has been requested.   This case was linked to MOD-2021-219410 (Patient Link).; Sender's Comments: Very limited information regarding these events has been provided at this time.  Further information has been requested.; Reported Cause(s) of Death: Cardiac arrest; Acute hypoxic respiratory failure; ARDS; Acute exacerbation of heart failure and sepsis"
	"1401732-1"	"1401732-1"	"THROMBOSIS"	"10043607"	"50-59 years"	"50-59"	"Seizures; Bood clots; Stuggling to breathe; Struggling to walk; ARDS; Acute hypoxic respiratory failure; Acute exacerbation of heart failure and sepsis; Acute exacerbation of heart failure and sepsis; Cardiac arrest; Blood infection; Fever; This spontaneous case was reported by a patient family member or friend (subsequently medically confirmed) and describes the occurrence of ACUTE RESPIRATORY DISTRESS SYNDROME (ARDS), ACUTE RESPIRATORY FAILURE (Acute hypoxic respiratory failure), SEPSIS (Acute exacerbation of heart failure and sepsis), CARDIAC FAILURE ACUTE (Acute exacerbation of heart failure and sepsis), CARDIAC ARREST (Cardiac arrest), SEIZURE (Seizures), THROMBOSIS (Bood clots), DYSPNOEA (Stuggling to breathe) and GAIT DISTURBANCE (Struggling to walk) in a 53-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below.     Concurrent medical conditions included Obesity.   On 16-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 15-May-2021 at 2:00 PM, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 15-May-2021, the patient experienced ACUTE RESPIRATORY DISTRESS SYNDROME (ARDS) (seriousness criteria death and medically significant), ACUTE RESPIRATORY FAILURE (Acute hypoxic respiratory failure) (seriousness criteria death and medically significant), DYSPNOEA (Stuggling to breathe) (seriousness criterion hospitalization prolonged) and GAIT DISTURBANCE (Struggling to walk) (seriousness criterion hospitalization prolonged). In May 2021, the patient experienced SEPSIS (Acute exacerbation of heart failure and sepsis) (seriousness criteria death and medically significant), CARDIAC FAILURE ACUTE (Acute exacerbation of heart failure and sepsis) (seriousness criteria death and medically significant), CARDIAC ARREST (Cardiac arrest) (seriousness criteria death and medically significant), INFECTION (Blood infection) and PYREXIA (Fever). On 17-May-2021, the patient experienced SEIZURE (Seizures) (seriousness criteria hospitalization prolonged and medically significant) and THROMBOSIS (Bood clots) (seriousness criteria hospitalization prolonged and medically significant). The patient was hospitalized from 15-May-2021 to 25-May-2021 due to DYSPNOEA, GAIT DISTURBANCE, SEIZURE and THROMBOSIS. The patient died on 25-May-2021. The reported cause of death was Cardiac arrest, Acute hypoxic respiratory failure, ards and acute exacerbation of heart failure and sepsis. It is unknown if an autopsy was performed. At the time of death, SEIZURE (Seizures), THROMBOSIS (Bood clots), DYSPNOEA (Stuggling to breathe), GAIT DISTURBANCE (Struggling to walk), INFECTION (Blood infection) and PYREXIA (Fever) outcome was unknown.      DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 15-May-2021, Blood pressure measurement: elevated (High) Twice normal. On 15-May-2021, Glycosylated haemoglobin: elevated (High) High. On 15-May-2021, Oxygen saturation: low (Low) Required intubation and was placed on ventilator.. On 15-May-2021, SARS-CoV-2 antibody test: negative (Negative) 1 negative COVID antibody test. On 15-May-2021, SARS-CoV-2 test: negatie (Negative) 3 negative COVID antigen tests.         No concomitant medications were provided.  It was reported that within few hours after second dose of vaccine patient was struggling to walk and to breathe. The reporter and her husband went to see the patient and took him to an emergency room (ER). In the ER his blood pressure was markedly elevated (twice normal) and his oxygen level was low and by midnight he required intubation and was placed on a ventilator. His HbgA1c was noted to be elevated. Two days after admission (17-May-2021), he developed seizures which the medical team believed to be due to blood clots and he was anti-coagulated. It was determined that he did not have blood clots on his heart valves as the source of the clots. The source of the blood clots was never identified. He later developed fever and was diagnosed with a blood infection and treated with antibiotics. At one point his oxygen requirement on the ventilator went down to 65% but later returned and remained at 100%. He ultimately died on 25-May-2021 and as per copy of his death certificate he had 4 causes of death as cardiac arrest, acute hypoxic respiratory failure, acute respiratory distress syndrome (ARDS) and acute exacerbation of heart failure and sepsis.  Treatment included, anticoagulants, antibiotics, intubation and ventilator.  Very limited information regarding these events has been provided at this time.  Further information has been requested.   This case was linked to MOD-2021-219410 (Patient Link).; Sender's Comments: Very limited information regarding these events has been provided at this time.  Further information has been requested.; Reported Cause(s) of Death: Cardiac arrest; Acute hypoxic respiratory failure; ARDS; Acute exacerbation of heart failure and sepsis"
	"1402809-1"	"1402809-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Deceased 6/7/21 (Unsure if related)"
	"1407833-1"	"1407833-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient was found dead next day at home during sleep."
	"1408206-1"	"1408206-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Patient received both COVID vaccines.  On 5/21/21 she presented to the ED with COVID symptoms.  She was tested on  5/21/2021 and was positive for COVID-19.  She died on 6/7/2021 in hospital from complications of COVID-19"
	"1408206-1"	"1408206-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient received both COVID vaccines.  On 5/21/21 she presented to the ED with COVID symptoms.  She was tested on  5/21/2021 and was positive for COVID-19.  She died on 6/7/2021 in hospital from complications of COVID-19"
	"1408206-1"	"1408206-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"Patient received both COVID vaccines.  On 5/21/21 she presented to the ED with COVID symptoms.  She was tested on  5/21/2021 and was positive for COVID-19.  She died on 6/7/2021 in hospital from complications of COVID-19"
	"1413073-1"	"1413073-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"On April 27, after my husband took a 2 mile run.  He returned and collapse outside of our home.   My son and I immediately perform CPR on him.   Three week later my husband did from  respiratory heart failure - cardiac arrest.   He had no complaints about any chest pain ever.  We had just visited his doctor that afternoon and  gave no report of heart problems or any immediate health issues."
	"1413073-1"	"1413073-1"	"CARDIOPULMONARY FAILURE"	"10051093"	"50-59 years"	"50-59"	"On April 27, after my husband took a 2 mile run.  He returned and collapse outside of our home.   My son and I immediately perform CPR on him.   Three week later my husband did from  respiratory heart failure - cardiac arrest.   He had no complaints about any chest pain ever.  We had just visited his doctor that afternoon and  gave no report of heart problems or any immediate health issues."
	"1413073-1"	"1413073-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"On April 27, after my husband took a 2 mile run.  He returned and collapse outside of our home.   My son and I immediately perform CPR on him.   Three week later my husband did from  respiratory heart failure - cardiac arrest.   He had no complaints about any chest pain ever.  We had just visited his doctor that afternoon and  gave no report of heart problems or any immediate health issues."
	"1413073-1"	"1413073-1"	"LABORATORY TEST ABNORMAL"	"10023547"	"50-59 years"	"50-59"	"On April 27, after my husband took a 2 mile run.  He returned and collapse outside of our home.   My son and I immediately perform CPR on him.   Three week later my husband did from  respiratory heart failure - cardiac arrest.   He had no complaints about any chest pain ever.  We had just visited his doctor that afternoon and  gave no report of heart problems or any immediate health issues."
	"1413073-1"	"1413073-1"	"RESUSCITATION"	"10038749"	"50-59 years"	"50-59"	"On April 27, after my husband took a 2 mile run.  He returned and collapse outside of our home.   My son and I immediately perform CPR on him.   Three week later my husband did from  respiratory heart failure - cardiac arrest.   He had no complaints about any chest pain ever.  We had just visited his doctor that afternoon and  gave no report of heart problems or any immediate health issues."
	"1413073-1"	"1413073-1"	"SYNCOPE"	"10042772"	"50-59 years"	"50-59"	"On April 27, after my husband took a 2 mile run.  He returned and collapse outside of our home.   My son and I immediately perform CPR on him.   Three week later my husband did from  respiratory heart failure - cardiac arrest.   He had no complaints about any chest pain ever.  We had just visited his doctor that afternoon and  gave no report of heart problems or any immediate health issues."
	"1414219-1"	"1414219-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"The patient was vaccinated on 5/26/21 for dose one and 6/16/21 for dose two with Pfizer COVID-19 vaccine. Patient passed away the day following her second dose on 6/17/21."
	"1414727-1"	"1414727-1"	"ASTHENIA"	"10003549"	"50-59 years"	"50-59"	"Admitted to ER with complaints of generalized weakness and report of insomnia for 4 days to getting his second covid shot. He reports having one episode diarrhea and emesis pta. He reports there was no blood in his stool , no black stool, no blood in emesis tonight pta. He reports he saw blood in emesis one day prior"
	"1414727-1"	"1414727-1"	"DIARRHOEA"	"10012735"	"50-59 years"	"50-59"	"Admitted to ER with complaints of generalized weakness and report of insomnia for 4 days to getting his second covid shot. He reports having one episode diarrhea and emesis pta. He reports there was no blood in his stool , no black stool, no blood in emesis tonight pta. He reports he saw blood in emesis one day prior"
	"1414727-1"	"1414727-1"	"HAEMATEMESIS"	"10018830"	"50-59 years"	"50-59"	"Admitted to ER with complaints of generalized weakness and report of insomnia for 4 days to getting his second covid shot. He reports having one episode diarrhea and emesis pta. He reports there was no blood in his stool , no black stool, no blood in emesis tonight pta. He reports he saw blood in emesis one day prior"
	"1414727-1"	"1414727-1"	"INSOMNIA"	"10022437"	"50-59 years"	"50-59"	"Admitted to ER with complaints of generalized weakness and report of insomnia for 4 days to getting his second covid shot. He reports having one episode diarrhea and emesis pta. He reports there was no blood in his stool , no black stool, no blood in emesis tonight pta. He reports he saw blood in emesis one day prior"
	"1414727-1"	"1414727-1"	"VOMITING"	"10047700"	"50-59 years"	"50-59"	"Admitted to ER with complaints of generalized weakness and report of insomnia for 4 days to getting his second covid shot. He reports having one episode diarrhea and emesis pta. He reports there was no blood in his stool , no black stool, no blood in emesis tonight pta. He reports he saw blood in emesis one day prior"
	"1414988-1"	"1414988-1"	"ABDOMINAL PAIN UPPER"	"10000087"	"50-59 years"	"50-59"	""After receiving the 2nd vaccine on 5/15/21, on 5/16 patient had a ""stomach ache"", on 5/17 he went to work. At 9:30am, the camera's show him going into the women's restroom to service it, a lady tried to go into the restroom and could not go in, she called the supervisor, when the supervisor arrived there was no pulse. Report source believes he goes into work around 7:00AM.  Report sources states she was told "" his blood sugar was not elevated"".  Report source states that the death certificate states he had a cardiac arrest.""
	"1414988-1"	"1414988-1"	"BLOOD GLUCOSE NORMAL"	"10005558"	"50-59 years"	"50-59"	""After receiving the 2nd vaccine on 5/15/21, on 5/16 patient had a ""stomach ache"", on 5/17 he went to work. At 9:30am, the camera's show him going into the women's restroom to service it, a lady tried to go into the restroom and could not go in, she called the supervisor, when the supervisor arrived there was no pulse. Report source believes he goes into work around 7:00AM.  Report sources states she was told "" his blood sugar was not elevated"".  Report source states that the death certificate states he had a cardiac arrest.""
	"1414988-1"	"1414988-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	""After receiving the 2nd vaccine on 5/15/21, on 5/16 patient had a ""stomach ache"", on 5/17 he went to work. At 9:30am, the camera's show him going into the women's restroom to service it, a lady tried to go into the restroom and could not go in, she called the supervisor, when the supervisor arrived there was no pulse. Report source believes he goes into work around 7:00AM.  Report sources states she was told "" his blood sugar was not elevated"".  Report source states that the death certificate states he had a cardiac arrest.""
	"1414988-1"	"1414988-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	""After receiving the 2nd vaccine on 5/15/21, on 5/16 patient had a ""stomach ache"", on 5/17 he went to work. At 9:30am, the camera's show him going into the women's restroom to service it, a lady tried to go into the restroom and could not go in, she called the supervisor, when the supervisor arrived there was no pulse. Report source believes he goes into work around 7:00AM.  Report sources states she was told "" his blood sugar was not elevated"".  Report source states that the death certificate states he had a cardiac arrest.""
	"1414988-1"	"1414988-1"	"PULSE ABSENT"	"10037469"	"50-59 years"	"50-59"	""After receiving the 2nd vaccine on 5/15/21, on 5/16 patient had a ""stomach ache"", on 5/17 he went to work. At 9:30am, the camera's show him going into the women's restroom to service it, a lady tried to go into the restroom and could not go in, she called the supervisor, when the supervisor arrived there was no pulse. Report source believes he goes into work around 7:00AM.  Report sources states she was told "" his blood sugar was not elevated"".  Report source states that the death certificate states he had a cardiac arrest.""
	"1415733-1"	"1415733-1"	"CHILLS"	"10008531"	"50-59 years"	"50-59"	"The pt received his 2nd Moderna covid vaccine on 6/13/21 at 10:45 am (approximately).  Starting at 5pm he c/o pain, redness and tenderness  in the injection site, chills, and lethargy .  The next day he did not go to work b/o he felt tired and he stayed home with his 7 y/o daughter while his wife went to work.  His wife spoke with him in the am and he reports he was making breakfast for their daughter and he was going to lie down and sleep afterward.  He made lunch for daughter about 1 pm and he went to lie down in his chair.  His brother called his wife at about 4:30 pm stating he was blue.  911 was called and they were unable to revive him."
	"1415733-1"	"1415733-1"	"CYANOSIS"	"10011703"	"50-59 years"	"50-59"	"The pt received his 2nd Moderna covid vaccine on 6/13/21 at 10:45 am (approximately).  Starting at 5pm he c/o pain, redness and tenderness  in the injection site, chills, and lethargy .  The next day he did not go to work b/o he felt tired and he stayed home with his 7 y/o daughter while his wife went to work.  His wife spoke with him in the am and he reports he was making breakfast for their daughter and he was going to lie down and sleep afterward.  He made lunch for daughter about 1 pm and he went to lie down in his chair.  His brother called his wife at about 4:30 pm stating he was blue.  911 was called and they were unable to revive him."
	"1415733-1"	"1415733-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"The pt received his 2nd Moderna covid vaccine on 6/13/21 at 10:45 am (approximately).  Starting at 5pm he c/o pain, redness and tenderness  in the injection site, chills, and lethargy .  The next day he did not go to work b/o he felt tired and he stayed home with his 7 y/o daughter while his wife went to work.  His wife spoke with him in the am and he reports he was making breakfast for their daughter and he was going to lie down and sleep afterward.  He made lunch for daughter about 1 pm and he went to lie down in his chair.  His brother called his wife at about 4:30 pm stating he was blue.  911 was called and they were unable to revive him."
	"1415733-1"	"1415733-1"	"FATIGUE"	"10016256"	"50-59 years"	"50-59"	"The pt received his 2nd Moderna covid vaccine on 6/13/21 at 10:45 am (approximately).  Starting at 5pm he c/o pain, redness and tenderness  in the injection site, chills, and lethargy .  The next day he did not go to work b/o he felt tired and he stayed home with his 7 y/o daughter while his wife went to work.  His wife spoke with him in the am and he reports he was making breakfast for their daughter and he was going to lie down and sleep afterward.  He made lunch for daughter about 1 pm and he went to lie down in his chair.  His brother called his wife at about 4:30 pm stating he was blue.  911 was called and they were unable to revive him."
	"1415733-1"	"1415733-1"	"IMPAIRED WORK ABILITY"	"10052302"	"50-59 years"	"50-59"	"The pt received his 2nd Moderna covid vaccine on 6/13/21 at 10:45 am (approximately).  Starting at 5pm he c/o pain, redness and tenderness  in the injection site, chills, and lethargy .  The next day he did not go to work b/o he felt tired and he stayed home with his 7 y/o daughter while his wife went to work.  His wife spoke with him in the am and he reports he was making breakfast for their daughter and he was going to lie down and sleep afterward.  He made lunch for daughter about 1 pm and he went to lie down in his chair.  His brother called his wife at about 4:30 pm stating he was blue.  911 was called and they were unable to revive him."
	"1415733-1"	"1415733-1"	"INJECTION SITE ERYTHEMA"	"10022061"	"50-59 years"	"50-59"	"The pt received his 2nd Moderna covid vaccine on 6/13/21 at 10:45 am (approximately).  Starting at 5pm he c/o pain, redness and tenderness  in the injection site, chills, and lethargy .  The next day he did not go to work b/o he felt tired and he stayed home with his 7 y/o daughter while his wife went to work.  His wife spoke with him in the am and he reports he was making breakfast for their daughter and he was going to lie down and sleep afterward.  He made lunch for daughter about 1 pm and he went to lie down in his chair.  His brother called his wife at about 4:30 pm stating he was blue.  911 was called and they were unable to revive him."
	"1415733-1"	"1415733-1"	"INJECTION SITE PAIN"	"10022086"	"50-59 years"	"50-59"	"The pt received his 2nd Moderna covid vaccine on 6/13/21 at 10:45 am (approximately).  Starting at 5pm he c/o pain, redness and tenderness  in the injection site, chills, and lethargy .  The next day he did not go to work b/o he felt tired and he stayed home with his 7 y/o daughter while his wife went to work.  His wife spoke with him in the am and he reports he was making breakfast for their daughter and he was going to lie down and sleep afterward.  He made lunch for daughter about 1 pm and he went to lie down in his chair.  His brother called his wife at about 4:30 pm stating he was blue.  911 was called and they were unable to revive him."
	"1415733-1"	"1415733-1"	"LETHARGY"	"10024264"	"50-59 years"	"50-59"	"The pt received his 2nd Moderna covid vaccine on 6/13/21 at 10:45 am (approximately).  Starting at 5pm he c/o pain, redness and tenderness  in the injection site, chills, and lethargy .  The next day he did not go to work b/o he felt tired and he stayed home with his 7 y/o daughter while his wife went to work.  His wife spoke with him in the am and he reports he was making breakfast for their daughter and he was going to lie down and sleep afterward.  He made lunch for daughter about 1 pm and he went to lie down in his chair.  His brother called his wife at about 4:30 pm stating he was blue.  911 was called and they were unable to revive him."
	"1415733-1"	"1415733-1"	"SOMNOLENCE"	"10041349"	"50-59 years"	"50-59"	"The pt received his 2nd Moderna covid vaccine on 6/13/21 at 10:45 am (approximately).  Starting at 5pm he c/o pain, redness and tenderness  in the injection site, chills, and lethargy .  The next day he did not go to work b/o he felt tired and he stayed home with his 7 y/o daughter while his wife went to work.  His wife spoke with him in the am and he reports he was making breakfast for their daughter and he was going to lie down and sleep afterward.  He made lunch for daughter about 1 pm and he went to lie down in his chair.  His brother called his wife at about 4:30 pm stating he was blue.  911 was called and they were unable to revive him."
	"1417109-1"	"1417109-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Patient received first dose of Moderna on May 18, 2021. Spouse came to the pharmacy and informed us that the patient  passed away in the hospital on June 15, 2021. She  was diagnosed with COVID-19 during her stay at the hospital."
	"1417109-1"	"1417109-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient received first dose of Moderna on May 18, 2021. Spouse came to the pharmacy and informed us that the patient  passed away in the hospital on June 15, 2021. She  was diagnosed with COVID-19 during her stay at the hospital."
	"1417729-1"	"1417729-1"	"ACUTE MYOCARDIAL INFARCTION"	"10000891"	"50-59 years"	"50-59"	"This was very unfortunate 51 years old male with past medical history of hypertension, hyperlipidemia, obesity.  Patient presented with chief complaint of shortness of breath and chest pain. EMS reported that the patient has been complaining of some shortness of breath and chest pain intermittent for couple of weeks. 12 leads EKG showed evidence of anterior ST elevation myocardial infarction.  Code heart was called.  Patient developed PEA arrest in the Cath Lab.  CPR ACLS was initiated.  ROSC was achieved initially after 30 minutes of CPR.  Intra-aortic balloon pump was placed.  Coronary arteries were essentially clean.  Due to high suspicion for massive PE-TPA was given 100 mg without meaningful clinical improvement.  CPR was continued for more than an hour.  Despite all aggressive measures patient continued to deteriorate.  At 3:26 PM patient has no spontaneous breathing, no peripheral pulses, no heartbeats by auscultation or by monitor.  Pupils were fixed and dilated.  No cough no gag reflexes . patient was pronounced dead."
	"1417729-1"	"1417729-1"	"AREFLEXIA"	"10003084"	"50-59 years"	"50-59"	"This was very unfortunate 51 years old male with past medical history of hypertension, hyperlipidemia, obesity.  Patient presented with chief complaint of shortness of breath and chest pain. EMS reported that the patient has been complaining of some shortness of breath and chest pain intermittent for couple of weeks. 12 leads EKG showed evidence of anterior ST elevation myocardial infarction.  Code heart was called.  Patient developed PEA arrest in the Cath Lab.  CPR ACLS was initiated.  ROSC was achieved initially after 30 minutes of CPR.  Intra-aortic balloon pump was placed.  Coronary arteries were essentially clean.  Due to high suspicion for massive PE-TPA was given 100 mg without meaningful clinical improvement.  CPR was continued for more than an hour.  Despite all aggressive measures patient continued to deteriorate.  At 3:26 PM patient has no spontaneous breathing, no peripheral pulses, no heartbeats by auscultation or by monitor.  Pupils were fixed and dilated.  No cough no gag reflexes . patient was pronounced dead."
	"1417729-1"	"1417729-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"This was very unfortunate 51 years old male with past medical history of hypertension, hyperlipidemia, obesity.  Patient presented with chief complaint of shortness of breath and chest pain. EMS reported that the patient has been complaining of some shortness of breath and chest pain intermittent for couple of weeks. 12 leads EKG showed evidence of anterior ST elevation myocardial infarction.  Code heart was called.  Patient developed PEA arrest in the Cath Lab.  CPR ACLS was initiated.  ROSC was achieved initially after 30 minutes of CPR.  Intra-aortic balloon pump was placed.  Coronary arteries were essentially clean.  Due to high suspicion for massive PE-TPA was given 100 mg without meaningful clinical improvement.  CPR was continued for more than an hour.  Despite all aggressive measures patient continued to deteriorate.  At 3:26 PM patient has no spontaneous breathing, no peripheral pulses, no heartbeats by auscultation or by monitor.  Pupils were fixed and dilated.  No cough no gag reflexes . patient was pronounced dead."
	"1417729-1"	"1417729-1"	"CATHETERISATION CARDIAC NORMAL"	"10007817"	"50-59 years"	"50-59"	"This was very unfortunate 51 years old male with past medical history of hypertension, hyperlipidemia, obesity.  Patient presented with chief complaint of shortness of breath and chest pain. EMS reported that the patient has been complaining of some shortness of breath and chest pain intermittent for couple of weeks. 12 leads EKG showed evidence of anterior ST elevation myocardial infarction.  Code heart was called.  Patient developed PEA arrest in the Cath Lab.  CPR ACLS was initiated.  ROSC was achieved initially after 30 minutes of CPR.  Intra-aortic balloon pump was placed.  Coronary arteries were essentially clean.  Due to high suspicion for massive PE-TPA was given 100 mg without meaningful clinical improvement.  CPR was continued for more than an hour.  Despite all aggressive measures patient continued to deteriorate.  At 3:26 PM patient has no spontaneous breathing, no peripheral pulses, no heartbeats by auscultation or by monitor.  Pupils were fixed and dilated.  No cough no gag reflexes . patient was pronounced dead."
	"1417729-1"	"1417729-1"	"CHEST PAIN"	"10008479"	"50-59 years"	"50-59"	"This was very unfortunate 51 years old male with past medical history of hypertension, hyperlipidemia, obesity.  Patient presented with chief complaint of shortness of breath and chest pain. EMS reported that the patient has been complaining of some shortness of breath and chest pain intermittent for couple of weeks. 12 leads EKG showed evidence of anterior ST elevation myocardial infarction.  Code heart was called.  Patient developed PEA arrest in the Cath Lab.  CPR ACLS was initiated.  ROSC was achieved initially after 30 minutes of CPR.  Intra-aortic balloon pump was placed.  Coronary arteries were essentially clean.  Due to high suspicion for massive PE-TPA was given 100 mg without meaningful clinical improvement.  CPR was continued for more than an hour.  Despite all aggressive measures patient continued to deteriorate.  At 3:26 PM patient has no spontaneous breathing, no peripheral pulses, no heartbeats by auscultation or by monitor.  Pupils were fixed and dilated.  No cough no gag reflexes . patient was pronounced dead."
	"1417729-1"	"1417729-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"This was very unfortunate 51 years old male with past medical history of hypertension, hyperlipidemia, obesity.  Patient presented with chief complaint of shortness of breath and chest pain. EMS reported that the patient has been complaining of some shortness of breath and chest pain intermittent for couple of weeks. 12 leads EKG showed evidence of anterior ST elevation myocardial infarction.  Code heart was called.  Patient developed PEA arrest in the Cath Lab.  CPR ACLS was initiated.  ROSC was achieved initially after 30 minutes of CPR.  Intra-aortic balloon pump was placed.  Coronary arteries were essentially clean.  Due to high suspicion for massive PE-TPA was given 100 mg without meaningful clinical improvement.  CPR was continued for more than an hour.  Despite all aggressive measures patient continued to deteriorate.  At 3:26 PM patient has no spontaneous breathing, no peripheral pulses, no heartbeats by auscultation or by monitor.  Pupils were fixed and dilated.  No cough no gag reflexes . patient was pronounced dead."
	"1417729-1"	"1417729-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"This was very unfortunate 51 years old male with past medical history of hypertension, hyperlipidemia, obesity.  Patient presented with chief complaint of shortness of breath and chest pain. EMS reported that the patient has been complaining of some shortness of breath and chest pain intermittent for couple of weeks. 12 leads EKG showed evidence of anterior ST elevation myocardial infarction.  Code heart was called.  Patient developed PEA arrest in the Cath Lab.  CPR ACLS was initiated.  ROSC was achieved initially after 30 minutes of CPR.  Intra-aortic balloon pump was placed.  Coronary arteries were essentially clean.  Due to high suspicion for massive PE-TPA was given 100 mg without meaningful clinical improvement.  CPR was continued for more than an hour.  Despite all aggressive measures patient continued to deteriorate.  At 3:26 PM patient has no spontaneous breathing, no peripheral pulses, no heartbeats by auscultation or by monitor.  Pupils were fixed and dilated.  No cough no gag reflexes . patient was pronounced dead."
	"1417729-1"	"1417729-1"	"ELECTROCARDIOGRAM ST SEGMENT ELEVATION"	"10014392"	"50-59 years"	"50-59"	"This was very unfortunate 51 years old male with past medical history of hypertension, hyperlipidemia, obesity.  Patient presented with chief complaint of shortness of breath and chest pain. EMS reported that the patient has been complaining of some shortness of breath and chest pain intermittent for couple of weeks. 12 leads EKG showed evidence of anterior ST elevation myocardial infarction.  Code heart was called.  Patient developed PEA arrest in the Cath Lab.  CPR ACLS was initiated.  ROSC was achieved initially after 30 minutes of CPR.  Intra-aortic balloon pump was placed.  Coronary arteries were essentially clean.  Due to high suspicion for massive PE-TPA was given 100 mg without meaningful clinical improvement.  CPR was continued for more than an hour.  Despite all aggressive measures patient continued to deteriorate.  At 3:26 PM patient has no spontaneous breathing, no peripheral pulses, no heartbeats by auscultation or by monitor.  Pupils were fixed and dilated.  No cough no gag reflexes . patient was pronounced dead."
	"1417729-1"	"1417729-1"	"GENERAL PHYSICAL HEALTH DETERIORATION"	"10049438"	"50-59 years"	"50-59"	"This was very unfortunate 51 years old male with past medical history of hypertension, hyperlipidemia, obesity.  Patient presented with chief complaint of shortness of breath and chest pain. EMS reported that the patient has been complaining of some shortness of breath and chest pain intermittent for couple of weeks. 12 leads EKG showed evidence of anterior ST elevation myocardial infarction.  Code heart was called.  Patient developed PEA arrest in the Cath Lab.  CPR ACLS was initiated.  ROSC was achieved initially after 30 minutes of CPR.  Intra-aortic balloon pump was placed.  Coronary arteries were essentially clean.  Due to high suspicion for massive PE-TPA was given 100 mg without meaningful clinical improvement.  CPR was continued for more than an hour.  Despite all aggressive measures patient continued to deteriorate.  At 3:26 PM patient has no spontaneous breathing, no peripheral pulses, no heartbeats by auscultation or by monitor.  Pupils were fixed and dilated.  No cough no gag reflexes . patient was pronounced dead."
	"1417729-1"	"1417729-1"	"INTRA-AORTIC BALLOON PLACEMENT"	"10052989"	"50-59 years"	"50-59"	"This was very unfortunate 51 years old male with past medical history of hypertension, hyperlipidemia, obesity.  Patient presented with chief complaint of shortness of breath and chest pain. EMS reported that the patient has been complaining of some shortness of breath and chest pain intermittent for couple of weeks. 12 leads EKG showed evidence of anterior ST elevation myocardial infarction.  Code heart was called.  Patient developed PEA arrest in the Cath Lab.  CPR ACLS was initiated.  ROSC was achieved initially after 30 minutes of CPR.  Intra-aortic balloon pump was placed.  Coronary arteries were essentially clean.  Due to high suspicion for massive PE-TPA was given 100 mg without meaningful clinical improvement.  CPR was continued for more than an hour.  Despite all aggressive measures patient continued to deteriorate.  At 3:26 PM patient has no spontaneous breathing, no peripheral pulses, no heartbeats by auscultation or by monitor.  Pupils were fixed and dilated.  No cough no gag reflexes . patient was pronounced dead."
	"1417729-1"	"1417729-1"	"MYDRIASIS"	"10028521"	"50-59 years"	"50-59"	"This was very unfortunate 51 years old male with past medical history of hypertension, hyperlipidemia, obesity.  Patient presented with chief complaint of shortness of breath and chest pain. EMS reported that the patient has been complaining of some shortness of breath and chest pain intermittent for couple of weeks. 12 leads EKG showed evidence of anterior ST elevation myocardial infarction.  Code heart was called.  Patient developed PEA arrest in the Cath Lab.  CPR ACLS was initiated.  ROSC was achieved initially after 30 minutes of CPR.  Intra-aortic balloon pump was placed.  Coronary arteries were essentially clean.  Due to high suspicion for massive PE-TPA was given 100 mg without meaningful clinical improvement.  CPR was continued for more than an hour.  Despite all aggressive measures patient continued to deteriorate.  At 3:26 PM patient has no spontaneous breathing, no peripheral pulses, no heartbeats by auscultation or by monitor.  Pupils were fixed and dilated.  No cough no gag reflexes . patient was pronounced dead."
	"1417729-1"	"1417729-1"	"PULMONARY EMBOLISM"	"10037377"	"50-59 years"	"50-59"	"This was very unfortunate 51 years old male with past medical history of hypertension, hyperlipidemia, obesity.  Patient presented with chief complaint of shortness of breath and chest pain. EMS reported that the patient has been complaining of some shortness of breath and chest pain intermittent for couple of weeks. 12 leads EKG showed evidence of anterior ST elevation myocardial infarction.  Code heart was called.  Patient developed PEA arrest in the Cath Lab.  CPR ACLS was initiated.  ROSC was achieved initially after 30 minutes of CPR.  Intra-aortic balloon pump was placed.  Coronary arteries were essentially clean.  Due to high suspicion for massive PE-TPA was given 100 mg without meaningful clinical improvement.  CPR was continued for more than an hour.  Despite all aggressive measures patient continued to deteriorate.  At 3:26 PM patient has no spontaneous breathing, no peripheral pulses, no heartbeats by auscultation or by monitor.  Pupils were fixed and dilated.  No cough no gag reflexes . patient was pronounced dead."
	"1417729-1"	"1417729-1"	"PULSE ABSENT"	"10037469"	"50-59 years"	"50-59"	"This was very unfortunate 51 years old male with past medical history of hypertension, hyperlipidemia, obesity.  Patient presented with chief complaint of shortness of breath and chest pain. EMS reported that the patient has been complaining of some shortness of breath and chest pain intermittent for couple of weeks. 12 leads EKG showed evidence of anterior ST elevation myocardial infarction.  Code heart was called.  Patient developed PEA arrest in the Cath Lab.  CPR ACLS was initiated.  ROSC was achieved initially after 30 minutes of CPR.  Intra-aortic balloon pump was placed.  Coronary arteries were essentially clean.  Due to high suspicion for massive PE-TPA was given 100 mg without meaningful clinical improvement.  CPR was continued for more than an hour.  Despite all aggressive measures patient continued to deteriorate.  At 3:26 PM patient has no spontaneous breathing, no peripheral pulses, no heartbeats by auscultation or by monitor.  Pupils were fixed and dilated.  No cough no gag reflexes . patient was pronounced dead."
	"1417729-1"	"1417729-1"	"PULSELESS ELECTRICAL ACTIVITY"	"10058151"	"50-59 years"	"50-59"	"This was very unfortunate 51 years old male with past medical history of hypertension, hyperlipidemia, obesity.  Patient presented with chief complaint of shortness of breath and chest pain. EMS reported that the patient has been complaining of some shortness of breath and chest pain intermittent for couple of weeks. 12 leads EKG showed evidence of anterior ST elevation myocardial infarction.  Code heart was called.  Patient developed PEA arrest in the Cath Lab.  CPR ACLS was initiated.  ROSC was achieved initially after 30 minutes of CPR.  Intra-aortic balloon pump was placed.  Coronary arteries were essentially clean.  Due to high suspicion for massive PE-TPA was given 100 mg without meaningful clinical improvement.  CPR was continued for more than an hour.  Despite all aggressive measures patient continued to deteriorate.  At 3:26 PM patient has no spontaneous breathing, no peripheral pulses, no heartbeats by auscultation or by monitor.  Pupils were fixed and dilated.  No cough no gag reflexes . patient was pronounced dead."
	"1417729-1"	"1417729-1"	"PUPIL FIXED"	"10037515"	"50-59 years"	"50-59"	"This was very unfortunate 51 years old male with past medical history of hypertension, hyperlipidemia, obesity.  Patient presented with chief complaint of shortness of breath and chest pain. EMS reported that the patient has been complaining of some shortness of breath and chest pain intermittent for couple of weeks. 12 leads EKG showed evidence of anterior ST elevation myocardial infarction.  Code heart was called.  Patient developed PEA arrest in the Cath Lab.  CPR ACLS was initiated.  ROSC was achieved initially after 30 minutes of CPR.  Intra-aortic balloon pump was placed.  Coronary arteries were essentially clean.  Due to high suspicion for massive PE-TPA was given 100 mg without meaningful clinical improvement.  CPR was continued for more than an hour.  Despite all aggressive measures patient continued to deteriorate.  At 3:26 PM patient has no spontaneous breathing, no peripheral pulses, no heartbeats by auscultation or by monitor.  Pupils were fixed and dilated.  No cough no gag reflexes . patient was pronounced dead."
	"1417729-1"	"1417729-1"	"RESPIRATORY ARREST"	"10038669"	"50-59 years"	"50-59"	"This was very unfortunate 51 years old male with past medical history of hypertension, hyperlipidemia, obesity.  Patient presented with chief complaint of shortness of breath and chest pain. EMS reported that the patient has been complaining of some shortness of breath and chest pain intermittent for couple of weeks. 12 leads EKG showed evidence of anterior ST elevation myocardial infarction.  Code heart was called.  Patient developed PEA arrest in the Cath Lab.  CPR ACLS was initiated.  ROSC was achieved initially after 30 minutes of CPR.  Intra-aortic balloon pump was placed.  Coronary arteries were essentially clean.  Due to high suspicion for massive PE-TPA was given 100 mg without meaningful clinical improvement.  CPR was continued for more than an hour.  Despite all aggressive measures patient continued to deteriorate.  At 3:26 PM patient has no spontaneous breathing, no peripheral pulses, no heartbeats by auscultation or by monitor.  Pupils were fixed and dilated.  No cough no gag reflexes . patient was pronounced dead."
	"1417729-1"	"1417729-1"	"RESUSCITATION"	"10038749"	"50-59 years"	"50-59"	"This was very unfortunate 51 years old male with past medical history of hypertension, hyperlipidemia, obesity.  Patient presented with chief complaint of shortness of breath and chest pain. EMS reported that the patient has been complaining of some shortness of breath and chest pain intermittent for couple of weeks. 12 leads EKG showed evidence of anterior ST elevation myocardial infarction.  Code heart was called.  Patient developed PEA arrest in the Cath Lab.  CPR ACLS was initiated.  ROSC was achieved initially after 30 minutes of CPR.  Intra-aortic balloon pump was placed.  Coronary arteries were essentially clean.  Due to high suspicion for massive PE-TPA was given 100 mg without meaningful clinical improvement.  CPR was continued for more than an hour.  Despite all aggressive measures patient continued to deteriorate.  At 3:26 PM patient has no spontaneous breathing, no peripheral pulses, no heartbeats by auscultation or by monitor.  Pupils were fixed and dilated.  No cough no gag reflexes . patient was pronounced dead."
	"1418095-1"	"1418095-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient was found dead in his bed on June 11, 2021."
	"1420765-1"	"1420765-1"	"INTESTINAL PERFORATION"	"10022694"	"50-59 years"	"50-59"	"Renal cell carcinoma of right kidney metastatic to other site   ? Bone metastasis  ? Perforated bowel"
	"1420765-1"	"1420765-1"	"METASTASES TO BONE"	"10027452"	"50-59 years"	"50-59"	"Renal cell carcinoma of right kidney metastatic to other site   ? Bone metastasis  ? Perforated bowel"
	"1420765-1"	"1420765-1"	"RENAL CANCER METASTATIC"	"10050018"	"50-59 years"	"50-59"	"Renal cell carcinoma of right kidney metastatic to other site   ? Bone metastasis  ? Perforated bowel"
	"1420765-1"	"1420765-1"	"RENAL CELL CARCINOMA"	"10067946"	"50-59 years"	"50-59"	"Renal cell carcinoma of right kidney metastatic to other site   ? Bone metastasis  ? Perforated bowel"
	"1423055-1"	"1423055-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"suffered a massive heart attack; Feeling of faintness; Palpitations; Shortness of Breath; This spontaneous case was reported by a consumer and describes the occurrence of MYOCARDIAL INFARCTION (suffered a massive heart attack), SYNCOPE (Feeling of faintness), PALPITATIONS (Palpitations) and DYSPNOEA (Shortness of Breath) in a 59-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination.     No Medical History information was reported.    On 13-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 27-May-2021, the patient experienced SYNCOPE (Feeling of faintness) (seriousness criterion medically significant), PALPITATIONS (Palpitations) (seriousness criterion medically significant) and DYSPNOEA (Shortness of Breath) (seriousness criterion medically significant). On 09-Jun-2021, the patient experienced MYOCARDIAL INFARCTION (suffered a massive heart attack) (seriousness criteria death and medically significant). The patient died on 09-Jun-2021. The reported cause of death was suffered a massive heart attack. It is unknown if an autopsy was performed. At the time of death, SYNCOPE (Feeling of faintness), PALPITATIONS (Palpitations) and DYSPNOEA (Shortness of Breath) outcome was unknown.            No concomitant information was reported. No treatment information was reported. Action taken with mRNA-1273 was not applicable.  A Patient called to report that two weeks after the first dose of the Moderna Covid-19 vaccine on 27-May-2021, his boyfriend began to experience palpitations, shortness of breath and feeling of faintness. The caller stated that her boyfriend did not want to go to the emergency room and only set an appointment with his Health Care Provider, but on the 09-Jun-2021, the day that he was going to the appointment, he suffered a massive heart attack and passed away.  This is a case of sudden death in a 59-year-old male subject, who died 23 days after receiving first dose of vaccine. Very limited information has been provided at this time. Patient medical history was not provided.; Sender's Comments: This is a case of sudden death in a 59-year-old male subject, who died 23 days after receiving first dose of vaccine. Very limited information has been provided at this time. Patient medical history was not provided.; Reported Cause(s) of Death: suffered a massive heart attack"
	"1423055-1"	"1423055-1"	"MYOCARDIAL INFARCTION"	"10028596"	"50-59 years"	"50-59"	"suffered a massive heart attack; Feeling of faintness; Palpitations; Shortness of Breath; This spontaneous case was reported by a consumer and describes the occurrence of MYOCARDIAL INFARCTION (suffered a massive heart attack), SYNCOPE (Feeling of faintness), PALPITATIONS (Palpitations) and DYSPNOEA (Shortness of Breath) in a 59-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination.     No Medical History information was reported.    On 13-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 27-May-2021, the patient experienced SYNCOPE (Feeling of faintness) (seriousness criterion medically significant), PALPITATIONS (Palpitations) (seriousness criterion medically significant) and DYSPNOEA (Shortness of Breath) (seriousness criterion medically significant). On 09-Jun-2021, the patient experienced MYOCARDIAL INFARCTION (suffered a massive heart attack) (seriousness criteria death and medically significant). The patient died on 09-Jun-2021. The reported cause of death was suffered a massive heart attack. It is unknown if an autopsy was performed. At the time of death, SYNCOPE (Feeling of faintness), PALPITATIONS (Palpitations) and DYSPNOEA (Shortness of Breath) outcome was unknown.            No concomitant information was reported. No treatment information was reported. Action taken with mRNA-1273 was not applicable.  A Patient called to report that two weeks after the first dose of the Moderna Covid-19 vaccine on 27-May-2021, his boyfriend began to experience palpitations, shortness of breath and feeling of faintness. The caller stated that her boyfriend did not want to go to the emergency room and only set an appointment with his Health Care Provider, but on the 09-Jun-2021, the day that he was going to the appointment, he suffered a massive heart attack and passed away.  This is a case of sudden death in a 59-year-old male subject, who died 23 days after receiving first dose of vaccine. Very limited information has been provided at this time. Patient medical history was not provided.; Sender's Comments: This is a case of sudden death in a 59-year-old male subject, who died 23 days after receiving first dose of vaccine. Very limited information has been provided at this time. Patient medical history was not provided.; Reported Cause(s) of Death: suffered a massive heart attack"
	"1423055-1"	"1423055-1"	"PALPITATIONS"	"10033557"	"50-59 years"	"50-59"	"suffered a massive heart attack; Feeling of faintness; Palpitations; Shortness of Breath; This spontaneous case was reported by a consumer and describes the occurrence of MYOCARDIAL INFARCTION (suffered a massive heart attack), SYNCOPE (Feeling of faintness), PALPITATIONS (Palpitations) and DYSPNOEA (Shortness of Breath) in a 59-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination.     No Medical History information was reported.    On 13-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 27-May-2021, the patient experienced SYNCOPE (Feeling of faintness) (seriousness criterion medically significant), PALPITATIONS (Palpitations) (seriousness criterion medically significant) and DYSPNOEA (Shortness of Breath) (seriousness criterion medically significant). On 09-Jun-2021, the patient experienced MYOCARDIAL INFARCTION (suffered a massive heart attack) (seriousness criteria death and medically significant). The patient died on 09-Jun-2021. The reported cause of death was suffered a massive heart attack. It is unknown if an autopsy was performed. At the time of death, SYNCOPE (Feeling of faintness), PALPITATIONS (Palpitations) and DYSPNOEA (Shortness of Breath) outcome was unknown.            No concomitant information was reported. No treatment information was reported. Action taken with mRNA-1273 was not applicable.  A Patient called to report that two weeks after the first dose of the Moderna Covid-19 vaccine on 27-May-2021, his boyfriend began to experience palpitations, shortness of breath and feeling of faintness. The caller stated that her boyfriend did not want to go to the emergency room and only set an appointment with his Health Care Provider, but on the 09-Jun-2021, the day that he was going to the appointment, he suffered a massive heart attack and passed away.  This is a case of sudden death in a 59-year-old male subject, who died 23 days after receiving first dose of vaccine. Very limited information has been provided at this time. Patient medical history was not provided.; Sender's Comments: This is a case of sudden death in a 59-year-old male subject, who died 23 days after receiving first dose of vaccine. Very limited information has been provided at this time. Patient medical history was not provided.; Reported Cause(s) of Death: suffered a massive heart attack"
	"1423055-1"	"1423055-1"	"SYNCOPE"	"10042772"	"50-59 years"	"50-59"	"suffered a massive heart attack; Feeling of faintness; Palpitations; Shortness of Breath; This spontaneous case was reported by a consumer and describes the occurrence of MYOCARDIAL INFARCTION (suffered a massive heart attack), SYNCOPE (Feeling of faintness), PALPITATIONS (Palpitations) and DYSPNOEA (Shortness of Breath) in a 59-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination.     No Medical History information was reported.    On 13-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 27-May-2021, the patient experienced SYNCOPE (Feeling of faintness) (seriousness criterion medically significant), PALPITATIONS (Palpitations) (seriousness criterion medically significant) and DYSPNOEA (Shortness of Breath) (seriousness criterion medically significant). On 09-Jun-2021, the patient experienced MYOCARDIAL INFARCTION (suffered a massive heart attack) (seriousness criteria death and medically significant). The patient died on 09-Jun-2021. The reported cause of death was suffered a massive heart attack. It is unknown if an autopsy was performed. At the time of death, SYNCOPE (Feeling of faintness), PALPITATIONS (Palpitations) and DYSPNOEA (Shortness of Breath) outcome was unknown.            No concomitant information was reported. No treatment information was reported. Action taken with mRNA-1273 was not applicable.  A Patient called to report that two weeks after the first dose of the Moderna Covid-19 vaccine on 27-May-2021, his boyfriend began to experience palpitations, shortness of breath and feeling of faintness. The caller stated that her boyfriend did not want to go to the emergency room and only set an appointment with his Health Care Provider, but on the 09-Jun-2021, the day that he was going to the appointment, he suffered a massive heart attack and passed away.  This is a case of sudden death in a 59-year-old male subject, who died 23 days after receiving first dose of vaccine. Very limited information has been provided at this time. Patient medical history was not provided.; Sender's Comments: This is a case of sudden death in a 59-year-old male subject, who died 23 days after receiving first dose of vaccine. Very limited information has been provided at this time. Patient medical history was not provided.; Reported Cause(s) of Death: suffered a massive heart attack"
	"1423211-1"	"1423211-1"	"SUDDEN DEATH"	"10042434"	"50-59 years"	"50-59"	"Sudden unexpected death the day after the vaccine"
	"1423619-1"	"1423619-1"	"AORTIC RUPTURE"	"10060874"	"50-59 years"	"50-59"	"My husband died of ?heart Attack? on April 17, 2021  Had an enlarge hearth and rupture in the Aortic Artery"
	"1423619-1"	"1423619-1"	"CARDIOMEGALY"	"10007632"	"50-59 years"	"50-59"	"My husband died of ?heart Attack? on April 17, 2021  Had an enlarge hearth and rupture in the Aortic Artery"
	"1423619-1"	"1423619-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"My husband died of ?heart Attack? on April 17, 2021  Had an enlarge hearth and rupture in the Aortic Artery"
	"1423619-1"	"1423619-1"	"MYOCARDIAL INFARCTION"	"10028596"	"50-59 years"	"50-59"	"My husband died of ?heart Attack? on April 17, 2021  Had an enlarge hearth and rupture in the Aortic Artery"
	"1426149-1"	"1426149-1"	"ACUTE RESPIRATORY FAILURE"	"10001053"	"50-59 years"	"50-59"	"Death  4/29/2021 Causes of death listed on death certificate: 1) COVID 19 Pneumonia  2) Acute hypoxic respiratory failure  3) advanced amyotrophic lateral sclerosis"
	"1426149-1"	"1426149-1"	"AMYOTROPHIC LATERAL SCLEROSIS"	"10002026"	"50-59 years"	"50-59"	"Death  4/29/2021 Causes of death listed on death certificate: 1) COVID 19 Pneumonia  2) Acute hypoxic respiratory failure  3) advanced amyotrophic lateral sclerosis"
	"1426149-1"	"1426149-1"	"CONDITION AGGRAVATED"	"10010264"	"50-59 years"	"50-59"	"Death  4/29/2021 Causes of death listed on death certificate: 1) COVID 19 Pneumonia  2) Acute hypoxic respiratory failure  3) advanced amyotrophic lateral sclerosis"
	"1426149-1"	"1426149-1"	"COVID-19 PNEUMONIA"	"10084380"	"50-59 years"	"50-59"	"Death  4/29/2021 Causes of death listed on death certificate: 1) COVID 19 Pneumonia  2) Acute hypoxic respiratory failure  3) advanced amyotrophic lateral sclerosis"
	"1426149-1"	"1426149-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Death  4/29/2021 Causes of death listed on death certificate: 1) COVID 19 Pneumonia  2) Acute hypoxic respiratory failure  3) advanced amyotrophic lateral sclerosis"
	"1426149-1"	"1426149-1"	"NUCLEIC ACID TEST"	"10083356"	"50-59 years"	"50-59"	"Death  4/29/2021 Causes of death listed on death certificate: 1) COVID 19 Pneumonia  2) Acute hypoxic respiratory failure  3) advanced amyotrophic lateral sclerosis"
	"1426149-1"	"1426149-1"	"SARS-COV-2 TEST"	"10084354"	"50-59 years"	"50-59"	"Death  4/29/2021 Causes of death listed on death certificate: 1) COVID 19 Pneumonia  2) Acute hypoxic respiratory failure  3) advanced amyotrophic lateral sclerosis"
	"1428001-1"	"1428001-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient received their vaccine on 6/17 and had no complaints of adverse effects. The patient was found unconscious at some point between 6/17-6/18. They appeared jaundice and had low BP. They were airlifted to the hospital and died on 6/18/21."
	"1428001-1"	"1428001-1"	"HYPOTENSION"	"10021097"	"50-59 years"	"50-59"	"Patient received their vaccine on 6/17 and had no complaints of adverse effects. The patient was found unconscious at some point between 6/17-6/18. They appeared jaundice and had low BP. They were airlifted to the hospital and died on 6/18/21."
	"1428001-1"	"1428001-1"	"JAUNDICE"	"10023126"	"50-59 years"	"50-59"	"Patient received their vaccine on 6/17 and had no complaints of adverse effects. The patient was found unconscious at some point between 6/17-6/18. They appeared jaundice and had low BP. They were airlifted to the hospital and died on 6/18/21."
	"1428001-1"	"1428001-1"	"LOSS OF CONSCIOUSNESS"	"10024855"	"50-59 years"	"50-59"	"Patient received their vaccine on 6/17 and had no complaints of adverse effects. The patient was found unconscious at some point between 6/17-6/18. They appeared jaundice and had low BP. They were airlifted to the hospital and died on 6/18/21."
	"1428887-1"	"1428887-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Sudden Brain Aneurysm on May 11, 2021, Revived and kept alive on machines until taken off life support and subsequently died on May 21, 2021"
	"1428887-1"	"1428887-1"	"INTRACRANIAL ANEURYSM"	"10022758"	"50-59 years"	"50-59"	"Sudden Brain Aneurysm on May 11, 2021, Revived and kept alive on machines until taken off life support and subsequently died on May 21, 2021"
	"1428887-1"	"1428887-1"	"LIFE SUPPORT"	"10024447"	"50-59 years"	"50-59"	"Sudden Brain Aneurysm on May 11, 2021, Revived and kept alive on machines until taken off life support and subsequently died on May 21, 2021"
	"1428887-1"	"1428887-1"	"RESUSCITATION"	"10038749"	"50-59 years"	"50-59"	"Sudden Brain Aneurysm on May 11, 2021, Revived and kept alive on machines until taken off life support and subsequently died on May 21, 2021"
	"1430563-1"	"1430563-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"On April 2, 2021, person went to the ED at  10:15 AM, where she complained of shortness of breath, fatigue, mild headache and nausea.  Patient symptoms were going on for about 3 days.  She also reported feeling a bit achy and decreased appetite. She was treated and discharged home the same day.  It was later reported by a family member that this person was found unconscious on floor of her bedroom by family members and taken to hospital where she passed away. It was reported hat Doctors were thinking that this was caused by a rare blood disorder (Thrombotic thrombocytopenic purpura, a disease which causes small blood clots and interrupts the blood's ability to deliver oxygen properly)."
	"1430563-1"	"1430563-1"	"DECREASED APPETITE"	"10061428"	"50-59 years"	"50-59"	"On April 2, 2021, person went to the ED at  10:15 AM, where she complained of shortness of breath, fatigue, mild headache and nausea.  Patient symptoms were going on for about 3 days.  She also reported feeling a bit achy and decreased appetite. She was treated and discharged home the same day.  It was later reported by a family member that this person was found unconscious on floor of her bedroom by family members and taken to hospital where she passed away. It was reported hat Doctors were thinking that this was caused by a rare blood disorder (Thrombotic thrombocytopenic purpura, a disease which causes small blood clots and interrupts the blood's ability to deliver oxygen properly)."
	"1430563-1"	"1430563-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"On April 2, 2021, person went to the ED at  10:15 AM, where she complained of shortness of breath, fatigue, mild headache and nausea.  Patient symptoms were going on for about 3 days.  She also reported feeling a bit achy and decreased appetite. She was treated and discharged home the same day.  It was later reported by a family member that this person was found unconscious on floor of her bedroom by family members and taken to hospital where she passed away. It was reported hat Doctors were thinking that this was caused by a rare blood disorder (Thrombotic thrombocytopenic purpura, a disease which causes small blood clots and interrupts the blood's ability to deliver oxygen properly)."
	"1430563-1"	"1430563-1"	"FATIGUE"	"10016256"	"50-59 years"	"50-59"	"On April 2, 2021, person went to the ED at  10:15 AM, where she complained of shortness of breath, fatigue, mild headache and nausea.  Patient symptoms were going on for about 3 days.  She also reported feeling a bit achy and decreased appetite. She was treated and discharged home the same day.  It was later reported by a family member that this person was found unconscious on floor of her bedroom by family members and taken to hospital where she passed away. It was reported hat Doctors were thinking that this was caused by a rare blood disorder (Thrombotic thrombocytopenic purpura, a disease which causes small blood clots and interrupts the blood's ability to deliver oxygen properly)."
	"1430563-1"	"1430563-1"	"HEADACHE"	"10019211"	"50-59 years"	"50-59"	"On April 2, 2021, person went to the ED at  10:15 AM, where she complained of shortness of breath, fatigue, mild headache and nausea.  Patient symptoms were going on for about 3 days.  She also reported feeling a bit achy and decreased appetite. She was treated and discharged home the same day.  It was later reported by a family member that this person was found unconscious on floor of her bedroom by family members and taken to hospital where she passed away. It was reported hat Doctors were thinking that this was caused by a rare blood disorder (Thrombotic thrombocytopenic purpura, a disease which causes small blood clots and interrupts the blood's ability to deliver oxygen properly)."
	"1430563-1"	"1430563-1"	"LOSS OF CONSCIOUSNESS"	"10024855"	"50-59 years"	"50-59"	"On April 2, 2021, person went to the ED at  10:15 AM, where she complained of shortness of breath, fatigue, mild headache and nausea.  Patient symptoms were going on for about 3 days.  She also reported feeling a bit achy and decreased appetite. She was treated and discharged home the same day.  It was later reported by a family member that this person was found unconscious on floor of her bedroom by family members and taken to hospital where she passed away. It was reported hat Doctors were thinking that this was caused by a rare blood disorder (Thrombotic thrombocytopenic purpura, a disease which causes small blood clots and interrupts the blood's ability to deliver oxygen properly)."
	"1430563-1"	"1430563-1"	"NAUSEA"	"10028813"	"50-59 years"	"50-59"	"On April 2, 2021, person went to the ED at  10:15 AM, where she complained of shortness of breath, fatigue, mild headache and nausea.  Patient symptoms were going on for about 3 days.  She also reported feeling a bit achy and decreased appetite. She was treated and discharged home the same day.  It was later reported by a family member that this person was found unconscious on floor of her bedroom by family members and taken to hospital where she passed away. It was reported hat Doctors were thinking that this was caused by a rare blood disorder (Thrombotic thrombocytopenic purpura, a disease which causes small blood clots and interrupts the blood's ability to deliver oxygen properly)."
	"1430563-1"	"1430563-1"	"PAIN"	"10033371"	"50-59 years"	"50-59"	"On April 2, 2021, person went to the ED at  10:15 AM, where she complained of shortness of breath, fatigue, mild headache and nausea.  Patient symptoms were going on for about 3 days.  She also reported feeling a bit achy and decreased appetite. She was treated and discharged home the same day.  It was later reported by a family member that this person was found unconscious on floor of her bedroom by family members and taken to hospital where she passed away. It was reported hat Doctors were thinking that this was caused by a rare blood disorder (Thrombotic thrombocytopenic purpura, a disease which causes small blood clots and interrupts the blood's ability to deliver oxygen properly)."
	"1430563-1"	"1430563-1"	"THROMBOTIC THROMBOCYTOPENIC PURPURA"	"10043648"	"50-59 years"	"50-59"	"On April 2, 2021, person went to the ED at  10:15 AM, where she complained of shortness of breath, fatigue, mild headache and nausea.  Patient symptoms were going on for about 3 days.  She also reported feeling a bit achy and decreased appetite. She was treated and discharged home the same day.  It was later reported by a family member that this person was found unconscious on floor of her bedroom by family members and taken to hospital where she passed away. It was reported hat Doctors were thinking that this was caused by a rare blood disorder (Thrombotic thrombocytopenic purpura, a disease which causes small blood clots and interrupts the blood's ability to deliver oxygen properly)."
	"1430566-1"	"1430566-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"on 06/18/2021 my husband suffered a central brain aneurysm and passed away om 06/19/2021"
	"1430566-1"	"1430566-1"	"INTRA-CEREBRAL ANEURYSM OPERATION"	"10022736"	"50-59 years"	"50-59"	"on 06/18/2021 my husband suffered a central brain aneurysm and passed away om 06/19/2021"
	"1430566-1"	"1430566-1"	"INTRACRANIAL ANEURYSM"	"10022758"	"50-59 years"	"50-59"	"on 06/18/2021 my husband suffered a central brain aneurysm and passed away om 06/19/2021"
	"1431530-1"	"1431530-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Pt. got shot on 5/25 but started feeling real bad arm pain on day 2. The pain got worse in arm and patient reached out to pharmacy questioning arm pain to which he was told it was an expected side effect of the shot but because he was still in pain he made an appointment with his doctor on the coming Monday, but unfortunately, he passed away on Sunday 5/30/21 and was found by neighbors. Brother wants to report death because he took the vaccine"
	"1431530-1"	"1431530-1"	"PAIN IN EXTREMITY"	"10033425"	"50-59 years"	"50-59"	"Pt. got shot on 5/25 but started feeling real bad arm pain on day 2. The pain got worse in arm and patient reached out to pharmacy questioning arm pain to which he was told it was an expected side effect of the shot but because he was still in pain he made an appointment with his doctor on the coming Monday, but unfortunately, he passed away on Sunday 5/30/21 and was found by neighbors. Brother wants to report death because he took the vaccine"
	"1433305-1"	"1433305-1"	"COAGULOPATHY"	"10009802"	"50-59 years"	"50-59"	"patient collapse with subsequent EMS transport to ED, multi organ system failure, coagulation issues, required mechanical ventilation"
	"1433305-1"	"1433305-1"	"MECHANICAL VENTILATION"	"10067221"	"50-59 years"	"50-59"	"patient collapse with subsequent EMS transport to ED, multi organ system failure, coagulation issues, required mechanical ventilation"
	"1433305-1"	"1433305-1"	"MULTIPLE ORGAN DYSFUNCTION SYNDROME"	"10077361"	"50-59 years"	"50-59"	"patient collapse with subsequent EMS transport to ED, multi organ system failure, coagulation issues, required mechanical ventilation"
	"1433305-1"	"1433305-1"	"SYNCOPE"	"10042772"	"50-59 years"	"50-59"	"patient collapse with subsequent EMS transport to ED, multi organ system failure, coagulation issues, required mechanical ventilation"
	"1433939-1"	"1433939-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient received Moderna #1 on 4/20/21 and Moderna #2 on 6/15/21. Our office was notified on 6/19/21 that this patient was found deceased and appeared to have passed away several days prior due to level of decomposition. The cause of death is unknown at this time and is being evaluated by Medical Examiner due to recent Covid vaccination and recent drug overdose on 6/2/21. No foul play suspected."
	"1437053-1"	"1437053-1"	"ASTHENIA"	"10003549"	"50-59 years"	"50-59"	"Site: Bruising at Injection Site-Mild, Site: Itching at Injection Site-Mild, Site: Pain at Injection Site-Mild, Site: Redness at Injection Site-Mild, Site: Swelling at Injection Site-Mild, Systemic: Body Aches Generalized-Severe, Systemic: Chills-Severe, Systemic: Confusion-Severe, Systemic: Exhaustion / Lethargy-Severe, Systemic: Fever-Severe, Systemic: severe flu-like symptoms-Severe, Systemic: Headache-Severe, Systemic: Weakness-Severe, Additional Details: husband reported patient had severe flu-like sypmtoms"
	"1437053-1"	"1437053-1"	"CHILLS"	"10008531"	"50-59 years"	"50-59"	"Site: Bruising at Injection Site-Mild, Site: Itching at Injection Site-Mild, Site: Pain at Injection Site-Mild, Site: Redness at Injection Site-Mild, Site: Swelling at Injection Site-Mild, Systemic: Body Aches Generalized-Severe, Systemic: Chills-Severe, Systemic: Confusion-Severe, Systemic: Exhaustion / Lethargy-Severe, Systemic: Fever-Severe, Systemic: severe flu-like symptoms-Severe, Systemic: Headache-Severe, Systemic: Weakness-Severe, Additional Details: husband reported patient had severe flu-like sypmtoms"
	"1437053-1"	"1437053-1"	"CONFUSIONAL STATE"	"10010305"	"50-59 years"	"50-59"	"Site: Bruising at Injection Site-Mild, Site: Itching at Injection Site-Mild, Site: Pain at Injection Site-Mild, Site: Redness at Injection Site-Mild, Site: Swelling at Injection Site-Mild, Systemic: Body Aches Generalized-Severe, Systemic: Chills-Severe, Systemic: Confusion-Severe, Systemic: Exhaustion / Lethargy-Severe, Systemic: Fever-Severe, Systemic: severe flu-like symptoms-Severe, Systemic: Headache-Severe, Systemic: Weakness-Severe, Additional Details: husband reported patient had severe flu-like sypmtoms"
	"1437053-1"	"1437053-1"	"FATIGUE"	"10016256"	"50-59 years"	"50-59"	"Site: Bruising at Injection Site-Mild, Site: Itching at Injection Site-Mild, Site: Pain at Injection Site-Mild, Site: Redness at Injection Site-Mild, Site: Swelling at Injection Site-Mild, Systemic: Body Aches Generalized-Severe, Systemic: Chills-Severe, Systemic: Confusion-Severe, Systemic: Exhaustion / Lethargy-Severe, Systemic: Fever-Severe, Systemic: severe flu-like symptoms-Severe, Systemic: Headache-Severe, Systemic: Weakness-Severe, Additional Details: husband reported patient had severe flu-like sypmtoms"
	"1437053-1"	"1437053-1"	"HEADACHE"	"10019211"	"50-59 years"	"50-59"	"Site: Bruising at Injection Site-Mild, Site: Itching at Injection Site-Mild, Site: Pain at Injection Site-Mild, Site: Redness at Injection Site-Mild, Site: Swelling at Injection Site-Mild, Systemic: Body Aches Generalized-Severe, Systemic: Chills-Severe, Systemic: Confusion-Severe, Systemic: Exhaustion / Lethargy-Severe, Systemic: Fever-Severe, Systemic: severe flu-like symptoms-Severe, Systemic: Headache-Severe, Systemic: Weakness-Severe, Additional Details: husband reported patient had severe flu-like sypmtoms"
	"1437053-1"	"1437053-1"	"INFLUENZA LIKE ILLNESS"	"10022004"	"50-59 years"	"50-59"	"Site: Bruising at Injection Site-Mild, Site: Itching at Injection Site-Mild, Site: Pain at Injection Site-Mild, Site: Redness at Injection Site-Mild, Site: Swelling at Injection Site-Mild, Systemic: Body Aches Generalized-Severe, Systemic: Chills-Severe, Systemic: Confusion-Severe, Systemic: Exhaustion / Lethargy-Severe, Systemic: Fever-Severe, Systemic: severe flu-like symptoms-Severe, Systemic: Headache-Severe, Systemic: Weakness-Severe, Additional Details: husband reported patient had severe flu-like sypmtoms"
	"1437053-1"	"1437053-1"	"INJECTION SITE BRUISING"	"10022052"	"50-59 years"	"50-59"	"Site: Bruising at Injection Site-Mild, Site: Itching at Injection Site-Mild, Site: Pain at Injection Site-Mild, Site: Redness at Injection Site-Mild, Site: Swelling at Injection Site-Mild, Systemic: Body Aches Generalized-Severe, Systemic: Chills-Severe, Systemic: Confusion-Severe, Systemic: Exhaustion / Lethargy-Severe, Systemic: Fever-Severe, Systemic: severe flu-like symptoms-Severe, Systemic: Headache-Severe, Systemic: Weakness-Severe, Additional Details: husband reported patient had severe flu-like sypmtoms"
	"1437053-1"	"1437053-1"	"INJECTION SITE ERYTHEMA"	"10022061"	"50-59 years"	"50-59"	"Site: Bruising at Injection Site-Mild, Site: Itching at Injection Site-Mild, Site: Pain at Injection Site-Mild, Site: Redness at Injection Site-Mild, Site: Swelling at Injection Site-Mild, Systemic: Body Aches Generalized-Severe, Systemic: Chills-Severe, Systemic: Confusion-Severe, Systemic: Exhaustion / Lethargy-Severe, Systemic: Fever-Severe, Systemic: severe flu-like symptoms-Severe, Systemic: Headache-Severe, Systemic: Weakness-Severe, Additional Details: husband reported patient had severe flu-like sypmtoms"
	"1437053-1"	"1437053-1"	"INJECTION SITE PAIN"	"10022086"	"50-59 years"	"50-59"	"Site: Bruising at Injection Site-Mild, Site: Itching at Injection Site-Mild, Site: Pain at Injection Site-Mild, Site: Redness at Injection Site-Mild, Site: Swelling at Injection Site-Mild, Systemic: Body Aches Generalized-Severe, Systemic: Chills-Severe, Systemic: Confusion-Severe, Systemic: Exhaustion / Lethargy-Severe, Systemic: Fever-Severe, Systemic: severe flu-like symptoms-Severe, Systemic: Headache-Severe, Systemic: Weakness-Severe, Additional Details: husband reported patient had severe flu-like sypmtoms"
	"1437053-1"	"1437053-1"	"INJECTION SITE PRURITUS"	"10022093"	"50-59 years"	"50-59"	"Site: Bruising at Injection Site-Mild, Site: Itching at Injection Site-Mild, Site: Pain at Injection Site-Mild, Site: Redness at Injection Site-Mild, Site: Swelling at Injection Site-Mild, Systemic: Body Aches Generalized-Severe, Systemic: Chills-Severe, Systemic: Confusion-Severe, Systemic: Exhaustion / Lethargy-Severe, Systemic: Fever-Severe, Systemic: severe flu-like symptoms-Severe, Systemic: Headache-Severe, Systemic: Weakness-Severe, Additional Details: husband reported patient had severe flu-like sypmtoms"
	"1437053-1"	"1437053-1"	"INJECTION SITE SWELLING"	"10053425"	"50-59 years"	"50-59"	"Site: Bruising at Injection Site-Mild, Site: Itching at Injection Site-Mild, Site: Pain at Injection Site-Mild, Site: Redness at Injection Site-Mild, Site: Swelling at Injection Site-Mild, Systemic: Body Aches Generalized-Severe, Systemic: Chills-Severe, Systemic: Confusion-Severe, Systemic: Exhaustion / Lethargy-Severe, Systemic: Fever-Severe, Systemic: severe flu-like symptoms-Severe, Systemic: Headache-Severe, Systemic: Weakness-Severe, Additional Details: husband reported patient had severe flu-like sypmtoms"
	"1437053-1"	"1437053-1"	"LETHARGY"	"10024264"	"50-59 years"	"50-59"	"Site: Bruising at Injection Site-Mild, Site: Itching at Injection Site-Mild, Site: Pain at Injection Site-Mild, Site: Redness at Injection Site-Mild, Site: Swelling at Injection Site-Mild, Systemic: Body Aches Generalized-Severe, Systemic: Chills-Severe, Systemic: Confusion-Severe, Systemic: Exhaustion / Lethargy-Severe, Systemic: Fever-Severe, Systemic: severe flu-like symptoms-Severe, Systemic: Headache-Severe, Systemic: Weakness-Severe, Additional Details: husband reported patient had severe flu-like sypmtoms"
	"1437053-1"	"1437053-1"	"PAIN"	"10033371"	"50-59 years"	"50-59"	"Site: Bruising at Injection Site-Mild, Site: Itching at Injection Site-Mild, Site: Pain at Injection Site-Mild, Site: Redness at Injection Site-Mild, Site: Swelling at Injection Site-Mild, Systemic: Body Aches Generalized-Severe, Systemic: Chills-Severe, Systemic: Confusion-Severe, Systemic: Exhaustion / Lethargy-Severe, Systemic: Fever-Severe, Systemic: severe flu-like symptoms-Severe, Systemic: Headache-Severe, Systemic: Weakness-Severe, Additional Details: husband reported patient had severe flu-like sypmtoms"
	"1437053-1"	"1437053-1"	"PYREXIA"	"10037660"	"50-59 years"	"50-59"	"Site: Bruising at Injection Site-Mild, Site: Itching at Injection Site-Mild, Site: Pain at Injection Site-Mild, Site: Redness at Injection Site-Mild, Site: Swelling at Injection Site-Mild, Systemic: Body Aches Generalized-Severe, Systemic: Chills-Severe, Systemic: Confusion-Severe, Systemic: Exhaustion / Lethargy-Severe, Systemic: Fever-Severe, Systemic: severe flu-like symptoms-Severe, Systemic: Headache-Severe, Systemic: Weakness-Severe, Additional Details: husband reported patient had severe flu-like sypmtoms"
	"1437381-1"	"1437381-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Death  06/04/2021"
	"1437381-1"	"1437381-1"	"SARS-COV-2 TEST"	"10084354"	"50-59 years"	"50-59"	"Death  06/04/2021"
	"1437814-1"	"1437814-1"	"HEADACHE"	"10019211"	"50-59 years"	"50-59"	"mild fever, congestion, headaches"
	"1437814-1"	"1437814-1"	"PYREXIA"	"10037660"	"50-59 years"	"50-59"	"mild fever, congestion, headaches"
	"1437814-1"	"1437814-1"	"RESPIRATORY TRACT CONGESTION"	"10052251"	"50-59 years"	"50-59"	"mild fever, congestion, headaches"
	"1440830-1"	"1440830-1"	"ANKLE FRACTURE"	"10002544"	"50-59 years"	"50-59"	"Patient presented to the ED for closed fraction dislocation of left ankle on 5/30/2021. Patient was hospitalized on 6/8/2021 for hospice/palliative care. Patient hospitalized on 6/9/2021 for open reduction internal fixation left trimalleolar ankle fracture, medial and lateral malleoli with fixation of the syndesmosis. He died on 6/24/2021. These visits are within 6 weeks of receiving COVID vaccination."
	"1440830-1"	"1440830-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient presented to the ED for closed fraction dislocation of left ankle on 5/30/2021. Patient was hospitalized on 6/8/2021 for hospice/palliative care. Patient hospitalized on 6/9/2021 for open reduction internal fixation left trimalleolar ankle fracture, medial and lateral malleoli with fixation of the syndesmosis. He died on 6/24/2021. These visits are within 6 weeks of receiving COVID vaccination."
	"1440830-1"	"1440830-1"	"JOINT DISLOCATION"	"10023204"	"50-59 years"	"50-59"	"Patient presented to the ED for closed fraction dislocation of left ankle on 5/30/2021. Patient was hospitalized on 6/8/2021 for hospice/palliative care. Patient hospitalized on 6/9/2021 for open reduction internal fixation left trimalleolar ankle fracture, medial and lateral malleoli with fixation of the syndesmosis. He died on 6/24/2021. These visits are within 6 weeks of receiving COVID vaccination."
	"1440830-1"	"1440830-1"	"LIGAMENT OPERATION"	"10065122"	"50-59 years"	"50-59"	"Patient presented to the ED for closed fraction dislocation of left ankle on 5/30/2021. Patient was hospitalized on 6/8/2021 for hospice/palliative care. Patient hospitalized on 6/9/2021 for open reduction internal fixation left trimalleolar ankle fracture, medial and lateral malleoli with fixation of the syndesmosis. He died on 6/24/2021. These visits are within 6 weeks of receiving COVID vaccination."
	"1440830-1"	"1440830-1"	"OPEN REDUCTION OF FRACTURE"	"10030682"	"50-59 years"	"50-59"	"Patient presented to the ED for closed fraction dislocation of left ankle on 5/30/2021. Patient was hospitalized on 6/8/2021 for hospice/palliative care. Patient hospitalized on 6/9/2021 for open reduction internal fixation left trimalleolar ankle fracture, medial and lateral malleoli with fixation of the syndesmosis. He died on 6/24/2021. These visits are within 6 weeks of receiving COVID vaccination."
	"1444158-1"	"1444158-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Death... left ventricle rupture  of the heart 4 days after the vaccine"
	"1444158-1"	"1444158-1"	"VENTRICLE RUPTURE"	"10047279"	"50-59 years"	"50-59"	"Death... left ventricle rupture  of the heart 4 days after the vaccine"
	"1446466-1"	"1446466-1"	"CEREBROVASCULAR ACCIDENT"	"10008190"	"50-59 years"	"50-59"	"Died of cardiac complications, heart attack, stroke or blood clot were all mentioned. Collapsed at work, grabbing his chest. Was revived 5 times before dying. Doctors mentioned his chest was oddly discolored so they thought blood clot but ekg was abnormal as well so heart attack was also mentioned."
	"1446466-1"	"1446466-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Died of cardiac complications, heart attack, stroke or blood clot were all mentioned. Collapsed at work, grabbing his chest. Was revived 5 times before dying. Doctors mentioned his chest was oddly discolored so they thought blood clot but ekg was abnormal as well so heart attack was also mentioned."
	"1446466-1"	"1446466-1"	"ELECTROCARDIOGRAM ABNORMAL"	"10014363"	"50-59 years"	"50-59"	"Died of cardiac complications, heart attack, stroke or blood clot were all mentioned. Collapsed at work, grabbing his chest. Was revived 5 times before dying. Doctors mentioned his chest was oddly discolored so they thought blood clot but ekg was abnormal as well so heart attack was also mentioned."
	"1446466-1"	"1446466-1"	"MYOCARDIAL INFARCTION"	"10028596"	"50-59 years"	"50-59"	"Died of cardiac complications, heart attack, stroke or blood clot were all mentioned. Collapsed at work, grabbing his chest. Was revived 5 times before dying. Doctors mentioned his chest was oddly discolored so they thought blood clot but ekg was abnormal as well so heart attack was also mentioned."
	"1446466-1"	"1446466-1"	"RESUSCITATION"	"10038749"	"50-59 years"	"50-59"	"Died of cardiac complications, heart attack, stroke or blood clot were all mentioned. Collapsed at work, grabbing his chest. Was revived 5 times before dying. Doctors mentioned his chest was oddly discolored so they thought blood clot but ekg was abnormal as well so heart attack was also mentioned."
	"1446466-1"	"1446466-1"	"SKIN DISCOLOURATION"	"10040829"	"50-59 years"	"50-59"	"Died of cardiac complications, heart attack, stroke or blood clot were all mentioned. Collapsed at work, grabbing his chest. Was revived 5 times before dying. Doctors mentioned his chest was oddly discolored so they thought blood clot but ekg was abnormal as well so heart attack was also mentioned."
	"1446466-1"	"1446466-1"	"SYNCOPE"	"10042772"	"50-59 years"	"50-59"	"Died of cardiac complications, heart attack, stroke or blood clot were all mentioned. Collapsed at work, grabbing his chest. Was revived 5 times before dying. Doctors mentioned his chest was oddly discolored so they thought blood clot but ekg was abnormal as well so heart attack was also mentioned."
	"1446466-1"	"1446466-1"	"THROMBOSIS"	"10043607"	"50-59 years"	"50-59"	"Died of cardiac complications, heart attack, stroke or blood clot were all mentioned. Collapsed at work, grabbing his chest. Was revived 5 times before dying. Doctors mentioned his chest was oddly discolored so they thought blood clot but ekg was abnormal as well so heart attack was also mentioned."
	"1450231-1"	"1450231-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Pt. went  to pharmacy on 6/22/21 to receive the second dose of Pfizer-BioNTech vaccine, lot number EW0177.  The day after the vaccine was administered, her lower arm was swollen, red and her elbow felt hot to the touch.  It was too painful to fully extend her arm.  There was a white streak across the reddish purple elbow area where it appeared as though there was an infection growing.  She went  to her normal doctors office, she saw his nurse practitioner who took an x-ray and gave her two intravenous injections of antibiotic (unknown type).  One in each buttock and prescribed an oral antibiotic: Cephalexin 500 mg., and Ibuprofen 800 mg. From that day forward she was unable to move the arm at all and the medication did not bring the swelling or the infection down.  She was very tired and her arm did not lessen in pain as the days passed.    On June 29, 2021 she was in her bedroom and her older daughter was in her room and believed her mother was resting.  At approximately 7:20 p.m., pts. husband returned from work and came into the master bedroom turning on the television.  As he did so he made joke expecting pt. to laugh or comment, when she made no response he looked over at her and saw that she was laying on the love seat at an awkward angle.  He moved to her side and saw her eyes were open but unseeing and saw that her dental prosthetic was partially pushed out of place.  He removed and called EMS immediately, not detecting any obvious signs of life.  Her daughter came into the room and immediately started CPR.  Paramedics arrived in under 2 minutes and moved pt. to the living room where they could intubate a breathing pathway and carried on with attempts to revive her heart muscle for approximately 25 minutes before Paramedic called time of death at 8:02 p.m.   Paramedics departed and the Police arrived staying  until the Mortuary attendants came to the home at about midnight to accept pt. body for transport to its facility.      The Family is seeking an autopsy and the coroner is claiming one is not necessary.  The family believes it is absolutely necessary to ascertain whether or not the second dose caused her death as it seems is likely and whether she should have been advised of her heighten risk level. Regardless of COVID 19 Emergency measures, an autopsy is necessary and the family is determined to ensure that it is conducted.   Pt. has had a history of the following: Adult onset Asthma, allergic reactions in skin rashes that were significant. Hypothrodism (Graves Disease) which proved to be difficult to find the right meds to bring it under control; prone to incidents of Atrial fibrillation which have escalated as she has aged; she has been treated for emergency visits for Tachycardia; she frequently has developed respiratory issues as a result of the asthma which often landed her  in  the emergency and days in the hospital on oxygen.  She often experienced shortness of breath and chest pain and last year underwent emergency appendicitis.  Her last episode of atrial fibrillation which landed in the hospital was 12/29/16.  She has been on anticoagulants for many years.    Since COVID 19 she may not have been able to afford her Eliquis prescription however which she did not disclose to any of her family members that she was struggling in this wasy.   She is likely not to have been taking her Hypothyrodism (Graves) medication either since these medications have not been recovered since her death."
	"1450231-1"	"1450231-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"50-59 years"	"50-59"	"Pt. went  to pharmacy on 6/22/21 to receive the second dose of Pfizer-BioNTech vaccine, lot number EW0177.  The day after the vaccine was administered, her lower arm was swollen, red and her elbow felt hot to the touch.  It was too painful to fully extend her arm.  There was a white streak across the reddish purple elbow area where it appeared as though there was an infection growing.  She went  to her normal doctors office, she saw his nurse practitioner who took an x-ray and gave her two intravenous injections of antibiotic (unknown type).  One in each buttock and prescribed an oral antibiotic: Cephalexin 500 mg., and Ibuprofen 800 mg. From that day forward she was unable to move the arm at all and the medication did not bring the swelling or the infection down.  She was very tired and her arm did not lessen in pain as the days passed.    On June 29, 2021 she was in her bedroom and her older daughter was in her room and believed her mother was resting.  At approximately 7:20 p.m., pts. husband returned from work and came into the master bedroom turning on the television.  As he did so he made joke expecting pt. to laugh or comment, when she made no response he looked over at her and saw that she was laying on the love seat at an awkward angle.  He moved to her side and saw her eyes were open but unseeing and saw that her dental prosthetic was partially pushed out of place.  He removed and called EMS immediately, not detecting any obvious signs of life.  Her daughter came into the room and immediately started CPR.  Paramedics arrived in under 2 minutes and moved pt. to the living room where they could intubate a breathing pathway and carried on with attempts to revive her heart muscle for approximately 25 minutes before Paramedic called time of death at 8:02 p.m.   Paramedics departed and the Police arrived staying  until the Mortuary attendants came to the home at about midnight to accept pt. body for transport to its facility.      The Family is seeking an autopsy and the coroner is claiming one is not necessary.  The family believes it is absolutely necessary to ascertain whether or not the second dose caused her death as it seems is likely and whether she should have been advised of her heighten risk level. Regardless of COVID 19 Emergency measures, an autopsy is necessary and the family is determined to ensure that it is conducted.   Pt. has had a history of the following: Adult onset Asthma, allergic reactions in skin rashes that were significant. Hypothrodism (Graves Disease) which proved to be difficult to find the right meds to bring it under control; prone to incidents of Atrial fibrillation which have escalated as she has aged; she has been treated for emergency visits for Tachycardia; she frequently has developed respiratory issues as a result of the asthma which often landed her  in  the emergency and days in the hospital on oxygen.  She often experienced shortness of breath and chest pain and last year underwent emergency appendicitis.  Her last episode of atrial fibrillation which landed in the hospital was 12/29/16.  She has been on anticoagulants for many years.    Since COVID 19 she may not have been able to afford her Eliquis prescription however which she did not disclose to any of her family members that she was struggling in this wasy.   She is likely not to have been taking her Hypothyrodism (Graves) medication either since these medications have not been recovered since her death."
	"1450231-1"	"1450231-1"	"ERYTHEMA"	"10015150"	"50-59 years"	"50-59"	"Pt. went  to pharmacy on 6/22/21 to receive the second dose of Pfizer-BioNTech vaccine, lot number EW0177.  The day after the vaccine was administered, her lower arm was swollen, red and her elbow felt hot to the touch.  It was too painful to fully extend her arm.  There was a white streak across the reddish purple elbow area where it appeared as though there was an infection growing.  She went  to her normal doctors office, she saw his nurse practitioner who took an x-ray and gave her two intravenous injections of antibiotic (unknown type).  One in each buttock and prescribed an oral antibiotic: Cephalexin 500 mg., and Ibuprofen 800 mg. From that day forward she was unable to move the arm at all and the medication did not bring the swelling or the infection down.  She was very tired and her arm did not lessen in pain as the days passed.    On June 29, 2021 she was in her bedroom and her older daughter was in her room and believed her mother was resting.  At approximately 7:20 p.m., pts. husband returned from work and came into the master bedroom turning on the television.  As he did so he made joke expecting pt. to laugh or comment, when she made no response he looked over at her and saw that she was laying on the love seat at an awkward angle.  He moved to her side and saw her eyes were open but unseeing and saw that her dental prosthetic was partially pushed out of place.  He removed and called EMS immediately, not detecting any obvious signs of life.  Her daughter came into the room and immediately started CPR.  Paramedics arrived in under 2 minutes and moved pt. to the living room where they could intubate a breathing pathway and carried on with attempts to revive her heart muscle for approximately 25 minutes before Paramedic called time of death at 8:02 p.m.   Paramedics departed and the Police arrived staying  until the Mortuary attendants came to the home at about midnight to accept pt. body for transport to its facility.      The Family is seeking an autopsy and the coroner is claiming one is not necessary.  The family believes it is absolutely necessary to ascertain whether or not the second dose caused her death as it seems is likely and whether she should have been advised of her heighten risk level. Regardless of COVID 19 Emergency measures, an autopsy is necessary and the family is determined to ensure that it is conducted.   Pt. has had a history of the following: Adult onset Asthma, allergic reactions in skin rashes that were significant. Hypothrodism (Graves Disease) which proved to be difficult to find the right meds to bring it under control; prone to incidents of Atrial fibrillation which have escalated as she has aged; she has been treated for emergency visits for Tachycardia; she frequently has developed respiratory issues as a result of the asthma which often landed her  in  the emergency and days in the hospital on oxygen.  She often experienced shortness of breath and chest pain and last year underwent emergency appendicitis.  Her last episode of atrial fibrillation which landed in the hospital was 12/29/16.  She has been on anticoagulants for many years.    Since COVID 19 she may not have been able to afford her Eliquis prescription however which she did not disclose to any of her family members that she was struggling in this wasy.   She is likely not to have been taking her Hypothyrodism (Graves) medication either since these medications have not been recovered since her death."
	"1450231-1"	"1450231-1"	"FATIGUE"	"10016256"	"50-59 years"	"50-59"	"Pt. went  to pharmacy on 6/22/21 to receive the second dose of Pfizer-BioNTech vaccine, lot number EW0177.  The day after the vaccine was administered, her lower arm was swollen, red and her elbow felt hot to the touch.  It was too painful to fully extend her arm.  There was a white streak across the reddish purple elbow area where it appeared as though there was an infection growing.  She went  to her normal doctors office, she saw his nurse practitioner who took an x-ray and gave her two intravenous injections of antibiotic (unknown type).  One in each buttock and prescribed an oral antibiotic: Cephalexin 500 mg., and Ibuprofen 800 mg. From that day forward she was unable to move the arm at all and the medication did not bring the swelling or the infection down.  She was very tired and her arm did not lessen in pain as the days passed.    On June 29, 2021 she was in her bedroom and her older daughter was in her room and believed her mother was resting.  At approximately 7:20 p.m., pts. husband returned from work and came into the master bedroom turning on the television.  As he did so he made joke expecting pt. to laugh or comment, when she made no response he looked over at her and saw that she was laying on the love seat at an awkward angle.  He moved to her side and saw her eyes were open but unseeing and saw that her dental prosthetic was partially pushed out of place.  He removed and called EMS immediately, not detecting any obvious signs of life.  Her daughter came into the room and immediately started CPR.  Paramedics arrived in under 2 minutes and moved pt. to the living room where they could intubate a breathing pathway and carried on with attempts to revive her heart muscle for approximately 25 minutes before Paramedic called time of death at 8:02 p.m.   Paramedics departed and the Police arrived staying  until the Mortuary attendants came to the home at about midnight to accept pt. body for transport to its facility.      The Family is seeking an autopsy and the coroner is claiming one is not necessary.  The family believes it is absolutely necessary to ascertain whether or not the second dose caused her death as it seems is likely and whether she should have been advised of her heighten risk level. Regardless of COVID 19 Emergency measures, an autopsy is necessary and the family is determined to ensure that it is conducted.   Pt. has had a history of the following: Adult onset Asthma, allergic reactions in skin rashes that were significant. Hypothrodism (Graves Disease) which proved to be difficult to find the right meds to bring it under control; prone to incidents of Atrial fibrillation which have escalated as she has aged; she has been treated for emergency visits for Tachycardia; she frequently has developed respiratory issues as a result of the asthma which often landed her  in  the emergency and days in the hospital on oxygen.  She often experienced shortness of breath and chest pain and last year underwent emergency appendicitis.  Her last episode of atrial fibrillation which landed in the hospital was 12/29/16.  She has been on anticoagulants for many years.    Since COVID 19 she may not have been able to afford her Eliquis prescription however which she did not disclose to any of her family members that she was struggling in this wasy.   She is likely not to have been taking her Hypothyrodism (Graves) medication either since these medications have not been recovered since her death."
	"1450231-1"	"1450231-1"	"MOBILITY DECREASED"	"10048334"	"50-59 years"	"50-59"	"Pt. went  to pharmacy on 6/22/21 to receive the second dose of Pfizer-BioNTech vaccine, lot number EW0177.  The day after the vaccine was administered, her lower arm was swollen, red and her elbow felt hot to the touch.  It was too painful to fully extend her arm.  There was a white streak across the reddish purple elbow area where it appeared as though there was an infection growing.  She went  to her normal doctors office, she saw his nurse practitioner who took an x-ray and gave her two intravenous injections of antibiotic (unknown type).  One in each buttock and prescribed an oral antibiotic: Cephalexin 500 mg., and Ibuprofen 800 mg. From that day forward she was unable to move the arm at all and the medication did not bring the swelling or the infection down.  She was very tired and her arm did not lessen in pain as the days passed.    On June 29, 2021 she was in her bedroom and her older daughter was in her room and believed her mother was resting.  At approximately 7:20 p.m., pts. husband returned from work and came into the master bedroom turning on the television.  As he did so he made joke expecting pt. to laugh or comment, when she made no response he looked over at her and saw that she was laying on the love seat at an awkward angle.  He moved to her side and saw her eyes were open but unseeing and saw that her dental prosthetic was partially pushed out of place.  He removed and called EMS immediately, not detecting any obvious signs of life.  Her daughter came into the room and immediately started CPR.  Paramedics arrived in under 2 minutes and moved pt. to the living room where they could intubate a breathing pathway and carried on with attempts to revive her heart muscle for approximately 25 minutes before Paramedic called time of death at 8:02 p.m.   Paramedics departed and the Police arrived staying  until the Mortuary attendants came to the home at about midnight to accept pt. body for transport to its facility.      The Family is seeking an autopsy and the coroner is claiming one is not necessary.  The family believes it is absolutely necessary to ascertain whether or not the second dose caused her death as it seems is likely and whether she should have been advised of her heighten risk level. Regardless of COVID 19 Emergency measures, an autopsy is necessary and the family is determined to ensure that it is conducted.   Pt. has had a history of the following: Adult onset Asthma, allergic reactions in skin rashes that were significant. Hypothrodism (Graves Disease) which proved to be difficult to find the right meds to bring it under control; prone to incidents of Atrial fibrillation which have escalated as she has aged; she has been treated for emergency visits for Tachycardia; she frequently has developed respiratory issues as a result of the asthma which often landed her  in  the emergency and days in the hospital on oxygen.  She often experienced shortness of breath and chest pain and last year underwent emergency appendicitis.  Her last episode of atrial fibrillation which landed in the hospital was 12/29/16.  She has been on anticoagulants for many years.    Since COVID 19 she may not have been able to afford her Eliquis prescription however which she did not disclose to any of her family members that she was struggling in this wasy.   She is likely not to have been taking her Hypothyrodism (Graves) medication either since these medications have not been recovered since her death."
	"1450231-1"	"1450231-1"	"PAIN"	"10033371"	"50-59 years"	"50-59"	"Pt. went  to pharmacy on 6/22/21 to receive the second dose of Pfizer-BioNTech vaccine, lot number EW0177.  The day after the vaccine was administered, her lower arm was swollen, red and her elbow felt hot to the touch.  It was too painful to fully extend her arm.  There was a white streak across the reddish purple elbow area where it appeared as though there was an infection growing.  She went  to her normal doctors office, she saw his nurse practitioner who took an x-ray and gave her two intravenous injections of antibiotic (unknown type).  One in each buttock and prescribed an oral antibiotic: Cephalexin 500 mg., and Ibuprofen 800 mg. From that day forward she was unable to move the arm at all and the medication did not bring the swelling or the infection down.  She was very tired and her arm did not lessen in pain as the days passed.    On June 29, 2021 she was in her bedroom and her older daughter was in her room and believed her mother was resting.  At approximately 7:20 p.m., pts. husband returned from work and came into the master bedroom turning on the television.  As he did so he made joke expecting pt. to laugh or comment, when she made no response he looked over at her and saw that she was laying on the love seat at an awkward angle.  He moved to her side and saw her eyes were open but unseeing and saw that her dental prosthetic was partially pushed out of place.  He removed and called EMS immediately, not detecting any obvious signs of life.  Her daughter came into the room and immediately started CPR.  Paramedics arrived in under 2 minutes and moved pt. to the living room where they could intubate a breathing pathway and carried on with attempts to revive her heart muscle for approximately 25 minutes before Paramedic called time of death at 8:02 p.m.   Paramedics departed and the Police arrived staying  until the Mortuary attendants came to the home at about midnight to accept pt. body for transport to its facility.      The Family is seeking an autopsy and the coroner is claiming one is not necessary.  The family believes it is absolutely necessary to ascertain whether or not the second dose caused her death as it seems is likely and whether she should have been advised of her heighten risk level. Regardless of COVID 19 Emergency measures, an autopsy is necessary and the family is determined to ensure that it is conducted.   Pt. has had a history of the following: Adult onset Asthma, allergic reactions in skin rashes that were significant. Hypothrodism (Graves Disease) which proved to be difficult to find the right meds to bring it under control; prone to incidents of Atrial fibrillation which have escalated as she has aged; she has been treated for emergency visits for Tachycardia; she frequently has developed respiratory issues as a result of the asthma which often landed her  in  the emergency and days in the hospital on oxygen.  She often experienced shortness of breath and chest pain and last year underwent emergency appendicitis.  Her last episode of atrial fibrillation which landed in the hospital was 12/29/16.  She has been on anticoagulants for many years.    Since COVID 19 she may not have been able to afford her Eliquis prescription however which she did not disclose to any of her family members that she was struggling in this wasy.   She is likely not to have been taking her Hypothyrodism (Graves) medication either since these medications have not been recovered since her death."
	"1450231-1"	"1450231-1"	"PAIN IN EXTREMITY"	"10033425"	"50-59 years"	"50-59"	"Pt. went  to pharmacy on 6/22/21 to receive the second dose of Pfizer-BioNTech vaccine, lot number EW0177.  The day after the vaccine was administered, her lower arm was swollen, red and her elbow felt hot to the touch.  It was too painful to fully extend her arm.  There was a white streak across the reddish purple elbow area where it appeared as though there was an infection growing.  She went  to her normal doctors office, she saw his nurse practitioner who took an x-ray and gave her two intravenous injections of antibiotic (unknown type).  One in each buttock and prescribed an oral antibiotic: Cephalexin 500 mg., and Ibuprofen 800 mg. From that day forward she was unable to move the arm at all and the medication did not bring the swelling or the infection down.  She was very tired and her arm did not lessen in pain as the days passed.    On June 29, 2021 she was in her bedroom and her older daughter was in her room and believed her mother was resting.  At approximately 7:20 p.m., pts. husband returned from work and came into the master bedroom turning on the television.  As he did so he made joke expecting pt. to laugh or comment, when she made no response he looked over at her and saw that she was laying on the love seat at an awkward angle.  He moved to her side and saw her eyes were open but unseeing and saw that her dental prosthetic was partially pushed out of place.  He removed and called EMS immediately, not detecting any obvious signs of life.  Her daughter came into the room and immediately started CPR.  Paramedics arrived in under 2 minutes and moved pt. to the living room where they could intubate a breathing pathway and carried on with attempts to revive her heart muscle for approximately 25 minutes before Paramedic called time of death at 8:02 p.m.   Paramedics departed and the Police arrived staying  until the Mortuary attendants came to the home at about midnight to accept pt. body for transport to its facility.      The Family is seeking an autopsy and the coroner is claiming one is not necessary.  The family believes it is absolutely necessary to ascertain whether or not the second dose caused her death as it seems is likely and whether she should have been advised of her heighten risk level. Regardless of COVID 19 Emergency measures, an autopsy is necessary and the family is determined to ensure that it is conducted.   Pt. has had a history of the following: Adult onset Asthma, allergic reactions in skin rashes that were significant. Hypothrodism (Graves Disease) which proved to be difficult to find the right meds to bring it under control; prone to incidents of Atrial fibrillation which have escalated as she has aged; she has been treated for emergency visits for Tachycardia; she frequently has developed respiratory issues as a result of the asthma which often landed her  in  the emergency and days in the hospital on oxygen.  She often experienced shortness of breath and chest pain and last year underwent emergency appendicitis.  Her last episode of atrial fibrillation which landed in the hospital was 12/29/16.  She has been on anticoagulants for many years.    Since COVID 19 she may not have been able to afford her Eliquis prescription however which she did not disclose to any of her family members that she was struggling in this wasy.   She is likely not to have been taking her Hypothyrodism (Graves) medication either since these medications have not been recovered since her death."
	"1450231-1"	"1450231-1"	"PERIPHERAL SWELLING"	"10048959"	"50-59 years"	"50-59"	"Pt. went  to pharmacy on 6/22/21 to receive the second dose of Pfizer-BioNTech vaccine, lot number EW0177.  The day after the vaccine was administered, her lower arm was swollen, red and her elbow felt hot to the touch.  It was too painful to fully extend her arm.  There was a white streak across the reddish purple elbow area where it appeared as though there was an infection growing.  She went  to her normal doctors office, she saw his nurse practitioner who took an x-ray and gave her two intravenous injections of antibiotic (unknown type).  One in each buttock and prescribed an oral antibiotic: Cephalexin 500 mg., and Ibuprofen 800 mg. From that day forward she was unable to move the arm at all and the medication did not bring the swelling or the infection down.  She was very tired and her arm did not lessen in pain as the days passed.    On June 29, 2021 she was in her bedroom and her older daughter was in her room and believed her mother was resting.  At approximately 7:20 p.m., pts. husband returned from work and came into the master bedroom turning on the television.  As he did so he made joke expecting pt. to laugh or comment, when she made no response he looked over at her and saw that she was laying on the love seat at an awkward angle.  He moved to her side and saw her eyes were open but unseeing and saw that her dental prosthetic was partially pushed out of place.  He removed and called EMS immediately, not detecting any obvious signs of life.  Her daughter came into the room and immediately started CPR.  Paramedics arrived in under 2 minutes and moved pt. to the living room where they could intubate a breathing pathway and carried on with attempts to revive her heart muscle for approximately 25 minutes before Paramedic called time of death at 8:02 p.m.   Paramedics departed and the Police arrived staying  until the Mortuary attendants came to the home at about midnight to accept pt. body for transport to its facility.      The Family is seeking an autopsy and the coroner is claiming one is not necessary.  The family believes it is absolutely necessary to ascertain whether or not the second dose caused her death as it seems is likely and whether she should have been advised of her heighten risk level. Regardless of COVID 19 Emergency measures, an autopsy is necessary and the family is determined to ensure that it is conducted.   Pt. has had a history of the following: Adult onset Asthma, allergic reactions in skin rashes that were significant. Hypothrodism (Graves Disease) which proved to be difficult to find the right meds to bring it under control; prone to incidents of Atrial fibrillation which have escalated as she has aged; she has been treated for emergency visits for Tachycardia; she frequently has developed respiratory issues as a result of the asthma which often landed her  in  the emergency and days in the hospital on oxygen.  She often experienced shortness of breath and chest pain and last year underwent emergency appendicitis.  Her last episode of atrial fibrillation which landed in the hospital was 12/29/16.  She has been on anticoagulants for many years.    Since COVID 19 she may not have been able to afford her Eliquis prescription however which she did not disclose to any of her family members that she was struggling in this wasy.   She is likely not to have been taking her Hypothyrodism (Graves) medication either since these medications have not been recovered since her death."
	"1450231-1"	"1450231-1"	"RESUSCITATION"	"10038749"	"50-59 years"	"50-59"	"Pt. went  to pharmacy on 6/22/21 to receive the second dose of Pfizer-BioNTech vaccine, lot number EW0177.  The day after the vaccine was administered, her lower arm was swollen, red and her elbow felt hot to the touch.  It was too painful to fully extend her arm.  There was a white streak across the reddish purple elbow area where it appeared as though there was an infection growing.  She went  to her normal doctors office, she saw his nurse practitioner who took an x-ray and gave her two intravenous injections of antibiotic (unknown type).  One in each buttock and prescribed an oral antibiotic: Cephalexin 500 mg., and Ibuprofen 800 mg. From that day forward she was unable to move the arm at all and the medication did not bring the swelling or the infection down.  She was very tired and her arm did not lessen in pain as the days passed.    On June 29, 2021 she was in her bedroom and her older daughter was in her room and believed her mother was resting.  At approximately 7:20 p.m., pts. husband returned from work and came into the master bedroom turning on the television.  As he did so he made joke expecting pt. to laugh or comment, when she made no response he looked over at her and saw that she was laying on the love seat at an awkward angle.  He moved to her side and saw her eyes were open but unseeing and saw that her dental prosthetic was partially pushed out of place.  He removed and called EMS immediately, not detecting any obvious signs of life.  Her daughter came into the room and immediately started CPR.  Paramedics arrived in under 2 minutes and moved pt. to the living room where they could intubate a breathing pathway and carried on with attempts to revive her heart muscle for approximately 25 minutes before Paramedic called time of death at 8:02 p.m.   Paramedics departed and the Police arrived staying  until the Mortuary attendants came to the home at about midnight to accept pt. body for transport to its facility.      The Family is seeking an autopsy and the coroner is claiming one is not necessary.  The family believes it is absolutely necessary to ascertain whether or not the second dose caused her death as it seems is likely and whether she should have been advised of her heighten risk level. Regardless of COVID 19 Emergency measures, an autopsy is necessary and the family is determined to ensure that it is conducted.   Pt. has had a history of the following: Adult onset Asthma, allergic reactions in skin rashes that were significant. Hypothrodism (Graves Disease) which proved to be difficult to find the right meds to bring it under control; prone to incidents of Atrial fibrillation which have escalated as she has aged; she has been treated for emergency visits for Tachycardia; she frequently has developed respiratory issues as a result of the asthma which often landed her  in  the emergency and days in the hospital on oxygen.  She often experienced shortness of breath and chest pain and last year underwent emergency appendicitis.  Her last episode of atrial fibrillation which landed in the hospital was 12/29/16.  She has been on anticoagulants for many years.    Since COVID 19 she may not have been able to afford her Eliquis prescription however which she did not disclose to any of her family members that she was struggling in this wasy.   She is likely not to have been taking her Hypothyrodism (Graves) medication either since these medications have not been recovered since her death."
	"1450231-1"	"1450231-1"	"SKIN DISCOLOURATION"	"10040829"	"50-59 years"	"50-59"	"Pt. went  to pharmacy on 6/22/21 to receive the second dose of Pfizer-BioNTech vaccine, lot number EW0177.  The day after the vaccine was administered, her lower arm was swollen, red and her elbow felt hot to the touch.  It was too painful to fully extend her arm.  There was a white streak across the reddish purple elbow area where it appeared as though there was an infection growing.  She went  to her normal doctors office, she saw his nurse practitioner who took an x-ray and gave her two intravenous injections of antibiotic (unknown type).  One in each buttock and prescribed an oral antibiotic: Cephalexin 500 mg., and Ibuprofen 800 mg. From that day forward she was unable to move the arm at all and the medication did not bring the swelling or the infection down.  She was very tired and her arm did not lessen in pain as the days passed.    On June 29, 2021 she was in her bedroom and her older daughter was in her room and believed her mother was resting.  At approximately 7:20 p.m., pts. husband returned from work and came into the master bedroom turning on the television.  As he did so he made joke expecting pt. to laugh or comment, when she made no response he looked over at her and saw that she was laying on the love seat at an awkward angle.  He moved to her side and saw her eyes were open but unseeing and saw that her dental prosthetic was partially pushed out of place.  He removed and called EMS immediately, not detecting any obvious signs of life.  Her daughter came into the room and immediately started CPR.  Paramedics arrived in under 2 minutes and moved pt. to the living room where they could intubate a breathing pathway and carried on with attempts to revive her heart muscle for approximately 25 minutes before Paramedic called time of death at 8:02 p.m.   Paramedics departed and the Police arrived staying  until the Mortuary attendants came to the home at about midnight to accept pt. body for transport to its facility.      The Family is seeking an autopsy and the coroner is claiming one is not necessary.  The family believes it is absolutely necessary to ascertain whether or not the second dose caused her death as it seems is likely and whether she should have been advised of her heighten risk level. Regardless of COVID 19 Emergency measures, an autopsy is necessary and the family is determined to ensure that it is conducted.   Pt. has had a history of the following: Adult onset Asthma, allergic reactions in skin rashes that were significant. Hypothrodism (Graves Disease) which proved to be difficult to find the right meds to bring it under control; prone to incidents of Atrial fibrillation which have escalated as she has aged; she has been treated for emergency visits for Tachycardia; she frequently has developed respiratory issues as a result of the asthma which often landed her  in  the emergency and days in the hospital on oxygen.  She often experienced shortness of breath and chest pain and last year underwent emergency appendicitis.  Her last episode of atrial fibrillation which landed in the hospital was 12/29/16.  She has been on anticoagulants for many years.    Since COVID 19 she may not have been able to afford her Eliquis prescription however which she did not disclose to any of her family members that she was struggling in this wasy.   She is likely not to have been taking her Hypothyrodism (Graves) medication either since these medications have not been recovered since her death."
	"1450231-1"	"1450231-1"	"SKIN WARM"	"10040952"	"50-59 years"	"50-59"	"Pt. went  to pharmacy on 6/22/21 to receive the second dose of Pfizer-BioNTech vaccine, lot number EW0177.  The day after the vaccine was administered, her lower arm was swollen, red and her elbow felt hot to the touch.  It was too painful to fully extend her arm.  There was a white streak across the reddish purple elbow area where it appeared as though there was an infection growing.  She went  to her normal doctors office, she saw his nurse practitioner who took an x-ray and gave her two intravenous injections of antibiotic (unknown type).  One in each buttock and prescribed an oral antibiotic: Cephalexin 500 mg., and Ibuprofen 800 mg. From that day forward she was unable to move the arm at all and the medication did not bring the swelling or the infection down.  She was very tired and her arm did not lessen in pain as the days passed.    On June 29, 2021 she was in her bedroom and her older daughter was in her room and believed her mother was resting.  At approximately 7:20 p.m., pts. husband returned from work and came into the master bedroom turning on the television.  As he did so he made joke expecting pt. to laugh or comment, when she made no response he looked over at her and saw that she was laying on the love seat at an awkward angle.  He moved to her side and saw her eyes were open but unseeing and saw that her dental prosthetic was partially pushed out of place.  He removed and called EMS immediately, not detecting any obvious signs of life.  Her daughter came into the room and immediately started CPR.  Paramedics arrived in under 2 minutes and moved pt. to the living room where they could intubate a breathing pathway and carried on with attempts to revive her heart muscle for approximately 25 minutes before Paramedic called time of death at 8:02 p.m.   Paramedics departed and the Police arrived staying  until the Mortuary attendants came to the home at about midnight to accept pt. body for transport to its facility.      The Family is seeking an autopsy and the coroner is claiming one is not necessary.  The family believes it is absolutely necessary to ascertain whether or not the second dose caused her death as it seems is likely and whether she should have been advised of her heighten risk level. Regardless of COVID 19 Emergency measures, an autopsy is necessary and the family is determined to ensure that it is conducted.   Pt. has had a history of the following: Adult onset Asthma, allergic reactions in skin rashes that were significant. Hypothrodism (Graves Disease) which proved to be difficult to find the right meds to bring it under control; prone to incidents of Atrial fibrillation which have escalated as she has aged; she has been treated for emergency visits for Tachycardia; she frequently has developed respiratory issues as a result of the asthma which often landed her  in  the emergency and days in the hospital on oxygen.  She often experienced shortness of breath and chest pain and last year underwent emergency appendicitis.  Her last episode of atrial fibrillation which landed in the hospital was 12/29/16.  She has been on anticoagulants for many years.    Since COVID 19 she may not have been able to afford her Eliquis prescription however which she did not disclose to any of her family members that she was struggling in this wasy.   She is likely not to have been taking her Hypothyrodism (Graves) medication either since these medications have not been recovered since her death."
	"1450231-1"	"1450231-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"50-59 years"	"50-59"	"Pt. went  to pharmacy on 6/22/21 to receive the second dose of Pfizer-BioNTech vaccine, lot number EW0177.  The day after the vaccine was administered, her lower arm was swollen, red and her elbow felt hot to the touch.  It was too painful to fully extend her arm.  There was a white streak across the reddish purple elbow area where it appeared as though there was an infection growing.  She went  to her normal doctors office, she saw his nurse practitioner who took an x-ray and gave her two intravenous injections of antibiotic (unknown type).  One in each buttock and prescribed an oral antibiotic: Cephalexin 500 mg., and Ibuprofen 800 mg. From that day forward she was unable to move the arm at all and the medication did not bring the swelling or the infection down.  She was very tired and her arm did not lessen in pain as the days passed.    On June 29, 2021 she was in her bedroom and her older daughter was in her room and believed her mother was resting.  At approximately 7:20 p.m., pts. husband returned from work and came into the master bedroom turning on the television.  As he did so he made joke expecting pt. to laugh or comment, when she made no response he looked over at her and saw that she was laying on the love seat at an awkward angle.  He moved to her side and saw her eyes were open but unseeing and saw that her dental prosthetic was partially pushed out of place.  He removed and called EMS immediately, not detecting any obvious signs of life.  Her daughter came into the room and immediately started CPR.  Paramedics arrived in under 2 minutes and moved pt. to the living room where they could intubate a breathing pathway and carried on with attempts to revive her heart muscle for approximately 25 minutes before Paramedic called time of death at 8:02 p.m.   Paramedics departed and the Police arrived staying  until the Mortuary attendants came to the home at about midnight to accept pt. body for transport to its facility.      The Family is seeking an autopsy and the coroner is claiming one is not necessary.  The family believes it is absolutely necessary to ascertain whether or not the second dose caused her death as it seems is likely and whether she should have been advised of her heighten risk level. Regardless of COVID 19 Emergency measures, an autopsy is necessary and the family is determined to ensure that it is conducted.   Pt. has had a history of the following: Adult onset Asthma, allergic reactions in skin rashes that were significant. Hypothrodism (Graves Disease) which proved to be difficult to find the right meds to bring it under control; prone to incidents of Atrial fibrillation which have escalated as she has aged; she has been treated for emergency visits for Tachycardia; she frequently has developed respiratory issues as a result of the asthma which often landed her  in  the emergency and days in the hospital on oxygen.  She often experienced shortness of breath and chest pain and last year underwent emergency appendicitis.  Her last episode of atrial fibrillation which landed in the hospital was 12/29/16.  She has been on anticoagulants for many years.    Since COVID 19 she may not have been able to afford her Eliquis prescription however which she did not disclose to any of her family members that she was struggling in this wasy.   She is likely not to have been taking her Hypothyrodism (Graves) medication either since these medications have not been recovered since her death."
	"1450231-1"	"1450231-1"	"X-RAY"	"10048064"	"50-59 years"	"50-59"	"Pt. went  to pharmacy on 6/22/21 to receive the second dose of Pfizer-BioNTech vaccine, lot number EW0177.  The day after the vaccine was administered, her lower arm was swollen, red and her elbow felt hot to the touch.  It was too painful to fully extend her arm.  There was a white streak across the reddish purple elbow area where it appeared as though there was an infection growing.  She went  to her normal doctors office, she saw his nurse practitioner who took an x-ray and gave her two intravenous injections of antibiotic (unknown type).  One in each buttock and prescribed an oral antibiotic: Cephalexin 500 mg., and Ibuprofen 800 mg. From that day forward she was unable to move the arm at all and the medication did not bring the swelling or the infection down.  She was very tired and her arm did not lessen in pain as the days passed.    On June 29, 2021 she was in her bedroom and her older daughter was in her room and believed her mother was resting.  At approximately 7:20 p.m., pts. husband returned from work and came into the master bedroom turning on the television.  As he did so he made joke expecting pt. to laugh or comment, when she made no response he looked over at her and saw that she was laying on the love seat at an awkward angle.  He moved to her side and saw her eyes were open but unseeing and saw that her dental prosthetic was partially pushed out of place.  He removed and called EMS immediately, not detecting any obvious signs of life.  Her daughter came into the room and immediately started CPR.  Paramedics arrived in under 2 minutes and moved pt. to the living room where they could intubate a breathing pathway and carried on with attempts to revive her heart muscle for approximately 25 minutes before Paramedic called time of death at 8:02 p.m.   Paramedics departed and the Police arrived staying  until the Mortuary attendants came to the home at about midnight to accept pt. body for transport to its facility.      The Family is seeking an autopsy and the coroner is claiming one is not necessary.  The family believes it is absolutely necessary to ascertain whether or not the second dose caused her death as it seems is likely and whether she should have been advised of her heighten risk level. Regardless of COVID 19 Emergency measures, an autopsy is necessary and the family is determined to ensure that it is conducted.   Pt. has had a history of the following: Adult onset Asthma, allergic reactions in skin rashes that were significant. Hypothrodism (Graves Disease) which proved to be difficult to find the right meds to bring it under control; prone to incidents of Atrial fibrillation which have escalated as she has aged; she has been treated for emergency visits for Tachycardia; she frequently has developed respiratory issues as a result of the asthma which often landed her  in  the emergency and days in the hospital on oxygen.  She often experienced shortness of breath and chest pain and last year underwent emergency appendicitis.  Her last episode of atrial fibrillation which landed in the hospital was 12/29/16.  She has been on anticoagulants for many years.    Since COVID 19 she may not have been able to afford her Eliquis prescription however which she did not disclose to any of her family members that she was struggling in this wasy.   She is likely not to have been taking her Hypothyrodism (Graves) medication either since these medications have not been recovered since her death."
	"1450706-1"	"1450706-1"	"SUDDEN DEATH"	"10042434"	"50-59 years"	"50-59"	"Sudden death"
	"1454630-1"	"1454630-1"	"AUTOPSY"	"10050117"	"50-59 years"	"50-59"	"Sudden death 5 days after second vaccination."
	"1454630-1"	"1454630-1"	"SUDDEN DEATH"	"10042434"	"50-59 years"	"50-59"	"Sudden death 5 days after second vaccination."
	"1457452-1"	"1457452-1"	"COMPLETED SUICIDE"	"10010144"	"50-59 years"	"50-59"	"Completed suicide on 04/29/2021. Family reported an increase in suicidal ideations after the vaccination."
	"1457452-1"	"1457452-1"	"SUICIDAL IDEATION"	"10042458"	"50-59 years"	"50-59"	"Completed suicide on 04/29/2021. Family reported an increase in suicidal ideations after the vaccination."
	"1457622-1"	"1457622-1"	"CHEST X-RAY"	"10008498"	"50-59 years"	"50-59"	"Vaccine received 4/28/30. During 4/30/21 resident overall status changed to altered mental status, which included unresponsive and inability to take in food or drink. Breathing became shallow. Skin pale. Lungs congested w/Chest xray ordered. Moved to Covid PUI unit. Hospice notified w/comfort care initiated and preparations made for end of life w/family notification. COVID testing negative. Bedside observations continued w/NP noting possibility of adverse effect to vaccine r/t multiple sclerosis dx. Hx of others w/multiple sclerosis observed by NP included returning to baseline within 24-48 hours. IV gently hydration initiated during time of little to no response. Within 12 hours, resident was observed to exhibit returning to her baseline status which included responsiveness, ability to drink, swallow, eat, interact w/communication. She returned to baseline, was seen by MD and cleared to return to her previous living area. After several weeks of baseline, she did decline gradually overall with end of life under hospice care with exacerbation of multiple sclerosis symptoms and expired at facility."
	"1457622-1"	"1457622-1"	"CONDITION AGGRAVATED"	"10010264"	"50-59 years"	"50-59"	"Vaccine received 4/28/30. During 4/30/21 resident overall status changed to altered mental status, which included unresponsive and inability to take in food or drink. Breathing became shallow. Skin pale. Lungs congested w/Chest xray ordered. Moved to Covid PUI unit. Hospice notified w/comfort care initiated and preparations made for end of life w/family notification. COVID testing negative. Bedside observations continued w/NP noting possibility of adverse effect to vaccine r/t multiple sclerosis dx. Hx of others w/multiple sclerosis observed by NP included returning to baseline within 24-48 hours. IV gently hydration initiated during time of little to no response. Within 12 hours, resident was observed to exhibit returning to her baseline status which included responsiveness, ability to drink, swallow, eat, interact w/communication. She returned to baseline, was seen by MD and cleared to return to her previous living area. After several weeks of baseline, she did decline gradually overall with end of life under hospice care with exacerbation of multiple sclerosis symptoms and expired at facility."
	"1457622-1"	"1457622-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Vaccine received 4/28/30. During 4/30/21 resident overall status changed to altered mental status, which included unresponsive and inability to take in food or drink. Breathing became shallow. Skin pale. Lungs congested w/Chest xray ordered. Moved to Covid PUI unit. Hospice notified w/comfort care initiated and preparations made for end of life w/family notification. COVID testing negative. Bedside observations continued w/NP noting possibility of adverse effect to vaccine r/t multiple sclerosis dx. Hx of others w/multiple sclerosis observed by NP included returning to baseline within 24-48 hours. IV gently hydration initiated during time of little to no response. Within 12 hours, resident was observed to exhibit returning to her baseline status which included responsiveness, ability to drink, swallow, eat, interact w/communication. She returned to baseline, was seen by MD and cleared to return to her previous living area. After several weeks of baseline, she did decline gradually overall with end of life under hospice care with exacerbation of multiple sclerosis symptoms and expired at facility."
	"1457622-1"	"1457622-1"	"DYSPHAGIA"	"10013950"	"50-59 years"	"50-59"	"Vaccine received 4/28/30. During 4/30/21 resident overall status changed to altered mental status, which included unresponsive and inability to take in food or drink. Breathing became shallow. Skin pale. Lungs congested w/Chest xray ordered. Moved to Covid PUI unit. Hospice notified w/comfort care initiated and preparations made for end of life w/family notification. COVID testing negative. Bedside observations continued w/NP noting possibility of adverse effect to vaccine r/t multiple sclerosis dx. Hx of others w/multiple sclerosis observed by NP included returning to baseline within 24-48 hours. IV gently hydration initiated during time of little to no response. Within 12 hours, resident was observed to exhibit returning to her baseline status which included responsiveness, ability to drink, swallow, eat, interact w/communication. She returned to baseline, was seen by MD and cleared to return to her previous living area. After several weeks of baseline, she did decline gradually overall with end of life under hospice care with exacerbation of multiple sclerosis symptoms and expired at facility."
	"1457622-1"	"1457622-1"	"FEEDING DISORDER"	"10061148"	"50-59 years"	"50-59"	"Vaccine received 4/28/30. During 4/30/21 resident overall status changed to altered mental status, which included unresponsive and inability to take in food or drink. Breathing became shallow. Skin pale. Lungs congested w/Chest xray ordered. Moved to Covid PUI unit. Hospice notified w/comfort care initiated and preparations made for end of life w/family notification. COVID testing negative. Bedside observations continued w/NP noting possibility of adverse effect to vaccine r/t multiple sclerosis dx. Hx of others w/multiple sclerosis observed by NP included returning to baseline within 24-48 hours. IV gently hydration initiated during time of little to no response. Within 12 hours, resident was observed to exhibit returning to her baseline status which included responsiveness, ability to drink, swallow, eat, interact w/communication. She returned to baseline, was seen by MD and cleared to return to her previous living area. After several weeks of baseline, she did decline gradually overall with end of life under hospice care with exacerbation of multiple sclerosis symptoms and expired at facility."
	"1457622-1"	"1457622-1"	"HYPOPNOEA"	"10021079"	"50-59 years"	"50-59"	"Vaccine received 4/28/30. During 4/30/21 resident overall status changed to altered mental status, which included unresponsive and inability to take in food or drink. Breathing became shallow. Skin pale. Lungs congested w/Chest xray ordered. Moved to Covid PUI unit. Hospice notified w/comfort care initiated and preparations made for end of life w/family notification. COVID testing negative. Bedside observations continued w/NP noting possibility of adverse effect to vaccine r/t multiple sclerosis dx. Hx of others w/multiple sclerosis observed by NP included returning to baseline within 24-48 hours. IV gently hydration initiated during time of little to no response. Within 12 hours, resident was observed to exhibit returning to her baseline status which included responsiveness, ability to drink, swallow, eat, interact w/communication. She returned to baseline, was seen by MD and cleared to return to her previous living area. After several weeks of baseline, she did decline gradually overall with end of life under hospice care with exacerbation of multiple sclerosis symptoms and expired at facility."
	"1457622-1"	"1457622-1"	"MENTAL STATUS CHANGES"	"10048294"	"50-59 years"	"50-59"	"Vaccine received 4/28/30. During 4/30/21 resident overall status changed to altered mental status, which included unresponsive and inability to take in food or drink. Breathing became shallow. Skin pale. Lungs congested w/Chest xray ordered. Moved to Covid PUI unit. Hospice notified w/comfort care initiated and preparations made for end of life w/family notification. COVID testing negative. Bedside observations continued w/NP noting possibility of adverse effect to vaccine r/t multiple sclerosis dx. Hx of others w/multiple sclerosis observed by NP included returning to baseline within 24-48 hours. IV gently hydration initiated during time of little to no response. Within 12 hours, resident was observed to exhibit returning to her baseline status which included responsiveness, ability to drink, swallow, eat, interact w/communication. She returned to baseline, was seen by MD and cleared to return to her previous living area. After several weeks of baseline, she did decline gradually overall with end of life under hospice care with exacerbation of multiple sclerosis symptoms and expired at facility."
	"1457622-1"	"1457622-1"	"MULTIPLE SCLEROSIS"	"10028245"	"50-59 years"	"50-59"	"Vaccine received 4/28/30. During 4/30/21 resident overall status changed to altered mental status, which included unresponsive and inability to take in food or drink. Breathing became shallow. Skin pale. Lungs congested w/Chest xray ordered. Moved to Covid PUI unit. Hospice notified w/comfort care initiated and preparations made for end of life w/family notification. COVID testing negative. Bedside observations continued w/NP noting possibility of adverse effect to vaccine r/t multiple sclerosis dx. Hx of others w/multiple sclerosis observed by NP included returning to baseline within 24-48 hours. IV gently hydration initiated during time of little to no response. Within 12 hours, resident was observed to exhibit returning to her baseline status which included responsiveness, ability to drink, swallow, eat, interact w/communication. She returned to baseline, was seen by MD and cleared to return to her previous living area. After several weeks of baseline, she did decline gradually overall with end of life under hospice care with exacerbation of multiple sclerosis symptoms and expired at facility."
	"1457622-1"	"1457622-1"	"PALLOR"	"10033546"	"50-59 years"	"50-59"	"Vaccine received 4/28/30. During 4/30/21 resident overall status changed to altered mental status, which included unresponsive and inability to take in food or drink. Breathing became shallow. Skin pale. Lungs congested w/Chest xray ordered. Moved to Covid PUI unit. Hospice notified w/comfort care initiated and preparations made for end of life w/family notification. COVID testing negative. Bedside observations continued w/NP noting possibility of adverse effect to vaccine r/t multiple sclerosis dx. Hx of others w/multiple sclerosis observed by NP included returning to baseline within 24-48 hours. IV gently hydration initiated during time of little to no response. Within 12 hours, resident was observed to exhibit returning to her baseline status which included responsiveness, ability to drink, swallow, eat, interact w/communication. She returned to baseline, was seen by MD and cleared to return to her previous living area. After several weeks of baseline, she did decline gradually overall with end of life under hospice care with exacerbation of multiple sclerosis symptoms and expired at facility."
	"1457622-1"	"1457622-1"	"PULMONARY CONGESTION"	"10037368"	"50-59 years"	"50-59"	"Vaccine received 4/28/30. During 4/30/21 resident overall status changed to altered mental status, which included unresponsive and inability to take in food or drink. Breathing became shallow. Skin pale. Lungs congested w/Chest xray ordered. Moved to Covid PUI unit. Hospice notified w/comfort care initiated and preparations made for end of life w/family notification. COVID testing negative. Bedside observations continued w/NP noting possibility of adverse effect to vaccine r/t multiple sclerosis dx. Hx of others w/multiple sclerosis observed by NP included returning to baseline within 24-48 hours. IV gently hydration initiated during time of little to no response. Within 12 hours, resident was observed to exhibit returning to her baseline status which included responsiveness, ability to drink, swallow, eat, interact w/communication. She returned to baseline, was seen by MD and cleared to return to her previous living area. After several weeks of baseline, she did decline gradually overall with end of life under hospice care with exacerbation of multiple sclerosis symptoms and expired at facility."
	"1457622-1"	"1457622-1"	"SARS-COV-2 TEST NEGATIVE"	"10084273"	"50-59 years"	"50-59"	"Vaccine received 4/28/30. During 4/30/21 resident overall status changed to altered mental status, which included unresponsive and inability to take in food or drink. Breathing became shallow. Skin pale. Lungs congested w/Chest xray ordered. Moved to Covid PUI unit. Hospice notified w/comfort care initiated and preparations made for end of life w/family notification. COVID testing negative. Bedside observations continued w/NP noting possibility of adverse effect to vaccine r/t multiple sclerosis dx. Hx of others w/multiple sclerosis observed by NP included returning to baseline within 24-48 hours. IV gently hydration initiated during time of little to no response. Within 12 hours, resident was observed to exhibit returning to her baseline status which included responsiveness, ability to drink, swallow, eat, interact w/communication. She returned to baseline, was seen by MD and cleared to return to her previous living area. After several weeks of baseline, she did decline gradually overall with end of life under hospice care with exacerbation of multiple sclerosis symptoms and expired at facility."
	"1457622-1"	"1457622-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"50-59 years"	"50-59"	"Vaccine received 4/28/30. During 4/30/21 resident overall status changed to altered mental status, which included unresponsive and inability to take in food or drink. Breathing became shallow. Skin pale. Lungs congested w/Chest xray ordered. Moved to Covid PUI unit. Hospice notified w/comfort care initiated and preparations made for end of life w/family notification. COVID testing negative. Bedside observations continued w/NP noting possibility of adverse effect to vaccine r/t multiple sclerosis dx. Hx of others w/multiple sclerosis observed by NP included returning to baseline within 24-48 hours. IV gently hydration initiated during time of little to no response. Within 12 hours, resident was observed to exhibit returning to her baseline status which included responsiveness, ability to drink, swallow, eat, interact w/communication. She returned to baseline, was seen by MD and cleared to return to her previous living area. After several weeks of baseline, she did decline gradually overall with end of life under hospice care with exacerbation of multiple sclerosis symptoms and expired at facility."
	"1458145-1"	"1458145-1"	"CARDIAC VALVE RUPTURE"	"10068165"	"50-59 years"	"50-59"	"Fever, coughing, body ache, head ache, congestion, chest pain, death"
	"1458145-1"	"1458145-1"	"CHEST PAIN"	"10008479"	"50-59 years"	"50-59"	"Fever, coughing, body ache, head ache, congestion, chest pain, death"
	"1458145-1"	"1458145-1"	"COUGH"	"10011224"	"50-59 years"	"50-59"	"Fever, coughing, body ache, head ache, congestion, chest pain, death"
	"1458145-1"	"1458145-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Fever, coughing, body ache, head ache, congestion, chest pain, death"
	"1458145-1"	"1458145-1"	"HEADACHE"	"10019211"	"50-59 years"	"50-59"	"Fever, coughing, body ache, head ache, congestion, chest pain, death"
	"1458145-1"	"1458145-1"	"PAIN"	"10033371"	"50-59 years"	"50-59"	"Fever, coughing, body ache, head ache, congestion, chest pain, death"
	"1458145-1"	"1458145-1"	"PYREXIA"	"10037660"	"50-59 years"	"50-59"	"Fever, coughing, body ache, head ache, congestion, chest pain, death"
	"1458145-1"	"1458145-1"	"RESPIRATORY TRACT CONGESTION"	"10052251"	"50-59 years"	"50-59"	"Fever, coughing, body ache, head ache, congestion, chest pain, death"
	"1459756-1"	"1459756-1"	"AUTOPSY"	"10050117"	"50-59 years"	"50-59"	"Pericarditis, large vessel vasculitis, death"
	"1459756-1"	"1459756-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Pericarditis, large vessel vasculitis, death"
	"1459756-1"	"1459756-1"	"HISTOLOGY"	"10062005"	"50-59 years"	"50-59"	"Pericarditis, large vessel vasculitis, death"
	"1459756-1"	"1459756-1"	"PERICARDITIS"	"10034484"	"50-59 years"	"50-59"	"Pericarditis, large vessel vasculitis, death"
	"1459756-1"	"1459756-1"	"VASCULITIS"	"10047115"	"50-59 years"	"50-59"	"Pericarditis, large vessel vasculitis, death"
	"1459791-1"	"1459791-1"	"ERYTHEMA"	"10015150"	"50-59 years"	"50-59"	"A few days after taken the vaccine are became swollen with a big knot under it and turning red"
	"1459791-1"	"1459791-1"	"NODULE"	"10054107"	"50-59 years"	"50-59"	"A few days after taken the vaccine are became swollen with a big knot under it and turning red"
	"1459791-1"	"1459791-1"	"PERIPHERAL SWELLING"	"10048959"	"50-59 years"	"50-59"	"A few days after taken the vaccine are became swollen with a big knot under it and turning red"
	"1459796-1"	"1459796-1"	"CARDIAC DISORDER"	"10061024"	"50-59 years"	"50-59"	"three days before the patent died he started having sloop apnea and for several days before the event he started having memory problems and the day before the event he started having a issue with his heart where he just said his heart felt irregular."
	"1459796-1"	"1459796-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"three days before the patent died he started having sloop apnea and for several days before the event he started having memory problems and the day before the event he started having a issue with his heart where he just said his heart felt irregular."
	"1459796-1"	"1459796-1"	"HEART RATE IRREGULAR"	"10019304"	"50-59 years"	"50-59"	"three days before the patent died he started having sloop apnea and for several days before the event he started having memory problems and the day before the event he started having a issue with his heart where he just said his heart felt irregular."
	"1459796-1"	"1459796-1"	"MEMORY IMPAIRMENT"	"10027175"	"50-59 years"	"50-59"	"three days before the patent died he started having sloop apnea and for several days before the event he started having memory problems and the day before the event he started having a issue with his heart where he just said his heart felt irregular."
	"1459796-1"	"1459796-1"	"SLEEP APNOEA SYNDROME"	"10040979"	"50-59 years"	"50-59"	"three days before the patent died he started having sloop apnea and for several days before the event he started having memory problems and the day before the event he started having a issue with his heart where he just said his heart felt irregular."
	"1460241-1"	"1460241-1"	"ARTERIOSCLEROSIS"	"10003210"	"50-59 years"	"50-59"	"Sudden death 17 hours after vaccine shot.  Ambulance to Hospital.  Unable to resuscitate."
	"1460241-1"	"1460241-1"	"AUTOPSY"	"10050117"	"50-59 years"	"50-59"	"Sudden death 17 hours after vaccine shot.  Ambulance to Hospital.  Unable to resuscitate."
	"1460241-1"	"1460241-1"	"RESUSCITATION"	"10038749"	"50-59 years"	"50-59"	"Sudden death 17 hours after vaccine shot.  Ambulance to Hospital.  Unable to resuscitate."
	"1460241-1"	"1460241-1"	"SUDDEN DEATH"	"10042434"	"50-59 years"	"50-59"	"Sudden death 17 hours after vaccine shot.  Ambulance to Hospital.  Unable to resuscitate."
	"1463406-1"	"1463406-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Death. My mother died 4 days after receiving the first round of Moderna vaccine."
	"1464404-1"	"1464404-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"She had a brain aneurysm. We question if this was related to the covid 19  vaccine"
	"1464404-1"	"1464404-1"	"INTRACRANIAL ANEURYSM"	"10022758"	"50-59 years"	"50-59"	"She had a brain aneurysm. We question if this was related to the covid 19  vaccine"
	"1464551-1"	"1464551-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Discovered dead in residence three days after vaccination.  Last seen alive on day of vaccination"
	"1464745-1"	"1464745-1"	"CENTRAL NERVOUS SYSTEM INFLAMMATION"	"10051288"	"50-59 years"	"50-59"	"Reporter stated that patient got real ill and new symptoms arrived everyday from the day she reviewed the vaccine.. loose stool, fatigue nausea and pain in her spine and headaches. . A few  days after the vaccine patient went to the hospital and tested positive for COVID. Patient went to the Hospital on June3rd around 5pm. Test was perform and said she was filled with inflammation of the spine. Patient was release from hospital on June 4th with pain killers and steroids. Patient was pronounced dead on June 6th."
	"1464745-1"	"1464745-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Reporter stated that patient got real ill and new symptoms arrived everyday from the day she reviewed the vaccine.. loose stool, fatigue nausea and pain in her spine and headaches. . A few  days after the vaccine patient went to the hospital and tested positive for COVID. Patient went to the Hospital on June3rd around 5pm. Test was perform and said she was filled with inflammation of the spine. Patient was release from hospital on June 4th with pain killers and steroids. Patient was pronounced dead on June 6th."
	"1464745-1"	"1464745-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Reporter stated that patient got real ill and new symptoms arrived everyday from the day she reviewed the vaccine.. loose stool, fatigue nausea and pain in her spine and headaches. . A few  days after the vaccine patient went to the hospital and tested positive for COVID. Patient went to the Hospital on June3rd around 5pm. Test was perform and said she was filled with inflammation of the spine. Patient was release from hospital on June 4th with pain killers and steroids. Patient was pronounced dead on June 6th."
	"1464745-1"	"1464745-1"	"DIARRHOEA"	"10012735"	"50-59 years"	"50-59"	"Reporter stated that patient got real ill and new symptoms arrived everyday from the day she reviewed the vaccine.. loose stool, fatigue nausea and pain in her spine and headaches. . A few  days after the vaccine patient went to the hospital and tested positive for COVID. Patient went to the Hospital on June3rd around 5pm. Test was perform and said she was filled with inflammation of the spine. Patient was release from hospital on June 4th with pain killers and steroids. Patient was pronounced dead on June 6th."
	"1464745-1"	"1464745-1"	"FATIGUE"	"10016256"	"50-59 years"	"50-59"	"Reporter stated that patient got real ill and new symptoms arrived everyday from the day she reviewed the vaccine.. loose stool, fatigue nausea and pain in her spine and headaches. . A few  days after the vaccine patient went to the hospital and tested positive for COVID. Patient went to the Hospital on June3rd around 5pm. Test was perform and said she was filled with inflammation of the spine. Patient was release from hospital on June 4th with pain killers and steroids. Patient was pronounced dead on June 6th."
	"1464745-1"	"1464745-1"	"HEADACHE"	"10019211"	"50-59 years"	"50-59"	"Reporter stated that patient got real ill and new symptoms arrived everyday from the day she reviewed the vaccine.. loose stool, fatigue nausea and pain in her spine and headaches. . A few  days after the vaccine patient went to the hospital and tested positive for COVID. Patient went to the Hospital on June3rd around 5pm. Test was perform and said she was filled with inflammation of the spine. Patient was release from hospital on June 4th with pain killers and steroids. Patient was pronounced dead on June 6th."
	"1464745-1"	"1464745-1"	"MALAISE"	"10025482"	"50-59 years"	"50-59"	"Reporter stated that patient got real ill and new symptoms arrived everyday from the day she reviewed the vaccine.. loose stool, fatigue nausea and pain in her spine and headaches. . A few  days after the vaccine patient went to the hospital and tested positive for COVID. Patient went to the Hospital on June3rd around 5pm. Test was perform and said she was filled with inflammation of the spine. Patient was release from hospital on June 4th with pain killers and steroids. Patient was pronounced dead on June 6th."
	"1464745-1"	"1464745-1"	"NAUSEA"	"10028813"	"50-59 years"	"50-59"	"Reporter stated that patient got real ill and new symptoms arrived everyday from the day she reviewed the vaccine.. loose stool, fatigue nausea and pain in her spine and headaches. . A few  days after the vaccine patient went to the hospital and tested positive for COVID. Patient went to the Hospital on June3rd around 5pm. Test was perform and said she was filled with inflammation of the spine. Patient was release from hospital on June 4th with pain killers and steroids. Patient was pronounced dead on June 6th."
	"1464745-1"	"1464745-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"Reporter stated that patient got real ill and new symptoms arrived everyday from the day she reviewed the vaccine.. loose stool, fatigue nausea and pain in her spine and headaches. . A few  days after the vaccine patient went to the hospital and tested positive for COVID. Patient went to the Hospital on June3rd around 5pm. Test was perform and said she was filled with inflammation of the spine. Patient was release from hospital on June 4th with pain killers and steroids. Patient was pronounced dead on June 6th."
	"1464745-1"	"1464745-1"	"SPINAL PAIN"	"10072005"	"50-59 years"	"50-59"	"Reporter stated that patient got real ill and new symptoms arrived everyday from the day she reviewed the vaccine.. loose stool, fatigue nausea and pain in her spine and headaches. . A few  days after the vaccine patient went to the hospital and tested positive for COVID. Patient went to the Hospital on June3rd around 5pm. Test was perform and said she was filled with inflammation of the spine. Patient was release from hospital on June 4th with pain killers and steroids. Patient was pronounced dead on June 6th."
	"1466254-1"	"1466254-1"	"ILLNESS"	"10080284"	"50-59 years"	"50-59"	"Patient receive vaccine, was very sick the first 3 days after getting it started to feel better for two more days and then died suddenly around 3 p.m."
	"1466254-1"	"1466254-1"	"SUDDEN DEATH"	"10042434"	"50-59 years"	"50-59"	"Patient receive vaccine, was very sick the first 3 days after getting it started to feel better for two more days and then died suddenly around 3 p.m."
	"1466883-1"	"1466883-1"	"CHILLS"	"10008531"	"50-59 years"	"50-59"	""""Chills and aches"" the day and evening of the shot.  After a couple of weeks, Pt began to experience various pains at different points of his body.  He developed severe indigestion resulting in him visiting his physician on April 19th where he was put on a 7-day steroid regimen.  One week later, early on Monday morning, April 26, 2021, Pt collapsed in his bathroom at home, was unresponsive, and pronounced dead by the paramedics who responded.""
	"1466883-1"	"1466883-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	""""Chills and aches"" the day and evening of the shot.  After a couple of weeks, Pt began to experience various pains at different points of his body.  He developed severe indigestion resulting in him visiting his physician on April 19th where he was put on a 7-day steroid regimen.  One week later, early on Monday morning, April 26, 2021, Pt collapsed in his bathroom at home, was unresponsive, and pronounced dead by the paramedics who responded.""
	"1466883-1"	"1466883-1"	"DYSPEPSIA"	"10013946"	"50-59 years"	"50-59"	""""Chills and aches"" the day and evening of the shot.  After a couple of weeks, Pt began to experience various pains at different points of his body.  He developed severe indigestion resulting in him visiting his physician on April 19th where he was put on a 7-day steroid regimen.  One week later, early on Monday morning, April 26, 2021, Pt collapsed in his bathroom at home, was unresponsive, and pronounced dead by the paramedics who responded.""
	"1466883-1"	"1466883-1"	"PAIN"	"10033371"	"50-59 years"	"50-59"	""""Chills and aches"" the day and evening of the shot.  After a couple of weeks, Pt began to experience various pains at different points of his body.  He developed severe indigestion resulting in him visiting his physician on April 19th where he was put on a 7-day steroid regimen.  One week later, early on Monday morning, April 26, 2021, Pt collapsed in his bathroom at home, was unresponsive, and pronounced dead by the paramedics who responded.""
	"1466883-1"	"1466883-1"	"SYNCOPE"	"10042772"	"50-59 years"	"50-59"	""""Chills and aches"" the day and evening of the shot.  After a couple of weeks, Pt began to experience various pains at different points of his body.  He developed severe indigestion resulting in him visiting his physician on April 19th where he was put on a 7-day steroid regimen.  One week later, early on Monday morning, April 26, 2021, Pt collapsed in his bathroom at home, was unresponsive, and pronounced dead by the paramedics who responded.""
	"1466883-1"	"1466883-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"50-59 years"	"50-59"	""""Chills and aches"" the day and evening of the shot.  After a couple of weeks, Pt began to experience various pains at different points of his body.  He developed severe indigestion resulting in him visiting his physician on April 19th where he was put on a 7-day steroid regimen.  One week later, early on Monday morning, April 26, 2021, Pt collapsed in his bathroom at home, was unresponsive, and pronounced dead by the paramedics who responded.""
	"1470120-1"	"1470120-1"	"AUTOPSY"	"10050117"	"50-59 years"	"50-59"	""Patient had 1st dose of Moderna COVID-19 vaccine on 5/10/2021.  Several days after he complained of ""not feeling well"" and fatigue, but did not give more specific symptomatology.  On 5/17/2021 he had a sudden collapse at home and was transported to local hospital, where he was pronounced dead.  Case accepted as medical examiner jurisdiction due to no apparent medical history and sudden death after vaccine administration.  Full autopsy completed on 5/19/21 revealed obstructive pulmonary thromboemboli as cause of death, with lower extremity DVT.  Both portions of the pulmonary thromboembolus and the DVT show organization, thus raising question of whether this process started before or after the vaccination.   No known history of thrombophilic disorder, recent injury, or prolonged stasis/immobility.  Not known to be current smoker.  See below for additional autopsy information.""
	"1470120-1"	"1470120-1"	"CARDIAC HYPERTROPHY"	"10007572"	"50-59 years"	"50-59"	""Patient had 1st dose of Moderna COVID-19 vaccine on 5/10/2021.  Several days after he complained of ""not feeling well"" and fatigue, but did not give more specific symptomatology.  On 5/17/2021 he had a sudden collapse at home and was transported to local hospital, where he was pronounced dead.  Case accepted as medical examiner jurisdiction due to no apparent medical history and sudden death after vaccine administration.  Full autopsy completed on 5/19/21 revealed obstructive pulmonary thromboemboli as cause of death, with lower extremity DVT.  Both portions of the pulmonary thromboembolus and the DVT show organization, thus raising question of whether this process started before or after the vaccination.   No known history of thrombophilic disorder, recent injury, or prolonged stasis/immobility.  Not known to be current smoker.  See below for additional autopsy information.""
	"1470120-1"	"1470120-1"	"DEEP VEIN THROMBOSIS"	"10051055"	"50-59 years"	"50-59"	""Patient had 1st dose of Moderna COVID-19 vaccine on 5/10/2021.  Several days after he complained of ""not feeling well"" and fatigue, but did not give more specific symptomatology.  On 5/17/2021 he had a sudden collapse at home and was transported to local hospital, where he was pronounced dead.  Case accepted as medical examiner jurisdiction due to no apparent medical history and sudden death after vaccine administration.  Full autopsy completed on 5/19/21 revealed obstructive pulmonary thromboemboli as cause of death, with lower extremity DVT.  Both portions of the pulmonary thromboembolus and the DVT show organization, thus raising question of whether this process started before or after the vaccination.   No known history of thrombophilic disorder, recent injury, or prolonged stasis/immobility.  Not known to be current smoker.  See below for additional autopsy information.""
	"1470120-1"	"1470120-1"	"ELECTROCARDIOGRAM ST-T SEGMENT ABNORMAL"	"10052333"	"50-59 years"	"50-59"	""Patient had 1st dose of Moderna COVID-19 vaccine on 5/10/2021.  Several days after he complained of ""not feeling well"" and fatigue, but did not give more specific symptomatology.  On 5/17/2021 he had a sudden collapse at home and was transported to local hospital, where he was pronounced dead.  Case accepted as medical examiner jurisdiction due to no apparent medical history and sudden death after vaccine administration.  Full autopsy completed on 5/19/21 revealed obstructive pulmonary thromboemboli as cause of death, with lower extremity DVT.  Both portions of the pulmonary thromboembolus and the DVT show organization, thus raising question of whether this process started before or after the vaccination.   No known history of thrombophilic disorder, recent injury, or prolonged stasis/immobility.  Not known to be current smoker.  See below for additional autopsy information.""
	"1470120-1"	"1470120-1"	"FATIGUE"	"10016256"	"50-59 years"	"50-59"	""Patient had 1st dose of Moderna COVID-19 vaccine on 5/10/2021.  Several days after he complained of ""not feeling well"" and fatigue, but did not give more specific symptomatology.  On 5/17/2021 he had a sudden collapse at home and was transported to local hospital, where he was pronounced dead.  Case accepted as medical examiner jurisdiction due to no apparent medical history and sudden death after vaccine administration.  Full autopsy completed on 5/19/21 revealed obstructive pulmonary thromboemboli as cause of death, with lower extremity DVT.  Both portions of the pulmonary thromboembolus and the DVT show organization, thus raising question of whether this process started before or after the vaccination.   No known history of thrombophilic disorder, recent injury, or prolonged stasis/immobility.  Not known to be current smoker.  See below for additional autopsy information.""
	"1470120-1"	"1470120-1"	"INFLUENZA VIRUS TEST NEGATIVE"	"10070718"	"50-59 years"	"50-59"	""Patient had 1st dose of Moderna COVID-19 vaccine on 5/10/2021.  Several days after he complained of ""not feeling well"" and fatigue, but did not give more specific symptomatology.  On 5/17/2021 he had a sudden collapse at home and was transported to local hospital, where he was pronounced dead.  Case accepted as medical examiner jurisdiction due to no apparent medical history and sudden death after vaccine administration.  Full autopsy completed on 5/19/21 revealed obstructive pulmonary thromboemboli as cause of death, with lower extremity DVT.  Both portions of the pulmonary thromboembolus and the DVT show organization, thus raising question of whether this process started before or after the vaccination.   No known history of thrombophilic disorder, recent injury, or prolonged stasis/immobility.  Not known to be current smoker.  See below for additional autopsy information.""
	"1470120-1"	"1470120-1"	"MALAISE"	"10025482"	"50-59 years"	"50-59"	""Patient had 1st dose of Moderna COVID-19 vaccine on 5/10/2021.  Several days after he complained of ""not feeling well"" and fatigue, but did not give more specific symptomatology.  On 5/17/2021 he had a sudden collapse at home and was transported to local hospital, where he was pronounced dead.  Case accepted as medical examiner jurisdiction due to no apparent medical history and sudden death after vaccine administration.  Full autopsy completed on 5/19/21 revealed obstructive pulmonary thromboemboli as cause of death, with lower extremity DVT.  Both portions of the pulmonary thromboembolus and the DVT show organization, thus raising question of whether this process started before or after the vaccination.   No known history of thrombophilic disorder, recent injury, or prolonged stasis/immobility.  Not known to be current smoker.  See below for additional autopsy information.""
	"1470120-1"	"1470120-1"	"MYOCARDIAL STRAIN"	"10066954"	"50-59 years"	"50-59"	""Patient had 1st dose of Moderna COVID-19 vaccine on 5/10/2021.  Several days after he complained of ""not feeling well"" and fatigue, but did not give more specific symptomatology.  On 5/17/2021 he had a sudden collapse at home and was transported to local hospital, where he was pronounced dead.  Case accepted as medical examiner jurisdiction due to no apparent medical history and sudden death after vaccine administration.  Full autopsy completed on 5/19/21 revealed obstructive pulmonary thromboemboli as cause of death, with lower extremity DVT.  Both portions of the pulmonary thromboembolus and the DVT show organization, thus raising question of whether this process started before or after the vaccination.   No known history of thrombophilic disorder, recent injury, or prolonged stasis/immobility.  Not known to be current smoker.  See below for additional autopsy information.""
	"1470120-1"	"1470120-1"	"NUCLEIC ACID TEST"	"10083356"	"50-59 years"	"50-59"	""Patient had 1st dose of Moderna COVID-19 vaccine on 5/10/2021.  Several days after he complained of ""not feeling well"" and fatigue, but did not give more specific symptomatology.  On 5/17/2021 he had a sudden collapse at home and was transported to local hospital, where he was pronounced dead.  Case accepted as medical examiner jurisdiction due to no apparent medical history and sudden death after vaccine administration.  Full autopsy completed on 5/19/21 revealed obstructive pulmonary thromboemboli as cause of death, with lower extremity DVT.  Both portions of the pulmonary thromboembolus and the DVT show organization, thus raising question of whether this process started before or after the vaccination.   No known history of thrombophilic disorder, recent injury, or prolonged stasis/immobility.  Not known to be current smoker.  See below for additional autopsy information.""
	"1470120-1"	"1470120-1"	"PROSTATE CANCER"	"10060862"	"50-59 years"	"50-59"	""Patient had 1st dose of Moderna COVID-19 vaccine on 5/10/2021.  Several days after he complained of ""not feeling well"" and fatigue, but did not give more specific symptomatology.  On 5/17/2021 he had a sudden collapse at home and was transported to local hospital, where he was pronounced dead.  Case accepted as medical examiner jurisdiction due to no apparent medical history and sudden death after vaccine administration.  Full autopsy completed on 5/19/21 revealed obstructive pulmonary thromboemboli as cause of death, with lower extremity DVT.  Both portions of the pulmonary thromboembolus and the DVT show organization, thus raising question of whether this process started before or after the vaccination.   No known history of thrombophilic disorder, recent injury, or prolonged stasis/immobility.  Not known to be current smoker.  See below for additional autopsy information.""
	"1470120-1"	"1470120-1"	"PULMONARY EMBOLISM"	"10037377"	"50-59 years"	"50-59"	""Patient had 1st dose of Moderna COVID-19 vaccine on 5/10/2021.  Several days after he complained of ""not feeling well"" and fatigue, but did not give more specific symptomatology.  On 5/17/2021 he had a sudden collapse at home and was transported to local hospital, where he was pronounced dead.  Case accepted as medical examiner jurisdiction due to no apparent medical history and sudden death after vaccine administration.  Full autopsy completed on 5/19/21 revealed obstructive pulmonary thromboemboli as cause of death, with lower extremity DVT.  Both portions of the pulmonary thromboembolus and the DVT show organization, thus raising question of whether this process started before or after the vaccination.   No known history of thrombophilic disorder, recent injury, or prolonged stasis/immobility.  Not known to be current smoker.  See below for additional autopsy information.""
	"1470120-1"	"1470120-1"	"SARS-COV-2 TEST NEGATIVE"	"10084273"	"50-59 years"	"50-59"	""Patient had 1st dose of Moderna COVID-19 vaccine on 5/10/2021.  Several days after he complained of ""not feeling well"" and fatigue, but did not give more specific symptomatology.  On 5/17/2021 he had a sudden collapse at home and was transported to local hospital, where he was pronounced dead.  Case accepted as medical examiner jurisdiction due to no apparent medical history and sudden death after vaccine administration.  Full autopsy completed on 5/19/21 revealed obstructive pulmonary thromboemboli as cause of death, with lower extremity DVT.  Both portions of the pulmonary thromboembolus and the DVT show organization, thus raising question of whether this process started before or after the vaccination.   No known history of thrombophilic disorder, recent injury, or prolonged stasis/immobility.  Not known to be current smoker.  See below for additional autopsy information.""
	"1470120-1"	"1470120-1"	"SUDDEN DEATH"	"10042434"	"50-59 years"	"50-59"	""Patient had 1st dose of Moderna COVID-19 vaccine on 5/10/2021.  Several days after he complained of ""not feeling well"" and fatigue, but did not give more specific symptomatology.  On 5/17/2021 he had a sudden collapse at home and was transported to local hospital, where he was pronounced dead.  Case accepted as medical examiner jurisdiction due to no apparent medical history and sudden death after vaccine administration.  Full autopsy completed on 5/19/21 revealed obstructive pulmonary thromboemboli as cause of death, with lower extremity DVT.  Both portions of the pulmonary thromboembolus and the DVT show organization, thus raising question of whether this process started before or after the vaccination.   No known history of thrombophilic disorder, recent injury, or prolonged stasis/immobility.  Not known to be current smoker.  See below for additional autopsy information.""
	"1470120-1"	"1470120-1"	"SYNCOPE"	"10042772"	"50-59 years"	"50-59"	""Patient had 1st dose of Moderna COVID-19 vaccine on 5/10/2021.  Several days after he complained of ""not feeling well"" and fatigue, but did not give more specific symptomatology.  On 5/17/2021 he had a sudden collapse at home and was transported to local hospital, where he was pronounced dead.  Case accepted as medical examiner jurisdiction due to no apparent medical history and sudden death after vaccine administration.  Full autopsy completed on 5/19/21 revealed obstructive pulmonary thromboemboli as cause of death, with lower extremity DVT.  Both portions of the pulmonary thromboembolus and the DVT show organization, thus raising question of whether this process started before or after the vaccination.   No known history of thrombophilic disorder, recent injury, or prolonged stasis/immobility.  Not known to be current smoker.  See below for additional autopsy information.""
	"1470120-1"	"1470120-1"	"TOXICOLOGIC TEST NORMAL"	"10061383"	"50-59 years"	"50-59"	""Patient had 1st dose of Moderna COVID-19 vaccine on 5/10/2021.  Several days after he complained of ""not feeling well"" and fatigue, but did not give more specific symptomatology.  On 5/17/2021 he had a sudden collapse at home and was transported to local hospital, where he was pronounced dead.  Case accepted as medical examiner jurisdiction due to no apparent medical history and sudden death after vaccine administration.  Full autopsy completed on 5/19/21 revealed obstructive pulmonary thromboemboli as cause of death, with lower extremity DVT.  Both portions of the pulmonary thromboembolus and the DVT show organization, thus raising question of whether this process started before or after the vaccination.   No known history of thrombophilic disorder, recent injury, or prolonged stasis/immobility.  Not known to be current smoker.  See below for additional autopsy information.""
	"1474311-1"	"1474311-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient died 04/06/2021 Covid vaccine #1 Pfizer 03/16/2021 Lot #EN6207 Covid Vaccine #2 Pfizer 03/19/2021 Lot # N/A"
	"1474379-1"	"1474379-1"	"ABDOMINAL PAIN"	"10000081"	"50-59 years"	"50-59"	"No immediate adverse reaction, however, began developing nightly fevers/profuse sweating on June 11.  This continued for two weeks with increasing symptoms of loss of appetite, nausea, abdominal pain, tingling sensation on scalp before going to ER.  Visited urgent care on June 16 and bloodwork results indicated elevated white blood cell count and eosinophil count.  There was a question as to whether patient had been subjected to a tick bite, so doxycycline was prescribed.  After several days, patient returned to urgent care for follow-up bloodwork (June 20th).  Results showed WBC and eosinophil count continued to escalate.  He went to ER on June 25th and was admitted to the hospital for 5 days.  During his visit at Hospital, he was seen by a team of specialists:  cardiologist, pulmonologist, hematologist, infectious disease doctor.  Multiple tests were run, as the doctors started broad to eliminate certain diagnoses - i.e., bone marrow biopsy, heart cath, CT scans, x-rays, thoracentesis, etc.  Patient had fluid around his heart and lungs and was diagnosed with myocarditis.  He had no previous heart issues nor family history of heart issues.  Test results indicated no abnormal  blockage or other issues, other than inflammation and his heart strength was at 27%.  I am unable to access his account, as it was disabled after his death.  An autopsy is being performed and results are pending; however, the question(s) at large:  what was the condition of his heart at the time of his death and was this vaccine-related?  Did his myocarditis get worse?  Did his heart muscle weaken further and rupture?    Please let me know if the autopsy results are needed and where to send them."
	"1474379-1"	"1474379-1"	"ASPIRATION PLEURAL CAVITY"	"10003522"	"50-59 years"	"50-59"	"No immediate adverse reaction, however, began developing nightly fevers/profuse sweating on June 11.  This continued for two weeks with increasing symptoms of loss of appetite, nausea, abdominal pain, tingling sensation on scalp before going to ER.  Visited urgent care on June 16 and bloodwork results indicated elevated white blood cell count and eosinophil count.  There was a question as to whether patient had been subjected to a tick bite, so doxycycline was prescribed.  After several days, patient returned to urgent care for follow-up bloodwork (June 20th).  Results showed WBC and eosinophil count continued to escalate.  He went to ER on June 25th and was admitted to the hospital for 5 days.  During his visit at Hospital, he was seen by a team of specialists:  cardiologist, pulmonologist, hematologist, infectious disease doctor.  Multiple tests were run, as the doctors started broad to eliminate certain diagnoses - i.e., bone marrow biopsy, heart cath, CT scans, x-rays, thoracentesis, etc.  Patient had fluid around his heart and lungs and was diagnosed with myocarditis.  He had no previous heart issues nor family history of heart issues.  Test results indicated no abnormal  blockage or other issues, other than inflammation and his heart strength was at 27%.  I am unable to access his account, as it was disabled after his death.  An autopsy is being performed and results are pending; however, the question(s) at large:  what was the condition of his heart at the time of his death and was this vaccine-related?  Did his myocarditis get worse?  Did his heart muscle weaken further and rupture?    Please let me know if the autopsy results are needed and where to send them."
	"1474379-1"	"1474379-1"	"AUTOPSY"	"10050117"	"50-59 years"	"50-59"	"No immediate adverse reaction, however, began developing nightly fevers/profuse sweating on June 11.  This continued for two weeks with increasing symptoms of loss of appetite, nausea, abdominal pain, tingling sensation on scalp before going to ER.  Visited urgent care on June 16 and bloodwork results indicated elevated white blood cell count and eosinophil count.  There was a question as to whether patient had been subjected to a tick bite, so doxycycline was prescribed.  After several days, patient returned to urgent care for follow-up bloodwork (June 20th).  Results showed WBC and eosinophil count continued to escalate.  He went to ER on June 25th and was admitted to the hospital for 5 days.  During his visit at Hospital, he was seen by a team of specialists:  cardiologist, pulmonologist, hematologist, infectious disease doctor.  Multiple tests were run, as the doctors started broad to eliminate certain diagnoses - i.e., bone marrow biopsy, heart cath, CT scans, x-rays, thoracentesis, etc.  Patient had fluid around his heart and lungs and was diagnosed with myocarditis.  He had no previous heart issues nor family history of heart issues.  Test results indicated no abnormal  blockage or other issues, other than inflammation and his heart strength was at 27%.  I am unable to access his account, as it was disabled after his death.  An autopsy is being performed and results are pending; however, the question(s) at large:  what was the condition of his heart at the time of his death and was this vaccine-related?  Did his myocarditis get worse?  Did his heart muscle weaken further and rupture?    Please let me know if the autopsy results are needed and where to send them."
	"1474379-1"	"1474379-1"	"BIOPSY BONE MARROW"	"10004737"	"50-59 years"	"50-59"	"No immediate adverse reaction, however, began developing nightly fevers/profuse sweating on June 11.  This continued for two weeks with increasing symptoms of loss of appetite, nausea, abdominal pain, tingling sensation on scalp before going to ER.  Visited urgent care on June 16 and bloodwork results indicated elevated white blood cell count and eosinophil count.  There was a question as to whether patient had been subjected to a tick bite, so doxycycline was prescribed.  After several days, patient returned to urgent care for follow-up bloodwork (June 20th).  Results showed WBC and eosinophil count continued to escalate.  He went to ER on June 25th and was admitted to the hospital for 5 days.  During his visit at Hospital, he was seen by a team of specialists:  cardiologist, pulmonologist, hematologist, infectious disease doctor.  Multiple tests were run, as the doctors started broad to eliminate certain diagnoses - i.e., bone marrow biopsy, heart cath, CT scans, x-rays, thoracentesis, etc.  Patient had fluid around his heart and lungs and was diagnosed with myocarditis.  He had no previous heart issues nor family history of heart issues.  Test results indicated no abnormal  blockage or other issues, other than inflammation and his heart strength was at 27%.  I am unable to access his account, as it was disabled after his death.  An autopsy is being performed and results are pending; however, the question(s) at large:  what was the condition of his heart at the time of his death and was this vaccine-related?  Did his myocarditis get worse?  Did his heart muscle weaken further and rupture?    Please let me know if the autopsy results are needed and where to send them."
	"1474379-1"	"1474379-1"	"BLOOD TEST ABNORMAL"	"10061016"	"50-59 years"	"50-59"	"No immediate adverse reaction, however, began developing nightly fevers/profuse sweating on June 11.  This continued for two weeks with increasing symptoms of loss of appetite, nausea, abdominal pain, tingling sensation on scalp before going to ER.  Visited urgent care on June 16 and bloodwork results indicated elevated white blood cell count and eosinophil count.  There was a question as to whether patient had been subjected to a tick bite, so doxycycline was prescribed.  After several days, patient returned to urgent care for follow-up bloodwork (June 20th).  Results showed WBC and eosinophil count continued to escalate.  He went to ER on June 25th and was admitted to the hospital for 5 days.  During his visit at Hospital, he was seen by a team of specialists:  cardiologist, pulmonologist, hematologist, infectious disease doctor.  Multiple tests were run, as the doctors started broad to eliminate certain diagnoses - i.e., bone marrow biopsy, heart cath, CT scans, x-rays, thoracentesis, etc.  Patient had fluid around his heart and lungs and was diagnosed with myocarditis.  He had no previous heart issues nor family history of heart issues.  Test results indicated no abnormal  blockage or other issues, other than inflammation and his heart strength was at 27%.  I am unable to access his account, as it was disabled after his death.  An autopsy is being performed and results are pending; however, the question(s) at large:  what was the condition of his heart at the time of his death and was this vaccine-related?  Did his myocarditis get worse?  Did his heart muscle weaken further and rupture?    Please let me know if the autopsy results are needed and where to send them."
	"1474379-1"	"1474379-1"	"CATHETERISATION CARDIAC"	"10007815"	"50-59 years"	"50-59"	"No immediate adverse reaction, however, began developing nightly fevers/profuse sweating on June 11.  This continued for two weeks with increasing symptoms of loss of appetite, nausea, abdominal pain, tingling sensation on scalp before going to ER.  Visited urgent care on June 16 and bloodwork results indicated elevated white blood cell count and eosinophil count.  There was a question as to whether patient had been subjected to a tick bite, so doxycycline was prescribed.  After several days, patient returned to urgent care for follow-up bloodwork (June 20th).  Results showed WBC and eosinophil count continued to escalate.  He went to ER on June 25th and was admitted to the hospital for 5 days.  During his visit at Hospital, he was seen by a team of specialists:  cardiologist, pulmonologist, hematologist, infectious disease doctor.  Multiple tests were run, as the doctors started broad to eliminate certain diagnoses - i.e., bone marrow biopsy, heart cath, CT scans, x-rays, thoracentesis, etc.  Patient had fluid around his heart and lungs and was diagnosed with myocarditis.  He had no previous heart issues nor family history of heart issues.  Test results indicated no abnormal  blockage or other issues, other than inflammation and his heart strength was at 27%.  I am unable to access his account, as it was disabled after his death.  An autopsy is being performed and results are pending; however, the question(s) at large:  what was the condition of his heart at the time of his death and was this vaccine-related?  Did his myocarditis get worse?  Did his heart muscle weaken further and rupture?    Please let me know if the autopsy results are needed and where to send them."
	"1474379-1"	"1474379-1"	"COMPUTERISED TOMOGRAM"	"10010234"	"50-59 years"	"50-59"	"No immediate adverse reaction, however, began developing nightly fevers/profuse sweating on June 11.  This continued for two weeks with increasing symptoms of loss of appetite, nausea, abdominal pain, tingling sensation on scalp before going to ER.  Visited urgent care on June 16 and bloodwork results indicated elevated white blood cell count and eosinophil count.  There was a question as to whether patient had been subjected to a tick bite, so doxycycline was prescribed.  After several days, patient returned to urgent care for follow-up bloodwork (June 20th).  Results showed WBC and eosinophil count continued to escalate.  He went to ER on June 25th and was admitted to the hospital for 5 days.  During his visit at Hospital, he was seen by a team of specialists:  cardiologist, pulmonologist, hematologist, infectious disease doctor.  Multiple tests were run, as the doctors started broad to eliminate certain diagnoses - i.e., bone marrow biopsy, heart cath, CT scans, x-rays, thoracentesis, etc.  Patient had fluid around his heart and lungs and was diagnosed with myocarditis.  He had no previous heart issues nor family history of heart issues.  Test results indicated no abnormal  blockage or other issues, other than inflammation and his heart strength was at 27%.  I am unable to access his account, as it was disabled after his death.  An autopsy is being performed and results are pending; however, the question(s) at large:  what was the condition of his heart at the time of his death and was this vaccine-related?  Did his myocarditis get worse?  Did his heart muscle weaken further and rupture?    Please let me know if the autopsy results are needed and where to send them."
	"1474379-1"	"1474379-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"No immediate adverse reaction, however, began developing nightly fevers/profuse sweating on June 11.  This continued for two weeks with increasing symptoms of loss of appetite, nausea, abdominal pain, tingling sensation on scalp before going to ER.  Visited urgent care on June 16 and bloodwork results indicated elevated white blood cell count and eosinophil count.  There was a question as to whether patient had been subjected to a tick bite, so doxycycline was prescribed.  After several days, patient returned to urgent care for follow-up bloodwork (June 20th).  Results showed WBC and eosinophil count continued to escalate.  He went to ER on June 25th and was admitted to the hospital for 5 days.  During his visit at Hospital, he was seen by a team of specialists:  cardiologist, pulmonologist, hematologist, infectious disease doctor.  Multiple tests were run, as the doctors started broad to eliminate certain diagnoses - i.e., bone marrow biopsy, heart cath, CT scans, x-rays, thoracentesis, etc.  Patient had fluid around his heart and lungs and was diagnosed with myocarditis.  He had no previous heart issues nor family history of heart issues.  Test results indicated no abnormal  blockage or other issues, other than inflammation and his heart strength was at 27%.  I am unable to access his account, as it was disabled after his death.  An autopsy is being performed and results are pending; however, the question(s) at large:  what was the condition of his heart at the time of his death and was this vaccine-related?  Did his myocarditis get worse?  Did his heart muscle weaken further and rupture?    Please let me know if the autopsy results are needed and where to send them."
	"1474379-1"	"1474379-1"	"DECREASED APPETITE"	"10061428"	"50-59 years"	"50-59"	"No immediate adverse reaction, however, began developing nightly fevers/profuse sweating on June 11.  This continued for two weeks with increasing symptoms of loss of appetite, nausea, abdominal pain, tingling sensation on scalp before going to ER.  Visited urgent care on June 16 and bloodwork results indicated elevated white blood cell count and eosinophil count.  There was a question as to whether patient had been subjected to a tick bite, so doxycycline was prescribed.  After several days, patient returned to urgent care for follow-up bloodwork (June 20th).  Results showed WBC and eosinophil count continued to escalate.  He went to ER on June 25th and was admitted to the hospital for 5 days.  During his visit at Hospital, he was seen by a team of specialists:  cardiologist, pulmonologist, hematologist, infectious disease doctor.  Multiple tests were run, as the doctors started broad to eliminate certain diagnoses - i.e., bone marrow biopsy, heart cath, CT scans, x-rays, thoracentesis, etc.  Patient had fluid around his heart and lungs and was diagnosed with myocarditis.  He had no previous heart issues nor family history of heart issues.  Test results indicated no abnormal  blockage or other issues, other than inflammation and his heart strength was at 27%.  I am unable to access his account, as it was disabled after his death.  An autopsy is being performed and results are pending; however, the question(s) at large:  what was the condition of his heart at the time of his death and was this vaccine-related?  Did his myocarditis get worse?  Did his heart muscle weaken further and rupture?    Please let me know if the autopsy results are needed and where to send them."
	"1474379-1"	"1474379-1"	"EOSINOPHIL COUNT INCREASED"	"10014945"	"50-59 years"	"50-59"	"No immediate adverse reaction, however, began developing nightly fevers/profuse sweating on June 11.  This continued for two weeks with increasing symptoms of loss of appetite, nausea, abdominal pain, tingling sensation on scalp before going to ER.  Visited urgent care on June 16 and bloodwork results indicated elevated white blood cell count and eosinophil count.  There was a question as to whether patient had been subjected to a tick bite, so doxycycline was prescribed.  After several days, patient returned to urgent care for follow-up bloodwork (June 20th).  Results showed WBC and eosinophil count continued to escalate.  He went to ER on June 25th and was admitted to the hospital for 5 days.  During his visit at Hospital, he was seen by a team of specialists:  cardiologist, pulmonologist, hematologist, infectious disease doctor.  Multiple tests were run, as the doctors started broad to eliminate certain diagnoses - i.e., bone marrow biopsy, heart cath, CT scans, x-rays, thoracentesis, etc.  Patient had fluid around his heart and lungs and was diagnosed with myocarditis.  He had no previous heart issues nor family history of heart issues.  Test results indicated no abnormal  blockage or other issues, other than inflammation and his heart strength was at 27%.  I am unable to access his account, as it was disabled after his death.  An autopsy is being performed and results are pending; however, the question(s) at large:  what was the condition of his heart at the time of his death and was this vaccine-related?  Did his myocarditis get worse?  Did his heart muscle weaken further and rupture?    Please let me know if the autopsy results are needed and where to send them."
	"1474379-1"	"1474379-1"	"INFLAMMATION"	"10061218"	"50-59 years"	"50-59"	"No immediate adverse reaction, however, began developing nightly fevers/profuse sweating on June 11.  This continued for two weeks with increasing symptoms of loss of appetite, nausea, abdominal pain, tingling sensation on scalp before going to ER.  Visited urgent care on June 16 and bloodwork results indicated elevated white blood cell count and eosinophil count.  There was a question as to whether patient had been subjected to a tick bite, so doxycycline was prescribed.  After several days, patient returned to urgent care for follow-up bloodwork (June 20th).  Results showed WBC and eosinophil count continued to escalate.  He went to ER on June 25th and was admitted to the hospital for 5 days.  During his visit at Hospital, he was seen by a team of specialists:  cardiologist, pulmonologist, hematologist, infectious disease doctor.  Multiple tests were run, as the doctors started broad to eliminate certain diagnoses - i.e., bone marrow biopsy, heart cath, CT scans, x-rays, thoracentesis, etc.  Patient had fluid around his heart and lungs and was diagnosed with myocarditis.  He had no previous heart issues nor family history of heart issues.  Test results indicated no abnormal  blockage or other issues, other than inflammation and his heart strength was at 27%.  I am unable to access his account, as it was disabled after his death.  An autopsy is being performed and results are pending; however, the question(s) at large:  what was the condition of his heart at the time of his death and was this vaccine-related?  Did his myocarditis get worse?  Did his heart muscle weaken further and rupture?    Please let me know if the autopsy results are needed and where to send them."
	"1474379-1"	"1474379-1"	"MYOCARDITIS"	"10028606"	"50-59 years"	"50-59"	"No immediate adverse reaction, however, began developing nightly fevers/profuse sweating on June 11.  This continued for two weeks with increasing symptoms of loss of appetite, nausea, abdominal pain, tingling sensation on scalp before going to ER.  Visited urgent care on June 16 and bloodwork results indicated elevated white blood cell count and eosinophil count.  There was a question as to whether patient had been subjected to a tick bite, so doxycycline was prescribed.  After several days, patient returned to urgent care for follow-up bloodwork (June 20th).  Results showed WBC and eosinophil count continued to escalate.  He went to ER on June 25th and was admitted to the hospital for 5 days.  During his visit at Hospital, he was seen by a team of specialists:  cardiologist, pulmonologist, hematologist, infectious disease doctor.  Multiple tests were run, as the doctors started broad to eliminate certain diagnoses - i.e., bone marrow biopsy, heart cath, CT scans, x-rays, thoracentesis, etc.  Patient had fluid around his heart and lungs and was diagnosed with myocarditis.  He had no previous heart issues nor family history of heart issues.  Test results indicated no abnormal  blockage or other issues, other than inflammation and his heart strength was at 27%.  I am unable to access his account, as it was disabled after his death.  An autopsy is being performed and results are pending; however, the question(s) at large:  what was the condition of his heart at the time of his death and was this vaccine-related?  Did his myocarditis get worse?  Did his heart muscle weaken further and rupture?    Please let me know if the autopsy results are needed and where to send them."
	"1474379-1"	"1474379-1"	"NAUSEA"	"10028813"	"50-59 years"	"50-59"	"No immediate adverse reaction, however, began developing nightly fevers/profuse sweating on June 11.  This continued for two weeks with increasing symptoms of loss of appetite, nausea, abdominal pain, tingling sensation on scalp before going to ER.  Visited urgent care on June 16 and bloodwork results indicated elevated white blood cell count and eosinophil count.  There was a question as to whether patient had been subjected to a tick bite, so doxycycline was prescribed.  After several days, patient returned to urgent care for follow-up bloodwork (June 20th).  Results showed WBC and eosinophil count continued to escalate.  He went to ER on June 25th and was admitted to the hospital for 5 days.  During his visit at Hospital, he was seen by a team of specialists:  cardiologist, pulmonologist, hematologist, infectious disease doctor.  Multiple tests were run, as the doctors started broad to eliminate certain diagnoses - i.e., bone marrow biopsy, heart cath, CT scans, x-rays, thoracentesis, etc.  Patient had fluid around his heart and lungs and was diagnosed with myocarditis.  He had no previous heart issues nor family history of heart issues.  Test results indicated no abnormal  blockage or other issues, other than inflammation and his heart strength was at 27%.  I am unable to access his account, as it was disabled after his death.  An autopsy is being performed and results are pending; however, the question(s) at large:  what was the condition of his heart at the time of his death and was this vaccine-related?  Did his myocarditis get worse?  Did his heart muscle weaken further and rupture?    Please let me know if the autopsy results are needed and where to send them."
	"1474379-1"	"1474379-1"	"NIGHT SWEATS"	"10029410"	"50-59 years"	"50-59"	"No immediate adverse reaction, however, began developing nightly fevers/profuse sweating on June 11.  This continued for two weeks with increasing symptoms of loss of appetite, nausea, abdominal pain, tingling sensation on scalp before going to ER.  Visited urgent care on June 16 and bloodwork results indicated elevated white blood cell count and eosinophil count.  There was a question as to whether patient had been subjected to a tick bite, so doxycycline was prescribed.  After several days, patient returned to urgent care for follow-up bloodwork (June 20th).  Results showed WBC and eosinophil count continued to escalate.  He went to ER on June 25th and was admitted to the hospital for 5 days.  During his visit at Hospital, he was seen by a team of specialists:  cardiologist, pulmonologist, hematologist, infectious disease doctor.  Multiple tests were run, as the doctors started broad to eliminate certain diagnoses - i.e., bone marrow biopsy, heart cath, CT scans, x-rays, thoracentesis, etc.  Patient had fluid around his heart and lungs and was diagnosed with myocarditis.  He had no previous heart issues nor family history of heart issues.  Test results indicated no abnormal  blockage or other issues, other than inflammation and his heart strength was at 27%.  I am unable to access his account, as it was disabled after his death.  An autopsy is being performed and results are pending; however, the question(s) at large:  what was the condition of his heart at the time of his death and was this vaccine-related?  Did his myocarditis get worse?  Did his heart muscle weaken further and rupture?    Please let me know if the autopsy results are needed and where to send them."
	"1474379-1"	"1474379-1"	"PARAESTHESIA"	"10033775"	"50-59 years"	"50-59"	"No immediate adverse reaction, however, began developing nightly fevers/profuse sweating on June 11.  This continued for two weeks with increasing symptoms of loss of appetite, nausea, abdominal pain, tingling sensation on scalp before going to ER.  Visited urgent care on June 16 and bloodwork results indicated elevated white blood cell count and eosinophil count.  There was a question as to whether patient had been subjected to a tick bite, so doxycycline was prescribed.  After several days, patient returned to urgent care for follow-up bloodwork (June 20th).  Results showed WBC and eosinophil count continued to escalate.  He went to ER on June 25th and was admitted to the hospital for 5 days.  During his visit at Hospital, he was seen by a team of specialists:  cardiologist, pulmonologist, hematologist, infectious disease doctor.  Multiple tests were run, as the doctors started broad to eliminate certain diagnoses - i.e., bone marrow biopsy, heart cath, CT scans, x-rays, thoracentesis, etc.  Patient had fluid around his heart and lungs and was diagnosed with myocarditis.  He had no previous heart issues nor family history of heart issues.  Test results indicated no abnormal  blockage or other issues, other than inflammation and his heart strength was at 27%.  I am unable to access his account, as it was disabled after his death.  An autopsy is being performed and results are pending; however, the question(s) at large:  what was the condition of his heart at the time of his death and was this vaccine-related?  Did his myocarditis get worse?  Did his heart muscle weaken further and rupture?    Please let me know if the autopsy results are needed and where to send them."
	"1474379-1"	"1474379-1"	"PERICARDIAL EFFUSION"	"10034474"	"50-59 years"	"50-59"	"No immediate adverse reaction, however, began developing nightly fevers/profuse sweating on June 11.  This continued for two weeks with increasing symptoms of loss of appetite, nausea, abdominal pain, tingling sensation on scalp before going to ER.  Visited urgent care on June 16 and bloodwork results indicated elevated white blood cell count and eosinophil count.  There was a question as to whether patient had been subjected to a tick bite, so doxycycline was prescribed.  After several days, patient returned to urgent care for follow-up bloodwork (June 20th).  Results showed WBC and eosinophil count continued to escalate.  He went to ER on June 25th and was admitted to the hospital for 5 days.  During his visit at Hospital, he was seen by a team of specialists:  cardiologist, pulmonologist, hematologist, infectious disease doctor.  Multiple tests were run, as the doctors started broad to eliminate certain diagnoses - i.e., bone marrow biopsy, heart cath, CT scans, x-rays, thoracentesis, etc.  Patient had fluid around his heart and lungs and was diagnosed with myocarditis.  He had no previous heart issues nor family history of heart issues.  Test results indicated no abnormal  blockage or other issues, other than inflammation and his heart strength was at 27%.  I am unable to access his account, as it was disabled after his death.  An autopsy is being performed and results are pending; however, the question(s) at large:  what was the condition of his heart at the time of his death and was this vaccine-related?  Did his myocarditis get worse?  Did his heart muscle weaken further and rupture?    Please let me know if the autopsy results are needed and where to send them."
	"1474379-1"	"1474379-1"	"PLEURAL EFFUSION"	"10035598"	"50-59 years"	"50-59"	"No immediate adverse reaction, however, began developing nightly fevers/profuse sweating on June 11.  This continued for two weeks with increasing symptoms of loss of appetite, nausea, abdominal pain, tingling sensation on scalp before going to ER.  Visited urgent care on June 16 and bloodwork results indicated elevated white blood cell count and eosinophil count.  There was a question as to whether patient had been subjected to a tick bite, so doxycycline was prescribed.  After several days, patient returned to urgent care for follow-up bloodwork (June 20th).  Results showed WBC and eosinophil count continued to escalate.  He went to ER on June 25th and was admitted to the hospital for 5 days.  During his visit at Hospital, he was seen by a team of specialists:  cardiologist, pulmonologist, hematologist, infectious disease doctor.  Multiple tests were run, as the doctors started broad to eliminate certain diagnoses - i.e., bone marrow biopsy, heart cath, CT scans, x-rays, thoracentesis, etc.  Patient had fluid around his heart and lungs and was diagnosed with myocarditis.  He had no previous heart issues nor family history of heart issues.  Test results indicated no abnormal  blockage or other issues, other than inflammation and his heart strength was at 27%.  I am unable to access his account, as it was disabled after his death.  An autopsy is being performed and results are pending; however, the question(s) at large:  what was the condition of his heart at the time of his death and was this vaccine-related?  Did his myocarditis get worse?  Did his heart muscle weaken further and rupture?    Please let me know if the autopsy results are needed and where to send them."
	"1474379-1"	"1474379-1"	"PYREXIA"	"10037660"	"50-59 years"	"50-59"	"No immediate adverse reaction, however, began developing nightly fevers/profuse sweating on June 11.  This continued for two weeks with increasing symptoms of loss of appetite, nausea, abdominal pain, tingling sensation on scalp before going to ER.  Visited urgent care on June 16 and bloodwork results indicated elevated white blood cell count and eosinophil count.  There was a question as to whether patient had been subjected to a tick bite, so doxycycline was prescribed.  After several days, patient returned to urgent care for follow-up bloodwork (June 20th).  Results showed WBC and eosinophil count continued to escalate.  He went to ER on June 25th and was admitted to the hospital for 5 days.  During his visit at Hospital, he was seen by a team of specialists:  cardiologist, pulmonologist, hematologist, infectious disease doctor.  Multiple tests were run, as the doctors started broad to eliminate certain diagnoses - i.e., bone marrow biopsy, heart cath, CT scans, x-rays, thoracentesis, etc.  Patient had fluid around his heart and lungs and was diagnosed with myocarditis.  He had no previous heart issues nor family history of heart issues.  Test results indicated no abnormal  blockage or other issues, other than inflammation and his heart strength was at 27%.  I am unable to access his account, as it was disabled after his death.  An autopsy is being performed and results are pending; however, the question(s) at large:  what was the condition of his heart at the time of his death and was this vaccine-related?  Did his myocarditis get worse?  Did his heart muscle weaken further and rupture?    Please let me know if the autopsy results are needed and where to send them."
	"1474379-1"	"1474379-1"	"WHITE BLOOD CELL COUNT INCREASED"	"10047943"	"50-59 years"	"50-59"	"No immediate adverse reaction, however, began developing nightly fevers/profuse sweating on June 11.  This continued for two weeks with increasing symptoms of loss of appetite, nausea, abdominal pain, tingling sensation on scalp before going to ER.  Visited urgent care on June 16 and bloodwork results indicated elevated white blood cell count and eosinophil count.  There was a question as to whether patient had been subjected to a tick bite, so doxycycline was prescribed.  After several days, patient returned to urgent care for follow-up bloodwork (June 20th).  Results showed WBC and eosinophil count continued to escalate.  He went to ER on June 25th and was admitted to the hospital for 5 days.  During his visit at Hospital, he was seen by a team of specialists:  cardiologist, pulmonologist, hematologist, infectious disease doctor.  Multiple tests were run, as the doctors started broad to eliminate certain diagnoses - i.e., bone marrow biopsy, heart cath, CT scans, x-rays, thoracentesis, etc.  Patient had fluid around his heart and lungs and was diagnosed with myocarditis.  He had no previous heart issues nor family history of heart issues.  Test results indicated no abnormal  blockage or other issues, other than inflammation and his heart strength was at 27%.  I am unable to access his account, as it was disabled after his death.  An autopsy is being performed and results are pending; however, the question(s) at large:  what was the condition of his heart at the time of his death and was this vaccine-related?  Did his myocarditis get worse?  Did his heart muscle weaken further and rupture?    Please let me know if the autopsy results are needed and where to send them."
	"1474379-1"	"1474379-1"	"X-RAY"	"10048064"	"50-59 years"	"50-59"	"No immediate adverse reaction, however, began developing nightly fevers/profuse sweating on June 11.  This continued for two weeks with increasing symptoms of loss of appetite, nausea, abdominal pain, tingling sensation on scalp before going to ER.  Visited urgent care on June 16 and bloodwork results indicated elevated white blood cell count and eosinophil count.  There was a question as to whether patient had been subjected to a tick bite, so doxycycline was prescribed.  After several days, patient returned to urgent care for follow-up bloodwork (June 20th).  Results showed WBC and eosinophil count continued to escalate.  He went to ER on June 25th and was admitted to the hospital for 5 days.  During his visit at Hospital, he was seen by a team of specialists:  cardiologist, pulmonologist, hematologist, infectious disease doctor.  Multiple tests were run, as the doctors started broad to eliminate certain diagnoses - i.e., bone marrow biopsy, heart cath, CT scans, x-rays, thoracentesis, etc.  Patient had fluid around his heart and lungs and was diagnosed with myocarditis.  He had no previous heart issues nor family history of heart issues.  Test results indicated no abnormal  blockage or other issues, other than inflammation and his heart strength was at 27%.  I am unable to access his account, as it was disabled after his death.  An autopsy is being performed and results are pending; however, the question(s) at large:  what was the condition of his heart at the time of his death and was this vaccine-related?  Did his myocarditis get worse?  Did his heart muscle weaken further and rupture?    Please let me know if the autopsy results are needed and where to send them."
	"1478259-1"	"1478259-1"	"ACUTE HEPATIC FAILURE"	"10000804"	"50-59 years"	"50-59"	"no known cardiovascular disease. He has been feeling less well recently .  About 1 month ago, he received the 2nd dose of the Moderna COVID-19 vaccine, and he developed an erythematous, non-raised rash involving the upper and lower extremities. This has subsided, but still persists on his thighs. He presented to the emergency department on 7/3 with worsening dyspnea. and diagnosed with  pulmonary emboli.  After a week in the hospital deteriorating with the following the patient expired.  Pulmonary embolism  Active Problems:   Cardiogenic shock    NSTEMI (non-ST elevated myocardial infarction)    Cardiomyopathy    Acute liver failure without hepatic coma   Rheumatoid arthritis    Renal failure   Aortic stenosis   Lactic acidosis   Cardiac arrest    Cerebral anoxia"
	"1478259-1"	"1478259-1"	"ACUTE MYOCARDIAL INFARCTION"	"10000891"	"50-59 years"	"50-59"	"no known cardiovascular disease. He has been feeling less well recently .  About 1 month ago, he received the 2nd dose of the Moderna COVID-19 vaccine, and he developed an erythematous, non-raised rash involving the upper and lower extremities. This has subsided, but still persists on his thighs. He presented to the emergency department on 7/3 with worsening dyspnea. and diagnosed with  pulmonary emboli.  After a week in the hospital deteriorating with the following the patient expired.  Pulmonary embolism  Active Problems:   Cardiogenic shock    NSTEMI (non-ST elevated myocardial infarction)    Cardiomyopathy    Acute liver failure without hepatic coma   Rheumatoid arthritis    Renal failure   Aortic stenosis   Lactic acidosis   Cardiac arrest    Cerebral anoxia"
	"1478259-1"	"1478259-1"	"AORTIC STENOSIS"	"10002906"	"50-59 years"	"50-59"	"no known cardiovascular disease. He has been feeling less well recently .  About 1 month ago, he received the 2nd dose of the Moderna COVID-19 vaccine, and he developed an erythematous, non-raised rash involving the upper and lower extremities. This has subsided, but still persists on his thighs. He presented to the emergency department on 7/3 with worsening dyspnea. and diagnosed with  pulmonary emboli.  After a week in the hospital deteriorating with the following the patient expired.  Pulmonary embolism  Active Problems:   Cardiogenic shock    NSTEMI (non-ST elevated myocardial infarction)    Cardiomyopathy    Acute liver failure without hepatic coma   Rheumatoid arthritis    Renal failure   Aortic stenosis   Lactic acidosis   Cardiac arrest    Cerebral anoxia"
	"1478259-1"	"1478259-1"	"BRAIN HYPOXIA"	"10006127"	"50-59 years"	"50-59"	"no known cardiovascular disease. He has been feeling less well recently .  About 1 month ago, he received the 2nd dose of the Moderna COVID-19 vaccine, and he developed an erythematous, non-raised rash involving the upper and lower extremities. This has subsided, but still persists on his thighs. He presented to the emergency department on 7/3 with worsening dyspnea. and diagnosed with  pulmonary emboli.  After a week in the hospital deteriorating with the following the patient expired.  Pulmonary embolism  Active Problems:   Cardiogenic shock    NSTEMI (non-ST elevated myocardial infarction)    Cardiomyopathy    Acute liver failure without hepatic coma   Rheumatoid arthritis    Renal failure   Aortic stenosis   Lactic acidosis   Cardiac arrest    Cerebral anoxia"
	"1478259-1"	"1478259-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"no known cardiovascular disease. He has been feeling less well recently .  About 1 month ago, he received the 2nd dose of the Moderna COVID-19 vaccine, and he developed an erythematous, non-raised rash involving the upper and lower extremities. This has subsided, but still persists on his thighs. He presented to the emergency department on 7/3 with worsening dyspnea. and diagnosed with  pulmonary emboli.  After a week in the hospital deteriorating with the following the patient expired.  Pulmonary embolism  Active Problems:   Cardiogenic shock    NSTEMI (non-ST elevated myocardial infarction)    Cardiomyopathy    Acute liver failure without hepatic coma   Rheumatoid arthritis    Renal failure   Aortic stenosis   Lactic acidosis   Cardiac arrest    Cerebral anoxia"
	"1478259-1"	"1478259-1"	"CARDIOGENIC SHOCK"	"10007625"	"50-59 years"	"50-59"	"no known cardiovascular disease. He has been feeling less well recently .  About 1 month ago, he received the 2nd dose of the Moderna COVID-19 vaccine, and he developed an erythematous, non-raised rash involving the upper and lower extremities. This has subsided, but still persists on his thighs. He presented to the emergency department on 7/3 with worsening dyspnea. and diagnosed with  pulmonary emboli.  After a week in the hospital deteriorating with the following the patient expired.  Pulmonary embolism  Active Problems:   Cardiogenic shock    NSTEMI (non-ST elevated myocardial infarction)    Cardiomyopathy    Acute liver failure without hepatic coma   Rheumatoid arthritis    Renal failure   Aortic stenosis   Lactic acidosis   Cardiac arrest    Cerebral anoxia"
	"1478259-1"	"1478259-1"	"CARDIOMYOPATHY"	"10007636"	"50-59 years"	"50-59"	"no known cardiovascular disease. He has been feeling less well recently .  About 1 month ago, he received the 2nd dose of the Moderna COVID-19 vaccine, and he developed an erythematous, non-raised rash involving the upper and lower extremities. This has subsided, but still persists on his thighs. He presented to the emergency department on 7/3 with worsening dyspnea. and diagnosed with  pulmonary emboli.  After a week in the hospital deteriorating with the following the patient expired.  Pulmonary embolism  Active Problems:   Cardiogenic shock    NSTEMI (non-ST elevated myocardial infarction)    Cardiomyopathy    Acute liver failure without hepatic coma   Rheumatoid arthritis    Renal failure   Aortic stenosis   Lactic acidosis   Cardiac arrest    Cerebral anoxia"
	"1478259-1"	"1478259-1"	"CONDITION AGGRAVATED"	"10010264"	"50-59 years"	"50-59"	"no known cardiovascular disease. He has been feeling less well recently .  About 1 month ago, he received the 2nd dose of the Moderna COVID-19 vaccine, and he developed an erythematous, non-raised rash involving the upper and lower extremities. This has subsided, but still persists on his thighs. He presented to the emergency department on 7/3 with worsening dyspnea. and diagnosed with  pulmonary emboli.  After a week in the hospital deteriorating with the following the patient expired.  Pulmonary embolism  Active Problems:   Cardiogenic shock    NSTEMI (non-ST elevated myocardial infarction)    Cardiomyopathy    Acute liver failure without hepatic coma   Rheumatoid arthritis    Renal failure   Aortic stenosis   Lactic acidosis   Cardiac arrest    Cerebral anoxia"
	"1478259-1"	"1478259-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"no known cardiovascular disease. He has been feeling less well recently .  About 1 month ago, he received the 2nd dose of the Moderna COVID-19 vaccine, and he developed an erythematous, non-raised rash involving the upper and lower extremities. This has subsided, but still persists on his thighs. He presented to the emergency department on 7/3 with worsening dyspnea. and diagnosed with  pulmonary emboli.  After a week in the hospital deteriorating with the following the patient expired.  Pulmonary embolism  Active Problems:   Cardiogenic shock    NSTEMI (non-ST elevated myocardial infarction)    Cardiomyopathy    Acute liver failure without hepatic coma   Rheumatoid arthritis    Renal failure   Aortic stenosis   Lactic acidosis   Cardiac arrest    Cerebral anoxia"
	"1478259-1"	"1478259-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"no known cardiovascular disease. He has been feeling less well recently .  About 1 month ago, he received the 2nd dose of the Moderna COVID-19 vaccine, and he developed an erythematous, non-raised rash involving the upper and lower extremities. This has subsided, but still persists on his thighs. He presented to the emergency department on 7/3 with worsening dyspnea. and diagnosed with  pulmonary emboli.  After a week in the hospital deteriorating with the following the patient expired.  Pulmonary embolism  Active Problems:   Cardiogenic shock    NSTEMI (non-ST elevated myocardial infarction)    Cardiomyopathy    Acute liver failure without hepatic coma   Rheumatoid arthritis    Renal failure   Aortic stenosis   Lactic acidosis   Cardiac arrest    Cerebral anoxia"
	"1478259-1"	"1478259-1"	"GENERAL PHYSICAL HEALTH DETERIORATION"	"10049438"	"50-59 years"	"50-59"	"no known cardiovascular disease. He has been feeling less well recently .  About 1 month ago, he received the 2nd dose of the Moderna COVID-19 vaccine, and he developed an erythematous, non-raised rash involving the upper and lower extremities. This has subsided, but still persists on his thighs. He presented to the emergency department on 7/3 with worsening dyspnea. and diagnosed with  pulmonary emboli.  After a week in the hospital deteriorating with the following the patient expired.  Pulmonary embolism  Active Problems:   Cardiogenic shock    NSTEMI (non-ST elevated myocardial infarction)    Cardiomyopathy    Acute liver failure without hepatic coma   Rheumatoid arthritis    Renal failure   Aortic stenosis   Lactic acidosis   Cardiac arrest    Cerebral anoxia"
	"1478259-1"	"1478259-1"	"LABORATORY TEST"	"10059938"	"50-59 years"	"50-59"	"no known cardiovascular disease. He has been feeling less well recently .  About 1 month ago, he received the 2nd dose of the Moderna COVID-19 vaccine, and he developed an erythematous, non-raised rash involving the upper and lower extremities. This has subsided, but still persists on his thighs. He presented to the emergency department on 7/3 with worsening dyspnea. and diagnosed with  pulmonary emboli.  After a week in the hospital deteriorating with the following the patient expired.  Pulmonary embolism  Active Problems:   Cardiogenic shock    NSTEMI (non-ST elevated myocardial infarction)    Cardiomyopathy    Acute liver failure without hepatic coma   Rheumatoid arthritis    Renal failure   Aortic stenosis   Lactic acidosis   Cardiac arrest    Cerebral anoxia"
	"1478259-1"	"1478259-1"	"LACTIC ACIDOSIS"	"10023676"	"50-59 years"	"50-59"	"no known cardiovascular disease. He has been feeling less well recently .  About 1 month ago, he received the 2nd dose of the Moderna COVID-19 vaccine, and he developed an erythematous, non-raised rash involving the upper and lower extremities. This has subsided, but still persists on his thighs. He presented to the emergency department on 7/3 with worsening dyspnea. and diagnosed with  pulmonary emboli.  After a week in the hospital deteriorating with the following the patient expired.  Pulmonary embolism  Active Problems:   Cardiogenic shock    NSTEMI (non-ST elevated myocardial infarction)    Cardiomyopathy    Acute liver failure without hepatic coma   Rheumatoid arthritis    Renal failure   Aortic stenosis   Lactic acidosis   Cardiac arrest    Cerebral anoxia"
	"1478259-1"	"1478259-1"	"MALAISE"	"10025482"	"50-59 years"	"50-59"	"no known cardiovascular disease. He has been feeling less well recently .  About 1 month ago, he received the 2nd dose of the Moderna COVID-19 vaccine, and he developed an erythematous, non-raised rash involving the upper and lower extremities. This has subsided, but still persists on his thighs. He presented to the emergency department on 7/3 with worsening dyspnea. and diagnosed with  pulmonary emboli.  After a week in the hospital deteriorating with the following the patient expired.  Pulmonary embolism  Active Problems:   Cardiogenic shock    NSTEMI (non-ST elevated myocardial infarction)    Cardiomyopathy    Acute liver failure without hepatic coma   Rheumatoid arthritis    Renal failure   Aortic stenosis   Lactic acidosis   Cardiac arrest    Cerebral anoxia"
	"1478259-1"	"1478259-1"	"PULMONARY EMBOLISM"	"10037377"	"50-59 years"	"50-59"	"no known cardiovascular disease. He has been feeling less well recently .  About 1 month ago, he received the 2nd dose of the Moderna COVID-19 vaccine, and he developed an erythematous, non-raised rash involving the upper and lower extremities. This has subsided, but still persists on his thighs. He presented to the emergency department on 7/3 with worsening dyspnea. and diagnosed with  pulmonary emboli.  After a week in the hospital deteriorating with the following the patient expired.  Pulmonary embolism  Active Problems:   Cardiogenic shock    NSTEMI (non-ST elevated myocardial infarction)    Cardiomyopathy    Acute liver failure without hepatic coma   Rheumatoid arthritis    Renal failure   Aortic stenosis   Lactic acidosis   Cardiac arrest    Cerebral anoxia"
	"1478259-1"	"1478259-1"	"RASH"	"10037844"	"50-59 years"	"50-59"	"no known cardiovascular disease. He has been feeling less well recently .  About 1 month ago, he received the 2nd dose of the Moderna COVID-19 vaccine, and he developed an erythematous, non-raised rash involving the upper and lower extremities. This has subsided, but still persists on his thighs. He presented to the emergency department on 7/3 with worsening dyspnea. and diagnosed with  pulmonary emboli.  After a week in the hospital deteriorating with the following the patient expired.  Pulmonary embolism  Active Problems:   Cardiogenic shock    NSTEMI (non-ST elevated myocardial infarction)    Cardiomyopathy    Acute liver failure without hepatic coma   Rheumatoid arthritis    Renal failure   Aortic stenosis   Lactic acidosis   Cardiac arrest    Cerebral anoxia"
	"1478259-1"	"1478259-1"	"RASH ERYTHEMATOUS"	"10037855"	"50-59 years"	"50-59"	"no known cardiovascular disease. He has been feeling less well recently .  About 1 month ago, he received the 2nd dose of the Moderna COVID-19 vaccine, and he developed an erythematous, non-raised rash involving the upper and lower extremities. This has subsided, but still persists on his thighs. He presented to the emergency department on 7/3 with worsening dyspnea. and diagnosed with  pulmonary emboli.  After a week in the hospital deteriorating with the following the patient expired.  Pulmonary embolism  Active Problems:   Cardiogenic shock    NSTEMI (non-ST elevated myocardial infarction)    Cardiomyopathy    Acute liver failure without hepatic coma   Rheumatoid arthritis    Renal failure   Aortic stenosis   Lactic acidosis   Cardiac arrest    Cerebral anoxia"
	"1478259-1"	"1478259-1"	"RASH PAPULAR"	"10037876"	"50-59 years"	"50-59"	"no known cardiovascular disease. He has been feeling less well recently .  About 1 month ago, he received the 2nd dose of the Moderna COVID-19 vaccine, and he developed an erythematous, non-raised rash involving the upper and lower extremities. This has subsided, but still persists on his thighs. He presented to the emergency department on 7/3 with worsening dyspnea. and diagnosed with  pulmonary emboli.  After a week in the hospital deteriorating with the following the patient expired.  Pulmonary embolism  Active Problems:   Cardiogenic shock    NSTEMI (non-ST elevated myocardial infarction)    Cardiomyopathy    Acute liver failure without hepatic coma   Rheumatoid arthritis    Renal failure   Aortic stenosis   Lactic acidosis   Cardiac arrest    Cerebral anoxia"
	"1478259-1"	"1478259-1"	"RENAL FAILURE"	"10038435"	"50-59 years"	"50-59"	"no known cardiovascular disease. He has been feeling less well recently .  About 1 month ago, he received the 2nd dose of the Moderna COVID-19 vaccine, and he developed an erythematous, non-raised rash involving the upper and lower extremities. This has subsided, but still persists on his thighs. He presented to the emergency department on 7/3 with worsening dyspnea. and diagnosed with  pulmonary emboli.  After a week in the hospital deteriorating with the following the patient expired.  Pulmonary embolism  Active Problems:   Cardiogenic shock    NSTEMI (non-ST elevated myocardial infarction)    Cardiomyopathy    Acute liver failure without hepatic coma   Rheumatoid arthritis    Renal failure   Aortic stenosis   Lactic acidosis   Cardiac arrest    Cerebral anoxia"
	"1478259-1"	"1478259-1"	"RHEUMATOID ARTHRITIS"	"10039073"	"50-59 years"	"50-59"	"no known cardiovascular disease. He has been feeling less well recently .  About 1 month ago, he received the 2nd dose of the Moderna COVID-19 vaccine, and he developed an erythematous, non-raised rash involving the upper and lower extremities. This has subsided, but still persists on his thighs. He presented to the emergency department on 7/3 with worsening dyspnea. and diagnosed with  pulmonary emboli.  After a week in the hospital deteriorating with the following the patient expired.  Pulmonary embolism  Active Problems:   Cardiogenic shock    NSTEMI (non-ST elevated myocardial infarction)    Cardiomyopathy    Acute liver failure without hepatic coma   Rheumatoid arthritis    Renal failure   Aortic stenosis   Lactic acidosis   Cardiac arrest    Cerebral anoxia"
	"1478618-1"	"1478618-1"	"CHEST PAIN"	"10008479"	"50-59 years"	"50-59"	"Patient reported deceased to public health today. Date of death: 7/15/2021.   Sister of patient reports that case reported chest pain while at home walking on his treadmill, he then had to lie down and sister asked him if he was having pain and wanted ambulance called. Reports that patient declined 911 call. Sister then reports that patient had what looked like a seizure, but then went completely unresponsive, so she initiated CPR and called 911. Reports that CPR and 911 response was not successful and patient passed away."
	"1478618-1"	"1478618-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient reported deceased to public health today. Date of death: 7/15/2021.   Sister of patient reports that case reported chest pain while at home walking on his treadmill, he then had to lie down and sister asked him if he was having pain and wanted ambulance called. Reports that patient declined 911 call. Sister then reports that patient had what looked like a seizure, but then went completely unresponsive, so she initiated CPR and called 911. Reports that CPR and 911 response was not successful and patient passed away."
	"1478618-1"	"1478618-1"	"RESUSCITATION"	"10038749"	"50-59 years"	"50-59"	"Patient reported deceased to public health today. Date of death: 7/15/2021.   Sister of patient reports that case reported chest pain while at home walking on his treadmill, he then had to lie down and sister asked him if he was having pain and wanted ambulance called. Reports that patient declined 911 call. Sister then reports that patient had what looked like a seizure, but then went completely unresponsive, so she initiated CPR and called 911. Reports that CPR and 911 response was not successful and patient passed away."
	"1478618-1"	"1478618-1"	"SEIZURE LIKE PHENOMENA"	"10071048"	"50-59 years"	"50-59"	"Patient reported deceased to public health today. Date of death: 7/15/2021.   Sister of patient reports that case reported chest pain while at home walking on his treadmill, he then had to lie down and sister asked him if he was having pain and wanted ambulance called. Reports that patient declined 911 call. Sister then reports that patient had what looked like a seizure, but then went completely unresponsive, so she initiated CPR and called 911. Reports that CPR and 911 response was not successful and patient passed away."
	"1478618-1"	"1478618-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"50-59 years"	"50-59"	"Patient reported deceased to public health today. Date of death: 7/15/2021.   Sister of patient reports that case reported chest pain while at home walking on his treadmill, he then had to lie down and sister asked him if he was having pain and wanted ambulance called. Reports that patient declined 911 call. Sister then reports that patient had what looked like a seizure, but then went completely unresponsive, so she initiated CPR and called 911. Reports that CPR and 911 response was not successful and patient passed away."
	"1483928-1"	"1483928-1"	"NEURALGIC AMYOTROPHY"	"10029229"	"50-59 years"	"50-59"	"Left brachial plexus neuritis with paralysis 3 days after second covid shot. hospitalized again for seizure episode on 4/21/21 , hospitalized again for sepsis on 6/10/2021"
	"1483928-1"	"1483928-1"	"PARALYSIS"	"10033799"	"50-59 years"	"50-59"	"Left brachial plexus neuritis with paralysis 3 days after second covid shot. hospitalized again for seizure episode on 4/21/21 , hospitalized again for sepsis on 6/10/2021"
	"1483928-1"	"1483928-1"	"SEIZURE"	"10039906"	"50-59 years"	"50-59"	"Left brachial plexus neuritis with paralysis 3 days after second covid shot. hospitalized again for seizure episode on 4/21/21 , hospitalized again for sepsis on 6/10/2021"
	"1483928-1"	"1483928-1"	"SEPSIS"	"10040047"	"50-59 years"	"50-59"	"Left brachial plexus neuritis with paralysis 3 days after second covid shot. hospitalized again for seizure episode on 4/21/21 , hospitalized again for sepsis on 6/10/2021"
	"1484107-1"	"1484107-1"	"ARRHYTHMIA"	"10003119"	"50-59 years"	"50-59"	"arrhythmia, presumed MI, death"
	"1484107-1"	"1484107-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"arrhythmia, presumed MI, death"
	"1484107-1"	"1484107-1"	"MYOCARDIAL INFARCTION"	"10028596"	"50-59 years"	"50-59"	"arrhythmia, presumed MI, death"
	"1484118-1"	"1484118-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Death"
	"1484890-1"	"1484890-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Death, found dead at home"
	"1484930-1"	"1484930-1"	"ACUTE KIDNEY INJURY"	"10069339"	"50-59 years"	"50-59"	"death E87.1 - Hypo-osmolality and hyponatremia N17.9 - AKI (acute kidney injury) (CMS/HCC)"
	"1484930-1"	"1484930-1"	"BLOOD OSMOLARITY DECREASED"	"10005696"	"50-59 years"	"50-59"	"death E87.1 - Hypo-osmolality and hyponatremia N17.9 - AKI (acute kidney injury) (CMS/HCC)"
	"1484930-1"	"1484930-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"death E87.1 - Hypo-osmolality and hyponatremia N17.9 - AKI (acute kidney injury) (CMS/HCC)"
	"1484930-1"	"1484930-1"	"HYPONATRAEMIA"	"10021036"	"50-59 years"	"50-59"	"death E87.1 - Hypo-osmolality and hyponatremia N17.9 - AKI (acute kidney injury) (CMS/HCC)"
	"1486815-1"	"1486815-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Death. Body was found and pronounced dead on 6/14/2021. It is assumed he died on 6/4/2021 as body was badly decomposed at time he was pronounced dead."
	"1486815-1"	"1486815-1"	"MYOCARDIAL INFARCTION"	"10028596"	"50-59 years"	"50-59"	"Death. Body was found and pronounced dead on 6/14/2021. It is assumed he died on 6/4/2021 as body was badly decomposed at time he was pronounced dead."
	"1486995-1"	"1486995-1"	"BLOOD GASES"	"10005537"	"50-59 years"	"50-59"	"Shortness of breath, fatigue, body aches, cough, diarrhea, nausea. Supplemental nasal cannula O2, labs, VBG, D-Dimer, chest imaging, COVID-19 test. Low probability of pulmonary embolism; CXR- bilateral hazy opacities on wet read; dexamethasone"
	"1486995-1"	"1486995-1"	"CHEST SCAN"	"10076373"	"50-59 years"	"50-59"	"Shortness of breath, fatigue, body aches, cough, diarrhea, nausea. Supplemental nasal cannula O2, labs, VBG, D-Dimer, chest imaging, COVID-19 test. Low probability of pulmonary embolism; CXR- bilateral hazy opacities on wet read; dexamethasone"
	"1486995-1"	"1486995-1"	"CHEST X-RAY ABNORMAL"	"10008499"	"50-59 years"	"50-59"	"Shortness of breath, fatigue, body aches, cough, diarrhea, nausea. Supplemental nasal cannula O2, labs, VBG, D-Dimer, chest imaging, COVID-19 test. Low probability of pulmonary embolism; CXR- bilateral hazy opacities on wet read; dexamethasone"
	"1486995-1"	"1486995-1"	"COUGH"	"10011224"	"50-59 years"	"50-59"	"Shortness of breath, fatigue, body aches, cough, diarrhea, nausea. Supplemental nasal cannula O2, labs, VBG, D-Dimer, chest imaging, COVID-19 test. Low probability of pulmonary embolism; CXR- bilateral hazy opacities on wet read; dexamethasone"
	"1486995-1"	"1486995-1"	"DIARRHOEA"	"10012735"	"50-59 years"	"50-59"	"Shortness of breath, fatigue, body aches, cough, diarrhea, nausea. Supplemental nasal cannula O2, labs, VBG, D-Dimer, chest imaging, COVID-19 test. Low probability of pulmonary embolism; CXR- bilateral hazy opacities on wet read; dexamethasone"
	"1486995-1"	"1486995-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"Shortness of breath, fatigue, body aches, cough, diarrhea, nausea. Supplemental nasal cannula O2, labs, VBG, D-Dimer, chest imaging, COVID-19 test. Low probability of pulmonary embolism; CXR- bilateral hazy opacities on wet read; dexamethasone"
	"1486995-1"	"1486995-1"	"FATIGUE"	"10016256"	"50-59 years"	"50-59"	"Shortness of breath, fatigue, body aches, cough, diarrhea, nausea. Supplemental nasal cannula O2, labs, VBG, D-Dimer, chest imaging, COVID-19 test. Low probability of pulmonary embolism; CXR- bilateral hazy opacities on wet read; dexamethasone"
	"1486995-1"	"1486995-1"	"FIBRIN D DIMER"	"10016577"	"50-59 years"	"50-59"	"Shortness of breath, fatigue, body aches, cough, diarrhea, nausea. Supplemental nasal cannula O2, labs, VBG, D-Dimer, chest imaging, COVID-19 test. Low probability of pulmonary embolism; CXR- bilateral hazy opacities on wet read; dexamethasone"
	"1486995-1"	"1486995-1"	"LABORATORY TEST"	"10059938"	"50-59 years"	"50-59"	"Shortness of breath, fatigue, body aches, cough, diarrhea, nausea. Supplemental nasal cannula O2, labs, VBG, D-Dimer, chest imaging, COVID-19 test. Low probability of pulmonary embolism; CXR- bilateral hazy opacities on wet read; dexamethasone"
	"1486995-1"	"1486995-1"	"LUNG OPACITY"	"10081792"	"50-59 years"	"50-59"	"Shortness of breath, fatigue, body aches, cough, diarrhea, nausea. Supplemental nasal cannula O2, labs, VBG, D-Dimer, chest imaging, COVID-19 test. Low probability of pulmonary embolism; CXR- bilateral hazy opacities on wet read; dexamethasone"
	"1486995-1"	"1486995-1"	"NAUSEA"	"10028813"	"50-59 years"	"50-59"	"Shortness of breath, fatigue, body aches, cough, diarrhea, nausea. Supplemental nasal cannula O2, labs, VBG, D-Dimer, chest imaging, COVID-19 test. Low probability of pulmonary embolism; CXR- bilateral hazy opacities on wet read; dexamethasone"
	"1486995-1"	"1486995-1"	"PAIN"	"10033371"	"50-59 years"	"50-59"	"Shortness of breath, fatigue, body aches, cough, diarrhea, nausea. Supplemental nasal cannula O2, labs, VBG, D-Dimer, chest imaging, COVID-19 test. Low probability of pulmonary embolism; CXR- bilateral hazy opacities on wet read; dexamethasone"
	"1486995-1"	"1486995-1"	"SARS-COV-2 TEST"	"10084354"	"50-59 years"	"50-59"	"Shortness of breath, fatigue, body aches, cough, diarrhea, nausea. Supplemental nasal cannula O2, labs, VBG, D-Dimer, chest imaging, COVID-19 test. Low probability of pulmonary embolism; CXR- bilateral hazy opacities on wet read; dexamethasone"
	"1487409-1"	"1487409-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"Pt admitted to inpatient rehab hospital following a stroke with PMH significant for hypertension and hyperlipidemia.  She had  multiple cardiac arrests secondary to massive pulmonary embolism and right ventricular failure.    Patient expired on 5/20/2021 upon chart review it was identified patient had received J&J vaccine on 4/7/2021."
	"1487409-1"	"1487409-1"	"CEREBROVASCULAR ACCIDENT"	"10008190"	"50-59 years"	"50-59"	"Pt admitted to inpatient rehab hospital following a stroke with PMH significant for hypertension and hyperlipidemia.  She had  multiple cardiac arrests secondary to massive pulmonary embolism and right ventricular failure.    Patient expired on 5/20/2021 upon chart review it was identified patient had received J&J vaccine on 4/7/2021."
	"1487409-1"	"1487409-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Pt admitted to inpatient rehab hospital following a stroke with PMH significant for hypertension and hyperlipidemia.  She had  multiple cardiac arrests secondary to massive pulmonary embolism and right ventricular failure.    Patient expired on 5/20/2021 upon chart review it was identified patient had received J&J vaccine on 4/7/2021."
	"1487409-1"	"1487409-1"	"PULMONARY EMBOLISM"	"10037377"	"50-59 years"	"50-59"	"Pt admitted to inpatient rehab hospital following a stroke with PMH significant for hypertension and hyperlipidemia.  She had  multiple cardiac arrests secondary to massive pulmonary embolism and right ventricular failure.    Patient expired on 5/20/2021 upon chart review it was identified patient had received J&J vaccine on 4/7/2021."
	"1487409-1"	"1487409-1"	"RIGHT VENTRICULAR FAILURE"	"10039163"	"50-59 years"	"50-59"	"Pt admitted to inpatient rehab hospital following a stroke with PMH significant for hypertension and hyperlipidemia.  She had  multiple cardiac arrests secondary to massive pulmonary embolism and right ventricular failure.    Patient expired on 5/20/2021 upon chart review it was identified patient had received J&J vaccine on 4/7/2021."
	"1490373-1"	"1490373-1"	"MALAISE"	"10025482"	"50-59 years"	"50-59"	"Within 24 hours of taking the vaccine my mom was very sick. She could not get out of bed and didn't leave her room for two days. She was shaking hard as if she was cold and could barely talk."
	"1490373-1"	"1490373-1"	"MOBILITY DECREASED"	"10048334"	"50-59 years"	"50-59"	"Within 24 hours of taking the vaccine my mom was very sick. She could not get out of bed and didn't leave her room for two days. She was shaking hard as if she was cold and could barely talk."
	"1490373-1"	"1490373-1"	"SPEECH DISORDER"	"10041466"	"50-59 years"	"50-59"	"Within 24 hours of taking the vaccine my mom was very sick. She could not get out of bed and didn't leave her room for two days. She was shaking hard as if she was cold and could barely talk."
	"1490373-1"	"1490373-1"	"TREMOR"	"10044565"	"50-59 years"	"50-59"	"Within 24 hours of taking the vaccine my mom was very sick. She could not get out of bed and didn't leave her room for two days. She was shaking hard as if she was cold and could barely talk."
	"1490511-1"	"1490511-1"	"BLOOD GLUCOSE INCREASED"	"10005557"	"50-59 years"	"50-59"	"Family notes patient started to have issues controlling blood glucose levels, prior to day of event patient had syncope episodes. 7/21/2021 patient had sudden cardiac arrest."
	"1490511-1"	"1490511-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"Family notes patient started to have issues controlling blood glucose levels, prior to day of event patient had syncope episodes. 7/21/2021 patient had sudden cardiac arrest."
	"1490511-1"	"1490511-1"	"CONDITION AGGRAVATED"	"10010264"	"50-59 years"	"50-59"	"Family notes patient started to have issues controlling blood glucose levels, prior to day of event patient had syncope episodes. 7/21/2021 patient had sudden cardiac arrest."
	"1490511-1"	"1490511-1"	"DIABETES MELLITUS"	"10012601"	"50-59 years"	"50-59"	"Family notes patient started to have issues controlling blood glucose levels, prior to day of event patient had syncope episodes. 7/21/2021 patient had sudden cardiac arrest."
	"1490511-1"	"1490511-1"	"SYNCOPE"	"10042772"	"50-59 years"	"50-59"	"Family notes patient started to have issues controlling blood glucose levels, prior to day of event patient had syncope episodes. 7/21/2021 patient had sudden cardiac arrest."
	"1490551-1"	"1490551-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"UNKNOWN COVID-19 vaccine was administered within the community on the same day patient expired.  Family might have this information.  Was not shared with us."
	"1490927-1"	"1490927-1"	"ACUTE RESPIRATORY FAILURE"	"10001053"	"50-59 years"	"50-59"	"Patient presented to hospital with acute hypoxemic resp failure. Pt had history of COVID19 infection in Nov 2020. Pt has chronic medical conditional including but not limited to marginal zone lymphoma on chemo, h/o aspergillus, MAC on atovoqone and voriconazole. Pt received moderna vaccine in May (1st shot), and June (2nd shot). Pt admitted on 7/16 found to have positive covid infection second time. Pt resp status steadily worsen from NC to reservoir, and then HFNC. Despite on remdesivir, prednisone, antibiotics, and antifungal. Pt had code blue due to resp arrest, intubated, then coded again in ICU for over 1 hour. Family elevated make patient DNR, and she died soon after on 7/20."
	"1490927-1"	"1490927-1"	"CARDIO-RESPIRATORY ARREST"	"10007617"	"50-59 years"	"50-59"	"Patient presented to hospital with acute hypoxemic resp failure. Pt had history of COVID19 infection in Nov 2020. Pt has chronic medical conditional including but not limited to marginal zone lymphoma on chemo, h/o aspergillus, MAC on atovoqone and voriconazole. Pt received moderna vaccine in May (1st shot), and June (2nd shot). Pt admitted on 7/16 found to have positive covid infection second time. Pt resp status steadily worsen from NC to reservoir, and then HFNC. Despite on remdesivir, prednisone, antibiotics, and antifungal. Pt had code blue due to resp arrest, intubated, then coded again in ICU for over 1 hour. Family elevated make patient DNR, and she died soon after on 7/20."
	"1490927-1"	"1490927-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Patient presented to hospital with acute hypoxemic resp failure. Pt had history of COVID19 infection in Nov 2020. Pt has chronic medical conditional including but not limited to marginal zone lymphoma on chemo, h/o aspergillus, MAC on atovoqone and voriconazole. Pt received moderna vaccine in May (1st shot), and June (2nd shot). Pt admitted on 7/16 found to have positive covid infection second time. Pt resp status steadily worsen from NC to reservoir, and then HFNC. Despite on remdesivir, prednisone, antibiotics, and antifungal. Pt had code blue due to resp arrest, intubated, then coded again in ICU for over 1 hour. Family elevated make patient DNR, and she died soon after on 7/20."
	"1490927-1"	"1490927-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient presented to hospital with acute hypoxemic resp failure. Pt had history of COVID19 infection in Nov 2020. Pt has chronic medical conditional including but not limited to marginal zone lymphoma on chemo, h/o aspergillus, MAC on atovoqone and voriconazole. Pt received moderna vaccine in May (1st shot), and June (2nd shot). Pt admitted on 7/16 found to have positive covid infection second time. Pt resp status steadily worsen from NC to reservoir, and then HFNC. Despite on remdesivir, prednisone, antibiotics, and antifungal. Pt had code blue due to resp arrest, intubated, then coded again in ICU for over 1 hour. Family elevated make patient DNR, and she died soon after on 7/20."
	"1490927-1"	"1490927-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"50-59 years"	"50-59"	"Patient presented to hospital with acute hypoxemic resp failure. Pt had history of COVID19 infection in Nov 2020. Pt has chronic medical conditional including but not limited to marginal zone lymphoma on chemo, h/o aspergillus, MAC on atovoqone and voriconazole. Pt received moderna vaccine in May (1st shot), and June (2nd shot). Pt admitted on 7/16 found to have positive covid infection second time. Pt resp status steadily worsen from NC to reservoir, and then HFNC. Despite on remdesivir, prednisone, antibiotics, and antifungal. Pt had code blue due to resp arrest, intubated, then coded again in ICU for over 1 hour. Family elevated make patient DNR, and she died soon after on 7/20."
	"1490927-1"	"1490927-1"	"INTENSIVE CARE"	"10022519"	"50-59 years"	"50-59"	"Patient presented to hospital with acute hypoxemic resp failure. Pt had history of COVID19 infection in Nov 2020. Pt has chronic medical conditional including but not limited to marginal zone lymphoma on chemo, h/o aspergillus, MAC on atovoqone and voriconazole. Pt received moderna vaccine in May (1st shot), and June (2nd shot). Pt admitted on 7/16 found to have positive covid infection second time. Pt resp status steadily worsen from NC to reservoir, and then HFNC. Despite on remdesivir, prednisone, antibiotics, and antifungal. Pt had code blue due to resp arrest, intubated, then coded again in ICU for over 1 hour. Family elevated make patient DNR, and she died soon after on 7/20."
	"1490927-1"	"1490927-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"Patient presented to hospital with acute hypoxemic resp failure. Pt had history of COVID19 infection in Nov 2020. Pt has chronic medical conditional including but not limited to marginal zone lymphoma on chemo, h/o aspergillus, MAC on atovoqone and voriconazole. Pt received moderna vaccine in May (1st shot), and June (2nd shot). Pt admitted on 7/16 found to have positive covid infection second time. Pt resp status steadily worsen from NC to reservoir, and then HFNC. Despite on remdesivir, prednisone, antibiotics, and antifungal. Pt had code blue due to resp arrest, intubated, then coded again in ICU for over 1 hour. Family elevated make patient DNR, and she died soon after on 7/20."
	"1494343-1"	"1494343-1"	"CARDIAC MONITORING"	"10053438"	"50-59 years"	"50-59"	"Started with suspected seizure onset after 3/10/21 covid vaccine and subsequently deceased of unclear etiology on 7/12/21. Family is concerned it is covid vaccine related."
	"1494343-1"	"1494343-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Started with suspected seizure onset after 3/10/21 covid vaccine and subsequently deceased of unclear etiology on 7/12/21. Family is concerned it is covid vaccine related."
	"1494343-1"	"1494343-1"	"ELECTROCARDIOGRAM"	"10014362"	"50-59 years"	"50-59"	"Started with suspected seizure onset after 3/10/21 covid vaccine and subsequently deceased of unclear etiology on 7/12/21. Family is concerned it is covid vaccine related."
	"1494343-1"	"1494343-1"	"ELECTROENCEPHALOGRAM"	"10014407"	"50-59 years"	"50-59"	"Started with suspected seizure onset after 3/10/21 covid vaccine and subsequently deceased of unclear etiology on 7/12/21. Family is concerned it is covid vaccine related."
	"1494343-1"	"1494343-1"	"LABORATORY TEST"	"10059938"	"50-59 years"	"50-59"	"Started with suspected seizure onset after 3/10/21 covid vaccine and subsequently deceased of unclear etiology on 7/12/21. Family is concerned it is covid vaccine related."
	"1494343-1"	"1494343-1"	"MAGNETIC RESONANCE IMAGING HEAD"	"10085255"	"50-59 years"	"50-59"	"Started with suspected seizure onset after 3/10/21 covid vaccine and subsequently deceased of unclear etiology on 7/12/21. Family is concerned it is covid vaccine related."
	"1494343-1"	"1494343-1"	"SEIZURE"	"10039906"	"50-59 years"	"50-59"	"Started with suspected seizure onset after 3/10/21 covid vaccine and subsequently deceased of unclear etiology on 7/12/21. Family is concerned it is covid vaccine related."
	"1496326-1"	"1496326-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Pt died 15  days post vaccine admin without prior medical history."
	"1501182-1"	"1501182-1"	"COMPLETED SUICIDE"	"10010144"	"50-59 years"	"50-59"	"Suicide"
	"1501811-1"	"1501811-1"	"CHILLS"	"10008531"	"50-59 years"	"50-59"	"Day of injection patient was experiencing fever and chills, also had sore arm. 2 days after the injection the patient was found dead"
	"1501811-1"	"1501811-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Day of injection patient was experiencing fever and chills, also had sore arm. 2 days after the injection the patient was found dead"
	"1501811-1"	"1501811-1"	"PAIN IN EXTREMITY"	"10033425"	"50-59 years"	"50-59"	"Day of injection patient was experiencing fever and chills, also had sore arm. 2 days after the injection the patient was found dead"
	"1501811-1"	"1501811-1"	"PYREXIA"	"10037660"	"50-59 years"	"50-59"	"Day of injection patient was experiencing fever and chills, also had sore arm. 2 days after the injection the patient was found dead"
	"1501826-1"	"1501826-1"	"ACUTE KIDNEY INJURY"	"10069339"	"50-59 years"	"50-59"	"7/4/2021: Patient transferred from Hosptial after presenting with generalized weakness, cough, shortness of breath and blood in the urine.  Patient tested positive for COVID on 7/3/2021.   Diagnosed with acute bilateral pneumonia secondary to COVID-19, acute hypoxic resp failure, severe ARDS, acute metabolic encephalopathy, AKI. intubated in the ICU.  Note: patient fully vaccinated with Moderna COVID-19 vaccine.  7.25.21: patient died."
	"1501826-1"	"1501826-1"	"ACUTE RESPIRATORY DISTRESS SYNDROME"	"10001052"	"50-59 years"	"50-59"	"7/4/2021: Patient transferred from Hosptial after presenting with generalized weakness, cough, shortness of breath and blood in the urine.  Patient tested positive for COVID on 7/3/2021.   Diagnosed with acute bilateral pneumonia secondary to COVID-19, acute hypoxic resp failure, severe ARDS, acute metabolic encephalopathy, AKI. intubated in the ICU.  Note: patient fully vaccinated with Moderna COVID-19 vaccine.  7.25.21: patient died."
	"1501826-1"	"1501826-1"	"ACUTE RESPIRATORY FAILURE"	"10001053"	"50-59 years"	"50-59"	"7/4/2021: Patient transferred from Hosptial after presenting with generalized weakness, cough, shortness of breath and blood in the urine.  Patient tested positive for COVID on 7/3/2021.   Diagnosed with acute bilateral pneumonia secondary to COVID-19, acute hypoxic resp failure, severe ARDS, acute metabolic encephalopathy, AKI. intubated in the ICU.  Note: patient fully vaccinated with Moderna COVID-19 vaccine.  7.25.21: patient died."
	"1501826-1"	"1501826-1"	"ASTHENIA"	"10003549"	"50-59 years"	"50-59"	"7/4/2021: Patient transferred from Hosptial after presenting with generalized weakness, cough, shortness of breath and blood in the urine.  Patient tested positive for COVID on 7/3/2021.   Diagnosed with acute bilateral pneumonia secondary to COVID-19, acute hypoxic resp failure, severe ARDS, acute metabolic encephalopathy, AKI. intubated in the ICU.  Note: patient fully vaccinated with Moderna COVID-19 vaccine.  7.25.21: patient died."
	"1501826-1"	"1501826-1"	"BLOOD URINE PRESENT"	"10018870"	"50-59 years"	"50-59"	"7/4/2021: Patient transferred from Hosptial after presenting with generalized weakness, cough, shortness of breath and blood in the urine.  Patient tested positive for COVID on 7/3/2021.   Diagnosed with acute bilateral pneumonia secondary to COVID-19, acute hypoxic resp failure, severe ARDS, acute metabolic encephalopathy, AKI. intubated in the ICU.  Note: patient fully vaccinated with Moderna COVID-19 vaccine.  7.25.21: patient died."
	"1501826-1"	"1501826-1"	"COUGH"	"10011224"	"50-59 years"	"50-59"	"7/4/2021: Patient transferred from Hosptial after presenting with generalized weakness, cough, shortness of breath and blood in the urine.  Patient tested positive for COVID on 7/3/2021.   Diagnosed with acute bilateral pneumonia secondary to COVID-19, acute hypoxic resp failure, severe ARDS, acute metabolic encephalopathy, AKI. intubated in the ICU.  Note: patient fully vaccinated with Moderna COVID-19 vaccine.  7.25.21: patient died."
	"1501826-1"	"1501826-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"7/4/2021: Patient transferred from Hosptial after presenting with generalized weakness, cough, shortness of breath and blood in the urine.  Patient tested positive for COVID on 7/3/2021.   Diagnosed with acute bilateral pneumonia secondary to COVID-19, acute hypoxic resp failure, severe ARDS, acute metabolic encephalopathy, AKI. intubated in the ICU.  Note: patient fully vaccinated with Moderna COVID-19 vaccine.  7.25.21: patient died."
	"1501826-1"	"1501826-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"7/4/2021: Patient transferred from Hosptial after presenting with generalized weakness, cough, shortness of breath and blood in the urine.  Patient tested positive for COVID on 7/3/2021.   Diagnosed with acute bilateral pneumonia secondary to COVID-19, acute hypoxic resp failure, severe ARDS, acute metabolic encephalopathy, AKI. intubated in the ICU.  Note: patient fully vaccinated with Moderna COVID-19 vaccine.  7.25.21: patient died."
	"1501826-1"	"1501826-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"7/4/2021: Patient transferred from Hosptial after presenting with generalized weakness, cough, shortness of breath and blood in the urine.  Patient tested positive for COVID on 7/3/2021.   Diagnosed with acute bilateral pneumonia secondary to COVID-19, acute hypoxic resp failure, severe ARDS, acute metabolic encephalopathy, AKI. intubated in the ICU.  Note: patient fully vaccinated with Moderna COVID-19 vaccine.  7.25.21: patient died."
	"1501826-1"	"1501826-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"50-59 years"	"50-59"	"7/4/2021: Patient transferred from Hosptial after presenting with generalized weakness, cough, shortness of breath and blood in the urine.  Patient tested positive for COVID on 7/3/2021.   Diagnosed with acute bilateral pneumonia secondary to COVID-19, acute hypoxic resp failure, severe ARDS, acute metabolic encephalopathy, AKI. intubated in the ICU.  Note: patient fully vaccinated with Moderna COVID-19 vaccine.  7.25.21: patient died."
	"1501826-1"	"1501826-1"	"INTENSIVE CARE"	"10022519"	"50-59 years"	"50-59"	"7/4/2021: Patient transferred from Hosptial after presenting with generalized weakness, cough, shortness of breath and blood in the urine.  Patient tested positive for COVID on 7/3/2021.   Diagnosed with acute bilateral pneumonia secondary to COVID-19, acute hypoxic resp failure, severe ARDS, acute metabolic encephalopathy, AKI. intubated in the ICU.  Note: patient fully vaccinated with Moderna COVID-19 vaccine.  7.25.21: patient died."
	"1501826-1"	"1501826-1"	"METABOLIC ENCEPHALOPATHY"	"10062190"	"50-59 years"	"50-59"	"7/4/2021: Patient transferred from Hosptial after presenting with generalized weakness, cough, shortness of breath and blood in the urine.  Patient tested positive for COVID on 7/3/2021.   Diagnosed with acute bilateral pneumonia secondary to COVID-19, acute hypoxic resp failure, severe ARDS, acute metabolic encephalopathy, AKI. intubated in the ICU.  Note: patient fully vaccinated with Moderna COVID-19 vaccine.  7.25.21: patient died."
	"1501826-1"	"1501826-1"	"PNEUMONIA"	"10035664"	"50-59 years"	"50-59"	"7/4/2021: Patient transferred from Hosptial after presenting with generalized weakness, cough, shortness of breath and blood in the urine.  Patient tested positive for COVID on 7/3/2021.   Diagnosed with acute bilateral pneumonia secondary to COVID-19, acute hypoxic resp failure, severe ARDS, acute metabolic encephalopathy, AKI. intubated in the ICU.  Note: patient fully vaccinated with Moderna COVID-19 vaccine.  7.25.21: patient died."
	"1501826-1"	"1501826-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"7/4/2021: Patient transferred from Hosptial after presenting with generalized weakness, cough, shortness of breath and blood in the urine.  Patient tested positive for COVID on 7/3/2021.   Diagnosed with acute bilateral pneumonia secondary to COVID-19, acute hypoxic resp failure, severe ARDS, acute metabolic encephalopathy, AKI. intubated in the ICU.  Note: patient fully vaccinated with Moderna COVID-19 vaccine.  7.25.21: patient died."
	"1502028-1"	"1502028-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"ADMITTED TO HOSPITAL AND SUBSEQUESTLY DIED"
	"1502028-1"	"1502028-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"ADMITTED TO HOSPITAL AND SUBSEQUESTLY DIED"
	"1502028-1"	"1502028-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"ADMITTED TO HOSPITAL AND SUBSEQUESTLY DIED"
	"1502051-1"	"1502051-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Death R65.10 - SIRS (systemic inflammatory response syndrome)"
	"1502051-1"	"1502051-1"	"SYSTEMIC INFLAMMATORY RESPONSE SYNDROME"	"10051379"	"50-59 years"	"50-59"	"Death R65.10 - SIRS (systemic inflammatory response syndrome)"
	"1502072-1"	"1502072-1"	"ACUTE KIDNEY INJURY"	"10069339"	"50-59 years"	"50-59"	"death J18.9 - Pneumonia, unspecified organism K92.2 - Gastrointestinal hemorrhage, unspecified N17.9 - Acute kidney failure, unspecified"
	"1502072-1"	"1502072-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"death J18.9 - Pneumonia, unspecified organism K92.2 - Gastrointestinal hemorrhage, unspecified N17.9 - Acute kidney failure, unspecified"
	"1502072-1"	"1502072-1"	"GASTROINTESTINAL HAEMORRHAGE"	"10017955"	"50-59 years"	"50-59"	"death J18.9 - Pneumonia, unspecified organism K92.2 - Gastrointestinal hemorrhage, unspecified N17.9 - Acute kidney failure, unspecified"
	"1502072-1"	"1502072-1"	"PNEUMONIA"	"10035664"	"50-59 years"	"50-59"	"death J18.9 - Pneumonia, unspecified organism K92.2 - Gastrointestinal hemorrhage, unspecified N17.9 - Acute kidney failure, unspecified"
	"1509660-1"	"1509660-1"	"ARTERIAL THROMBOSIS"	"10003178"	"50-59 years"	"50-59"	"pt developed fever later the day after getting his covid vax so he took ibuprofen and went to bed.  Next day he went back to work.  Pt showed no symptoms until the month of June when he started complaining about pain in both arms.  He was using a heating pad on his shoulders to help with the pain.   He was taking Aleve for the pain but it was not helping so he no longer wanted to take it.  He had a vomiting episode on the afternoon of June 16th stating he thought he has eaten a bad lemon.  He wasn't feeling well the morning of June 18th, 2021 but continued working.  He only wanted something light to eat since he didn't feel well and was headed to bed.  When his wife went to go to bed she found him collapsed on the bedroom floor with face forward in the bed.  She turned him around and found him unresponsive.  She contacted 911 and he was taken to Medical Center ER.  They were not able to revive him.  County conducted an autopsy where they found a blood clot in left artery."
	"1509660-1"	"1509660-1"	"AUTOPSY"	"10050117"	"50-59 years"	"50-59"	"pt developed fever later the day after getting his covid vax so he took ibuprofen and went to bed.  Next day he went back to work.  Pt showed no symptoms until the month of June when he started complaining about pain in both arms.  He was using a heating pad on his shoulders to help with the pain.   He was taking Aleve for the pain but it was not helping so he no longer wanted to take it.  He had a vomiting episode on the afternoon of June 16th stating he thought he has eaten a bad lemon.  He wasn't feeling well the morning of June 18th, 2021 but continued working.  He only wanted something light to eat since he didn't feel well and was headed to bed.  When his wife went to go to bed she found him collapsed on the bedroom floor with face forward in the bed.  She turned him around and found him unresponsive.  She contacted 911 and he was taken to Medical Center ER.  They were not able to revive him.  County conducted an autopsy where they found a blood clot in left artery."
	"1509660-1"	"1509660-1"	"MALAISE"	"10025482"	"50-59 years"	"50-59"	"pt developed fever later the day after getting his covid vax so he took ibuprofen and went to bed.  Next day he went back to work.  Pt showed no symptoms until the month of June when he started complaining about pain in both arms.  He was using a heating pad on his shoulders to help with the pain.   He was taking Aleve for the pain but it was not helping so he no longer wanted to take it.  He had a vomiting episode on the afternoon of June 16th stating he thought he has eaten a bad lemon.  He wasn't feeling well the morning of June 18th, 2021 but continued working.  He only wanted something light to eat since he didn't feel well and was headed to bed.  When his wife went to go to bed she found him collapsed on the bedroom floor with face forward in the bed.  She turned him around and found him unresponsive.  She contacted 911 and he was taken to Medical Center ER.  They were not able to revive him.  County conducted an autopsy where they found a blood clot in left artery."
	"1509660-1"	"1509660-1"	"PAIN IN EXTREMITY"	"10033425"	"50-59 years"	"50-59"	"pt developed fever later the day after getting his covid vax so he took ibuprofen and went to bed.  Next day he went back to work.  Pt showed no symptoms until the month of June when he started complaining about pain in both arms.  He was using a heating pad on his shoulders to help with the pain.   He was taking Aleve for the pain but it was not helping so he no longer wanted to take it.  He had a vomiting episode on the afternoon of June 16th stating he thought he has eaten a bad lemon.  He wasn't feeling well the morning of June 18th, 2021 but continued working.  He only wanted something light to eat since he didn't feel well and was headed to bed.  When his wife went to go to bed she found him collapsed on the bedroom floor with face forward in the bed.  She turned him around and found him unresponsive.  She contacted 911 and he was taken to Medical Center ER.  They were not able to revive him.  County conducted an autopsy where they found a blood clot in left artery."
	"1509660-1"	"1509660-1"	"PYREXIA"	"10037660"	"50-59 years"	"50-59"	"pt developed fever later the day after getting his covid vax so he took ibuprofen and went to bed.  Next day he went back to work.  Pt showed no symptoms until the month of June when he started complaining about pain in both arms.  He was using a heating pad on his shoulders to help with the pain.   He was taking Aleve for the pain but it was not helping so he no longer wanted to take it.  He had a vomiting episode on the afternoon of June 16th stating he thought he has eaten a bad lemon.  He wasn't feeling well the morning of June 18th, 2021 but continued working.  He only wanted something light to eat since he didn't feel well and was headed to bed.  When his wife went to go to bed she found him collapsed on the bedroom floor with face forward in the bed.  She turned him around and found him unresponsive.  She contacted 911 and he was taken to Medical Center ER.  They were not able to revive him.  County conducted an autopsy where they found a blood clot in left artery."
	"1509660-1"	"1509660-1"	"SYNCOPE"	"10042772"	"50-59 years"	"50-59"	"pt developed fever later the day after getting his covid vax so he took ibuprofen and went to bed.  Next day he went back to work.  Pt showed no symptoms until the month of June when he started complaining about pain in both arms.  He was using a heating pad on his shoulders to help with the pain.   He was taking Aleve for the pain but it was not helping so he no longer wanted to take it.  He had a vomiting episode on the afternoon of June 16th stating he thought he has eaten a bad lemon.  He wasn't feeling well the morning of June 18th, 2021 but continued working.  He only wanted something light to eat since he didn't feel well and was headed to bed.  When his wife went to go to bed she found him collapsed on the bedroom floor with face forward in the bed.  She turned him around and found him unresponsive.  She contacted 911 and he was taken to Medical Center ER.  They were not able to revive him.  County conducted an autopsy where they found a blood clot in left artery."
	"1509660-1"	"1509660-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"50-59 years"	"50-59"	"pt developed fever later the day after getting his covid vax so he took ibuprofen and went to bed.  Next day he went back to work.  Pt showed no symptoms until the month of June when he started complaining about pain in both arms.  He was using a heating pad on his shoulders to help with the pain.   He was taking Aleve for the pain but it was not helping so he no longer wanted to take it.  He had a vomiting episode on the afternoon of June 16th stating he thought he has eaten a bad lemon.  He wasn't feeling well the morning of June 18th, 2021 but continued working.  He only wanted something light to eat since he didn't feel well and was headed to bed.  When his wife went to go to bed she found him collapsed on the bedroom floor with face forward in the bed.  She turned him around and found him unresponsive.  She contacted 911 and he was taken to Medical Center ER.  They were not able to revive him.  County conducted an autopsy where they found a blood clot in left artery."
	"1509660-1"	"1509660-1"	"VOMITING"	"10047700"	"50-59 years"	"50-59"	"pt developed fever later the day after getting his covid vax so he took ibuprofen and went to bed.  Next day he went back to work.  Pt showed no symptoms until the month of June when he started complaining about pain in both arms.  He was using a heating pad on his shoulders to help with the pain.   He was taking Aleve for the pain but it was not helping so he no longer wanted to take it.  He had a vomiting episode on the afternoon of June 16th stating he thought he has eaten a bad lemon.  He wasn't feeling well the morning of June 18th, 2021 but continued working.  He only wanted something light to eat since he didn't feel well and was headed to bed.  When his wife went to go to bed she found him collapsed on the bedroom floor with face forward in the bed.  She turned him around and found him unresponsive.  She contacted 911 and he was taken to Medical Center ER.  They were not able to revive him.  County conducted an autopsy where they found a blood clot in left artery."
	"1509756-1"	"1509756-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient was hospitalized and passed away.   2nd vaccine given 4/6/2021"
	"1511612-1"	"1511612-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"He passed in his sleep that night.; This spontaneous case was reported by a consumer and describes the occurrence of DEATH (He passed in his sleep that night.) in a 52-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 091D21A) for COVID-19 vaccination.     No Medical History information was reported.    On 22-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. Death occurred on 22-Jul-2021 The patient died on 22-Jul-2021. The cause of death was not reported. It is unknown if an autopsy was performed.            No concomitant medication was given. No treatment information was given. Patient received the 1st dose of the Moderna Covid-19 vaccine. He died in his sleep that night.  This a report of dead one day after the first dose of the product in an 52-year-old patient with no comorbidities. Very limited information regarding the event has been provided for inferring causality. Further information is not expected.; Sender's Comments: This a report of dead one day after the first dose of the product in an 52-year-old patient with no comorbidities. Very limited information regarding the event has been provided for inferring causality. Further information is not expected.; Reported Cause(s) of Death: unknown"
	"1512416-1"	"1512416-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"Patient tested positive for COVID on 12/16/2020. Patient received both doses of the Pfizer COVID vaccine on 01/14/2021 and 02/04/2021, and again tested positive for COVID on 03/26/2021. She was transferred from outside medical facility to Medical Center on 03/28/2021 due to concerns over new COVID infection and cellulitis. Patient was found unresponsive and not breathing the morning of 03/30/2021 and died at 5:34AM from cardiac arrest."
	"1512416-1"	"1512416-1"	"CELLULITIS"	"10007882"	"50-59 years"	"50-59"	"Patient tested positive for COVID on 12/16/2020. Patient received both doses of the Pfizer COVID vaccine on 01/14/2021 and 02/04/2021, and again tested positive for COVID on 03/26/2021. She was transferred from outside medical facility to Medical Center on 03/28/2021 due to concerns over new COVID infection and cellulitis. Patient was found unresponsive and not breathing the morning of 03/30/2021 and died at 5:34AM from cardiac arrest."
	"1512416-1"	"1512416-1"	"CONDITION AGGRAVATED"	"10010264"	"50-59 years"	"50-59"	"Patient tested positive for COVID on 12/16/2020. Patient received both doses of the Pfizer COVID vaccine on 01/14/2021 and 02/04/2021, and again tested positive for COVID on 03/26/2021. She was transferred from outside medical facility to Medical Center on 03/28/2021 due to concerns over new COVID infection and cellulitis. Patient was found unresponsive and not breathing the morning of 03/30/2021 and died at 5:34AM from cardiac arrest."
	"1512416-1"	"1512416-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Patient tested positive for COVID on 12/16/2020. Patient received both doses of the Pfizer COVID vaccine on 01/14/2021 and 02/04/2021, and again tested positive for COVID on 03/26/2021. She was transferred from outside medical facility to Medical Center on 03/28/2021 due to concerns over new COVID infection and cellulitis. Patient was found unresponsive and not breathing the morning of 03/30/2021 and died at 5:34AM from cardiac arrest."
	"1512416-1"	"1512416-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient tested positive for COVID on 12/16/2020. Patient received both doses of the Pfizer COVID vaccine on 01/14/2021 and 02/04/2021, and again tested positive for COVID on 03/26/2021. She was transferred from outside medical facility to Medical Center on 03/28/2021 due to concerns over new COVID infection and cellulitis. Patient was found unresponsive and not breathing the morning of 03/30/2021 and died at 5:34AM from cardiac arrest."
	"1512416-1"	"1512416-1"	"RESPIRATORY ARREST"	"10038669"	"50-59 years"	"50-59"	"Patient tested positive for COVID on 12/16/2020. Patient received both doses of the Pfizer COVID vaccine on 01/14/2021 and 02/04/2021, and again tested positive for COVID on 03/26/2021. She was transferred from outside medical facility to Medical Center on 03/28/2021 due to concerns over new COVID infection and cellulitis. Patient was found unresponsive and not breathing the morning of 03/30/2021 and died at 5:34AM from cardiac arrest."
	"1512416-1"	"1512416-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"Patient tested positive for COVID on 12/16/2020. Patient received both doses of the Pfizer COVID vaccine on 01/14/2021 and 02/04/2021, and again tested positive for COVID on 03/26/2021. She was transferred from outside medical facility to Medical Center on 03/28/2021 due to concerns over new COVID infection and cellulitis. Patient was found unresponsive and not breathing the morning of 03/30/2021 and died at 5:34AM from cardiac arrest."
	"1512416-1"	"1512416-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"50-59 years"	"50-59"	"Patient tested positive for COVID on 12/16/2020. Patient received both doses of the Pfizer COVID vaccine on 01/14/2021 and 02/04/2021, and again tested positive for COVID on 03/26/2021. She was transferred from outside medical facility to Medical Center on 03/28/2021 due to concerns over new COVID infection and cellulitis. Patient was found unresponsive and not breathing the morning of 03/30/2021 and died at 5:34AM from cardiac arrest."
	"1515405-1"	"1515405-1"	"BLOOD CREATININE INCREASED"	"10005483"	"50-59 years"	"50-59"	"Pt found unresponsive at home and confused. Enroute to hospital by EMS, pt respiratory arrested. ROSC was achieved.  Pt cardiac arrested 2nd time, with ROSC.  Pt critical upon admission."
	"1515405-1"	"1515405-1"	"BLOOD GLUCOSE DECREASED"	"10005555"	"50-59 years"	"50-59"	"Pt found unresponsive at home and confused. Enroute to hospital by EMS, pt respiratory arrested. ROSC was achieved.  Pt cardiac arrested 2nd time, with ROSC.  Pt critical upon admission."
	"1515405-1"	"1515405-1"	"BLOOD POTASSIUM INCREASED"	"10005725"	"50-59 years"	"50-59"	"Pt found unresponsive at home and confused. Enroute to hospital by EMS, pt respiratory arrested. ROSC was achieved.  Pt cardiac arrested 2nd time, with ROSC.  Pt critical upon admission."
	"1515405-1"	"1515405-1"	"BLOOD SODIUM DECREASED"	"10005802"	"50-59 years"	"50-59"	"Pt found unresponsive at home and confused. Enroute to hospital by EMS, pt respiratory arrested. ROSC was achieved.  Pt cardiac arrested 2nd time, with ROSC.  Pt critical upon admission."
	"1515405-1"	"1515405-1"	"BLOOD UREA INCREASED"	"10005851"	"50-59 years"	"50-59"	"Pt found unresponsive at home and confused. Enroute to hospital by EMS, pt respiratory arrested. ROSC was achieved.  Pt cardiac arrested 2nd time, with ROSC.  Pt critical upon admission."
	"1515405-1"	"1515405-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"Pt found unresponsive at home and confused. Enroute to hospital by EMS, pt respiratory arrested. ROSC was achieved.  Pt cardiac arrested 2nd time, with ROSC.  Pt critical upon admission."
	"1515405-1"	"1515405-1"	"CONFUSIONAL STATE"	"10010305"	"50-59 years"	"50-59"	"Pt found unresponsive at home and confused. Enroute to hospital by EMS, pt respiratory arrested. ROSC was achieved.  Pt cardiac arrested 2nd time, with ROSC.  Pt critical upon admission."
	"1515405-1"	"1515405-1"	"CRITICAL ILLNESS"	"10077264"	"50-59 years"	"50-59"	"Pt found unresponsive at home and confused. Enroute to hospital by EMS, pt respiratory arrested. ROSC was achieved.  Pt cardiac arrested 2nd time, with ROSC.  Pt critical upon admission."
	"1515405-1"	"1515405-1"	"RESPIRATORY ARREST"	"10038669"	"50-59 years"	"50-59"	"Pt found unresponsive at home and confused. Enroute to hospital by EMS, pt respiratory arrested. ROSC was achieved.  Pt cardiac arrested 2nd time, with ROSC.  Pt critical upon admission."
	"1515405-1"	"1515405-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"50-59 years"	"50-59"	"Pt found unresponsive at home and confused. Enroute to hospital by EMS, pt respiratory arrested. ROSC was achieved.  Pt cardiac arrested 2nd time, with ROSC.  Pt critical upon admission."
	"1515405-1"	"1515405-1"	"WHITE BLOOD CELL COUNT NORMAL"	"10047944"	"50-59 years"	"50-59"	"Pt found unresponsive at home and confused. Enroute to hospital by EMS, pt respiratory arrested. ROSC was achieved.  Pt cardiac arrested 2nd time, with ROSC.  Pt critical upon admission."
	"1519779-1"	"1519779-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"50-59 years"	"50-59"	"Admit to Medical Center 7/9/2021. Intubated 7/18-7/24 & 7/26-7/30"
	"1519797-1"	"1519797-1"	"BLOOD LACTIC ACID"	"10005632"	"50-59 years"	"50-59"	"Admit 7/1-7/4. Re-Admission 7/11. Expired 7/14."
	"1519797-1"	"1519797-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Admit 7/1-7/4. Re-Admission 7/11. Expired 7/14."
	"1519797-1"	"1519797-1"	"PROTHROMBIN TIME PROLONGED"	"10037063"	"50-59 years"	"50-59"	"Admit 7/1-7/4. Re-Admission 7/11. Expired 7/14."
	"1519797-1"	"1519797-1"	"WHITE BLOOD CELL COUNT INCREASED"	"10047943"	"50-59 years"	"50-59"	"Admit 7/1-7/4. Re-Admission 7/11. Expired 7/14."
	"1522879-1"	"1522879-1"	"COUGH"	"10011224"	"50-59 years"	"50-59"	"Cough, Fever, Muscle Aches"
	"1522879-1"	"1522879-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Cough, Fever, Muscle Aches"
	"1522879-1"	"1522879-1"	"MYALGIA"	"10028411"	"50-59 years"	"50-59"	"Cough, Fever, Muscle Aches"
	"1522879-1"	"1522879-1"	"PYREXIA"	"10037660"	"50-59 years"	"50-59"	"Cough, Fever, Muscle Aches"
	"1522879-1"	"1522879-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"Cough, Fever, Muscle Aches"
	"1522949-1"	"1522949-1"	"ANTICOAGULANT THERAPY"	"10053468"	"50-59 years"	"50-59"	"Case fully Covid-19 vaccinated at the end of February. On 07/16/2021 patient tested positive with Covid-19. Patient admitted on 07/27/2021 ICU with shortness of breath, productive cough and O2 % on 86%. CXR on 07/27/2021 shows bilateral infiltrate's. patient was hypoxic and tachypneic.  07/31/2021 patient become more shortness of breath and was put on CPAP high flow and CT of the chest was done showing PE. Patient was put on Heparin drip. Patient decompensated  on 08/02/2021, was connected to MV and went to cardiac arrest, patient pass at 09:57 on 08/02/2021."
	"1522949-1"	"1522949-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"Case fully Covid-19 vaccinated at the end of February. On 07/16/2021 patient tested positive with Covid-19. Patient admitted on 07/27/2021 ICU with shortness of breath, productive cough and O2 % on 86%. CXR on 07/27/2021 shows bilateral infiltrate's. patient was hypoxic and tachypneic.  07/31/2021 patient become more shortness of breath and was put on CPAP high flow and CT of the chest was done showing PE. Patient was put on Heparin drip. Patient decompensated  on 08/02/2021, was connected to MV and went to cardiac arrest, patient pass at 09:57 on 08/02/2021."
	"1522949-1"	"1522949-1"	"CHEST X-RAY ABNORMAL"	"10008499"	"50-59 years"	"50-59"	"Case fully Covid-19 vaccinated at the end of February. On 07/16/2021 patient tested positive with Covid-19. Patient admitted on 07/27/2021 ICU with shortness of breath, productive cough and O2 % on 86%. CXR on 07/27/2021 shows bilateral infiltrate's. patient was hypoxic and tachypneic.  07/31/2021 patient become more shortness of breath and was put on CPAP high flow and CT of the chest was done showing PE. Patient was put on Heparin drip. Patient decompensated  on 08/02/2021, was connected to MV and went to cardiac arrest, patient pass at 09:57 on 08/02/2021."
	"1522949-1"	"1522949-1"	"COMPUTERISED TOMOGRAM THORAX ABNORMAL"	"10057799"	"50-59 years"	"50-59"	"Case fully Covid-19 vaccinated at the end of February. On 07/16/2021 patient tested positive with Covid-19. Patient admitted on 07/27/2021 ICU with shortness of breath, productive cough and O2 % on 86%. CXR on 07/27/2021 shows bilateral infiltrate's. patient was hypoxic and tachypneic.  07/31/2021 patient become more shortness of breath and was put on CPAP high flow and CT of the chest was done showing PE. Patient was put on Heparin drip. Patient decompensated  on 08/02/2021, was connected to MV and went to cardiac arrest, patient pass at 09:57 on 08/02/2021."
	"1522949-1"	"1522949-1"	"CONTINUOUS POSITIVE AIRWAY PRESSURE"	"10052934"	"50-59 years"	"50-59"	"Case fully Covid-19 vaccinated at the end of February. On 07/16/2021 patient tested positive with Covid-19. Patient admitted on 07/27/2021 ICU with shortness of breath, productive cough and O2 % on 86%. CXR on 07/27/2021 shows bilateral infiltrate's. patient was hypoxic and tachypneic.  07/31/2021 patient become more shortness of breath and was put on CPAP high flow and CT of the chest was done showing PE. Patient was put on Heparin drip. Patient decompensated  on 08/02/2021, was connected to MV and went to cardiac arrest, patient pass at 09:57 on 08/02/2021."
	"1522949-1"	"1522949-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Case fully Covid-19 vaccinated at the end of February. On 07/16/2021 patient tested positive with Covid-19. Patient admitted on 07/27/2021 ICU with shortness of breath, productive cough and O2 % on 86%. CXR on 07/27/2021 shows bilateral infiltrate's. patient was hypoxic and tachypneic.  07/31/2021 patient become more shortness of breath and was put on CPAP high flow and CT of the chest was done showing PE. Patient was put on Heparin drip. Patient decompensated  on 08/02/2021, was connected to MV and went to cardiac arrest, patient pass at 09:57 on 08/02/2021."
	"1522949-1"	"1522949-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Case fully Covid-19 vaccinated at the end of February. On 07/16/2021 patient tested positive with Covid-19. Patient admitted on 07/27/2021 ICU with shortness of breath, productive cough and O2 % on 86%. CXR on 07/27/2021 shows bilateral infiltrate's. patient was hypoxic and tachypneic.  07/31/2021 patient become more shortness of breath and was put on CPAP high flow and CT of the chest was done showing PE. Patient was put on Heparin drip. Patient decompensated  on 08/02/2021, was connected to MV and went to cardiac arrest, patient pass at 09:57 on 08/02/2021."
	"1522949-1"	"1522949-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"Case fully Covid-19 vaccinated at the end of February. On 07/16/2021 patient tested positive with Covid-19. Patient admitted on 07/27/2021 ICU with shortness of breath, productive cough and O2 % on 86%. CXR on 07/27/2021 shows bilateral infiltrate's. patient was hypoxic and tachypneic.  07/31/2021 patient become more shortness of breath and was put on CPAP high flow and CT of the chest was done showing PE. Patient was put on Heparin drip. Patient decompensated  on 08/02/2021, was connected to MV and went to cardiac arrest, patient pass at 09:57 on 08/02/2021."
	"1522949-1"	"1522949-1"	"HYPOXIA"	"10021143"	"50-59 years"	"50-59"	"Case fully Covid-19 vaccinated at the end of February. On 07/16/2021 patient tested positive with Covid-19. Patient admitted on 07/27/2021 ICU with shortness of breath, productive cough and O2 % on 86%. CXR on 07/27/2021 shows bilateral infiltrate's. patient was hypoxic and tachypneic.  07/31/2021 patient become more shortness of breath and was put on CPAP high flow and CT of the chest was done showing PE. Patient was put on Heparin drip. Patient decompensated  on 08/02/2021, was connected to MV and went to cardiac arrest, patient pass at 09:57 on 08/02/2021."
	"1522949-1"	"1522949-1"	"INTENSIVE CARE"	"10022519"	"50-59 years"	"50-59"	"Case fully Covid-19 vaccinated at the end of February. On 07/16/2021 patient tested positive with Covid-19. Patient admitted on 07/27/2021 ICU with shortness of breath, productive cough and O2 % on 86%. CXR on 07/27/2021 shows bilateral infiltrate's. patient was hypoxic and tachypneic.  07/31/2021 patient become more shortness of breath and was put on CPAP high flow and CT of the chest was done showing PE. Patient was put on Heparin drip. Patient decompensated  on 08/02/2021, was connected to MV and went to cardiac arrest, patient pass at 09:57 on 08/02/2021."
	"1522949-1"	"1522949-1"	"LUNG INFILTRATION"	"10025102"	"50-59 years"	"50-59"	"Case fully Covid-19 vaccinated at the end of February. On 07/16/2021 patient tested positive with Covid-19. Patient admitted on 07/27/2021 ICU with shortness of breath, productive cough and O2 % on 86%. CXR on 07/27/2021 shows bilateral infiltrate's. patient was hypoxic and tachypneic.  07/31/2021 patient become more shortness of breath and was put on CPAP high flow and CT of the chest was done showing PE. Patient was put on Heparin drip. Patient decompensated  on 08/02/2021, was connected to MV and went to cardiac arrest, patient pass at 09:57 on 08/02/2021."
	"1522949-1"	"1522949-1"	"MECHANICAL VENTILATION"	"10067221"	"50-59 years"	"50-59"	"Case fully Covid-19 vaccinated at the end of February. On 07/16/2021 patient tested positive with Covid-19. Patient admitted on 07/27/2021 ICU with shortness of breath, productive cough and O2 % on 86%. CXR on 07/27/2021 shows bilateral infiltrate's. patient was hypoxic and tachypneic.  07/31/2021 patient become more shortness of breath and was put on CPAP high flow and CT of the chest was done showing PE. Patient was put on Heparin drip. Patient decompensated  on 08/02/2021, was connected to MV and went to cardiac arrest, patient pass at 09:57 on 08/02/2021."
	"1522949-1"	"1522949-1"	"OXYGEN SATURATION DECREASED"	"10033318"	"50-59 years"	"50-59"	"Case fully Covid-19 vaccinated at the end of February. On 07/16/2021 patient tested positive with Covid-19. Patient admitted on 07/27/2021 ICU with shortness of breath, productive cough and O2 % on 86%. CXR on 07/27/2021 shows bilateral infiltrate's. patient was hypoxic and tachypneic.  07/31/2021 patient become more shortness of breath and was put on CPAP high flow and CT of the chest was done showing PE. Patient was put on Heparin drip. Patient decompensated  on 08/02/2021, was connected to MV and went to cardiac arrest, patient pass at 09:57 on 08/02/2021."
	"1522949-1"	"1522949-1"	"PRODUCTIVE COUGH"	"10036790"	"50-59 years"	"50-59"	"Case fully Covid-19 vaccinated at the end of February. On 07/16/2021 patient tested positive with Covid-19. Patient admitted on 07/27/2021 ICU with shortness of breath, productive cough and O2 % on 86%. CXR on 07/27/2021 shows bilateral infiltrate's. patient was hypoxic and tachypneic.  07/31/2021 patient become more shortness of breath and was put on CPAP high flow and CT of the chest was done showing PE. Patient was put on Heparin drip. Patient decompensated  on 08/02/2021, was connected to MV and went to cardiac arrest, patient pass at 09:57 on 08/02/2021."
	"1522949-1"	"1522949-1"	"PULMONARY EMBOLISM"	"10037377"	"50-59 years"	"50-59"	"Case fully Covid-19 vaccinated at the end of February. On 07/16/2021 patient tested positive with Covid-19. Patient admitted on 07/27/2021 ICU with shortness of breath, productive cough and O2 % on 86%. CXR on 07/27/2021 shows bilateral infiltrate's. patient was hypoxic and tachypneic.  07/31/2021 patient become more shortness of breath and was put on CPAP high flow and CT of the chest was done showing PE. Patient was put on Heparin drip. Patient decompensated  on 08/02/2021, was connected to MV and went to cardiac arrest, patient pass at 09:57 on 08/02/2021."
	"1522949-1"	"1522949-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"Case fully Covid-19 vaccinated at the end of February. On 07/16/2021 patient tested positive with Covid-19. Patient admitted on 07/27/2021 ICU with shortness of breath, productive cough and O2 % on 86%. CXR on 07/27/2021 shows bilateral infiltrate's. patient was hypoxic and tachypneic.  07/31/2021 patient become more shortness of breath and was put on CPAP high flow and CT of the chest was done showing PE. Patient was put on Heparin drip. Patient decompensated  on 08/02/2021, was connected to MV and went to cardiac arrest, patient pass at 09:57 on 08/02/2021."
	"1522949-1"	"1522949-1"	"TACHYPNOEA"	"10043089"	"50-59 years"	"50-59"	"Case fully Covid-19 vaccinated at the end of February. On 07/16/2021 patient tested positive with Covid-19. Patient admitted on 07/27/2021 ICU with shortness of breath, productive cough and O2 % on 86%. CXR on 07/27/2021 shows bilateral infiltrate's. patient was hypoxic and tachypneic.  07/31/2021 patient become more shortness of breath and was put on CPAP high flow and CT of the chest was done showing PE. Patient was put on Heparin drip. Patient decompensated  on 08/02/2021, was connected to MV and went to cardiac arrest, patient pass at 09:57 on 08/02/2021."
	"1523152-1"	"1523152-1"	"SUDDEN DEATH"	"10042434"	"50-59 years"	"50-59"	""Girlfriend came in for her 2nd dose and reported that her boyfriend ""died in my arms from a blood clot after his first covid vaccine."" Patient, died suddenly at home on 7/21/2021 in the presence of Girlfriend.  She called 911 and the fire department responded. He was dead when they arrived. They did not transport him to the hospital but directly to the morgue.  No autopsy was performed. The coroner did not speak with Girlfriend.  She got the information about the blood clot from the EMTs who said ""I could tell by looking at his neck that he had a clot"".  Not sure why she attributed it to the Moderna vaccine?  He was vaccinated in our pharmacy on 7/6/2021. I told Girlfriend I would report this to the Pharmacy system and to VAERS.  She said no one else had reported it to her knowledge.""
	"1523152-1"	"1523152-1"	"THROMBOSIS"	"10043607"	"50-59 years"	"50-59"	""Girlfriend came in for her 2nd dose and reported that her boyfriend ""died in my arms from a blood clot after his first covid vaccine."" Patient, died suddenly at home on 7/21/2021 in the presence of Girlfriend.  She called 911 and the fire department responded. He was dead when they arrived. They did not transport him to the hospital but directly to the morgue.  No autopsy was performed. The coroner did not speak with Girlfriend.  She got the information about the blood clot from the EMTs who said ""I could tell by looking at his neck that he had a clot"".  Not sure why she attributed it to the Moderna vaccine?  He was vaccinated in our pharmacy on 7/6/2021. I told Girlfriend I would report this to the Pharmacy system and to VAERS.  She said no one else had reported it to her knowledge.""
	"1526316-1"	"1526316-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"death of unknown reason"
	"1528238-1"	"1528238-1"	"APNOEA"	"10002974"	"50-59 years"	"50-59"	"Heart attack and lungs filled with water; Heart attack and lungs filled with water; Stopped breating; This is a spontaneous report from a contactable consumer. A 52-years-old female patient received  BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 2 via an unspecified route of administration, administered in left arm on 23Jun2021 (Batch/Lot number was not reported) as dose 2, single for covid-19 immunisation.  Medical history included stroke  occurred 20 years ago, kidney problems, heart attack  eight years ago, patient had 7 stents around her heart, her capillaries were small, The veins to her heart were small, asthma, schizophrenia, stated lungs were bad, had a stroke 20 years ago and it affected her emotions. She could only laugh or be mad.  Concomitant drug were unspecified. Patient was on a lot of them. The patient had first shot of BNT162B2 on 31May2021 in left arm for COVID-19 Immunization and she started crying. The patient experienced heart attack and lungs filled with water (death, hospitalization) on Jul2021 with fatal outcome, stopped breating (hospitalization) on 28Jun2021 with outcome of unknown.  The patient was hospitalized for 3 days. The patient died in Jul2021. It was unknown  whether autopsy done.  The clinical course was reported as follows: Caller on the line who mentioned he was a PCA, clarified as a patient care attendant for his wife. He is calling about the Pfizer Shot, the vaccination, clarified as to prevent COVID, the COVID Shot. He stated his wife died due to the shot. He mentioned he has no avenue to go down. No direction. He stated he is upset no research has been done form people who died from the shot, or information from it causing one to have a heart attack, lungs filling with water, or weakening the immune system. He later clarified this is what happened to his wife. Caller stated he feels that his wife died from the COVID shot, but he is not a scientist and has no way of proving that. He wants someone to call him and tell him. Caller clarified the patient's cause of death. He stated the death certificate has she passed away due to heart attack due to lungs filling with water and she could not be resuscitated. They tried for two hours. Caller stated he does not know the exact date patient passed away, it is all packed up. It was either 02Jul 2021 or 03Jul2021. He confirmed the heart attack and lungs filling with water occurred on the date she passed away. Caller explained, he wanted to explain what he saw. After she first got the shot she started crying. He mentioned his wife had a stroke 20 years ago and it affected her emotions. She could only laugh or be mad. Patient's mother and father had passed away within three months of each other and she could not even cry then. Caller stated after patient got the shot she started crying and did not know what was going on. He mentioned she was close to menopause and he thought it was just menopause going on. It was all day, every day, she was crying. Then after the second shot a few days later patient stopped breathing. The paramedics were called who provided a breathing treatment. Patient was taken to the hospital and was there for three days. They could not figure out what was wrong. They did work-ups. Patient was in ICU. Then she crashed. They started CPR. Patient's lungs filled up with water, patient had a heart attack, and she stopped breathing. Caller clarified patient had the issues with breathing and stopped breathing initially like on 28Jun2021. Then patient was taken to the hospital. Stated patient's health was never like us. However, he kept her not sick. He was good at his job. However, when patient was sick he would take patient to the hospital or the doctor's to find out what is going on. When sick she was in the hospital, when she was fine she was home. No vaccines administered on same date of the pfizer suspect. Confirmed none were given on the same date. The paramedics were called, patient was taken to hospital and was admitted to ICU due to patient stopped breathing.   Information on the lot/batch number has been requested.; Reported Cause(s) of Death: Heart attack; Lungs filled with water"
	"1528238-1"	"1528238-1"	"MYOCARDIAL INFARCTION"	"10028596"	"50-59 years"	"50-59"	"Heart attack and lungs filled with water; Heart attack and lungs filled with water; Stopped breating; This is a spontaneous report from a contactable consumer. A 52-years-old female patient received  BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 2 via an unspecified route of administration, administered in left arm on 23Jun2021 (Batch/Lot number was not reported) as dose 2, single for covid-19 immunisation.  Medical history included stroke  occurred 20 years ago, kidney problems, heart attack  eight years ago, patient had 7 stents around her heart, her capillaries were small, The veins to her heart were small, asthma, schizophrenia, stated lungs were bad, had a stroke 20 years ago and it affected her emotions. She could only laugh or be mad.  Concomitant drug were unspecified. Patient was on a lot of them. The patient had first shot of BNT162B2 on 31May2021 in left arm for COVID-19 Immunization and she started crying. The patient experienced heart attack and lungs filled with water (death, hospitalization) on Jul2021 with fatal outcome, stopped breating (hospitalization) on 28Jun2021 with outcome of unknown.  The patient was hospitalized for 3 days. The patient died in Jul2021. It was unknown  whether autopsy done.  The clinical course was reported as follows: Caller on the line who mentioned he was a PCA, clarified as a patient care attendant for his wife. He is calling about the Pfizer Shot, the vaccination, clarified as to prevent COVID, the COVID Shot. He stated his wife died due to the shot. He mentioned he has no avenue to go down. No direction. He stated he is upset no research has been done form people who died from the shot, or information from it causing one to have a heart attack, lungs filling with water, or weakening the immune system. He later clarified this is what happened to his wife. Caller stated he feels that his wife died from the COVID shot, but he is not a scientist and has no way of proving that. He wants someone to call him and tell him. Caller clarified the patient's cause of death. He stated the death certificate has she passed away due to heart attack due to lungs filling with water and she could not be resuscitated. They tried for two hours. Caller stated he does not know the exact date patient passed away, it is all packed up. It was either 02Jul 2021 or 03Jul2021. He confirmed the heart attack and lungs filling with water occurred on the date she passed away. Caller explained, he wanted to explain what he saw. After she first got the shot she started crying. He mentioned his wife had a stroke 20 years ago and it affected her emotions. She could only laugh or be mad. Patient's mother and father had passed away within three months of each other and she could not even cry then. Caller stated after patient got the shot she started crying and did not know what was going on. He mentioned she was close to menopause and he thought it was just menopause going on. It was all day, every day, she was crying. Then after the second shot a few days later patient stopped breathing. The paramedics were called who provided a breathing treatment. Patient was taken to the hospital and was there for three days. They could not figure out what was wrong. They did work-ups. Patient was in ICU. Then she crashed. They started CPR. Patient's lungs filled up with water, patient had a heart attack, and she stopped breathing. Caller clarified patient had the issues with breathing and stopped breathing initially like on 28Jun2021. Then patient was taken to the hospital. Stated patient's health was never like us. However, he kept her not sick. He was good at his job. However, when patient was sick he would take patient to the hospital or the doctor's to find out what is going on. When sick she was in the hospital, when she was fine she was home. No vaccines administered on same date of the pfizer suspect. Confirmed none were given on the same date. The paramedics were called, patient was taken to hospital and was admitted to ICU due to patient stopped breathing.   Information on the lot/batch number has been requested.; Reported Cause(s) of Death: Heart attack; Lungs filled with water"
	"1528238-1"	"1528238-1"	"PULMONARY OEDEMA"	"10037423"	"50-59 years"	"50-59"	"Heart attack and lungs filled with water; Heart attack and lungs filled with water; Stopped breating; This is a spontaneous report from a contactable consumer. A 52-years-old female patient received  BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 2 via an unspecified route of administration, administered in left arm on 23Jun2021 (Batch/Lot number was not reported) as dose 2, single for covid-19 immunisation.  Medical history included stroke  occurred 20 years ago, kidney problems, heart attack  eight years ago, patient had 7 stents around her heart, her capillaries were small, The veins to her heart were small, asthma, schizophrenia, stated lungs were bad, had a stroke 20 years ago and it affected her emotions. She could only laugh or be mad.  Concomitant drug were unspecified. Patient was on a lot of them. The patient had first shot of BNT162B2 on 31May2021 in left arm for COVID-19 Immunization and she started crying. The patient experienced heart attack and lungs filled with water (death, hospitalization) on Jul2021 with fatal outcome, stopped breating (hospitalization) on 28Jun2021 with outcome of unknown.  The patient was hospitalized for 3 days. The patient died in Jul2021. It was unknown  whether autopsy done.  The clinical course was reported as follows: Caller on the line who mentioned he was a PCA, clarified as a patient care attendant for his wife. He is calling about the Pfizer Shot, the vaccination, clarified as to prevent COVID, the COVID Shot. He stated his wife died due to the shot. He mentioned he has no avenue to go down. No direction. He stated he is upset no research has been done form people who died from the shot, or information from it causing one to have a heart attack, lungs filling with water, or weakening the immune system. He later clarified this is what happened to his wife. Caller stated he feels that his wife died from the COVID shot, but he is not a scientist and has no way of proving that. He wants someone to call him and tell him. Caller clarified the patient's cause of death. He stated the death certificate has she passed away due to heart attack due to lungs filling with water and she could not be resuscitated. They tried for two hours. Caller stated he does not know the exact date patient passed away, it is all packed up. It was either 02Jul 2021 or 03Jul2021. He confirmed the heart attack and lungs filling with water occurred on the date she passed away. Caller explained, he wanted to explain what he saw. After she first got the shot she started crying. He mentioned his wife had a stroke 20 years ago and it affected her emotions. She could only laugh or be mad. Patient's mother and father had passed away within three months of each other and she could not even cry then. Caller stated after patient got the shot she started crying and did not know what was going on. He mentioned she was close to menopause and he thought it was just menopause going on. It was all day, every day, she was crying. Then after the second shot a few days later patient stopped breathing. The paramedics were called who provided a breathing treatment. Patient was taken to the hospital and was there for three days. They could not figure out what was wrong. They did work-ups. Patient was in ICU. Then she crashed. They started CPR. Patient's lungs filled up with water, patient had a heart attack, and she stopped breathing. Caller clarified patient had the issues with breathing and stopped breathing initially like on 28Jun2021. Then patient was taken to the hospital. Stated patient's health was never like us. However, he kept her not sick. He was good at his job. However, when patient was sick he would take patient to the hospital or the doctor's to find out what is going on. When sick she was in the hospital, when she was fine she was home. No vaccines administered on same date of the pfizer suspect. Confirmed none were given on the same date. The paramedics were called, patient was taken to hospital and was admitted to ICU due to patient stopped breathing.   Information on the lot/batch number has been requested.; Reported Cause(s) of Death: Heart attack; Lungs filled with water"
	"1528593-1"	"1528593-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Vaccinated patient, tested positive and was admitted with COVID on  5/21/2021. Patient passed away on 6/7/2021."
	"1528593-1"	"1528593-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Vaccinated patient, tested positive and was admitted with COVID on  5/21/2021. Patient passed away on 6/7/2021."
	"1528593-1"	"1528593-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"Vaccinated patient, tested positive and was admitted with COVID on  5/21/2021. Patient passed away on 6/7/2021."
	"1532040-1"	"1532040-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Vaccinated at a location on 5/17/2021, staff mentioned her obituary June 24th, 2021 and was concerned of her death so close to her vaccination date."
	"1532890-1"	"1532890-1"	"ACIDOSIS"	"10000486"	"50-59 years"	"50-59"	"Patient received vaccine on 7/28/21 at clinic. Presented to ER on 7/31/21 after vomiting large amount of bright red blood 1 hour PTA.  She was admitted to ICU, required 8 units PRBSx, 3 units FFP, and 1 unit platelets with poor response in Hgb and Hct. Required pressors  up to maintain BP.  EGD revealed bleeding varices which were banded.  On ICU day 2 patient became increasingly acidotic and began to desaturate. Oxygenation improved with increased sedation and 2 additional units PRBC.  On ICU day 3 patient became hypertensive, pressors were stopped.  There was acute change in LOC with decreased responsiveness to painful stimuli and nonreactive pupils. Head CT showed severe diffuse cerebral edema c/w hypoxic brain injury.  Patient continued to deteriorate and decision made for compassionate extubation. Pateint  expired at 2110."
	"1532890-1"	"1532890-1"	"AMMONIA INCREASED"	"10001946"	"50-59 years"	"50-59"	"Patient received vaccine on 7/28/21 at clinic. Presented to ER on 7/31/21 after vomiting large amount of bright red blood 1 hour PTA.  She was admitted to ICU, required 8 units PRBSx, 3 units FFP, and 1 unit platelets with poor response in Hgb and Hct. Required pressors  up to maintain BP.  EGD revealed bleeding varices which were banded.  On ICU day 2 patient became increasingly acidotic and began to desaturate. Oxygenation improved with increased sedation and 2 additional units PRBC.  On ICU day 3 patient became hypertensive, pressors were stopped.  There was acute change in LOC with decreased responsiveness to painful stimuli and nonreactive pupils. Head CT showed severe diffuse cerebral edema c/w hypoxic brain injury.  Patient continued to deteriorate and decision made for compassionate extubation. Pateint  expired at 2110."
	"1532890-1"	"1532890-1"	"ANION GAP DECREASED"	"10002526"	"50-59 years"	"50-59"	"Patient received vaccine on 7/28/21 at clinic. Presented to ER on 7/31/21 after vomiting large amount of bright red blood 1 hour PTA.  She was admitted to ICU, required 8 units PRBSx, 3 units FFP, and 1 unit platelets with poor response in Hgb and Hct. Required pressors  up to maintain BP.  EGD revealed bleeding varices which were banded.  On ICU day 2 patient became increasingly acidotic and began to desaturate. Oxygenation improved with increased sedation and 2 additional units PRBC.  On ICU day 3 patient became hypertensive, pressors were stopped.  There was acute change in LOC with decreased responsiveness to painful stimuli and nonreactive pupils. Head CT showed severe diffuse cerebral edema c/w hypoxic brain injury.  Patient continued to deteriorate and decision made for compassionate extubation. Pateint  expired at 2110."
	"1532890-1"	"1532890-1"	"BLOOD CALCIUM DECREASED"	"10005395"	"50-59 years"	"50-59"	"Patient received vaccine on 7/28/21 at clinic. Presented to ER on 7/31/21 after vomiting large amount of bright red blood 1 hour PTA.  She was admitted to ICU, required 8 units PRBSx, 3 units FFP, and 1 unit platelets with poor response in Hgb and Hct. Required pressors  up to maintain BP.  EGD revealed bleeding varices which were banded.  On ICU day 2 patient became increasingly acidotic and began to desaturate. Oxygenation improved with increased sedation and 2 additional units PRBC.  On ICU day 3 patient became hypertensive, pressors were stopped.  There was acute change in LOC with decreased responsiveness to painful stimuli and nonreactive pupils. Head CT showed severe diffuse cerebral edema c/w hypoxic brain injury.  Patient continued to deteriorate and decision made for compassionate extubation. Pateint  expired at 2110."
	"1532890-1"	"1532890-1"	"BLOOD CHLORIDE NORMAL"	"10005421"	"50-59 years"	"50-59"	"Patient received vaccine on 7/28/21 at clinic. Presented to ER on 7/31/21 after vomiting large amount of bright red blood 1 hour PTA.  She was admitted to ICU, required 8 units PRBSx, 3 units FFP, and 1 unit platelets with poor response in Hgb and Hct. Required pressors  up to maintain BP.  EGD revealed bleeding varices which were banded.  On ICU day 2 patient became increasingly acidotic and began to desaturate. Oxygenation improved with increased sedation and 2 additional units PRBC.  On ICU day 3 patient became hypertensive, pressors were stopped.  There was acute change in LOC with decreased responsiveness to painful stimuli and nonreactive pupils. Head CT showed severe diffuse cerebral edema c/w hypoxic brain injury.  Patient continued to deteriorate and decision made for compassionate extubation. Pateint  expired at 2110."
	"1532890-1"	"1532890-1"	"BLOOD CREATINE INCREASED"	"10005464"	"50-59 years"	"50-59"	"Patient received vaccine on 7/28/21 at clinic. Presented to ER on 7/31/21 after vomiting large amount of bright red blood 1 hour PTA.  She was admitted to ICU, required 8 units PRBSx, 3 units FFP, and 1 unit platelets with poor response in Hgb and Hct. Required pressors  up to maintain BP.  EGD revealed bleeding varices which were banded.  On ICU day 2 patient became increasingly acidotic and began to desaturate. Oxygenation improved with increased sedation and 2 additional units PRBC.  On ICU day 3 patient became hypertensive, pressors were stopped.  There was acute change in LOC with decreased responsiveness to painful stimuli and nonreactive pupils. Head CT showed severe diffuse cerebral edema c/w hypoxic brain injury.  Patient continued to deteriorate and decision made for compassionate extubation. Pateint  expired at 2110."
	"1532890-1"	"1532890-1"	"BLOOD GLUCOSE NORMAL"	"10005558"	"50-59 years"	"50-59"	"Patient received vaccine on 7/28/21 at clinic. Presented to ER on 7/31/21 after vomiting large amount of bright red blood 1 hour PTA.  She was admitted to ICU, required 8 units PRBSx, 3 units FFP, and 1 unit platelets with poor response in Hgb and Hct. Required pressors  up to maintain BP.  EGD revealed bleeding varices which were banded.  On ICU day 2 patient became increasingly acidotic and began to desaturate. Oxygenation improved with increased sedation and 2 additional units PRBC.  On ICU day 3 patient became hypertensive, pressors were stopped.  There was acute change in LOC with decreased responsiveness to painful stimuli and nonreactive pupils. Head CT showed severe diffuse cerebral edema c/w hypoxic brain injury.  Patient continued to deteriorate and decision made for compassionate extubation. Pateint  expired at 2110."
	"1532890-1"	"1532890-1"	"BLOOD LACTIC ACID INCREASED"	"10005635"	"50-59 years"	"50-59"	"Patient received vaccine on 7/28/21 at clinic. Presented to ER on 7/31/21 after vomiting large amount of bright red blood 1 hour PTA.  She was admitted to ICU, required 8 units PRBSx, 3 units FFP, and 1 unit platelets with poor response in Hgb and Hct. Required pressors  up to maintain BP.  EGD revealed bleeding varices which were banded.  On ICU day 2 patient became increasingly acidotic and began to desaturate. Oxygenation improved with increased sedation and 2 additional units PRBC.  On ICU day 3 patient became hypertensive, pressors were stopped.  There was acute change in LOC with decreased responsiveness to painful stimuli and nonreactive pupils. Head CT showed severe diffuse cerebral edema c/w hypoxic brain injury.  Patient continued to deteriorate and decision made for compassionate extubation. Pateint  expired at 2110."
	"1532890-1"	"1532890-1"	"BLOOD MAGNESIUM INCREASED"	"10005655"	"50-59 years"	"50-59"	"Patient received vaccine on 7/28/21 at clinic. Presented to ER on 7/31/21 after vomiting large amount of bright red blood 1 hour PTA.  She was admitted to ICU, required 8 units PRBSx, 3 units FFP, and 1 unit platelets with poor response in Hgb and Hct. Required pressors  up to maintain BP.  EGD revealed bleeding varices which were banded.  On ICU day 2 patient became increasingly acidotic and began to desaturate. Oxygenation improved with increased sedation and 2 additional units PRBC.  On ICU day 3 patient became hypertensive, pressors were stopped.  There was acute change in LOC with decreased responsiveness to painful stimuli and nonreactive pupils. Head CT showed severe diffuse cerebral edema c/w hypoxic brain injury.  Patient continued to deteriorate and decision made for compassionate extubation. Pateint  expired at 2110."
	"1532890-1"	"1532890-1"	"BLOOD POTASSIUM NORMAL"	"10005726"	"50-59 years"	"50-59"	"Patient received vaccine on 7/28/21 at clinic. Presented to ER on 7/31/21 after vomiting large amount of bright red blood 1 hour PTA.  She was admitted to ICU, required 8 units PRBSx, 3 units FFP, and 1 unit platelets with poor response in Hgb and Hct. Required pressors  up to maintain BP.  EGD revealed bleeding varices which were banded.  On ICU day 2 patient became increasingly acidotic and began to desaturate. Oxygenation improved with increased sedation and 2 additional units PRBC.  On ICU day 3 patient became hypertensive, pressors were stopped.  There was acute change in LOC with decreased responsiveness to painful stimuli and nonreactive pupils. Head CT showed severe diffuse cerebral edema c/w hypoxic brain injury.  Patient continued to deteriorate and decision made for compassionate extubation. Pateint  expired at 2110."
	"1532890-1"	"1532890-1"	"BLOOD PRESSURE ABNORMAL"	"10005728"	"50-59 years"	"50-59"	"Patient received vaccine on 7/28/21 at clinic. Presented to ER on 7/31/21 after vomiting large amount of bright red blood 1 hour PTA.  She was admitted to ICU, required 8 units PRBSx, 3 units FFP, and 1 unit platelets with poor response in Hgb and Hct. Required pressors  up to maintain BP.  EGD revealed bleeding varices which were banded.  On ICU day 2 patient became increasingly acidotic and began to desaturate. Oxygenation improved with increased sedation and 2 additional units PRBC.  On ICU day 3 patient became hypertensive, pressors were stopped.  There was acute change in LOC with decreased responsiveness to painful stimuli and nonreactive pupils. Head CT showed severe diffuse cerebral edema c/w hypoxic brain injury.  Patient continued to deteriorate and decision made for compassionate extubation. Pateint  expired at 2110."
	"1532890-1"	"1532890-1"	"BLOOD SODIUM DECREASED"	"10005802"	"50-59 years"	"50-59"	"Patient received vaccine on 7/28/21 at clinic. Presented to ER on 7/31/21 after vomiting large amount of bright red blood 1 hour PTA.  She was admitted to ICU, required 8 units PRBSx, 3 units FFP, and 1 unit platelets with poor response in Hgb and Hct. Required pressors  up to maintain BP.  EGD revealed bleeding varices which were banded.  On ICU day 2 patient became increasingly acidotic and began to desaturate. Oxygenation improved with increased sedation and 2 additional units PRBC.  On ICU day 3 patient became hypertensive, pressors were stopped.  There was acute change in LOC with decreased responsiveness to painful stimuli and nonreactive pupils. Head CT showed severe diffuse cerebral edema c/w hypoxic brain injury.  Patient continued to deteriorate and decision made for compassionate extubation. Pateint  expired at 2110."
	"1532890-1"	"1532890-1"	"BLOOD UREA INCREASED"	"10005851"	"50-59 years"	"50-59"	"Patient received vaccine on 7/28/21 at clinic. Presented to ER on 7/31/21 after vomiting large amount of bright red blood 1 hour PTA.  She was admitted to ICU, required 8 units PRBSx, 3 units FFP, and 1 unit platelets with poor response in Hgb and Hct. Required pressors  up to maintain BP.  EGD revealed bleeding varices which were banded.  On ICU day 2 patient became increasingly acidotic and began to desaturate. Oxygenation improved with increased sedation and 2 additional units PRBC.  On ICU day 3 patient became hypertensive, pressors were stopped.  There was acute change in LOC with decreased responsiveness to painful stimuli and nonreactive pupils. Head CT showed severe diffuse cerebral edema c/w hypoxic brain injury.  Patient continued to deteriorate and decision made for compassionate extubation. Pateint  expired at 2110."
	"1532890-1"	"1532890-1"	"BRAIN INJURY"	"10067967"	"50-59 years"	"50-59"	"Patient received vaccine on 7/28/21 at clinic. Presented to ER on 7/31/21 after vomiting large amount of bright red blood 1 hour PTA.  She was admitted to ICU, required 8 units PRBSx, 3 units FFP, and 1 unit platelets with poor response in Hgb and Hct. Required pressors  up to maintain BP.  EGD revealed bleeding varices which were banded.  On ICU day 2 patient became increasingly acidotic and began to desaturate. Oxygenation improved with increased sedation and 2 additional units PRBC.  On ICU day 3 patient became hypertensive, pressors were stopped.  There was acute change in LOC with decreased responsiveness to painful stimuli and nonreactive pupils. Head CT showed severe diffuse cerebral edema c/w hypoxic brain injury.  Patient continued to deteriorate and decision made for compassionate extubation. Pateint  expired at 2110."
	"1532890-1"	"1532890-1"	"BRAIN OEDEMA"	"10048962"	"50-59 years"	"50-59"	"Patient received vaccine on 7/28/21 at clinic. Presented to ER on 7/31/21 after vomiting large amount of bright red blood 1 hour PTA.  She was admitted to ICU, required 8 units PRBSx, 3 units FFP, and 1 unit platelets with poor response in Hgb and Hct. Required pressors  up to maintain BP.  EGD revealed bleeding varices which were banded.  On ICU day 2 patient became increasingly acidotic and began to desaturate. Oxygenation improved with increased sedation and 2 additional units PRBC.  On ICU day 3 patient became hypertensive, pressors were stopped.  There was acute change in LOC with decreased responsiveness to painful stimuli and nonreactive pupils. Head CT showed severe diffuse cerebral edema c/w hypoxic brain injury.  Patient continued to deteriorate and decision made for compassionate extubation. Pateint  expired at 2110."
	"1532890-1"	"1532890-1"	"CARBON DIOXIDE NORMAL"	"10007228"	"50-59 years"	"50-59"	"Patient received vaccine on 7/28/21 at clinic. Presented to ER on 7/31/21 after vomiting large amount of bright red blood 1 hour PTA.  She was admitted to ICU, required 8 units PRBSx, 3 units FFP, and 1 unit platelets with poor response in Hgb and Hct. Required pressors  up to maintain BP.  EGD revealed bleeding varices which were banded.  On ICU day 2 patient became increasingly acidotic and began to desaturate. Oxygenation improved with increased sedation and 2 additional units PRBC.  On ICU day 3 patient became hypertensive, pressors were stopped.  There was acute change in LOC with decreased responsiveness to painful stimuli and nonreactive pupils. Head CT showed severe diffuse cerebral edema c/w hypoxic brain injury.  Patient continued to deteriorate and decision made for compassionate extubation. Pateint  expired at 2110."
	"1532890-1"	"1532890-1"	"COMPUTERISED TOMOGRAM HEAD ABNORMAL"	"10072168"	"50-59 years"	"50-59"	"Patient received vaccine on 7/28/21 at clinic. Presented to ER on 7/31/21 after vomiting large amount of bright red blood 1 hour PTA.  She was admitted to ICU, required 8 units PRBSx, 3 units FFP, and 1 unit platelets with poor response in Hgb and Hct. Required pressors  up to maintain BP.  EGD revealed bleeding varices which were banded.  On ICU day 2 patient became increasingly acidotic and began to desaturate. Oxygenation improved with increased sedation and 2 additional units PRBC.  On ICU day 3 patient became hypertensive, pressors were stopped.  There was acute change in LOC with decreased responsiveness to painful stimuli and nonreactive pupils. Head CT showed severe diffuse cerebral edema c/w hypoxic brain injury.  Patient continued to deteriorate and decision made for compassionate extubation. Pateint  expired at 2110."
	"1532890-1"	"1532890-1"	"CONDITION AGGRAVATED"	"10010264"	"50-59 years"	"50-59"	"Patient received vaccine on 7/28/21 at clinic. Presented to ER on 7/31/21 after vomiting large amount of bright red blood 1 hour PTA.  She was admitted to ICU, required 8 units PRBSx, 3 units FFP, and 1 unit platelets with poor response in Hgb and Hct. Required pressors  up to maintain BP.  EGD revealed bleeding varices which were banded.  On ICU day 2 patient became increasingly acidotic and began to desaturate. Oxygenation improved with increased sedation and 2 additional units PRBC.  On ICU day 3 patient became hypertensive, pressors were stopped.  There was acute change in LOC with decreased responsiveness to painful stimuli and nonreactive pupils. Head CT showed severe diffuse cerebral edema c/w hypoxic brain injury.  Patient continued to deteriorate and decision made for compassionate extubation. Pateint  expired at 2110."
	"1532890-1"	"1532890-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient received vaccine on 7/28/21 at clinic. Presented to ER on 7/31/21 after vomiting large amount of bright red blood 1 hour PTA.  She was admitted to ICU, required 8 units PRBSx, 3 units FFP, and 1 unit platelets with poor response in Hgb and Hct. Required pressors  up to maintain BP.  EGD revealed bleeding varices which were banded.  On ICU day 2 patient became increasingly acidotic and began to desaturate. Oxygenation improved with increased sedation and 2 additional units PRBC.  On ICU day 3 patient became hypertensive, pressors were stopped.  There was acute change in LOC with decreased responsiveness to painful stimuli and nonreactive pupils. Head CT showed severe diffuse cerebral edema c/w hypoxic brain injury.  Patient continued to deteriorate and decision made for compassionate extubation. Pateint  expired at 2110."
	"1532890-1"	"1532890-1"	"DEPRESSED LEVEL OF CONSCIOUSNESS"	"10012373"	"50-59 years"	"50-59"	"Patient received vaccine on 7/28/21 at clinic. Presented to ER on 7/31/21 after vomiting large amount of bright red blood 1 hour PTA.  She was admitted to ICU, required 8 units PRBSx, 3 units FFP, and 1 unit platelets with poor response in Hgb and Hct. Required pressors  up to maintain BP.  EGD revealed bleeding varices which were banded.  On ICU day 2 patient became increasingly acidotic and began to desaturate. Oxygenation improved with increased sedation and 2 additional units PRBC.  On ICU day 3 patient became hypertensive, pressors were stopped.  There was acute change in LOC with decreased responsiveness to painful stimuli and nonreactive pupils. Head CT showed severe diffuse cerebral edema c/w hypoxic brain injury.  Patient continued to deteriorate and decision made for compassionate extubation. Pateint  expired at 2110."
	"1532890-1"	"1532890-1"	"GENERAL PHYSICAL HEALTH DETERIORATION"	"10049438"	"50-59 years"	"50-59"	"Patient received vaccine on 7/28/21 at clinic. Presented to ER on 7/31/21 after vomiting large amount of bright red blood 1 hour PTA.  She was admitted to ICU, required 8 units PRBSx, 3 units FFP, and 1 unit platelets with poor response in Hgb and Hct. Required pressors  up to maintain BP.  EGD revealed bleeding varices which were banded.  On ICU day 2 patient became increasingly acidotic and began to desaturate. Oxygenation improved with increased sedation and 2 additional units PRBC.  On ICU day 3 patient became hypertensive, pressors were stopped.  There was acute change in LOC with decreased responsiveness to painful stimuli and nonreactive pupils. Head CT showed severe diffuse cerebral edema c/w hypoxic brain injury.  Patient continued to deteriorate and decision made for compassionate extubation. Pateint  expired at 2110."
	"1532890-1"	"1532890-1"	"GLOMERULAR FILTRATION RATE DECREASED"	"10018358"	"50-59 years"	"50-59"	"Patient received vaccine on 7/28/21 at clinic. Presented to ER on 7/31/21 after vomiting large amount of bright red blood 1 hour PTA.  She was admitted to ICU, required 8 units PRBSx, 3 units FFP, and 1 unit platelets with poor response in Hgb and Hct. Required pressors  up to maintain BP.  EGD revealed bleeding varices which were banded.  On ICU day 2 patient became increasingly acidotic and began to desaturate. Oxygenation improved with increased sedation and 2 additional units PRBC.  On ICU day 3 patient became hypertensive, pressors were stopped.  There was acute change in LOC with decreased responsiveness to painful stimuli and nonreactive pupils. Head CT showed severe diffuse cerebral edema c/w hypoxic brain injury.  Patient continued to deteriorate and decision made for compassionate extubation. Pateint  expired at 2110."
	"1532890-1"	"1532890-1"	"HAEMATEMESIS"	"10018830"	"50-59 years"	"50-59"	"Patient received vaccine on 7/28/21 at clinic. Presented to ER on 7/31/21 after vomiting large amount of bright red blood 1 hour PTA.  She was admitted to ICU, required 8 units PRBSx, 3 units FFP, and 1 unit platelets with poor response in Hgb and Hct. Required pressors  up to maintain BP.  EGD revealed bleeding varices which were banded.  On ICU day 2 patient became increasingly acidotic and began to desaturate. Oxygenation improved with increased sedation and 2 additional units PRBC.  On ICU day 3 patient became hypertensive, pressors were stopped.  There was acute change in LOC with decreased responsiveness to painful stimuli and nonreactive pupils. Head CT showed severe diffuse cerebral edema c/w hypoxic brain injury.  Patient continued to deteriorate and decision made for compassionate extubation. Pateint  expired at 2110."
	"1532890-1"	"1532890-1"	"HAEMATOCRIT DECREASED"	"10018838"	"50-59 years"	"50-59"	"Patient received vaccine on 7/28/21 at clinic. Presented to ER on 7/31/21 after vomiting large amount of bright red blood 1 hour PTA.  She was admitted to ICU, required 8 units PRBSx, 3 units FFP, and 1 unit platelets with poor response in Hgb and Hct. Required pressors  up to maintain BP.  EGD revealed bleeding varices which were banded.  On ICU day 2 patient became increasingly acidotic and began to desaturate. Oxygenation improved with increased sedation and 2 additional units PRBC.  On ICU day 3 patient became hypertensive, pressors were stopped.  There was acute change in LOC with decreased responsiveness to painful stimuli and nonreactive pupils. Head CT showed severe diffuse cerebral edema c/w hypoxic brain injury.  Patient continued to deteriorate and decision made for compassionate extubation. Pateint  expired at 2110."
	"1532890-1"	"1532890-1"	"HAEMOGLOBIN INCREASED"	"10018888"	"50-59 years"	"50-59"	"Patient received vaccine on 7/28/21 at clinic. Presented to ER on 7/31/21 after vomiting large amount of bright red blood 1 hour PTA.  She was admitted to ICU, required 8 units PRBSx, 3 units FFP, and 1 unit platelets with poor response in Hgb and Hct. Required pressors  up to maintain BP.  EGD revealed bleeding varices which were banded.  On ICU day 2 patient became increasingly acidotic and began to desaturate. Oxygenation improved with increased sedation and 2 additional units PRBC.  On ICU day 3 patient became hypertensive, pressors were stopped.  There was acute change in LOC with decreased responsiveness to painful stimuli and nonreactive pupils. Head CT showed severe diffuse cerebral edema c/w hypoxic brain injury.  Patient continued to deteriorate and decision made for compassionate extubation. Pateint  expired at 2110."
	"1532890-1"	"1532890-1"	"HYPERTENSION"	"10020772"	"50-59 years"	"50-59"	"Patient received vaccine on 7/28/21 at clinic. Presented to ER on 7/31/21 after vomiting large amount of bright red blood 1 hour PTA.  She was admitted to ICU, required 8 units PRBSx, 3 units FFP, and 1 unit platelets with poor response in Hgb and Hct. Required pressors  up to maintain BP.  EGD revealed bleeding varices which were banded.  On ICU day 2 patient became increasingly acidotic and began to desaturate. Oxygenation improved with increased sedation and 2 additional units PRBC.  On ICU day 3 patient became hypertensive, pressors were stopped.  There was acute change in LOC with decreased responsiveness to painful stimuli and nonreactive pupils. Head CT showed severe diffuse cerebral edema c/w hypoxic brain injury.  Patient continued to deteriorate and decision made for compassionate extubation. Pateint  expired at 2110."
	"1532890-1"	"1532890-1"	"INTENSIVE CARE"	"10022519"	"50-59 years"	"50-59"	"Patient received vaccine on 7/28/21 at clinic. Presented to ER on 7/31/21 after vomiting large amount of bright red blood 1 hour PTA.  She was admitted to ICU, required 8 units PRBSx, 3 units FFP, and 1 unit platelets with poor response in Hgb and Hct. Required pressors  up to maintain BP.  EGD revealed bleeding varices which were banded.  On ICU day 2 patient became increasingly acidotic and began to desaturate. Oxygenation improved with increased sedation and 2 additional units PRBC.  On ICU day 3 patient became hypertensive, pressors were stopped.  There was acute change in LOC with decreased responsiveness to painful stimuli and nonreactive pupils. Head CT showed severe diffuse cerebral edema c/w hypoxic brain injury.  Patient continued to deteriorate and decision made for compassionate extubation. Pateint  expired at 2110."
	"1532890-1"	"1532890-1"	"MEAN CELL HAEMOGLOBIN CONCENTRATION NORMAL"	"10026994"	"50-59 years"	"50-59"	"Patient received vaccine on 7/28/21 at clinic. Presented to ER on 7/31/21 after vomiting large amount of bright red blood 1 hour PTA.  She was admitted to ICU, required 8 units PRBSx, 3 units FFP, and 1 unit platelets with poor response in Hgb and Hct. Required pressors  up to maintain BP.  EGD revealed bleeding varices which were banded.  On ICU day 2 patient became increasingly acidotic and began to desaturate. Oxygenation improved with increased sedation and 2 additional units PRBC.  On ICU day 3 patient became hypertensive, pressors were stopped.  There was acute change in LOC with decreased responsiveness to painful stimuli and nonreactive pupils. Head CT showed severe diffuse cerebral edema c/w hypoxic brain injury.  Patient continued to deteriorate and decision made for compassionate extubation. Pateint  expired at 2110."
	"1532890-1"	"1532890-1"	"MEAN CELL HAEMOGLOBIN INCREASED"	"10026996"	"50-59 years"	"50-59"	"Patient received vaccine on 7/28/21 at clinic. Presented to ER on 7/31/21 after vomiting large amount of bright red blood 1 hour PTA.  She was admitted to ICU, required 8 units PRBSx, 3 units FFP, and 1 unit platelets with poor response in Hgb and Hct. Required pressors  up to maintain BP.  EGD revealed bleeding varices which were banded.  On ICU day 2 patient became increasingly acidotic and began to desaturate. Oxygenation improved with increased sedation and 2 additional units PRBC.  On ICU day 3 patient became hypertensive, pressors were stopped.  There was acute change in LOC with decreased responsiveness to painful stimuli and nonreactive pupils. Head CT showed severe diffuse cerebral edema c/w hypoxic brain injury.  Patient continued to deteriorate and decision made for compassionate extubation. Pateint  expired at 2110."
	"1532890-1"	"1532890-1"	"MEAN CELL VOLUME NORMAL"	"10027006"	"50-59 years"	"50-59"	"Patient received vaccine on 7/28/21 at clinic. Presented to ER on 7/31/21 after vomiting large amount of bright red blood 1 hour PTA.  She was admitted to ICU, required 8 units PRBSx, 3 units FFP, and 1 unit platelets with poor response in Hgb and Hct. Required pressors  up to maintain BP.  EGD revealed bleeding varices which were banded.  On ICU day 2 patient became increasingly acidotic and began to desaturate. Oxygenation improved with increased sedation and 2 additional units PRBC.  On ICU day 3 patient became hypertensive, pressors were stopped.  There was acute change in LOC with decreased responsiveness to painful stimuli and nonreactive pupils. Head CT showed severe diffuse cerebral edema c/w hypoxic brain injury.  Patient continued to deteriorate and decision made for compassionate extubation. Pateint  expired at 2110."
	"1532890-1"	"1532890-1"	"OESOPHAGEAL VARICEAL LIGATION"	"10030208"	"50-59 years"	"50-59"	"Patient received vaccine on 7/28/21 at clinic. Presented to ER on 7/31/21 after vomiting large amount of bright red blood 1 hour PTA.  She was admitted to ICU, required 8 units PRBSx, 3 units FFP, and 1 unit platelets with poor response in Hgb and Hct. Required pressors  up to maintain BP.  EGD revealed bleeding varices which were banded.  On ICU day 2 patient became increasingly acidotic and began to desaturate. Oxygenation improved with increased sedation and 2 additional units PRBC.  On ICU day 3 patient became hypertensive, pressors were stopped.  There was acute change in LOC with decreased responsiveness to painful stimuli and nonreactive pupils. Head CT showed severe diffuse cerebral edema c/w hypoxic brain injury.  Patient continued to deteriorate and decision made for compassionate extubation. Pateint  expired at 2110."
	"1532890-1"	"1532890-1"	"OESOPHAGEAL VARICES HAEMORRHAGE"	"10030210"	"50-59 years"	"50-59"	"Patient received vaccine on 7/28/21 at clinic. Presented to ER on 7/31/21 after vomiting large amount of bright red blood 1 hour PTA.  She was admitted to ICU, required 8 units PRBSx, 3 units FFP, and 1 unit platelets with poor response in Hgb and Hct. Required pressors  up to maintain BP.  EGD revealed bleeding varices which were banded.  On ICU day 2 patient became increasingly acidotic and began to desaturate. Oxygenation improved with increased sedation and 2 additional units PRBC.  On ICU day 3 patient became hypertensive, pressors were stopped.  There was acute change in LOC with decreased responsiveness to painful stimuli and nonreactive pupils. Head CT showed severe diffuse cerebral edema c/w hypoxic brain injury.  Patient continued to deteriorate and decision made for compassionate extubation. Pateint  expired at 2110."
	"1532890-1"	"1532890-1"	"OESOPHAGOGASTRODUODENOSCOPY ABNORMAL"	"10072163"	"50-59 years"	"50-59"	"Patient received vaccine on 7/28/21 at clinic. Presented to ER on 7/31/21 after vomiting large amount of bright red blood 1 hour PTA.  She was admitted to ICU, required 8 units PRBSx, 3 units FFP, and 1 unit platelets with poor response in Hgb and Hct. Required pressors  up to maintain BP.  EGD revealed bleeding varices which were banded.  On ICU day 2 patient became increasingly acidotic and began to desaturate. Oxygenation improved with increased sedation and 2 additional units PRBC.  On ICU day 3 patient became hypertensive, pressors were stopped.  There was acute change in LOC with decreased responsiveness to painful stimuli and nonreactive pupils. Head CT showed severe diffuse cerebral edema c/w hypoxic brain injury.  Patient continued to deteriorate and decision made for compassionate extubation. Pateint  expired at 2110."
	"1532890-1"	"1532890-1"	"OXYGEN SATURATION DECREASED"	"10033318"	"50-59 years"	"50-59"	"Patient received vaccine on 7/28/21 at clinic. Presented to ER on 7/31/21 after vomiting large amount of bright red blood 1 hour PTA.  She was admitted to ICU, required 8 units PRBSx, 3 units FFP, and 1 unit platelets with poor response in Hgb and Hct. Required pressors  up to maintain BP.  EGD revealed bleeding varices which were banded.  On ICU day 2 patient became increasingly acidotic and began to desaturate. Oxygenation improved with increased sedation and 2 additional units PRBC.  On ICU day 3 patient became hypertensive, pressors were stopped.  There was acute change in LOC with decreased responsiveness to painful stimuli and nonreactive pupils. Head CT showed severe diffuse cerebral edema c/w hypoxic brain injury.  Patient continued to deteriorate and decision made for compassionate extubation. Pateint  expired at 2110."
	"1532890-1"	"1532890-1"	"PACKED RED BLOOD CELL TRANSFUSION"	"10033359"	"50-59 years"	"50-59"	"Patient received vaccine on 7/28/21 at clinic. Presented to ER on 7/31/21 after vomiting large amount of bright red blood 1 hour PTA.  She was admitted to ICU, required 8 units PRBSx, 3 units FFP, and 1 unit platelets with poor response in Hgb and Hct. Required pressors  up to maintain BP.  EGD revealed bleeding varices which were banded.  On ICU day 2 patient became increasingly acidotic and began to desaturate. Oxygenation improved with increased sedation and 2 additional units PRBC.  On ICU day 3 patient became hypertensive, pressors were stopped.  There was acute change in LOC with decreased responsiveness to painful stimuli and nonreactive pupils. Head CT showed severe diffuse cerebral edema c/w hypoxic brain injury.  Patient continued to deteriorate and decision made for compassionate extubation. Pateint  expired at 2110."
	"1532890-1"	"1532890-1"	"PLATELET COUNT DECREASED"	"10035528"	"50-59 years"	"50-59"	"Patient received vaccine on 7/28/21 at clinic. Presented to ER on 7/31/21 after vomiting large amount of bright red blood 1 hour PTA.  She was admitted to ICU, required 8 units PRBSx, 3 units FFP, and 1 unit platelets with poor response in Hgb and Hct. Required pressors  up to maintain BP.  EGD revealed bleeding varices which were banded.  On ICU day 2 patient became increasingly acidotic and began to desaturate. Oxygenation improved with increased sedation and 2 additional units PRBC.  On ICU day 3 patient became hypertensive, pressors were stopped.  There was acute change in LOC with decreased responsiveness to painful stimuli and nonreactive pupils. Head CT showed severe diffuse cerebral edema c/w hypoxic brain injury.  Patient continued to deteriorate and decision made for compassionate extubation. Pateint  expired at 2110."
	"1532890-1"	"1532890-1"	"PLATELET TRANSFUSION"	"10035543"	"50-59 years"	"50-59"	"Patient received vaccine on 7/28/21 at clinic. Presented to ER on 7/31/21 after vomiting large amount of bright red blood 1 hour PTA.  She was admitted to ICU, required 8 units PRBSx, 3 units FFP, and 1 unit platelets with poor response in Hgb and Hct. Required pressors  up to maintain BP.  EGD revealed bleeding varices which were banded.  On ICU day 2 patient became increasingly acidotic and began to desaturate. Oxygenation improved with increased sedation and 2 additional units PRBC.  On ICU day 3 patient became hypertensive, pressors were stopped.  There was acute change in LOC with decreased responsiveness to painful stimuli and nonreactive pupils. Head CT showed severe diffuse cerebral edema c/w hypoxic brain injury.  Patient continued to deteriorate and decision made for compassionate extubation. Pateint  expired at 2110."
	"1532890-1"	"1532890-1"	"PUPIL FIXED"	"10037515"	"50-59 years"	"50-59"	"Patient received vaccine on 7/28/21 at clinic. Presented to ER on 7/31/21 after vomiting large amount of bright red blood 1 hour PTA.  She was admitted to ICU, required 8 units PRBSx, 3 units FFP, and 1 unit platelets with poor response in Hgb and Hct. Required pressors  up to maintain BP.  EGD revealed bleeding varices which were banded.  On ICU day 2 patient became increasingly acidotic and began to desaturate. Oxygenation improved with increased sedation and 2 additional units PRBC.  On ICU day 3 patient became hypertensive, pressors were stopped.  There was acute change in LOC with decreased responsiveness to painful stimuli and nonreactive pupils. Head CT showed severe diffuse cerebral edema c/w hypoxic brain injury.  Patient continued to deteriorate and decision made for compassionate extubation. Pateint  expired at 2110."
	"1532890-1"	"1532890-1"	"RED BLOOD CELL COUNT DECREASED"	"10038153"	"50-59 years"	"50-59"	"Patient received vaccine on 7/28/21 at clinic. Presented to ER on 7/31/21 after vomiting large amount of bright red blood 1 hour PTA.  She was admitted to ICU, required 8 units PRBSx, 3 units FFP, and 1 unit platelets with poor response in Hgb and Hct. Required pressors  up to maintain BP.  EGD revealed bleeding varices which were banded.  On ICU day 2 patient became increasingly acidotic and began to desaturate. Oxygenation improved with increased sedation and 2 additional units PRBC.  On ICU day 3 patient became hypertensive, pressors were stopped.  There was acute change in LOC with decreased responsiveness to painful stimuli and nonreactive pupils. Head CT showed severe diffuse cerebral edema c/w hypoxic brain injury.  Patient continued to deteriorate and decision made for compassionate extubation. Pateint  expired at 2110."
	"1532890-1"	"1532890-1"	"RED CELL DISTRIBUTION WIDTH INCREASED"	"10053920"	"50-59 years"	"50-59"	"Patient received vaccine on 7/28/21 at clinic. Presented to ER on 7/31/21 after vomiting large amount of bright red blood 1 hour PTA.  She was admitted to ICU, required 8 units PRBSx, 3 units FFP, and 1 unit platelets with poor response in Hgb and Hct. Required pressors  up to maintain BP.  EGD revealed bleeding varices which were banded.  On ICU day 2 patient became increasingly acidotic and began to desaturate. Oxygenation improved with increased sedation and 2 additional units PRBC.  On ICU day 3 patient became hypertensive, pressors were stopped.  There was acute change in LOC with decreased responsiveness to painful stimuli and nonreactive pupils. Head CT showed severe diffuse cerebral edema c/w hypoxic brain injury.  Patient continued to deteriorate and decision made for compassionate extubation. Pateint  expired at 2110."
	"1532890-1"	"1532890-1"	"TRANSFUSION"	"10066152"	"50-59 years"	"50-59"	"Patient received vaccine on 7/28/21 at clinic. Presented to ER on 7/31/21 after vomiting large amount of bright red blood 1 hour PTA.  She was admitted to ICU, required 8 units PRBSx, 3 units FFP, and 1 unit platelets with poor response in Hgb and Hct. Required pressors  up to maintain BP.  EGD revealed bleeding varices which were banded.  On ICU day 2 patient became increasingly acidotic and began to desaturate. Oxygenation improved with increased sedation and 2 additional units PRBC.  On ICU day 3 patient became hypertensive, pressors were stopped.  There was acute change in LOC with decreased responsiveness to painful stimuli and nonreactive pupils. Head CT showed severe diffuse cerebral edema c/w hypoxic brain injury.  Patient continued to deteriorate and decision made for compassionate extubation. Pateint  expired at 2110."
	"1532890-1"	"1532890-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"50-59 years"	"50-59"	"Patient received vaccine on 7/28/21 at clinic. Presented to ER on 7/31/21 after vomiting large amount of bright red blood 1 hour PTA.  She was admitted to ICU, required 8 units PRBSx, 3 units FFP, and 1 unit platelets with poor response in Hgb and Hct. Required pressors  up to maintain BP.  EGD revealed bleeding varices which were banded.  On ICU day 2 patient became increasingly acidotic and began to desaturate. Oxygenation improved with increased sedation and 2 additional units PRBC.  On ICU day 3 patient became hypertensive, pressors were stopped.  There was acute change in LOC with decreased responsiveness to painful stimuli and nonreactive pupils. Head CT showed severe diffuse cerebral edema c/w hypoxic brain injury.  Patient continued to deteriorate and decision made for compassionate extubation. Pateint  expired at 2110."
	"1532890-1"	"1532890-1"	"WHITE BLOOD CELL COUNT INCREASED"	"10047943"	"50-59 years"	"50-59"	"Patient received vaccine on 7/28/21 at clinic. Presented to ER on 7/31/21 after vomiting large amount of bright red blood 1 hour PTA.  She was admitted to ICU, required 8 units PRBSx, 3 units FFP, and 1 unit platelets with poor response in Hgb and Hct. Required pressors  up to maintain BP.  EGD revealed bleeding varices which were banded.  On ICU day 2 patient became increasingly acidotic and began to desaturate. Oxygenation improved with increased sedation and 2 additional units PRBC.  On ICU day 3 patient became hypertensive, pressors were stopped.  There was acute change in LOC with decreased responsiveness to painful stimuli and nonreactive pupils. Head CT showed severe diffuse cerebral edema c/w hypoxic brain injury.  Patient continued to deteriorate and decision made for compassionate extubation. Pateint  expired at 2110."
	"1535013-1"	"1535013-1"	"AORTIC DISSECTION"	"10002895"	"50-59 years"	"50-59"	""On 5/22/21 he was taken emergently to the operating room and underwent repair of Type A aortic dissection with replacement of ascending aorta with re-suspension of his aortic valve.  Post op he developed new onset right arm and right sided facial twitching along with right arm weakness.  Neurology was consulted for focal motor status epilepticus and he was loaded on Keppra and started on Vimpat.  EEG and MRI brain ordered.  MRI revealed small foci of acute infarcts in the left occipital and right  temporal lobes which may be embolic in etiology.  He was initially very slow to wake up and follow commands appropriately.  This improved over a number of weeks.  By day of discharge on 6/21 to acute rehab, his right arm and facial twitching had completely resolved.  He was alert, oriented X 3.  His right arm continued to have slow return of function with fine motor skills. 6/22, patient reportedly had a 1 hour episode of AMS, witnessed by wife and daughter, in which his eyes rolled back into his head. He was arousable and answered simple questions. He had no associated tremors, shaking, rigidity. This resolved with an episode of emesis and patient was back to baseline within minutes of vomiting. 6/23, patient had another episode described as  ""generalized seizure"" involving upper and lower extremities last several seconds followed by multiple focal seizures including only UEs. Was readmitted on 6/24 and was discharged on 7/16/21. He subsequently passed away on 7/19/21""
	"1535013-1"	"1535013-1"	"AORTIC VALVE REPLACEMENT"	"10002916"	"50-59 years"	"50-59"	""On 5/22/21 he was taken emergently to the operating room and underwent repair of Type A aortic dissection with replacement of ascending aorta with re-suspension of his aortic valve.  Post op he developed new onset right arm and right sided facial twitching along with right arm weakness.  Neurology was consulted for focal motor status epilepticus and he was loaded on Keppra and started on Vimpat.  EEG and MRI brain ordered.  MRI revealed small foci of acute infarcts in the left occipital and right  temporal lobes which may be embolic in etiology.  He was initially very slow to wake up and follow commands appropriately.  This improved over a number of weeks.  By day of discharge on 6/21 to acute rehab, his right arm and facial twitching had completely resolved.  He was alert, oriented X 3.  His right arm continued to have slow return of function with fine motor skills. 6/22, patient reportedly had a 1 hour episode of AMS, witnessed by wife and daughter, in which his eyes rolled back into his head. He was arousable and answered simple questions. He had no associated tremors, shaking, rigidity. This resolved with an episode of emesis and patient was back to baseline within minutes of vomiting. 6/23, patient had another episode described as  ""generalized seizure"" involving upper and lower extremities last several seconds followed by multiple focal seizures including only UEs. Was readmitted on 6/24 and was discharged on 7/16/21. He subsequently passed away on 7/19/21""
	"1535013-1"	"1535013-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	""On 5/22/21 he was taken emergently to the operating room and underwent repair of Type A aortic dissection with replacement of ascending aorta with re-suspension of his aortic valve.  Post op he developed new onset right arm and right sided facial twitching along with right arm weakness.  Neurology was consulted for focal motor status epilepticus and he was loaded on Keppra and started on Vimpat.  EEG and MRI brain ordered.  MRI revealed small foci of acute infarcts in the left occipital and right  temporal lobes which may be embolic in etiology.  He was initially very slow to wake up and follow commands appropriately.  This improved over a number of weeks.  By day of discharge on 6/21 to acute rehab, his right arm and facial twitching had completely resolved.  He was alert, oriented X 3.  His right arm continued to have slow return of function with fine motor skills. 6/22, patient reportedly had a 1 hour episode of AMS, witnessed by wife and daughter, in which his eyes rolled back into his head. He was arousable and answered simple questions. He had no associated tremors, shaking, rigidity. This resolved with an episode of emesis and patient was back to baseline within minutes of vomiting. 6/23, patient had another episode described as  ""generalized seizure"" involving upper and lower extremities last several seconds followed by multiple focal seizures including only UEs. Was readmitted on 6/24 and was discharged on 7/16/21. He subsequently passed away on 7/19/21""
	"1535013-1"	"1535013-1"	"ELECTROENCEPHALOGRAM"	"10014407"	"50-59 years"	"50-59"	""On 5/22/21 he was taken emergently to the operating room and underwent repair of Type A aortic dissection with replacement of ascending aorta with re-suspension of his aortic valve.  Post op he developed new onset right arm and right sided facial twitching along with right arm weakness.  Neurology was consulted for focal motor status epilepticus and he was loaded on Keppra and started on Vimpat.  EEG and MRI brain ordered.  MRI revealed small foci of acute infarcts in the left occipital and right  temporal lobes which may be embolic in etiology.  He was initially very slow to wake up and follow commands appropriately.  This improved over a number of weeks.  By day of discharge on 6/21 to acute rehab, his right arm and facial twitching had completely resolved.  He was alert, oriented X 3.  His right arm continued to have slow return of function with fine motor skills. 6/22, patient reportedly had a 1 hour episode of AMS, witnessed by wife and daughter, in which his eyes rolled back into his head. He was arousable and answered simple questions. He had no associated tremors, shaking, rigidity. This resolved with an episode of emesis and patient was back to baseline within minutes of vomiting. 6/23, patient had another episode described as  ""generalized seizure"" involving upper and lower extremities last several seconds followed by multiple focal seizures including only UEs. Was readmitted on 6/24 and was discharged on 7/16/21. He subsequently passed away on 7/19/21""
	"1535013-1"	"1535013-1"	"GAZE PALSY"	"10056696"	"50-59 years"	"50-59"	""On 5/22/21 he was taken emergently to the operating room and underwent repair of Type A aortic dissection with replacement of ascending aorta with re-suspension of his aortic valve.  Post op he developed new onset right arm and right sided facial twitching along with right arm weakness.  Neurology was consulted for focal motor status epilepticus and he was loaded on Keppra and started on Vimpat.  EEG and MRI brain ordered.  MRI revealed small foci of acute infarcts in the left occipital and right  temporal lobes which may be embolic in etiology.  He was initially very slow to wake up and follow commands appropriately.  This improved over a number of weeks.  By day of discharge on 6/21 to acute rehab, his right arm and facial twitching had completely resolved.  He was alert, oriented X 3.  His right arm continued to have slow return of function with fine motor skills. 6/22, patient reportedly had a 1 hour episode of AMS, witnessed by wife and daughter, in which his eyes rolled back into his head. He was arousable and answered simple questions. He had no associated tremors, shaking, rigidity. This resolved with an episode of emesis and patient was back to baseline within minutes of vomiting. 6/23, patient had another episode described as  ""generalized seizure"" involving upper and lower extremities last several seconds followed by multiple focal seizures including only UEs. Was readmitted on 6/24 and was discharged on 7/16/21. He subsequently passed away on 7/19/21""
	"1535013-1"	"1535013-1"	"INFARCTION"	"10061216"	"50-59 years"	"50-59"	""On 5/22/21 he was taken emergently to the operating room and underwent repair of Type A aortic dissection with replacement of ascending aorta with re-suspension of his aortic valve.  Post op he developed new onset right arm and right sided facial twitching along with right arm weakness.  Neurology was consulted for focal motor status epilepticus and he was loaded on Keppra and started on Vimpat.  EEG and MRI brain ordered.  MRI revealed small foci of acute infarcts in the left occipital and right  temporal lobes which may be embolic in etiology.  He was initially very slow to wake up and follow commands appropriately.  This improved over a number of weeks.  By day of discharge on 6/21 to acute rehab, his right arm and facial twitching had completely resolved.  He was alert, oriented X 3.  His right arm continued to have slow return of function with fine motor skills. 6/22, patient reportedly had a 1 hour episode of AMS, witnessed by wife and daughter, in which his eyes rolled back into his head. He was arousable and answered simple questions. He had no associated tremors, shaking, rigidity. This resolved with an episode of emesis and patient was back to baseline within minutes of vomiting. 6/23, patient had another episode described as  ""generalized seizure"" involving upper and lower extremities last several seconds followed by multiple focal seizures including only UEs. Was readmitted on 6/24 and was discharged on 7/16/21. He subsequently passed away on 7/19/21""
	"1535013-1"	"1535013-1"	"MAGNETIC RESONANCE IMAGING HEAD ABNORMAL"	"10085256"	"50-59 years"	"50-59"	""On 5/22/21 he was taken emergently to the operating room and underwent repair of Type A aortic dissection with replacement of ascending aorta with re-suspension of his aortic valve.  Post op he developed new onset right arm and right sided facial twitching along with right arm weakness.  Neurology was consulted for focal motor status epilepticus and he was loaded on Keppra and started on Vimpat.  EEG and MRI brain ordered.  MRI revealed small foci of acute infarcts in the left occipital and right  temporal lobes which may be embolic in etiology.  He was initially very slow to wake up and follow commands appropriately.  This improved over a number of weeks.  By day of discharge on 6/21 to acute rehab, his right arm and facial twitching had completely resolved.  He was alert, oriented X 3.  His right arm continued to have slow return of function with fine motor skills. 6/22, patient reportedly had a 1 hour episode of AMS, witnessed by wife and daughter, in which his eyes rolled back into his head. He was arousable and answered simple questions. He had no associated tremors, shaking, rigidity. This resolved with an episode of emesis and patient was back to baseline within minutes of vomiting. 6/23, patient had another episode described as  ""generalized seizure"" involving upper and lower extremities last several seconds followed by multiple focal seizures including only UEs. Was readmitted on 6/24 and was discharged on 7/16/21. He subsequently passed away on 7/19/21""
	"1535013-1"	"1535013-1"	"MENTAL STATUS CHANGES"	"10048294"	"50-59 years"	"50-59"	""On 5/22/21 he was taken emergently to the operating room and underwent repair of Type A aortic dissection with replacement of ascending aorta with re-suspension of his aortic valve.  Post op he developed new onset right arm and right sided facial twitching along with right arm weakness.  Neurology was consulted for focal motor status epilepticus and he was loaded on Keppra and started on Vimpat.  EEG and MRI brain ordered.  MRI revealed small foci of acute infarcts in the left occipital and right  temporal lobes which may be embolic in etiology.  He was initially very slow to wake up and follow commands appropriately.  This improved over a number of weeks.  By day of discharge on 6/21 to acute rehab, his right arm and facial twitching had completely resolved.  He was alert, oriented X 3.  His right arm continued to have slow return of function with fine motor skills. 6/22, patient reportedly had a 1 hour episode of AMS, witnessed by wife and daughter, in which his eyes rolled back into his head. He was arousable and answered simple questions. He had no associated tremors, shaking, rigidity. This resolved with an episode of emesis and patient was back to baseline within minutes of vomiting. 6/23, patient had another episode described as  ""generalized seizure"" involving upper and lower extremities last several seconds followed by multiple focal seizures including only UEs. Was readmitted on 6/24 and was discharged on 7/16/21. He subsequently passed away on 7/19/21""
	"1535013-1"	"1535013-1"	"MUSCLE RIGIDITY"	"10028330"	"50-59 years"	"50-59"	""On 5/22/21 he was taken emergently to the operating room and underwent repair of Type A aortic dissection with replacement of ascending aorta with re-suspension of his aortic valve.  Post op he developed new onset right arm and right sided facial twitching along with right arm weakness.  Neurology was consulted for focal motor status epilepticus and he was loaded on Keppra and started on Vimpat.  EEG and MRI brain ordered.  MRI revealed small foci of acute infarcts in the left occipital and right  temporal lobes which may be embolic in etiology.  He was initially very slow to wake up and follow commands appropriately.  This improved over a number of weeks.  By day of discharge on 6/21 to acute rehab, his right arm and facial twitching had completely resolved.  He was alert, oriented X 3.  His right arm continued to have slow return of function with fine motor skills. 6/22, patient reportedly had a 1 hour episode of AMS, witnessed by wife and daughter, in which his eyes rolled back into his head. He was arousable and answered simple questions. He had no associated tremors, shaking, rigidity. This resolved with an episode of emesis and patient was back to baseline within minutes of vomiting. 6/23, patient had another episode described as  ""generalized seizure"" involving upper and lower extremities last several seconds followed by multiple focal seizures including only UEs. Was readmitted on 6/24 and was discharged on 7/16/21. He subsequently passed away on 7/19/21""
	"1535013-1"	"1535013-1"	"MUSCLE TWITCHING"	"10028347"	"50-59 years"	"50-59"	""On 5/22/21 he was taken emergently to the operating room and underwent repair of Type A aortic dissection with replacement of ascending aorta with re-suspension of his aortic valve.  Post op he developed new onset right arm and right sided facial twitching along with right arm weakness.  Neurology was consulted for focal motor status epilepticus and he was loaded on Keppra and started on Vimpat.  EEG and MRI brain ordered.  MRI revealed small foci of acute infarcts in the left occipital and right  temporal lobes which may be embolic in etiology.  He was initially very slow to wake up and follow commands appropriately.  This improved over a number of weeks.  By day of discharge on 6/21 to acute rehab, his right arm and facial twitching had completely resolved.  He was alert, oriented X 3.  His right arm continued to have slow return of function with fine motor skills. 6/22, patient reportedly had a 1 hour episode of AMS, witnessed by wife and daughter, in which his eyes rolled back into his head. He was arousable and answered simple questions. He had no associated tremors, shaking, rigidity. This resolved with an episode of emesis and patient was back to baseline within minutes of vomiting. 6/23, patient had another episode described as  ""generalized seizure"" involving upper and lower extremities last several seconds followed by multiple focal seizures including only UEs. Was readmitted on 6/24 and was discharged on 7/16/21. He subsequently passed away on 7/19/21""
	"1535013-1"	"1535013-1"	"MUSCULAR WEAKNESS"	"10028372"	"50-59 years"	"50-59"	""On 5/22/21 he was taken emergently to the operating room and underwent repair of Type A aortic dissection with replacement of ascending aorta with re-suspension of his aortic valve.  Post op he developed new onset right arm and right sided facial twitching along with right arm weakness.  Neurology was consulted for focal motor status epilepticus and he was loaded on Keppra and started on Vimpat.  EEG and MRI brain ordered.  MRI revealed small foci of acute infarcts in the left occipital and right  temporal lobes which may be embolic in etiology.  He was initially very slow to wake up and follow commands appropriately.  This improved over a number of weeks.  By day of discharge on 6/21 to acute rehab, his right arm and facial twitching had completely resolved.  He was alert, oriented X 3.  His right arm continued to have slow return of function with fine motor skills. 6/22, patient reportedly had a 1 hour episode of AMS, witnessed by wife and daughter, in which his eyes rolled back into his head. He was arousable and answered simple questions. He had no associated tremors, shaking, rigidity. This resolved with an episode of emesis and patient was back to baseline within minutes of vomiting. 6/23, patient had another episode described as  ""generalized seizure"" involving upper and lower extremities last several seconds followed by multiple focal seizures including only UEs. Was readmitted on 6/24 and was discharged on 7/16/21. He subsequently passed away on 7/19/21""
	"1535013-1"	"1535013-1"	"PARTIAL SEIZURES"	"10061334"	"50-59 years"	"50-59"	""On 5/22/21 he was taken emergently to the operating room and underwent repair of Type A aortic dissection with replacement of ascending aorta with re-suspension of his aortic valve.  Post op he developed new onset right arm and right sided facial twitching along with right arm weakness.  Neurology was consulted for focal motor status epilepticus and he was loaded on Keppra and started on Vimpat.  EEG and MRI brain ordered.  MRI revealed small foci of acute infarcts in the left occipital and right  temporal lobes which may be embolic in etiology.  He was initially very slow to wake up and follow commands appropriately.  This improved over a number of weeks.  By day of discharge on 6/21 to acute rehab, his right arm and facial twitching had completely resolved.  He was alert, oriented X 3.  His right arm continued to have slow return of function with fine motor skills. 6/22, patient reportedly had a 1 hour episode of AMS, witnessed by wife and daughter, in which his eyes rolled back into his head. He was arousable and answered simple questions. He had no associated tremors, shaking, rigidity. This resolved with an episode of emesis and patient was back to baseline within minutes of vomiting. 6/23, patient had another episode described as  ""generalized seizure"" involving upper and lower extremities last several seconds followed by multiple focal seizures including only UEs. Was readmitted on 6/24 and was discharged on 7/16/21. He subsequently passed away on 7/19/21""
	"1535013-1"	"1535013-1"	"SEIZURE"	"10039906"	"50-59 years"	"50-59"	""On 5/22/21 he was taken emergently to the operating room and underwent repair of Type A aortic dissection with replacement of ascending aorta with re-suspension of his aortic valve.  Post op he developed new onset right arm and right sided facial twitching along with right arm weakness.  Neurology was consulted for focal motor status epilepticus and he was loaded on Keppra and started on Vimpat.  EEG and MRI brain ordered.  MRI revealed small foci of acute infarcts in the left occipital and right  temporal lobes which may be embolic in etiology.  He was initially very slow to wake up and follow commands appropriately.  This improved over a number of weeks.  By day of discharge on 6/21 to acute rehab, his right arm and facial twitching had completely resolved.  He was alert, oriented X 3.  His right arm continued to have slow return of function with fine motor skills. 6/22, patient reportedly had a 1 hour episode of AMS, witnessed by wife and daughter, in which his eyes rolled back into his head. He was arousable and answered simple questions. He had no associated tremors, shaking, rigidity. This resolved with an episode of emesis and patient was back to baseline within minutes of vomiting. 6/23, patient had another episode described as  ""generalized seizure"" involving upper and lower extremities last several seconds followed by multiple focal seizures including only UEs. Was readmitted on 6/24 and was discharged on 7/16/21. He subsequently passed away on 7/19/21""
	"1535013-1"	"1535013-1"	"TREMOR"	"10044565"	"50-59 years"	"50-59"	""On 5/22/21 he was taken emergently to the operating room and underwent repair of Type A aortic dissection with replacement of ascending aorta with re-suspension of his aortic valve.  Post op he developed new onset right arm and right sided facial twitching along with right arm weakness.  Neurology was consulted for focal motor status epilepticus and he was loaded on Keppra and started on Vimpat.  EEG and MRI brain ordered.  MRI revealed small foci of acute infarcts in the left occipital and right  temporal lobes which may be embolic in etiology.  He was initially very slow to wake up and follow commands appropriately.  This improved over a number of weeks.  By day of discharge on 6/21 to acute rehab, his right arm and facial twitching had completely resolved.  He was alert, oriented X 3.  His right arm continued to have slow return of function with fine motor skills. 6/22, patient reportedly had a 1 hour episode of AMS, witnessed by wife and daughter, in which his eyes rolled back into his head. He was arousable and answered simple questions. He had no associated tremors, shaking, rigidity. This resolved with an episode of emesis and patient was back to baseline within minutes of vomiting. 6/23, patient had another episode described as  ""generalized seizure"" involving upper and lower extremities last several seconds followed by multiple focal seizures including only UEs. Was readmitted on 6/24 and was discharged on 7/16/21. He subsequently passed away on 7/19/21""
	"1535013-1"	"1535013-1"	"VOMITING"	"10047700"	"50-59 years"	"50-59"	""On 5/22/21 he was taken emergently to the operating room and underwent repair of Type A aortic dissection with replacement of ascending aorta with re-suspension of his aortic valve.  Post op he developed new onset right arm and right sided facial twitching along with right arm weakness.  Neurology was consulted for focal motor status epilepticus and he was loaded on Keppra and started on Vimpat.  EEG and MRI brain ordered.  MRI revealed small foci of acute infarcts in the left occipital and right  temporal lobes which may be embolic in etiology.  He was initially very slow to wake up and follow commands appropriately.  This improved over a number of weeks.  By day of discharge on 6/21 to acute rehab, his right arm and facial twitching had completely resolved.  He was alert, oriented X 3.  His right arm continued to have slow return of function with fine motor skills. 6/22, patient reportedly had a 1 hour episode of AMS, witnessed by wife and daughter, in which his eyes rolled back into his head. He was arousable and answered simple questions. He had no associated tremors, shaking, rigidity. This resolved with an episode of emesis and patient was back to baseline within minutes of vomiting. 6/23, patient had another episode described as  ""generalized seizure"" involving upper and lower extremities last several seconds followed by multiple focal seizures including only UEs. Was readmitted on 6/24 and was discharged on 7/16/21. He subsequently passed away on 7/19/21""
	"1535017-1"	"1535017-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"C/O feeling short of breath & flushed at times. Unsure if he went to his primary doctor for a follow up. He was found deceased at home by his daughter"
	"1535017-1"	"1535017-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"C/O feeling short of breath & flushed at times. Unsure if he went to his primary doctor for a follow up. He was found deceased at home by his daughter"
	"1535017-1"	"1535017-1"	"FLUSHING"	"10016825"	"50-59 years"	"50-59"	"C/O feeling short of breath & flushed at times. Unsure if he went to his primary doctor for a follow up. He was found deceased at home by his daughter"
	"1535913-1"	"1535913-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient was hospitalized on 6/7/2021 for severe protein-calorie malnutrition and received the first dose of covid vaccine while hospitalized. Patient received second dose on 6/30/2021. Patient presented to the ED and was subsequently hospitalized on 7/4/2021 for squamous cell carcinoma of right lung. She died on 7/20/2021."
	"1535913-1"	"1535913-1"	"SQUAMOUS CELL CARCINOMA OF LUNG"	"10041826"	"50-59 years"	"50-59"	"Patient was hospitalized on 6/7/2021 for severe protein-calorie malnutrition and received the first dose of covid vaccine while hospitalized. Patient received second dose on 6/30/2021. Patient presented to the ED and was subsequently hospitalized on 7/4/2021 for squamous cell carcinoma of right lung. She died on 7/20/2021."
	"1536019-1"	"1536019-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Contracted Covid-19. Died after 12 days in hospital"
	"1536019-1"	"1536019-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Contracted Covid-19. Died after 12 days in hospital"
	"1536019-1"	"1536019-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"Contracted Covid-19. Died after 12 days in hospital"
	"1536077-1"	"1536077-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"death"
	"1540687-1"	"1540687-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"Found in cardiac arrest at his residence. Brought into the emergency department by ems in cardiac arrest. No return of spontaneous circulation. Pronounced dead at 0746."
	"1540687-1"	"1540687-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Found in cardiac arrest at his residence. Brought into the emergency department by ems in cardiac arrest. No return of spontaneous circulation. Pronounced dead at 0746."
	"1540952-1"	"1540952-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"Cardiac arrest resulting in death"
	"1540952-1"	"1540952-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Cardiac arrest resulting in death"
	"1541088-1"	"1541088-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"The patient died on 08/09/2021"
	"1542102-1"	"1542102-1"	"SUDDEN CARDIAC DEATH"	"10049418"	"50-59 years"	"50-59"	"SUDDEN CARDIAC DEATH"
	"1542106-1"	"1542106-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"CARDIAC ARREST"
	"1542108-1"	"1542108-1"	"MYOCARDIAL INFARCTION"	"10028596"	"50-59 years"	"50-59"	"Myocardial Infarction"
	"1542844-1"	"1542844-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"CARDIAC ARREST"
	"1544945-1"	"1544945-1"	"CEREBROVASCULAR ACCIDENT"	"10008190"	"50-59 years"	"50-59"	"None stated."
	"1544965-1"	"1544965-1"	"CARDIOPULMONARY FAILURE"	"10051093"	"50-59 years"	"50-59"	"CARDIOPULMONARY FAILURE"
	"1544970-1"	"1544970-1"	"ACUTE MYOCARDIAL INFARCTION"	"10000891"	"50-59 years"	"50-59"	"AMI"
	"1544982-1"	"1544982-1"	"CARDIO-RESPIRATORY ARREST"	"10007617"	"50-59 years"	"50-59"	"CARDIOPULMONARY ARREST"
	"1544990-1"	"1544990-1"	"MYOCARDIAL INFARCTION"	"10028596"	"50-59 years"	"50-59"	"MYOCARDIAL INFRACTION"
	"1549456-1"	"1549456-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient was hospitalized multiple times and died within 60 days of receiving a COVID vaccine series"
	"1549500-1"	"1549500-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient was hospitalized multiple times and died within 60 days of receiving a COVID vaccine series"
	"1553728-1"	"1553728-1"	"AUTOPSY"	"10050117"	"50-59 years"	"50-59"	"There were no signs or symptoms. Patient received his last Covid19 vaccine on 5/13/21. He passed away on 06/15/2021. The diagnosis on the autopsy report shows that he died from Dilated Cardiomyopathy. There was no evidence of trauma and a clean toxicity report. He has no previous diagnosed health problems."
	"1553728-1"	"1553728-1"	"CONGESTIVE CARDIOMYOPATHY"	"10056370"	"50-59 years"	"50-59"	"There were no signs or symptoms. Patient received his last Covid19 vaccine on 5/13/21. He passed away on 06/15/2021. The diagnosis on the autopsy report shows that he died from Dilated Cardiomyopathy. There was no evidence of trauma and a clean toxicity report. He has no previous diagnosed health problems."
	"1553728-1"	"1553728-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"There were no signs or symptoms. Patient received his last Covid19 vaccine on 5/13/21. He passed away on 06/15/2021. The diagnosis on the autopsy report shows that he died from Dilated Cardiomyopathy. There was no evidence of trauma and a clean toxicity report. He has no previous diagnosed health problems."
	"1573981-1"	"1573981-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"Patient has 1st dose of Pfizer vaccine documented on 8/4/2021. Per hospital notes, pateint recevied dose and has been short of breath since."
	"1574001-1"	"1574001-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"On 8/12/21 at 8:30 p.m. resident noted in bed alert and responsive.  Resident noted talking to nurse.  At 9:10 p.m., resident noted to be unresponsive by staff.  CPR initiated.  911 arrived at 9:27 p.m. and was unsuccessful.  Pronouncement of death at 9:30 p.m.  Medical examiner deemed resident death as natural causes"
	"1574001-1"	"1574001-1"	"RESUSCITATION"	"10038749"	"50-59 years"	"50-59"	"On 8/12/21 at 8:30 p.m. resident noted in bed alert and responsive.  Resident noted talking to nurse.  At 9:10 p.m., resident noted to be unresponsive by staff.  CPR initiated.  911 arrived at 9:27 p.m. and was unsuccessful.  Pronouncement of death at 9:30 p.m.  Medical examiner deemed resident death as natural causes"
	"1574001-1"	"1574001-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"50-59 years"	"50-59"	"On 8/12/21 at 8:30 p.m. resident noted in bed alert and responsive.  Resident noted talking to nurse.  At 9:10 p.m., resident noted to be unresponsive by staff.  CPR initiated.  911 arrived at 9:27 p.m. and was unsuccessful.  Pronouncement of death at 9:30 p.m.  Medical examiner deemed resident death as natural causes"
	"1577653-1"	"1577653-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Hospitalization for COVID19 7/24/21 and death 08/02/2021"
	"1577653-1"	"1577653-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Hospitalization for COVID19 7/24/21 and death 08/02/2021"
	"1578362-1"	"1578362-1"	"BILEVEL POSITIVE AIRWAY PRESSURE"	"10064530"	"50-59 years"	"50-59"	"Admit 6/24, vaccine 3/16, 4/6. H/O HTN, CAD, emphysema. Per wife patient had asymptomatic COVID in Dec 2020.Admit for fever, SOB. Admit for spetic shock, lactic acidosis. Patient progressively hypoxic, BiPap then emergent intubation. Tfer to ICU, sepsis tx started. Shortly after pt required vasopressors. Coded, cardiac arrest and expired."
	"1578362-1"	"1578362-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"Admit 6/24, vaccine 3/16, 4/6. H/O HTN, CAD, emphysema. Per wife patient had asymptomatic COVID in Dec 2020.Admit for fever, SOB. Admit for spetic shock, lactic acidosis. Patient progressively hypoxic, BiPap then emergent intubation. Tfer to ICU, sepsis tx started. Shortly after pt required vasopressors. Coded, cardiac arrest and expired."
	"1578362-1"	"1578362-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Admit 6/24, vaccine 3/16, 4/6. H/O HTN, CAD, emphysema. Per wife patient had asymptomatic COVID in Dec 2020.Admit for fever, SOB. Admit for spetic shock, lactic acidosis. Patient progressively hypoxic, BiPap then emergent intubation. Tfer to ICU, sepsis tx started. Shortly after pt required vasopressors. Coded, cardiac arrest and expired."
	"1578362-1"	"1578362-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"Admit 6/24, vaccine 3/16, 4/6. H/O HTN, CAD, emphysema. Per wife patient had asymptomatic COVID in Dec 2020.Admit for fever, SOB. Admit for spetic shock, lactic acidosis. Patient progressively hypoxic, BiPap then emergent intubation. Tfer to ICU, sepsis tx started. Shortly after pt required vasopressors. Coded, cardiac arrest and expired."
	"1578362-1"	"1578362-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"50-59 years"	"50-59"	"Admit 6/24, vaccine 3/16, 4/6. H/O HTN, CAD, emphysema. Per wife patient had asymptomatic COVID in Dec 2020.Admit for fever, SOB. Admit for spetic shock, lactic acidosis. Patient progressively hypoxic, BiPap then emergent intubation. Tfer to ICU, sepsis tx started. Shortly after pt required vasopressors. Coded, cardiac arrest and expired."
	"1578362-1"	"1578362-1"	"HYPOXIA"	"10021143"	"50-59 years"	"50-59"	"Admit 6/24, vaccine 3/16, 4/6. H/O HTN, CAD, emphysema. Per wife patient had asymptomatic COVID in Dec 2020.Admit for fever, SOB. Admit for spetic shock, lactic acidosis. Patient progressively hypoxic, BiPap then emergent intubation. Tfer to ICU, sepsis tx started. Shortly after pt required vasopressors. Coded, cardiac arrest and expired."
	"1578362-1"	"1578362-1"	"INTENSIVE CARE"	"10022519"	"50-59 years"	"50-59"	"Admit 6/24, vaccine 3/16, 4/6. H/O HTN, CAD, emphysema. Per wife patient had asymptomatic COVID in Dec 2020.Admit for fever, SOB. Admit for spetic shock, lactic acidosis. Patient progressively hypoxic, BiPap then emergent intubation. Tfer to ICU, sepsis tx started. Shortly after pt required vasopressors. Coded, cardiac arrest and expired."
	"1578362-1"	"1578362-1"	"LACTIC ACIDOSIS"	"10023676"	"50-59 years"	"50-59"	"Admit 6/24, vaccine 3/16, 4/6. H/O HTN, CAD, emphysema. Per wife patient had asymptomatic COVID in Dec 2020.Admit for fever, SOB. Admit for spetic shock, lactic acidosis. Patient progressively hypoxic, BiPap then emergent intubation. Tfer to ICU, sepsis tx started. Shortly after pt required vasopressors. Coded, cardiac arrest and expired."
	"1578362-1"	"1578362-1"	"PYREXIA"	"10037660"	"50-59 years"	"50-59"	"Admit 6/24, vaccine 3/16, 4/6. H/O HTN, CAD, emphysema. Per wife patient had asymptomatic COVID in Dec 2020.Admit for fever, SOB. Admit for spetic shock, lactic acidosis. Patient progressively hypoxic, BiPap then emergent intubation. Tfer to ICU, sepsis tx started. Shortly after pt required vasopressors. Coded, cardiac arrest and expired."
	"1578362-1"	"1578362-1"	"SEPTIC SHOCK"	"10040070"	"50-59 years"	"50-59"	"Admit 6/24, vaccine 3/16, 4/6. H/O HTN, CAD, emphysema. Per wife patient had asymptomatic COVID in Dec 2020.Admit for fever, SOB. Admit for spetic shock, lactic acidosis. Patient progressively hypoxic, BiPap then emergent intubation. Tfer to ICU, sepsis tx started. Shortly after pt required vasopressors. Coded, cardiac arrest and expired."
	"1582161-1"	"1582161-1"	"ACUTE KIDNEY INJURY"	"10069339"	"50-59 years"	"50-59"	"death N17.9 - Acute kidney failure, unspecified"
	"1582161-1"	"1582161-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"death N17.9 - Acute kidney failure, unspecified"
	"1582847-1"	"1582847-1"	"ACUTE RESPIRATORY DISTRESS SYNDROME"	"10001052"	"50-59 years"	"50-59"	"Patient was a 58 year old patient. He had ESRD on HD MWF.  He had previously been hospitalized 8/4/21 - 8/5/21 - diagnosed with Covid 19 during this stay - stabilized and was able to be discharged home. He deteriorated at home and was brought back to the ED via EMS 8/6/21 with ARDS secondary to Covid - 19. He was intubated and remained for the duration of his stay in the ICU. He had two code incidents 8/16/21 and 8/17/21. Upon the 3rd Code, they were unable to revive him and upon discussion with family - decision made to stop CPR and patient expired."
	"1582847-1"	"1582847-1"	"CARDIO-RESPIRATORY ARREST"	"10007617"	"50-59 years"	"50-59"	"Patient was a 58 year old patient. He had ESRD on HD MWF.  He had previously been hospitalized 8/4/21 - 8/5/21 - diagnosed with Covid 19 during this stay - stabilized and was able to be discharged home. He deteriorated at home and was brought back to the ED via EMS 8/6/21 with ARDS secondary to Covid - 19. He was intubated and remained for the duration of his stay in the ICU. He had two code incidents 8/16/21 and 8/17/21. Upon the 3rd Code, they were unable to revive him and upon discussion with family - decision made to stop CPR and patient expired."
	"1582847-1"	"1582847-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Patient was a 58 year old patient. He had ESRD on HD MWF.  He had previously been hospitalized 8/4/21 - 8/5/21 - diagnosed with Covid 19 during this stay - stabilized and was able to be discharged home. He deteriorated at home and was brought back to the ED via EMS 8/6/21 with ARDS secondary to Covid - 19. He was intubated and remained for the duration of his stay in the ICU. He had two code incidents 8/16/21 and 8/17/21. Upon the 3rd Code, they were unable to revive him and upon discussion with family - decision made to stop CPR and patient expired."
	"1582847-1"	"1582847-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient was a 58 year old patient. He had ESRD on HD MWF.  He had previously been hospitalized 8/4/21 - 8/5/21 - diagnosed with Covid 19 during this stay - stabilized and was able to be discharged home. He deteriorated at home and was brought back to the ED via EMS 8/6/21 with ARDS secondary to Covid - 19. He was intubated and remained for the duration of his stay in the ICU. He had two code incidents 8/16/21 and 8/17/21. Upon the 3rd Code, they were unable to revive him and upon discussion with family - decision made to stop CPR and patient expired."
	"1582847-1"	"1582847-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"50-59 years"	"50-59"	"Patient was a 58 year old patient. He had ESRD on HD MWF.  He had previously been hospitalized 8/4/21 - 8/5/21 - diagnosed with Covid 19 during this stay - stabilized and was able to be discharged home. He deteriorated at home and was brought back to the ED via EMS 8/6/21 with ARDS secondary to Covid - 19. He was intubated and remained for the duration of his stay in the ICU. He had two code incidents 8/16/21 and 8/17/21. Upon the 3rd Code, they were unable to revive him and upon discussion with family - decision made to stop CPR and patient expired."
	"1582847-1"	"1582847-1"	"GENERAL PHYSICAL HEALTH DETERIORATION"	"10049438"	"50-59 years"	"50-59"	"Patient was a 58 year old patient. He had ESRD on HD MWF.  He had previously been hospitalized 8/4/21 - 8/5/21 - diagnosed with Covid 19 during this stay - stabilized and was able to be discharged home. He deteriorated at home and was brought back to the ED via EMS 8/6/21 with ARDS secondary to Covid - 19. He was intubated and remained for the duration of his stay in the ICU. He had two code incidents 8/16/21 and 8/17/21. Upon the 3rd Code, they were unable to revive him and upon discussion with family - decision made to stop CPR and patient expired."
	"1582847-1"	"1582847-1"	"INTENSIVE CARE"	"10022519"	"50-59 years"	"50-59"	"Patient was a 58 year old patient. He had ESRD on HD MWF.  He had previously been hospitalized 8/4/21 - 8/5/21 - diagnosed with Covid 19 during this stay - stabilized and was able to be discharged home. He deteriorated at home and was brought back to the ED via EMS 8/6/21 with ARDS secondary to Covid - 19. He was intubated and remained for the duration of his stay in the ICU. He had two code incidents 8/16/21 and 8/17/21. Upon the 3rd Code, they were unable to revive him and upon discussion with family - decision made to stop CPR and patient expired."
	"1582847-1"	"1582847-1"	"LABORATORY TEST"	"10059938"	"50-59 years"	"50-59"	"Patient was a 58 year old patient. He had ESRD on HD MWF.  He had previously been hospitalized 8/4/21 - 8/5/21 - diagnosed with Covid 19 during this stay - stabilized and was able to be discharged home. He deteriorated at home and was brought back to the ED via EMS 8/6/21 with ARDS secondary to Covid - 19. He was intubated and remained for the duration of his stay in the ICU. He had two code incidents 8/16/21 and 8/17/21. Upon the 3rd Code, they were unable to revive him and upon discussion with family - decision made to stop CPR and patient expired."
	"1582847-1"	"1582847-1"	"RESUSCITATION"	"10038749"	"50-59 years"	"50-59"	"Patient was a 58 year old patient. He had ESRD on HD MWF.  He had previously been hospitalized 8/4/21 - 8/5/21 - diagnosed with Covid 19 during this stay - stabilized and was able to be discharged home. He deteriorated at home and was brought back to the ED via EMS 8/6/21 with ARDS secondary to Covid - 19. He was intubated and remained for the duration of his stay in the ICU. He had two code incidents 8/16/21 and 8/17/21. Upon the 3rd Code, they were unable to revive him and upon discussion with family - decision made to stop CPR and patient expired."
	"1582847-1"	"1582847-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"Patient was a 58 year old patient. He had ESRD on HD MWF.  He had previously been hospitalized 8/4/21 - 8/5/21 - diagnosed with Covid 19 during this stay - stabilized and was able to be discharged home. He deteriorated at home and was brought back to the ED via EMS 8/6/21 with ARDS secondary to Covid - 19. He was intubated and remained for the duration of his stay in the ICU. He had two code incidents 8/16/21 and 8/17/21. Upon the 3rd Code, they were unable to revive him and upon discussion with family - decision made to stop CPR and patient expired."
	"1586877-1"	"1586877-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Resident had no issues after receiving vaccination. The next morning he was found in his room laying face down on the floor and unresponsive. CPR was started, 911 called. Unfortunately resident was pronounced dead at 7:55am."
	"1586877-1"	"1586877-1"	"RESUSCITATION"	"10038749"	"50-59 years"	"50-59"	"Resident had no issues after receiving vaccination. The next morning he was found in his room laying face down on the floor and unresponsive. CPR was started, 911 called. Unfortunately resident was pronounced dead at 7:55am."
	"1586877-1"	"1586877-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"50-59 years"	"50-59"	"Resident had no issues after receiving vaccination. The next morning he was found in his room laying face down on the floor and unresponsive. CPR was started, 911 called. Unfortunately resident was pronounced dead at 7:55am."
	"1587223-1"	"1587223-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient passed away on 08/03/2021."
	"1591538-1"	"1591538-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Pt was admitted on 7/30/21 for SARS-CoV-2 and remained hospitalized until 8/16/2021 when he expired."
	"1591538-1"	"1591538-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Pt was admitted on 7/30/21 for SARS-CoV-2 and remained hospitalized until 8/16/2021 when he expired."
	"1591552-1"	"1591552-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient passed away on 08/19/2021"
	"1591564-1"	"1591564-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Case received second covid vaccine on 03/04/2021. Hospital on 8/7/21 with respiratory distress . Positive COVID lab on 8/7/21. Case expired at hospital on 8/18/2021."
	"1591564-1"	"1591564-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Case received second covid vaccine on 03/04/2021. Hospital on 8/7/21 with respiratory distress . Positive COVID lab on 8/7/21. Case expired at hospital on 8/18/2021."
	"1591564-1"	"1591564-1"	"RESPIRATORY DISTRESS"	"10038687"	"50-59 years"	"50-59"	"Case received second covid vaccine on 03/04/2021. Hospital on 8/7/21 with respiratory distress . Positive COVID lab on 8/7/21. Case expired at hospital on 8/18/2021."
	"1591564-1"	"1591564-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"Case received second covid vaccine on 03/04/2021. Hospital on 8/7/21 with respiratory distress . Positive COVID lab on 8/7/21. Case expired at hospital on 8/18/2021."
	"1591682-1"	"1591682-1"	"ACUTE RESPIRATORY FAILURE"	"10001053"	"50-59 years"	"50-59"	"2ND COVID19 VACCINE ADMINISTERED 4/13/2021. ADMITTED TO MEDICAL CENTER ON 08/06/2021 WITH COVID PNEUMONIA AND ACUTE HYPOXIC RESPIRATORY FAILURE. WAS TREATED WITH REMDESEVIR IV, DEXAMETHASONE, AND PLACED ON HIGH FLOW O2. PATIENT DECOMPENSATED, WAS PLACED ON BIPAP, AND THEN TRANSFERRED TO ICU AND INTUBATED. CONTINUED TO HAVE INCREASING VENTILATORY SUPPORT. FAMILY EVENTUALLY REQUESTED COMFORT-FOCUSED CARE. EXTUBATED AND EXPIRED ON 8/18/2021."
	"1591682-1"	"1591682-1"	"BILEVEL POSITIVE AIRWAY PRESSURE"	"10064530"	"50-59 years"	"50-59"	"2ND COVID19 VACCINE ADMINISTERED 4/13/2021. ADMITTED TO MEDICAL CENTER ON 08/06/2021 WITH COVID PNEUMONIA AND ACUTE HYPOXIC RESPIRATORY FAILURE. WAS TREATED WITH REMDESEVIR IV, DEXAMETHASONE, AND PLACED ON HIGH FLOW O2. PATIENT DECOMPENSATED, WAS PLACED ON BIPAP, AND THEN TRANSFERRED TO ICU AND INTUBATED. CONTINUED TO HAVE INCREASING VENTILATORY SUPPORT. FAMILY EVENTUALLY REQUESTED COMFORT-FOCUSED CARE. EXTUBATED AND EXPIRED ON 8/18/2021."
	"1591682-1"	"1591682-1"	"COVID-19 PNEUMONIA"	"10084380"	"50-59 years"	"50-59"	"2ND COVID19 VACCINE ADMINISTERED 4/13/2021. ADMITTED TO MEDICAL CENTER ON 08/06/2021 WITH COVID PNEUMONIA AND ACUTE HYPOXIC RESPIRATORY FAILURE. WAS TREATED WITH REMDESEVIR IV, DEXAMETHASONE, AND PLACED ON HIGH FLOW O2. PATIENT DECOMPENSATED, WAS PLACED ON BIPAP, AND THEN TRANSFERRED TO ICU AND INTUBATED. CONTINUED TO HAVE INCREASING VENTILATORY SUPPORT. FAMILY EVENTUALLY REQUESTED COMFORT-FOCUSED CARE. EXTUBATED AND EXPIRED ON 8/18/2021."
	"1591682-1"	"1591682-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"2ND COVID19 VACCINE ADMINISTERED 4/13/2021. ADMITTED TO MEDICAL CENTER ON 08/06/2021 WITH COVID PNEUMONIA AND ACUTE HYPOXIC RESPIRATORY FAILURE. WAS TREATED WITH REMDESEVIR IV, DEXAMETHASONE, AND PLACED ON HIGH FLOW O2. PATIENT DECOMPENSATED, WAS PLACED ON BIPAP, AND THEN TRANSFERRED TO ICU AND INTUBATED. CONTINUED TO HAVE INCREASING VENTILATORY SUPPORT. FAMILY EVENTUALLY REQUESTED COMFORT-FOCUSED CARE. EXTUBATED AND EXPIRED ON 8/18/2021."
	"1591682-1"	"1591682-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"50-59 years"	"50-59"	"2ND COVID19 VACCINE ADMINISTERED 4/13/2021. ADMITTED TO MEDICAL CENTER ON 08/06/2021 WITH COVID PNEUMONIA AND ACUTE HYPOXIC RESPIRATORY FAILURE. WAS TREATED WITH REMDESEVIR IV, DEXAMETHASONE, AND PLACED ON HIGH FLOW O2. PATIENT DECOMPENSATED, WAS PLACED ON BIPAP, AND THEN TRANSFERRED TO ICU AND INTUBATED. CONTINUED TO HAVE INCREASING VENTILATORY SUPPORT. FAMILY EVENTUALLY REQUESTED COMFORT-FOCUSED CARE. EXTUBATED AND EXPIRED ON 8/18/2021."
	"1591682-1"	"1591682-1"	"EXTUBATION"	"10015894"	"50-59 years"	"50-59"	"2ND COVID19 VACCINE ADMINISTERED 4/13/2021. ADMITTED TO MEDICAL CENTER ON 08/06/2021 WITH COVID PNEUMONIA AND ACUTE HYPOXIC RESPIRATORY FAILURE. WAS TREATED WITH REMDESEVIR IV, DEXAMETHASONE, AND PLACED ON HIGH FLOW O2. PATIENT DECOMPENSATED, WAS PLACED ON BIPAP, AND THEN TRANSFERRED TO ICU AND INTUBATED. CONTINUED TO HAVE INCREASING VENTILATORY SUPPORT. FAMILY EVENTUALLY REQUESTED COMFORT-FOCUSED CARE. EXTUBATED AND EXPIRED ON 8/18/2021."
	"1591682-1"	"1591682-1"	"INTENSIVE CARE"	"10022519"	"50-59 years"	"50-59"	"2ND COVID19 VACCINE ADMINISTERED 4/13/2021. ADMITTED TO MEDICAL CENTER ON 08/06/2021 WITH COVID PNEUMONIA AND ACUTE HYPOXIC RESPIRATORY FAILURE. WAS TREATED WITH REMDESEVIR IV, DEXAMETHASONE, AND PLACED ON HIGH FLOW O2. PATIENT DECOMPENSATED, WAS PLACED ON BIPAP, AND THEN TRANSFERRED TO ICU AND INTUBATED. CONTINUED TO HAVE INCREASING VENTILATORY SUPPORT. FAMILY EVENTUALLY REQUESTED COMFORT-FOCUSED CARE. EXTUBATED AND EXPIRED ON 8/18/2021."
	"1592110-1"	"1592110-1"	"COUGH"	"10011224"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID19 resulting in Hospitalization/ Death Patient received Pfizer Vaccines on 4/14/2021 and 5/5/2021. Patient presented to ED on 8/8/2021 with symptom onset 8/6/2021 of SOB, Cough, Fever, Body Aches, diagnosed with COVID-19 and pneumonia.  Patient expired on 8/14/2021."
	"1592110-1"	"1592110-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID19 resulting in Hospitalization/ Death Patient received Pfizer Vaccines on 4/14/2021 and 5/5/2021. Patient presented to ED on 8/8/2021 with symptom onset 8/6/2021 of SOB, Cough, Fever, Body Aches, diagnosed with COVID-19 and pneumonia.  Patient expired on 8/14/2021."
	"1592110-1"	"1592110-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID19 resulting in Hospitalization/ Death Patient received Pfizer Vaccines on 4/14/2021 and 5/5/2021. Patient presented to ED on 8/8/2021 with symptom onset 8/6/2021 of SOB, Cough, Fever, Body Aches, diagnosed with COVID-19 and pneumonia.  Patient expired on 8/14/2021."
	"1592110-1"	"1592110-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID19 resulting in Hospitalization/ Death Patient received Pfizer Vaccines on 4/14/2021 and 5/5/2021. Patient presented to ED on 8/8/2021 with symptom onset 8/6/2021 of SOB, Cough, Fever, Body Aches, diagnosed with COVID-19 and pneumonia.  Patient expired on 8/14/2021."
	"1592110-1"	"1592110-1"	"PAIN"	"10033371"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID19 resulting in Hospitalization/ Death Patient received Pfizer Vaccines on 4/14/2021 and 5/5/2021. Patient presented to ED on 8/8/2021 with symptom onset 8/6/2021 of SOB, Cough, Fever, Body Aches, diagnosed with COVID-19 and pneumonia.  Patient expired on 8/14/2021."
	"1592110-1"	"1592110-1"	"PNEUMONIA"	"10035664"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID19 resulting in Hospitalization/ Death Patient received Pfizer Vaccines on 4/14/2021 and 5/5/2021. Patient presented to ED on 8/8/2021 with symptom onset 8/6/2021 of SOB, Cough, Fever, Body Aches, diagnosed with COVID-19 and pneumonia.  Patient expired on 8/14/2021."
	"1592110-1"	"1592110-1"	"PYREXIA"	"10037660"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID19 resulting in Hospitalization/ Death Patient received Pfizer Vaccines on 4/14/2021 and 5/5/2021. Patient presented to ED on 8/8/2021 with symptom onset 8/6/2021 of SOB, Cough, Fever, Body Aches, diagnosed with COVID-19 and pneumonia.  Patient expired on 8/14/2021."
	"1604558-1"	"1604558-1"	"CARDIAC FAILURE"	"10007554"	"50-59 years"	"50-59"	"Brought on water retention and heart failure symptoms 3 weeks after second dose. Death on August 5 2021"
	"1604558-1"	"1604558-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Brought on water retention and heart failure symptoms 3 weeks after second dose. Death on August 5 2021"
	"1604558-1"	"1604558-1"	"FLUID RETENTION"	"10016807"	"50-59 years"	"50-59"	"Brought on water retention and heart failure symptoms 3 weeks after second dose. Death on August 5 2021"
	"1617479-1"	"1617479-1"	"ACUTE KIDNEY INJURY"	"10069339"	"50-59 years"	"50-59"	"Patient required hospitalization due to breakthrough infection. She received the Moderna vaccine (2nd dose in series) on 07/10/21. Hospitalized from 08/01/21 - 08/12/21 (discharged and then admitted 2 hours later, result was death in ED). Below is copied from discharge summary:   Patient is a 50 y/o morbidly obese female admitted on 8/2/2021 due to acute respiratory failure due to COVID 19 pneumonia.    Severe Sepsis with acute organ dysfunction/ Acute respiratory failure with hypoxia 2/2 COVID 19: - Now on 4L , oxygen delivered at bedside - Chest Xray showed bilateral atypical findings - CRP 63, sed rate 22.  - DVT ppx given while inpatient - dexamethasone completed x10 days on 8/10/2021 - atorvastatin given during admission - Completed Remdesevir 8/5/2021 - Isolation   Chronic lymphocytic leukemia  - Leukocytosis due to CLL  Flow cytometry with CD+5 mature B cell lymphoma  CT abdomen showing lymphadenopathy Out patient hematology follow up, no need for acute intervention    AKI: resolved  -Cr back to baseline    Hyperkalemia: -Resolved    Arterial hypertension -Controlled - continue amlodipine + HCTz   Morbid Obesity, BMI of> 40s: -would benefit from lifestyles modifications regarding low fat diet, weight loss and daily excercise -F/U with PCP     Patient is discharged in stable condition with stable vital signs. All questions rearding hospital course and plan of care after discharge have been answered to satisfaction. Prescriptions for medications needed to be taken after discharge have been given to patient. Patient has been instructed to follow up with PCP  within the next 7 days after discharge. Patient verbalizes understanding all given instructions and has no further doubts regarding discharge.   ED admission 2 hours later:  50 y.o. female presents c/o SOB. Pt was discharged from hospital today and was known covid positive. She was discharged with home O2. At home, patient's mother noticed that she was having more difficulty breathing than usual, prompting her to call 911. Pt arrived via EMS, which states she became unresponsive on arrival with a faint pulse. She quickly lost her pulse after her arrival here. Hx limited by events/condition of patient.    The history is provided by the EMS personnel, a parent and medical records. The history is limited by the condition of the patient."
	"1617479-1"	"1617479-1"	"ACUTE RESPIRATORY FAILURE"	"10001053"	"50-59 years"	"50-59"	"Patient required hospitalization due to breakthrough infection. She received the Moderna vaccine (2nd dose in series) on 07/10/21. Hospitalized from 08/01/21 - 08/12/21 (discharged and then admitted 2 hours later, result was death in ED). Below is copied from discharge summary:   Patient is a 50 y/o morbidly obese female admitted on 8/2/2021 due to acute respiratory failure due to COVID 19 pneumonia.    Severe Sepsis with acute organ dysfunction/ Acute respiratory failure with hypoxia 2/2 COVID 19: - Now on 4L , oxygen delivered at bedside - Chest Xray showed bilateral atypical findings - CRP 63, sed rate 22.  - DVT ppx given while inpatient - dexamethasone completed x10 days on 8/10/2021 - atorvastatin given during admission - Completed Remdesevir 8/5/2021 - Isolation   Chronic lymphocytic leukemia  - Leukocytosis due to CLL  Flow cytometry with CD+5 mature B cell lymphoma  CT abdomen showing lymphadenopathy Out patient hematology follow up, no need for acute intervention    AKI: resolved  -Cr back to baseline    Hyperkalemia: -Resolved    Arterial hypertension -Controlled - continue amlodipine + HCTz   Morbid Obesity, BMI of> 40s: -would benefit from lifestyles modifications regarding low fat diet, weight loss and daily excercise -F/U with PCP     Patient is discharged in stable condition with stable vital signs. All questions rearding hospital course and plan of care after discharge have been answered to satisfaction. Prescriptions for medications needed to be taken after discharge have been given to patient. Patient has been instructed to follow up with PCP  within the next 7 days after discharge. Patient verbalizes understanding all given instructions and has no further doubts regarding discharge.   ED admission 2 hours later:  50 y.o. female presents c/o SOB. Pt was discharged from hospital today and was known covid positive. She was discharged with home O2. At home, patient's mother noticed that she was having more difficulty breathing than usual, prompting her to call 911. Pt arrived via EMS, which states she became unresponsive on arrival with a faint pulse. She quickly lost her pulse after her arrival here. Hx limited by events/condition of patient.    The history is provided by the EMS personnel, a parent and medical records. The history is limited by the condition of the patient."
	"1617479-1"	"1617479-1"	"ATYPICAL PNEUMONIA"	"10003757"	"50-59 years"	"50-59"	"Patient required hospitalization due to breakthrough infection. She received the Moderna vaccine (2nd dose in series) on 07/10/21. Hospitalized from 08/01/21 - 08/12/21 (discharged and then admitted 2 hours later, result was death in ED). Below is copied from discharge summary:   Patient is a 50 y/o morbidly obese female admitted on 8/2/2021 due to acute respiratory failure due to COVID 19 pneumonia.    Severe Sepsis with acute organ dysfunction/ Acute respiratory failure with hypoxia 2/2 COVID 19: - Now on 4L , oxygen delivered at bedside - Chest Xray showed bilateral atypical findings - CRP 63, sed rate 22.  - DVT ppx given while inpatient - dexamethasone completed x10 days on 8/10/2021 - atorvastatin given during admission - Completed Remdesevir 8/5/2021 - Isolation   Chronic lymphocytic leukemia  - Leukocytosis due to CLL  Flow cytometry with CD+5 mature B cell lymphoma  CT abdomen showing lymphadenopathy Out patient hematology follow up, no need for acute intervention    AKI: resolved  -Cr back to baseline    Hyperkalemia: -Resolved    Arterial hypertension -Controlled - continue amlodipine + HCTz   Morbid Obesity, BMI of> 40s: -would benefit from lifestyles modifications regarding low fat diet, weight loss and daily excercise -F/U with PCP     Patient is discharged in stable condition with stable vital signs. All questions rearding hospital course and plan of care after discharge have been answered to satisfaction. Prescriptions for medications needed to be taken after discharge have been given to patient. Patient has been instructed to follow up with PCP  within the next 7 days after discharge. Patient verbalizes understanding all given instructions and has no further doubts regarding discharge.   ED admission 2 hours later:  50 y.o. female presents c/o SOB. Pt was discharged from hospital today and was known covid positive. She was discharged with home O2. At home, patient's mother noticed that she was having more difficulty breathing than usual, prompting her to call 911. Pt arrived via EMS, which states she became unresponsive on arrival with a faint pulse. She quickly lost her pulse after her arrival here. Hx limited by events/condition of patient.    The history is provided by the EMS personnel, a parent and medical records. The history is limited by the condition of the patient."
	"1617479-1"	"1617479-1"	"B-CELL LYMPHOMA"	"10003899"	"50-59 years"	"50-59"	"Patient required hospitalization due to breakthrough infection. She received the Moderna vaccine (2nd dose in series) on 07/10/21. Hospitalized from 08/01/21 - 08/12/21 (discharged and then admitted 2 hours later, result was death in ED). Below is copied from discharge summary:   Patient is a 50 y/o morbidly obese female admitted on 8/2/2021 due to acute respiratory failure due to COVID 19 pneumonia.    Severe Sepsis with acute organ dysfunction/ Acute respiratory failure with hypoxia 2/2 COVID 19: - Now on 4L , oxygen delivered at bedside - Chest Xray showed bilateral atypical findings - CRP 63, sed rate 22.  - DVT ppx given while inpatient - dexamethasone completed x10 days on 8/10/2021 - atorvastatin given during admission - Completed Remdesevir 8/5/2021 - Isolation   Chronic lymphocytic leukemia  - Leukocytosis due to CLL  Flow cytometry with CD+5 mature B cell lymphoma  CT abdomen showing lymphadenopathy Out patient hematology follow up, no need for acute intervention    AKI: resolved  -Cr back to baseline    Hyperkalemia: -Resolved    Arterial hypertension -Controlled - continue amlodipine + HCTz   Morbid Obesity, BMI of> 40s: -would benefit from lifestyles modifications regarding low fat diet, weight loss and daily excercise -F/U with PCP     Patient is discharged in stable condition with stable vital signs. All questions rearding hospital course and plan of care after discharge have been answered to satisfaction. Prescriptions for medications needed to be taken after discharge have been given to patient. Patient has been instructed to follow up with PCP  within the next 7 days after discharge. Patient verbalizes understanding all given instructions and has no further doubts regarding discharge.   ED admission 2 hours later:  50 y.o. female presents c/o SOB. Pt was discharged from hospital today and was known covid positive. She was discharged with home O2. At home, patient's mother noticed that she was having more difficulty breathing than usual, prompting her to call 911. Pt arrived via EMS, which states she became unresponsive on arrival with a faint pulse. She quickly lost her pulse after her arrival here. Hx limited by events/condition of patient.    The history is provided by the EMS personnel, a parent and medical records. The history is limited by the condition of the patient."
	"1617479-1"	"1617479-1"	"C-REACTIVE PROTEIN INCREASED"	"10006825"	"50-59 years"	"50-59"	"Patient required hospitalization due to breakthrough infection. She received the Moderna vaccine (2nd dose in series) on 07/10/21. Hospitalized from 08/01/21 - 08/12/21 (discharged and then admitted 2 hours later, result was death in ED). Below is copied from discharge summary:   Patient is a 50 y/o morbidly obese female admitted on 8/2/2021 due to acute respiratory failure due to COVID 19 pneumonia.    Severe Sepsis with acute organ dysfunction/ Acute respiratory failure with hypoxia 2/2 COVID 19: - Now on 4L , oxygen delivered at bedside - Chest Xray showed bilateral atypical findings - CRP 63, sed rate 22.  - DVT ppx given while inpatient - dexamethasone completed x10 days on 8/10/2021 - atorvastatin given during admission - Completed Remdesevir 8/5/2021 - Isolation   Chronic lymphocytic leukemia  - Leukocytosis due to CLL  Flow cytometry with CD+5 mature B cell lymphoma  CT abdomen showing lymphadenopathy Out patient hematology follow up, no need for acute intervention    AKI: resolved  -Cr back to baseline    Hyperkalemia: -Resolved    Arterial hypertension -Controlled - continue amlodipine + HCTz   Morbid Obesity, BMI of> 40s: -would benefit from lifestyles modifications regarding low fat diet, weight loss and daily excercise -F/U with PCP     Patient is discharged in stable condition with stable vital signs. All questions rearding hospital course and plan of care after discharge have been answered to satisfaction. Prescriptions for medications needed to be taken after discharge have been given to patient. Patient has been instructed to follow up with PCP  within the next 7 days after discharge. Patient verbalizes understanding all given instructions and has no further doubts regarding discharge.   ED admission 2 hours later:  50 y.o. female presents c/o SOB. Pt was discharged from hospital today and was known covid positive. She was discharged with home O2. At home, patient's mother noticed that she was having more difficulty breathing than usual, prompting her to call 911. Pt arrived via EMS, which states she became unresponsive on arrival with a faint pulse. She quickly lost her pulse after her arrival here. Hx limited by events/condition of patient.    The history is provided by the EMS personnel, a parent and medical records. The history is limited by the condition of the patient."
	"1617479-1"	"1617479-1"	"CHEST X-RAY ABNORMAL"	"10008499"	"50-59 years"	"50-59"	"Patient required hospitalization due to breakthrough infection. She received the Moderna vaccine (2nd dose in series) on 07/10/21. Hospitalized from 08/01/21 - 08/12/21 (discharged and then admitted 2 hours later, result was death in ED). Below is copied from discharge summary:   Patient is a 50 y/o morbidly obese female admitted on 8/2/2021 due to acute respiratory failure due to COVID 19 pneumonia.    Severe Sepsis with acute organ dysfunction/ Acute respiratory failure with hypoxia 2/2 COVID 19: - Now on 4L , oxygen delivered at bedside - Chest Xray showed bilateral atypical findings - CRP 63, sed rate 22.  - DVT ppx given while inpatient - dexamethasone completed x10 days on 8/10/2021 - atorvastatin given during admission - Completed Remdesevir 8/5/2021 - Isolation   Chronic lymphocytic leukemia  - Leukocytosis due to CLL  Flow cytometry with CD+5 mature B cell lymphoma  CT abdomen showing lymphadenopathy Out patient hematology follow up, no need for acute intervention    AKI: resolved  -Cr back to baseline    Hyperkalemia: -Resolved    Arterial hypertension -Controlled - continue amlodipine + HCTz   Morbid Obesity, BMI of> 40s: -would benefit from lifestyles modifications regarding low fat diet, weight loss and daily excercise -F/U with PCP     Patient is discharged in stable condition with stable vital signs. All questions rearding hospital course and plan of care after discharge have been answered to satisfaction. Prescriptions for medications needed to be taken after discharge have been given to patient. Patient has been instructed to follow up with PCP  within the next 7 days after discharge. Patient verbalizes understanding all given instructions and has no further doubts regarding discharge.   ED admission 2 hours later:  50 y.o. female presents c/o SOB. Pt was discharged from hospital today and was known covid positive. She was discharged with home O2. At home, patient's mother noticed that she was having more difficulty breathing than usual, prompting her to call 911. Pt arrived via EMS, which states she became unresponsive on arrival with a faint pulse. She quickly lost her pulse after her arrival here. Hx limited by events/condition of patient.    The history is provided by the EMS personnel, a parent and medical records. The history is limited by the condition of the patient."
	"1617479-1"	"1617479-1"	"CHRONIC LYMPHOCYTIC LEUKAEMIA"	"10008958"	"50-59 years"	"50-59"	"Patient required hospitalization due to breakthrough infection. She received the Moderna vaccine (2nd dose in series) on 07/10/21. Hospitalized from 08/01/21 - 08/12/21 (discharged and then admitted 2 hours later, result was death in ED). Below is copied from discharge summary:   Patient is a 50 y/o morbidly obese female admitted on 8/2/2021 due to acute respiratory failure due to COVID 19 pneumonia.    Severe Sepsis with acute organ dysfunction/ Acute respiratory failure with hypoxia 2/2 COVID 19: - Now on 4L , oxygen delivered at bedside - Chest Xray showed bilateral atypical findings - CRP 63, sed rate 22.  - DVT ppx given while inpatient - dexamethasone completed x10 days on 8/10/2021 - atorvastatin given during admission - Completed Remdesevir 8/5/2021 - Isolation   Chronic lymphocytic leukemia  - Leukocytosis due to CLL  Flow cytometry with CD+5 mature B cell lymphoma  CT abdomen showing lymphadenopathy Out patient hematology follow up, no need for acute intervention    AKI: resolved  -Cr back to baseline    Hyperkalemia: -Resolved    Arterial hypertension -Controlled - continue amlodipine + HCTz   Morbid Obesity, BMI of> 40s: -would benefit from lifestyles modifications regarding low fat diet, weight loss and daily excercise -F/U with PCP     Patient is discharged in stable condition with stable vital signs. All questions rearding hospital course and plan of care after discharge have been answered to satisfaction. Prescriptions for medications needed to be taken after discharge have been given to patient. Patient has been instructed to follow up with PCP  within the next 7 days after discharge. Patient verbalizes understanding all given instructions and has no further doubts regarding discharge.   ED admission 2 hours later:  50 y.o. female presents c/o SOB. Pt was discharged from hospital today and was known covid positive. She was discharged with home O2. At home, patient's mother noticed that she was having more difficulty breathing than usual, prompting her to call 911. Pt arrived via EMS, which states she became unresponsive on arrival with a faint pulse. She quickly lost her pulse after her arrival here. Hx limited by events/condition of patient.    The history is provided by the EMS personnel, a parent and medical records. The history is limited by the condition of the patient."
	"1617479-1"	"1617479-1"	"COMPUTERISED TOMOGRAM ABDOMEN ABNORMAL"	"10057798"	"50-59 years"	"50-59"	"Patient required hospitalization due to breakthrough infection. She received the Moderna vaccine (2nd dose in series) on 07/10/21. Hospitalized from 08/01/21 - 08/12/21 (discharged and then admitted 2 hours later, result was death in ED). Below is copied from discharge summary:   Patient is a 50 y/o morbidly obese female admitted on 8/2/2021 due to acute respiratory failure due to COVID 19 pneumonia.    Severe Sepsis with acute organ dysfunction/ Acute respiratory failure with hypoxia 2/2 COVID 19: - Now on 4L , oxygen delivered at bedside - Chest Xray showed bilateral atypical findings - CRP 63, sed rate 22.  - DVT ppx given while inpatient - dexamethasone completed x10 days on 8/10/2021 - atorvastatin given during admission - Completed Remdesevir 8/5/2021 - Isolation   Chronic lymphocytic leukemia  - Leukocytosis due to CLL  Flow cytometry with CD+5 mature B cell lymphoma  CT abdomen showing lymphadenopathy Out patient hematology follow up, no need for acute intervention    AKI: resolved  -Cr back to baseline    Hyperkalemia: -Resolved    Arterial hypertension -Controlled - continue amlodipine + HCTz   Morbid Obesity, BMI of> 40s: -would benefit from lifestyles modifications regarding low fat diet, weight loss and daily excercise -F/U with PCP     Patient is discharged in stable condition with stable vital signs. All questions rearding hospital course and plan of care after discharge have been answered to satisfaction. Prescriptions for medications needed to be taken after discharge have been given to patient. Patient has been instructed to follow up with PCP  within the next 7 days after discharge. Patient verbalizes understanding all given instructions and has no further doubts regarding discharge.   ED admission 2 hours later:  50 y.o. female presents c/o SOB. Pt was discharged from hospital today and was known covid positive. She was discharged with home O2. At home, patient's mother noticed that she was having more difficulty breathing than usual, prompting her to call 911. Pt arrived via EMS, which states she became unresponsive on arrival with a faint pulse. She quickly lost her pulse after her arrival here. Hx limited by events/condition of patient.    The history is provided by the EMS personnel, a parent and medical records. The history is limited by the condition of the patient."
	"1617479-1"	"1617479-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Patient required hospitalization due to breakthrough infection. She received the Moderna vaccine (2nd dose in series) on 07/10/21. Hospitalized from 08/01/21 - 08/12/21 (discharged and then admitted 2 hours later, result was death in ED). Below is copied from discharge summary:   Patient is a 50 y/o morbidly obese female admitted on 8/2/2021 due to acute respiratory failure due to COVID 19 pneumonia.    Severe Sepsis with acute organ dysfunction/ Acute respiratory failure with hypoxia 2/2 COVID 19: - Now on 4L , oxygen delivered at bedside - Chest Xray showed bilateral atypical findings - CRP 63, sed rate 22.  - DVT ppx given while inpatient - dexamethasone completed x10 days on 8/10/2021 - atorvastatin given during admission - Completed Remdesevir 8/5/2021 - Isolation   Chronic lymphocytic leukemia  - Leukocytosis due to CLL  Flow cytometry with CD+5 mature B cell lymphoma  CT abdomen showing lymphadenopathy Out patient hematology follow up, no need for acute intervention    AKI: resolved  -Cr back to baseline    Hyperkalemia: -Resolved    Arterial hypertension -Controlled - continue amlodipine + HCTz   Morbid Obesity, BMI of> 40s: -would benefit from lifestyles modifications regarding low fat diet, weight loss and daily excercise -F/U with PCP     Patient is discharged in stable condition with stable vital signs. All questions rearding hospital course and plan of care after discharge have been answered to satisfaction. Prescriptions for medications needed to be taken after discharge have been given to patient. Patient has been instructed to follow up with PCP  within the next 7 days after discharge. Patient verbalizes understanding all given instructions and has no further doubts regarding discharge.   ED admission 2 hours later:  50 y.o. female presents c/o SOB. Pt was discharged from hospital today and was known covid positive. She was discharged with home O2. At home, patient's mother noticed that she was having more difficulty breathing than usual, prompting her to call 911. Pt arrived via EMS, which states she became unresponsive on arrival with a faint pulse. She quickly lost her pulse after her arrival here. Hx limited by events/condition of patient.    The history is provided by the EMS personnel, a parent and medical records. The history is limited by the condition of the patient."
	"1617479-1"	"1617479-1"	"COVID-19 PNEUMONIA"	"10084380"	"50-59 years"	"50-59"	"Patient required hospitalization due to breakthrough infection. She received the Moderna vaccine (2nd dose in series) on 07/10/21. Hospitalized from 08/01/21 - 08/12/21 (discharged and then admitted 2 hours later, result was death in ED). Below is copied from discharge summary:   Patient is a 50 y/o morbidly obese female admitted on 8/2/2021 due to acute respiratory failure due to COVID 19 pneumonia.    Severe Sepsis with acute organ dysfunction/ Acute respiratory failure with hypoxia 2/2 COVID 19: - Now on 4L , oxygen delivered at bedside - Chest Xray showed bilateral atypical findings - CRP 63, sed rate 22.  - DVT ppx given while inpatient - dexamethasone completed x10 days on 8/10/2021 - atorvastatin given during admission - Completed Remdesevir 8/5/2021 - Isolation   Chronic lymphocytic leukemia  - Leukocytosis due to CLL  Flow cytometry with CD+5 mature B cell lymphoma  CT abdomen showing lymphadenopathy Out patient hematology follow up, no need for acute intervention    AKI: resolved  -Cr back to baseline    Hyperkalemia: -Resolved    Arterial hypertension -Controlled - continue amlodipine + HCTz   Morbid Obesity, BMI of> 40s: -would benefit from lifestyles modifications regarding low fat diet, weight loss and daily excercise -F/U with PCP     Patient is discharged in stable condition with stable vital signs. All questions rearding hospital course and plan of care after discharge have been answered to satisfaction. Prescriptions for medications needed to be taken after discharge have been given to patient. Patient has been instructed to follow up with PCP  within the next 7 days after discharge. Patient verbalizes understanding all given instructions and has no further doubts regarding discharge.   ED admission 2 hours later:  50 y.o. female presents c/o SOB. Pt was discharged from hospital today and was known covid positive. She was discharged with home O2. At home, patient's mother noticed that she was having more difficulty breathing than usual, prompting her to call 911. Pt arrived via EMS, which states she became unresponsive on arrival with a faint pulse. She quickly lost her pulse after her arrival here. Hx limited by events/condition of patient.    The history is provided by the EMS personnel, a parent and medical records. The history is limited by the condition of the patient."
	"1617479-1"	"1617479-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient required hospitalization due to breakthrough infection. She received the Moderna vaccine (2nd dose in series) on 07/10/21. Hospitalized from 08/01/21 - 08/12/21 (discharged and then admitted 2 hours later, result was death in ED). Below is copied from discharge summary:   Patient is a 50 y/o morbidly obese female admitted on 8/2/2021 due to acute respiratory failure due to COVID 19 pneumonia.    Severe Sepsis with acute organ dysfunction/ Acute respiratory failure with hypoxia 2/2 COVID 19: - Now on 4L , oxygen delivered at bedside - Chest Xray showed bilateral atypical findings - CRP 63, sed rate 22.  - DVT ppx given while inpatient - dexamethasone completed x10 days on 8/10/2021 - atorvastatin given during admission - Completed Remdesevir 8/5/2021 - Isolation   Chronic lymphocytic leukemia  - Leukocytosis due to CLL  Flow cytometry with CD+5 mature B cell lymphoma  CT abdomen showing lymphadenopathy Out patient hematology follow up, no need for acute intervention    AKI: resolved  -Cr back to baseline    Hyperkalemia: -Resolved    Arterial hypertension -Controlled - continue amlodipine + HCTz   Morbid Obesity, BMI of> 40s: -would benefit from lifestyles modifications regarding low fat diet, weight loss and daily excercise -F/U with PCP     Patient is discharged in stable condition with stable vital signs. All questions rearding hospital course and plan of care after discharge have been answered to satisfaction. Prescriptions for medications needed to be taken after discharge have been given to patient. Patient has been instructed to follow up with PCP  within the next 7 days after discharge. Patient verbalizes understanding all given instructions and has no further doubts regarding discharge.   ED admission 2 hours later:  50 y.o. female presents c/o SOB. Pt was discharged from hospital today and was known covid positive. She was discharged with home O2. At home, patient's mother noticed that she was having more difficulty breathing than usual, prompting her to call 911. Pt arrived via EMS, which states she became unresponsive on arrival with a faint pulse. She quickly lost her pulse after her arrival here. Hx limited by events/condition of patient.    The history is provided by the EMS personnel, a parent and medical records. The history is limited by the condition of the patient."
	"1617479-1"	"1617479-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"Patient required hospitalization due to breakthrough infection. She received the Moderna vaccine (2nd dose in series) on 07/10/21. Hospitalized from 08/01/21 - 08/12/21 (discharged and then admitted 2 hours later, result was death in ED). Below is copied from discharge summary:   Patient is a 50 y/o morbidly obese female admitted on 8/2/2021 due to acute respiratory failure due to COVID 19 pneumonia.    Severe Sepsis with acute organ dysfunction/ Acute respiratory failure with hypoxia 2/2 COVID 19: - Now on 4L , oxygen delivered at bedside - Chest Xray showed bilateral atypical findings - CRP 63, sed rate 22.  - DVT ppx given while inpatient - dexamethasone completed x10 days on 8/10/2021 - atorvastatin given during admission - Completed Remdesevir 8/5/2021 - Isolation   Chronic lymphocytic leukemia  - Leukocytosis due to CLL  Flow cytometry with CD+5 mature B cell lymphoma  CT abdomen showing lymphadenopathy Out patient hematology follow up, no need for acute intervention    AKI: resolved  -Cr back to baseline    Hyperkalemia: -Resolved    Arterial hypertension -Controlled - continue amlodipine + HCTz   Morbid Obesity, BMI of> 40s: -would benefit from lifestyles modifications regarding low fat diet, weight loss and daily excercise -F/U with PCP     Patient is discharged in stable condition with stable vital signs. All questions rearding hospital course and plan of care after discharge have been answered to satisfaction. Prescriptions for medications needed to be taken after discharge have been given to patient. Patient has been instructed to follow up with PCP  within the next 7 days after discharge. Patient verbalizes understanding all given instructions and has no further doubts regarding discharge.   ED admission 2 hours later:  50 y.o. female presents c/o SOB. Pt was discharged from hospital today and was known covid positive. She was discharged with home O2. At home, patient's mother noticed that she was having more difficulty breathing than usual, prompting her to call 911. Pt arrived via EMS, which states she became unresponsive on arrival with a faint pulse. She quickly lost her pulse after her arrival here. Hx limited by events/condition of patient.    The history is provided by the EMS personnel, a parent and medical records. The history is limited by the condition of the patient."
	"1617479-1"	"1617479-1"	"FLOW CYTOMETRY"	"10065440"	"50-59 years"	"50-59"	"Patient required hospitalization due to breakthrough infection. She received the Moderna vaccine (2nd dose in series) on 07/10/21. Hospitalized from 08/01/21 - 08/12/21 (discharged and then admitted 2 hours later, result was death in ED). Below is copied from discharge summary:   Patient is a 50 y/o morbidly obese female admitted on 8/2/2021 due to acute respiratory failure due to COVID 19 pneumonia.    Severe Sepsis with acute organ dysfunction/ Acute respiratory failure with hypoxia 2/2 COVID 19: - Now on 4L , oxygen delivered at bedside - Chest Xray showed bilateral atypical findings - CRP 63, sed rate 22.  - DVT ppx given while inpatient - dexamethasone completed x10 days on 8/10/2021 - atorvastatin given during admission - Completed Remdesevir 8/5/2021 - Isolation   Chronic lymphocytic leukemia  - Leukocytosis due to CLL  Flow cytometry with CD+5 mature B cell lymphoma  CT abdomen showing lymphadenopathy Out patient hematology follow up, no need for acute intervention    AKI: resolved  -Cr back to baseline    Hyperkalemia: -Resolved    Arterial hypertension -Controlled - continue amlodipine + HCTz   Morbid Obesity, BMI of> 40s: -would benefit from lifestyles modifications regarding low fat diet, weight loss and daily excercise -F/U with PCP     Patient is discharged in stable condition with stable vital signs. All questions rearding hospital course and plan of care after discharge have been answered to satisfaction. Prescriptions for medications needed to be taken after discharge have been given to patient. Patient has been instructed to follow up with PCP  within the next 7 days after discharge. Patient verbalizes understanding all given instructions and has no further doubts regarding discharge.   ED admission 2 hours later:  50 y.o. female presents c/o SOB. Pt was discharged from hospital today and was known covid positive. She was discharged with home O2. At home, patient's mother noticed that she was having more difficulty breathing than usual, prompting her to call 911. Pt arrived via EMS, which states she became unresponsive on arrival with a faint pulse. She quickly lost her pulse after her arrival here. Hx limited by events/condition of patient.    The history is provided by the EMS personnel, a parent and medical records. The history is limited by the condition of the patient."
	"1617479-1"	"1617479-1"	"HYPERKALAEMIA"	"10020646"	"50-59 years"	"50-59"	"Patient required hospitalization due to breakthrough infection. She received the Moderna vaccine (2nd dose in series) on 07/10/21. Hospitalized from 08/01/21 - 08/12/21 (discharged and then admitted 2 hours later, result was death in ED). Below is copied from discharge summary:   Patient is a 50 y/o morbidly obese female admitted on 8/2/2021 due to acute respiratory failure due to COVID 19 pneumonia.    Severe Sepsis with acute organ dysfunction/ Acute respiratory failure with hypoxia 2/2 COVID 19: - Now on 4L , oxygen delivered at bedside - Chest Xray showed bilateral atypical findings - CRP 63, sed rate 22.  - DVT ppx given while inpatient - dexamethasone completed x10 days on 8/10/2021 - atorvastatin given during admission - Completed Remdesevir 8/5/2021 - Isolation   Chronic lymphocytic leukemia  - Leukocytosis due to CLL  Flow cytometry with CD+5 mature B cell lymphoma  CT abdomen showing lymphadenopathy Out patient hematology follow up, no need for acute intervention    AKI: resolved  -Cr back to baseline    Hyperkalemia: -Resolved    Arterial hypertension -Controlled - continue amlodipine + HCTz   Morbid Obesity, BMI of> 40s: -would benefit from lifestyles modifications regarding low fat diet, weight loss and daily excercise -F/U with PCP     Patient is discharged in stable condition with stable vital signs. All questions rearding hospital course and plan of care after discharge have been answered to satisfaction. Prescriptions for medications needed to be taken after discharge have been given to patient. Patient has been instructed to follow up with PCP  within the next 7 days after discharge. Patient verbalizes understanding all given instructions and has no further doubts regarding discharge.   ED admission 2 hours later:  50 y.o. female presents c/o SOB. Pt was discharged from hospital today and was known covid positive. She was discharged with home O2. At home, patient's mother noticed that she was having more difficulty breathing than usual, prompting her to call 911. Pt arrived via EMS, which states she became unresponsive on arrival with a faint pulse. She quickly lost her pulse after her arrival here. Hx limited by events/condition of patient.    The history is provided by the EMS personnel, a parent and medical records. The history is limited by the condition of the patient."
	"1617479-1"	"1617479-1"	"HYPERTENSION"	"10020772"	"50-59 years"	"50-59"	"Patient required hospitalization due to breakthrough infection. She received the Moderna vaccine (2nd dose in series) on 07/10/21. Hospitalized from 08/01/21 - 08/12/21 (discharged and then admitted 2 hours later, result was death in ED). Below is copied from discharge summary:   Patient is a 50 y/o morbidly obese female admitted on 8/2/2021 due to acute respiratory failure due to COVID 19 pneumonia.    Severe Sepsis with acute organ dysfunction/ Acute respiratory failure with hypoxia 2/2 COVID 19: - Now on 4L , oxygen delivered at bedside - Chest Xray showed bilateral atypical findings - CRP 63, sed rate 22.  - DVT ppx given while inpatient - dexamethasone completed x10 days on 8/10/2021 - atorvastatin given during admission - Completed Remdesevir 8/5/2021 - Isolation   Chronic lymphocytic leukemia  - Leukocytosis due to CLL  Flow cytometry with CD+5 mature B cell lymphoma  CT abdomen showing lymphadenopathy Out patient hematology follow up, no need for acute intervention    AKI: resolved  -Cr back to baseline    Hyperkalemia: -Resolved    Arterial hypertension -Controlled - continue amlodipine + HCTz   Morbid Obesity, BMI of> 40s: -would benefit from lifestyles modifications regarding low fat diet, weight loss and daily excercise -F/U with PCP     Patient is discharged in stable condition with stable vital signs. All questions rearding hospital course and plan of care after discharge have been answered to satisfaction. Prescriptions for medications needed to be taken after discharge have been given to patient. Patient has been instructed to follow up with PCP  within the next 7 days after discharge. Patient verbalizes understanding all given instructions and has no further doubts regarding discharge.   ED admission 2 hours later:  50 y.o. female presents c/o SOB. Pt was discharged from hospital today and was known covid positive. She was discharged with home O2. At home, patient's mother noticed that she was having more difficulty breathing than usual, prompting her to call 911. Pt arrived via EMS, which states she became unresponsive on arrival with a faint pulse. She quickly lost her pulse after her arrival here. Hx limited by events/condition of patient.    The history is provided by the EMS personnel, a parent and medical records. The history is limited by the condition of the patient."
	"1617479-1"	"1617479-1"	"LEUKOCYTOSIS"	"10024378"	"50-59 years"	"50-59"	"Patient required hospitalization due to breakthrough infection. She received the Moderna vaccine (2nd dose in series) on 07/10/21. Hospitalized from 08/01/21 - 08/12/21 (discharged and then admitted 2 hours later, result was death in ED). Below is copied from discharge summary:   Patient is a 50 y/o morbidly obese female admitted on 8/2/2021 due to acute respiratory failure due to COVID 19 pneumonia.    Severe Sepsis with acute organ dysfunction/ Acute respiratory failure with hypoxia 2/2 COVID 19: - Now on 4L , oxygen delivered at bedside - Chest Xray showed bilateral atypical findings - CRP 63, sed rate 22.  - DVT ppx given while inpatient - dexamethasone completed x10 days on 8/10/2021 - atorvastatin given during admission - Completed Remdesevir 8/5/2021 - Isolation   Chronic lymphocytic leukemia  - Leukocytosis due to CLL  Flow cytometry with CD+5 mature B cell lymphoma  CT abdomen showing lymphadenopathy Out patient hematology follow up, no need for acute intervention    AKI: resolved  -Cr back to baseline    Hyperkalemia: -Resolved    Arterial hypertension -Controlled - continue amlodipine + HCTz   Morbid Obesity, BMI of> 40s: -would benefit from lifestyles modifications regarding low fat diet, weight loss and daily excercise -F/U with PCP     Patient is discharged in stable condition with stable vital signs. All questions rearding hospital course and plan of care after discharge have been answered to satisfaction. Prescriptions for medications needed to be taken after discharge have been given to patient. Patient has been instructed to follow up with PCP  within the next 7 days after discharge. Patient verbalizes understanding all given instructions and has no further doubts regarding discharge.   ED admission 2 hours later:  50 y.o. female presents c/o SOB. Pt was discharged from hospital today and was known covid positive. She was discharged with home O2. At home, patient's mother noticed that she was having more difficulty breathing than usual, prompting her to call 911. Pt arrived via EMS, which states she became unresponsive on arrival with a faint pulse. She quickly lost her pulse after her arrival here. Hx limited by events/condition of patient.    The history is provided by the EMS personnel, a parent and medical records. The history is limited by the condition of the patient."
	"1617479-1"	"1617479-1"	"LYMPHADENOPATHY"	"10025197"	"50-59 years"	"50-59"	"Patient required hospitalization due to breakthrough infection. She received the Moderna vaccine (2nd dose in series) on 07/10/21. Hospitalized from 08/01/21 - 08/12/21 (discharged and then admitted 2 hours later, result was death in ED). Below is copied from discharge summary:   Patient is a 50 y/o morbidly obese female admitted on 8/2/2021 due to acute respiratory failure due to COVID 19 pneumonia.    Severe Sepsis with acute organ dysfunction/ Acute respiratory failure with hypoxia 2/2 COVID 19: - Now on 4L , oxygen delivered at bedside - Chest Xray showed bilateral atypical findings - CRP 63, sed rate 22.  - DVT ppx given while inpatient - dexamethasone completed x10 days on 8/10/2021 - atorvastatin given during admission - Completed Remdesevir 8/5/2021 - Isolation   Chronic lymphocytic leukemia  - Leukocytosis due to CLL  Flow cytometry with CD+5 mature B cell lymphoma  CT abdomen showing lymphadenopathy Out patient hematology follow up, no need for acute intervention    AKI: resolved  -Cr back to baseline    Hyperkalemia: -Resolved    Arterial hypertension -Controlled - continue amlodipine + HCTz   Morbid Obesity, BMI of> 40s: -would benefit from lifestyles modifications regarding low fat diet, weight loss and daily excercise -F/U with PCP     Patient is discharged in stable condition with stable vital signs. All questions rearding hospital course and plan of care after discharge have been answered to satisfaction. Prescriptions for medications needed to be taken after discharge have been given to patient. Patient has been instructed to follow up with PCP  within the next 7 days after discharge. Patient verbalizes understanding all given instructions and has no further doubts regarding discharge.   ED admission 2 hours later:  50 y.o. female presents c/o SOB. Pt was discharged from hospital today and was known covid positive. She was discharged with home O2. At home, patient's mother noticed that she was having more difficulty breathing than usual, prompting her to call 911. Pt arrived via EMS, which states she became unresponsive on arrival with a faint pulse. She quickly lost her pulse after her arrival here. Hx limited by events/condition of patient.    The history is provided by the EMS personnel, a parent and medical records. The history is limited by the condition of the patient."
	"1617479-1"	"1617479-1"	"NUCLEIC ACID TEST"	"10083356"	"50-59 years"	"50-59"	"Patient required hospitalization due to breakthrough infection. She received the Moderna vaccine (2nd dose in series) on 07/10/21. Hospitalized from 08/01/21 - 08/12/21 (discharged and then admitted 2 hours later, result was death in ED). Below is copied from discharge summary:   Patient is a 50 y/o morbidly obese female admitted on 8/2/2021 due to acute respiratory failure due to COVID 19 pneumonia.    Severe Sepsis with acute organ dysfunction/ Acute respiratory failure with hypoxia 2/2 COVID 19: - Now on 4L , oxygen delivered at bedside - Chest Xray showed bilateral atypical findings - CRP 63, sed rate 22.  - DVT ppx given while inpatient - dexamethasone completed x10 days on 8/10/2021 - atorvastatin given during admission - Completed Remdesevir 8/5/2021 - Isolation   Chronic lymphocytic leukemia  - Leukocytosis due to CLL  Flow cytometry with CD+5 mature B cell lymphoma  CT abdomen showing lymphadenopathy Out patient hematology follow up, no need for acute intervention    AKI: resolved  -Cr back to baseline    Hyperkalemia: -Resolved    Arterial hypertension -Controlled - continue amlodipine + HCTz   Morbid Obesity, BMI of> 40s: -would benefit from lifestyles modifications regarding low fat diet, weight loss and daily excercise -F/U with PCP     Patient is discharged in stable condition with stable vital signs. All questions rearding hospital course and plan of care after discharge have been answered to satisfaction. Prescriptions for medications needed to be taken after discharge have been given to patient. Patient has been instructed to follow up with PCP  within the next 7 days after discharge. Patient verbalizes understanding all given instructions and has no further doubts regarding discharge.   ED admission 2 hours later:  50 y.o. female presents c/o SOB. Pt was discharged from hospital today and was known covid positive. She was discharged with home O2. At home, patient's mother noticed that she was having more difficulty breathing than usual, prompting her to call 911. Pt arrived via EMS, which states she became unresponsive on arrival with a faint pulse. She quickly lost her pulse after her arrival here. Hx limited by events/condition of patient.    The history is provided by the EMS personnel, a parent and medical records. The history is limited by the condition of the patient."
	"1617479-1"	"1617479-1"	"OBESITY"	"10029883"	"50-59 years"	"50-59"	"Patient required hospitalization due to breakthrough infection. She received the Moderna vaccine (2nd dose in series) on 07/10/21. Hospitalized from 08/01/21 - 08/12/21 (discharged and then admitted 2 hours later, result was death in ED). Below is copied from discharge summary:   Patient is a 50 y/o morbidly obese female admitted on 8/2/2021 due to acute respiratory failure due to COVID 19 pneumonia.    Severe Sepsis with acute organ dysfunction/ Acute respiratory failure with hypoxia 2/2 COVID 19: - Now on 4L , oxygen delivered at bedside - Chest Xray showed bilateral atypical findings - CRP 63, sed rate 22.  - DVT ppx given while inpatient - dexamethasone completed x10 days on 8/10/2021 - atorvastatin given during admission - Completed Remdesevir 8/5/2021 - Isolation   Chronic lymphocytic leukemia  - Leukocytosis due to CLL  Flow cytometry with CD+5 mature B cell lymphoma  CT abdomen showing lymphadenopathy Out patient hematology follow up, no need for acute intervention    AKI: resolved  -Cr back to baseline    Hyperkalemia: -Resolved    Arterial hypertension -Controlled - continue amlodipine + HCTz   Morbid Obesity, BMI of> 40s: -would benefit from lifestyles modifications regarding low fat diet, weight loss and daily excercise -F/U with PCP     Patient is discharged in stable condition with stable vital signs. All questions rearding hospital course and plan of care after discharge have been answered to satisfaction. Prescriptions for medications needed to be taken after discharge have been given to patient. Patient has been instructed to follow up with PCP  within the next 7 days after discharge. Patient verbalizes understanding all given instructions and has no further doubts regarding discharge.   ED admission 2 hours later:  50 y.o. female presents c/o SOB. Pt was discharged from hospital today and was known covid positive. She was discharged with home O2. At home, patient's mother noticed that she was having more difficulty breathing than usual, prompting her to call 911. Pt arrived via EMS, which states she became unresponsive on arrival with a faint pulse. She quickly lost her pulse after her arrival here. Hx limited by events/condition of patient.    The history is provided by the EMS personnel, a parent and medical records. The history is limited by the condition of the patient."
	"1617479-1"	"1617479-1"	"ORGAN FAILURE"	"10053159"	"50-59 years"	"50-59"	"Patient required hospitalization due to breakthrough infection. She received the Moderna vaccine (2nd dose in series) on 07/10/21. Hospitalized from 08/01/21 - 08/12/21 (discharged and then admitted 2 hours later, result was death in ED). Below is copied from discharge summary:   Patient is a 50 y/o morbidly obese female admitted on 8/2/2021 due to acute respiratory failure due to COVID 19 pneumonia.    Severe Sepsis with acute organ dysfunction/ Acute respiratory failure with hypoxia 2/2 COVID 19: - Now on 4L , oxygen delivered at bedside - Chest Xray showed bilateral atypical findings - CRP 63, sed rate 22.  - DVT ppx given while inpatient - dexamethasone completed x10 days on 8/10/2021 - atorvastatin given during admission - Completed Remdesevir 8/5/2021 - Isolation   Chronic lymphocytic leukemia  - Leukocytosis due to CLL  Flow cytometry with CD+5 mature B cell lymphoma  CT abdomen showing lymphadenopathy Out patient hematology follow up, no need for acute intervention    AKI: resolved  -Cr back to baseline    Hyperkalemia: -Resolved    Arterial hypertension -Controlled - continue amlodipine + HCTz   Morbid Obesity, BMI of> 40s: -would benefit from lifestyles modifications regarding low fat diet, weight loss and daily excercise -F/U with PCP     Patient is discharged in stable condition with stable vital signs. All questions rearding hospital course and plan of care after discharge have been answered to satisfaction. Prescriptions for medications needed to be taken after discharge have been given to patient. Patient has been instructed to follow up with PCP  within the next 7 days after discharge. Patient verbalizes understanding all given instructions and has no further doubts regarding discharge.   ED admission 2 hours later:  50 y.o. female presents c/o SOB. Pt was discharged from hospital today and was known covid positive. She was discharged with home O2. At home, patient's mother noticed that she was having more difficulty breathing than usual, prompting her to call 911. Pt arrived via EMS, which states she became unresponsive on arrival with a faint pulse. She quickly lost her pulse after her arrival here. Hx limited by events/condition of patient.    The history is provided by the EMS personnel, a parent and medical records. The history is limited by the condition of the patient."
	"1617479-1"	"1617479-1"	"PATIENT ISOLATION"	"10053315"	"50-59 years"	"50-59"	"Patient required hospitalization due to breakthrough infection. She received the Moderna vaccine (2nd dose in series) on 07/10/21. Hospitalized from 08/01/21 - 08/12/21 (discharged and then admitted 2 hours later, result was death in ED). Below is copied from discharge summary:   Patient is a 50 y/o morbidly obese female admitted on 8/2/2021 due to acute respiratory failure due to COVID 19 pneumonia.    Severe Sepsis with acute organ dysfunction/ Acute respiratory failure with hypoxia 2/2 COVID 19: - Now on 4L , oxygen delivered at bedside - Chest Xray showed bilateral atypical findings - CRP 63, sed rate 22.  - DVT ppx given while inpatient - dexamethasone completed x10 days on 8/10/2021 - atorvastatin given during admission - Completed Remdesevir 8/5/2021 - Isolation   Chronic lymphocytic leukemia  - Leukocytosis due to CLL  Flow cytometry with CD+5 mature B cell lymphoma  CT abdomen showing lymphadenopathy Out patient hematology follow up, no need for acute intervention    AKI: resolved  -Cr back to baseline    Hyperkalemia: -Resolved    Arterial hypertension -Controlled - continue amlodipine + HCTz   Morbid Obesity, BMI of> 40s: -would benefit from lifestyles modifications regarding low fat diet, weight loss and daily excercise -F/U with PCP     Patient is discharged in stable condition with stable vital signs. All questions rearding hospital course and plan of care after discharge have been answered to satisfaction. Prescriptions for medications needed to be taken after discharge have been given to patient. Patient has been instructed to follow up with PCP  within the next 7 days after discharge. Patient verbalizes understanding all given instructions and has no further doubts regarding discharge.   ED admission 2 hours later:  50 y.o. female presents c/o SOB. Pt was discharged from hospital today and was known covid positive. She was discharged with home O2. At home, patient's mother noticed that she was having more difficulty breathing than usual, prompting her to call 911. Pt arrived via EMS, which states she became unresponsive on arrival with a faint pulse. She quickly lost her pulse after her arrival here. Hx limited by events/condition of patient.    The history is provided by the EMS personnel, a parent and medical records. The history is limited by the condition of the patient."
	"1617479-1"	"1617479-1"	"PNEUMONIA"	"10035664"	"50-59 years"	"50-59"	"Patient required hospitalization due to breakthrough infection. She received the Moderna vaccine (2nd dose in series) on 07/10/21. Hospitalized from 08/01/21 - 08/12/21 (discharged and then admitted 2 hours later, result was death in ED). Below is copied from discharge summary:   Patient is a 50 y/o morbidly obese female admitted on 8/2/2021 due to acute respiratory failure due to COVID 19 pneumonia.    Severe Sepsis with acute organ dysfunction/ Acute respiratory failure with hypoxia 2/2 COVID 19: - Now on 4L , oxygen delivered at bedside - Chest Xray showed bilateral atypical findings - CRP 63, sed rate 22.  - DVT ppx given while inpatient - dexamethasone completed x10 days on 8/10/2021 - atorvastatin given during admission - Completed Remdesevir 8/5/2021 - Isolation   Chronic lymphocytic leukemia  - Leukocytosis due to CLL  Flow cytometry with CD+5 mature B cell lymphoma  CT abdomen showing lymphadenopathy Out patient hematology follow up, no need for acute intervention    AKI: resolved  -Cr back to baseline    Hyperkalemia: -Resolved    Arterial hypertension -Controlled - continue amlodipine + HCTz   Morbid Obesity, BMI of> 40s: -would benefit from lifestyles modifications regarding low fat diet, weight loss and daily excercise -F/U with PCP     Patient is discharged in stable condition with stable vital signs. All questions rearding hospital course and plan of care after discharge have been answered to satisfaction. Prescriptions for medications needed to be taken after discharge have been given to patient. Patient has been instructed to follow up with PCP  within the next 7 days after discharge. Patient verbalizes understanding all given instructions and has no further doubts regarding discharge.   ED admission 2 hours later:  50 y.o. female presents c/o SOB. Pt was discharged from hospital today and was known covid positive. She was discharged with home O2. At home, patient's mother noticed that she was having more difficulty breathing than usual, prompting her to call 911. Pt arrived via EMS, which states she became unresponsive on arrival with a faint pulse. She quickly lost her pulse after her arrival here. Hx limited by events/condition of patient.    The history is provided by the EMS personnel, a parent and medical records. The history is limited by the condition of the patient."
	"1617479-1"	"1617479-1"	"PULSE ABNORMAL"	"10037466"	"50-59 years"	"50-59"	"Patient required hospitalization due to breakthrough infection. She received the Moderna vaccine (2nd dose in series) on 07/10/21. Hospitalized from 08/01/21 - 08/12/21 (discharged and then admitted 2 hours later, result was death in ED). Below is copied from discharge summary:   Patient is a 50 y/o morbidly obese female admitted on 8/2/2021 due to acute respiratory failure due to COVID 19 pneumonia.    Severe Sepsis with acute organ dysfunction/ Acute respiratory failure with hypoxia 2/2 COVID 19: - Now on 4L , oxygen delivered at bedside - Chest Xray showed bilateral atypical findings - CRP 63, sed rate 22.  - DVT ppx given while inpatient - dexamethasone completed x10 days on 8/10/2021 - atorvastatin given during admission - Completed Remdesevir 8/5/2021 - Isolation   Chronic lymphocytic leukemia  - Leukocytosis due to CLL  Flow cytometry with CD+5 mature B cell lymphoma  CT abdomen showing lymphadenopathy Out patient hematology follow up, no need for acute intervention    AKI: resolved  -Cr back to baseline    Hyperkalemia: -Resolved    Arterial hypertension -Controlled - continue amlodipine + HCTz   Morbid Obesity, BMI of> 40s: -would benefit from lifestyles modifications regarding low fat diet, weight loss and daily excercise -F/U with PCP     Patient is discharged in stable condition with stable vital signs. All questions rearding hospital course and plan of care after discharge have been answered to satisfaction. Prescriptions for medications needed to be taken after discharge have been given to patient. Patient has been instructed to follow up with PCP  within the next 7 days after discharge. Patient verbalizes understanding all given instructions and has no further doubts regarding discharge.   ED admission 2 hours later:  50 y.o. female presents c/o SOB. Pt was discharged from hospital today and was known covid positive. She was discharged with home O2. At home, patient's mother noticed that she was having more difficulty breathing than usual, prompting her to call 911. Pt arrived via EMS, which states she became unresponsive on arrival with a faint pulse. She quickly lost her pulse after her arrival here. Hx limited by events/condition of patient.    The history is provided by the EMS personnel, a parent and medical records. The history is limited by the condition of the patient."
	"1617479-1"	"1617479-1"	"RED BLOOD CELL SEDIMENTATION RATE INCREASED"	"10049187"	"50-59 years"	"50-59"	"Patient required hospitalization due to breakthrough infection. She received the Moderna vaccine (2nd dose in series) on 07/10/21. Hospitalized from 08/01/21 - 08/12/21 (discharged and then admitted 2 hours later, result was death in ED). Below is copied from discharge summary:   Patient is a 50 y/o morbidly obese female admitted on 8/2/2021 due to acute respiratory failure due to COVID 19 pneumonia.    Severe Sepsis with acute organ dysfunction/ Acute respiratory failure with hypoxia 2/2 COVID 19: - Now on 4L , oxygen delivered at bedside - Chest Xray showed bilateral atypical findings - CRP 63, sed rate 22.  - DVT ppx given while inpatient - dexamethasone completed x10 days on 8/10/2021 - atorvastatin given during admission - Completed Remdesevir 8/5/2021 - Isolation   Chronic lymphocytic leukemia  - Leukocytosis due to CLL  Flow cytometry with CD+5 mature B cell lymphoma  CT abdomen showing lymphadenopathy Out patient hematology follow up, no need for acute intervention    AKI: resolved  -Cr back to baseline    Hyperkalemia: -Resolved    Arterial hypertension -Controlled - continue amlodipine + HCTz   Morbid Obesity, BMI of> 40s: -would benefit from lifestyles modifications regarding low fat diet, weight loss and daily excercise -F/U with PCP     Patient is discharged in stable condition with stable vital signs. All questions rearding hospital course and plan of care after discharge have been answered to satisfaction. Prescriptions for medications needed to be taken after discharge have been given to patient. Patient has been instructed to follow up with PCP  within the next 7 days after discharge. Patient verbalizes understanding all given instructions and has no further doubts regarding discharge.   ED admission 2 hours later:  50 y.o. female presents c/o SOB. Pt was discharged from hospital today and was known covid positive. She was discharged with home O2. At home, patient's mother noticed that she was having more difficulty breathing than usual, prompting her to call 911. Pt arrived via EMS, which states she became unresponsive on arrival with a faint pulse. She quickly lost her pulse after her arrival here. Hx limited by events/condition of patient.    The history is provided by the EMS personnel, a parent and medical records. The history is limited by the condition of the patient."
	"1617479-1"	"1617479-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"Patient required hospitalization due to breakthrough infection. She received the Moderna vaccine (2nd dose in series) on 07/10/21. Hospitalized from 08/01/21 - 08/12/21 (discharged and then admitted 2 hours later, result was death in ED). Below is copied from discharge summary:   Patient is a 50 y/o morbidly obese female admitted on 8/2/2021 due to acute respiratory failure due to COVID 19 pneumonia.    Severe Sepsis with acute organ dysfunction/ Acute respiratory failure with hypoxia 2/2 COVID 19: - Now on 4L , oxygen delivered at bedside - Chest Xray showed bilateral atypical findings - CRP 63, sed rate 22.  - DVT ppx given while inpatient - dexamethasone completed x10 days on 8/10/2021 - atorvastatin given during admission - Completed Remdesevir 8/5/2021 - Isolation   Chronic lymphocytic leukemia  - Leukocytosis due to CLL  Flow cytometry with CD+5 mature B cell lymphoma  CT abdomen showing lymphadenopathy Out patient hematology follow up, no need for acute intervention    AKI: resolved  -Cr back to baseline    Hyperkalemia: -Resolved    Arterial hypertension -Controlled - continue amlodipine + HCTz   Morbid Obesity, BMI of> 40s: -would benefit from lifestyles modifications regarding low fat diet, weight loss and daily excercise -F/U with PCP     Patient is discharged in stable condition with stable vital signs. All questions rearding hospital course and plan of care after discharge have been answered to satisfaction. Prescriptions for medications needed to be taken after discharge have been given to patient. Patient has been instructed to follow up with PCP  within the next 7 days after discharge. Patient verbalizes understanding all given instructions and has no further doubts regarding discharge.   ED admission 2 hours later:  50 y.o. female presents c/o SOB. Pt was discharged from hospital today and was known covid positive. She was discharged with home O2. At home, patient's mother noticed that she was having more difficulty breathing than usual, prompting her to call 911. Pt arrived via EMS, which states she became unresponsive on arrival with a faint pulse. She quickly lost her pulse after her arrival here. Hx limited by events/condition of patient.    The history is provided by the EMS personnel, a parent and medical records. The history is limited by the condition of the patient."
	"1617479-1"	"1617479-1"	"SEPSIS"	"10040047"	"50-59 years"	"50-59"	"Patient required hospitalization due to breakthrough infection. She received the Moderna vaccine (2nd dose in series) on 07/10/21. Hospitalized from 08/01/21 - 08/12/21 (discharged and then admitted 2 hours later, result was death in ED). Below is copied from discharge summary:   Patient is a 50 y/o morbidly obese female admitted on 8/2/2021 due to acute respiratory failure due to COVID 19 pneumonia.    Severe Sepsis with acute organ dysfunction/ Acute respiratory failure with hypoxia 2/2 COVID 19: - Now on 4L , oxygen delivered at bedside - Chest Xray showed bilateral atypical findings - CRP 63, sed rate 22.  - DVT ppx given while inpatient - dexamethasone completed x10 days on 8/10/2021 - atorvastatin given during admission - Completed Remdesevir 8/5/2021 - Isolation   Chronic lymphocytic leukemia  - Leukocytosis due to CLL  Flow cytometry with CD+5 mature B cell lymphoma  CT abdomen showing lymphadenopathy Out patient hematology follow up, no need for acute intervention    AKI: resolved  -Cr back to baseline    Hyperkalemia: -Resolved    Arterial hypertension -Controlled - continue amlodipine + HCTz   Morbid Obesity, BMI of> 40s: -would benefit from lifestyles modifications regarding low fat diet, weight loss and daily excercise -F/U with PCP     Patient is discharged in stable condition with stable vital signs. All questions rearding hospital course and plan of care after discharge have been answered to satisfaction. Prescriptions for medications needed to be taken after discharge have been given to patient. Patient has been instructed to follow up with PCP  within the next 7 days after discharge. Patient verbalizes understanding all given instructions and has no further doubts regarding discharge.   ED admission 2 hours later:  50 y.o. female presents c/o SOB. Pt was discharged from hospital today and was known covid positive. She was discharged with home O2. At home, patient's mother noticed that she was having more difficulty breathing than usual, prompting her to call 911. Pt arrived via EMS, which states she became unresponsive on arrival with a faint pulse. She quickly lost her pulse after her arrival here. Hx limited by events/condition of patient.    The history is provided by the EMS personnel, a parent and medical records. The history is limited by the condition of the patient."
	"1617479-1"	"1617479-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"50-59 years"	"50-59"	"Patient required hospitalization due to breakthrough infection. She received the Moderna vaccine (2nd dose in series) on 07/10/21. Hospitalized from 08/01/21 - 08/12/21 (discharged and then admitted 2 hours later, result was death in ED). Below is copied from discharge summary:   Patient is a 50 y/o morbidly obese female admitted on 8/2/2021 due to acute respiratory failure due to COVID 19 pneumonia.    Severe Sepsis with acute organ dysfunction/ Acute respiratory failure with hypoxia 2/2 COVID 19: - Now on 4L , oxygen delivered at bedside - Chest Xray showed bilateral atypical findings - CRP 63, sed rate 22.  - DVT ppx given while inpatient - dexamethasone completed x10 days on 8/10/2021 - atorvastatin given during admission - Completed Remdesevir 8/5/2021 - Isolation   Chronic lymphocytic leukemia  - Leukocytosis due to CLL  Flow cytometry with CD+5 mature B cell lymphoma  CT abdomen showing lymphadenopathy Out patient hematology follow up, no need for acute intervention    AKI: resolved  -Cr back to baseline    Hyperkalemia: -Resolved    Arterial hypertension -Controlled - continue amlodipine + HCTz   Morbid Obesity, BMI of> 40s: -would benefit from lifestyles modifications regarding low fat diet, weight loss and daily excercise -F/U with PCP     Patient is discharged in stable condition with stable vital signs. All questions rearding hospital course and plan of care after discharge have been answered to satisfaction. Prescriptions for medications needed to be taken after discharge have been given to patient. Patient has been instructed to follow up with PCP  within the next 7 days after discharge. Patient verbalizes understanding all given instructions and has no further doubts regarding discharge.   ED admission 2 hours later:  50 y.o. female presents c/o SOB. Pt was discharged from hospital today and was known covid positive. She was discharged with home O2. At home, patient's mother noticed that she was having more difficulty breathing than usual, prompting her to call 911. Pt arrived via EMS, which states she became unresponsive on arrival with a faint pulse. She quickly lost her pulse after her arrival here. Hx limited by events/condition of patient.    The history is provided by the EMS personnel, a parent and medical records. The history is limited by the condition of the patient."
	"1617479-1"	"1617479-1"	"VACCINE BREAKTHROUGH INFECTION"	"10067923"	"50-59 years"	"50-59"	"Patient required hospitalization due to breakthrough infection. She received the Moderna vaccine (2nd dose in series) on 07/10/21. Hospitalized from 08/01/21 - 08/12/21 (discharged and then admitted 2 hours later, result was death in ED). Below is copied from discharge summary:   Patient is a 50 y/o morbidly obese female admitted on 8/2/2021 due to acute respiratory failure due to COVID 19 pneumonia.    Severe Sepsis with acute organ dysfunction/ Acute respiratory failure with hypoxia 2/2 COVID 19: - Now on 4L , oxygen delivered at bedside - Chest Xray showed bilateral atypical findings - CRP 63, sed rate 22.  - DVT ppx given while inpatient - dexamethasone completed x10 days on 8/10/2021 - atorvastatin given during admission - Completed Remdesevir 8/5/2021 - Isolation   Chronic lymphocytic leukemia  - Leukocytosis due to CLL  Flow cytometry with CD+5 mature B cell lymphoma  CT abdomen showing lymphadenopathy Out patient hematology follow up, no need for acute intervention    AKI: resolved  -Cr back to baseline    Hyperkalemia: -Resolved    Arterial hypertension -Controlled - continue amlodipine + HCTz   Morbid Obesity, BMI of> 40s: -would benefit from lifestyles modifications regarding low fat diet, weight loss and daily excercise -F/U with PCP     Patient is discharged in stable condition with stable vital signs. All questions rearding hospital course and plan of care after discharge have been answered to satisfaction. Prescriptions for medications needed to be taken after discharge have been given to patient. Patient has been instructed to follow up with PCP  within the next 7 days after discharge. Patient verbalizes understanding all given instructions and has no further doubts regarding discharge.   ED admission 2 hours later:  50 y.o. female presents c/o SOB. Pt was discharged from hospital today and was known covid positive. She was discharged with home O2. At home, patient's mother noticed that she was having more difficulty breathing than usual, prompting her to call 911. Pt arrived via EMS, which states she became unresponsive on arrival with a faint pulse. She quickly lost her pulse after her arrival here. Hx limited by events/condition of patient.    The history is provided by the EMS personnel, a parent and medical records. The history is limited by the condition of the patient."
	"1617843-1"	"1617843-1"	"CHEST PAIN"	"10008479"	"50-59 years"	"50-59"	"Burning in chest, vomiting.  Death"
	"1617843-1"	"1617843-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Burning in chest, vomiting.  Death"
	"1617843-1"	"1617843-1"	"VOMITING"	"10047700"	"50-59 years"	"50-59"	"Burning in chest, vomiting.  Death"
	"1622381-1"	"1622381-1"	"ABDOMINAL PAIN UPPER"	"10000087"	"50-59 years"	"50-59"	"Feeling sick after the Modena vaccine; Stomachache; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of ABDOMINAL PAIN UPPER (Stomachache) and MALAISE (Feeling sick after the Modena vaccine) in a 53-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 028A21A) for COVID-19 vaccination.     Concurrent medical conditions included Heart disorder.    On 25-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. In April 2021,  after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced ABDOMINAL PAIN UPPER (Stomachache). On an unknown date, the patient experienced MALAISE (Feeling sick after the Modena vaccine). At the time of the report, ABDOMINAL PAIN UPPER (Stomachache) and MALAISE (Feeling sick after the Modena vaccine) outcome was unknown.            Concomitant product use was not provided by the reporter.  After 2-3 weeks of vaccination patient experienced stomachache, patient thought this was indigestion or pancreatitis. Patient contacted doctor online. Patient's condition aggravated after second dose and died on 05-Jun-2021.  No treatment was provided.  Action taken with mRNA-1273 in response to the events was not Applicable.    This case was linked to MOD-2021-211616 (Patient Link).   Most recent FOLLOW-UP information incorporated above includes: On 07-Jun-2021: Follow up information received on  07-May-2021 had a new event feeling sick after the Modena vaccine was added to the case."
	"1622381-1"	"1622381-1"	"MALAISE"	"10025482"	"50-59 years"	"50-59"	"Feeling sick after the Modena vaccine; Stomachache; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of ABDOMINAL PAIN UPPER (Stomachache) and MALAISE (Feeling sick after the Modena vaccine) in a 53-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 028A21A) for COVID-19 vaccination.     Concurrent medical conditions included Heart disorder.    On 25-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. In April 2021,  after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced ABDOMINAL PAIN UPPER (Stomachache). On an unknown date, the patient experienced MALAISE (Feeling sick after the Modena vaccine). At the time of the report, ABDOMINAL PAIN UPPER (Stomachache) and MALAISE (Feeling sick after the Modena vaccine) outcome was unknown.            Concomitant product use was not provided by the reporter.  After 2-3 weeks of vaccination patient experienced stomachache, patient thought this was indigestion or pancreatitis. Patient contacted doctor online. Patient's condition aggravated after second dose and died on 05-Jun-2021.  No treatment was provided.  Action taken with mRNA-1273 in response to the events was not Applicable.    This case was linked to MOD-2021-211616 (Patient Link).   Most recent FOLLOW-UP information incorporated above includes: On 07-Jun-2021: Follow up information received on  07-May-2021 had a new event feeling sick after the Modena vaccine was added to the case."
	"1623771-1"	"1623771-1"	"COVID-19 PNEUMONIA"	"10084380"	"50-59 years"	"50-59"	"Covid 19 pneumonia"
	"1623771-1"	"1623771-1"	"SARS-COV-2 TEST"	"10084354"	"50-59 years"	"50-59"	"Covid 19 pneumonia"
	"1624181-1"	"1624181-1"	"AUTOPSY"	"10050117"	"50-59 years"	"50-59"	"Patient  Passed on august ."
	"1624181-1"	"1624181-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient  Passed on august ."
	"1624181-1"	"1624181-1"	"INTRACARDIAC THROMBUS"	"10048620"	"50-59 years"	"50-59"	"Patient  Passed on august ."
	"1624304-1"	"1624304-1"	"AUTOPSY"	"10050117"	"50-59 years"	"50-59"	"Vomiting and Diarrhea 08/03-08/09. Found dead at residence on 08/09."
	"1624304-1"	"1624304-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Vomiting and Diarrhea 08/03-08/09. Found dead at residence on 08/09."
	"1624304-1"	"1624304-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Vomiting and Diarrhea 08/03-08/09. Found dead at residence on 08/09."
	"1624304-1"	"1624304-1"	"DIARRHOEA"	"10012735"	"50-59 years"	"50-59"	"Vomiting and Diarrhea 08/03-08/09. Found dead at residence on 08/09."
	"1624304-1"	"1624304-1"	"PULMONARY EMBOLISM"	"10037377"	"50-59 years"	"50-59"	"Vomiting and Diarrhea 08/03-08/09. Found dead at residence on 08/09."
	"1624304-1"	"1624304-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"Vomiting and Diarrhea 08/03-08/09. Found dead at residence on 08/09."
	"1624304-1"	"1624304-1"	"VOMITING"	"10047700"	"50-59 years"	"50-59"	"Vomiting and Diarrhea 08/03-08/09. Found dead at residence on 08/09."
	"1629537-1"	"1629537-1"	"ANGIOGRAM NORMAL"	"10061638"	"50-59 years"	"50-59"	"PT WAS VACCINATED SEVERAL MONTHS AGO, PRESENTED TO ER WITH C/O CP AND SOB 8/22, NEG ANGIOGRAM COMPLETED 8/23, DC HOME 8/23 RETURNED TO ER 8/24 WITH LARGE SADDLE PE, PT EXPIRED. ONLY REPORTING BECAUSE PT HAD NO PRIOR HISTORY OF MI OR THROMBOSIS, ONLY HTN AND TYPE 2 DM."
	"1629537-1"	"1629537-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"PT WAS VACCINATED SEVERAL MONTHS AGO, PRESENTED TO ER WITH C/O CP AND SOB 8/22, NEG ANGIOGRAM COMPLETED 8/23, DC HOME 8/23 RETURNED TO ER 8/24 WITH LARGE SADDLE PE, PT EXPIRED. ONLY REPORTING BECAUSE PT HAD NO PRIOR HISTORY OF MI OR THROMBOSIS, ONLY HTN AND TYPE 2 DM."
	"1629537-1"	"1629537-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"PT WAS VACCINATED SEVERAL MONTHS AGO, PRESENTED TO ER WITH C/O CP AND SOB 8/22, NEG ANGIOGRAM COMPLETED 8/23, DC HOME 8/23 RETURNED TO ER 8/24 WITH LARGE SADDLE PE, PT EXPIRED. ONLY REPORTING BECAUSE PT HAD NO PRIOR HISTORY OF MI OR THROMBOSIS, ONLY HTN AND TYPE 2 DM."
	"1629537-1"	"1629537-1"	"PERICARDITIS CONSTRICTIVE"	"10034487"	"50-59 years"	"50-59"	"PT WAS VACCINATED SEVERAL MONTHS AGO, PRESENTED TO ER WITH C/O CP AND SOB 8/22, NEG ANGIOGRAM COMPLETED 8/23, DC HOME 8/23 RETURNED TO ER 8/24 WITH LARGE SADDLE PE, PT EXPIRED. ONLY REPORTING BECAUSE PT HAD NO PRIOR HISTORY OF MI OR THROMBOSIS, ONLY HTN AND TYPE 2 DM."
	"1629537-1"	"1629537-1"	"PULMONARY EMBOLISM"	"10037377"	"50-59 years"	"50-59"	"PT WAS VACCINATED SEVERAL MONTHS AGO, PRESENTED TO ER WITH C/O CP AND SOB 8/22, NEG ANGIOGRAM COMPLETED 8/23, DC HOME 8/23 RETURNED TO ER 8/24 WITH LARGE SADDLE PE, PT EXPIRED. ONLY REPORTING BECAUSE PT HAD NO PRIOR HISTORY OF MI OR THROMBOSIS, ONLY HTN AND TYPE 2 DM."
	"1632254-1"	"1632254-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"patient given the Pfizer vaccine on 8/24 and went into cardiac arrest and died at 0650 8/25/21"
	"1632254-1"	"1632254-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"patient given the Pfizer vaccine on 8/24 and went into cardiac arrest and died at 0650 8/25/21"
	"1636499-1"	"1636499-1"	"ACUTE KIDNEY INJURY"	"10069339"	"50-59 years"	"50-59"	"Present on 8/11 following 4-5 days of myalgias, fevers and fatigue. Received only 1 dose of cvocid vaccine. Admitted and started on antibiotics. COVID +. Given decadron and 5 day course of remdesivir. His stay was complicated by AKI and CKD. Respiratory status continued to decline and antibiotics broadened but continued to worsen."
	"1636499-1"	"1636499-1"	"CHEST X-RAY ABNORMAL"	"10008499"	"50-59 years"	"50-59"	"Present on 8/11 following 4-5 days of myalgias, fevers and fatigue. Received only 1 dose of cvocid vaccine. Admitted and started on antibiotics. COVID +. Given decadron and 5 day course of remdesivir. His stay was complicated by AKI and CKD. Respiratory status continued to decline and antibiotics broadened but continued to worsen."
	"1636499-1"	"1636499-1"	"CHRONIC KIDNEY DISEASE"	"10064848"	"50-59 years"	"50-59"	"Present on 8/11 following 4-5 days of myalgias, fevers and fatigue. Received only 1 dose of cvocid vaccine. Admitted and started on antibiotics. COVID +. Given decadron and 5 day course of remdesivir. His stay was complicated by AKI and CKD. Respiratory status continued to decline and antibiotics broadened but continued to worsen."
	"1636499-1"	"1636499-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Present on 8/11 following 4-5 days of myalgias, fevers and fatigue. Received only 1 dose of cvocid vaccine. Admitted and started on antibiotics. COVID +. Given decadron and 5 day course of remdesivir. His stay was complicated by AKI and CKD. Respiratory status continued to decline and antibiotics broadened but continued to worsen."
	"1636499-1"	"1636499-1"	"FATIGUE"	"10016256"	"50-59 years"	"50-59"	"Present on 8/11 following 4-5 days of myalgias, fevers and fatigue. Received only 1 dose of cvocid vaccine. Admitted and started on antibiotics. COVID +. Given decadron and 5 day course of remdesivir. His stay was complicated by AKI and CKD. Respiratory status continued to decline and antibiotics broadened but continued to worsen."
	"1636499-1"	"1636499-1"	"LUNG OPACITY"	"10081792"	"50-59 years"	"50-59"	"Present on 8/11 following 4-5 days of myalgias, fevers and fatigue. Received only 1 dose of cvocid vaccine. Admitted and started on antibiotics. COVID +. Given decadron and 5 day course of remdesivir. His stay was complicated by AKI and CKD. Respiratory status continued to decline and antibiotics broadened but continued to worsen."
	"1636499-1"	"1636499-1"	"MYALGIA"	"10028411"	"50-59 years"	"50-59"	"Present on 8/11 following 4-5 days of myalgias, fevers and fatigue. Received only 1 dose of cvocid vaccine. Admitted and started on antibiotics. COVID +. Given decadron and 5 day course of remdesivir. His stay was complicated by AKI and CKD. Respiratory status continued to decline and antibiotics broadened but continued to worsen."
	"1636499-1"	"1636499-1"	"PYREXIA"	"10037660"	"50-59 years"	"50-59"	"Present on 8/11 following 4-5 days of myalgias, fevers and fatigue. Received only 1 dose of cvocid vaccine. Admitted and started on antibiotics. COVID +. Given decadron and 5 day course of remdesivir. His stay was complicated by AKI and CKD. Respiratory status continued to decline and antibiotics broadened but continued to worsen."
	"1636499-1"	"1636499-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"Present on 8/11 following 4-5 days of myalgias, fevers and fatigue. Received only 1 dose of cvocid vaccine. Admitted and started on antibiotics. COVID +. Given decadron and 5 day course of remdesivir. His stay was complicated by AKI and CKD. Respiratory status continued to decline and antibiotics broadened but continued to worsen."
	"1636956-1"	"1636956-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Pt. given dose.  NO lot number in our vaccination system, pt. passed from COVID19 on 8/22/2021."
	"1636956-1"	"1636956-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Pt. given dose.  NO lot number in our vaccination system, pt. passed from COVID19 on 8/22/2021."
	"1641249-1"	"1641249-1"	"CHEST X-RAY ABNORMAL"	"10008499"	"50-59 years"	"50-59"	"Pt came to ER with difficulty breathing and cough onset 1 week ago.  Patient admitted to ICU."
	"1641249-1"	"1641249-1"	"COUGH"	"10011224"	"50-59 years"	"50-59"	"Pt came to ER with difficulty breathing and cough onset 1 week ago.  Patient admitted to ICU."
	"1641249-1"	"1641249-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Pt came to ER with difficulty breathing and cough onset 1 week ago.  Patient admitted to ICU."
	"1641249-1"	"1641249-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"Pt came to ER with difficulty breathing and cough onset 1 week ago.  Patient admitted to ICU."
	"1641249-1"	"1641249-1"	"INTENSIVE CARE"	"10022519"	"50-59 years"	"50-59"	"Pt came to ER with difficulty breathing and cough onset 1 week ago.  Patient admitted to ICU."
	"1641249-1"	"1641249-1"	"PNEUMONIA"	"10035664"	"50-59 years"	"50-59"	"Pt came to ER with difficulty breathing and cough onset 1 week ago.  Patient admitted to ICU."
	"1641249-1"	"1641249-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"Pt came to ER with difficulty breathing and cough onset 1 week ago.  Patient admitted to ICU."
	"1641622-1"	"1641622-1"	"ACIDOSIS"	"10000486"	"50-59 years"	"50-59"	"Patient admitted 7/21/2021 for presents as transfer for acute hypoxic respiratory failure and covid pneumonia. Vaccinated for COVID 3/31/2021, tested positive 7/21/2021 Patient discharged, DEATH, 7/26/2021  Date of Vaccination:3/31/2021 & 3/10/2021 Dose: 2 doses total Vaccine Manufacturer: Pfizer Lot #: EN6202/EN6207 Clinic Administering Vaccine: unknown Injection site: R deltoid both times Description of event/reaction: patient died from severe ARDS from COVID-19   Patient initially presented on 06/29 with dyspnea, productive cough and wheezing. She reported having difficulty breathing for the last month, however, her symptoms progressively worsened after 6/26/21. Patient was found to be hypoxic on her home oxygen requirement of 3L to SpO2 52% upon arrival to ER. Of note, patient was discharged from a hospitalization on 6/22/21 (unknown reason for hospitalization, duration, and location).    Patient is reportedly fully vaccinated for COVID prior to her current admission and received her last vaccine in February 2021. She tested positive for COVID on 6/29 upon admission, and stated that her daughter had been sick recently and tested negative for COVID. Patient was started on Remdesivir, Decadron, Albuterol, Thiamine, Zinc, Quercetin complex, and Vitamin D. Patient was also started on Vapotherm for supplemental oxygen which was alternated with BiPAP, as well as empiric Vancomycin (6/29-7/10 and 7/15-7/21) and Zosyn (6/29-7/8). Patient was ultimately intubated on 07/15 and her antibiotics were escalated to Vanc and Meropenem (7/13-7/21) for presumed pneumonia. She continued to require high ventilator settings (100%, PEEP 16).  Her hospitalization was complicated by shock requiring vasopressors. On 7/17, patient was increasingly acidotic with pH 6.99 and PCO2 78 and was subsequently proned and paralyzed.  Her infectious work-up was positive for VRE bacteremia on 7/17 and candida in urine culture. On 7/21 she was transferred to MICU for hypoxic respiratory failure and COVID pneumonia. On arrival, she is sedated on mechanical ventilation...Acute Hypoxic Hypercapneic Respiratory Failure requiring Mechanical Ventilation (POA) COVID PNA (POA) History of COPD (POA) - Etiology: COVID PNA - COVID positive 6/29 - Fully vaccinated with Moderna vaccine prior to admission - s/p Remdesivir, convalescent plasma, dexamethasone - 7/15 Intubated at outside hospital - 7/17 Paralyzed and proned - CXR: bilateral diffuse patchy airspace disease - ABG on arrival: 7.43/53/65/35 on 80%, PEEP 10, PF 81 PLAN: - PAL, comp resp panel, Strep and Legionella urine Ag pending - Continue mechanical ventilation to optimize ventilation and oxygenation, maintain SpO2 >/= 92% - DuoNebs q4hr - Empiric broad spectrum antibiotics as outlined below: Linezolid and cefepime - Propofol and Dilaudid drips to facilitate tolerance of mechanical ventilation - Start DEXARDS protocol - Repeat ABG at 2000; prone if PF ratio not improved - Consider CT chest when clinically stable   VRE Bacteremia (POA) Sepsis (POA) Leukocytosis (POA) - Has received dexamethasone - Received the following courses abx: Vanc 6/29-7/10, 7/15- 7/21 Zosyn 6/29 - 7/8 Merrem 7/13-7/21 - BCx from 7/17 resulted for +VRE; transitioned to Linezolid prior to transfer - On vasopressors on 7/18 - WBC 26k, lactate here 1.2 - CXR: bilateral diffuse patchy airspace disease Plan: - PAN cultures: Bcx, UA, PAL, strep/legionella urinary Ag pending - Follow cultures; determine insertion date of PICC line - Empiric antibiotics with : Linezolid (start 7/21) and cefepime - ECHO pending   AKI (POA) - Scr on admission 0.96, up to 1.96 on 7/17  - Multifactorial AKI is likely related to sepsis PLAN:  - BMP here pending - Renal lytes pending - Renally dose medications, avoid contrast medications - Consult the renal team when appropriate      T2DM (POA) - HgbA1C pending - FSBG with correction SSI q6hr per ICU protocol"
	"1641622-1"	"1641622-1"	"ACUTE KIDNEY INJURY"	"10069339"	"50-59 years"	"50-59"	"Patient admitted 7/21/2021 for presents as transfer for acute hypoxic respiratory failure and covid pneumonia. Vaccinated for COVID 3/31/2021, tested positive 7/21/2021 Patient discharged, DEATH, 7/26/2021  Date of Vaccination:3/31/2021 & 3/10/2021 Dose: 2 doses total Vaccine Manufacturer: Pfizer Lot #: EN6202/EN6207 Clinic Administering Vaccine: unknown Injection site: R deltoid both times Description of event/reaction: patient died from severe ARDS from COVID-19   Patient initially presented on 06/29 with dyspnea, productive cough and wheezing. She reported having difficulty breathing for the last month, however, her symptoms progressively worsened after 6/26/21. Patient was found to be hypoxic on her home oxygen requirement of 3L to SpO2 52% upon arrival to ER. Of note, patient was discharged from a hospitalization on 6/22/21 (unknown reason for hospitalization, duration, and location).    Patient is reportedly fully vaccinated for COVID prior to her current admission and received her last vaccine in February 2021. She tested positive for COVID on 6/29 upon admission, and stated that her daughter had been sick recently and tested negative for COVID. Patient was started on Remdesivir, Decadron, Albuterol, Thiamine, Zinc, Quercetin complex, and Vitamin D. Patient was also started on Vapotherm for supplemental oxygen which was alternated with BiPAP, as well as empiric Vancomycin (6/29-7/10 and 7/15-7/21) and Zosyn (6/29-7/8). Patient was ultimately intubated on 07/15 and her antibiotics were escalated to Vanc and Meropenem (7/13-7/21) for presumed pneumonia. She continued to require high ventilator settings (100%, PEEP 16).  Her hospitalization was complicated by shock requiring vasopressors. On 7/17, patient was increasingly acidotic with pH 6.99 and PCO2 78 and was subsequently proned and paralyzed.  Her infectious work-up was positive for VRE bacteremia on 7/17 and candida in urine culture. On 7/21 she was transferred to MICU for hypoxic respiratory failure and COVID pneumonia. On arrival, she is sedated on mechanical ventilation...Acute Hypoxic Hypercapneic Respiratory Failure requiring Mechanical Ventilation (POA) COVID PNA (POA) History of COPD (POA) - Etiology: COVID PNA - COVID positive 6/29 - Fully vaccinated with Moderna vaccine prior to admission - s/p Remdesivir, convalescent plasma, dexamethasone - 7/15 Intubated at outside hospital - 7/17 Paralyzed and proned - CXR: bilateral diffuse patchy airspace disease - ABG on arrival: 7.43/53/65/35 on 80%, PEEP 10, PF 81 PLAN: - PAL, comp resp panel, Strep and Legionella urine Ag pending - Continue mechanical ventilation to optimize ventilation and oxygenation, maintain SpO2 >/= 92% - DuoNebs q4hr - Empiric broad spectrum antibiotics as outlined below: Linezolid and cefepime - Propofol and Dilaudid drips to facilitate tolerance of mechanical ventilation - Start DEXARDS protocol - Repeat ABG at 2000; prone if PF ratio not improved - Consider CT chest when clinically stable   VRE Bacteremia (POA) Sepsis (POA) Leukocytosis (POA) - Has received dexamethasone - Received the following courses abx: Vanc 6/29-7/10, 7/15- 7/21 Zosyn 6/29 - 7/8 Merrem 7/13-7/21 - BCx from 7/17 resulted for +VRE; transitioned to Linezolid prior to transfer - On vasopressors on 7/18 - WBC 26k, lactate here 1.2 - CXR: bilateral diffuse patchy airspace disease Plan: - PAN cultures: Bcx, UA, PAL, strep/legionella urinary Ag pending - Follow cultures; determine insertion date of PICC line - Empiric antibiotics with : Linezolid (start 7/21) and cefepime - ECHO pending   AKI (POA) - Scr on admission 0.96, up to 1.96 on 7/17  - Multifactorial AKI is likely related to sepsis PLAN:  - BMP here pending - Renal lytes pending - Renally dose medications, avoid contrast medications - Consult the renal team when appropriate      T2DM (POA) - HgbA1C pending - FSBG with correction SSI q6hr per ICU protocol"
	"1641622-1"	"1641622-1"	"ACUTE RESPIRATORY DISTRESS SYNDROME"	"10001052"	"50-59 years"	"50-59"	"Patient admitted 7/21/2021 for presents as transfer for acute hypoxic respiratory failure and covid pneumonia. Vaccinated for COVID 3/31/2021, tested positive 7/21/2021 Patient discharged, DEATH, 7/26/2021  Date of Vaccination:3/31/2021 & 3/10/2021 Dose: 2 doses total Vaccine Manufacturer: Pfizer Lot #: EN6202/EN6207 Clinic Administering Vaccine: unknown Injection site: R deltoid both times Description of event/reaction: patient died from severe ARDS from COVID-19   Patient initially presented on 06/29 with dyspnea, productive cough and wheezing. She reported having difficulty breathing for the last month, however, her symptoms progressively worsened after 6/26/21. Patient was found to be hypoxic on her home oxygen requirement of 3L to SpO2 52% upon arrival to ER. Of note, patient was discharged from a hospitalization on 6/22/21 (unknown reason for hospitalization, duration, and location).    Patient is reportedly fully vaccinated for COVID prior to her current admission and received her last vaccine in February 2021. She tested positive for COVID on 6/29 upon admission, and stated that her daughter had been sick recently and tested negative for COVID. Patient was started on Remdesivir, Decadron, Albuterol, Thiamine, Zinc, Quercetin complex, and Vitamin D. Patient was also started on Vapotherm for supplemental oxygen which was alternated with BiPAP, as well as empiric Vancomycin (6/29-7/10 and 7/15-7/21) and Zosyn (6/29-7/8). Patient was ultimately intubated on 07/15 and her antibiotics were escalated to Vanc and Meropenem (7/13-7/21) for presumed pneumonia. She continued to require high ventilator settings (100%, PEEP 16).  Her hospitalization was complicated by shock requiring vasopressors. On 7/17, patient was increasingly acidotic with pH 6.99 and PCO2 78 and was subsequently proned and paralyzed.  Her infectious work-up was positive for VRE bacteremia on 7/17 and candida in urine culture. On 7/21 she was transferred to MICU for hypoxic respiratory failure and COVID pneumonia. On arrival, she is sedated on mechanical ventilation...Acute Hypoxic Hypercapneic Respiratory Failure requiring Mechanical Ventilation (POA) COVID PNA (POA) History of COPD (POA) - Etiology: COVID PNA - COVID positive 6/29 - Fully vaccinated with Moderna vaccine prior to admission - s/p Remdesivir, convalescent plasma, dexamethasone - 7/15 Intubated at outside hospital - 7/17 Paralyzed and proned - CXR: bilateral diffuse patchy airspace disease - ABG on arrival: 7.43/53/65/35 on 80%, PEEP 10, PF 81 PLAN: - PAL, comp resp panel, Strep and Legionella urine Ag pending - Continue mechanical ventilation to optimize ventilation and oxygenation, maintain SpO2 >/= 92% - DuoNebs q4hr - Empiric broad spectrum antibiotics as outlined below: Linezolid and cefepime - Propofol and Dilaudid drips to facilitate tolerance of mechanical ventilation - Start DEXARDS protocol - Repeat ABG at 2000; prone if PF ratio not improved - Consider CT chest when clinically stable   VRE Bacteremia (POA) Sepsis (POA) Leukocytosis (POA) - Has received dexamethasone - Received the following courses abx: Vanc 6/29-7/10, 7/15- 7/21 Zosyn 6/29 - 7/8 Merrem 7/13-7/21 - BCx from 7/17 resulted for +VRE; transitioned to Linezolid prior to transfer - On vasopressors on 7/18 - WBC 26k, lactate here 1.2 - CXR: bilateral diffuse patchy airspace disease Plan: - PAN cultures: Bcx, UA, PAL, strep/legionella urinary Ag pending - Follow cultures; determine insertion date of PICC line - Empiric antibiotics with : Linezolid (start 7/21) and cefepime - ECHO pending   AKI (POA) - Scr on admission 0.96, up to 1.96 on 7/17  - Multifactorial AKI is likely related to sepsis PLAN:  - BMP here pending - Renal lytes pending - Renally dose medications, avoid contrast medications - Consult the renal team when appropriate      T2DM (POA) - HgbA1C pending - FSBG with correction SSI q6hr per ICU protocol"
	"1641622-1"	"1641622-1"	"ACUTE RESPIRATORY FAILURE"	"10001053"	"50-59 years"	"50-59"	"Patient admitted 7/21/2021 for presents as transfer for acute hypoxic respiratory failure and covid pneumonia. Vaccinated for COVID 3/31/2021, tested positive 7/21/2021 Patient discharged, DEATH, 7/26/2021  Date of Vaccination:3/31/2021 & 3/10/2021 Dose: 2 doses total Vaccine Manufacturer: Pfizer Lot #: EN6202/EN6207 Clinic Administering Vaccine: unknown Injection site: R deltoid both times Description of event/reaction: patient died from severe ARDS from COVID-19   Patient initially presented on 06/29 with dyspnea, productive cough and wheezing. She reported having difficulty breathing for the last month, however, her symptoms progressively worsened after 6/26/21. Patient was found to be hypoxic on her home oxygen requirement of 3L to SpO2 52% upon arrival to ER. Of note, patient was discharged from a hospitalization on 6/22/21 (unknown reason for hospitalization, duration, and location).    Patient is reportedly fully vaccinated for COVID prior to her current admission and received her last vaccine in February 2021. She tested positive for COVID on 6/29 upon admission, and stated that her daughter had been sick recently and tested negative for COVID. Patient was started on Remdesivir, Decadron, Albuterol, Thiamine, Zinc, Quercetin complex, and Vitamin D. Patient was also started on Vapotherm for supplemental oxygen which was alternated with BiPAP, as well as empiric Vancomycin (6/29-7/10 and 7/15-7/21) and Zosyn (6/29-7/8). Patient was ultimately intubated on 07/15 and her antibiotics were escalated to Vanc and Meropenem (7/13-7/21) for presumed pneumonia. She continued to require high ventilator settings (100%, PEEP 16).  Her hospitalization was complicated by shock requiring vasopressors. On 7/17, patient was increasingly acidotic with pH 6.99 and PCO2 78 and was subsequently proned and paralyzed.  Her infectious work-up was positive for VRE bacteremia on 7/17 and candida in urine culture. On 7/21 she was transferred to MICU for hypoxic respiratory failure and COVID pneumonia. On arrival, she is sedated on mechanical ventilation...Acute Hypoxic Hypercapneic Respiratory Failure requiring Mechanical Ventilation (POA) COVID PNA (POA) History of COPD (POA) - Etiology: COVID PNA - COVID positive 6/29 - Fully vaccinated with Moderna vaccine prior to admission - s/p Remdesivir, convalescent plasma, dexamethasone - 7/15 Intubated at outside hospital - 7/17 Paralyzed and proned - CXR: bilateral diffuse patchy airspace disease - ABG on arrival: 7.43/53/65/35 on 80%, PEEP 10, PF 81 PLAN: - PAL, comp resp panel, Strep and Legionella urine Ag pending - Continue mechanical ventilation to optimize ventilation and oxygenation, maintain SpO2 >/= 92% - DuoNebs q4hr - Empiric broad spectrum antibiotics as outlined below: Linezolid and cefepime - Propofol and Dilaudid drips to facilitate tolerance of mechanical ventilation - Start DEXARDS protocol - Repeat ABG at 2000; prone if PF ratio not improved - Consider CT chest when clinically stable   VRE Bacteremia (POA) Sepsis (POA) Leukocytosis (POA) - Has received dexamethasone - Received the following courses abx: Vanc 6/29-7/10, 7/15- 7/21 Zosyn 6/29 - 7/8 Merrem 7/13-7/21 - BCx from 7/17 resulted for +VRE; transitioned to Linezolid prior to transfer - On vasopressors on 7/18 - WBC 26k, lactate here 1.2 - CXR: bilateral diffuse patchy airspace disease Plan: - PAN cultures: Bcx, UA, PAL, strep/legionella urinary Ag pending - Follow cultures; determine insertion date of PICC line - Empiric antibiotics with : Linezolid (start 7/21) and cefepime - ECHO pending   AKI (POA) - Scr on admission 0.96, up to 1.96 on 7/17  - Multifactorial AKI is likely related to sepsis PLAN:  - BMP here pending - Renal lytes pending - Renally dose medications, avoid contrast medications - Consult the renal team when appropriate      T2DM (POA) - HgbA1C pending - FSBG with correction SSI q6hr per ICU protocol"
	"1641622-1"	"1641622-1"	"BACTERIAL TEST POSITIVE"	"10059421"	"50-59 years"	"50-59"	"Patient admitted 7/21/2021 for presents as transfer for acute hypoxic respiratory failure and covid pneumonia. Vaccinated for COVID 3/31/2021, tested positive 7/21/2021 Patient discharged, DEATH, 7/26/2021  Date of Vaccination:3/31/2021 & 3/10/2021 Dose: 2 doses total Vaccine Manufacturer: Pfizer Lot #: EN6202/EN6207 Clinic Administering Vaccine: unknown Injection site: R deltoid both times Description of event/reaction: patient died from severe ARDS from COVID-19   Patient initially presented on 06/29 with dyspnea, productive cough and wheezing. She reported having difficulty breathing for the last month, however, her symptoms progressively worsened after 6/26/21. Patient was found to be hypoxic on her home oxygen requirement of 3L to SpO2 52% upon arrival to ER. Of note, patient was discharged from a hospitalization on 6/22/21 (unknown reason for hospitalization, duration, and location).    Patient is reportedly fully vaccinated for COVID prior to her current admission and received her last vaccine in February 2021. She tested positive for COVID on 6/29 upon admission, and stated that her daughter had been sick recently and tested negative for COVID. Patient was started on Remdesivir, Decadron, Albuterol, Thiamine, Zinc, Quercetin complex, and Vitamin D. Patient was also started on Vapotherm for supplemental oxygen which was alternated with BiPAP, as well as empiric Vancomycin (6/29-7/10 and 7/15-7/21) and Zosyn (6/29-7/8). Patient was ultimately intubated on 07/15 and her antibiotics were escalated to Vanc and Meropenem (7/13-7/21) for presumed pneumonia. She continued to require high ventilator settings (100%, PEEP 16).  Her hospitalization was complicated by shock requiring vasopressors. On 7/17, patient was increasingly acidotic with pH 6.99 and PCO2 78 and was subsequently proned and paralyzed.  Her infectious work-up was positive for VRE bacteremia on 7/17 and candida in urine culture. On 7/21 she was transferred to MICU for hypoxic respiratory failure and COVID pneumonia. On arrival, she is sedated on mechanical ventilation...Acute Hypoxic Hypercapneic Respiratory Failure requiring Mechanical Ventilation (POA) COVID PNA (POA) History of COPD (POA) - Etiology: COVID PNA - COVID positive 6/29 - Fully vaccinated with Moderna vaccine prior to admission - s/p Remdesivir, convalescent plasma, dexamethasone - 7/15 Intubated at outside hospital - 7/17 Paralyzed and proned - CXR: bilateral diffuse patchy airspace disease - ABG on arrival: 7.43/53/65/35 on 80%, PEEP 10, PF 81 PLAN: - PAL, comp resp panel, Strep and Legionella urine Ag pending - Continue mechanical ventilation to optimize ventilation and oxygenation, maintain SpO2 >/= 92% - DuoNebs q4hr - Empiric broad spectrum antibiotics as outlined below: Linezolid and cefepime - Propofol and Dilaudid drips to facilitate tolerance of mechanical ventilation - Start DEXARDS protocol - Repeat ABG at 2000; prone if PF ratio not improved - Consider CT chest when clinically stable   VRE Bacteremia (POA) Sepsis (POA) Leukocytosis (POA) - Has received dexamethasone - Received the following courses abx: Vanc 6/29-7/10, 7/15- 7/21 Zosyn 6/29 - 7/8 Merrem 7/13-7/21 - BCx from 7/17 resulted for +VRE; transitioned to Linezolid prior to transfer - On vasopressors on 7/18 - WBC 26k, lactate here 1.2 - CXR: bilateral diffuse patchy airspace disease Plan: - PAN cultures: Bcx, UA, PAL, strep/legionella urinary Ag pending - Follow cultures; determine insertion date of PICC line - Empiric antibiotics with : Linezolid (start 7/21) and cefepime - ECHO pending   AKI (POA) - Scr on admission 0.96, up to 1.96 on 7/17  - Multifactorial AKI is likely related to sepsis PLAN:  - BMP here pending - Renal lytes pending - Renally dose medications, avoid contrast medications - Consult the renal team when appropriate      T2DM (POA) - HgbA1C pending - FSBG with correction SSI q6hr per ICU protocol"
	"1641622-1"	"1641622-1"	"BILEVEL POSITIVE AIRWAY PRESSURE"	"10064530"	"50-59 years"	"50-59"	"Patient admitted 7/21/2021 for presents as transfer for acute hypoxic respiratory failure and covid pneumonia. Vaccinated for COVID 3/31/2021, tested positive 7/21/2021 Patient discharged, DEATH, 7/26/2021  Date of Vaccination:3/31/2021 & 3/10/2021 Dose: 2 doses total Vaccine Manufacturer: Pfizer Lot #: EN6202/EN6207 Clinic Administering Vaccine: unknown Injection site: R deltoid both times Description of event/reaction: patient died from severe ARDS from COVID-19   Patient initially presented on 06/29 with dyspnea, productive cough and wheezing. She reported having difficulty breathing for the last month, however, her symptoms progressively worsened after 6/26/21. Patient was found to be hypoxic on her home oxygen requirement of 3L to SpO2 52% upon arrival to ER. Of note, patient was discharged from a hospitalization on 6/22/21 (unknown reason for hospitalization, duration, and location).    Patient is reportedly fully vaccinated for COVID prior to her current admission and received her last vaccine in February 2021. She tested positive for COVID on 6/29 upon admission, and stated that her daughter had been sick recently and tested negative for COVID. Patient was started on Remdesivir, Decadron, Albuterol, Thiamine, Zinc, Quercetin complex, and Vitamin D. Patient was also started on Vapotherm for supplemental oxygen which was alternated with BiPAP, as well as empiric Vancomycin (6/29-7/10 and 7/15-7/21) and Zosyn (6/29-7/8). Patient was ultimately intubated on 07/15 and her antibiotics were escalated to Vanc and Meropenem (7/13-7/21) for presumed pneumonia. She continued to require high ventilator settings (100%, PEEP 16).  Her hospitalization was complicated by shock requiring vasopressors. On 7/17, patient was increasingly acidotic with pH 6.99 and PCO2 78 and was subsequently proned and paralyzed.  Her infectious work-up was positive for VRE bacteremia on 7/17 and candida in urine culture. On 7/21 she was transferred to MICU for hypoxic respiratory failure and COVID pneumonia. On arrival, she is sedated on mechanical ventilation...Acute Hypoxic Hypercapneic Respiratory Failure requiring Mechanical Ventilation (POA) COVID PNA (POA) History of COPD (POA) - Etiology: COVID PNA - COVID positive 6/29 - Fully vaccinated with Moderna vaccine prior to admission - s/p Remdesivir, convalescent plasma, dexamethasone - 7/15 Intubated at outside hospital - 7/17 Paralyzed and proned - CXR: bilateral diffuse patchy airspace disease - ABG on arrival: 7.43/53/65/35 on 80%, PEEP 10, PF 81 PLAN: - PAL, comp resp panel, Strep and Legionella urine Ag pending - Continue mechanical ventilation to optimize ventilation and oxygenation, maintain SpO2 >/= 92% - DuoNebs q4hr - Empiric broad spectrum antibiotics as outlined below: Linezolid and cefepime - Propofol and Dilaudid drips to facilitate tolerance of mechanical ventilation - Start DEXARDS protocol - Repeat ABG at 2000; prone if PF ratio not improved - Consider CT chest when clinically stable   VRE Bacteremia (POA) Sepsis (POA) Leukocytosis (POA) - Has received dexamethasone - Received the following courses abx: Vanc 6/29-7/10, 7/15- 7/21 Zosyn 6/29 - 7/8 Merrem 7/13-7/21 - BCx from 7/17 resulted for +VRE; transitioned to Linezolid prior to transfer - On vasopressors on 7/18 - WBC 26k, lactate here 1.2 - CXR: bilateral diffuse patchy airspace disease Plan: - PAN cultures: Bcx, UA, PAL, strep/legionella urinary Ag pending - Follow cultures; determine insertion date of PICC line - Empiric antibiotics with : Linezolid (start 7/21) and cefepime - ECHO pending   AKI (POA) - Scr on admission 0.96, up to 1.96 on 7/17  - Multifactorial AKI is likely related to sepsis PLAN:  - BMP here pending - Renal lytes pending - Renally dose medications, avoid contrast medications - Consult the renal team when appropriate      T2DM (POA) - HgbA1C pending - FSBG with correction SSI q6hr per ICU protocol"
	"1641622-1"	"1641622-1"	"BLOOD LACTIC ACID"	"10005632"	"50-59 years"	"50-59"	"Patient admitted 7/21/2021 for presents as transfer for acute hypoxic respiratory failure and covid pneumonia. Vaccinated for COVID 3/31/2021, tested positive 7/21/2021 Patient discharged, DEATH, 7/26/2021  Date of Vaccination:3/31/2021 & 3/10/2021 Dose: 2 doses total Vaccine Manufacturer: Pfizer Lot #: EN6202/EN6207 Clinic Administering Vaccine: unknown Injection site: R deltoid both times Description of event/reaction: patient died from severe ARDS from COVID-19   Patient initially presented on 06/29 with dyspnea, productive cough and wheezing. She reported having difficulty breathing for the last month, however, her symptoms progressively worsened after 6/26/21. Patient was found to be hypoxic on her home oxygen requirement of 3L to SpO2 52% upon arrival to ER. Of note, patient was discharged from a hospitalization on 6/22/21 (unknown reason for hospitalization, duration, and location).    Patient is reportedly fully vaccinated for COVID prior to her current admission and received her last vaccine in February 2021. She tested positive for COVID on 6/29 upon admission, and stated that her daughter had been sick recently and tested negative for COVID. Patient was started on Remdesivir, Decadron, Albuterol, Thiamine, Zinc, Quercetin complex, and Vitamin D. Patient was also started on Vapotherm for supplemental oxygen which was alternated with BiPAP, as well as empiric Vancomycin (6/29-7/10 and 7/15-7/21) and Zosyn (6/29-7/8). Patient was ultimately intubated on 07/15 and her antibiotics were escalated to Vanc and Meropenem (7/13-7/21) for presumed pneumonia. She continued to require high ventilator settings (100%, PEEP 16).  Her hospitalization was complicated by shock requiring vasopressors. On 7/17, patient was increasingly acidotic with pH 6.99 and PCO2 78 and was subsequently proned and paralyzed.  Her infectious work-up was positive for VRE bacteremia on 7/17 and candida in urine culture. On 7/21 she was transferred to MICU for hypoxic respiratory failure and COVID pneumonia. On arrival, she is sedated on mechanical ventilation...Acute Hypoxic Hypercapneic Respiratory Failure requiring Mechanical Ventilation (POA) COVID PNA (POA) History of COPD (POA) - Etiology: COVID PNA - COVID positive 6/29 - Fully vaccinated with Moderna vaccine prior to admission - s/p Remdesivir, convalescent plasma, dexamethasone - 7/15 Intubated at outside hospital - 7/17 Paralyzed and proned - CXR: bilateral diffuse patchy airspace disease - ABG on arrival: 7.43/53/65/35 on 80%, PEEP 10, PF 81 PLAN: - PAL, comp resp panel, Strep and Legionella urine Ag pending - Continue mechanical ventilation to optimize ventilation and oxygenation, maintain SpO2 >/= 92% - DuoNebs q4hr - Empiric broad spectrum antibiotics as outlined below: Linezolid and cefepime - Propofol and Dilaudid drips to facilitate tolerance of mechanical ventilation - Start DEXARDS protocol - Repeat ABG at 2000; prone if PF ratio not improved - Consider CT chest when clinically stable   VRE Bacteremia (POA) Sepsis (POA) Leukocytosis (POA) - Has received dexamethasone - Received the following courses abx: Vanc 6/29-7/10, 7/15- 7/21 Zosyn 6/29 - 7/8 Merrem 7/13-7/21 - BCx from 7/17 resulted for +VRE; transitioned to Linezolid prior to transfer - On vasopressors on 7/18 - WBC 26k, lactate here 1.2 - CXR: bilateral diffuse patchy airspace disease Plan: - PAN cultures: Bcx, UA, PAL, strep/legionella urinary Ag pending - Follow cultures; determine insertion date of PICC line - Empiric antibiotics with : Linezolid (start 7/21) and cefepime - ECHO pending   AKI (POA) - Scr on admission 0.96, up to 1.96 on 7/17  - Multifactorial AKI is likely related to sepsis PLAN:  - BMP here pending - Renal lytes pending - Renally dose medications, avoid contrast medications - Consult the renal team when appropriate      T2DM (POA) - HgbA1C pending - FSBG with correction SSI q6hr per ICU protocol"
	"1641622-1"	"1641622-1"	"BLOOD PH DECREASED"	"10005706"	"50-59 years"	"50-59"	"Patient admitted 7/21/2021 for presents as transfer for acute hypoxic respiratory failure and covid pneumonia. Vaccinated for COVID 3/31/2021, tested positive 7/21/2021 Patient discharged, DEATH, 7/26/2021  Date of Vaccination:3/31/2021 & 3/10/2021 Dose: 2 doses total Vaccine Manufacturer: Pfizer Lot #: EN6202/EN6207 Clinic Administering Vaccine: unknown Injection site: R deltoid both times Description of event/reaction: patient died from severe ARDS from COVID-19   Patient initially presented on 06/29 with dyspnea, productive cough and wheezing. She reported having difficulty breathing for the last month, however, her symptoms progressively worsened after 6/26/21. Patient was found to be hypoxic on her home oxygen requirement of 3L to SpO2 52% upon arrival to ER. Of note, patient was discharged from a hospitalization on 6/22/21 (unknown reason for hospitalization, duration, and location).    Patient is reportedly fully vaccinated for COVID prior to her current admission and received her last vaccine in February 2021. She tested positive for COVID on 6/29 upon admission, and stated that her daughter had been sick recently and tested negative for COVID. Patient was started on Remdesivir, Decadron, Albuterol, Thiamine, Zinc, Quercetin complex, and Vitamin D. Patient was also started on Vapotherm for supplemental oxygen which was alternated with BiPAP, as well as empiric Vancomycin (6/29-7/10 and 7/15-7/21) and Zosyn (6/29-7/8). Patient was ultimately intubated on 07/15 and her antibiotics were escalated to Vanc and Meropenem (7/13-7/21) for presumed pneumonia. She continued to require high ventilator settings (100%, PEEP 16).  Her hospitalization was complicated by shock requiring vasopressors. On 7/17, patient was increasingly acidotic with pH 6.99 and PCO2 78 and was subsequently proned and paralyzed.  Her infectious work-up was positive for VRE bacteremia on 7/17 and candida in urine culture. On 7/21 she was transferred to MICU for hypoxic respiratory failure and COVID pneumonia. On arrival, she is sedated on mechanical ventilation...Acute Hypoxic Hypercapneic Respiratory Failure requiring Mechanical Ventilation (POA) COVID PNA (POA) History of COPD (POA) - Etiology: COVID PNA - COVID positive 6/29 - Fully vaccinated with Moderna vaccine prior to admission - s/p Remdesivir, convalescent plasma, dexamethasone - 7/15 Intubated at outside hospital - 7/17 Paralyzed and proned - CXR: bilateral diffuse patchy airspace disease - ABG on arrival: 7.43/53/65/35 on 80%, PEEP 10, PF 81 PLAN: - PAL, comp resp panel, Strep and Legionella urine Ag pending - Continue mechanical ventilation to optimize ventilation and oxygenation, maintain SpO2 >/= 92% - DuoNebs q4hr - Empiric broad spectrum antibiotics as outlined below: Linezolid and cefepime - Propofol and Dilaudid drips to facilitate tolerance of mechanical ventilation - Start DEXARDS protocol - Repeat ABG at 2000; prone if PF ratio not improved - Consider CT chest when clinically stable   VRE Bacteremia (POA) Sepsis (POA) Leukocytosis (POA) - Has received dexamethasone - Received the following courses abx: Vanc 6/29-7/10, 7/15- 7/21 Zosyn 6/29 - 7/8 Merrem 7/13-7/21 - BCx from 7/17 resulted for +VRE; transitioned to Linezolid prior to transfer - On vasopressors on 7/18 - WBC 26k, lactate here 1.2 - CXR: bilateral diffuse patchy airspace disease Plan: - PAN cultures: Bcx, UA, PAL, strep/legionella urinary Ag pending - Follow cultures; determine insertion date of PICC line - Empiric antibiotics with : Linezolid (start 7/21) and cefepime - ECHO pending   AKI (POA) - Scr on admission 0.96, up to 1.96 on 7/17  - Multifactorial AKI is likely related to sepsis PLAN:  - BMP here pending - Renal lytes pending - Renally dose medications, avoid contrast medications - Consult the renal team when appropriate      T2DM (POA) - HgbA1C pending - FSBG with correction SSI q6hr per ICU protocol"
	"1641622-1"	"1641622-1"	"CHEST X-RAY ABNORMAL"	"10008499"	"50-59 years"	"50-59"	"Patient admitted 7/21/2021 for presents as transfer for acute hypoxic respiratory failure and covid pneumonia. Vaccinated for COVID 3/31/2021, tested positive 7/21/2021 Patient discharged, DEATH, 7/26/2021  Date of Vaccination:3/31/2021 & 3/10/2021 Dose: 2 doses total Vaccine Manufacturer: Pfizer Lot #: EN6202/EN6207 Clinic Administering Vaccine: unknown Injection site: R deltoid both times Description of event/reaction: patient died from severe ARDS from COVID-19   Patient initially presented on 06/29 with dyspnea, productive cough and wheezing. She reported having difficulty breathing for the last month, however, her symptoms progressively worsened after 6/26/21. Patient was found to be hypoxic on her home oxygen requirement of 3L to SpO2 52% upon arrival to ER. Of note, patient was discharged from a hospitalization on 6/22/21 (unknown reason for hospitalization, duration, and location).    Patient is reportedly fully vaccinated for COVID prior to her current admission and received her last vaccine in February 2021. She tested positive for COVID on 6/29 upon admission, and stated that her daughter had been sick recently and tested negative for COVID. Patient was started on Remdesivir, Decadron, Albuterol, Thiamine, Zinc, Quercetin complex, and Vitamin D. Patient was also started on Vapotherm for supplemental oxygen which was alternated with BiPAP, as well as empiric Vancomycin (6/29-7/10 and 7/15-7/21) and Zosyn (6/29-7/8). Patient was ultimately intubated on 07/15 and her antibiotics were escalated to Vanc and Meropenem (7/13-7/21) for presumed pneumonia. She continued to require high ventilator settings (100%, PEEP 16).  Her hospitalization was complicated by shock requiring vasopressors. On 7/17, patient was increasingly acidotic with pH 6.99 and PCO2 78 and was subsequently proned and paralyzed.  Her infectious work-up was positive for VRE bacteremia on 7/17 and candida in urine culture. On 7/21 she was transferred to MICU for hypoxic respiratory failure and COVID pneumonia. On arrival, she is sedated on mechanical ventilation...Acute Hypoxic Hypercapneic Respiratory Failure requiring Mechanical Ventilation (POA) COVID PNA (POA) History of COPD (POA) - Etiology: COVID PNA - COVID positive 6/29 - Fully vaccinated with Moderna vaccine prior to admission - s/p Remdesivir, convalescent plasma, dexamethasone - 7/15 Intubated at outside hospital - 7/17 Paralyzed and proned - CXR: bilateral diffuse patchy airspace disease - ABG on arrival: 7.43/53/65/35 on 80%, PEEP 10, PF 81 PLAN: - PAL, comp resp panel, Strep and Legionella urine Ag pending - Continue mechanical ventilation to optimize ventilation and oxygenation, maintain SpO2 >/= 92% - DuoNebs q4hr - Empiric broad spectrum antibiotics as outlined below: Linezolid and cefepime - Propofol and Dilaudid drips to facilitate tolerance of mechanical ventilation - Start DEXARDS protocol - Repeat ABG at 2000; prone if PF ratio not improved - Consider CT chest when clinically stable   VRE Bacteremia (POA) Sepsis (POA) Leukocytosis (POA) - Has received dexamethasone - Received the following courses abx: Vanc 6/29-7/10, 7/15- 7/21 Zosyn 6/29 - 7/8 Merrem 7/13-7/21 - BCx from 7/17 resulted for +VRE; transitioned to Linezolid prior to transfer - On vasopressors on 7/18 - WBC 26k, lactate here 1.2 - CXR: bilateral diffuse patchy airspace disease Plan: - PAN cultures: Bcx, UA, PAL, strep/legionella urinary Ag pending - Follow cultures; determine insertion date of PICC line - Empiric antibiotics with : Linezolid (start 7/21) and cefepime - ECHO pending   AKI (POA) - Scr on admission 0.96, up to 1.96 on 7/17  - Multifactorial AKI is likely related to sepsis PLAN:  - BMP here pending - Renal lytes pending - Renally dose medications, avoid contrast medications - Consult the renal team when appropriate      T2DM (POA) - HgbA1C pending - FSBG with correction SSI q6hr per ICU protocol"
	"1641622-1"	"1641622-1"	"CONVALESCENT PLASMA TRANSFUSION"	"10084817"	"50-59 years"	"50-59"	"Patient admitted 7/21/2021 for presents as transfer for acute hypoxic respiratory failure and covid pneumonia. Vaccinated for COVID 3/31/2021, tested positive 7/21/2021 Patient discharged, DEATH, 7/26/2021  Date of Vaccination:3/31/2021 & 3/10/2021 Dose: 2 doses total Vaccine Manufacturer: Pfizer Lot #: EN6202/EN6207 Clinic Administering Vaccine: unknown Injection site: R deltoid both times Description of event/reaction: patient died from severe ARDS from COVID-19   Patient initially presented on 06/29 with dyspnea, productive cough and wheezing. She reported having difficulty breathing for the last month, however, her symptoms progressively worsened after 6/26/21. Patient was found to be hypoxic on her home oxygen requirement of 3L to SpO2 52% upon arrival to ER. Of note, patient was discharged from a hospitalization on 6/22/21 (unknown reason for hospitalization, duration, and location).    Patient is reportedly fully vaccinated for COVID prior to her current admission and received her last vaccine in February 2021. She tested positive for COVID on 6/29 upon admission, and stated that her daughter had been sick recently and tested negative for COVID. Patient was started on Remdesivir, Decadron, Albuterol, Thiamine, Zinc, Quercetin complex, and Vitamin D. Patient was also started on Vapotherm for supplemental oxygen which was alternated with BiPAP, as well as empiric Vancomycin (6/29-7/10 and 7/15-7/21) and Zosyn (6/29-7/8). Patient was ultimately intubated on 07/15 and her antibiotics were escalated to Vanc and Meropenem (7/13-7/21) for presumed pneumonia. She continued to require high ventilator settings (100%, PEEP 16).  Her hospitalization was complicated by shock requiring vasopressors. On 7/17, patient was increasingly acidotic with pH 6.99 and PCO2 78 and was subsequently proned and paralyzed.  Her infectious work-up was positive for VRE bacteremia on 7/17 and candida in urine culture. On 7/21 she was transferred to MICU for hypoxic respiratory failure and COVID pneumonia. On arrival, she is sedated on mechanical ventilation...Acute Hypoxic Hypercapneic Respiratory Failure requiring Mechanical Ventilation (POA) COVID PNA (POA) History of COPD (POA) - Etiology: COVID PNA - COVID positive 6/29 - Fully vaccinated with Moderna vaccine prior to admission - s/p Remdesivir, convalescent plasma, dexamethasone - 7/15 Intubated at outside hospital - 7/17 Paralyzed and proned - CXR: bilateral diffuse patchy airspace disease - ABG on arrival: 7.43/53/65/35 on 80%, PEEP 10, PF 81 PLAN: - PAL, comp resp panel, Strep and Legionella urine Ag pending - Continue mechanical ventilation to optimize ventilation and oxygenation, maintain SpO2 >/= 92% - DuoNebs q4hr - Empiric broad spectrum antibiotics as outlined below: Linezolid and cefepime - Propofol and Dilaudid drips to facilitate tolerance of mechanical ventilation - Start DEXARDS protocol - Repeat ABG at 2000; prone if PF ratio not improved - Consider CT chest when clinically stable   VRE Bacteremia (POA) Sepsis (POA) Leukocytosis (POA) - Has received dexamethasone - Received the following courses abx: Vanc 6/29-7/10, 7/15- 7/21 Zosyn 6/29 - 7/8 Merrem 7/13-7/21 - BCx from 7/17 resulted for +VRE; transitioned to Linezolid prior to transfer - On vasopressors on 7/18 - WBC 26k, lactate here 1.2 - CXR: bilateral diffuse patchy airspace disease Plan: - PAN cultures: Bcx, UA, PAL, strep/legionella urinary Ag pending - Follow cultures; determine insertion date of PICC line - Empiric antibiotics with : Linezolid (start 7/21) and cefepime - ECHO pending   AKI (POA) - Scr on admission 0.96, up to 1.96 on 7/17  - Multifactorial AKI is likely related to sepsis PLAN:  - BMP here pending - Renal lytes pending - Renally dose medications, avoid contrast medications - Consult the renal team when appropriate      T2DM (POA) - HgbA1C pending - FSBG with correction SSI q6hr per ICU protocol"
	"1641622-1"	"1641622-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Patient admitted 7/21/2021 for presents as transfer for acute hypoxic respiratory failure and covid pneumonia. Vaccinated for COVID 3/31/2021, tested positive 7/21/2021 Patient discharged, DEATH, 7/26/2021  Date of Vaccination:3/31/2021 & 3/10/2021 Dose: 2 doses total Vaccine Manufacturer: Pfizer Lot #: EN6202/EN6207 Clinic Administering Vaccine: unknown Injection site: R deltoid both times Description of event/reaction: patient died from severe ARDS from COVID-19   Patient initially presented on 06/29 with dyspnea, productive cough and wheezing. She reported having difficulty breathing for the last month, however, her symptoms progressively worsened after 6/26/21. Patient was found to be hypoxic on her home oxygen requirement of 3L to SpO2 52% upon arrival to ER. Of note, patient was discharged from a hospitalization on 6/22/21 (unknown reason for hospitalization, duration, and location).    Patient is reportedly fully vaccinated for COVID prior to her current admission and received her last vaccine in February 2021. She tested positive for COVID on 6/29 upon admission, and stated that her daughter had been sick recently and tested negative for COVID. Patient was started on Remdesivir, Decadron, Albuterol, Thiamine, Zinc, Quercetin complex, and Vitamin D. Patient was also started on Vapotherm for supplemental oxygen which was alternated with BiPAP, as well as empiric Vancomycin (6/29-7/10 and 7/15-7/21) and Zosyn (6/29-7/8). Patient was ultimately intubated on 07/15 and her antibiotics were escalated to Vanc and Meropenem (7/13-7/21) for presumed pneumonia. She continued to require high ventilator settings (100%, PEEP 16).  Her hospitalization was complicated by shock requiring vasopressors. On 7/17, patient was increasingly acidotic with pH 6.99 and PCO2 78 and was subsequently proned and paralyzed.  Her infectious work-up was positive for VRE bacteremia on 7/17 and candida in urine culture. On 7/21 she was transferred to MICU for hypoxic respiratory failure and COVID pneumonia. On arrival, she is sedated on mechanical ventilation...Acute Hypoxic Hypercapneic Respiratory Failure requiring Mechanical Ventilation (POA) COVID PNA (POA) History of COPD (POA) - Etiology: COVID PNA - COVID positive 6/29 - Fully vaccinated with Moderna vaccine prior to admission - s/p Remdesivir, convalescent plasma, dexamethasone - 7/15 Intubated at outside hospital - 7/17 Paralyzed and proned - CXR: bilateral diffuse patchy airspace disease - ABG on arrival: 7.43/53/65/35 on 80%, PEEP 10, PF 81 PLAN: - PAL, comp resp panel, Strep and Legionella urine Ag pending - Continue mechanical ventilation to optimize ventilation and oxygenation, maintain SpO2 >/= 92% - DuoNebs q4hr - Empiric broad spectrum antibiotics as outlined below: Linezolid and cefepime - Propofol and Dilaudid drips to facilitate tolerance of mechanical ventilation - Start DEXARDS protocol - Repeat ABG at 2000; prone if PF ratio not improved - Consider CT chest when clinically stable   VRE Bacteremia (POA) Sepsis (POA) Leukocytosis (POA) - Has received dexamethasone - Received the following courses abx: Vanc 6/29-7/10, 7/15- 7/21 Zosyn 6/29 - 7/8 Merrem 7/13-7/21 - BCx from 7/17 resulted for +VRE; transitioned to Linezolid prior to transfer - On vasopressors on 7/18 - WBC 26k, lactate here 1.2 - CXR: bilateral diffuse patchy airspace disease Plan: - PAN cultures: Bcx, UA, PAL, strep/legionella urinary Ag pending - Follow cultures; determine insertion date of PICC line - Empiric antibiotics with : Linezolid (start 7/21) and cefepime - ECHO pending   AKI (POA) - Scr on admission 0.96, up to 1.96 on 7/17  - Multifactorial AKI is likely related to sepsis PLAN:  - BMP here pending - Renal lytes pending - Renally dose medications, avoid contrast medications - Consult the renal team when appropriate      T2DM (POA) - HgbA1C pending - FSBG with correction SSI q6hr per ICU protocol"
	"1641622-1"	"1641622-1"	"COVID-19 PNEUMONIA"	"10084380"	"50-59 years"	"50-59"	"Patient admitted 7/21/2021 for presents as transfer for acute hypoxic respiratory failure and covid pneumonia. Vaccinated for COVID 3/31/2021, tested positive 7/21/2021 Patient discharged, DEATH, 7/26/2021  Date of Vaccination:3/31/2021 & 3/10/2021 Dose: 2 doses total Vaccine Manufacturer: Pfizer Lot #: EN6202/EN6207 Clinic Administering Vaccine: unknown Injection site: R deltoid both times Description of event/reaction: patient died from severe ARDS from COVID-19   Patient initially presented on 06/29 with dyspnea, productive cough and wheezing. She reported having difficulty breathing for the last month, however, her symptoms progressively worsened after 6/26/21. Patient was found to be hypoxic on her home oxygen requirement of 3L to SpO2 52% upon arrival to ER. Of note, patient was discharged from a hospitalization on 6/22/21 (unknown reason for hospitalization, duration, and location).    Patient is reportedly fully vaccinated for COVID prior to her current admission and received her last vaccine in February 2021. She tested positive for COVID on 6/29 upon admission, and stated that her daughter had been sick recently and tested negative for COVID. Patient was started on Remdesivir, Decadron, Albuterol, Thiamine, Zinc, Quercetin complex, and Vitamin D. Patient was also started on Vapotherm for supplemental oxygen which was alternated with BiPAP, as well as empiric Vancomycin (6/29-7/10 and 7/15-7/21) and Zosyn (6/29-7/8). Patient was ultimately intubated on 07/15 and her antibiotics were escalated to Vanc and Meropenem (7/13-7/21) for presumed pneumonia. She continued to require high ventilator settings (100%, PEEP 16).  Her hospitalization was complicated by shock requiring vasopressors. On 7/17, patient was increasingly acidotic with pH 6.99 and PCO2 78 and was subsequently proned and paralyzed.  Her infectious work-up was positive for VRE bacteremia on 7/17 and candida in urine culture. On 7/21 she was transferred to MICU for hypoxic respiratory failure and COVID pneumonia. On arrival, she is sedated on mechanical ventilation...Acute Hypoxic Hypercapneic Respiratory Failure requiring Mechanical Ventilation (POA) COVID PNA (POA) History of COPD (POA) - Etiology: COVID PNA - COVID positive 6/29 - Fully vaccinated with Moderna vaccine prior to admission - s/p Remdesivir, convalescent plasma, dexamethasone - 7/15 Intubated at outside hospital - 7/17 Paralyzed and proned - CXR: bilateral diffuse patchy airspace disease - ABG on arrival: 7.43/53/65/35 on 80%, PEEP 10, PF 81 PLAN: - PAL, comp resp panel, Strep and Legionella urine Ag pending - Continue mechanical ventilation to optimize ventilation and oxygenation, maintain SpO2 >/= 92% - DuoNebs q4hr - Empiric broad spectrum antibiotics as outlined below: Linezolid and cefepime - Propofol and Dilaudid drips to facilitate tolerance of mechanical ventilation - Start DEXARDS protocol - Repeat ABG at 2000; prone if PF ratio not improved - Consider CT chest when clinically stable   VRE Bacteremia (POA) Sepsis (POA) Leukocytosis (POA) - Has received dexamethasone - Received the following courses abx: Vanc 6/29-7/10, 7/15- 7/21 Zosyn 6/29 - 7/8 Merrem 7/13-7/21 - BCx from 7/17 resulted for +VRE; transitioned to Linezolid prior to transfer - On vasopressors on 7/18 - WBC 26k, lactate here 1.2 - CXR: bilateral diffuse patchy airspace disease Plan: - PAN cultures: Bcx, UA, PAL, strep/legionella urinary Ag pending - Follow cultures; determine insertion date of PICC line - Empiric antibiotics with : Linezolid (start 7/21) and cefepime - ECHO pending   AKI (POA) - Scr on admission 0.96, up to 1.96 on 7/17  - Multifactorial AKI is likely related to sepsis PLAN:  - BMP here pending - Renal lytes pending - Renally dose medications, avoid contrast medications - Consult the renal team when appropriate      T2DM (POA) - HgbA1C pending - FSBG with correction SSI q6hr per ICU protocol"
	"1641622-1"	"1641622-1"	"CULTURE"	"10061447"	"50-59 years"	"50-59"	"Patient admitted 7/21/2021 for presents as transfer for acute hypoxic respiratory failure and covid pneumonia. Vaccinated for COVID 3/31/2021, tested positive 7/21/2021 Patient discharged, DEATH, 7/26/2021  Date of Vaccination:3/31/2021 & 3/10/2021 Dose: 2 doses total Vaccine Manufacturer: Pfizer Lot #: EN6202/EN6207 Clinic Administering Vaccine: unknown Injection site: R deltoid both times Description of event/reaction: patient died from severe ARDS from COVID-19   Patient initially presented on 06/29 with dyspnea, productive cough and wheezing. She reported having difficulty breathing for the last month, however, her symptoms progressively worsened after 6/26/21. Patient was found to be hypoxic on her home oxygen requirement of 3L to SpO2 52% upon arrival to ER. Of note, patient was discharged from a hospitalization on 6/22/21 (unknown reason for hospitalization, duration, and location).    Patient is reportedly fully vaccinated for COVID prior to her current admission and received her last vaccine in February 2021. She tested positive for COVID on 6/29 upon admission, and stated that her daughter had been sick recently and tested negative for COVID. Patient was started on Remdesivir, Decadron, Albuterol, Thiamine, Zinc, Quercetin complex, and Vitamin D. Patient was also started on Vapotherm for supplemental oxygen which was alternated with BiPAP, as well as empiric Vancomycin (6/29-7/10 and 7/15-7/21) and Zosyn (6/29-7/8). Patient was ultimately intubated on 07/15 and her antibiotics were escalated to Vanc and Meropenem (7/13-7/21) for presumed pneumonia. She continued to require high ventilator settings (100%, PEEP 16).  Her hospitalization was complicated by shock requiring vasopressors. On 7/17, patient was increasingly acidotic with pH 6.99 and PCO2 78 and was subsequently proned and paralyzed.  Her infectious work-up was positive for VRE bacteremia on 7/17 and candida in urine culture. On 7/21 she was transferred to MICU for hypoxic respiratory failure and COVID pneumonia. On arrival, she is sedated on mechanical ventilation...Acute Hypoxic Hypercapneic Respiratory Failure requiring Mechanical Ventilation (POA) COVID PNA (POA) History of COPD (POA) - Etiology: COVID PNA - COVID positive 6/29 - Fully vaccinated with Moderna vaccine prior to admission - s/p Remdesivir, convalescent plasma, dexamethasone - 7/15 Intubated at outside hospital - 7/17 Paralyzed and proned - CXR: bilateral diffuse patchy airspace disease - ABG on arrival: 7.43/53/65/35 on 80%, PEEP 10, PF 81 PLAN: - PAL, comp resp panel, Strep and Legionella urine Ag pending - Continue mechanical ventilation to optimize ventilation and oxygenation, maintain SpO2 >/= 92% - DuoNebs q4hr - Empiric broad spectrum antibiotics as outlined below: Linezolid and cefepime - Propofol and Dilaudid drips to facilitate tolerance of mechanical ventilation - Start DEXARDS protocol - Repeat ABG at 2000; prone if PF ratio not improved - Consider CT chest when clinically stable   VRE Bacteremia (POA) Sepsis (POA) Leukocytosis (POA) - Has received dexamethasone - Received the following courses abx: Vanc 6/29-7/10, 7/15- 7/21 Zosyn 6/29 - 7/8 Merrem 7/13-7/21 - BCx from 7/17 resulted for +VRE; transitioned to Linezolid prior to transfer - On vasopressors on 7/18 - WBC 26k, lactate here 1.2 - CXR: bilateral diffuse patchy airspace disease Plan: - PAN cultures: Bcx, UA, PAL, strep/legionella urinary Ag pending - Follow cultures; determine insertion date of PICC line - Empiric antibiotics with : Linezolid (start 7/21) and cefepime - ECHO pending   AKI (POA) - Scr on admission 0.96, up to 1.96 on 7/17  - Multifactorial AKI is likely related to sepsis PLAN:  - BMP here pending - Renal lytes pending - Renally dose medications, avoid contrast medications - Consult the renal team when appropriate      T2DM (POA) - HgbA1C pending - FSBG with correction SSI q6hr per ICU protocol"
	"1641622-1"	"1641622-1"	"CULTURE URINE POSITIVE"	"10011640"	"50-59 years"	"50-59"	"Patient admitted 7/21/2021 for presents as transfer for acute hypoxic respiratory failure and covid pneumonia. Vaccinated for COVID 3/31/2021, tested positive 7/21/2021 Patient discharged, DEATH, 7/26/2021  Date of Vaccination:3/31/2021 & 3/10/2021 Dose: 2 doses total Vaccine Manufacturer: Pfizer Lot #: EN6202/EN6207 Clinic Administering Vaccine: unknown Injection site: R deltoid both times Description of event/reaction: patient died from severe ARDS from COVID-19   Patient initially presented on 06/29 with dyspnea, productive cough and wheezing. She reported having difficulty breathing for the last month, however, her symptoms progressively worsened after 6/26/21. Patient was found to be hypoxic on her home oxygen requirement of 3L to SpO2 52% upon arrival to ER. Of note, patient was discharged from a hospitalization on 6/22/21 (unknown reason for hospitalization, duration, and location).    Patient is reportedly fully vaccinated for COVID prior to her current admission and received her last vaccine in February 2021. She tested positive for COVID on 6/29 upon admission, and stated that her daughter had been sick recently and tested negative for COVID. Patient was started on Remdesivir, Decadron, Albuterol, Thiamine, Zinc, Quercetin complex, and Vitamin D. Patient was also started on Vapotherm for supplemental oxygen which was alternated with BiPAP, as well as empiric Vancomycin (6/29-7/10 and 7/15-7/21) and Zosyn (6/29-7/8). Patient was ultimately intubated on 07/15 and her antibiotics were escalated to Vanc and Meropenem (7/13-7/21) for presumed pneumonia. She continued to require high ventilator settings (100%, PEEP 16).  Her hospitalization was complicated by shock requiring vasopressors. On 7/17, patient was increasingly acidotic with pH 6.99 and PCO2 78 and was subsequently proned and paralyzed.  Her infectious work-up was positive for VRE bacteremia on 7/17 and candida in urine culture. On 7/21 she was transferred to MICU for hypoxic respiratory failure and COVID pneumonia. On arrival, she is sedated on mechanical ventilation...Acute Hypoxic Hypercapneic Respiratory Failure requiring Mechanical Ventilation (POA) COVID PNA (POA) History of COPD (POA) - Etiology: COVID PNA - COVID positive 6/29 - Fully vaccinated with Moderna vaccine prior to admission - s/p Remdesivir, convalescent plasma, dexamethasone - 7/15 Intubated at outside hospital - 7/17 Paralyzed and proned - CXR: bilateral diffuse patchy airspace disease - ABG on arrival: 7.43/53/65/35 on 80%, PEEP 10, PF 81 PLAN: - PAL, comp resp panel, Strep and Legionella urine Ag pending - Continue mechanical ventilation to optimize ventilation and oxygenation, maintain SpO2 >/= 92% - DuoNebs q4hr - Empiric broad spectrum antibiotics as outlined below: Linezolid and cefepime - Propofol and Dilaudid drips to facilitate tolerance of mechanical ventilation - Start DEXARDS protocol - Repeat ABG at 2000; prone if PF ratio not improved - Consider CT chest when clinically stable   VRE Bacteremia (POA) Sepsis (POA) Leukocytosis (POA) - Has received dexamethasone - Received the following courses abx: Vanc 6/29-7/10, 7/15- 7/21 Zosyn 6/29 - 7/8 Merrem 7/13-7/21 - BCx from 7/17 resulted for +VRE; transitioned to Linezolid prior to transfer - On vasopressors on 7/18 - WBC 26k, lactate here 1.2 - CXR: bilateral diffuse patchy airspace disease Plan: - PAN cultures: Bcx, UA, PAL, strep/legionella urinary Ag pending - Follow cultures; determine insertion date of PICC line - Empiric antibiotics with : Linezolid (start 7/21) and cefepime - ECHO pending   AKI (POA) - Scr on admission 0.96, up to 1.96 on 7/17  - Multifactorial AKI is likely related to sepsis PLAN:  - BMP here pending - Renal lytes pending - Renally dose medications, avoid contrast medications - Consult the renal team when appropriate      T2DM (POA) - HgbA1C pending - FSBG with correction SSI q6hr per ICU protocol"
	"1641622-1"	"1641622-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient admitted 7/21/2021 for presents as transfer for acute hypoxic respiratory failure and covid pneumonia. Vaccinated for COVID 3/31/2021, tested positive 7/21/2021 Patient discharged, DEATH, 7/26/2021  Date of Vaccination:3/31/2021 & 3/10/2021 Dose: 2 doses total Vaccine Manufacturer: Pfizer Lot #: EN6202/EN6207 Clinic Administering Vaccine: unknown Injection site: R deltoid both times Description of event/reaction: patient died from severe ARDS from COVID-19   Patient initially presented on 06/29 with dyspnea, productive cough and wheezing. She reported having difficulty breathing for the last month, however, her symptoms progressively worsened after 6/26/21. Patient was found to be hypoxic on her home oxygen requirement of 3L to SpO2 52% upon arrival to ER. Of note, patient was discharged from a hospitalization on 6/22/21 (unknown reason for hospitalization, duration, and location).    Patient is reportedly fully vaccinated for COVID prior to her current admission and received her last vaccine in February 2021. She tested positive for COVID on 6/29 upon admission, and stated that her daughter had been sick recently and tested negative for COVID. Patient was started on Remdesivir, Decadron, Albuterol, Thiamine, Zinc, Quercetin complex, and Vitamin D. Patient was also started on Vapotherm for supplemental oxygen which was alternated with BiPAP, as well as empiric Vancomycin (6/29-7/10 and 7/15-7/21) and Zosyn (6/29-7/8). Patient was ultimately intubated on 07/15 and her antibiotics were escalated to Vanc and Meropenem (7/13-7/21) for presumed pneumonia. She continued to require high ventilator settings (100%, PEEP 16).  Her hospitalization was complicated by shock requiring vasopressors. On 7/17, patient was increasingly acidotic with pH 6.99 and PCO2 78 and was subsequently proned and paralyzed.  Her infectious work-up was positive for VRE bacteremia on 7/17 and candida in urine culture. On 7/21 she was transferred to MICU for hypoxic respiratory failure and COVID pneumonia. On arrival, she is sedated on mechanical ventilation...Acute Hypoxic Hypercapneic Respiratory Failure requiring Mechanical Ventilation (POA) COVID PNA (POA) History of COPD (POA) - Etiology: COVID PNA - COVID positive 6/29 - Fully vaccinated with Moderna vaccine prior to admission - s/p Remdesivir, convalescent plasma, dexamethasone - 7/15 Intubated at outside hospital - 7/17 Paralyzed and proned - CXR: bilateral diffuse patchy airspace disease - ABG on arrival: 7.43/53/65/35 on 80%, PEEP 10, PF 81 PLAN: - PAL, comp resp panel, Strep and Legionella urine Ag pending - Continue mechanical ventilation to optimize ventilation and oxygenation, maintain SpO2 >/= 92% - DuoNebs q4hr - Empiric broad spectrum antibiotics as outlined below: Linezolid and cefepime - Propofol and Dilaudid drips to facilitate tolerance of mechanical ventilation - Start DEXARDS protocol - Repeat ABG at 2000; prone if PF ratio not improved - Consider CT chest when clinically stable   VRE Bacteremia (POA) Sepsis (POA) Leukocytosis (POA) - Has received dexamethasone - Received the following courses abx: Vanc 6/29-7/10, 7/15- 7/21 Zosyn 6/29 - 7/8 Merrem 7/13-7/21 - BCx from 7/17 resulted for +VRE; transitioned to Linezolid prior to transfer - On vasopressors on 7/18 - WBC 26k, lactate here 1.2 - CXR: bilateral diffuse patchy airspace disease Plan: - PAN cultures: Bcx, UA, PAL, strep/legionella urinary Ag pending - Follow cultures; determine insertion date of PICC line - Empiric antibiotics with : Linezolid (start 7/21) and cefepime - ECHO pending   AKI (POA) - Scr on admission 0.96, up to 1.96 on 7/17  - Multifactorial AKI is likely related to sepsis PLAN:  - BMP here pending - Renal lytes pending - Renally dose medications, avoid contrast medications - Consult the renal team when appropriate      T2DM (POA) - HgbA1C pending - FSBG with correction SSI q6hr per ICU protocol"
	"1641622-1"	"1641622-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"Patient admitted 7/21/2021 for presents as transfer for acute hypoxic respiratory failure and covid pneumonia. Vaccinated for COVID 3/31/2021, tested positive 7/21/2021 Patient discharged, DEATH, 7/26/2021  Date of Vaccination:3/31/2021 & 3/10/2021 Dose: 2 doses total Vaccine Manufacturer: Pfizer Lot #: EN6202/EN6207 Clinic Administering Vaccine: unknown Injection site: R deltoid both times Description of event/reaction: patient died from severe ARDS from COVID-19   Patient initially presented on 06/29 with dyspnea, productive cough and wheezing. She reported having difficulty breathing for the last month, however, her symptoms progressively worsened after 6/26/21. Patient was found to be hypoxic on her home oxygen requirement of 3L to SpO2 52% upon arrival to ER. Of note, patient was discharged from a hospitalization on 6/22/21 (unknown reason for hospitalization, duration, and location).    Patient is reportedly fully vaccinated for COVID prior to her current admission and received her last vaccine in February 2021. She tested positive for COVID on 6/29 upon admission, and stated that her daughter had been sick recently and tested negative for COVID. Patient was started on Remdesivir, Decadron, Albuterol, Thiamine, Zinc, Quercetin complex, and Vitamin D. Patient was also started on Vapotherm for supplemental oxygen which was alternated with BiPAP, as well as empiric Vancomycin (6/29-7/10 and 7/15-7/21) and Zosyn (6/29-7/8). Patient was ultimately intubated on 07/15 and her antibiotics were escalated to Vanc and Meropenem (7/13-7/21) for presumed pneumonia. She continued to require high ventilator settings (100%, PEEP 16).  Her hospitalization was complicated by shock requiring vasopressors. On 7/17, patient was increasingly acidotic with pH 6.99 and PCO2 78 and was subsequently proned and paralyzed.  Her infectious work-up was positive for VRE bacteremia on 7/17 and candida in urine culture. On 7/21 she was transferred to MICU for hypoxic respiratory failure and COVID pneumonia. On arrival, she is sedated on mechanical ventilation...Acute Hypoxic Hypercapneic Respiratory Failure requiring Mechanical Ventilation (POA) COVID PNA (POA) History of COPD (POA) - Etiology: COVID PNA - COVID positive 6/29 - Fully vaccinated with Moderna vaccine prior to admission - s/p Remdesivir, convalescent plasma, dexamethasone - 7/15 Intubated at outside hospital - 7/17 Paralyzed and proned - CXR: bilateral diffuse patchy airspace disease - ABG on arrival: 7.43/53/65/35 on 80%, PEEP 10, PF 81 PLAN: - PAL, comp resp panel, Strep and Legionella urine Ag pending - Continue mechanical ventilation to optimize ventilation and oxygenation, maintain SpO2 >/= 92% - DuoNebs q4hr - Empiric broad spectrum antibiotics as outlined below: Linezolid and cefepime - Propofol and Dilaudid drips to facilitate tolerance of mechanical ventilation - Start DEXARDS protocol - Repeat ABG at 2000; prone if PF ratio not improved - Consider CT chest when clinically stable   VRE Bacteremia (POA) Sepsis (POA) Leukocytosis (POA) - Has received dexamethasone - Received the following courses abx: Vanc 6/29-7/10, 7/15- 7/21 Zosyn 6/29 - 7/8 Merrem 7/13-7/21 - BCx from 7/17 resulted for +VRE; transitioned to Linezolid prior to transfer - On vasopressors on 7/18 - WBC 26k, lactate here 1.2 - CXR: bilateral diffuse patchy airspace disease Plan: - PAN cultures: Bcx, UA, PAL, strep/legionella urinary Ag pending - Follow cultures; determine insertion date of PICC line - Empiric antibiotics with : Linezolid (start 7/21) and cefepime - ECHO pending   AKI (POA) - Scr on admission 0.96, up to 1.96 on 7/17  - Multifactorial AKI is likely related to sepsis PLAN:  - BMP here pending - Renal lytes pending - Renally dose medications, avoid contrast medications - Consult the renal team when appropriate      T2DM (POA) - HgbA1C pending - FSBG with correction SSI q6hr per ICU protocol"
	"1641622-1"	"1641622-1"	"ECHOCARDIOGRAM"	"10014113"	"50-59 years"	"50-59"	"Patient admitted 7/21/2021 for presents as transfer for acute hypoxic respiratory failure and covid pneumonia. Vaccinated for COVID 3/31/2021, tested positive 7/21/2021 Patient discharged, DEATH, 7/26/2021  Date of Vaccination:3/31/2021 & 3/10/2021 Dose: 2 doses total Vaccine Manufacturer: Pfizer Lot #: EN6202/EN6207 Clinic Administering Vaccine: unknown Injection site: R deltoid both times Description of event/reaction: patient died from severe ARDS from COVID-19   Patient initially presented on 06/29 with dyspnea, productive cough and wheezing. She reported having difficulty breathing for the last month, however, her symptoms progressively worsened after 6/26/21. Patient was found to be hypoxic on her home oxygen requirement of 3L to SpO2 52% upon arrival to ER. Of note, patient was discharged from a hospitalization on 6/22/21 (unknown reason for hospitalization, duration, and location).    Patient is reportedly fully vaccinated for COVID prior to her current admission and received her last vaccine in February 2021. She tested positive for COVID on 6/29 upon admission, and stated that her daughter had been sick recently and tested negative for COVID. Patient was started on Remdesivir, Decadron, Albuterol, Thiamine, Zinc, Quercetin complex, and Vitamin D. Patient was also started on Vapotherm for supplemental oxygen which was alternated with BiPAP, as well as empiric Vancomycin (6/29-7/10 and 7/15-7/21) and Zosyn (6/29-7/8). Patient was ultimately intubated on 07/15 and her antibiotics were escalated to Vanc and Meropenem (7/13-7/21) for presumed pneumonia. She continued to require high ventilator settings (100%, PEEP 16).  Her hospitalization was complicated by shock requiring vasopressors. On 7/17, patient was increasingly acidotic with pH 6.99 and PCO2 78 and was subsequently proned and paralyzed.  Her infectious work-up was positive for VRE bacteremia on 7/17 and candida in urine culture. On 7/21 she was transferred to MICU for hypoxic respiratory failure and COVID pneumonia. On arrival, she is sedated on mechanical ventilation...Acute Hypoxic Hypercapneic Respiratory Failure requiring Mechanical Ventilation (POA) COVID PNA (POA) History of COPD (POA) - Etiology: COVID PNA - COVID positive 6/29 - Fully vaccinated with Moderna vaccine prior to admission - s/p Remdesivir, convalescent plasma, dexamethasone - 7/15 Intubated at outside hospital - 7/17 Paralyzed and proned - CXR: bilateral diffuse patchy airspace disease - ABG on arrival: 7.43/53/65/35 on 80%, PEEP 10, PF 81 PLAN: - PAL, comp resp panel, Strep and Legionella urine Ag pending - Continue mechanical ventilation to optimize ventilation and oxygenation, maintain SpO2 >/= 92% - DuoNebs q4hr - Empiric broad spectrum antibiotics as outlined below: Linezolid and cefepime - Propofol and Dilaudid drips to facilitate tolerance of mechanical ventilation - Start DEXARDS protocol - Repeat ABG at 2000; prone if PF ratio not improved - Consider CT chest when clinically stable   VRE Bacteremia (POA) Sepsis (POA) Leukocytosis (POA) - Has received dexamethasone - Received the following courses abx: Vanc 6/29-7/10, 7/15- 7/21 Zosyn 6/29 - 7/8 Merrem 7/13-7/21 - BCx from 7/17 resulted for +VRE; transitioned to Linezolid prior to transfer - On vasopressors on 7/18 - WBC 26k, lactate here 1.2 - CXR: bilateral diffuse patchy airspace disease Plan: - PAN cultures: Bcx, UA, PAL, strep/legionella urinary Ag pending - Follow cultures; determine insertion date of PICC line - Empiric antibiotics with : Linezolid (start 7/21) and cefepime - ECHO pending   AKI (POA) - Scr on admission 0.96, up to 1.96 on 7/17  - Multifactorial AKI is likely related to sepsis PLAN:  - BMP here pending - Renal lytes pending - Renally dose medications, avoid contrast medications - Consult the renal team when appropriate      T2DM (POA) - HgbA1C pending - FSBG with correction SSI q6hr per ICU protocol"
	"1641622-1"	"1641622-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"50-59 years"	"50-59"	"Patient admitted 7/21/2021 for presents as transfer for acute hypoxic respiratory failure and covid pneumonia. Vaccinated for COVID 3/31/2021, tested positive 7/21/2021 Patient discharged, DEATH, 7/26/2021  Date of Vaccination:3/31/2021 & 3/10/2021 Dose: 2 doses total Vaccine Manufacturer: Pfizer Lot #: EN6202/EN6207 Clinic Administering Vaccine: unknown Injection site: R deltoid both times Description of event/reaction: patient died from severe ARDS from COVID-19   Patient initially presented on 06/29 with dyspnea, productive cough and wheezing. She reported having difficulty breathing for the last month, however, her symptoms progressively worsened after 6/26/21. Patient was found to be hypoxic on her home oxygen requirement of 3L to SpO2 52% upon arrival to ER. Of note, patient was discharged from a hospitalization on 6/22/21 (unknown reason for hospitalization, duration, and location).    Patient is reportedly fully vaccinated for COVID prior to her current admission and received her last vaccine in February 2021. She tested positive for COVID on 6/29 upon admission, and stated that her daughter had been sick recently and tested negative for COVID. Patient was started on Remdesivir, Decadron, Albuterol, Thiamine, Zinc, Quercetin complex, and Vitamin D. Patient was also started on Vapotherm for supplemental oxygen which was alternated with BiPAP, as well as empiric Vancomycin (6/29-7/10 and 7/15-7/21) and Zosyn (6/29-7/8). Patient was ultimately intubated on 07/15 and her antibiotics were escalated to Vanc and Meropenem (7/13-7/21) for presumed pneumonia. She continued to require high ventilator settings (100%, PEEP 16).  Her hospitalization was complicated by shock requiring vasopressors. On 7/17, patient was increasingly acidotic with pH 6.99 and PCO2 78 and was subsequently proned and paralyzed.  Her infectious work-up was positive for VRE bacteremia on 7/17 and candida in urine culture. On 7/21 she was transferred to MICU for hypoxic respiratory failure and COVID pneumonia. On arrival, she is sedated on mechanical ventilation...Acute Hypoxic Hypercapneic Respiratory Failure requiring Mechanical Ventilation (POA) COVID PNA (POA) History of COPD (POA) - Etiology: COVID PNA - COVID positive 6/29 - Fully vaccinated with Moderna vaccine prior to admission - s/p Remdesivir, convalescent plasma, dexamethasone - 7/15 Intubated at outside hospital - 7/17 Paralyzed and proned - CXR: bilateral diffuse patchy airspace disease - ABG on arrival: 7.43/53/65/35 on 80%, PEEP 10, PF 81 PLAN: - PAL, comp resp panel, Strep and Legionella urine Ag pending - Continue mechanical ventilation to optimize ventilation and oxygenation, maintain SpO2 >/= 92% - DuoNebs q4hr - Empiric broad spectrum antibiotics as outlined below: Linezolid and cefepime - Propofol and Dilaudid drips to facilitate tolerance of mechanical ventilation - Start DEXARDS protocol - Repeat ABG at 2000; prone if PF ratio not improved - Consider CT chest when clinically stable   VRE Bacteremia (POA) Sepsis (POA) Leukocytosis (POA) - Has received dexamethasone - Received the following courses abx: Vanc 6/29-7/10, 7/15- 7/21 Zosyn 6/29 - 7/8 Merrem 7/13-7/21 - BCx from 7/17 resulted for +VRE; transitioned to Linezolid prior to transfer - On vasopressors on 7/18 - WBC 26k, lactate here 1.2 - CXR: bilateral diffuse patchy airspace disease Plan: - PAN cultures: Bcx, UA, PAL, strep/legionella urinary Ag pending - Follow cultures; determine insertion date of PICC line - Empiric antibiotics with : Linezolid (start 7/21) and cefepime - ECHO pending   AKI (POA) - Scr on admission 0.96, up to 1.96 on 7/17  - Multifactorial AKI is likely related to sepsis PLAN:  - BMP here pending - Renal lytes pending - Renally dose medications, avoid contrast medications - Consult the renal team when appropriate      T2DM (POA) - HgbA1C pending - FSBG with correction SSI q6hr per ICU protocol"
	"1641622-1"	"1641622-1"	"ENTEROCOCCAL INFECTION"	"10061124"	"50-59 years"	"50-59"	"Patient admitted 7/21/2021 for presents as transfer for acute hypoxic respiratory failure and covid pneumonia. Vaccinated for COVID 3/31/2021, tested positive 7/21/2021 Patient discharged, DEATH, 7/26/2021  Date of Vaccination:3/31/2021 & 3/10/2021 Dose: 2 doses total Vaccine Manufacturer: Pfizer Lot #: EN6202/EN6207 Clinic Administering Vaccine: unknown Injection site: R deltoid both times Description of event/reaction: patient died from severe ARDS from COVID-19   Patient initially presented on 06/29 with dyspnea, productive cough and wheezing. She reported having difficulty breathing for the last month, however, her symptoms progressively worsened after 6/26/21. Patient was found to be hypoxic on her home oxygen requirement of 3L to SpO2 52% upon arrival to ER. Of note, patient was discharged from a hospitalization on 6/22/21 (unknown reason for hospitalization, duration, and location).    Patient is reportedly fully vaccinated for COVID prior to her current admission and received her last vaccine in February 2021. She tested positive for COVID on 6/29 upon admission, and stated that her daughter had been sick recently and tested negative for COVID. Patient was started on Remdesivir, Decadron, Albuterol, Thiamine, Zinc, Quercetin complex, and Vitamin D. Patient was also started on Vapotherm for supplemental oxygen which was alternated with BiPAP, as well as empiric Vancomycin (6/29-7/10 and 7/15-7/21) and Zosyn (6/29-7/8). Patient was ultimately intubated on 07/15 and her antibiotics were escalated to Vanc and Meropenem (7/13-7/21) for presumed pneumonia. She continued to require high ventilator settings (100%, PEEP 16).  Her hospitalization was complicated by shock requiring vasopressors. On 7/17, patient was increasingly acidotic with pH 6.99 and PCO2 78 and was subsequently proned and paralyzed.  Her infectious work-up was positive for VRE bacteremia on 7/17 and candida in urine culture. On 7/21 she was transferred to MICU for hypoxic respiratory failure and COVID pneumonia. On arrival, she is sedated on mechanical ventilation...Acute Hypoxic Hypercapneic Respiratory Failure requiring Mechanical Ventilation (POA) COVID PNA (POA) History of COPD (POA) - Etiology: COVID PNA - COVID positive 6/29 - Fully vaccinated with Moderna vaccine prior to admission - s/p Remdesivir, convalescent plasma, dexamethasone - 7/15 Intubated at outside hospital - 7/17 Paralyzed and proned - CXR: bilateral diffuse patchy airspace disease - ABG on arrival: 7.43/53/65/35 on 80%, PEEP 10, PF 81 PLAN: - PAL, comp resp panel, Strep and Legionella urine Ag pending - Continue mechanical ventilation to optimize ventilation and oxygenation, maintain SpO2 >/= 92% - DuoNebs q4hr - Empiric broad spectrum antibiotics as outlined below: Linezolid and cefepime - Propofol and Dilaudid drips to facilitate tolerance of mechanical ventilation - Start DEXARDS protocol - Repeat ABG at 2000; prone if PF ratio not improved - Consider CT chest when clinically stable   VRE Bacteremia (POA) Sepsis (POA) Leukocytosis (POA) - Has received dexamethasone - Received the following courses abx: Vanc 6/29-7/10, 7/15- 7/21 Zosyn 6/29 - 7/8 Merrem 7/13-7/21 - BCx from 7/17 resulted for +VRE; transitioned to Linezolid prior to transfer - On vasopressors on 7/18 - WBC 26k, lactate here 1.2 - CXR: bilateral diffuse patchy airspace disease Plan: - PAN cultures: Bcx, UA, PAL, strep/legionella urinary Ag pending - Follow cultures; determine insertion date of PICC line - Empiric antibiotics with : Linezolid (start 7/21) and cefepime - ECHO pending   AKI (POA) - Scr on admission 0.96, up to 1.96 on 7/17  - Multifactorial AKI is likely related to sepsis PLAN:  - BMP here pending - Renal lytes pending - Renally dose medications, avoid contrast medications - Consult the renal team when appropriate      T2DM (POA) - HgbA1C pending - FSBG with correction SSI q6hr per ICU protocol"
	"1641622-1"	"1641622-1"	"GLYCOSYLATED HAEMOGLOBIN"	"10018480"	"50-59 years"	"50-59"	"Patient admitted 7/21/2021 for presents as transfer for acute hypoxic respiratory failure and covid pneumonia. Vaccinated for COVID 3/31/2021, tested positive 7/21/2021 Patient discharged, DEATH, 7/26/2021  Date of Vaccination:3/31/2021 & 3/10/2021 Dose: 2 doses total Vaccine Manufacturer: Pfizer Lot #: EN6202/EN6207 Clinic Administering Vaccine: unknown Injection site: R deltoid both times Description of event/reaction: patient died from severe ARDS from COVID-19   Patient initially presented on 06/29 with dyspnea, productive cough and wheezing. She reported having difficulty breathing for the last month, however, her symptoms progressively worsened after 6/26/21. Patient was found to be hypoxic on her home oxygen requirement of 3L to SpO2 52% upon arrival to ER. Of note, patient was discharged from a hospitalization on 6/22/21 (unknown reason for hospitalization, duration, and location).    Patient is reportedly fully vaccinated for COVID prior to her current admission and received her last vaccine in February 2021. She tested positive for COVID on 6/29 upon admission, and stated that her daughter had been sick recently and tested negative for COVID. Patient was started on Remdesivir, Decadron, Albuterol, Thiamine, Zinc, Quercetin complex, and Vitamin D. Patient was also started on Vapotherm for supplemental oxygen which was alternated with BiPAP, as well as empiric Vancomycin (6/29-7/10 and 7/15-7/21) and Zosyn (6/29-7/8). Patient was ultimately intubated on 07/15 and her antibiotics were escalated to Vanc and Meropenem (7/13-7/21) for presumed pneumonia. She continued to require high ventilator settings (100%, PEEP 16).  Her hospitalization was complicated by shock requiring vasopressors. On 7/17, patient was increasingly acidotic with pH 6.99 and PCO2 78 and was subsequently proned and paralyzed.  Her infectious work-up was positive for VRE bacteremia on 7/17 and candida in urine culture. On 7/21 she was transferred to MICU for hypoxic respiratory failure and COVID pneumonia. On arrival, she is sedated on mechanical ventilation...Acute Hypoxic Hypercapneic Respiratory Failure requiring Mechanical Ventilation (POA) COVID PNA (POA) History of COPD (POA) - Etiology: COVID PNA - COVID positive 6/29 - Fully vaccinated with Moderna vaccine prior to admission - s/p Remdesivir, convalescent plasma, dexamethasone - 7/15 Intubated at outside hospital - 7/17 Paralyzed and proned - CXR: bilateral diffuse patchy airspace disease - ABG on arrival: 7.43/53/65/35 on 80%, PEEP 10, PF 81 PLAN: - PAL, comp resp panel, Strep and Legionella urine Ag pending - Continue mechanical ventilation to optimize ventilation and oxygenation, maintain SpO2 >/= 92% - DuoNebs q4hr - Empiric broad spectrum antibiotics as outlined below: Linezolid and cefepime - Propofol and Dilaudid drips to facilitate tolerance of mechanical ventilation - Start DEXARDS protocol - Repeat ABG at 2000; prone if PF ratio not improved - Consider CT chest when clinically stable   VRE Bacteremia (POA) Sepsis (POA) Leukocytosis (POA) - Has received dexamethasone - Received the following courses abx: Vanc 6/29-7/10, 7/15- 7/21 Zosyn 6/29 - 7/8 Merrem 7/13-7/21 - BCx from 7/17 resulted for +VRE; transitioned to Linezolid prior to transfer - On vasopressors on 7/18 - WBC 26k, lactate here 1.2 - CXR: bilateral diffuse patchy airspace disease Plan: - PAN cultures: Bcx, UA, PAL, strep/legionella urinary Ag pending - Follow cultures; determine insertion date of PICC line - Empiric antibiotics with : Linezolid (start 7/21) and cefepime - ECHO pending   AKI (POA) - Scr on admission 0.96, up to 1.96 on 7/17  - Multifactorial AKI is likely related to sepsis PLAN:  - BMP here pending - Renal lytes pending - Renally dose medications, avoid contrast medications - Consult the renal team when appropriate      T2DM (POA) - HgbA1C pending - FSBG with correction SSI q6hr per ICU protocol"
	"1641622-1"	"1641622-1"	"HYPOXIA"	"10021143"	"50-59 years"	"50-59"	"Patient admitted 7/21/2021 for presents as transfer for acute hypoxic respiratory failure and covid pneumonia. Vaccinated for COVID 3/31/2021, tested positive 7/21/2021 Patient discharged, DEATH, 7/26/2021  Date of Vaccination:3/31/2021 & 3/10/2021 Dose: 2 doses total Vaccine Manufacturer: Pfizer Lot #: EN6202/EN6207 Clinic Administering Vaccine: unknown Injection site: R deltoid both times Description of event/reaction: patient died from severe ARDS from COVID-19   Patient initially presented on 06/29 with dyspnea, productive cough and wheezing. She reported having difficulty breathing for the last month, however, her symptoms progressively worsened after 6/26/21. Patient was found to be hypoxic on her home oxygen requirement of 3L to SpO2 52% upon arrival to ER. Of note, patient was discharged from a hospitalization on 6/22/21 (unknown reason for hospitalization, duration, and location).    Patient is reportedly fully vaccinated for COVID prior to her current admission and received her last vaccine in February 2021. She tested positive for COVID on 6/29 upon admission, and stated that her daughter had been sick recently and tested negative for COVID. Patient was started on Remdesivir, Decadron, Albuterol, Thiamine, Zinc, Quercetin complex, and Vitamin D. Patient was also started on Vapotherm for supplemental oxygen which was alternated with BiPAP, as well as empiric Vancomycin (6/29-7/10 and 7/15-7/21) and Zosyn (6/29-7/8). Patient was ultimately intubated on 07/15 and her antibiotics were escalated to Vanc and Meropenem (7/13-7/21) for presumed pneumonia. She continued to require high ventilator settings (100%, PEEP 16).  Her hospitalization was complicated by shock requiring vasopressors. On 7/17, patient was increasingly acidotic with pH 6.99 and PCO2 78 and was subsequently proned and paralyzed.  Her infectious work-up was positive for VRE bacteremia on 7/17 and candida in urine culture. On 7/21 she was transferred to MICU for hypoxic respiratory failure and COVID pneumonia. On arrival, she is sedated on mechanical ventilation...Acute Hypoxic Hypercapneic Respiratory Failure requiring Mechanical Ventilation (POA) COVID PNA (POA) History of COPD (POA) - Etiology: COVID PNA - COVID positive 6/29 - Fully vaccinated with Moderna vaccine prior to admission - s/p Remdesivir, convalescent plasma, dexamethasone - 7/15 Intubated at outside hospital - 7/17 Paralyzed and proned - CXR: bilateral diffuse patchy airspace disease - ABG on arrival: 7.43/53/65/35 on 80%, PEEP 10, PF 81 PLAN: - PAL, comp resp panel, Strep and Legionella urine Ag pending - Continue mechanical ventilation to optimize ventilation and oxygenation, maintain SpO2 >/= 92% - DuoNebs q4hr - Empiric broad spectrum antibiotics as outlined below: Linezolid and cefepime - Propofol and Dilaudid drips to facilitate tolerance of mechanical ventilation - Start DEXARDS protocol - Repeat ABG at 2000; prone if PF ratio not improved - Consider CT chest when clinically stable   VRE Bacteremia (POA) Sepsis (POA) Leukocytosis (POA) - Has received dexamethasone - Received the following courses abx: Vanc 6/29-7/10, 7/15- 7/21 Zosyn 6/29 - 7/8 Merrem 7/13-7/21 - BCx from 7/17 resulted for +VRE; transitioned to Linezolid prior to transfer - On vasopressors on 7/18 - WBC 26k, lactate here 1.2 - CXR: bilateral diffuse patchy airspace disease Plan: - PAN cultures: Bcx, UA, PAL, strep/legionella urinary Ag pending - Follow cultures; determine insertion date of PICC line - Empiric antibiotics with : Linezolid (start 7/21) and cefepime - ECHO pending   AKI (POA) - Scr on admission 0.96, up to 1.96 on 7/17  - Multifactorial AKI is likely related to sepsis PLAN:  - BMP here pending - Renal lytes pending - Renally dose medications, avoid contrast medications - Consult the renal team when appropriate      T2DM (POA) - HgbA1C pending - FSBG with correction SSI q6hr per ICU protocol"
	"1641622-1"	"1641622-1"	"INTENSIVE CARE"	"10022519"	"50-59 years"	"50-59"	"Patient admitted 7/21/2021 for presents as transfer for acute hypoxic respiratory failure and covid pneumonia. Vaccinated for COVID 3/31/2021, tested positive 7/21/2021 Patient discharged, DEATH, 7/26/2021  Date of Vaccination:3/31/2021 & 3/10/2021 Dose: 2 doses total Vaccine Manufacturer: Pfizer Lot #: EN6202/EN6207 Clinic Administering Vaccine: unknown Injection site: R deltoid both times Description of event/reaction: patient died from severe ARDS from COVID-19   Patient initially presented on 06/29 with dyspnea, productive cough and wheezing. She reported having difficulty breathing for the last month, however, her symptoms progressively worsened after 6/26/21. Patient was found to be hypoxic on her home oxygen requirement of 3L to SpO2 52% upon arrival to ER. Of note, patient was discharged from a hospitalization on 6/22/21 (unknown reason for hospitalization, duration, and location).    Patient is reportedly fully vaccinated for COVID prior to her current admission and received her last vaccine in February 2021. She tested positive for COVID on 6/29 upon admission, and stated that her daughter had been sick recently and tested negative for COVID. Patient was started on Remdesivir, Decadron, Albuterol, Thiamine, Zinc, Quercetin complex, and Vitamin D. Patient was also started on Vapotherm for supplemental oxygen which was alternated with BiPAP, as well as empiric Vancomycin (6/29-7/10 and 7/15-7/21) and Zosyn (6/29-7/8). Patient was ultimately intubated on 07/15 and her antibiotics were escalated to Vanc and Meropenem (7/13-7/21) for presumed pneumonia. She continued to require high ventilator settings (100%, PEEP 16).  Her hospitalization was complicated by shock requiring vasopressors. On 7/17, patient was increasingly acidotic with pH 6.99 and PCO2 78 and was subsequently proned and paralyzed.  Her infectious work-up was positive for VRE bacteremia on 7/17 and candida in urine culture. On 7/21 she was transferred to MICU for hypoxic respiratory failure and COVID pneumonia. On arrival, she is sedated on mechanical ventilation...Acute Hypoxic Hypercapneic Respiratory Failure requiring Mechanical Ventilation (POA) COVID PNA (POA) History of COPD (POA) - Etiology: COVID PNA - COVID positive 6/29 - Fully vaccinated with Moderna vaccine prior to admission - s/p Remdesivir, convalescent plasma, dexamethasone - 7/15 Intubated at outside hospital - 7/17 Paralyzed and proned - CXR: bilateral diffuse patchy airspace disease - ABG on arrival: 7.43/53/65/35 on 80%, PEEP 10, PF 81 PLAN: - PAL, comp resp panel, Strep and Legionella urine Ag pending - Continue mechanical ventilation to optimize ventilation and oxygenation, maintain SpO2 >/= 92% - DuoNebs q4hr - Empiric broad spectrum antibiotics as outlined below: Linezolid and cefepime - Propofol and Dilaudid drips to facilitate tolerance of mechanical ventilation - Start DEXARDS protocol - Repeat ABG at 2000; prone if PF ratio not improved - Consider CT chest when clinically stable   VRE Bacteremia (POA) Sepsis (POA) Leukocytosis (POA) - Has received dexamethasone - Received the following courses abx: Vanc 6/29-7/10, 7/15- 7/21 Zosyn 6/29 - 7/8 Merrem 7/13-7/21 - BCx from 7/17 resulted for +VRE; transitioned to Linezolid prior to transfer - On vasopressors on 7/18 - WBC 26k, lactate here 1.2 - CXR: bilateral diffuse patchy airspace disease Plan: - PAN cultures: Bcx, UA, PAL, strep/legionella urinary Ag pending - Follow cultures; determine insertion date of PICC line - Empiric antibiotics with : Linezolid (start 7/21) and cefepime - ECHO pending   AKI (POA) - Scr on admission 0.96, up to 1.96 on 7/17  - Multifactorial AKI is likely related to sepsis PLAN:  - BMP here pending - Renal lytes pending - Renally dose medications, avoid contrast medications - Consult the renal team when appropriate      T2DM (POA) - HgbA1C pending - FSBG with correction SSI q6hr per ICU protocol"
	"1641622-1"	"1641622-1"	"LABORATORY TEST"	"10059938"	"50-59 years"	"50-59"	"Patient admitted 7/21/2021 for presents as transfer for acute hypoxic respiratory failure and covid pneumonia. Vaccinated for COVID 3/31/2021, tested positive 7/21/2021 Patient discharged, DEATH, 7/26/2021  Date of Vaccination:3/31/2021 & 3/10/2021 Dose: 2 doses total Vaccine Manufacturer: Pfizer Lot #: EN6202/EN6207 Clinic Administering Vaccine: unknown Injection site: R deltoid both times Description of event/reaction: patient died from severe ARDS from COVID-19   Patient initially presented on 06/29 with dyspnea, productive cough and wheezing. She reported having difficulty breathing for the last month, however, her symptoms progressively worsened after 6/26/21. Patient was found to be hypoxic on her home oxygen requirement of 3L to SpO2 52% upon arrival to ER. Of note, patient was discharged from a hospitalization on 6/22/21 (unknown reason for hospitalization, duration, and location).    Patient is reportedly fully vaccinated for COVID prior to her current admission and received her last vaccine in February 2021. She tested positive for COVID on 6/29 upon admission, and stated that her daughter had been sick recently and tested negative for COVID. Patient was started on Remdesivir, Decadron, Albuterol, Thiamine, Zinc, Quercetin complex, and Vitamin D. Patient was also started on Vapotherm for supplemental oxygen which was alternated with BiPAP, as well as empiric Vancomycin (6/29-7/10 and 7/15-7/21) and Zosyn (6/29-7/8). Patient was ultimately intubated on 07/15 and her antibiotics were escalated to Vanc and Meropenem (7/13-7/21) for presumed pneumonia. She continued to require high ventilator settings (100%, PEEP 16).  Her hospitalization was complicated by shock requiring vasopressors. On 7/17, patient was increasingly acidotic with pH 6.99 and PCO2 78 and was subsequently proned and paralyzed.  Her infectious work-up was positive for VRE bacteremia on 7/17 and candida in urine culture. On 7/21 she was transferred to MICU for hypoxic respiratory failure and COVID pneumonia. On arrival, she is sedated on mechanical ventilation...Acute Hypoxic Hypercapneic Respiratory Failure requiring Mechanical Ventilation (POA) COVID PNA (POA) History of COPD (POA) - Etiology: COVID PNA - COVID positive 6/29 - Fully vaccinated with Moderna vaccine prior to admission - s/p Remdesivir, convalescent plasma, dexamethasone - 7/15 Intubated at outside hospital - 7/17 Paralyzed and proned - CXR: bilateral diffuse patchy airspace disease - ABG on arrival: 7.43/53/65/35 on 80%, PEEP 10, PF 81 PLAN: - PAL, comp resp panel, Strep and Legionella urine Ag pending - Continue mechanical ventilation to optimize ventilation and oxygenation, maintain SpO2 >/= 92% - DuoNebs q4hr - Empiric broad spectrum antibiotics as outlined below: Linezolid and cefepime - Propofol and Dilaudid drips to facilitate tolerance of mechanical ventilation - Start DEXARDS protocol - Repeat ABG at 2000; prone if PF ratio not improved - Consider CT chest when clinically stable   VRE Bacteremia (POA) Sepsis (POA) Leukocytosis (POA) - Has received dexamethasone - Received the following courses abx: Vanc 6/29-7/10, 7/15- 7/21 Zosyn 6/29 - 7/8 Merrem 7/13-7/21 - BCx from 7/17 resulted for +VRE; transitioned to Linezolid prior to transfer - On vasopressors on 7/18 - WBC 26k, lactate here 1.2 - CXR: bilateral diffuse patchy airspace disease Plan: - PAN cultures: Bcx, UA, PAL, strep/legionella urinary Ag pending - Follow cultures; determine insertion date of PICC line - Empiric antibiotics with : Linezolid (start 7/21) and cefepime - ECHO pending   AKI (POA) - Scr on admission 0.96, up to 1.96 on 7/17  - Multifactorial AKI is likely related to sepsis PLAN:  - BMP here pending - Renal lytes pending - Renally dose medications, avoid contrast medications - Consult the renal team when appropriate      T2DM (POA) - HgbA1C pending - FSBG with correction SSI q6hr per ICU protocol"
	"1641622-1"	"1641622-1"	"LEGIONELLA TEST"	"10070410"	"50-59 years"	"50-59"	"Patient admitted 7/21/2021 for presents as transfer for acute hypoxic respiratory failure and covid pneumonia. Vaccinated for COVID 3/31/2021, tested positive 7/21/2021 Patient discharged, DEATH, 7/26/2021  Date of Vaccination:3/31/2021 & 3/10/2021 Dose: 2 doses total Vaccine Manufacturer: Pfizer Lot #: EN6202/EN6207 Clinic Administering Vaccine: unknown Injection site: R deltoid both times Description of event/reaction: patient died from severe ARDS from COVID-19   Patient initially presented on 06/29 with dyspnea, productive cough and wheezing. She reported having difficulty breathing for the last month, however, her symptoms progressively worsened after 6/26/21. Patient was found to be hypoxic on her home oxygen requirement of 3L to SpO2 52% upon arrival to ER. Of note, patient was discharged from a hospitalization on 6/22/21 (unknown reason for hospitalization, duration, and location).    Patient is reportedly fully vaccinated for COVID prior to her current admission and received her last vaccine in February 2021. She tested positive for COVID on 6/29 upon admission, and stated that her daughter had been sick recently and tested negative for COVID. Patient was started on Remdesivir, Decadron, Albuterol, Thiamine, Zinc, Quercetin complex, and Vitamin D. Patient was also started on Vapotherm for supplemental oxygen which was alternated with BiPAP, as well as empiric Vancomycin (6/29-7/10 and 7/15-7/21) and Zosyn (6/29-7/8). Patient was ultimately intubated on 07/15 and her antibiotics were escalated to Vanc and Meropenem (7/13-7/21) for presumed pneumonia. She continued to require high ventilator settings (100%, PEEP 16).  Her hospitalization was complicated by shock requiring vasopressors. On 7/17, patient was increasingly acidotic with pH 6.99 and PCO2 78 and was subsequently proned and paralyzed.  Her infectious work-up was positive for VRE bacteremia on 7/17 and candida in urine culture. On 7/21 she was transferred to MICU for hypoxic respiratory failure and COVID pneumonia. On arrival, she is sedated on mechanical ventilation...Acute Hypoxic Hypercapneic Respiratory Failure requiring Mechanical Ventilation (POA) COVID PNA (POA) History of COPD (POA) - Etiology: COVID PNA - COVID positive 6/29 - Fully vaccinated with Moderna vaccine prior to admission - s/p Remdesivir, convalescent plasma, dexamethasone - 7/15 Intubated at outside hospital - 7/17 Paralyzed and proned - CXR: bilateral diffuse patchy airspace disease - ABG on arrival: 7.43/53/65/35 on 80%, PEEP 10, PF 81 PLAN: - PAL, comp resp panel, Strep and Legionella urine Ag pending - Continue mechanical ventilation to optimize ventilation and oxygenation, maintain SpO2 >/= 92% - DuoNebs q4hr - Empiric broad spectrum antibiotics as outlined below: Linezolid and cefepime - Propofol and Dilaudid drips to facilitate tolerance of mechanical ventilation - Start DEXARDS protocol - Repeat ABG at 2000; prone if PF ratio not improved - Consider CT chest when clinically stable   VRE Bacteremia (POA) Sepsis (POA) Leukocytosis (POA) - Has received dexamethasone - Received the following courses abx: Vanc 6/29-7/10, 7/15- 7/21 Zosyn 6/29 - 7/8 Merrem 7/13-7/21 - BCx from 7/17 resulted for +VRE; transitioned to Linezolid prior to transfer - On vasopressors on 7/18 - WBC 26k, lactate here 1.2 - CXR: bilateral diffuse patchy airspace disease Plan: - PAN cultures: Bcx, UA, PAL, strep/legionella urinary Ag pending - Follow cultures; determine insertion date of PICC line - Empiric antibiotics with : Linezolid (start 7/21) and cefepime - ECHO pending   AKI (POA) - Scr on admission 0.96, up to 1.96 on 7/17  - Multifactorial AKI is likely related to sepsis PLAN:  - BMP here pending - Renal lytes pending - Renally dose medications, avoid contrast medications - Consult the renal team when appropriate      T2DM (POA) - HgbA1C pending - FSBG with correction SSI q6hr per ICU protocol"
	"1641622-1"	"1641622-1"	"LEUKOCYTOSIS"	"10024378"	"50-59 years"	"50-59"	"Patient admitted 7/21/2021 for presents as transfer for acute hypoxic respiratory failure and covid pneumonia. Vaccinated for COVID 3/31/2021, tested positive 7/21/2021 Patient discharged, DEATH, 7/26/2021  Date of Vaccination:3/31/2021 & 3/10/2021 Dose: 2 doses total Vaccine Manufacturer: Pfizer Lot #: EN6202/EN6207 Clinic Administering Vaccine: unknown Injection site: R deltoid both times Description of event/reaction: patient died from severe ARDS from COVID-19   Patient initially presented on 06/29 with dyspnea, productive cough and wheezing. She reported having difficulty breathing for the last month, however, her symptoms progressively worsened after 6/26/21. Patient was found to be hypoxic on her home oxygen requirement of 3L to SpO2 52% upon arrival to ER. Of note, patient was discharged from a hospitalization on 6/22/21 (unknown reason for hospitalization, duration, and location).    Patient is reportedly fully vaccinated for COVID prior to her current admission and received her last vaccine in February 2021. She tested positive for COVID on 6/29 upon admission, and stated that her daughter had been sick recently and tested negative for COVID. Patient was started on Remdesivir, Decadron, Albuterol, Thiamine, Zinc, Quercetin complex, and Vitamin D. Patient was also started on Vapotherm for supplemental oxygen which was alternated with BiPAP, as well as empiric Vancomycin (6/29-7/10 and 7/15-7/21) and Zosyn (6/29-7/8). Patient was ultimately intubated on 07/15 and her antibiotics were escalated to Vanc and Meropenem (7/13-7/21) for presumed pneumonia. She continued to require high ventilator settings (100%, PEEP 16).  Her hospitalization was complicated by shock requiring vasopressors. On 7/17, patient was increasingly acidotic with pH 6.99 and PCO2 78 and was subsequently proned and paralyzed.  Her infectious work-up was positive for VRE bacteremia on 7/17 and candida in urine culture. On 7/21 she was transferred to MICU for hypoxic respiratory failure and COVID pneumonia. On arrival, she is sedated on mechanical ventilation...Acute Hypoxic Hypercapneic Respiratory Failure requiring Mechanical Ventilation (POA) COVID PNA (POA) History of COPD (POA) - Etiology: COVID PNA - COVID positive 6/29 - Fully vaccinated with Moderna vaccine prior to admission - s/p Remdesivir, convalescent plasma, dexamethasone - 7/15 Intubated at outside hospital - 7/17 Paralyzed and proned - CXR: bilateral diffuse patchy airspace disease - ABG on arrival: 7.43/53/65/35 on 80%, PEEP 10, PF 81 PLAN: - PAL, comp resp panel, Strep and Legionella urine Ag pending - Continue mechanical ventilation to optimize ventilation and oxygenation, maintain SpO2 >/= 92% - DuoNebs q4hr - Empiric broad spectrum antibiotics as outlined below: Linezolid and cefepime - Propofol and Dilaudid drips to facilitate tolerance of mechanical ventilation - Start DEXARDS protocol - Repeat ABG at 2000; prone if PF ratio not improved - Consider CT chest when clinically stable   VRE Bacteremia (POA) Sepsis (POA) Leukocytosis (POA) - Has received dexamethasone - Received the following courses abx: Vanc 6/29-7/10, 7/15- 7/21 Zosyn 6/29 - 7/8 Merrem 7/13-7/21 - BCx from 7/17 resulted for +VRE; transitioned to Linezolid prior to transfer - On vasopressors on 7/18 - WBC 26k, lactate here 1.2 - CXR: bilateral diffuse patchy airspace disease Plan: - PAN cultures: Bcx, UA, PAL, strep/legionella urinary Ag pending - Follow cultures; determine insertion date of PICC line - Empiric antibiotics with : Linezolid (start 7/21) and cefepime - ECHO pending   AKI (POA) - Scr on admission 0.96, up to 1.96 on 7/17  - Multifactorial AKI is likely related to sepsis PLAN:  - BMP here pending - Renal lytes pending - Renally dose medications, avoid contrast medications - Consult the renal team when appropriate      T2DM (POA) - HgbA1C pending - FSBG with correction SSI q6hr per ICU protocol"
	"1641622-1"	"1641622-1"	"LUNG OPACITY"	"10081792"	"50-59 years"	"50-59"	"Patient admitted 7/21/2021 for presents as transfer for acute hypoxic respiratory failure and covid pneumonia. Vaccinated for COVID 3/31/2021, tested positive 7/21/2021 Patient discharged, DEATH, 7/26/2021  Date of Vaccination:3/31/2021 & 3/10/2021 Dose: 2 doses total Vaccine Manufacturer: Pfizer Lot #: EN6202/EN6207 Clinic Administering Vaccine: unknown Injection site: R deltoid both times Description of event/reaction: patient died from severe ARDS from COVID-19   Patient initially presented on 06/29 with dyspnea, productive cough and wheezing. She reported having difficulty breathing for the last month, however, her symptoms progressively worsened after 6/26/21. Patient was found to be hypoxic on her home oxygen requirement of 3L to SpO2 52% upon arrival to ER. Of note, patient was discharged from a hospitalization on 6/22/21 (unknown reason for hospitalization, duration, and location).    Patient is reportedly fully vaccinated for COVID prior to her current admission and received her last vaccine in February 2021. She tested positive for COVID on 6/29 upon admission, and stated that her daughter had been sick recently and tested negative for COVID. Patient was started on Remdesivir, Decadron, Albuterol, Thiamine, Zinc, Quercetin complex, and Vitamin D. Patient was also started on Vapotherm for supplemental oxygen which was alternated with BiPAP, as well as empiric Vancomycin (6/29-7/10 and 7/15-7/21) and Zosyn (6/29-7/8). Patient was ultimately intubated on 07/15 and her antibiotics were escalated to Vanc and Meropenem (7/13-7/21) for presumed pneumonia. She continued to require high ventilator settings (100%, PEEP 16).  Her hospitalization was complicated by shock requiring vasopressors. On 7/17, patient was increasingly acidotic with pH 6.99 and PCO2 78 and was subsequently proned and paralyzed.  Her infectious work-up was positive for VRE bacteremia on 7/17 and candida in urine culture. On 7/21 she was transferred to MICU for hypoxic respiratory failure and COVID pneumonia. On arrival, she is sedated on mechanical ventilation...Acute Hypoxic Hypercapneic Respiratory Failure requiring Mechanical Ventilation (POA) COVID PNA (POA) History of COPD (POA) - Etiology: COVID PNA - COVID positive 6/29 - Fully vaccinated with Moderna vaccine prior to admission - s/p Remdesivir, convalescent plasma, dexamethasone - 7/15 Intubated at outside hospital - 7/17 Paralyzed and proned - CXR: bilateral diffuse patchy airspace disease - ABG on arrival: 7.43/53/65/35 on 80%, PEEP 10, PF 81 PLAN: - PAL, comp resp panel, Strep and Legionella urine Ag pending - Continue mechanical ventilation to optimize ventilation and oxygenation, maintain SpO2 >/= 92% - DuoNebs q4hr - Empiric broad spectrum antibiotics as outlined below: Linezolid and cefepime - Propofol and Dilaudid drips to facilitate tolerance of mechanical ventilation - Start DEXARDS protocol - Repeat ABG at 2000; prone if PF ratio not improved - Consider CT chest when clinically stable   VRE Bacteremia (POA) Sepsis (POA) Leukocytosis (POA) - Has received dexamethasone - Received the following courses abx: Vanc 6/29-7/10, 7/15- 7/21 Zosyn 6/29 - 7/8 Merrem 7/13-7/21 - BCx from 7/17 resulted for +VRE; transitioned to Linezolid prior to transfer - On vasopressors on 7/18 - WBC 26k, lactate here 1.2 - CXR: bilateral diffuse patchy airspace disease Plan: - PAN cultures: Bcx, UA, PAL, strep/legionella urinary Ag pending - Follow cultures; determine insertion date of PICC line - Empiric antibiotics with : Linezolid (start 7/21) and cefepime - ECHO pending   AKI (POA) - Scr on admission 0.96, up to 1.96 on 7/17  - Multifactorial AKI is likely related to sepsis PLAN:  - BMP here pending - Renal lytes pending - Renally dose medications, avoid contrast medications - Consult the renal team when appropriate      T2DM (POA) - HgbA1C pending - FSBG with correction SSI q6hr per ICU protocol"
	"1641622-1"	"1641622-1"	"MECHANICAL VENTILATION"	"10067221"	"50-59 years"	"50-59"	"Patient admitted 7/21/2021 for presents as transfer for acute hypoxic respiratory failure and covid pneumonia. Vaccinated for COVID 3/31/2021, tested positive 7/21/2021 Patient discharged, DEATH, 7/26/2021  Date of Vaccination:3/31/2021 & 3/10/2021 Dose: 2 doses total Vaccine Manufacturer: Pfizer Lot #: EN6202/EN6207 Clinic Administering Vaccine: unknown Injection site: R deltoid both times Description of event/reaction: patient died from severe ARDS from COVID-19   Patient initially presented on 06/29 with dyspnea, productive cough and wheezing. She reported having difficulty breathing for the last month, however, her symptoms progressively worsened after 6/26/21. Patient was found to be hypoxic on her home oxygen requirement of 3L to SpO2 52% upon arrival to ER. Of note, patient was discharged from a hospitalization on 6/22/21 (unknown reason for hospitalization, duration, and location).    Patient is reportedly fully vaccinated for COVID prior to her current admission and received her last vaccine in February 2021. She tested positive for COVID on 6/29 upon admission, and stated that her daughter had been sick recently and tested negative for COVID. Patient was started on Remdesivir, Decadron, Albuterol, Thiamine, Zinc, Quercetin complex, and Vitamin D. Patient was also started on Vapotherm for supplemental oxygen which was alternated with BiPAP, as well as empiric Vancomycin (6/29-7/10 and 7/15-7/21) and Zosyn (6/29-7/8). Patient was ultimately intubated on 07/15 and her antibiotics were escalated to Vanc and Meropenem (7/13-7/21) for presumed pneumonia. She continued to require high ventilator settings (100%, PEEP 16).  Her hospitalization was complicated by shock requiring vasopressors. On 7/17, patient was increasingly acidotic with pH 6.99 and PCO2 78 and was subsequently proned and paralyzed.  Her infectious work-up was positive for VRE bacteremia on 7/17 and candida in urine culture. On 7/21 she was transferred to MICU for hypoxic respiratory failure and COVID pneumonia. On arrival, she is sedated on mechanical ventilation...Acute Hypoxic Hypercapneic Respiratory Failure requiring Mechanical Ventilation (POA) COVID PNA (POA) History of COPD (POA) - Etiology: COVID PNA - COVID positive 6/29 - Fully vaccinated with Moderna vaccine prior to admission - s/p Remdesivir, convalescent plasma, dexamethasone - 7/15 Intubated at outside hospital - 7/17 Paralyzed and proned - CXR: bilateral diffuse patchy airspace disease - ABG on arrival: 7.43/53/65/35 on 80%, PEEP 10, PF 81 PLAN: - PAL, comp resp panel, Strep and Legionella urine Ag pending - Continue mechanical ventilation to optimize ventilation and oxygenation, maintain SpO2 >/= 92% - DuoNebs q4hr - Empiric broad spectrum antibiotics as outlined below: Linezolid and cefepime - Propofol and Dilaudid drips to facilitate tolerance of mechanical ventilation - Start DEXARDS protocol - Repeat ABG at 2000; prone if PF ratio not improved - Consider CT chest when clinically stable   VRE Bacteremia (POA) Sepsis (POA) Leukocytosis (POA) - Has received dexamethasone - Received the following courses abx: Vanc 6/29-7/10, 7/15- 7/21 Zosyn 6/29 - 7/8 Merrem 7/13-7/21 - BCx from 7/17 resulted for +VRE; transitioned to Linezolid prior to transfer - On vasopressors on 7/18 - WBC 26k, lactate here 1.2 - CXR: bilateral diffuse patchy airspace disease Plan: - PAN cultures: Bcx, UA, PAL, strep/legionella urinary Ag pending - Follow cultures; determine insertion date of PICC line - Empiric antibiotics with : Linezolid (start 7/21) and cefepime - ECHO pending   AKI (POA) - Scr on admission 0.96, up to 1.96 on 7/17  - Multifactorial AKI is likely related to sepsis PLAN:  - BMP here pending - Renal lytes pending - Renally dose medications, avoid contrast medications - Consult the renal team when appropriate      T2DM (POA) - HgbA1C pending - FSBG with correction SSI q6hr per ICU protocol"
	"1641622-1"	"1641622-1"	"METABOLIC FUNCTION TEST"	"10062191"	"50-59 years"	"50-59"	"Patient admitted 7/21/2021 for presents as transfer for acute hypoxic respiratory failure and covid pneumonia. Vaccinated for COVID 3/31/2021, tested positive 7/21/2021 Patient discharged, DEATH, 7/26/2021  Date of Vaccination:3/31/2021 & 3/10/2021 Dose: 2 doses total Vaccine Manufacturer: Pfizer Lot #: EN6202/EN6207 Clinic Administering Vaccine: unknown Injection site: R deltoid both times Description of event/reaction: patient died from severe ARDS from COVID-19   Patient initially presented on 06/29 with dyspnea, productive cough and wheezing. She reported having difficulty breathing for the last month, however, her symptoms progressively worsened after 6/26/21. Patient was found to be hypoxic on her home oxygen requirement of 3L to SpO2 52% upon arrival to ER. Of note, patient was discharged from a hospitalization on 6/22/21 (unknown reason for hospitalization, duration, and location).    Patient is reportedly fully vaccinated for COVID prior to her current admission and received her last vaccine in February 2021. She tested positive for COVID on 6/29 upon admission, and stated that her daughter had been sick recently and tested negative for COVID. Patient was started on Remdesivir, Decadron, Albuterol, Thiamine, Zinc, Quercetin complex, and Vitamin D. Patient was also started on Vapotherm for supplemental oxygen which was alternated with BiPAP, as well as empiric Vancomycin (6/29-7/10 and 7/15-7/21) and Zosyn (6/29-7/8). Patient was ultimately intubated on 07/15 and her antibiotics were escalated to Vanc and Meropenem (7/13-7/21) for presumed pneumonia. She continued to require high ventilator settings (100%, PEEP 16).  Her hospitalization was complicated by shock requiring vasopressors. On 7/17, patient was increasingly acidotic with pH 6.99 and PCO2 78 and was subsequently proned and paralyzed.  Her infectious work-up was positive for VRE bacteremia on 7/17 and candida in urine culture. On 7/21 she was transferred to MICU for hypoxic respiratory failure and COVID pneumonia. On arrival, she is sedated on mechanical ventilation...Acute Hypoxic Hypercapneic Respiratory Failure requiring Mechanical Ventilation (POA) COVID PNA (POA) History of COPD (POA) - Etiology: COVID PNA - COVID positive 6/29 - Fully vaccinated with Moderna vaccine prior to admission - s/p Remdesivir, convalescent plasma, dexamethasone - 7/15 Intubated at outside hospital - 7/17 Paralyzed and proned - CXR: bilateral diffuse patchy airspace disease - ABG on arrival: 7.43/53/65/35 on 80%, PEEP 10, PF 81 PLAN: - PAL, comp resp panel, Strep and Legionella urine Ag pending - Continue mechanical ventilation to optimize ventilation and oxygenation, maintain SpO2 >/= 92% - DuoNebs q4hr - Empiric broad spectrum antibiotics as outlined below: Linezolid and cefepime - Propofol and Dilaudid drips to facilitate tolerance of mechanical ventilation - Start DEXARDS protocol - Repeat ABG at 2000; prone if PF ratio not improved - Consider CT chest when clinically stable   VRE Bacteremia (POA) Sepsis (POA) Leukocytosis (POA) - Has received dexamethasone - Received the following courses abx: Vanc 6/29-7/10, 7/15- 7/21 Zosyn 6/29 - 7/8 Merrem 7/13-7/21 - BCx from 7/17 resulted for +VRE; transitioned to Linezolid prior to transfer - On vasopressors on 7/18 - WBC 26k, lactate here 1.2 - CXR: bilateral diffuse patchy airspace disease Plan: - PAN cultures: Bcx, UA, PAL, strep/legionella urinary Ag pending - Follow cultures; determine insertion date of PICC line - Empiric antibiotics with : Linezolid (start 7/21) and cefepime - ECHO pending   AKI (POA) - Scr on admission 0.96, up to 1.96 on 7/17  - Multifactorial AKI is likely related to sepsis PLAN:  - BMP here pending - Renal lytes pending - Renally dose medications, avoid contrast medications - Consult the renal team when appropriate      T2DM (POA) - HgbA1C pending - FSBG with correction SSI q6hr per ICU protocol"
	"1641622-1"	"1641622-1"	"PARALYSIS"	"10033799"	"50-59 years"	"50-59"	"Patient admitted 7/21/2021 for presents as transfer for acute hypoxic respiratory failure and covid pneumonia. Vaccinated for COVID 3/31/2021, tested positive 7/21/2021 Patient discharged, DEATH, 7/26/2021  Date of Vaccination:3/31/2021 & 3/10/2021 Dose: 2 doses total Vaccine Manufacturer: Pfizer Lot #: EN6202/EN6207 Clinic Administering Vaccine: unknown Injection site: R deltoid both times Description of event/reaction: patient died from severe ARDS from COVID-19   Patient initially presented on 06/29 with dyspnea, productive cough and wheezing. She reported having difficulty breathing for the last month, however, her symptoms progressively worsened after 6/26/21. Patient was found to be hypoxic on her home oxygen requirement of 3L to SpO2 52% upon arrival to ER. Of note, patient was discharged from a hospitalization on 6/22/21 (unknown reason for hospitalization, duration, and location).    Patient is reportedly fully vaccinated for COVID prior to her current admission and received her last vaccine in February 2021. She tested positive for COVID on 6/29 upon admission, and stated that her daughter had been sick recently and tested negative for COVID. Patient was started on Remdesivir, Decadron, Albuterol, Thiamine, Zinc, Quercetin complex, and Vitamin D. Patient was also started on Vapotherm for supplemental oxygen which was alternated with BiPAP, as well as empiric Vancomycin (6/29-7/10 and 7/15-7/21) and Zosyn (6/29-7/8). Patient was ultimately intubated on 07/15 and her antibiotics were escalated to Vanc and Meropenem (7/13-7/21) for presumed pneumonia. She continued to require high ventilator settings (100%, PEEP 16).  Her hospitalization was complicated by shock requiring vasopressors. On 7/17, patient was increasingly acidotic with pH 6.99 and PCO2 78 and was subsequently proned and paralyzed.  Her infectious work-up was positive for VRE bacteremia on 7/17 and candida in urine culture. On 7/21 she was transferred to MICU for hypoxic respiratory failure and COVID pneumonia. On arrival, she is sedated on mechanical ventilation...Acute Hypoxic Hypercapneic Respiratory Failure requiring Mechanical Ventilation (POA) COVID PNA (POA) History of COPD (POA) - Etiology: COVID PNA - COVID positive 6/29 - Fully vaccinated with Moderna vaccine prior to admission - s/p Remdesivir, convalescent plasma, dexamethasone - 7/15 Intubated at outside hospital - 7/17 Paralyzed and proned - CXR: bilateral diffuse patchy airspace disease - ABG on arrival: 7.43/53/65/35 on 80%, PEEP 10, PF 81 PLAN: - PAL, comp resp panel, Strep and Legionella urine Ag pending - Continue mechanical ventilation to optimize ventilation and oxygenation, maintain SpO2 >/= 92% - DuoNebs q4hr - Empiric broad spectrum antibiotics as outlined below: Linezolid and cefepime - Propofol and Dilaudid drips to facilitate tolerance of mechanical ventilation - Start DEXARDS protocol - Repeat ABG at 2000; prone if PF ratio not improved - Consider CT chest when clinically stable   VRE Bacteremia (POA) Sepsis (POA) Leukocytosis (POA) - Has received dexamethasone - Received the following courses abx: Vanc 6/29-7/10, 7/15- 7/21 Zosyn 6/29 - 7/8 Merrem 7/13-7/21 - BCx from 7/17 resulted for +VRE; transitioned to Linezolid prior to transfer - On vasopressors on 7/18 - WBC 26k, lactate here 1.2 - CXR: bilateral diffuse patchy airspace disease Plan: - PAN cultures: Bcx, UA, PAL, strep/legionella urinary Ag pending - Follow cultures; determine insertion date of PICC line - Empiric antibiotics with : Linezolid (start 7/21) and cefepime - ECHO pending   AKI (POA) - Scr on admission 0.96, up to 1.96 on 7/17  - Multifactorial AKI is likely related to sepsis PLAN:  - BMP here pending - Renal lytes pending - Renally dose medications, avoid contrast medications - Consult the renal team when appropriate      T2DM (POA) - HgbA1C pending - FSBG with correction SSI q6hr per ICU protocol"
	"1641622-1"	"1641622-1"	"PCO2 INCREASED"	"10034183"	"50-59 years"	"50-59"	"Patient admitted 7/21/2021 for presents as transfer for acute hypoxic respiratory failure and covid pneumonia. Vaccinated for COVID 3/31/2021, tested positive 7/21/2021 Patient discharged, DEATH, 7/26/2021  Date of Vaccination:3/31/2021 & 3/10/2021 Dose: 2 doses total Vaccine Manufacturer: Pfizer Lot #: EN6202/EN6207 Clinic Administering Vaccine: unknown Injection site: R deltoid both times Description of event/reaction: patient died from severe ARDS from COVID-19   Patient initially presented on 06/29 with dyspnea, productive cough and wheezing. She reported having difficulty breathing for the last month, however, her symptoms progressively worsened after 6/26/21. Patient was found to be hypoxic on her home oxygen requirement of 3L to SpO2 52% upon arrival to ER. Of note, patient was discharged from a hospitalization on 6/22/21 (unknown reason for hospitalization, duration, and location).    Patient is reportedly fully vaccinated for COVID prior to her current admission and received her last vaccine in February 2021. She tested positive for COVID on 6/29 upon admission, and stated that her daughter had been sick recently and tested negative for COVID. Patient was started on Remdesivir, Decadron, Albuterol, Thiamine, Zinc, Quercetin complex, and Vitamin D. Patient was also started on Vapotherm for supplemental oxygen which was alternated with BiPAP, as well as empiric Vancomycin (6/29-7/10 and 7/15-7/21) and Zosyn (6/29-7/8). Patient was ultimately intubated on 07/15 and her antibiotics were escalated to Vanc and Meropenem (7/13-7/21) for presumed pneumonia. She continued to require high ventilator settings (100%, PEEP 16).  Her hospitalization was complicated by shock requiring vasopressors. On 7/17, patient was increasingly acidotic with pH 6.99 and PCO2 78 and was subsequently proned and paralyzed.  Her infectious work-up was positive for VRE bacteremia on 7/17 and candida in urine culture. On 7/21 she was transferred to MICU for hypoxic respiratory failure and COVID pneumonia. On arrival, she is sedated on mechanical ventilation...Acute Hypoxic Hypercapneic Respiratory Failure requiring Mechanical Ventilation (POA) COVID PNA (POA) History of COPD (POA) - Etiology: COVID PNA - COVID positive 6/29 - Fully vaccinated with Moderna vaccine prior to admission - s/p Remdesivir, convalescent plasma, dexamethasone - 7/15 Intubated at outside hospital - 7/17 Paralyzed and proned - CXR: bilateral diffuse patchy airspace disease - ABG on arrival: 7.43/53/65/35 on 80%, PEEP 10, PF 81 PLAN: - PAL, comp resp panel, Strep and Legionella urine Ag pending - Continue mechanical ventilation to optimize ventilation and oxygenation, maintain SpO2 >/= 92% - DuoNebs q4hr - Empiric broad spectrum antibiotics as outlined below: Linezolid and cefepime - Propofol and Dilaudid drips to facilitate tolerance of mechanical ventilation - Start DEXARDS protocol - Repeat ABG at 2000; prone if PF ratio not improved - Consider CT chest when clinically stable   VRE Bacteremia (POA) Sepsis (POA) Leukocytosis (POA) - Has received dexamethasone - Received the following courses abx: Vanc 6/29-7/10, 7/15- 7/21 Zosyn 6/29 - 7/8 Merrem 7/13-7/21 - BCx from 7/17 resulted for +VRE; transitioned to Linezolid prior to transfer - On vasopressors on 7/18 - WBC 26k, lactate here 1.2 - CXR: bilateral diffuse patchy airspace disease Plan: - PAN cultures: Bcx, UA, PAL, strep/legionella urinary Ag pending - Follow cultures; determine insertion date of PICC line - Empiric antibiotics with : Linezolid (start 7/21) and cefepime - ECHO pending   AKI (POA) - Scr on admission 0.96, up to 1.96 on 7/17  - Multifactorial AKI is likely related to sepsis PLAN:  - BMP here pending - Renal lytes pending - Renally dose medications, avoid contrast medications - Consult the renal team when appropriate      T2DM (POA) - HgbA1C pending - FSBG with correction SSI q6hr per ICU protocol"
	"1641622-1"	"1641622-1"	"POSITIVE END-EXPIRATORY PRESSURE"	"10059890"	"50-59 years"	"50-59"	"Patient admitted 7/21/2021 for presents as transfer for acute hypoxic respiratory failure and covid pneumonia. Vaccinated for COVID 3/31/2021, tested positive 7/21/2021 Patient discharged, DEATH, 7/26/2021  Date of Vaccination:3/31/2021 & 3/10/2021 Dose: 2 doses total Vaccine Manufacturer: Pfizer Lot #: EN6202/EN6207 Clinic Administering Vaccine: unknown Injection site: R deltoid both times Description of event/reaction: patient died from severe ARDS from COVID-19   Patient initially presented on 06/29 with dyspnea, productive cough and wheezing. She reported having difficulty breathing for the last month, however, her symptoms progressively worsened after 6/26/21. Patient was found to be hypoxic on her home oxygen requirement of 3L to SpO2 52% upon arrival to ER. Of note, patient was discharged from a hospitalization on 6/22/21 (unknown reason for hospitalization, duration, and location).    Patient is reportedly fully vaccinated for COVID prior to her current admission and received her last vaccine in February 2021. She tested positive for COVID on 6/29 upon admission, and stated that her daughter had been sick recently and tested negative for COVID. Patient was started on Remdesivir, Decadron, Albuterol, Thiamine, Zinc, Quercetin complex, and Vitamin D. Patient was also started on Vapotherm for supplemental oxygen which was alternated with BiPAP, as well as empiric Vancomycin (6/29-7/10 and 7/15-7/21) and Zosyn (6/29-7/8). Patient was ultimately intubated on 07/15 and her antibiotics were escalated to Vanc and Meropenem (7/13-7/21) for presumed pneumonia. She continued to require high ventilator settings (100%, PEEP 16).  Her hospitalization was complicated by shock requiring vasopressors. On 7/17, patient was increasingly acidotic with pH 6.99 and PCO2 78 and was subsequently proned and paralyzed.  Her infectious work-up was positive for VRE bacteremia on 7/17 and candida in urine culture. On 7/21 she was transferred to MICU for hypoxic respiratory failure and COVID pneumonia. On arrival, she is sedated on mechanical ventilation...Acute Hypoxic Hypercapneic Respiratory Failure requiring Mechanical Ventilation (POA) COVID PNA (POA) History of COPD (POA) - Etiology: COVID PNA - COVID positive 6/29 - Fully vaccinated with Moderna vaccine prior to admission - s/p Remdesivir, convalescent plasma, dexamethasone - 7/15 Intubated at outside hospital - 7/17 Paralyzed and proned - CXR: bilateral diffuse patchy airspace disease - ABG on arrival: 7.43/53/65/35 on 80%, PEEP 10, PF 81 PLAN: - PAL, comp resp panel, Strep and Legionella urine Ag pending - Continue mechanical ventilation to optimize ventilation and oxygenation, maintain SpO2 >/= 92% - DuoNebs q4hr - Empiric broad spectrum antibiotics as outlined below: Linezolid and cefepime - Propofol and Dilaudid drips to facilitate tolerance of mechanical ventilation - Start DEXARDS protocol - Repeat ABG at 2000; prone if PF ratio not improved - Consider CT chest when clinically stable   VRE Bacteremia (POA) Sepsis (POA) Leukocytosis (POA) - Has received dexamethasone - Received the following courses abx: Vanc 6/29-7/10, 7/15- 7/21 Zosyn 6/29 - 7/8 Merrem 7/13-7/21 - BCx from 7/17 resulted for +VRE; transitioned to Linezolid prior to transfer - On vasopressors on 7/18 - WBC 26k, lactate here 1.2 - CXR: bilateral diffuse patchy airspace disease Plan: - PAN cultures: Bcx, UA, PAL, strep/legionella urinary Ag pending - Follow cultures; determine insertion date of PICC line - Empiric antibiotics with : Linezolid (start 7/21) and cefepime - ECHO pending   AKI (POA) - Scr on admission 0.96, up to 1.96 on 7/17  - Multifactorial AKI is likely related to sepsis PLAN:  - BMP here pending - Renal lytes pending - Renally dose medications, avoid contrast medications - Consult the renal team when appropriate      T2DM (POA) - HgbA1C pending - FSBG with correction SSI q6hr per ICU protocol"
	"1641622-1"	"1641622-1"	"PRODUCTIVE COUGH"	"10036790"	"50-59 years"	"50-59"	"Patient admitted 7/21/2021 for presents as transfer for acute hypoxic respiratory failure and covid pneumonia. Vaccinated for COVID 3/31/2021, tested positive 7/21/2021 Patient discharged, DEATH, 7/26/2021  Date of Vaccination:3/31/2021 & 3/10/2021 Dose: 2 doses total Vaccine Manufacturer: Pfizer Lot #: EN6202/EN6207 Clinic Administering Vaccine: unknown Injection site: R deltoid both times Description of event/reaction: patient died from severe ARDS from COVID-19   Patient initially presented on 06/29 with dyspnea, productive cough and wheezing. She reported having difficulty breathing for the last month, however, her symptoms progressively worsened after 6/26/21. Patient was found to be hypoxic on her home oxygen requirement of 3L to SpO2 52% upon arrival to ER. Of note, patient was discharged from a hospitalization on 6/22/21 (unknown reason for hospitalization, duration, and location).    Patient is reportedly fully vaccinated for COVID prior to her current admission and received her last vaccine in February 2021. She tested positive for COVID on 6/29 upon admission, and stated that her daughter had been sick recently and tested negative for COVID. Patient was started on Remdesivir, Decadron, Albuterol, Thiamine, Zinc, Quercetin complex, and Vitamin D. Patient was also started on Vapotherm for supplemental oxygen which was alternated with BiPAP, as well as empiric Vancomycin (6/29-7/10 and 7/15-7/21) and Zosyn (6/29-7/8). Patient was ultimately intubated on 07/15 and her antibiotics were escalated to Vanc and Meropenem (7/13-7/21) for presumed pneumonia. She continued to require high ventilator settings (100%, PEEP 16).  Her hospitalization was complicated by shock requiring vasopressors. On 7/17, patient was increasingly acidotic with pH 6.99 and PCO2 78 and was subsequently proned and paralyzed.  Her infectious work-up was positive for VRE bacteremia on 7/17 and candida in urine culture. On 7/21 she was transferred to MICU for hypoxic respiratory failure and COVID pneumonia. On arrival, she is sedated on mechanical ventilation...Acute Hypoxic Hypercapneic Respiratory Failure requiring Mechanical Ventilation (POA) COVID PNA (POA) History of COPD (POA) - Etiology: COVID PNA - COVID positive 6/29 - Fully vaccinated with Moderna vaccine prior to admission - s/p Remdesivir, convalescent plasma, dexamethasone - 7/15 Intubated at outside hospital - 7/17 Paralyzed and proned - CXR: bilateral diffuse patchy airspace disease - ABG on arrival: 7.43/53/65/35 on 80%, PEEP 10, PF 81 PLAN: - PAL, comp resp panel, Strep and Legionella urine Ag pending - Continue mechanical ventilation to optimize ventilation and oxygenation, maintain SpO2 >/= 92% - DuoNebs q4hr - Empiric broad spectrum antibiotics as outlined below: Linezolid and cefepime - Propofol and Dilaudid drips to facilitate tolerance of mechanical ventilation - Start DEXARDS protocol - Repeat ABG at 2000; prone if PF ratio not improved - Consider CT chest when clinically stable   VRE Bacteremia (POA) Sepsis (POA) Leukocytosis (POA) - Has received dexamethasone - Received the following courses abx: Vanc 6/29-7/10, 7/15- 7/21 Zosyn 6/29 - 7/8 Merrem 7/13-7/21 - BCx from 7/17 resulted for +VRE; transitioned to Linezolid prior to transfer - On vasopressors on 7/18 - WBC 26k, lactate here 1.2 - CXR: bilateral diffuse patchy airspace disease Plan: - PAN cultures: Bcx, UA, PAL, strep/legionella urinary Ag pending - Follow cultures; determine insertion date of PICC line - Empiric antibiotics with : Linezolid (start 7/21) and cefepime - ECHO pending   AKI (POA) - Scr on admission 0.96, up to 1.96 on 7/17  - Multifactorial AKI is likely related to sepsis PLAN:  - BMP here pending - Renal lytes pending - Renally dose medications, avoid contrast medications - Consult the renal team when appropriate      T2DM (POA) - HgbA1C pending - FSBG with correction SSI q6hr per ICU protocol"
	"1641622-1"	"1641622-1"	"RESPIRATORY FAILURE"	"10038695"	"50-59 years"	"50-59"	"Patient admitted 7/21/2021 for presents as transfer for acute hypoxic respiratory failure and covid pneumonia. Vaccinated for COVID 3/31/2021, tested positive 7/21/2021 Patient discharged, DEATH, 7/26/2021  Date of Vaccination:3/31/2021 & 3/10/2021 Dose: 2 doses total Vaccine Manufacturer: Pfizer Lot #: EN6202/EN6207 Clinic Administering Vaccine: unknown Injection site: R deltoid both times Description of event/reaction: patient died from severe ARDS from COVID-19   Patient initially presented on 06/29 with dyspnea, productive cough and wheezing. She reported having difficulty breathing for the last month, however, her symptoms progressively worsened after 6/26/21. Patient was found to be hypoxic on her home oxygen requirement of 3L to SpO2 52% upon arrival to ER. Of note, patient was discharged from a hospitalization on 6/22/21 (unknown reason for hospitalization, duration, and location).    Patient is reportedly fully vaccinated for COVID prior to her current admission and received her last vaccine in February 2021. She tested positive for COVID on 6/29 upon admission, and stated that her daughter had been sick recently and tested negative for COVID. Patient was started on Remdesivir, Decadron, Albuterol, Thiamine, Zinc, Quercetin complex, and Vitamin D. Patient was also started on Vapotherm for supplemental oxygen which was alternated with BiPAP, as well as empiric Vancomycin (6/29-7/10 and 7/15-7/21) and Zosyn (6/29-7/8). Patient was ultimately intubated on 07/15 and her antibiotics were escalated to Vanc and Meropenem (7/13-7/21) for presumed pneumonia. She continued to require high ventilator settings (100%, PEEP 16).  Her hospitalization was complicated by shock requiring vasopressors. On 7/17, patient was increasingly acidotic with pH 6.99 and PCO2 78 and was subsequently proned and paralyzed.  Her infectious work-up was positive for VRE bacteremia on 7/17 and candida in urine culture. On 7/21 she was transferred to MICU for hypoxic respiratory failure and COVID pneumonia. On arrival, she is sedated on mechanical ventilation...Acute Hypoxic Hypercapneic Respiratory Failure requiring Mechanical Ventilation (POA) COVID PNA (POA) History of COPD (POA) - Etiology: COVID PNA - COVID positive 6/29 - Fully vaccinated with Moderna vaccine prior to admission - s/p Remdesivir, convalescent plasma, dexamethasone - 7/15 Intubated at outside hospital - 7/17 Paralyzed and proned - CXR: bilateral diffuse patchy airspace disease - ABG on arrival: 7.43/53/65/35 on 80%, PEEP 10, PF 81 PLAN: - PAL, comp resp panel, Strep and Legionella urine Ag pending - Continue mechanical ventilation to optimize ventilation and oxygenation, maintain SpO2 >/= 92% - DuoNebs q4hr - Empiric broad spectrum antibiotics as outlined below: Linezolid and cefepime - Propofol and Dilaudid drips to facilitate tolerance of mechanical ventilation - Start DEXARDS protocol - Repeat ABG at 2000; prone if PF ratio not improved - Consider CT chest when clinically stable   VRE Bacteremia (POA) Sepsis (POA) Leukocytosis (POA) - Has received dexamethasone - Received the following courses abx: Vanc 6/29-7/10, 7/15- 7/21 Zosyn 6/29 - 7/8 Merrem 7/13-7/21 - BCx from 7/17 resulted for +VRE; transitioned to Linezolid prior to transfer - On vasopressors on 7/18 - WBC 26k, lactate here 1.2 - CXR: bilateral diffuse patchy airspace disease Plan: - PAN cultures: Bcx, UA, PAL, strep/legionella urinary Ag pending - Follow cultures; determine insertion date of PICC line - Empiric antibiotics with : Linezolid (start 7/21) and cefepime - ECHO pending   AKI (POA) - Scr on admission 0.96, up to 1.96 on 7/17  - Multifactorial AKI is likely related to sepsis PLAN:  - BMP here pending - Renal lytes pending - Renally dose medications, avoid contrast medications - Consult the renal team when appropriate      T2DM (POA) - HgbA1C pending - FSBG with correction SSI q6hr per ICU protocol"
	"1641622-1"	"1641622-1"	"RESPIRATORY VIRAL PANEL"	"10075165"	"50-59 years"	"50-59"	"Patient admitted 7/21/2021 for presents as transfer for acute hypoxic respiratory failure and covid pneumonia. Vaccinated for COVID 3/31/2021, tested positive 7/21/2021 Patient discharged, DEATH, 7/26/2021  Date of Vaccination:3/31/2021 & 3/10/2021 Dose: 2 doses total Vaccine Manufacturer: Pfizer Lot #: EN6202/EN6207 Clinic Administering Vaccine: unknown Injection site: R deltoid both times Description of event/reaction: patient died from severe ARDS from COVID-19   Patient initially presented on 06/29 with dyspnea, productive cough and wheezing. She reported having difficulty breathing for the last month, however, her symptoms progressively worsened after 6/26/21. Patient was found to be hypoxic on her home oxygen requirement of 3L to SpO2 52% upon arrival to ER. Of note, patient was discharged from a hospitalization on 6/22/21 (unknown reason for hospitalization, duration, and location).    Patient is reportedly fully vaccinated for COVID prior to her current admission and received her last vaccine in February 2021. She tested positive for COVID on 6/29 upon admission, and stated that her daughter had been sick recently and tested negative for COVID. Patient was started on Remdesivir, Decadron, Albuterol, Thiamine, Zinc, Quercetin complex, and Vitamin D. Patient was also started on Vapotherm for supplemental oxygen which was alternated with BiPAP, as well as empiric Vancomycin (6/29-7/10 and 7/15-7/21) and Zosyn (6/29-7/8). Patient was ultimately intubated on 07/15 and her antibiotics were escalated to Vanc and Meropenem (7/13-7/21) for presumed pneumonia. She continued to require high ventilator settings (100%, PEEP 16).  Her hospitalization was complicated by shock requiring vasopressors. On 7/17, patient was increasingly acidotic with pH 6.99 and PCO2 78 and was subsequently proned and paralyzed.  Her infectious work-up was positive for VRE bacteremia on 7/17 and candida in urine culture. On 7/21 she was transferred to MICU for hypoxic respiratory failure and COVID pneumonia. On arrival, she is sedated on mechanical ventilation...Acute Hypoxic Hypercapneic Respiratory Failure requiring Mechanical Ventilation (POA) COVID PNA (POA) History of COPD (POA) - Etiology: COVID PNA - COVID positive 6/29 - Fully vaccinated with Moderna vaccine prior to admission - s/p Remdesivir, convalescent plasma, dexamethasone - 7/15 Intubated at outside hospital - 7/17 Paralyzed and proned - CXR: bilateral diffuse patchy airspace disease - ABG on arrival: 7.43/53/65/35 on 80%, PEEP 10, PF 81 PLAN: - PAL, comp resp panel, Strep and Legionella urine Ag pending - Continue mechanical ventilation to optimize ventilation and oxygenation, maintain SpO2 >/= 92% - DuoNebs q4hr - Empiric broad spectrum antibiotics as outlined below: Linezolid and cefepime - Propofol and Dilaudid drips to facilitate tolerance of mechanical ventilation - Start DEXARDS protocol - Repeat ABG at 2000; prone if PF ratio not improved - Consider CT chest when clinically stable   VRE Bacteremia (POA) Sepsis (POA) Leukocytosis (POA) - Has received dexamethasone - Received the following courses abx: Vanc 6/29-7/10, 7/15- 7/21 Zosyn 6/29 - 7/8 Merrem 7/13-7/21 - BCx from 7/17 resulted for +VRE; transitioned to Linezolid prior to transfer - On vasopressors on 7/18 - WBC 26k, lactate here 1.2 - CXR: bilateral diffuse patchy airspace disease Plan: - PAN cultures: Bcx, UA, PAL, strep/legionella urinary Ag pending - Follow cultures; determine insertion date of PICC line - Empiric antibiotics with : Linezolid (start 7/21) and cefepime - ECHO pending   AKI (POA) - Scr on admission 0.96, up to 1.96 on 7/17  - Multifactorial AKI is likely related to sepsis PLAN:  - BMP here pending - Renal lytes pending - Renally dose medications, avoid contrast medications - Consult the renal team when appropriate      T2DM (POA) - HgbA1C pending - FSBG with correction SSI q6hr per ICU protocol"
	"1641622-1"	"1641622-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"Patient admitted 7/21/2021 for presents as transfer for acute hypoxic respiratory failure and covid pneumonia. Vaccinated for COVID 3/31/2021, tested positive 7/21/2021 Patient discharged, DEATH, 7/26/2021  Date of Vaccination:3/31/2021 & 3/10/2021 Dose: 2 doses total Vaccine Manufacturer: Pfizer Lot #: EN6202/EN6207 Clinic Administering Vaccine: unknown Injection site: R deltoid both times Description of event/reaction: patient died from severe ARDS from COVID-19   Patient initially presented on 06/29 with dyspnea, productive cough and wheezing. She reported having difficulty breathing for the last month, however, her symptoms progressively worsened after 6/26/21. Patient was found to be hypoxic on her home oxygen requirement of 3L to SpO2 52% upon arrival to ER. Of note, patient was discharged from a hospitalization on 6/22/21 (unknown reason for hospitalization, duration, and location).    Patient is reportedly fully vaccinated for COVID prior to her current admission and received her last vaccine in February 2021. She tested positive for COVID on 6/29 upon admission, and stated that her daughter had been sick recently and tested negative for COVID. Patient was started on Remdesivir, Decadron, Albuterol, Thiamine, Zinc, Quercetin complex, and Vitamin D. Patient was also started on Vapotherm for supplemental oxygen which was alternated with BiPAP, as well as empiric Vancomycin (6/29-7/10 and 7/15-7/21) and Zosyn (6/29-7/8). Patient was ultimately intubated on 07/15 and her antibiotics were escalated to Vanc and Meropenem (7/13-7/21) for presumed pneumonia. She continued to require high ventilator settings (100%, PEEP 16).  Her hospitalization was complicated by shock requiring vasopressors. On 7/17, patient was increasingly acidotic with pH 6.99 and PCO2 78 and was subsequently proned and paralyzed.  Her infectious work-up was positive for VRE bacteremia on 7/17 and candida in urine culture. On 7/21 she was transferred to MICU for hypoxic respiratory failure and COVID pneumonia. On arrival, she is sedated on mechanical ventilation...Acute Hypoxic Hypercapneic Respiratory Failure requiring Mechanical Ventilation (POA) COVID PNA (POA) History of COPD (POA) - Etiology: COVID PNA - COVID positive 6/29 - Fully vaccinated with Moderna vaccine prior to admission - s/p Remdesivir, convalescent plasma, dexamethasone - 7/15 Intubated at outside hospital - 7/17 Paralyzed and proned - CXR: bilateral diffuse patchy airspace disease - ABG on arrival: 7.43/53/65/35 on 80%, PEEP 10, PF 81 PLAN: - PAL, comp resp panel, Strep and Legionella urine Ag pending - Continue mechanical ventilation to optimize ventilation and oxygenation, maintain SpO2 >/= 92% - DuoNebs q4hr - Empiric broad spectrum antibiotics as outlined below: Linezolid and cefepime - Propofol and Dilaudid drips to facilitate tolerance of mechanical ventilation - Start DEXARDS protocol - Repeat ABG at 2000; prone if PF ratio not improved - Consider CT chest when clinically stable   VRE Bacteremia (POA) Sepsis (POA) Leukocytosis (POA) - Has received dexamethasone - Received the following courses abx: Vanc 6/29-7/10, 7/15- 7/21 Zosyn 6/29 - 7/8 Merrem 7/13-7/21 - BCx from 7/17 resulted for +VRE; transitioned to Linezolid prior to transfer - On vasopressors on 7/18 - WBC 26k, lactate here 1.2 - CXR: bilateral diffuse patchy airspace disease Plan: - PAN cultures: Bcx, UA, PAL, strep/legionella urinary Ag pending - Follow cultures; determine insertion date of PICC line - Empiric antibiotics with : Linezolid (start 7/21) and cefepime - ECHO pending   AKI (POA) - Scr on admission 0.96, up to 1.96 on 7/17  - Multifactorial AKI is likely related to sepsis PLAN:  - BMP here pending - Renal lytes pending - Renally dose medications, avoid contrast medications - Consult the renal team when appropriate      T2DM (POA) - HgbA1C pending - FSBG with correction SSI q6hr per ICU protocol"
	"1641622-1"	"1641622-1"	"SEPSIS"	"10040047"	"50-59 years"	"50-59"	"Patient admitted 7/21/2021 for presents as transfer for acute hypoxic respiratory failure and covid pneumonia. Vaccinated for COVID 3/31/2021, tested positive 7/21/2021 Patient discharged, DEATH, 7/26/2021  Date of Vaccination:3/31/2021 & 3/10/2021 Dose: 2 doses total Vaccine Manufacturer: Pfizer Lot #: EN6202/EN6207 Clinic Administering Vaccine: unknown Injection site: R deltoid both times Description of event/reaction: patient died from severe ARDS from COVID-19   Patient initially presented on 06/29 with dyspnea, productive cough and wheezing. She reported having difficulty breathing for the last month, however, her symptoms progressively worsened after 6/26/21. Patient was found to be hypoxic on her home oxygen requirement of 3L to SpO2 52% upon arrival to ER. Of note, patient was discharged from a hospitalization on 6/22/21 (unknown reason for hospitalization, duration, and location).    Patient is reportedly fully vaccinated for COVID prior to her current admission and received her last vaccine in February 2021. She tested positive for COVID on 6/29 upon admission, and stated that her daughter had been sick recently and tested negative for COVID. Patient was started on Remdesivir, Decadron, Albuterol, Thiamine, Zinc, Quercetin complex, and Vitamin D. Patient was also started on Vapotherm for supplemental oxygen which was alternated with BiPAP, as well as empiric Vancomycin (6/29-7/10 and 7/15-7/21) and Zosyn (6/29-7/8). Patient was ultimately intubated on 07/15 and her antibiotics were escalated to Vanc and Meropenem (7/13-7/21) for presumed pneumonia. She continued to require high ventilator settings (100%, PEEP 16).  Her hospitalization was complicated by shock requiring vasopressors. On 7/17, patient was increasingly acidotic with pH 6.99 and PCO2 78 and was subsequently proned and paralyzed.  Her infectious work-up was positive for VRE bacteremia on 7/17 and candida in urine culture. On 7/21 she was transferred to MICU for hypoxic respiratory failure and COVID pneumonia. On arrival, she is sedated on mechanical ventilation...Acute Hypoxic Hypercapneic Respiratory Failure requiring Mechanical Ventilation (POA) COVID PNA (POA) History of COPD (POA) - Etiology: COVID PNA - COVID positive 6/29 - Fully vaccinated with Moderna vaccine prior to admission - s/p Remdesivir, convalescent plasma, dexamethasone - 7/15 Intubated at outside hospital - 7/17 Paralyzed and proned - CXR: bilateral diffuse patchy airspace disease - ABG on arrival: 7.43/53/65/35 on 80%, PEEP 10, PF 81 PLAN: - PAL, comp resp panel, Strep and Legionella urine Ag pending - Continue mechanical ventilation to optimize ventilation and oxygenation, maintain SpO2 >/= 92% - DuoNebs q4hr - Empiric broad spectrum antibiotics as outlined below: Linezolid and cefepime - Propofol and Dilaudid drips to facilitate tolerance of mechanical ventilation - Start DEXARDS protocol - Repeat ABG at 2000; prone if PF ratio not improved - Consider CT chest when clinically stable   VRE Bacteremia (POA) Sepsis (POA) Leukocytosis (POA) - Has received dexamethasone - Received the following courses abx: Vanc 6/29-7/10, 7/15- 7/21 Zosyn 6/29 - 7/8 Merrem 7/13-7/21 - BCx from 7/17 resulted for +VRE; transitioned to Linezolid prior to transfer - On vasopressors on 7/18 - WBC 26k, lactate here 1.2 - CXR: bilateral diffuse patchy airspace disease Plan: - PAN cultures: Bcx, UA, PAL, strep/legionella urinary Ag pending - Follow cultures; determine insertion date of PICC line - Empiric antibiotics with : Linezolid (start 7/21) and cefepime - ECHO pending   AKI (POA) - Scr on admission 0.96, up to 1.96 on 7/17  - Multifactorial AKI is likely related to sepsis PLAN:  - BMP here pending - Renal lytes pending - Renally dose medications, avoid contrast medications - Consult the renal team when appropriate      T2DM (POA) - HgbA1C pending - FSBG with correction SSI q6hr per ICU protocol"
	"1641622-1"	"1641622-1"	"SHOCK"	"10040560"	"50-59 years"	"50-59"	"Patient admitted 7/21/2021 for presents as transfer for acute hypoxic respiratory failure and covid pneumonia. Vaccinated for COVID 3/31/2021, tested positive 7/21/2021 Patient discharged, DEATH, 7/26/2021  Date of Vaccination:3/31/2021 & 3/10/2021 Dose: 2 doses total Vaccine Manufacturer: Pfizer Lot #: EN6202/EN6207 Clinic Administering Vaccine: unknown Injection site: R deltoid both times Description of event/reaction: patient died from severe ARDS from COVID-19   Patient initially presented on 06/29 with dyspnea, productive cough and wheezing. She reported having difficulty breathing for the last month, however, her symptoms progressively worsened after 6/26/21. Patient was found to be hypoxic on her home oxygen requirement of 3L to SpO2 52% upon arrival to ER. Of note, patient was discharged from a hospitalization on 6/22/21 (unknown reason for hospitalization, duration, and location).    Patient is reportedly fully vaccinated for COVID prior to her current admission and received her last vaccine in February 2021. She tested positive for COVID on 6/29 upon admission, and stated that her daughter had been sick recently and tested negative for COVID. Patient was started on Remdesivir, Decadron, Albuterol, Thiamine, Zinc, Quercetin complex, and Vitamin D. Patient was also started on Vapotherm for supplemental oxygen which was alternated with BiPAP, as well as empiric Vancomycin (6/29-7/10 and 7/15-7/21) and Zosyn (6/29-7/8). Patient was ultimately intubated on 07/15 and her antibiotics were escalated to Vanc and Meropenem (7/13-7/21) for presumed pneumonia. She continued to require high ventilator settings (100%, PEEP 16).  Her hospitalization was complicated by shock requiring vasopressors. On 7/17, patient was increasingly acidotic with pH 6.99 and PCO2 78 and was subsequently proned and paralyzed.  Her infectious work-up was positive for VRE bacteremia on 7/17 and candida in urine culture. On 7/21 she was transferred to MICU for hypoxic respiratory failure and COVID pneumonia. On arrival, she is sedated on mechanical ventilation...Acute Hypoxic Hypercapneic Respiratory Failure requiring Mechanical Ventilation (POA) COVID PNA (POA) History of COPD (POA) - Etiology: COVID PNA - COVID positive 6/29 - Fully vaccinated with Moderna vaccine prior to admission - s/p Remdesivir, convalescent plasma, dexamethasone - 7/15 Intubated at outside hospital - 7/17 Paralyzed and proned - CXR: bilateral diffuse patchy airspace disease - ABG on arrival: 7.43/53/65/35 on 80%, PEEP 10, PF 81 PLAN: - PAL, comp resp panel, Strep and Legionella urine Ag pending - Continue mechanical ventilation to optimize ventilation and oxygenation, maintain SpO2 >/= 92% - DuoNebs q4hr - Empiric broad spectrum antibiotics as outlined below: Linezolid and cefepime - Propofol and Dilaudid drips to facilitate tolerance of mechanical ventilation - Start DEXARDS protocol - Repeat ABG at 2000; prone if PF ratio not improved - Consider CT chest when clinically stable   VRE Bacteremia (POA) Sepsis (POA) Leukocytosis (POA) - Has received dexamethasone - Received the following courses abx: Vanc 6/29-7/10, 7/15- 7/21 Zosyn 6/29 - 7/8 Merrem 7/13-7/21 - BCx from 7/17 resulted for +VRE; transitioned to Linezolid prior to transfer - On vasopressors on 7/18 - WBC 26k, lactate here 1.2 - CXR: bilateral diffuse patchy airspace disease Plan: - PAN cultures: Bcx, UA, PAL, strep/legionella urinary Ag pending - Follow cultures; determine insertion date of PICC line - Empiric antibiotics with : Linezolid (start 7/21) and cefepime - ECHO pending   AKI (POA) - Scr on admission 0.96, up to 1.96 on 7/17  - Multifactorial AKI is likely related to sepsis PLAN:  - BMP here pending - Renal lytes pending - Renally dose medications, avoid contrast medications - Consult the renal team when appropriate      T2DM (POA) - HgbA1C pending - FSBG with correction SSI q6hr per ICU protocol"
	"1641622-1"	"1641622-1"	"STREPTOCOCCUS TEST"	"10070414"	"50-59 years"	"50-59"	"Patient admitted 7/21/2021 for presents as transfer for acute hypoxic respiratory failure and covid pneumonia. Vaccinated for COVID 3/31/2021, tested positive 7/21/2021 Patient discharged, DEATH, 7/26/2021  Date of Vaccination:3/31/2021 & 3/10/2021 Dose: 2 doses total Vaccine Manufacturer: Pfizer Lot #: EN6202/EN6207 Clinic Administering Vaccine: unknown Injection site: R deltoid both times Description of event/reaction: patient died from severe ARDS from COVID-19   Patient initially presented on 06/29 with dyspnea, productive cough and wheezing. She reported having difficulty breathing for the last month, however, her symptoms progressively worsened after 6/26/21. Patient was found to be hypoxic on her home oxygen requirement of 3L to SpO2 52% upon arrival to ER. Of note, patient was discharged from a hospitalization on 6/22/21 (unknown reason for hospitalization, duration, and location).    Patient is reportedly fully vaccinated for COVID prior to her current admission and received her last vaccine in February 2021. She tested positive for COVID on 6/29 upon admission, and stated that her daughter had been sick recently and tested negative for COVID. Patient was started on Remdesivir, Decadron, Albuterol, Thiamine, Zinc, Quercetin complex, and Vitamin D. Patient was also started on Vapotherm for supplemental oxygen which was alternated with BiPAP, as well as empiric Vancomycin (6/29-7/10 and 7/15-7/21) and Zosyn (6/29-7/8). Patient was ultimately intubated on 07/15 and her antibiotics were escalated to Vanc and Meropenem (7/13-7/21) for presumed pneumonia. She continued to require high ventilator settings (100%, PEEP 16).  Her hospitalization was complicated by shock requiring vasopressors. On 7/17, patient was increasingly acidotic with pH 6.99 and PCO2 78 and was subsequently proned and paralyzed.  Her infectious work-up was positive for VRE bacteremia on 7/17 and candida in urine culture. On 7/21 she was transferred to MICU for hypoxic respiratory failure and COVID pneumonia. On arrival, she is sedated on mechanical ventilation...Acute Hypoxic Hypercapneic Respiratory Failure requiring Mechanical Ventilation (POA) COVID PNA (POA) History of COPD (POA) - Etiology: COVID PNA - COVID positive 6/29 - Fully vaccinated with Moderna vaccine prior to admission - s/p Remdesivir, convalescent plasma, dexamethasone - 7/15 Intubated at outside hospital - 7/17 Paralyzed and proned - CXR: bilateral diffuse patchy airspace disease - ABG on arrival: 7.43/53/65/35 on 80%, PEEP 10, PF 81 PLAN: - PAL, comp resp panel, Strep and Legionella urine Ag pending - Continue mechanical ventilation to optimize ventilation and oxygenation, maintain SpO2 >/= 92% - DuoNebs q4hr - Empiric broad spectrum antibiotics as outlined below: Linezolid and cefepime - Propofol and Dilaudid drips to facilitate tolerance of mechanical ventilation - Start DEXARDS protocol - Repeat ABG at 2000; prone if PF ratio not improved - Consider CT chest when clinically stable   VRE Bacteremia (POA) Sepsis (POA) Leukocytosis (POA) - Has received dexamethasone - Received the following courses abx: Vanc 6/29-7/10, 7/15- 7/21 Zosyn 6/29 - 7/8 Merrem 7/13-7/21 - BCx from 7/17 resulted for +VRE; transitioned to Linezolid prior to transfer - On vasopressors on 7/18 - WBC 26k, lactate here 1.2 - CXR: bilateral diffuse patchy airspace disease Plan: - PAN cultures: Bcx, UA, PAL, strep/legionella urinary Ag pending - Follow cultures; determine insertion date of PICC line - Empiric antibiotics with : Linezolid (start 7/21) and cefepime - ECHO pending   AKI (POA) - Scr on admission 0.96, up to 1.96 on 7/17  - Multifactorial AKI is likely related to sepsis PLAN:  - BMP here pending - Renal lytes pending - Renally dose medications, avoid contrast medications - Consult the renal team when appropriate      T2DM (POA) - HgbA1C pending - FSBG with correction SSI q6hr per ICU protocol"
	"1641622-1"	"1641622-1"	"URINARY TRACT CANDIDIASIS"	"10083162"	"50-59 years"	"50-59"	"Patient admitted 7/21/2021 for presents as transfer for acute hypoxic respiratory failure and covid pneumonia. Vaccinated for COVID 3/31/2021, tested positive 7/21/2021 Patient discharged, DEATH, 7/26/2021  Date of Vaccination:3/31/2021 & 3/10/2021 Dose: 2 doses total Vaccine Manufacturer: Pfizer Lot #: EN6202/EN6207 Clinic Administering Vaccine: unknown Injection site: R deltoid both times Description of event/reaction: patient died from severe ARDS from COVID-19   Patient initially presented on 06/29 with dyspnea, productive cough and wheezing. She reported having difficulty breathing for the last month, however, her symptoms progressively worsened after 6/26/21. Patient was found to be hypoxic on her home oxygen requirement of 3L to SpO2 52% upon arrival to ER. Of note, patient was discharged from a hospitalization on 6/22/21 (unknown reason for hospitalization, duration, and location).    Patient is reportedly fully vaccinated for COVID prior to her current admission and received her last vaccine in February 2021. She tested positive for COVID on 6/29 upon admission, and stated that her daughter had been sick recently and tested negative for COVID. Patient was started on Remdesivir, Decadron, Albuterol, Thiamine, Zinc, Quercetin complex, and Vitamin D. Patient was also started on Vapotherm for supplemental oxygen which was alternated with BiPAP, as well as empiric Vancomycin (6/29-7/10 and 7/15-7/21) and Zosyn (6/29-7/8). Patient was ultimately intubated on 07/15 and her antibiotics were escalated to Vanc and Meropenem (7/13-7/21) for presumed pneumonia. She continued to require high ventilator settings (100%, PEEP 16).  Her hospitalization was complicated by shock requiring vasopressors. On 7/17, patient was increasingly acidotic with pH 6.99 and PCO2 78 and was subsequently proned and paralyzed.  Her infectious work-up was positive for VRE bacteremia on 7/17 and candida in urine culture. On 7/21 she was transferred to MICU for hypoxic respiratory failure and COVID pneumonia. On arrival, she is sedated on mechanical ventilation...Acute Hypoxic Hypercapneic Respiratory Failure requiring Mechanical Ventilation (POA) COVID PNA (POA) History of COPD (POA) - Etiology: COVID PNA - COVID positive 6/29 - Fully vaccinated with Moderna vaccine prior to admission - s/p Remdesivir, convalescent plasma, dexamethasone - 7/15 Intubated at outside hospital - 7/17 Paralyzed and proned - CXR: bilateral diffuse patchy airspace disease - ABG on arrival: 7.43/53/65/35 on 80%, PEEP 10, PF 81 PLAN: - PAL, comp resp panel, Strep and Legionella urine Ag pending - Continue mechanical ventilation to optimize ventilation and oxygenation, maintain SpO2 >/= 92% - DuoNebs q4hr - Empiric broad spectrum antibiotics as outlined below: Linezolid and cefepime - Propofol and Dilaudid drips to facilitate tolerance of mechanical ventilation - Start DEXARDS protocol - Repeat ABG at 2000; prone if PF ratio not improved - Consider CT chest when clinically stable   VRE Bacteremia (POA) Sepsis (POA) Leukocytosis (POA) - Has received dexamethasone - Received the following courses abx: Vanc 6/29-7/10, 7/15- 7/21 Zosyn 6/29 - 7/8 Merrem 7/13-7/21 - BCx from 7/17 resulted for +VRE; transitioned to Linezolid prior to transfer - On vasopressors on 7/18 - WBC 26k, lactate here 1.2 - CXR: bilateral diffuse patchy airspace disease Plan: - PAN cultures: Bcx, UA, PAL, strep/legionella urinary Ag pending - Follow cultures; determine insertion date of PICC line - Empiric antibiotics with : Linezolid (start 7/21) and cefepime - ECHO pending   AKI (POA) - Scr on admission 0.96, up to 1.96 on 7/17  - Multifactorial AKI is likely related to sepsis PLAN:  - BMP here pending - Renal lytes pending - Renally dose medications, avoid contrast medications - Consult the renal team when appropriate      T2DM (POA) - HgbA1C pending - FSBG with correction SSI q6hr per ICU protocol"
	"1641622-1"	"1641622-1"	"WHEEZING"	"10047924"	"50-59 years"	"50-59"	"Patient admitted 7/21/2021 for presents as transfer for acute hypoxic respiratory failure and covid pneumonia. Vaccinated for COVID 3/31/2021, tested positive 7/21/2021 Patient discharged, DEATH, 7/26/2021  Date of Vaccination:3/31/2021 & 3/10/2021 Dose: 2 doses total Vaccine Manufacturer: Pfizer Lot #: EN6202/EN6207 Clinic Administering Vaccine: unknown Injection site: R deltoid both times Description of event/reaction: patient died from severe ARDS from COVID-19   Patient initially presented on 06/29 with dyspnea, productive cough and wheezing. She reported having difficulty breathing for the last month, however, her symptoms progressively worsened after 6/26/21. Patient was found to be hypoxic on her home oxygen requirement of 3L to SpO2 52% upon arrival to ER. Of note, patient was discharged from a hospitalization on 6/22/21 (unknown reason for hospitalization, duration, and location).    Patient is reportedly fully vaccinated for COVID prior to her current admission and received her last vaccine in February 2021. She tested positive for COVID on 6/29 upon admission, and stated that her daughter had been sick recently and tested negative for COVID. Patient was started on Remdesivir, Decadron, Albuterol, Thiamine, Zinc, Quercetin complex, and Vitamin D. Patient was also started on Vapotherm for supplemental oxygen which was alternated with BiPAP, as well as empiric Vancomycin (6/29-7/10 and 7/15-7/21) and Zosyn (6/29-7/8). Patient was ultimately intubated on 07/15 and her antibiotics were escalated to Vanc and Meropenem (7/13-7/21) for presumed pneumonia. She continued to require high ventilator settings (100%, PEEP 16).  Her hospitalization was complicated by shock requiring vasopressors. On 7/17, patient was increasingly acidotic with pH 6.99 and PCO2 78 and was subsequently proned and paralyzed.  Her infectious work-up was positive for VRE bacteremia on 7/17 and candida in urine culture. On 7/21 she was transferred to MICU for hypoxic respiratory failure and COVID pneumonia. On arrival, she is sedated on mechanical ventilation...Acute Hypoxic Hypercapneic Respiratory Failure requiring Mechanical Ventilation (POA) COVID PNA (POA) History of COPD (POA) - Etiology: COVID PNA - COVID positive 6/29 - Fully vaccinated with Moderna vaccine prior to admission - s/p Remdesivir, convalescent plasma, dexamethasone - 7/15 Intubated at outside hospital - 7/17 Paralyzed and proned - CXR: bilateral diffuse patchy airspace disease - ABG on arrival: 7.43/53/65/35 on 80%, PEEP 10, PF 81 PLAN: - PAL, comp resp panel, Strep and Legionella urine Ag pending - Continue mechanical ventilation to optimize ventilation and oxygenation, maintain SpO2 >/= 92% - DuoNebs q4hr - Empiric broad spectrum antibiotics as outlined below: Linezolid and cefepime - Propofol and Dilaudid drips to facilitate tolerance of mechanical ventilation - Start DEXARDS protocol - Repeat ABG at 2000; prone if PF ratio not improved - Consider CT chest when clinically stable   VRE Bacteremia (POA) Sepsis (POA) Leukocytosis (POA) - Has received dexamethasone - Received the following courses abx: Vanc 6/29-7/10, 7/15- 7/21 Zosyn 6/29 - 7/8 Merrem 7/13-7/21 - BCx from 7/17 resulted for +VRE; transitioned to Linezolid prior to transfer - On vasopressors on 7/18 - WBC 26k, lactate here 1.2 - CXR: bilateral diffuse patchy airspace disease Plan: - PAN cultures: Bcx, UA, PAL, strep/legionella urinary Ag pending - Follow cultures; determine insertion date of PICC line - Empiric antibiotics with : Linezolid (start 7/21) and cefepime - ECHO pending   AKI (POA) - Scr on admission 0.96, up to 1.96 on 7/17  - Multifactorial AKI is likely related to sepsis PLAN:  - BMP here pending - Renal lytes pending - Renally dose medications, avoid contrast medications - Consult the renal team when appropriate      T2DM (POA) - HgbA1C pending - FSBG with correction SSI q6hr per ICU protocol"
	"1641622-1"	"1641622-1"	"WHITE BLOOD CELL COUNT INCREASED"	"10047943"	"50-59 years"	"50-59"	"Patient admitted 7/21/2021 for presents as transfer for acute hypoxic respiratory failure and covid pneumonia. Vaccinated for COVID 3/31/2021, tested positive 7/21/2021 Patient discharged, DEATH, 7/26/2021  Date of Vaccination:3/31/2021 & 3/10/2021 Dose: 2 doses total Vaccine Manufacturer: Pfizer Lot #: EN6202/EN6207 Clinic Administering Vaccine: unknown Injection site: R deltoid both times Description of event/reaction: patient died from severe ARDS from COVID-19   Patient initially presented on 06/29 with dyspnea, productive cough and wheezing. She reported having difficulty breathing for the last month, however, her symptoms progressively worsened after 6/26/21. Patient was found to be hypoxic on her home oxygen requirement of 3L to SpO2 52% upon arrival to ER. Of note, patient was discharged from a hospitalization on 6/22/21 (unknown reason for hospitalization, duration, and location).    Patient is reportedly fully vaccinated for COVID prior to her current admission and received her last vaccine in February 2021. She tested positive for COVID on 6/29 upon admission, and stated that her daughter had been sick recently and tested negative for COVID. Patient was started on Remdesivir, Decadron, Albuterol, Thiamine, Zinc, Quercetin complex, and Vitamin D. Patient was also started on Vapotherm for supplemental oxygen which was alternated with BiPAP, as well as empiric Vancomycin (6/29-7/10 and 7/15-7/21) and Zosyn (6/29-7/8). Patient was ultimately intubated on 07/15 and her antibiotics were escalated to Vanc and Meropenem (7/13-7/21) for presumed pneumonia. She continued to require high ventilator settings (100%, PEEP 16).  Her hospitalization was complicated by shock requiring vasopressors. On 7/17, patient was increasingly acidotic with pH 6.99 and PCO2 78 and was subsequently proned and paralyzed.  Her infectious work-up was positive for VRE bacteremia on 7/17 and candida in urine culture. On 7/21 she was transferred to MICU for hypoxic respiratory failure and COVID pneumonia. On arrival, she is sedated on mechanical ventilation...Acute Hypoxic Hypercapneic Respiratory Failure requiring Mechanical Ventilation (POA) COVID PNA (POA) History of COPD (POA) - Etiology: COVID PNA - COVID positive 6/29 - Fully vaccinated with Moderna vaccine prior to admission - s/p Remdesivir, convalescent plasma, dexamethasone - 7/15 Intubated at outside hospital - 7/17 Paralyzed and proned - CXR: bilateral diffuse patchy airspace disease - ABG on arrival: 7.43/53/65/35 on 80%, PEEP 10, PF 81 PLAN: - PAL, comp resp panel, Strep and Legionella urine Ag pending - Continue mechanical ventilation to optimize ventilation and oxygenation, maintain SpO2 >/= 92% - DuoNebs q4hr - Empiric broad spectrum antibiotics as outlined below: Linezolid and cefepime - Propofol and Dilaudid drips to facilitate tolerance of mechanical ventilation - Start DEXARDS protocol - Repeat ABG at 2000; prone if PF ratio not improved - Consider CT chest when clinically stable   VRE Bacteremia (POA) Sepsis (POA) Leukocytosis (POA) - Has received dexamethasone - Received the following courses abx: Vanc 6/29-7/10, 7/15- 7/21 Zosyn 6/29 - 7/8 Merrem 7/13-7/21 - BCx from 7/17 resulted for +VRE; transitioned to Linezolid prior to transfer - On vasopressors on 7/18 - WBC 26k, lactate here 1.2 - CXR: bilateral diffuse patchy airspace disease Plan: - PAN cultures: Bcx, UA, PAL, strep/legionella urinary Ag pending - Follow cultures; determine insertion date of PICC line - Empiric antibiotics with : Linezolid (start 7/21) and cefepime - ECHO pending   AKI (POA) - Scr on admission 0.96, up to 1.96 on 7/17  - Multifactorial AKI is likely related to sepsis PLAN:  - BMP here pending - Renal lytes pending - Renally dose medications, avoid contrast medications - Consult the renal team when appropriate      T2DM (POA) - HgbA1C pending - FSBG with correction SSI q6hr per ICU protocol"
	"1655677-1"	"1655677-1"	"ACUTE KIDNEY INJURY"	"10069339"	"50-59 years"	"50-59"	""patient vaccinated 7/23/2021, admitted 7/29/2021, tested positive for covid 7/29/2021. discharged 8/14/2021, patient expired  Patient received Pfizer vaccine L deltoid lot numberFA6780 on 7/23/2021. Tested positive on 7/29/2021 after exposure. Writing  report since patient received vaccine and now critically ill and intubated to follow procedure. Patient intubated 8/7/2021  History Of Present Illness Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and the following day began having diarrhea and ""passed out"" 4 times since symptoms developed.  While on the floor the patient had been treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab, and had been improving, weaned from HFNC to 4L NC on 8/5.  On 8/6 the patient had worsening shortness of breath and was transition back to high-flow nasal cannula.  Today, 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia.  MICU was called and the patient was emergently intubated for acute hypoxic respiratory failure.     Past Medical History He has a past medical history of CKD (chronic kidney disease), stage IV (CMS/HCC), Gout, and Hypertension.  Assessment and Plan:  The patient is a 53 yo M with CKD4,HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    ARDS  COVID-19 PNA (POA) Pneumomediastinum, worsening  -XR chest with B/L peripheral and bibasilar opacities  -Inflammatory markers were up trending, will continue to monitor -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia, official read pending -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 124 PLAN:  - Evaluate to repeat CT chest with patient clinical decline.  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - ABG -Continue dexamethasone 6 mg daily (D6/10) -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx    AKI on CKD stage V not on Dialysis (POA) Hyperkalemia (POA) Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant PLAN:  -Nephrology following on floor, will notify of transfer to the ICU - Place Udall-- > IHD to start 8/7.  -Continue sodium bicarb 1300 TID, calcitriol and vitamin D2 at same doses -Strict I&O, Daily weights - Foley    Seizure-like activity - Patient with right-sided upper extremity and lower-extremity tonic activity following intubation.  - Prior to intubation, patient had EMV 15, appropriate and no focal deficits.  - Likely metabolic in nature, patient with BUN >100, sepsis, COVID  - No past history of seizures.  PLAN:  - TSH, B12, ammonia - EEG   Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:  -STOP coreg , HOLD home amlodipine  -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP today and as needed.    Suspected orthostatic syncope related to COVID-19 infection -Started prior to admission in the setting of ongoing diarrhea, nausea and poor PO intake -No episodes since, symptoms improved with adequate fluid resuscitation -EKG on admission with sinus tachycardia with no significant ST-T changes -PT/OT, recs home with assistance  Obesity (POA) - BMI 35.8, complicates all aspects of care.   Hospitalization Admit Date/Time: 7/29/2021 3:55 PM Admitting Attending:  Discharge Date: 08/14/21 Discharge Attending Physician:    8/9/2021 Assessment and Plan   The patient is a 53 yo M with CKD4, HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    Acute Respiratory Failure Requiring Mechanical Ventilation  Moderate ARDS  COVID-19 PNA (POA) Pneumomediastinum, stable Pneumopericardium, stable  HAP  -XR chest with B/L peripheral and bibasilar opacities  -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 127 - Started NMB on 8/8  PLAN:  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - DC nimbex today, PF ratio increased to 164 after paralytic  -Continue dexamethasone 6 mg daily (stop date 8/11)  -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx  -Empiric Cefepime for HAP--Follow up cultures from 8/7 - DC vanc    AKI on CKD stage V(POA) Hyperkalemia (POA)--resolving Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant -8/7: udall, failed IHD and converted to CRRT. PLAN:  - Nephrology following, appreciate recs  - Continue CRRT with goal net even  - Dose meds for CRRT  -Strict I&O, Daily weights   Shock, multifactorial  - Medication and sepsis related, stress induced CM - Received approx. 2 L IVF  - Cortisol 9.7 on 8/7 PLAN:  - Levophed for MAP >65 - Treatment of infections  - Defer stress steroids while on Dex, can evaluate to start stress HC Once steroids complete for Dex-ARDS.    Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:   -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP improving, weekly checks.    DM type 2 (POA) - Diet controlled at home.  PLAN:  - Start insulin gtt today, monitoring per protocol.    Hypertension - Hold Home meds until clinically appropriate.    Obesity (POA)- BMI 35.8, complicates all aspects of care  discharge note Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to UK ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and with reported syncopal events. Patient was treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab.     On 8/6 the patient had worsening shortness of breath with increasing oxygen requirements.  On 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia ultimately requiring intubation. Furthermore, a dialysis catheter was placed and CRRT was initiated. Broad spectrum ABX were continued. On 8/8, he required addition of NMB for continued ventilator dys-synchrony. He completed the dex-ARDS protocol on 8/10. The patient had a decline on 8/11 with a fever, worsening shock. He was started back on broad spectrum antibiotics, vasopressin in addition to levophed, and stress dose steroids. Unfortunately, Pt remained with persistent and profound hemodynamic instability. His response to aggressive live saving measures was minimal. WBC up to 80 with no infectious source able to be identified, escalation of ABX still continued. CT scans unable to be obtained secondary to risk of fatal event occurring if moved and/or transported to scanner. On 8/13, Pt going into arrythmias which further exacerbated further instability, required cardioversions X 3 and antiarrhythmic medications. Goals of care discussions completed with wife. Despite attempting to give Pt more time to possibly respond to treatments, his status remained critical. Wife came to see her husband at bedside to be with him briefly before he passed away. Pt passed away on 8/14 at 8:11.""
	"1655677-1"	"1655677-1"	"ACUTE RESPIRATORY DISTRESS SYNDROME"	"10001052"	"50-59 years"	"50-59"	""patient vaccinated 7/23/2021, admitted 7/29/2021, tested positive for covid 7/29/2021. discharged 8/14/2021, patient expired  Patient received Pfizer vaccine L deltoid lot numberFA6780 on 7/23/2021. Tested positive on 7/29/2021 after exposure. Writing  report since patient received vaccine and now critically ill and intubated to follow procedure. Patient intubated 8/7/2021  History Of Present Illness Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and the following day began having diarrhea and ""passed out"" 4 times since symptoms developed.  While on the floor the patient had been treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab, and had been improving, weaned from HFNC to 4L NC on 8/5.  On 8/6 the patient had worsening shortness of breath and was transition back to high-flow nasal cannula.  Today, 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia.  MICU was called and the patient was emergently intubated for acute hypoxic respiratory failure.     Past Medical History He has a past medical history of CKD (chronic kidney disease), stage IV (CMS/HCC), Gout, and Hypertension.  Assessment and Plan:  The patient is a 53 yo M with CKD4,HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    ARDS  COVID-19 PNA (POA) Pneumomediastinum, worsening  -XR chest with B/L peripheral and bibasilar opacities  -Inflammatory markers were up trending, will continue to monitor -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia, official read pending -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 124 PLAN:  - Evaluate to repeat CT chest with patient clinical decline.  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - ABG -Continue dexamethasone 6 mg daily (D6/10) -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx    AKI on CKD stage V not on Dialysis (POA) Hyperkalemia (POA) Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant PLAN:  -Nephrology following on floor, will notify of transfer to the ICU - Place Udall-- > IHD to start 8/7.  -Continue sodium bicarb 1300 TID, calcitriol and vitamin D2 at same doses -Strict I&O, Daily weights - Foley    Seizure-like activity - Patient with right-sided upper extremity and lower-extremity tonic activity following intubation.  - Prior to intubation, patient had EMV 15, appropriate and no focal deficits.  - Likely metabolic in nature, patient with BUN >100, sepsis, COVID  - No past history of seizures.  PLAN:  - TSH, B12, ammonia - EEG   Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:  -STOP coreg , HOLD home amlodipine  -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP today and as needed.    Suspected orthostatic syncope related to COVID-19 infection -Started prior to admission in the setting of ongoing diarrhea, nausea and poor PO intake -No episodes since, symptoms improved with adequate fluid resuscitation -EKG on admission with sinus tachycardia with no significant ST-T changes -PT/OT, recs home with assistance  Obesity (POA) - BMI 35.8, complicates all aspects of care.   Hospitalization Admit Date/Time: 7/29/2021 3:55 PM Admitting Attending:  Discharge Date: 08/14/21 Discharge Attending Physician:    8/9/2021 Assessment and Plan   The patient is a 53 yo M with CKD4, HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    Acute Respiratory Failure Requiring Mechanical Ventilation  Moderate ARDS  COVID-19 PNA (POA) Pneumomediastinum, stable Pneumopericardium, stable  HAP  -XR chest with B/L peripheral and bibasilar opacities  -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 127 - Started NMB on 8/8  PLAN:  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - DC nimbex today, PF ratio increased to 164 after paralytic  -Continue dexamethasone 6 mg daily (stop date 8/11)  -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx  -Empiric Cefepime for HAP--Follow up cultures from 8/7 - DC vanc    AKI on CKD stage V(POA) Hyperkalemia (POA)--resolving Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant -8/7: udall, failed IHD and converted to CRRT. PLAN:  - Nephrology following, appreciate recs  - Continue CRRT with goal net even  - Dose meds for CRRT  -Strict I&O, Daily weights   Shock, multifactorial  - Medication and sepsis related, stress induced CM - Received approx. 2 L IVF  - Cortisol 9.7 on 8/7 PLAN:  - Levophed for MAP >65 - Treatment of infections  - Defer stress steroids while on Dex, can evaluate to start stress HC Once steroids complete for Dex-ARDS.    Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:   -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP improving, weekly checks.    DM type 2 (POA) - Diet controlled at home.  PLAN:  - Start insulin gtt today, monitoring per protocol.    Hypertension - Hold Home meds until clinically appropriate.    Obesity (POA)- BMI 35.8, complicates all aspects of care  discharge note Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to UK ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and with reported syncopal events. Patient was treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab.     On 8/6 the patient had worsening shortness of breath with increasing oxygen requirements.  On 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia ultimately requiring intubation. Furthermore, a dialysis catheter was placed and CRRT was initiated. Broad spectrum ABX were continued. On 8/8, he required addition of NMB for continued ventilator dys-synchrony. He completed the dex-ARDS protocol on 8/10. The patient had a decline on 8/11 with a fever, worsening shock. He was started back on broad spectrum antibiotics, vasopressin in addition to levophed, and stress dose steroids. Unfortunately, Pt remained with persistent and profound hemodynamic instability. His response to aggressive live saving measures was minimal. WBC up to 80 with no infectious source able to be identified, escalation of ABX still continued. CT scans unable to be obtained secondary to risk of fatal event occurring if moved and/or transported to scanner. On 8/13, Pt going into arrythmias which further exacerbated further instability, required cardioversions X 3 and antiarrhythmic medications. Goals of care discussions completed with wife. Despite attempting to give Pt more time to possibly respond to treatments, his status remained critical. Wife came to see her husband at bedside to be with him briefly before he passed away. Pt passed away on 8/14 at 8:11.""
	"1655677-1"	"1655677-1"	"ACUTE RESPIRATORY FAILURE"	"10001053"	"50-59 years"	"50-59"	""patient vaccinated 7/23/2021, admitted 7/29/2021, tested positive for covid 7/29/2021. discharged 8/14/2021, patient expired  Patient received Pfizer vaccine L deltoid lot numberFA6780 on 7/23/2021. Tested positive on 7/29/2021 after exposure. Writing  report since patient received vaccine and now critically ill and intubated to follow procedure. Patient intubated 8/7/2021  History Of Present Illness Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and the following day began having diarrhea and ""passed out"" 4 times since symptoms developed.  While on the floor the patient had been treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab, and had been improving, weaned from HFNC to 4L NC on 8/5.  On 8/6 the patient had worsening shortness of breath and was transition back to high-flow nasal cannula.  Today, 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia.  MICU was called and the patient was emergently intubated for acute hypoxic respiratory failure.     Past Medical History He has a past medical history of CKD (chronic kidney disease), stage IV (CMS/HCC), Gout, and Hypertension.  Assessment and Plan:  The patient is a 53 yo M with CKD4,HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    ARDS  COVID-19 PNA (POA) Pneumomediastinum, worsening  -XR chest with B/L peripheral and bibasilar opacities  -Inflammatory markers were up trending, will continue to monitor -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia, official read pending -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 124 PLAN:  - Evaluate to repeat CT chest with patient clinical decline.  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - ABG -Continue dexamethasone 6 mg daily (D6/10) -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx    AKI on CKD stage V not on Dialysis (POA) Hyperkalemia (POA) Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant PLAN:  -Nephrology following on floor, will notify of transfer to the ICU - Place Udall-- > IHD to start 8/7.  -Continue sodium bicarb 1300 TID, calcitriol and vitamin D2 at same doses -Strict I&O, Daily weights - Foley    Seizure-like activity - Patient with right-sided upper extremity and lower-extremity tonic activity following intubation.  - Prior to intubation, patient had EMV 15, appropriate and no focal deficits.  - Likely metabolic in nature, patient with BUN >100, sepsis, COVID  - No past history of seizures.  PLAN:  - TSH, B12, ammonia - EEG   Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:  -STOP coreg , HOLD home amlodipine  -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP today and as needed.    Suspected orthostatic syncope related to COVID-19 infection -Started prior to admission in the setting of ongoing diarrhea, nausea and poor PO intake -No episodes since, symptoms improved with adequate fluid resuscitation -EKG on admission with sinus tachycardia with no significant ST-T changes -PT/OT, recs home with assistance  Obesity (POA) - BMI 35.8, complicates all aspects of care.   Hospitalization Admit Date/Time: 7/29/2021 3:55 PM Admitting Attending:  Discharge Date: 08/14/21 Discharge Attending Physician:    8/9/2021 Assessment and Plan   The patient is a 53 yo M with CKD4, HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    Acute Respiratory Failure Requiring Mechanical Ventilation  Moderate ARDS  COVID-19 PNA (POA) Pneumomediastinum, stable Pneumopericardium, stable  HAP  -XR chest with B/L peripheral and bibasilar opacities  -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 127 - Started NMB on 8/8  PLAN:  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - DC nimbex today, PF ratio increased to 164 after paralytic  -Continue dexamethasone 6 mg daily (stop date 8/11)  -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx  -Empiric Cefepime for HAP--Follow up cultures from 8/7 - DC vanc    AKI on CKD stage V(POA) Hyperkalemia (POA)--resolving Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant -8/7: udall, failed IHD and converted to CRRT. PLAN:  - Nephrology following, appreciate recs  - Continue CRRT with goal net even  - Dose meds for CRRT  -Strict I&O, Daily weights   Shock, multifactorial  - Medication and sepsis related, stress induced CM - Received approx. 2 L IVF  - Cortisol 9.7 on 8/7 PLAN:  - Levophed for MAP >65 - Treatment of infections  - Defer stress steroids while on Dex, can evaluate to start stress HC Once steroids complete for Dex-ARDS.    Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:   -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP improving, weekly checks.    DM type 2 (POA) - Diet controlled at home.  PLAN:  - Start insulin gtt today, monitoring per protocol.    Hypertension - Hold Home meds until clinically appropriate.    Obesity (POA)- BMI 35.8, complicates all aspects of care  discharge note Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to UK ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and with reported syncopal events. Patient was treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab.     On 8/6 the patient had worsening shortness of breath with increasing oxygen requirements.  On 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia ultimately requiring intubation. Furthermore, a dialysis catheter was placed and CRRT was initiated. Broad spectrum ABX were continued. On 8/8, he required addition of NMB for continued ventilator dys-synchrony. He completed the dex-ARDS protocol on 8/10. The patient had a decline on 8/11 with a fever, worsening shock. He was started back on broad spectrum antibiotics, vasopressin in addition to levophed, and stress dose steroids. Unfortunately, Pt remained with persistent and profound hemodynamic instability. His response to aggressive live saving measures was minimal. WBC up to 80 with no infectious source able to be identified, escalation of ABX still continued. CT scans unable to be obtained secondary to risk of fatal event occurring if moved and/or transported to scanner. On 8/13, Pt going into arrythmias which further exacerbated further instability, required cardioversions X 3 and antiarrhythmic medications. Goals of care discussions completed with wife. Despite attempting to give Pt more time to possibly respond to treatments, his status remained critical. Wife came to see her husband at bedside to be with him briefly before he passed away. Pt passed away on 8/14 at 8:11.""
	"1655677-1"	"1655677-1"	"AGEUSIA"	"10001480"	"50-59 years"	"50-59"	""patient vaccinated 7/23/2021, admitted 7/29/2021, tested positive for covid 7/29/2021. discharged 8/14/2021, patient expired  Patient received Pfizer vaccine L deltoid lot numberFA6780 on 7/23/2021. Tested positive on 7/29/2021 after exposure. Writing  report since patient received vaccine and now critically ill and intubated to follow procedure. Patient intubated 8/7/2021  History Of Present Illness Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and the following day began having diarrhea and ""passed out"" 4 times since symptoms developed.  While on the floor the patient had been treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab, and had been improving, weaned from HFNC to 4L NC on 8/5.  On 8/6 the patient had worsening shortness of breath and was transition back to high-flow nasal cannula.  Today, 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia.  MICU was called and the patient was emergently intubated for acute hypoxic respiratory failure.     Past Medical History He has a past medical history of CKD (chronic kidney disease), stage IV (CMS/HCC), Gout, and Hypertension.  Assessment and Plan:  The patient is a 53 yo M with CKD4,HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    ARDS  COVID-19 PNA (POA) Pneumomediastinum, worsening  -XR chest with B/L peripheral and bibasilar opacities  -Inflammatory markers were up trending, will continue to monitor -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia, official read pending -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 124 PLAN:  - Evaluate to repeat CT chest with patient clinical decline.  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - ABG -Continue dexamethasone 6 mg daily (D6/10) -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx    AKI on CKD stage V not on Dialysis (POA) Hyperkalemia (POA) Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant PLAN:  -Nephrology following on floor, will notify of transfer to the ICU - Place Udall-- > IHD to start 8/7.  -Continue sodium bicarb 1300 TID, calcitriol and vitamin D2 at same doses -Strict I&O, Daily weights - Foley    Seizure-like activity - Patient with right-sided upper extremity and lower-extremity tonic activity following intubation.  - Prior to intubation, patient had EMV 15, appropriate and no focal deficits.  - Likely metabolic in nature, patient with BUN >100, sepsis, COVID  - No past history of seizures.  PLAN:  - TSH, B12, ammonia - EEG   Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:  -STOP coreg , HOLD home amlodipine  -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP today and as needed.    Suspected orthostatic syncope related to COVID-19 infection -Started prior to admission in the setting of ongoing diarrhea, nausea and poor PO intake -No episodes since, symptoms improved with adequate fluid resuscitation -EKG on admission with sinus tachycardia with no significant ST-T changes -PT/OT, recs home with assistance  Obesity (POA) - BMI 35.8, complicates all aspects of care.   Hospitalization Admit Date/Time: 7/29/2021 3:55 PM Admitting Attending:  Discharge Date: 08/14/21 Discharge Attending Physician:    8/9/2021 Assessment and Plan   The patient is a 53 yo M with CKD4, HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    Acute Respiratory Failure Requiring Mechanical Ventilation  Moderate ARDS  COVID-19 PNA (POA) Pneumomediastinum, stable Pneumopericardium, stable  HAP  -XR chest with B/L peripheral and bibasilar opacities  -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 127 - Started NMB on 8/8  PLAN:  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - DC nimbex today, PF ratio increased to 164 after paralytic  -Continue dexamethasone 6 mg daily (stop date 8/11)  -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx  -Empiric Cefepime for HAP--Follow up cultures from 8/7 - DC vanc    AKI on CKD stage V(POA) Hyperkalemia (POA)--resolving Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant -8/7: udall, failed IHD and converted to CRRT. PLAN:  - Nephrology following, appreciate recs  - Continue CRRT with goal net even  - Dose meds for CRRT  -Strict I&O, Daily weights   Shock, multifactorial  - Medication and sepsis related, stress induced CM - Received approx. 2 L IVF  - Cortisol 9.7 on 8/7 PLAN:  - Levophed for MAP >65 - Treatment of infections  - Defer stress steroids while on Dex, can evaluate to start stress HC Once steroids complete for Dex-ARDS.    Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:   -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP improving, weekly checks.    DM type 2 (POA) - Diet controlled at home.  PLAN:  - Start insulin gtt today, monitoring per protocol.    Hypertension - Hold Home meds until clinically appropriate.    Obesity (POA)- BMI 35.8, complicates all aspects of care  discharge note Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to UK ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and with reported syncopal events. Patient was treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab.     On 8/6 the patient had worsening shortness of breath with increasing oxygen requirements.  On 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia ultimately requiring intubation. Furthermore, a dialysis catheter was placed and CRRT was initiated. Broad spectrum ABX were continued. On 8/8, he required addition of NMB for continued ventilator dys-synchrony. He completed the dex-ARDS protocol on 8/10. The patient had a decline on 8/11 with a fever, worsening shock. He was started back on broad spectrum antibiotics, vasopressin in addition to levophed, and stress dose steroids. Unfortunately, Pt remained with persistent and profound hemodynamic instability. His response to aggressive live saving measures was minimal. WBC up to 80 with no infectious source able to be identified, escalation of ABX still continued. CT scans unable to be obtained secondary to risk of fatal event occurring if moved and/or transported to scanner. On 8/13, Pt going into arrythmias which further exacerbated further instability, required cardioversions X 3 and antiarrhythmic medications. Goals of care discussions completed with wife. Despite attempting to give Pt more time to possibly respond to treatments, his status remained critical. Wife came to see her husband at bedside to be with him briefly before he passed away. Pt passed away on 8/14 at 8:11.""
	"1655677-1"	"1655677-1"	"ANOSMIA"	"10002653"	"50-59 years"	"50-59"	""patient vaccinated 7/23/2021, admitted 7/29/2021, tested positive for covid 7/29/2021. discharged 8/14/2021, patient expired  Patient received Pfizer vaccine L deltoid lot numberFA6780 on 7/23/2021. Tested positive on 7/29/2021 after exposure. Writing  report since patient received vaccine and now critically ill and intubated to follow procedure. Patient intubated 8/7/2021  History Of Present Illness Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and the following day began having diarrhea and ""passed out"" 4 times since symptoms developed.  While on the floor the patient had been treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab, and had been improving, weaned from HFNC to 4L NC on 8/5.  On 8/6 the patient had worsening shortness of breath and was transition back to high-flow nasal cannula.  Today, 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia.  MICU was called and the patient was emergently intubated for acute hypoxic respiratory failure.     Past Medical History He has a past medical history of CKD (chronic kidney disease), stage IV (CMS/HCC), Gout, and Hypertension.  Assessment and Plan:  The patient is a 53 yo M with CKD4,HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    ARDS  COVID-19 PNA (POA) Pneumomediastinum, worsening  -XR chest with B/L peripheral and bibasilar opacities  -Inflammatory markers were up trending, will continue to monitor -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia, official read pending -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 124 PLAN:  - Evaluate to repeat CT chest with patient clinical decline.  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - ABG -Continue dexamethasone 6 mg daily (D6/10) -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx    AKI on CKD stage V not on Dialysis (POA) Hyperkalemia (POA) Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant PLAN:  -Nephrology following on floor, will notify of transfer to the ICU - Place Udall-- > IHD to start 8/7.  -Continue sodium bicarb 1300 TID, calcitriol and vitamin D2 at same doses -Strict I&O, Daily weights - Foley    Seizure-like activity - Patient with right-sided upper extremity and lower-extremity tonic activity following intubation.  - Prior to intubation, patient had EMV 15, appropriate and no focal deficits.  - Likely metabolic in nature, patient with BUN >100, sepsis, COVID  - No past history of seizures.  PLAN:  - TSH, B12, ammonia - EEG   Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:  -STOP coreg , HOLD home amlodipine  -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP today and as needed.    Suspected orthostatic syncope related to COVID-19 infection -Started prior to admission in the setting of ongoing diarrhea, nausea and poor PO intake -No episodes since, symptoms improved with adequate fluid resuscitation -EKG on admission with sinus tachycardia with no significant ST-T changes -PT/OT, recs home with assistance  Obesity (POA) - BMI 35.8, complicates all aspects of care.   Hospitalization Admit Date/Time: 7/29/2021 3:55 PM Admitting Attending:  Discharge Date: 08/14/21 Discharge Attending Physician:    8/9/2021 Assessment and Plan   The patient is a 53 yo M with CKD4, HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    Acute Respiratory Failure Requiring Mechanical Ventilation  Moderate ARDS  COVID-19 PNA (POA) Pneumomediastinum, stable Pneumopericardium, stable  HAP  -XR chest with B/L peripheral and bibasilar opacities  -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 127 - Started NMB on 8/8  PLAN:  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - DC nimbex today, PF ratio increased to 164 after paralytic  -Continue dexamethasone 6 mg daily (stop date 8/11)  -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx  -Empiric Cefepime for HAP--Follow up cultures from 8/7 - DC vanc    AKI on CKD stage V(POA) Hyperkalemia (POA)--resolving Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant -8/7: udall, failed IHD and converted to CRRT. PLAN:  - Nephrology following, appreciate recs  - Continue CRRT with goal net even  - Dose meds for CRRT  -Strict I&O, Daily weights   Shock, multifactorial  - Medication and sepsis related, stress induced CM - Received approx. 2 L IVF  - Cortisol 9.7 on 8/7 PLAN:  - Levophed for MAP >65 - Treatment of infections  - Defer stress steroids while on Dex, can evaluate to start stress HC Once steroids complete for Dex-ARDS.    Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:   -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP improving, weekly checks.    DM type 2 (POA) - Diet controlled at home.  PLAN:  - Start insulin gtt today, monitoring per protocol.    Hypertension - Hold Home meds until clinically appropriate.    Obesity (POA)- BMI 35.8, complicates all aspects of care  discharge note Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to UK ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and with reported syncopal events. Patient was treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab.     On 8/6 the patient had worsening shortness of breath with increasing oxygen requirements.  On 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia ultimately requiring intubation. Furthermore, a dialysis catheter was placed and CRRT was initiated. Broad spectrum ABX were continued. On 8/8, he required addition of NMB for continued ventilator dys-synchrony. He completed the dex-ARDS protocol on 8/10. The patient had a decline on 8/11 with a fever, worsening shock. He was started back on broad spectrum antibiotics, vasopressin in addition to levophed, and stress dose steroids. Unfortunately, Pt remained with persistent and profound hemodynamic instability. His response to aggressive live saving measures was minimal. WBC up to 80 with no infectious source able to be identified, escalation of ABX still continued. CT scans unable to be obtained secondary to risk of fatal event occurring if moved and/or transported to scanner. On 8/13, Pt going into arrythmias which further exacerbated further instability, required cardioversions X 3 and antiarrhythmic medications. Goals of care discussions completed with wife. Despite attempting to give Pt more time to possibly respond to treatments, his status remained critical. Wife came to see her husband at bedside to be with him briefly before he passed away. Pt passed away on 8/14 at 8:11.""
	"1655677-1"	"1655677-1"	"ARRHYTHMIA"	"10003119"	"50-59 years"	"50-59"	""patient vaccinated 7/23/2021, admitted 7/29/2021, tested positive for covid 7/29/2021. discharged 8/14/2021, patient expired  Patient received Pfizer vaccine L deltoid lot numberFA6780 on 7/23/2021. Tested positive on 7/29/2021 after exposure. Writing  report since patient received vaccine and now critically ill and intubated to follow procedure. Patient intubated 8/7/2021  History Of Present Illness Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and the following day began having diarrhea and ""passed out"" 4 times since symptoms developed.  While on the floor the patient had been treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab, and had been improving, weaned from HFNC to 4L NC on 8/5.  On 8/6 the patient had worsening shortness of breath and was transition back to high-flow nasal cannula.  Today, 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia.  MICU was called and the patient was emergently intubated for acute hypoxic respiratory failure.     Past Medical History He has a past medical history of CKD (chronic kidney disease), stage IV (CMS/HCC), Gout, and Hypertension.  Assessment and Plan:  The patient is a 53 yo M with CKD4,HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    ARDS  COVID-19 PNA (POA) Pneumomediastinum, worsening  -XR chest with B/L peripheral and bibasilar opacities  -Inflammatory markers were up trending, will continue to monitor -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia, official read pending -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 124 PLAN:  - Evaluate to repeat CT chest with patient clinical decline.  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - ABG -Continue dexamethasone 6 mg daily (D6/10) -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx    AKI on CKD stage V not on Dialysis (POA) Hyperkalemia (POA) Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant PLAN:  -Nephrology following on floor, will notify of transfer to the ICU - Place Udall-- > IHD to start 8/7.  -Continue sodium bicarb 1300 TID, calcitriol and vitamin D2 at same doses -Strict I&O, Daily weights - Foley    Seizure-like activity - Patient with right-sided upper extremity and lower-extremity tonic activity following intubation.  - Prior to intubation, patient had EMV 15, appropriate and no focal deficits.  - Likely metabolic in nature, patient with BUN >100, sepsis, COVID  - No past history of seizures.  PLAN:  - TSH, B12, ammonia - EEG   Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:  -STOP coreg , HOLD home amlodipine  -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP today and as needed.    Suspected orthostatic syncope related to COVID-19 infection -Started prior to admission in the setting of ongoing diarrhea, nausea and poor PO intake -No episodes since, symptoms improved with adequate fluid resuscitation -EKG on admission with sinus tachycardia with no significant ST-T changes -PT/OT, recs home with assistance  Obesity (POA) - BMI 35.8, complicates all aspects of care.   Hospitalization Admit Date/Time: 7/29/2021 3:55 PM Admitting Attending:  Discharge Date: 08/14/21 Discharge Attending Physician:    8/9/2021 Assessment and Plan   The patient is a 53 yo M with CKD4, HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    Acute Respiratory Failure Requiring Mechanical Ventilation  Moderate ARDS  COVID-19 PNA (POA) Pneumomediastinum, stable Pneumopericardium, stable  HAP  -XR chest with B/L peripheral and bibasilar opacities  -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 127 - Started NMB on 8/8  PLAN:  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - DC nimbex today, PF ratio increased to 164 after paralytic  -Continue dexamethasone 6 mg daily (stop date 8/11)  -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx  -Empiric Cefepime for HAP--Follow up cultures from 8/7 - DC vanc    AKI on CKD stage V(POA) Hyperkalemia (POA)--resolving Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant -8/7: udall, failed IHD and converted to CRRT. PLAN:  - Nephrology following, appreciate recs  - Continue CRRT with goal net even  - Dose meds for CRRT  -Strict I&O, Daily weights   Shock, multifactorial  - Medication and sepsis related, stress induced CM - Received approx. 2 L IVF  - Cortisol 9.7 on 8/7 PLAN:  - Levophed for MAP >65 - Treatment of infections  - Defer stress steroids while on Dex, can evaluate to start stress HC Once steroids complete for Dex-ARDS.    Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:   -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP improving, weekly checks.    DM type 2 (POA) - Diet controlled at home.  PLAN:  - Start insulin gtt today, monitoring per protocol.    Hypertension - Hold Home meds until clinically appropriate.    Obesity (POA)- BMI 35.8, complicates all aspects of care  discharge note Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to UK ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and with reported syncopal events. Patient was treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab.     On 8/6 the patient had worsening shortness of breath with increasing oxygen requirements.  On 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia ultimately requiring intubation. Furthermore, a dialysis catheter was placed and CRRT was initiated. Broad spectrum ABX were continued. On 8/8, he required addition of NMB for continued ventilator dys-synchrony. He completed the dex-ARDS protocol on 8/10. The patient had a decline on 8/11 with a fever, worsening shock. He was started back on broad spectrum antibiotics, vasopressin in addition to levophed, and stress dose steroids. Unfortunately, Pt remained with persistent and profound hemodynamic instability. His response to aggressive live saving measures was minimal. WBC up to 80 with no infectious source able to be identified, escalation of ABX still continued. CT scans unable to be obtained secondary to risk of fatal event occurring if moved and/or transported to scanner. On 8/13, Pt going into arrythmias which further exacerbated further instability, required cardioversions X 3 and antiarrhythmic medications. Goals of care discussions completed with wife. Despite attempting to give Pt more time to possibly respond to treatments, his status remained critical. Wife came to see her husband at bedside to be with him briefly before he passed away. Pt passed away on 8/14 at 8:11.""
	"1655677-1"	"1655677-1"	"ASTHENIA"	"10003549"	"50-59 years"	"50-59"	""patient vaccinated 7/23/2021, admitted 7/29/2021, tested positive for covid 7/29/2021. discharged 8/14/2021, patient expired  Patient received Pfizer vaccine L deltoid lot numberFA6780 on 7/23/2021. Tested positive on 7/29/2021 after exposure. Writing  report since patient received vaccine and now critically ill and intubated to follow procedure. Patient intubated 8/7/2021  History Of Present Illness Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and the following day began having diarrhea and ""passed out"" 4 times since symptoms developed.  While on the floor the patient had been treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab, and had been improving, weaned from HFNC to 4L NC on 8/5.  On 8/6 the patient had worsening shortness of breath and was transition back to high-flow nasal cannula.  Today, 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia.  MICU was called and the patient was emergently intubated for acute hypoxic respiratory failure.     Past Medical History He has a past medical history of CKD (chronic kidney disease), stage IV (CMS/HCC), Gout, and Hypertension.  Assessment and Plan:  The patient is a 53 yo M with CKD4,HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    ARDS  COVID-19 PNA (POA) Pneumomediastinum, worsening  -XR chest with B/L peripheral and bibasilar opacities  -Inflammatory markers were up trending, will continue to monitor -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia, official read pending -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 124 PLAN:  - Evaluate to repeat CT chest with patient clinical decline.  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - ABG -Continue dexamethasone 6 mg daily (D6/10) -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx    AKI on CKD stage V not on Dialysis (POA) Hyperkalemia (POA) Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant PLAN:  -Nephrology following on floor, will notify of transfer to the ICU - Place Udall-- > IHD to start 8/7.  -Continue sodium bicarb 1300 TID, calcitriol and vitamin D2 at same doses -Strict I&O, Daily weights - Foley    Seizure-like activity - Patient with right-sided upper extremity and lower-extremity tonic activity following intubation.  - Prior to intubation, patient had EMV 15, appropriate and no focal deficits.  - Likely metabolic in nature, patient with BUN >100, sepsis, COVID  - No past history of seizures.  PLAN:  - TSH, B12, ammonia - EEG   Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:  -STOP coreg , HOLD home amlodipine  -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP today and as needed.    Suspected orthostatic syncope related to COVID-19 infection -Started prior to admission in the setting of ongoing diarrhea, nausea and poor PO intake -No episodes since, symptoms improved with adequate fluid resuscitation -EKG on admission with sinus tachycardia with no significant ST-T changes -PT/OT, recs home with assistance  Obesity (POA) - BMI 35.8, complicates all aspects of care.   Hospitalization Admit Date/Time: 7/29/2021 3:55 PM Admitting Attending:  Discharge Date: 08/14/21 Discharge Attending Physician:    8/9/2021 Assessment and Plan   The patient is a 53 yo M with CKD4, HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    Acute Respiratory Failure Requiring Mechanical Ventilation  Moderate ARDS  COVID-19 PNA (POA) Pneumomediastinum, stable Pneumopericardium, stable  HAP  -XR chest with B/L peripheral and bibasilar opacities  -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 127 - Started NMB on 8/8  PLAN:  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - DC nimbex today, PF ratio increased to 164 after paralytic  -Continue dexamethasone 6 mg daily (stop date 8/11)  -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx  -Empiric Cefepime for HAP--Follow up cultures from 8/7 - DC vanc    AKI on CKD stage V(POA) Hyperkalemia (POA)--resolving Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant -8/7: udall, failed IHD and converted to CRRT. PLAN:  - Nephrology following, appreciate recs  - Continue CRRT with goal net even  - Dose meds for CRRT  -Strict I&O, Daily weights   Shock, multifactorial  - Medication and sepsis related, stress induced CM - Received approx. 2 L IVF  - Cortisol 9.7 on 8/7 PLAN:  - Levophed for MAP >65 - Treatment of infections  - Defer stress steroids while on Dex, can evaluate to start stress HC Once steroids complete for Dex-ARDS.    Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:   -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP improving, weekly checks.    DM type 2 (POA) - Diet controlled at home.  PLAN:  - Start insulin gtt today, monitoring per protocol.    Hypertension - Hold Home meds until clinically appropriate.    Obesity (POA)- BMI 35.8, complicates all aspects of care  discharge note Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to UK ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and with reported syncopal events. Patient was treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab.     On 8/6 the patient had worsening shortness of breath with increasing oxygen requirements.  On 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia ultimately requiring intubation. Furthermore, a dialysis catheter was placed and CRRT was initiated. Broad spectrum ABX were continued. On 8/8, he required addition of NMB for continued ventilator dys-synchrony. He completed the dex-ARDS protocol on 8/10. The patient had a decline on 8/11 with a fever, worsening shock. He was started back on broad spectrum antibiotics, vasopressin in addition to levophed, and stress dose steroids. Unfortunately, Pt remained with persistent and profound hemodynamic instability. His response to aggressive live saving measures was minimal. WBC up to 80 with no infectious source able to be identified, escalation of ABX still continued. CT scans unable to be obtained secondary to risk of fatal event occurring if moved and/or transported to scanner. On 8/13, Pt going into arrythmias which further exacerbated further instability, required cardioversions X 3 and antiarrhythmic medications. Goals of care discussions completed with wife. Despite attempting to give Pt more time to possibly respond to treatments, his status remained critical. Wife came to see her husband at bedside to be with him briefly before he passed away. Pt passed away on 8/14 at 8:11.""
	"1655677-1"	"1655677-1"	"BLOOD CREATININE INCREASED"	"10005483"	"50-59 years"	"50-59"	""patient vaccinated 7/23/2021, admitted 7/29/2021, tested positive for covid 7/29/2021. discharged 8/14/2021, patient expired  Patient received Pfizer vaccine L deltoid lot numberFA6780 on 7/23/2021. Tested positive on 7/29/2021 after exposure. Writing  report since patient received vaccine and now critically ill and intubated to follow procedure. Patient intubated 8/7/2021  History Of Present Illness Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and the following day began having diarrhea and ""passed out"" 4 times since symptoms developed.  While on the floor the patient had been treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab, and had been improving, weaned from HFNC to 4L NC on 8/5.  On 8/6 the patient had worsening shortness of breath and was transition back to high-flow nasal cannula.  Today, 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia.  MICU was called and the patient was emergently intubated for acute hypoxic respiratory failure.     Past Medical History He has a past medical history of CKD (chronic kidney disease), stage IV (CMS/HCC), Gout, and Hypertension.  Assessment and Plan:  The patient is a 53 yo M with CKD4,HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    ARDS  COVID-19 PNA (POA) Pneumomediastinum, worsening  -XR chest with B/L peripheral and bibasilar opacities  -Inflammatory markers were up trending, will continue to monitor -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia, official read pending -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 124 PLAN:  - Evaluate to repeat CT chest with patient clinical decline.  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - ABG -Continue dexamethasone 6 mg daily (D6/10) -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx    AKI on CKD stage V not on Dialysis (POA) Hyperkalemia (POA) Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant PLAN:  -Nephrology following on floor, will notify of transfer to the ICU - Place Udall-- > IHD to start 8/7.  -Continue sodium bicarb 1300 TID, calcitriol and vitamin D2 at same doses -Strict I&O, Daily weights - Foley    Seizure-like activity - Patient with right-sided upper extremity and lower-extremity tonic activity following intubation.  - Prior to intubation, patient had EMV 15, appropriate and no focal deficits.  - Likely metabolic in nature, patient with BUN >100, sepsis, COVID  - No past history of seizures.  PLAN:  - TSH, B12, ammonia - EEG   Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:  -STOP coreg , HOLD home amlodipine  -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP today and as needed.    Suspected orthostatic syncope related to COVID-19 infection -Started prior to admission in the setting of ongoing diarrhea, nausea and poor PO intake -No episodes since, symptoms improved with adequate fluid resuscitation -EKG on admission with sinus tachycardia with no significant ST-T changes -PT/OT, recs home with assistance  Obesity (POA) - BMI 35.8, complicates all aspects of care.   Hospitalization Admit Date/Time: 7/29/2021 3:55 PM Admitting Attending:  Discharge Date: 08/14/21 Discharge Attending Physician:    8/9/2021 Assessment and Plan   The patient is a 53 yo M with CKD4, HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    Acute Respiratory Failure Requiring Mechanical Ventilation  Moderate ARDS  COVID-19 PNA (POA) Pneumomediastinum, stable Pneumopericardium, stable  HAP  -XR chest with B/L peripheral and bibasilar opacities  -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 127 - Started NMB on 8/8  PLAN:  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - DC nimbex today, PF ratio increased to 164 after paralytic  -Continue dexamethasone 6 mg daily (stop date 8/11)  -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx  -Empiric Cefepime for HAP--Follow up cultures from 8/7 - DC vanc    AKI on CKD stage V(POA) Hyperkalemia (POA)--resolving Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant -8/7: udall, failed IHD and converted to CRRT. PLAN:  - Nephrology following, appreciate recs  - Continue CRRT with goal net even  - Dose meds for CRRT  -Strict I&O, Daily weights   Shock, multifactorial  - Medication and sepsis related, stress induced CM - Received approx. 2 L IVF  - Cortisol 9.7 on 8/7 PLAN:  - Levophed for MAP >65 - Treatment of infections  - Defer stress steroids while on Dex, can evaluate to start stress HC Once steroids complete for Dex-ARDS.    Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:   -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP improving, weekly checks.    DM type 2 (POA) - Diet controlled at home.  PLAN:  - Start insulin gtt today, monitoring per protocol.    Hypertension - Hold Home meds until clinically appropriate.    Obesity (POA)- BMI 35.8, complicates all aspects of care  discharge note Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to UK ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and with reported syncopal events. Patient was treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab.     On 8/6 the patient had worsening shortness of breath with increasing oxygen requirements.  On 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia ultimately requiring intubation. Furthermore, a dialysis catheter was placed and CRRT was initiated. Broad spectrum ABX were continued. On 8/8, he required addition of NMB for continued ventilator dys-synchrony. He completed the dex-ARDS protocol on 8/10. The patient had a decline on 8/11 with a fever, worsening shock. He was started back on broad spectrum antibiotics, vasopressin in addition to levophed, and stress dose steroids. Unfortunately, Pt remained with persistent and profound hemodynamic instability. His response to aggressive live saving measures was minimal. WBC up to 80 with no infectious source able to be identified, escalation of ABX still continued. CT scans unable to be obtained secondary to risk of fatal event occurring if moved and/or transported to scanner. On 8/13, Pt going into arrythmias which further exacerbated further instability, required cardioversions X 3 and antiarrhythmic medications. Goals of care discussions completed with wife. Despite attempting to give Pt more time to possibly respond to treatments, his status remained critical. Wife came to see her husband at bedside to be with him briefly before he passed away. Pt passed away on 8/14 at 8:11.""
	"1655677-1"	"1655677-1"	"BLOOD POTASSIUM"	"10005721"	"50-59 years"	"50-59"	""patient vaccinated 7/23/2021, admitted 7/29/2021, tested positive for covid 7/29/2021. discharged 8/14/2021, patient expired  Patient received Pfizer vaccine L deltoid lot numberFA6780 on 7/23/2021. Tested positive on 7/29/2021 after exposure. Writing  report since patient received vaccine and now critically ill and intubated to follow procedure. Patient intubated 8/7/2021  History Of Present Illness Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and the following day began having diarrhea and ""passed out"" 4 times since symptoms developed.  While on the floor the patient had been treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab, and had been improving, weaned from HFNC to 4L NC on 8/5.  On 8/6 the patient had worsening shortness of breath and was transition back to high-flow nasal cannula.  Today, 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia.  MICU was called and the patient was emergently intubated for acute hypoxic respiratory failure.     Past Medical History He has a past medical history of CKD (chronic kidney disease), stage IV (CMS/HCC), Gout, and Hypertension.  Assessment and Plan:  The patient is a 53 yo M with CKD4,HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    ARDS  COVID-19 PNA (POA) Pneumomediastinum, worsening  -XR chest with B/L peripheral and bibasilar opacities  -Inflammatory markers were up trending, will continue to monitor -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia, official read pending -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 124 PLAN:  - Evaluate to repeat CT chest with patient clinical decline.  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - ABG -Continue dexamethasone 6 mg daily (D6/10) -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx    AKI on CKD stage V not on Dialysis (POA) Hyperkalemia (POA) Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant PLAN:  -Nephrology following on floor, will notify of transfer to the ICU - Place Udall-- > IHD to start 8/7.  -Continue sodium bicarb 1300 TID, calcitriol and vitamin D2 at same doses -Strict I&O, Daily weights - Foley    Seizure-like activity - Patient with right-sided upper extremity and lower-extremity tonic activity following intubation.  - Prior to intubation, patient had EMV 15, appropriate and no focal deficits.  - Likely metabolic in nature, patient with BUN >100, sepsis, COVID  - No past history of seizures.  PLAN:  - TSH, B12, ammonia - EEG   Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:  -STOP coreg , HOLD home amlodipine  -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP today and as needed.    Suspected orthostatic syncope related to COVID-19 infection -Started prior to admission in the setting of ongoing diarrhea, nausea and poor PO intake -No episodes since, symptoms improved with adequate fluid resuscitation -EKG on admission with sinus tachycardia with no significant ST-T changes -PT/OT, recs home with assistance  Obesity (POA) - BMI 35.8, complicates all aspects of care.   Hospitalization Admit Date/Time: 7/29/2021 3:55 PM Admitting Attending:  Discharge Date: 08/14/21 Discharge Attending Physician:    8/9/2021 Assessment and Plan   The patient is a 53 yo M with CKD4, HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    Acute Respiratory Failure Requiring Mechanical Ventilation  Moderate ARDS  COVID-19 PNA (POA) Pneumomediastinum, stable Pneumopericardium, stable  HAP  -XR chest with B/L peripheral and bibasilar opacities  -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 127 - Started NMB on 8/8  PLAN:  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - DC nimbex today, PF ratio increased to 164 after paralytic  -Continue dexamethasone 6 mg daily (stop date 8/11)  -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx  -Empiric Cefepime for HAP--Follow up cultures from 8/7 - DC vanc    AKI on CKD stage V(POA) Hyperkalemia (POA)--resolving Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant -8/7: udall, failed IHD and converted to CRRT. PLAN:  - Nephrology following, appreciate recs  - Continue CRRT with goal net even  - Dose meds for CRRT  -Strict I&O, Daily weights   Shock, multifactorial  - Medication and sepsis related, stress induced CM - Received approx. 2 L IVF  - Cortisol 9.7 on 8/7 PLAN:  - Levophed for MAP >65 - Treatment of infections  - Defer stress steroids while on Dex, can evaluate to start stress HC Once steroids complete for Dex-ARDS.    Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:   -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP improving, weekly checks.    DM type 2 (POA) - Diet controlled at home.  PLAN:  - Start insulin gtt today, monitoring per protocol.    Hypertension - Hold Home meds until clinically appropriate.    Obesity (POA)- BMI 35.8, complicates all aspects of care  discharge note Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to UK ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and with reported syncopal events. Patient was treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab.     On 8/6 the patient had worsening shortness of breath with increasing oxygen requirements.  On 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia ultimately requiring intubation. Furthermore, a dialysis catheter was placed and CRRT was initiated. Broad spectrum ABX were continued. On 8/8, he required addition of NMB for continued ventilator dys-synchrony. He completed the dex-ARDS protocol on 8/10. The patient had a decline on 8/11 with a fever, worsening shock. He was started back on broad spectrum antibiotics, vasopressin in addition to levophed, and stress dose steroids. Unfortunately, Pt remained with persistent and profound hemodynamic instability. His response to aggressive live saving measures was minimal. WBC up to 80 with no infectious source able to be identified, escalation of ABX still continued. CT scans unable to be obtained secondary to risk of fatal event occurring if moved and/or transported to scanner. On 8/13, Pt going into arrythmias which further exacerbated further instability, required cardioversions X 3 and antiarrhythmic medications. Goals of care discussions completed with wife. Despite attempting to give Pt more time to possibly respond to treatments, his status remained critical. Wife came to see her husband at bedside to be with him briefly before he passed away. Pt passed away on 8/14 at 8:11.""
	"1655677-1"	"1655677-1"	"BLOOD UREA INCREASED"	"10005851"	"50-59 years"	"50-59"	""patient vaccinated 7/23/2021, admitted 7/29/2021, tested positive for covid 7/29/2021. discharged 8/14/2021, patient expired  Patient received Pfizer vaccine L deltoid lot numberFA6780 on 7/23/2021. Tested positive on 7/29/2021 after exposure. Writing  report since patient received vaccine and now critically ill and intubated to follow procedure. Patient intubated 8/7/2021  History Of Present Illness Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and the following day began having diarrhea and ""passed out"" 4 times since symptoms developed.  While on the floor the patient had been treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab, and had been improving, weaned from HFNC to 4L NC on 8/5.  On 8/6 the patient had worsening shortness of breath and was transition back to high-flow nasal cannula.  Today, 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia.  MICU was called and the patient was emergently intubated for acute hypoxic respiratory failure.     Past Medical History He has a past medical history of CKD (chronic kidney disease), stage IV (CMS/HCC), Gout, and Hypertension.  Assessment and Plan:  The patient is a 53 yo M with CKD4,HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    ARDS  COVID-19 PNA (POA) Pneumomediastinum, worsening  -XR chest with B/L peripheral and bibasilar opacities  -Inflammatory markers were up trending, will continue to monitor -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia, official read pending -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 124 PLAN:  - Evaluate to repeat CT chest with patient clinical decline.  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - ABG -Continue dexamethasone 6 mg daily (D6/10) -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx    AKI on CKD stage V not on Dialysis (POA) Hyperkalemia (POA) Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant PLAN:  -Nephrology following on floor, will notify of transfer to the ICU - Place Udall-- > IHD to start 8/7.  -Continue sodium bicarb 1300 TID, calcitriol and vitamin D2 at same doses -Strict I&O, Daily weights - Foley    Seizure-like activity - Patient with right-sided upper extremity and lower-extremity tonic activity following intubation.  - Prior to intubation, patient had EMV 15, appropriate and no focal deficits.  - Likely metabolic in nature, patient with BUN >100, sepsis, COVID  - No past history of seizures.  PLAN:  - TSH, B12, ammonia - EEG   Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:  -STOP coreg , HOLD home amlodipine  -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP today and as needed.    Suspected orthostatic syncope related to COVID-19 infection -Started prior to admission in the setting of ongoing diarrhea, nausea and poor PO intake -No episodes since, symptoms improved with adequate fluid resuscitation -EKG on admission with sinus tachycardia with no significant ST-T changes -PT/OT, recs home with assistance  Obesity (POA) - BMI 35.8, complicates all aspects of care.   Hospitalization Admit Date/Time: 7/29/2021 3:55 PM Admitting Attending:  Discharge Date: 08/14/21 Discharge Attending Physician:    8/9/2021 Assessment and Plan   The patient is a 53 yo M with CKD4, HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    Acute Respiratory Failure Requiring Mechanical Ventilation  Moderate ARDS  COVID-19 PNA (POA) Pneumomediastinum, stable Pneumopericardium, stable  HAP  -XR chest with B/L peripheral and bibasilar opacities  -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 127 - Started NMB on 8/8  PLAN:  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - DC nimbex today, PF ratio increased to 164 after paralytic  -Continue dexamethasone 6 mg daily (stop date 8/11)  -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx  -Empiric Cefepime for HAP--Follow up cultures from 8/7 - DC vanc    AKI on CKD stage V(POA) Hyperkalemia (POA)--resolving Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant -8/7: udall, failed IHD and converted to CRRT. PLAN:  - Nephrology following, appreciate recs  - Continue CRRT with goal net even  - Dose meds for CRRT  -Strict I&O, Daily weights   Shock, multifactorial  - Medication and sepsis related, stress induced CM - Received approx. 2 L IVF  - Cortisol 9.7 on 8/7 PLAN:  - Levophed for MAP >65 - Treatment of infections  - Defer stress steroids while on Dex, can evaluate to start stress HC Once steroids complete for Dex-ARDS.    Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:   -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP improving, weekly checks.    DM type 2 (POA) - Diet controlled at home.  PLAN:  - Start insulin gtt today, monitoring per protocol.    Hypertension - Hold Home meds until clinically appropriate.    Obesity (POA)- BMI 35.8, complicates all aspects of care  discharge note Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to UK ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and with reported syncopal events. Patient was treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab.     On 8/6 the patient had worsening shortness of breath with increasing oxygen requirements.  On 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia ultimately requiring intubation. Furthermore, a dialysis catheter was placed and CRRT was initiated. Broad spectrum ABX were continued. On 8/8, he required addition of NMB for continued ventilator dys-synchrony. He completed the dex-ARDS protocol on 8/10. The patient had a decline on 8/11 with a fever, worsening shock. He was started back on broad spectrum antibiotics, vasopressin in addition to levophed, and stress dose steroids. Unfortunately, Pt remained with persistent and profound hemodynamic instability. His response to aggressive live saving measures was minimal. WBC up to 80 with no infectious source able to be identified, escalation of ABX still continued. CT scans unable to be obtained secondary to risk of fatal event occurring if moved and/or transported to scanner. On 8/13, Pt going into arrythmias which further exacerbated further instability, required cardioversions X 3 and antiarrhythmic medications. Goals of care discussions completed with wife. Despite attempting to give Pt more time to possibly respond to treatments, his status remained critical. Wife came to see her husband at bedside to be with him briefly before he passed away. Pt passed away on 8/14 at 8:11.""
	"1655677-1"	"1655677-1"	"BRONCHOPLEURAL FISTULA"	"10053481"	"50-59 years"	"50-59"	""patient vaccinated 7/23/2021, admitted 7/29/2021, tested positive for covid 7/29/2021. discharged 8/14/2021, patient expired  Patient received Pfizer vaccine L deltoid lot numberFA6780 on 7/23/2021. Tested positive on 7/29/2021 after exposure. Writing  report since patient received vaccine and now critically ill and intubated to follow procedure. Patient intubated 8/7/2021  History Of Present Illness Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and the following day began having diarrhea and ""passed out"" 4 times since symptoms developed.  While on the floor the patient had been treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab, and had been improving, weaned from HFNC to 4L NC on 8/5.  On 8/6 the patient had worsening shortness of breath and was transition back to high-flow nasal cannula.  Today, 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia.  MICU was called and the patient was emergently intubated for acute hypoxic respiratory failure.     Past Medical History He has a past medical history of CKD (chronic kidney disease), stage IV (CMS/HCC), Gout, and Hypertension.  Assessment and Plan:  The patient is a 53 yo M with CKD4,HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    ARDS  COVID-19 PNA (POA) Pneumomediastinum, worsening  -XR chest with B/L peripheral and bibasilar opacities  -Inflammatory markers were up trending, will continue to monitor -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia, official read pending -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 124 PLAN:  - Evaluate to repeat CT chest with patient clinical decline.  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - ABG -Continue dexamethasone 6 mg daily (D6/10) -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx    AKI on CKD stage V not on Dialysis (POA) Hyperkalemia (POA) Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant PLAN:  -Nephrology following on floor, will notify of transfer to the ICU - Place Udall-- > IHD to start 8/7.  -Continue sodium bicarb 1300 TID, calcitriol and vitamin D2 at same doses -Strict I&O, Daily weights - Foley    Seizure-like activity - Patient with right-sided upper extremity and lower-extremity tonic activity following intubation.  - Prior to intubation, patient had EMV 15, appropriate and no focal deficits.  - Likely metabolic in nature, patient with BUN >100, sepsis, COVID  - No past history of seizures.  PLAN:  - TSH, B12, ammonia - EEG   Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:  -STOP coreg , HOLD home amlodipine  -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP today and as needed.    Suspected orthostatic syncope related to COVID-19 infection -Started prior to admission in the setting of ongoing diarrhea, nausea and poor PO intake -No episodes since, symptoms improved with adequate fluid resuscitation -EKG on admission with sinus tachycardia with no significant ST-T changes -PT/OT, recs home with assistance  Obesity (POA) - BMI 35.8, complicates all aspects of care.   Hospitalization Admit Date/Time: 7/29/2021 3:55 PM Admitting Attending:  Discharge Date: 08/14/21 Discharge Attending Physician:    8/9/2021 Assessment and Plan   The patient is a 53 yo M with CKD4, HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    Acute Respiratory Failure Requiring Mechanical Ventilation  Moderate ARDS  COVID-19 PNA (POA) Pneumomediastinum, stable Pneumopericardium, stable  HAP  -XR chest with B/L peripheral and bibasilar opacities  -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 127 - Started NMB on 8/8  PLAN:  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - DC nimbex today, PF ratio increased to 164 after paralytic  -Continue dexamethasone 6 mg daily (stop date 8/11)  -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx  -Empiric Cefepime for HAP--Follow up cultures from 8/7 - DC vanc    AKI on CKD stage V(POA) Hyperkalemia (POA)--resolving Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant -8/7: udall, failed IHD and converted to CRRT. PLAN:  - Nephrology following, appreciate recs  - Continue CRRT with goal net even  - Dose meds for CRRT  -Strict I&O, Daily weights   Shock, multifactorial  - Medication and sepsis related, stress induced CM - Received approx. 2 L IVF  - Cortisol 9.7 on 8/7 PLAN:  - Levophed for MAP >65 - Treatment of infections  - Defer stress steroids while on Dex, can evaluate to start stress HC Once steroids complete for Dex-ARDS.    Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:   -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP improving, weekly checks.    DM type 2 (POA) - Diet controlled at home.  PLAN:  - Start insulin gtt today, monitoring per protocol.    Hypertension - Hold Home meds until clinically appropriate.    Obesity (POA)- BMI 35.8, complicates all aspects of care  discharge note Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to UK ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and with reported syncopal events. Patient was treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab.     On 8/6 the patient had worsening shortness of breath with increasing oxygen requirements.  On 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia ultimately requiring intubation. Furthermore, a dialysis catheter was placed and CRRT was initiated. Broad spectrum ABX were continued. On 8/8, he required addition of NMB for continued ventilator dys-synchrony. He completed the dex-ARDS protocol on 8/10. The patient had a decline on 8/11 with a fever, worsening shock. He was started back on broad spectrum antibiotics, vasopressin in addition to levophed, and stress dose steroids. Unfortunately, Pt remained with persistent and profound hemodynamic instability. His response to aggressive live saving measures was minimal. WBC up to 80 with no infectious source able to be identified, escalation of ABX still continued. CT scans unable to be obtained secondary to risk of fatal event occurring if moved and/or transported to scanner. On 8/13, Pt going into arrythmias which further exacerbated further instability, required cardioversions X 3 and antiarrhythmic medications. Goals of care discussions completed with wife. Despite attempting to give Pt more time to possibly respond to treatments, his status remained critical. Wife came to see her husband at bedside to be with him briefly before he passed away. Pt passed away on 8/14 at 8:11.""
	"1655677-1"	"1655677-1"	"CARDIAC FAILURE"	"10007554"	"50-59 years"	"50-59"	""patient vaccinated 7/23/2021, admitted 7/29/2021, tested positive for covid 7/29/2021. discharged 8/14/2021, patient expired  Patient received Pfizer vaccine L deltoid lot numberFA6780 on 7/23/2021. Tested positive on 7/29/2021 after exposure. Writing  report since patient received vaccine and now critically ill and intubated to follow procedure. Patient intubated 8/7/2021  History Of Present Illness Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and the following day began having diarrhea and ""passed out"" 4 times since symptoms developed.  While on the floor the patient had been treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab, and had been improving, weaned from HFNC to 4L NC on 8/5.  On 8/6 the patient had worsening shortness of breath and was transition back to high-flow nasal cannula.  Today, 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia.  MICU was called and the patient was emergently intubated for acute hypoxic respiratory failure.     Past Medical History He has a past medical history of CKD (chronic kidney disease), stage IV (CMS/HCC), Gout, and Hypertension.  Assessment and Plan:  The patient is a 53 yo M with CKD4,HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    ARDS  COVID-19 PNA (POA) Pneumomediastinum, worsening  -XR chest with B/L peripheral and bibasilar opacities  -Inflammatory markers were up trending, will continue to monitor -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia, official read pending -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 124 PLAN:  - Evaluate to repeat CT chest with patient clinical decline.  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - ABG -Continue dexamethasone 6 mg daily (D6/10) -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx    AKI on CKD stage V not on Dialysis (POA) Hyperkalemia (POA) Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant PLAN:  -Nephrology following on floor, will notify of transfer to the ICU - Place Udall-- > IHD to start 8/7.  -Continue sodium bicarb 1300 TID, calcitriol and vitamin D2 at same doses -Strict I&O, Daily weights - Foley    Seizure-like activity - Patient with right-sided upper extremity and lower-extremity tonic activity following intubation.  - Prior to intubation, patient had EMV 15, appropriate and no focal deficits.  - Likely metabolic in nature, patient with BUN >100, sepsis, COVID  - No past history of seizures.  PLAN:  - TSH, B12, ammonia - EEG   Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:  -STOP coreg , HOLD home amlodipine  -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP today and as needed.    Suspected orthostatic syncope related to COVID-19 infection -Started prior to admission in the setting of ongoing diarrhea, nausea and poor PO intake -No episodes since, symptoms improved with adequate fluid resuscitation -EKG on admission with sinus tachycardia with no significant ST-T changes -PT/OT, recs home with assistance  Obesity (POA) - BMI 35.8, complicates all aspects of care.   Hospitalization Admit Date/Time: 7/29/2021 3:55 PM Admitting Attending:  Discharge Date: 08/14/21 Discharge Attending Physician:    8/9/2021 Assessment and Plan   The patient is a 53 yo M with CKD4, HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    Acute Respiratory Failure Requiring Mechanical Ventilation  Moderate ARDS  COVID-19 PNA (POA) Pneumomediastinum, stable Pneumopericardium, stable  HAP  -XR chest with B/L peripheral and bibasilar opacities  -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 127 - Started NMB on 8/8  PLAN:  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - DC nimbex today, PF ratio increased to 164 after paralytic  -Continue dexamethasone 6 mg daily (stop date 8/11)  -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx  -Empiric Cefepime for HAP--Follow up cultures from 8/7 - DC vanc    AKI on CKD stage V(POA) Hyperkalemia (POA)--resolving Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant -8/7: udall, failed IHD and converted to CRRT. PLAN:  - Nephrology following, appreciate recs  - Continue CRRT with goal net even  - Dose meds for CRRT  -Strict I&O, Daily weights   Shock, multifactorial  - Medication and sepsis related, stress induced CM - Received approx. 2 L IVF  - Cortisol 9.7 on 8/7 PLAN:  - Levophed for MAP >65 - Treatment of infections  - Defer stress steroids while on Dex, can evaluate to start stress HC Once steroids complete for Dex-ARDS.    Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:   -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP improving, weekly checks.    DM type 2 (POA) - Diet controlled at home.  PLAN:  - Start insulin gtt today, monitoring per protocol.    Hypertension - Hold Home meds until clinically appropriate.    Obesity (POA)- BMI 35.8, complicates all aspects of care  discharge note Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to UK ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and with reported syncopal events. Patient was treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab.     On 8/6 the patient had worsening shortness of breath with increasing oxygen requirements.  On 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia ultimately requiring intubation. Furthermore, a dialysis catheter was placed and CRRT was initiated. Broad spectrum ABX were continued. On 8/8, he required addition of NMB for continued ventilator dys-synchrony. He completed the dex-ARDS protocol on 8/10. The patient had a decline on 8/11 with a fever, worsening shock. He was started back on broad spectrum antibiotics, vasopressin in addition to levophed, and stress dose steroids. Unfortunately, Pt remained with persistent and profound hemodynamic instability. His response to aggressive live saving measures was minimal. WBC up to 80 with no infectious source able to be identified, escalation of ABX still continued. CT scans unable to be obtained secondary to risk of fatal event occurring if moved and/or transported to scanner. On 8/13, Pt going into arrythmias which further exacerbated further instability, required cardioversions X 3 and antiarrhythmic medications. Goals of care discussions completed with wife. Despite attempting to give Pt more time to possibly respond to treatments, his status remained critical. Wife came to see her husband at bedside to be with him briefly before he passed away. Pt passed away on 8/14 at 8:11.""
	"1655677-1"	"1655677-1"	"CARDIOVERSION"	"10007661"	"50-59 years"	"50-59"	""patient vaccinated 7/23/2021, admitted 7/29/2021, tested positive for covid 7/29/2021. discharged 8/14/2021, patient expired  Patient received Pfizer vaccine L deltoid lot numberFA6780 on 7/23/2021. Tested positive on 7/29/2021 after exposure. Writing  report since patient received vaccine and now critically ill and intubated to follow procedure. Patient intubated 8/7/2021  History Of Present Illness Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and the following day began having diarrhea and ""passed out"" 4 times since symptoms developed.  While on the floor the patient had been treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab, and had been improving, weaned from HFNC to 4L NC on 8/5.  On 8/6 the patient had worsening shortness of breath and was transition back to high-flow nasal cannula.  Today, 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia.  MICU was called and the patient was emergently intubated for acute hypoxic respiratory failure.     Past Medical History He has a past medical history of CKD (chronic kidney disease), stage IV (CMS/HCC), Gout, and Hypertension.  Assessment and Plan:  The patient is a 53 yo M with CKD4,HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    ARDS  COVID-19 PNA (POA) Pneumomediastinum, worsening  -XR chest with B/L peripheral and bibasilar opacities  -Inflammatory markers were up trending, will continue to monitor -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia, official read pending -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 124 PLAN:  - Evaluate to repeat CT chest with patient clinical decline.  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - ABG -Continue dexamethasone 6 mg daily (D6/10) -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx    AKI on CKD stage V not on Dialysis (POA) Hyperkalemia (POA) Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant PLAN:  -Nephrology following on floor, will notify of transfer to the ICU - Place Udall-- > IHD to start 8/7.  -Continue sodium bicarb 1300 TID, calcitriol and vitamin D2 at same doses -Strict I&O, Daily weights - Foley    Seizure-like activity - Patient with right-sided upper extremity and lower-extremity tonic activity following intubation.  - Prior to intubation, patient had EMV 15, appropriate and no focal deficits.  - Likely metabolic in nature, patient with BUN >100, sepsis, COVID  - No past history of seizures.  PLAN:  - TSH, B12, ammonia - EEG   Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:  -STOP coreg , HOLD home amlodipine  -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP today and as needed.    Suspected orthostatic syncope related to COVID-19 infection -Started prior to admission in the setting of ongoing diarrhea, nausea and poor PO intake -No episodes since, symptoms improved with adequate fluid resuscitation -EKG on admission with sinus tachycardia with no significant ST-T changes -PT/OT, recs home with assistance  Obesity (POA) - BMI 35.8, complicates all aspects of care.   Hospitalization Admit Date/Time: 7/29/2021 3:55 PM Admitting Attending:  Discharge Date: 08/14/21 Discharge Attending Physician:    8/9/2021 Assessment and Plan   The patient is a 53 yo M with CKD4, HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    Acute Respiratory Failure Requiring Mechanical Ventilation  Moderate ARDS  COVID-19 PNA (POA) Pneumomediastinum, stable Pneumopericardium, stable  HAP  -XR chest with B/L peripheral and bibasilar opacities  -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 127 - Started NMB on 8/8  PLAN:  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - DC nimbex today, PF ratio increased to 164 after paralytic  -Continue dexamethasone 6 mg daily (stop date 8/11)  -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx  -Empiric Cefepime for HAP--Follow up cultures from 8/7 - DC vanc    AKI on CKD stage V(POA) Hyperkalemia (POA)--resolving Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant -8/7: udall, failed IHD and converted to CRRT. PLAN:  - Nephrology following, appreciate recs  - Continue CRRT with goal net even  - Dose meds for CRRT  -Strict I&O, Daily weights   Shock, multifactorial  - Medication and sepsis related, stress induced CM - Received approx. 2 L IVF  - Cortisol 9.7 on 8/7 PLAN:  - Levophed for MAP >65 - Treatment of infections  - Defer stress steroids while on Dex, can evaluate to start stress HC Once steroids complete for Dex-ARDS.    Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:   -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP improving, weekly checks.    DM type 2 (POA) - Diet controlled at home.  PLAN:  - Start insulin gtt today, monitoring per protocol.    Hypertension - Hold Home meds until clinically appropriate.    Obesity (POA)- BMI 35.8, complicates all aspects of care  discharge note Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to UK ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and with reported syncopal events. Patient was treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab.     On 8/6 the patient had worsening shortness of breath with increasing oxygen requirements.  On 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia ultimately requiring intubation. Furthermore, a dialysis catheter was placed and CRRT was initiated. Broad spectrum ABX were continued. On 8/8, he required addition of NMB for continued ventilator dys-synchrony. He completed the dex-ARDS protocol on 8/10. The patient had a decline on 8/11 with a fever, worsening shock. He was started back on broad spectrum antibiotics, vasopressin in addition to levophed, and stress dose steroids. Unfortunately, Pt remained with persistent and profound hemodynamic instability. His response to aggressive live saving measures was minimal. WBC up to 80 with no infectious source able to be identified, escalation of ABX still continued. CT scans unable to be obtained secondary to risk of fatal event occurring if moved and/or transported to scanner. On 8/13, Pt going into arrythmias which further exacerbated further instability, required cardioversions X 3 and antiarrhythmic medications. Goals of care discussions completed with wife. Despite attempting to give Pt more time to possibly respond to treatments, his status remained critical. Wife came to see her husband at bedside to be with him briefly before he passed away. Pt passed away on 8/14 at 8:11.""
	"1655677-1"	"1655677-1"	"CHEST X-RAY ABNORMAL"	"10008499"	"50-59 years"	"50-59"	""patient vaccinated 7/23/2021, admitted 7/29/2021, tested positive for covid 7/29/2021. discharged 8/14/2021, patient expired  Patient received Pfizer vaccine L deltoid lot numberFA6780 on 7/23/2021. Tested positive on 7/29/2021 after exposure. Writing  report since patient received vaccine and now critically ill and intubated to follow procedure. Patient intubated 8/7/2021  History Of Present Illness Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and the following day began having diarrhea and ""passed out"" 4 times since symptoms developed.  While on the floor the patient had been treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab, and had been improving, weaned from HFNC to 4L NC on 8/5.  On 8/6 the patient had worsening shortness of breath and was transition back to high-flow nasal cannula.  Today, 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia.  MICU was called and the patient was emergently intubated for acute hypoxic respiratory failure.     Past Medical History He has a past medical history of CKD (chronic kidney disease), stage IV (CMS/HCC), Gout, and Hypertension.  Assessment and Plan:  The patient is a 53 yo M with CKD4,HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    ARDS  COVID-19 PNA (POA) Pneumomediastinum, worsening  -XR chest with B/L peripheral and bibasilar opacities  -Inflammatory markers were up trending, will continue to monitor -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia, official read pending -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 124 PLAN:  - Evaluate to repeat CT chest with patient clinical decline.  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - ABG -Continue dexamethasone 6 mg daily (D6/10) -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx    AKI on CKD stage V not on Dialysis (POA) Hyperkalemia (POA) Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant PLAN:  -Nephrology following on floor, will notify of transfer to the ICU - Place Udall-- > IHD to start 8/7.  -Continue sodium bicarb 1300 TID, calcitriol and vitamin D2 at same doses -Strict I&O, Daily weights - Foley    Seizure-like activity - Patient with right-sided upper extremity and lower-extremity tonic activity following intubation.  - Prior to intubation, patient had EMV 15, appropriate and no focal deficits.  - Likely metabolic in nature, patient with BUN >100, sepsis, COVID  - No past history of seizures.  PLAN:  - TSH, B12, ammonia - EEG   Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:  -STOP coreg , HOLD home amlodipine  -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP today and as needed.    Suspected orthostatic syncope related to COVID-19 infection -Started prior to admission in the setting of ongoing diarrhea, nausea and poor PO intake -No episodes since, symptoms improved with adequate fluid resuscitation -EKG on admission with sinus tachycardia with no significant ST-T changes -PT/OT, recs home with assistance  Obesity (POA) - BMI 35.8, complicates all aspects of care.   Hospitalization Admit Date/Time: 7/29/2021 3:55 PM Admitting Attending:  Discharge Date: 08/14/21 Discharge Attending Physician:    8/9/2021 Assessment and Plan   The patient is a 53 yo M with CKD4, HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    Acute Respiratory Failure Requiring Mechanical Ventilation  Moderate ARDS  COVID-19 PNA (POA) Pneumomediastinum, stable Pneumopericardium, stable  HAP  -XR chest with B/L peripheral and bibasilar opacities  -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 127 - Started NMB on 8/8  PLAN:  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - DC nimbex today, PF ratio increased to 164 after paralytic  -Continue dexamethasone 6 mg daily (stop date 8/11)  -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx  -Empiric Cefepime for HAP--Follow up cultures from 8/7 - DC vanc    AKI on CKD stage V(POA) Hyperkalemia (POA)--resolving Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant -8/7: udall, failed IHD and converted to CRRT. PLAN:  - Nephrology following, appreciate recs  - Continue CRRT with goal net even  - Dose meds for CRRT  -Strict I&O, Daily weights   Shock, multifactorial  - Medication and sepsis related, stress induced CM - Received approx. 2 L IVF  - Cortisol 9.7 on 8/7 PLAN:  - Levophed for MAP >65 - Treatment of infections  - Defer stress steroids while on Dex, can evaluate to start stress HC Once steroids complete for Dex-ARDS.    Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:   -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP improving, weekly checks.    DM type 2 (POA) - Diet controlled at home.  PLAN:  - Start insulin gtt today, monitoring per protocol.    Hypertension - Hold Home meds until clinically appropriate.    Obesity (POA)- BMI 35.8, complicates all aspects of care  discharge note Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to UK ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and with reported syncopal events. Patient was treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab.     On 8/6 the patient had worsening shortness of breath with increasing oxygen requirements.  On 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia ultimately requiring intubation. Furthermore, a dialysis catheter was placed and CRRT was initiated. Broad spectrum ABX were continued. On 8/8, he required addition of NMB for continued ventilator dys-synchrony. He completed the dex-ARDS protocol on 8/10. The patient had a decline on 8/11 with a fever, worsening shock. He was started back on broad spectrum antibiotics, vasopressin in addition to levophed, and stress dose steroids. Unfortunately, Pt remained with persistent and profound hemodynamic instability. His response to aggressive live saving measures was minimal. WBC up to 80 with no infectious source able to be identified, escalation of ABX still continued. CT scans unable to be obtained secondary to risk of fatal event occurring if moved and/or transported to scanner. On 8/13, Pt going into arrythmias which further exacerbated further instability, required cardioversions X 3 and antiarrhythmic medications. Goals of care discussions completed with wife. Despite attempting to give Pt more time to possibly respond to treatments, his status remained critical. Wife came to see her husband at bedside to be with him briefly before he passed away. Pt passed away on 8/14 at 8:11.""
	"1655677-1"	"1655677-1"	"COMPUTERISED TOMOGRAM"	"10010234"	"50-59 years"	"50-59"	""patient vaccinated 7/23/2021, admitted 7/29/2021, tested positive for covid 7/29/2021. discharged 8/14/2021, patient expired  Patient received Pfizer vaccine L deltoid lot numberFA6780 on 7/23/2021. Tested positive on 7/29/2021 after exposure. Writing  report since patient received vaccine and now critically ill and intubated to follow procedure. Patient intubated 8/7/2021  History Of Present Illness Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and the following day began having diarrhea and ""passed out"" 4 times since symptoms developed.  While on the floor the patient had been treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab, and had been improving, weaned from HFNC to 4L NC on 8/5.  On 8/6 the patient had worsening shortness of breath and was transition back to high-flow nasal cannula.  Today, 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia.  MICU was called and the patient was emergently intubated for acute hypoxic respiratory failure.     Past Medical History He has a past medical history of CKD (chronic kidney disease), stage IV (CMS/HCC), Gout, and Hypertension.  Assessment and Plan:  The patient is a 53 yo M with CKD4,HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    ARDS  COVID-19 PNA (POA) Pneumomediastinum, worsening  -XR chest with B/L peripheral and bibasilar opacities  -Inflammatory markers were up trending, will continue to monitor -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia, official read pending -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 124 PLAN:  - Evaluate to repeat CT chest with patient clinical decline.  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - ABG -Continue dexamethasone 6 mg daily (D6/10) -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx    AKI on CKD stage V not on Dialysis (POA) Hyperkalemia (POA) Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant PLAN:  -Nephrology following on floor, will notify of transfer to the ICU - Place Udall-- > IHD to start 8/7.  -Continue sodium bicarb 1300 TID, calcitriol and vitamin D2 at same doses -Strict I&O, Daily weights - Foley    Seizure-like activity - Patient with right-sided upper extremity and lower-extremity tonic activity following intubation.  - Prior to intubation, patient had EMV 15, appropriate and no focal deficits.  - Likely metabolic in nature, patient with BUN >100, sepsis, COVID  - No past history of seizures.  PLAN:  - TSH, B12, ammonia - EEG   Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:  -STOP coreg , HOLD home amlodipine  -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP today and as needed.    Suspected orthostatic syncope related to COVID-19 infection -Started prior to admission in the setting of ongoing diarrhea, nausea and poor PO intake -No episodes since, symptoms improved with adequate fluid resuscitation -EKG on admission with sinus tachycardia with no significant ST-T changes -PT/OT, recs home with assistance  Obesity (POA) - BMI 35.8, complicates all aspects of care.   Hospitalization Admit Date/Time: 7/29/2021 3:55 PM Admitting Attending:  Discharge Date: 08/14/21 Discharge Attending Physician:    8/9/2021 Assessment and Plan   The patient is a 53 yo M with CKD4, HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    Acute Respiratory Failure Requiring Mechanical Ventilation  Moderate ARDS  COVID-19 PNA (POA) Pneumomediastinum, stable Pneumopericardium, stable  HAP  -XR chest with B/L peripheral and bibasilar opacities  -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 127 - Started NMB on 8/8  PLAN:  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - DC nimbex today, PF ratio increased to 164 after paralytic  -Continue dexamethasone 6 mg daily (stop date 8/11)  -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx  -Empiric Cefepime for HAP--Follow up cultures from 8/7 - DC vanc    AKI on CKD stage V(POA) Hyperkalemia (POA)--resolving Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant -8/7: udall, failed IHD and converted to CRRT. PLAN:  - Nephrology following, appreciate recs  - Continue CRRT with goal net even  - Dose meds for CRRT  -Strict I&O, Daily weights   Shock, multifactorial  - Medication and sepsis related, stress induced CM - Received approx. 2 L IVF  - Cortisol 9.7 on 8/7 PLAN:  - Levophed for MAP >65 - Treatment of infections  - Defer stress steroids while on Dex, can evaluate to start stress HC Once steroids complete for Dex-ARDS.    Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:   -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP improving, weekly checks.    DM type 2 (POA) - Diet controlled at home.  PLAN:  - Start insulin gtt today, monitoring per protocol.    Hypertension - Hold Home meds until clinically appropriate.    Obesity (POA)- BMI 35.8, complicates all aspects of care  discharge note Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to UK ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and with reported syncopal events. Patient was treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab.     On 8/6 the patient had worsening shortness of breath with increasing oxygen requirements.  On 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia ultimately requiring intubation. Furthermore, a dialysis catheter was placed and CRRT was initiated. Broad spectrum ABX were continued. On 8/8, he required addition of NMB for continued ventilator dys-synchrony. He completed the dex-ARDS protocol on 8/10. The patient had a decline on 8/11 with a fever, worsening shock. He was started back on broad spectrum antibiotics, vasopressin in addition to levophed, and stress dose steroids. Unfortunately, Pt remained with persistent and profound hemodynamic instability. His response to aggressive live saving measures was minimal. WBC up to 80 with no infectious source able to be identified, escalation of ABX still continued. CT scans unable to be obtained secondary to risk of fatal event occurring if moved and/or transported to scanner. On 8/13, Pt going into arrythmias which further exacerbated further instability, required cardioversions X 3 and antiarrhythmic medications. Goals of care discussions completed with wife. Despite attempting to give Pt more time to possibly respond to treatments, his status remained critical. Wife came to see her husband at bedside to be with him briefly before he passed away. Pt passed away on 8/14 at 8:11.""
	"1655677-1"	"1655677-1"	"COMPUTERISED TOMOGRAM ABNORMAL"	"10010235"	"50-59 years"	"50-59"	""patient vaccinated 7/23/2021, admitted 7/29/2021, tested positive for covid 7/29/2021. discharged 8/14/2021, patient expired  Patient received Pfizer vaccine L deltoid lot numberFA6780 on 7/23/2021. Tested positive on 7/29/2021 after exposure. Writing  report since patient received vaccine and now critically ill and intubated to follow procedure. Patient intubated 8/7/2021  History Of Present Illness Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and the following day began having diarrhea and ""passed out"" 4 times since symptoms developed.  While on the floor the patient had been treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab, and had been improving, weaned from HFNC to 4L NC on 8/5.  On 8/6 the patient had worsening shortness of breath and was transition back to high-flow nasal cannula.  Today, 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia.  MICU was called and the patient was emergently intubated for acute hypoxic respiratory failure.     Past Medical History He has a past medical history of CKD (chronic kidney disease), stage IV (CMS/HCC), Gout, and Hypertension.  Assessment and Plan:  The patient is a 53 yo M with CKD4,HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    ARDS  COVID-19 PNA (POA) Pneumomediastinum, worsening  -XR chest with B/L peripheral and bibasilar opacities  -Inflammatory markers were up trending, will continue to monitor -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia, official read pending -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 124 PLAN:  - Evaluate to repeat CT chest with patient clinical decline.  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - ABG -Continue dexamethasone 6 mg daily (D6/10) -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx    AKI on CKD stage V not on Dialysis (POA) Hyperkalemia (POA) Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant PLAN:  -Nephrology following on floor, will notify of transfer to the ICU - Place Udall-- > IHD to start 8/7.  -Continue sodium bicarb 1300 TID, calcitriol and vitamin D2 at same doses -Strict I&O, Daily weights - Foley    Seizure-like activity - Patient with right-sided upper extremity and lower-extremity tonic activity following intubation.  - Prior to intubation, patient had EMV 15, appropriate and no focal deficits.  - Likely metabolic in nature, patient with BUN >100, sepsis, COVID  - No past history of seizures.  PLAN:  - TSH, B12, ammonia - EEG   Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:  -STOP coreg , HOLD home amlodipine  -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP today and as needed.    Suspected orthostatic syncope related to COVID-19 infection -Started prior to admission in the setting of ongoing diarrhea, nausea and poor PO intake -No episodes since, symptoms improved with adequate fluid resuscitation -EKG on admission with sinus tachycardia with no significant ST-T changes -PT/OT, recs home with assistance  Obesity (POA) - BMI 35.8, complicates all aspects of care.   Hospitalization Admit Date/Time: 7/29/2021 3:55 PM Admitting Attending:  Discharge Date: 08/14/21 Discharge Attending Physician:    8/9/2021 Assessment and Plan   The patient is a 53 yo M with CKD4, HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    Acute Respiratory Failure Requiring Mechanical Ventilation  Moderate ARDS  COVID-19 PNA (POA) Pneumomediastinum, stable Pneumopericardium, stable  HAP  -XR chest with B/L peripheral and bibasilar opacities  -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 127 - Started NMB on 8/8  PLAN:  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - DC nimbex today, PF ratio increased to 164 after paralytic  -Continue dexamethasone 6 mg daily (stop date 8/11)  -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx  -Empiric Cefepime for HAP--Follow up cultures from 8/7 - DC vanc    AKI on CKD stage V(POA) Hyperkalemia (POA)--resolving Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant -8/7: udall, failed IHD and converted to CRRT. PLAN:  - Nephrology following, appreciate recs  - Continue CRRT with goal net even  - Dose meds for CRRT  -Strict I&O, Daily weights   Shock, multifactorial  - Medication and sepsis related, stress induced CM - Received approx. 2 L IVF  - Cortisol 9.7 on 8/7 PLAN:  - Levophed for MAP >65 - Treatment of infections  - Defer stress steroids while on Dex, can evaluate to start stress HC Once steroids complete for Dex-ARDS.    Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:   -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP improving, weekly checks.    DM type 2 (POA) - Diet controlled at home.  PLAN:  - Start insulin gtt today, monitoring per protocol.    Hypertension - Hold Home meds until clinically appropriate.    Obesity (POA)- BMI 35.8, complicates all aspects of care  discharge note Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to UK ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and with reported syncopal events. Patient was treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab.     On 8/6 the patient had worsening shortness of breath with increasing oxygen requirements.  On 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia ultimately requiring intubation. Furthermore, a dialysis catheter was placed and CRRT was initiated. Broad spectrum ABX were continued. On 8/8, he required addition of NMB for continued ventilator dys-synchrony. He completed the dex-ARDS protocol on 8/10. The patient had a decline on 8/11 with a fever, worsening shock. He was started back on broad spectrum antibiotics, vasopressin in addition to levophed, and stress dose steroids. Unfortunately, Pt remained with persistent and profound hemodynamic instability. His response to aggressive live saving measures was minimal. WBC up to 80 with no infectious source able to be identified, escalation of ABX still continued. CT scans unable to be obtained secondary to risk of fatal event occurring if moved and/or transported to scanner. On 8/13, Pt going into arrythmias which further exacerbated further instability, required cardioversions X 3 and antiarrhythmic medications. Goals of care discussions completed with wife. Despite attempting to give Pt more time to possibly respond to treatments, his status remained critical. Wife came to see her husband at bedside to be with him briefly before he passed away. Pt passed away on 8/14 at 8:11.""
	"1655677-1"	"1655677-1"	"COMPUTERISED TOMOGRAM THORAX"	"10053875"	"50-59 years"	"50-59"	""patient vaccinated 7/23/2021, admitted 7/29/2021, tested positive for covid 7/29/2021. discharged 8/14/2021, patient expired  Patient received Pfizer vaccine L deltoid lot numberFA6780 on 7/23/2021. Tested positive on 7/29/2021 after exposure. Writing  report since patient received vaccine and now critically ill and intubated to follow procedure. Patient intubated 8/7/2021  History Of Present Illness Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and the following day began having diarrhea and ""passed out"" 4 times since symptoms developed.  While on the floor the patient had been treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab, and had been improving, weaned from HFNC to 4L NC on 8/5.  On 8/6 the patient had worsening shortness of breath and was transition back to high-flow nasal cannula.  Today, 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia.  MICU was called and the patient was emergently intubated for acute hypoxic respiratory failure.     Past Medical History He has a past medical history of CKD (chronic kidney disease), stage IV (CMS/HCC), Gout, and Hypertension.  Assessment and Plan:  The patient is a 53 yo M with CKD4,HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    ARDS  COVID-19 PNA (POA) Pneumomediastinum, worsening  -XR chest with B/L peripheral and bibasilar opacities  -Inflammatory markers were up trending, will continue to monitor -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia, official read pending -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 124 PLAN:  - Evaluate to repeat CT chest with patient clinical decline.  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - ABG -Continue dexamethasone 6 mg daily (D6/10) -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx    AKI on CKD stage V not on Dialysis (POA) Hyperkalemia (POA) Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant PLAN:  -Nephrology following on floor, will notify of transfer to the ICU - Place Udall-- > IHD to start 8/7.  -Continue sodium bicarb 1300 TID, calcitriol and vitamin D2 at same doses -Strict I&O, Daily weights - Foley    Seizure-like activity - Patient with right-sided upper extremity and lower-extremity tonic activity following intubation.  - Prior to intubation, patient had EMV 15, appropriate and no focal deficits.  - Likely metabolic in nature, patient with BUN >100, sepsis, COVID  - No past history of seizures.  PLAN:  - TSH, B12, ammonia - EEG   Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:  -STOP coreg , HOLD home amlodipine  -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP today and as needed.    Suspected orthostatic syncope related to COVID-19 infection -Started prior to admission in the setting of ongoing diarrhea, nausea and poor PO intake -No episodes since, symptoms improved with adequate fluid resuscitation -EKG on admission with sinus tachycardia with no significant ST-T changes -PT/OT, recs home with assistance  Obesity (POA) - BMI 35.8, complicates all aspects of care.   Hospitalization Admit Date/Time: 7/29/2021 3:55 PM Admitting Attending:  Discharge Date: 08/14/21 Discharge Attending Physician:    8/9/2021 Assessment and Plan   The patient is a 53 yo M with CKD4, HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    Acute Respiratory Failure Requiring Mechanical Ventilation  Moderate ARDS  COVID-19 PNA (POA) Pneumomediastinum, stable Pneumopericardium, stable  HAP  -XR chest with B/L peripheral and bibasilar opacities  -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 127 - Started NMB on 8/8  PLAN:  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - DC nimbex today, PF ratio increased to 164 after paralytic  -Continue dexamethasone 6 mg daily (stop date 8/11)  -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx  -Empiric Cefepime for HAP--Follow up cultures from 8/7 - DC vanc    AKI on CKD stage V(POA) Hyperkalemia (POA)--resolving Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant -8/7: udall, failed IHD and converted to CRRT. PLAN:  - Nephrology following, appreciate recs  - Continue CRRT with goal net even  - Dose meds for CRRT  -Strict I&O, Daily weights   Shock, multifactorial  - Medication and sepsis related, stress induced CM - Received approx. 2 L IVF  - Cortisol 9.7 on 8/7 PLAN:  - Levophed for MAP >65 - Treatment of infections  - Defer stress steroids while on Dex, can evaluate to start stress HC Once steroids complete for Dex-ARDS.    Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:   -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP improving, weekly checks.    DM type 2 (POA) - Diet controlled at home.  PLAN:  - Start insulin gtt today, monitoring per protocol.    Hypertension - Hold Home meds until clinically appropriate.    Obesity (POA)- BMI 35.8, complicates all aspects of care  discharge note Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to UK ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and with reported syncopal events. Patient was treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab.     On 8/6 the patient had worsening shortness of breath with increasing oxygen requirements.  On 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia ultimately requiring intubation. Furthermore, a dialysis catheter was placed and CRRT was initiated. Broad spectrum ABX were continued. On 8/8, he required addition of NMB for continued ventilator dys-synchrony. He completed the dex-ARDS protocol on 8/10. The patient had a decline on 8/11 with a fever, worsening shock. He was started back on broad spectrum antibiotics, vasopressin in addition to levophed, and stress dose steroids. Unfortunately, Pt remained with persistent and profound hemodynamic instability. His response to aggressive live saving measures was minimal. WBC up to 80 with no infectious source able to be identified, escalation of ABX still continued. CT scans unable to be obtained secondary to risk of fatal event occurring if moved and/or transported to scanner. On 8/13, Pt going into arrythmias which further exacerbated further instability, required cardioversions X 3 and antiarrhythmic medications. Goals of care discussions completed with wife. Despite attempting to give Pt more time to possibly respond to treatments, his status remained critical. Wife came to see her husband at bedside to be with him briefly before he passed away. Pt passed away on 8/14 at 8:11.""
	"1655677-1"	"1655677-1"	"CORTISOL INCREASED"	"10011207"	"50-59 years"	"50-59"	""patient vaccinated 7/23/2021, admitted 7/29/2021, tested positive for covid 7/29/2021. discharged 8/14/2021, patient expired  Patient received Pfizer vaccine L deltoid lot numberFA6780 on 7/23/2021. Tested positive on 7/29/2021 after exposure. Writing  report since patient received vaccine and now critically ill and intubated to follow procedure. Patient intubated 8/7/2021  History Of Present Illness Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and the following day began having diarrhea and ""passed out"" 4 times since symptoms developed.  While on the floor the patient had been treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab, and had been improving, weaned from HFNC to 4L NC on 8/5.  On 8/6 the patient had worsening shortness of breath and was transition back to high-flow nasal cannula.  Today, 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia.  MICU was called and the patient was emergently intubated for acute hypoxic respiratory failure.     Past Medical History He has a past medical history of CKD (chronic kidney disease), stage IV (CMS/HCC), Gout, and Hypertension.  Assessment and Plan:  The patient is a 53 yo M with CKD4,HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    ARDS  COVID-19 PNA (POA) Pneumomediastinum, worsening  -XR chest with B/L peripheral and bibasilar opacities  -Inflammatory markers were up trending, will continue to monitor -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia, official read pending -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 124 PLAN:  - Evaluate to repeat CT chest with patient clinical decline.  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - ABG -Continue dexamethasone 6 mg daily (D6/10) -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx    AKI on CKD stage V not on Dialysis (POA) Hyperkalemia (POA) Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant PLAN:  -Nephrology following on floor, will notify of transfer to the ICU - Place Udall-- > IHD to start 8/7.  -Continue sodium bicarb 1300 TID, calcitriol and vitamin D2 at same doses -Strict I&O, Daily weights - Foley    Seizure-like activity - Patient with right-sided upper extremity and lower-extremity tonic activity following intubation.  - Prior to intubation, patient had EMV 15, appropriate and no focal deficits.  - Likely metabolic in nature, patient with BUN >100, sepsis, COVID  - No past history of seizures.  PLAN:  - TSH, B12, ammonia - EEG   Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:  -STOP coreg , HOLD home amlodipine  -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP today and as needed.    Suspected orthostatic syncope related to COVID-19 infection -Started prior to admission in the setting of ongoing diarrhea, nausea and poor PO intake -No episodes since, symptoms improved with adequate fluid resuscitation -EKG on admission with sinus tachycardia with no significant ST-T changes -PT/OT, recs home with assistance  Obesity (POA) - BMI 35.8, complicates all aspects of care.   Hospitalization Admit Date/Time: 7/29/2021 3:55 PM Admitting Attending:  Discharge Date: 08/14/21 Discharge Attending Physician:    8/9/2021 Assessment and Plan   The patient is a 53 yo M with CKD4, HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    Acute Respiratory Failure Requiring Mechanical Ventilation  Moderate ARDS  COVID-19 PNA (POA) Pneumomediastinum, stable Pneumopericardium, stable  HAP  -XR chest with B/L peripheral and bibasilar opacities  -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 127 - Started NMB on 8/8  PLAN:  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - DC nimbex today, PF ratio increased to 164 after paralytic  -Continue dexamethasone 6 mg daily (stop date 8/11)  -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx  -Empiric Cefepime for HAP--Follow up cultures from 8/7 - DC vanc    AKI on CKD stage V(POA) Hyperkalemia (POA)--resolving Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant -8/7: udall, failed IHD and converted to CRRT. PLAN:  - Nephrology following, appreciate recs  - Continue CRRT with goal net even  - Dose meds for CRRT  -Strict I&O, Daily weights   Shock, multifactorial  - Medication and sepsis related, stress induced CM - Received approx. 2 L IVF  - Cortisol 9.7 on 8/7 PLAN:  - Levophed for MAP >65 - Treatment of infections  - Defer stress steroids while on Dex, can evaluate to start stress HC Once steroids complete for Dex-ARDS.    Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:   -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP improving, weekly checks.    DM type 2 (POA) - Diet controlled at home.  PLAN:  - Start insulin gtt today, monitoring per protocol.    Hypertension - Hold Home meds until clinically appropriate.    Obesity (POA)- BMI 35.8, complicates all aspects of care  discharge note Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to UK ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and with reported syncopal events. Patient was treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab.     On 8/6 the patient had worsening shortness of breath with increasing oxygen requirements.  On 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia ultimately requiring intubation. Furthermore, a dialysis catheter was placed and CRRT was initiated. Broad spectrum ABX were continued. On 8/8, he required addition of NMB for continued ventilator dys-synchrony. He completed the dex-ARDS protocol on 8/10. The patient had a decline on 8/11 with a fever, worsening shock. He was started back on broad spectrum antibiotics, vasopressin in addition to levophed, and stress dose steroids. Unfortunately, Pt remained with persistent and profound hemodynamic instability. His response to aggressive live saving measures was minimal. WBC up to 80 with no infectious source able to be identified, escalation of ABX still continued. CT scans unable to be obtained secondary to risk of fatal event occurring if moved and/or transported to scanner. On 8/13, Pt going into arrythmias which further exacerbated further instability, required cardioversions X 3 and antiarrhythmic medications. Goals of care discussions completed with wife. Despite attempting to give Pt more time to possibly respond to treatments, his status remained critical. Wife came to see her husband at bedside to be with him briefly before he passed away. Pt passed away on 8/14 at 8:11.""
	"1655677-1"	"1655677-1"	"COUGH"	"10011224"	"50-59 years"	"50-59"	""patient vaccinated 7/23/2021, admitted 7/29/2021, tested positive for covid 7/29/2021. discharged 8/14/2021, patient expired  Patient received Pfizer vaccine L deltoid lot numberFA6780 on 7/23/2021. Tested positive on 7/29/2021 after exposure. Writing  report since patient received vaccine and now critically ill and intubated to follow procedure. Patient intubated 8/7/2021  History Of Present Illness Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and the following day began having diarrhea and ""passed out"" 4 times since symptoms developed.  While on the floor the patient had been treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab, and had been improving, weaned from HFNC to 4L NC on 8/5.  On 8/6 the patient had worsening shortness of breath and was transition back to high-flow nasal cannula.  Today, 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia.  MICU was called and the patient was emergently intubated for acute hypoxic respiratory failure.     Past Medical History He has a past medical history of CKD (chronic kidney disease), stage IV (CMS/HCC), Gout, and Hypertension.  Assessment and Plan:  The patient is a 53 yo M with CKD4,HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    ARDS  COVID-19 PNA (POA) Pneumomediastinum, worsening  -XR chest with B/L peripheral and bibasilar opacities  -Inflammatory markers were up trending, will continue to monitor -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia, official read pending -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 124 PLAN:  - Evaluate to repeat CT chest with patient clinical decline.  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - ABG -Continue dexamethasone 6 mg daily (D6/10) -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx    AKI on CKD stage V not on Dialysis (POA) Hyperkalemia (POA) Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant PLAN:  -Nephrology following on floor, will notify of transfer to the ICU - Place Udall-- > IHD to start 8/7.  -Continue sodium bicarb 1300 TID, calcitriol and vitamin D2 at same doses -Strict I&O, Daily weights - Foley    Seizure-like activity - Patient with right-sided upper extremity and lower-extremity tonic activity following intubation.  - Prior to intubation, patient had EMV 15, appropriate and no focal deficits.  - Likely metabolic in nature, patient with BUN >100, sepsis, COVID  - No past history of seizures.  PLAN:  - TSH, B12, ammonia - EEG   Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:  -STOP coreg , HOLD home amlodipine  -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP today and as needed.    Suspected orthostatic syncope related to COVID-19 infection -Started prior to admission in the setting of ongoing diarrhea, nausea and poor PO intake -No episodes since, symptoms improved with adequate fluid resuscitation -EKG on admission with sinus tachycardia with no significant ST-T changes -PT/OT, recs home with assistance  Obesity (POA) - BMI 35.8, complicates all aspects of care.   Hospitalization Admit Date/Time: 7/29/2021 3:55 PM Admitting Attending:  Discharge Date: 08/14/21 Discharge Attending Physician:    8/9/2021 Assessment and Plan   The patient is a 53 yo M with CKD4, HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    Acute Respiratory Failure Requiring Mechanical Ventilation  Moderate ARDS  COVID-19 PNA (POA) Pneumomediastinum, stable Pneumopericardium, stable  HAP  -XR chest with B/L peripheral and bibasilar opacities  -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 127 - Started NMB on 8/8  PLAN:  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - DC nimbex today, PF ratio increased to 164 after paralytic  -Continue dexamethasone 6 mg daily (stop date 8/11)  -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx  -Empiric Cefepime for HAP--Follow up cultures from 8/7 - DC vanc    AKI on CKD stage V(POA) Hyperkalemia (POA)--resolving Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant -8/7: udall, failed IHD and converted to CRRT. PLAN:  - Nephrology following, appreciate recs  - Continue CRRT with goal net even  - Dose meds for CRRT  -Strict I&O, Daily weights   Shock, multifactorial  - Medication and sepsis related, stress induced CM - Received approx. 2 L IVF  - Cortisol 9.7 on 8/7 PLAN:  - Levophed for MAP >65 - Treatment of infections  - Defer stress steroids while on Dex, can evaluate to start stress HC Once steroids complete for Dex-ARDS.    Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:   -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP improving, weekly checks.    DM type 2 (POA) - Diet controlled at home.  PLAN:  - Start insulin gtt today, monitoring per protocol.    Hypertension - Hold Home meds until clinically appropriate.    Obesity (POA)- BMI 35.8, complicates all aspects of care  discharge note Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to UK ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and with reported syncopal events. Patient was treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab.     On 8/6 the patient had worsening shortness of breath with increasing oxygen requirements.  On 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia ultimately requiring intubation. Furthermore, a dialysis catheter was placed and CRRT was initiated. Broad spectrum ABX were continued. On 8/8, he required addition of NMB for continued ventilator dys-synchrony. He completed the dex-ARDS protocol on 8/10. The patient had a decline on 8/11 with a fever, worsening shock. He was started back on broad spectrum antibiotics, vasopressin in addition to levophed, and stress dose steroids. Unfortunately, Pt remained with persistent and profound hemodynamic instability. His response to aggressive live saving measures was minimal. WBC up to 80 with no infectious source able to be identified, escalation of ABX still continued. CT scans unable to be obtained secondary to risk of fatal event occurring if moved and/or transported to scanner. On 8/13, Pt going into arrythmias which further exacerbated further instability, required cardioversions X 3 and antiarrhythmic medications. Goals of care discussions completed with wife. Despite attempting to give Pt more time to possibly respond to treatments, his status remained critical. Wife came to see her husband at bedside to be with him briefly before he passed away. Pt passed away on 8/14 at 8:11.""
	"1655677-1"	"1655677-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	""patient vaccinated 7/23/2021, admitted 7/29/2021, tested positive for covid 7/29/2021. discharged 8/14/2021, patient expired  Patient received Pfizer vaccine L deltoid lot numberFA6780 on 7/23/2021. Tested positive on 7/29/2021 after exposure. Writing  report since patient received vaccine and now critically ill and intubated to follow procedure. Patient intubated 8/7/2021  History Of Present Illness Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and the following day began having diarrhea and ""passed out"" 4 times since symptoms developed.  While on the floor the patient had been treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab, and had been improving, weaned from HFNC to 4L NC on 8/5.  On 8/6 the patient had worsening shortness of breath and was transition back to high-flow nasal cannula.  Today, 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia.  MICU was called and the patient was emergently intubated for acute hypoxic respiratory failure.     Past Medical History He has a past medical history of CKD (chronic kidney disease), stage IV (CMS/HCC), Gout, and Hypertension.  Assessment and Plan:  The patient is a 53 yo M with CKD4,HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    ARDS  COVID-19 PNA (POA) Pneumomediastinum, worsening  -XR chest with B/L peripheral and bibasilar opacities  -Inflammatory markers were up trending, will continue to monitor -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia, official read pending -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 124 PLAN:  - Evaluate to repeat CT chest with patient clinical decline.  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - ABG -Continue dexamethasone 6 mg daily (D6/10) -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx    AKI on CKD stage V not on Dialysis (POA) Hyperkalemia (POA) Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant PLAN:  -Nephrology following on floor, will notify of transfer to the ICU - Place Udall-- > IHD to start 8/7.  -Continue sodium bicarb 1300 TID, calcitriol and vitamin D2 at same doses -Strict I&O, Daily weights - Foley    Seizure-like activity - Patient with right-sided upper extremity and lower-extremity tonic activity following intubation.  - Prior to intubation, patient had EMV 15, appropriate and no focal deficits.  - Likely metabolic in nature, patient with BUN >100, sepsis, COVID  - No past history of seizures.  PLAN:  - TSH, B12, ammonia - EEG   Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:  -STOP coreg , HOLD home amlodipine  -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP today and as needed.    Suspected orthostatic syncope related to COVID-19 infection -Started prior to admission in the setting of ongoing diarrhea, nausea and poor PO intake -No episodes since, symptoms improved with adequate fluid resuscitation -EKG on admission with sinus tachycardia with no significant ST-T changes -PT/OT, recs home with assistance  Obesity (POA) - BMI 35.8, complicates all aspects of care.   Hospitalization Admit Date/Time: 7/29/2021 3:55 PM Admitting Attending:  Discharge Date: 08/14/21 Discharge Attending Physician:    8/9/2021 Assessment and Plan   The patient is a 53 yo M with CKD4, HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    Acute Respiratory Failure Requiring Mechanical Ventilation  Moderate ARDS  COVID-19 PNA (POA) Pneumomediastinum, stable Pneumopericardium, stable  HAP  -XR chest with B/L peripheral and bibasilar opacities  -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 127 - Started NMB on 8/8  PLAN:  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - DC nimbex today, PF ratio increased to 164 after paralytic  -Continue dexamethasone 6 mg daily (stop date 8/11)  -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx  -Empiric Cefepime for HAP--Follow up cultures from 8/7 - DC vanc    AKI on CKD stage V(POA) Hyperkalemia (POA)--resolving Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant -8/7: udall, failed IHD and converted to CRRT. PLAN:  - Nephrology following, appreciate recs  - Continue CRRT with goal net even  - Dose meds for CRRT  -Strict I&O, Daily weights   Shock, multifactorial  - Medication and sepsis related, stress induced CM - Received approx. 2 L IVF  - Cortisol 9.7 on 8/7 PLAN:  - Levophed for MAP >65 - Treatment of infections  - Defer stress steroids while on Dex, can evaluate to start stress HC Once steroids complete for Dex-ARDS.    Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:   -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP improving, weekly checks.    DM type 2 (POA) - Diet controlled at home.  PLAN:  - Start insulin gtt today, monitoring per protocol.    Hypertension - Hold Home meds until clinically appropriate.    Obesity (POA)- BMI 35.8, complicates all aspects of care  discharge note Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to UK ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and with reported syncopal events. Patient was treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab.     On 8/6 the patient had worsening shortness of breath with increasing oxygen requirements.  On 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia ultimately requiring intubation. Furthermore, a dialysis catheter was placed and CRRT was initiated. Broad spectrum ABX were continued. On 8/8, he required addition of NMB for continued ventilator dys-synchrony. He completed the dex-ARDS protocol on 8/10. The patient had a decline on 8/11 with a fever, worsening shock. He was started back on broad spectrum antibiotics, vasopressin in addition to levophed, and stress dose steroids. Unfortunately, Pt remained with persistent and profound hemodynamic instability. His response to aggressive live saving measures was minimal. WBC up to 80 with no infectious source able to be identified, escalation of ABX still continued. CT scans unable to be obtained secondary to risk of fatal event occurring if moved and/or transported to scanner. On 8/13, Pt going into arrythmias which further exacerbated further instability, required cardioversions X 3 and antiarrhythmic medications. Goals of care discussions completed with wife. Despite attempting to give Pt more time to possibly respond to treatments, his status remained critical. Wife came to see her husband at bedside to be with him briefly before he passed away. Pt passed away on 8/14 at 8:11.""
	"1655677-1"	"1655677-1"	"COVID-19 PNEUMONIA"	"10084380"	"50-59 years"	"50-59"	""patient vaccinated 7/23/2021, admitted 7/29/2021, tested positive for covid 7/29/2021. discharged 8/14/2021, patient expired  Patient received Pfizer vaccine L deltoid lot numberFA6780 on 7/23/2021. Tested positive on 7/29/2021 after exposure. Writing  report since patient received vaccine and now critically ill and intubated to follow procedure. Patient intubated 8/7/2021  History Of Present Illness Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and the following day began having diarrhea and ""passed out"" 4 times since symptoms developed.  While on the floor the patient had been treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab, and had been improving, weaned from HFNC to 4L NC on 8/5.  On 8/6 the patient had worsening shortness of breath and was transition back to high-flow nasal cannula.  Today, 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia.  MICU was called and the patient was emergently intubated for acute hypoxic respiratory failure.     Past Medical History He has a past medical history of CKD (chronic kidney disease), stage IV (CMS/HCC), Gout, and Hypertension.  Assessment and Plan:  The patient is a 53 yo M with CKD4,HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    ARDS  COVID-19 PNA (POA) Pneumomediastinum, worsening  -XR chest with B/L peripheral and bibasilar opacities  -Inflammatory markers were up trending, will continue to monitor -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia, official read pending -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 124 PLAN:  - Evaluate to repeat CT chest with patient clinical decline.  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - ABG -Continue dexamethasone 6 mg daily (D6/10) -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx    AKI on CKD stage V not on Dialysis (POA) Hyperkalemia (POA) Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant PLAN:  -Nephrology following on floor, will notify of transfer to the ICU - Place Udall-- > IHD to start 8/7.  -Continue sodium bicarb 1300 TID, calcitriol and vitamin D2 at same doses -Strict I&O, Daily weights - Foley    Seizure-like activity - Patient with right-sided upper extremity and lower-extremity tonic activity following intubation.  - Prior to intubation, patient had EMV 15, appropriate and no focal deficits.  - Likely metabolic in nature, patient with BUN >100, sepsis, COVID  - No past history of seizures.  PLAN:  - TSH, B12, ammonia - EEG   Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:  -STOP coreg , HOLD home amlodipine  -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP today and as needed.    Suspected orthostatic syncope related to COVID-19 infection -Started prior to admission in the setting of ongoing diarrhea, nausea and poor PO intake -No episodes since, symptoms improved with adequate fluid resuscitation -EKG on admission with sinus tachycardia with no significant ST-T changes -PT/OT, recs home with assistance  Obesity (POA) - BMI 35.8, complicates all aspects of care.   Hospitalization Admit Date/Time: 7/29/2021 3:55 PM Admitting Attending:  Discharge Date: 08/14/21 Discharge Attending Physician:    8/9/2021 Assessment and Plan   The patient is a 53 yo M with CKD4, HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    Acute Respiratory Failure Requiring Mechanical Ventilation  Moderate ARDS  COVID-19 PNA (POA) Pneumomediastinum, stable Pneumopericardium, stable  HAP  -XR chest with B/L peripheral and bibasilar opacities  -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 127 - Started NMB on 8/8  PLAN:  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - DC nimbex today, PF ratio increased to 164 after paralytic  -Continue dexamethasone 6 mg daily (stop date 8/11)  -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx  -Empiric Cefepime for HAP--Follow up cultures from 8/7 - DC vanc    AKI on CKD stage V(POA) Hyperkalemia (POA)--resolving Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant -8/7: udall, failed IHD and converted to CRRT. PLAN:  - Nephrology following, appreciate recs  - Continue CRRT with goal net even  - Dose meds for CRRT  -Strict I&O, Daily weights   Shock, multifactorial  - Medication and sepsis related, stress induced CM - Received approx. 2 L IVF  - Cortisol 9.7 on 8/7 PLAN:  - Levophed for MAP >65 - Treatment of infections  - Defer stress steroids while on Dex, can evaluate to start stress HC Once steroids complete for Dex-ARDS.    Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:   -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP improving, weekly checks.    DM type 2 (POA) - Diet controlled at home.  PLAN:  - Start insulin gtt today, monitoring per protocol.    Hypertension - Hold Home meds until clinically appropriate.    Obesity (POA)- BMI 35.8, complicates all aspects of care  discharge note Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to UK ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and with reported syncopal events. Patient was treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab.     On 8/6 the patient had worsening shortness of breath with increasing oxygen requirements.  On 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia ultimately requiring intubation. Furthermore, a dialysis catheter was placed and CRRT was initiated. Broad spectrum ABX were continued. On 8/8, he required addition of NMB for continued ventilator dys-synchrony. He completed the dex-ARDS protocol on 8/10. The patient had a decline on 8/11 with a fever, worsening shock. He was started back on broad spectrum antibiotics, vasopressin in addition to levophed, and stress dose steroids. Unfortunately, Pt remained with persistent and profound hemodynamic instability. His response to aggressive live saving measures was minimal. WBC up to 80 with no infectious source able to be identified, escalation of ABX still continued. CT scans unable to be obtained secondary to risk of fatal event occurring if moved and/or transported to scanner. On 8/13, Pt going into arrythmias which further exacerbated further instability, required cardioversions X 3 and antiarrhythmic medications. Goals of care discussions completed with wife. Despite attempting to give Pt more time to possibly respond to treatments, his status remained critical. Wife came to see her husband at bedside to be with him briefly before he passed away. Pt passed away on 8/14 at 8:11.""
	"1655677-1"	"1655677-1"	"CRITICAL ILLNESS"	"10077264"	"50-59 years"	"50-59"	""patient vaccinated 7/23/2021, admitted 7/29/2021, tested positive for covid 7/29/2021. discharged 8/14/2021, patient expired  Patient received Pfizer vaccine L deltoid lot numberFA6780 on 7/23/2021. Tested positive on 7/29/2021 after exposure. Writing  report since patient received vaccine and now critically ill and intubated to follow procedure. Patient intubated 8/7/2021  History Of Present Illness Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and the following day began having diarrhea and ""passed out"" 4 times since symptoms developed.  While on the floor the patient had been treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab, and had been improving, weaned from HFNC to 4L NC on 8/5.  On 8/6 the patient had worsening shortness of breath and was transition back to high-flow nasal cannula.  Today, 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia.  MICU was called and the patient was emergently intubated for acute hypoxic respiratory failure.     Past Medical History He has a past medical history of CKD (chronic kidney disease), stage IV (CMS/HCC), Gout, and Hypertension.  Assessment and Plan:  The patient is a 53 yo M with CKD4,HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    ARDS  COVID-19 PNA (POA) Pneumomediastinum, worsening  -XR chest with B/L peripheral and bibasilar opacities  -Inflammatory markers were up trending, will continue to monitor -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia, official read pending -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 124 PLAN:  - Evaluate to repeat CT chest with patient clinical decline.  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - ABG -Continue dexamethasone 6 mg daily (D6/10) -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx    AKI on CKD stage V not on Dialysis (POA) Hyperkalemia (POA) Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant PLAN:  -Nephrology following on floor, will notify of transfer to the ICU - Place Udall-- > IHD to start 8/7.  -Continue sodium bicarb 1300 TID, calcitriol and vitamin D2 at same doses -Strict I&O, Daily weights - Foley    Seizure-like activity - Patient with right-sided upper extremity and lower-extremity tonic activity following intubation.  - Prior to intubation, patient had EMV 15, appropriate and no focal deficits.  - Likely metabolic in nature, patient with BUN >100, sepsis, COVID  - No past history of seizures.  PLAN:  - TSH, B12, ammonia - EEG   Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:  -STOP coreg , HOLD home amlodipine  -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP today and as needed.    Suspected orthostatic syncope related to COVID-19 infection -Started prior to admission in the setting of ongoing diarrhea, nausea and poor PO intake -No episodes since, symptoms improved with adequate fluid resuscitation -EKG on admission with sinus tachycardia with no significant ST-T changes -PT/OT, recs home with assistance  Obesity (POA) - BMI 35.8, complicates all aspects of care.   Hospitalization Admit Date/Time: 7/29/2021 3:55 PM Admitting Attending:  Discharge Date: 08/14/21 Discharge Attending Physician:    8/9/2021 Assessment and Plan   The patient is a 53 yo M with CKD4, HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    Acute Respiratory Failure Requiring Mechanical Ventilation  Moderate ARDS  COVID-19 PNA (POA) Pneumomediastinum, stable Pneumopericardium, stable  HAP  -XR chest with B/L peripheral and bibasilar opacities  -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 127 - Started NMB on 8/8  PLAN:  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - DC nimbex today, PF ratio increased to 164 after paralytic  -Continue dexamethasone 6 mg daily (stop date 8/11)  -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx  -Empiric Cefepime for HAP--Follow up cultures from 8/7 - DC vanc    AKI on CKD stage V(POA) Hyperkalemia (POA)--resolving Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant -8/7: udall, failed IHD and converted to CRRT. PLAN:  - Nephrology following, appreciate recs  - Continue CRRT with goal net even  - Dose meds for CRRT  -Strict I&O, Daily weights   Shock, multifactorial  - Medication and sepsis related, stress induced CM - Received approx. 2 L IVF  - Cortisol 9.7 on 8/7 PLAN:  - Levophed for MAP >65 - Treatment of infections  - Defer stress steroids while on Dex, can evaluate to start stress HC Once steroids complete for Dex-ARDS.    Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:   -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP improving, weekly checks.    DM type 2 (POA) - Diet controlled at home.  PLAN:  - Start insulin gtt today, monitoring per protocol.    Hypertension - Hold Home meds until clinically appropriate.    Obesity (POA)- BMI 35.8, complicates all aspects of care  discharge note Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to UK ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and with reported syncopal events. Patient was treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab.     On 8/6 the patient had worsening shortness of breath with increasing oxygen requirements.  On 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia ultimately requiring intubation. Furthermore, a dialysis catheter was placed and CRRT was initiated. Broad spectrum ABX were continued. On 8/8, he required addition of NMB for continued ventilator dys-synchrony. He completed the dex-ARDS protocol on 8/10. The patient had a decline on 8/11 with a fever, worsening shock. He was started back on broad spectrum antibiotics, vasopressin in addition to levophed, and stress dose steroids. Unfortunately, Pt remained with persistent and profound hemodynamic instability. His response to aggressive live saving measures was minimal. WBC up to 80 with no infectious source able to be identified, escalation of ABX still continued. CT scans unable to be obtained secondary to risk of fatal event occurring if moved and/or transported to scanner. On 8/13, Pt going into arrythmias which further exacerbated further instability, required cardioversions X 3 and antiarrhythmic medications. Goals of care discussions completed with wife. Despite attempting to give Pt more time to possibly respond to treatments, his status remained critical. Wife came to see her husband at bedside to be with him briefly before he passed away. Pt passed away on 8/14 at 8:11.""
	"1655677-1"	"1655677-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	""patient vaccinated 7/23/2021, admitted 7/29/2021, tested positive for covid 7/29/2021. discharged 8/14/2021, patient expired  Patient received Pfizer vaccine L deltoid lot numberFA6780 on 7/23/2021. Tested positive on 7/29/2021 after exposure. Writing  report since patient received vaccine and now critically ill and intubated to follow procedure. Patient intubated 8/7/2021  History Of Present Illness Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and the following day began having diarrhea and ""passed out"" 4 times since symptoms developed.  While on the floor the patient had been treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab, and had been improving, weaned from HFNC to 4L NC on 8/5.  On 8/6 the patient had worsening shortness of breath and was transition back to high-flow nasal cannula.  Today, 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia.  MICU was called and the patient was emergently intubated for acute hypoxic respiratory failure.     Past Medical History He has a past medical history of CKD (chronic kidney disease), stage IV (CMS/HCC), Gout, and Hypertension.  Assessment and Plan:  The patient is a 53 yo M with CKD4,HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    ARDS  COVID-19 PNA (POA) Pneumomediastinum, worsening  -XR chest with B/L peripheral and bibasilar opacities  -Inflammatory markers were up trending, will continue to monitor -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia, official read pending -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 124 PLAN:  - Evaluate to repeat CT chest with patient clinical decline.  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - ABG -Continue dexamethasone 6 mg daily (D6/10) -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx    AKI on CKD stage V not on Dialysis (POA) Hyperkalemia (POA) Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant PLAN:  -Nephrology following on floor, will notify of transfer to the ICU - Place Udall-- > IHD to start 8/7.  -Continue sodium bicarb 1300 TID, calcitriol and vitamin D2 at same doses -Strict I&O, Daily weights - Foley    Seizure-like activity - Patient with right-sided upper extremity and lower-extremity tonic activity following intubation.  - Prior to intubation, patient had EMV 15, appropriate and no focal deficits.  - Likely metabolic in nature, patient with BUN >100, sepsis, COVID  - No past history of seizures.  PLAN:  - TSH, B12, ammonia - EEG   Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:  -STOP coreg , HOLD home amlodipine  -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP today and as needed.    Suspected orthostatic syncope related to COVID-19 infection -Started prior to admission in the setting of ongoing diarrhea, nausea and poor PO intake -No episodes since, symptoms improved with adequate fluid resuscitation -EKG on admission with sinus tachycardia with no significant ST-T changes -PT/OT, recs home with assistance  Obesity (POA) - BMI 35.8, complicates all aspects of care.   Hospitalization Admit Date/Time: 7/29/2021 3:55 PM Admitting Attending:  Discharge Date: 08/14/21 Discharge Attending Physician:    8/9/2021 Assessment and Plan   The patient is a 53 yo M with CKD4, HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    Acute Respiratory Failure Requiring Mechanical Ventilation  Moderate ARDS  COVID-19 PNA (POA) Pneumomediastinum, stable Pneumopericardium, stable  HAP  -XR chest with B/L peripheral and bibasilar opacities  -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 127 - Started NMB on 8/8  PLAN:  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - DC nimbex today, PF ratio increased to 164 after paralytic  -Continue dexamethasone 6 mg daily (stop date 8/11)  -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx  -Empiric Cefepime for HAP--Follow up cultures from 8/7 - DC vanc    AKI on CKD stage V(POA) Hyperkalemia (POA)--resolving Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant -8/7: udall, failed IHD and converted to CRRT. PLAN:  - Nephrology following, appreciate recs  - Continue CRRT with goal net even  - Dose meds for CRRT  -Strict I&O, Daily weights   Shock, multifactorial  - Medication and sepsis related, stress induced CM - Received approx. 2 L IVF  - Cortisol 9.7 on 8/7 PLAN:  - Levophed for MAP >65 - Treatment of infections  - Defer stress steroids while on Dex, can evaluate to start stress HC Once steroids complete for Dex-ARDS.    Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:   -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP improving, weekly checks.    DM type 2 (POA) - Diet controlled at home.  PLAN:  - Start insulin gtt today, monitoring per protocol.    Hypertension - Hold Home meds until clinically appropriate.    Obesity (POA)- BMI 35.8, complicates all aspects of care  discharge note Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to UK ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and with reported syncopal events. Patient was treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab.     On 8/6 the patient had worsening shortness of breath with increasing oxygen requirements.  On 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia ultimately requiring intubation. Furthermore, a dialysis catheter was placed and CRRT was initiated. Broad spectrum ABX were continued. On 8/8, he required addition of NMB for continued ventilator dys-synchrony. He completed the dex-ARDS protocol on 8/10. The patient had a decline on 8/11 with a fever, worsening shock. He was started back on broad spectrum antibiotics, vasopressin in addition to levophed, and stress dose steroids. Unfortunately, Pt remained with persistent and profound hemodynamic instability. His response to aggressive live saving measures was minimal. WBC up to 80 with no infectious source able to be identified, escalation of ABX still continued. CT scans unable to be obtained secondary to risk of fatal event occurring if moved and/or transported to scanner. On 8/13, Pt going into arrythmias which further exacerbated further instability, required cardioversions X 3 and antiarrhythmic medications. Goals of care discussions completed with wife. Despite attempting to give Pt more time to possibly respond to treatments, his status remained critical. Wife came to see her husband at bedside to be with him briefly before he passed away. Pt passed away on 8/14 at 8:11.""
	"1655677-1"	"1655677-1"	"DIARRHOEA"	"10012735"	"50-59 years"	"50-59"	""patient vaccinated 7/23/2021, admitted 7/29/2021, tested positive for covid 7/29/2021. discharged 8/14/2021, patient expired  Patient received Pfizer vaccine L deltoid lot numberFA6780 on 7/23/2021. Tested positive on 7/29/2021 after exposure. Writing  report since patient received vaccine and now critically ill and intubated to follow procedure. Patient intubated 8/7/2021  History Of Present Illness Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and the following day began having diarrhea and ""passed out"" 4 times since symptoms developed.  While on the floor the patient had been treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab, and had been improving, weaned from HFNC to 4L NC on 8/5.  On 8/6 the patient had worsening shortness of breath and was transition back to high-flow nasal cannula.  Today, 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia.  MICU was called and the patient was emergently intubated for acute hypoxic respiratory failure.     Past Medical History He has a past medical history of CKD (chronic kidney disease), stage IV (CMS/HCC), Gout, and Hypertension.  Assessment and Plan:  The patient is a 53 yo M with CKD4,HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    ARDS  COVID-19 PNA (POA) Pneumomediastinum, worsening  -XR chest with B/L peripheral and bibasilar opacities  -Inflammatory markers were up trending, will continue to monitor -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia, official read pending -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 124 PLAN:  - Evaluate to repeat CT chest with patient clinical decline.  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - ABG -Continue dexamethasone 6 mg daily (D6/10) -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx    AKI on CKD stage V not on Dialysis (POA) Hyperkalemia (POA) Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant PLAN:  -Nephrology following on floor, will notify of transfer to the ICU - Place Udall-- > IHD to start 8/7.  -Continue sodium bicarb 1300 TID, calcitriol and vitamin D2 at same doses -Strict I&O, Daily weights - Foley    Seizure-like activity - Patient with right-sided upper extremity and lower-extremity tonic activity following intubation.  - Prior to intubation, patient had EMV 15, appropriate and no focal deficits.  - Likely metabolic in nature, patient with BUN >100, sepsis, COVID  - No past history of seizures.  PLAN:  - TSH, B12, ammonia - EEG   Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:  -STOP coreg , HOLD home amlodipine  -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP today and as needed.    Suspected orthostatic syncope related to COVID-19 infection -Started prior to admission in the setting of ongoing diarrhea, nausea and poor PO intake -No episodes since, symptoms improved with adequate fluid resuscitation -EKG on admission with sinus tachycardia with no significant ST-T changes -PT/OT, recs home with assistance  Obesity (POA) - BMI 35.8, complicates all aspects of care.   Hospitalization Admit Date/Time: 7/29/2021 3:55 PM Admitting Attending:  Discharge Date: 08/14/21 Discharge Attending Physician:    8/9/2021 Assessment and Plan   The patient is a 53 yo M with CKD4, HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    Acute Respiratory Failure Requiring Mechanical Ventilation  Moderate ARDS  COVID-19 PNA (POA) Pneumomediastinum, stable Pneumopericardium, stable  HAP  -XR chest with B/L peripheral and bibasilar opacities  -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 127 - Started NMB on 8/8  PLAN:  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - DC nimbex today, PF ratio increased to 164 after paralytic  -Continue dexamethasone 6 mg daily (stop date 8/11)  -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx  -Empiric Cefepime for HAP--Follow up cultures from 8/7 - DC vanc    AKI on CKD stage V(POA) Hyperkalemia (POA)--resolving Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant -8/7: udall, failed IHD and converted to CRRT. PLAN:  - Nephrology following, appreciate recs  - Continue CRRT with goal net even  - Dose meds for CRRT  -Strict I&O, Daily weights   Shock, multifactorial  - Medication and sepsis related, stress induced CM - Received approx. 2 L IVF  - Cortisol 9.7 on 8/7 PLAN:  - Levophed for MAP >65 - Treatment of infections  - Defer stress steroids while on Dex, can evaluate to start stress HC Once steroids complete for Dex-ARDS.    Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:   -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP improving, weekly checks.    DM type 2 (POA) - Diet controlled at home.  PLAN:  - Start insulin gtt today, monitoring per protocol.    Hypertension - Hold Home meds until clinically appropriate.    Obesity (POA)- BMI 35.8, complicates all aspects of care  discharge note Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to UK ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and with reported syncopal events. Patient was treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab.     On 8/6 the patient had worsening shortness of breath with increasing oxygen requirements.  On 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia ultimately requiring intubation. Furthermore, a dialysis catheter was placed and CRRT was initiated. Broad spectrum ABX were continued. On 8/8, he required addition of NMB for continued ventilator dys-synchrony. He completed the dex-ARDS protocol on 8/10. The patient had a decline on 8/11 with a fever, worsening shock. He was started back on broad spectrum antibiotics, vasopressin in addition to levophed, and stress dose steroids. Unfortunately, Pt remained with persistent and profound hemodynamic instability. His response to aggressive live saving measures was minimal. WBC up to 80 with no infectious source able to be identified, escalation of ABX still continued. CT scans unable to be obtained secondary to risk of fatal event occurring if moved and/or transported to scanner. On 8/13, Pt going into arrythmias which further exacerbated further instability, required cardioversions X 3 and antiarrhythmic medications. Goals of care discussions completed with wife. Despite attempting to give Pt more time to possibly respond to treatments, his status remained critical. Wife came to see her husband at bedside to be with him briefly before he passed away. Pt passed away on 8/14 at 8:11.""
	"1655677-1"	"1655677-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	""patient vaccinated 7/23/2021, admitted 7/29/2021, tested positive for covid 7/29/2021. discharged 8/14/2021, patient expired  Patient received Pfizer vaccine L deltoid lot numberFA6780 on 7/23/2021. Tested positive on 7/29/2021 after exposure. Writing  report since patient received vaccine and now critically ill and intubated to follow procedure. Patient intubated 8/7/2021  History Of Present Illness Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and the following day began having diarrhea and ""passed out"" 4 times since symptoms developed.  While on the floor the patient had been treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab, and had been improving, weaned from HFNC to 4L NC on 8/5.  On 8/6 the patient had worsening shortness of breath and was transition back to high-flow nasal cannula.  Today, 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia.  MICU was called and the patient was emergently intubated for acute hypoxic respiratory failure.     Past Medical History He has a past medical history of CKD (chronic kidney disease), stage IV (CMS/HCC), Gout, and Hypertension.  Assessment and Plan:  The patient is a 53 yo M with CKD4,HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    ARDS  COVID-19 PNA (POA) Pneumomediastinum, worsening  -XR chest with B/L peripheral and bibasilar opacities  -Inflammatory markers were up trending, will continue to monitor -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia, official read pending -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 124 PLAN:  - Evaluate to repeat CT chest with patient clinical decline.  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - ABG -Continue dexamethasone 6 mg daily (D6/10) -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx    AKI on CKD stage V not on Dialysis (POA) Hyperkalemia (POA) Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant PLAN:  -Nephrology following on floor, will notify of transfer to the ICU - Place Udall-- > IHD to start 8/7.  -Continue sodium bicarb 1300 TID, calcitriol and vitamin D2 at same doses -Strict I&O, Daily weights - Foley    Seizure-like activity - Patient with right-sided upper extremity and lower-extremity tonic activity following intubation.  - Prior to intubation, patient had EMV 15, appropriate and no focal deficits.  - Likely metabolic in nature, patient with BUN >100, sepsis, COVID  - No past history of seizures.  PLAN:  - TSH, B12, ammonia - EEG   Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:  -STOP coreg , HOLD home amlodipine  -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP today and as needed.    Suspected orthostatic syncope related to COVID-19 infection -Started prior to admission in the setting of ongoing diarrhea, nausea and poor PO intake -No episodes since, symptoms improved with adequate fluid resuscitation -EKG on admission with sinus tachycardia with no significant ST-T changes -PT/OT, recs home with assistance  Obesity (POA) - BMI 35.8, complicates all aspects of care.   Hospitalization Admit Date/Time: 7/29/2021 3:55 PM Admitting Attending:  Discharge Date: 08/14/21 Discharge Attending Physician:    8/9/2021 Assessment and Plan   The patient is a 53 yo M with CKD4, HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    Acute Respiratory Failure Requiring Mechanical Ventilation  Moderate ARDS  COVID-19 PNA (POA) Pneumomediastinum, stable Pneumopericardium, stable  HAP  -XR chest with B/L peripheral and bibasilar opacities  -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 127 - Started NMB on 8/8  PLAN:  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - DC nimbex today, PF ratio increased to 164 after paralytic  -Continue dexamethasone 6 mg daily (stop date 8/11)  -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx  -Empiric Cefepime for HAP--Follow up cultures from 8/7 - DC vanc    AKI on CKD stage V(POA) Hyperkalemia (POA)--resolving Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant -8/7: udall, failed IHD and converted to CRRT. PLAN:  - Nephrology following, appreciate recs  - Continue CRRT with goal net even  - Dose meds for CRRT  -Strict I&O, Daily weights   Shock, multifactorial  - Medication and sepsis related, stress induced CM - Received approx. 2 L IVF  - Cortisol 9.7 on 8/7 PLAN:  - Levophed for MAP >65 - Treatment of infections  - Defer stress steroids while on Dex, can evaluate to start stress HC Once steroids complete for Dex-ARDS.    Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:   -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP improving, weekly checks.    DM type 2 (POA) - Diet controlled at home.  PLAN:  - Start insulin gtt today, monitoring per protocol.    Hypertension - Hold Home meds until clinically appropriate.    Obesity (POA)- BMI 35.8, complicates all aspects of care  discharge note Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to UK ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and with reported syncopal events. Patient was treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab.     On 8/6 the patient had worsening shortness of breath with increasing oxygen requirements.  On 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia ultimately requiring intubation. Furthermore, a dialysis catheter was placed and CRRT was initiated. Broad spectrum ABX were continued. On 8/8, he required addition of NMB for continued ventilator dys-synchrony. He completed the dex-ARDS protocol on 8/10. The patient had a decline on 8/11 with a fever, worsening shock. He was started back on broad spectrum antibiotics, vasopressin in addition to levophed, and stress dose steroids. Unfortunately, Pt remained with persistent and profound hemodynamic instability. His response to aggressive live saving measures was minimal. WBC up to 80 with no infectious source able to be identified, escalation of ABX still continued. CT scans unable to be obtained secondary to risk of fatal event occurring if moved and/or transported to scanner. On 8/13, Pt going into arrythmias which further exacerbated further instability, required cardioversions X 3 and antiarrhythmic medications. Goals of care discussions completed with wife. Despite attempting to give Pt more time to possibly respond to treatments, his status remained critical. Wife came to see her husband at bedside to be with him briefly before he passed away. Pt passed away on 8/14 at 8:11.""
	"1655677-1"	"1655677-1"	"ECHOCARDIOGRAM"	"10014113"	"50-59 years"	"50-59"	""patient vaccinated 7/23/2021, admitted 7/29/2021, tested positive for covid 7/29/2021. discharged 8/14/2021, patient expired  Patient received Pfizer vaccine L deltoid lot numberFA6780 on 7/23/2021. Tested positive on 7/29/2021 after exposure. Writing  report since patient received vaccine and now critically ill and intubated to follow procedure. Patient intubated 8/7/2021  History Of Present Illness Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and the following day began having diarrhea and ""passed out"" 4 times since symptoms developed.  While on the floor the patient had been treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab, and had been improving, weaned from HFNC to 4L NC on 8/5.  On 8/6 the patient had worsening shortness of breath and was transition back to high-flow nasal cannula.  Today, 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia.  MICU was called and the patient was emergently intubated for acute hypoxic respiratory failure.     Past Medical History He has a past medical history of CKD (chronic kidney disease), stage IV (CMS/HCC), Gout, and Hypertension.  Assessment and Plan:  The patient is a 53 yo M with CKD4,HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    ARDS  COVID-19 PNA (POA) Pneumomediastinum, worsening  -XR chest with B/L peripheral and bibasilar opacities  -Inflammatory markers were up trending, will continue to monitor -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia, official read pending -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 124 PLAN:  - Evaluate to repeat CT chest with patient clinical decline.  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - ABG -Continue dexamethasone 6 mg daily (D6/10) -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx    AKI on CKD stage V not on Dialysis (POA) Hyperkalemia (POA) Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant PLAN:  -Nephrology following on floor, will notify of transfer to the ICU - Place Udall-- > IHD to start 8/7.  -Continue sodium bicarb 1300 TID, calcitriol and vitamin D2 at same doses -Strict I&O, Daily weights - Foley    Seizure-like activity - Patient with right-sided upper extremity and lower-extremity tonic activity following intubation.  - Prior to intubation, patient had EMV 15, appropriate and no focal deficits.  - Likely metabolic in nature, patient with BUN >100, sepsis, COVID  - No past history of seizures.  PLAN:  - TSH, B12, ammonia - EEG   Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:  -STOP coreg , HOLD home amlodipine  -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP today and as needed.    Suspected orthostatic syncope related to COVID-19 infection -Started prior to admission in the setting of ongoing diarrhea, nausea and poor PO intake -No episodes since, symptoms improved with adequate fluid resuscitation -EKG on admission with sinus tachycardia with no significant ST-T changes -PT/OT, recs home with assistance  Obesity (POA) - BMI 35.8, complicates all aspects of care.   Hospitalization Admit Date/Time: 7/29/2021 3:55 PM Admitting Attending:  Discharge Date: 08/14/21 Discharge Attending Physician:    8/9/2021 Assessment and Plan   The patient is a 53 yo M with CKD4, HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    Acute Respiratory Failure Requiring Mechanical Ventilation  Moderate ARDS  COVID-19 PNA (POA) Pneumomediastinum, stable Pneumopericardium, stable  HAP  -XR chest with B/L peripheral and bibasilar opacities  -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 127 - Started NMB on 8/8  PLAN:  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - DC nimbex today, PF ratio increased to 164 after paralytic  -Continue dexamethasone 6 mg daily (stop date 8/11)  -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx  -Empiric Cefepime for HAP--Follow up cultures from 8/7 - DC vanc    AKI on CKD stage V(POA) Hyperkalemia (POA)--resolving Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant -8/7: udall, failed IHD and converted to CRRT. PLAN:  - Nephrology following, appreciate recs  - Continue CRRT with goal net even  - Dose meds for CRRT  -Strict I&O, Daily weights   Shock, multifactorial  - Medication and sepsis related, stress induced CM - Received approx. 2 L IVF  - Cortisol 9.7 on 8/7 PLAN:  - Levophed for MAP >65 - Treatment of infections  - Defer stress steroids while on Dex, can evaluate to start stress HC Once steroids complete for Dex-ARDS.    Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:   -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP improving, weekly checks.    DM type 2 (POA) - Diet controlled at home.  PLAN:  - Start insulin gtt today, monitoring per protocol.    Hypertension - Hold Home meds until clinically appropriate.    Obesity (POA)- BMI 35.8, complicates all aspects of care  discharge note Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to UK ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and with reported syncopal events. Patient was treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab.     On 8/6 the patient had worsening shortness of breath with increasing oxygen requirements.  On 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia ultimately requiring intubation. Furthermore, a dialysis catheter was placed and CRRT was initiated. Broad spectrum ABX were continued. On 8/8, he required addition of NMB for continued ventilator dys-synchrony. He completed the dex-ARDS protocol on 8/10. The patient had a decline on 8/11 with a fever, worsening shock. He was started back on broad spectrum antibiotics, vasopressin in addition to levophed, and stress dose steroids. Unfortunately, Pt remained with persistent and profound hemodynamic instability. His response to aggressive live saving measures was minimal. WBC up to 80 with no infectious source able to be identified, escalation of ABX still continued. CT scans unable to be obtained secondary to risk of fatal event occurring if moved and/or transported to scanner. On 8/13, Pt going into arrythmias which further exacerbated further instability, required cardioversions X 3 and antiarrhythmic medications. Goals of care discussions completed with wife. Despite attempting to give Pt more time to possibly respond to treatments, his status remained critical. Wife came to see her husband at bedside to be with him briefly before he passed away. Pt passed away on 8/14 at 8:11.""
	"1655677-1"	"1655677-1"	"ECHOCARDIOGRAM ABNORMAL"	"10061593"	"50-59 years"	"50-59"	""patient vaccinated 7/23/2021, admitted 7/29/2021, tested positive for covid 7/29/2021. discharged 8/14/2021, patient expired  Patient received Pfizer vaccine L deltoid lot numberFA6780 on 7/23/2021. Tested positive on 7/29/2021 after exposure. Writing  report since patient received vaccine and now critically ill and intubated to follow procedure. Patient intubated 8/7/2021  History Of Present Illness Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and the following day began having diarrhea and ""passed out"" 4 times since symptoms developed.  While on the floor the patient had been treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab, and had been improving, weaned from HFNC to 4L NC on 8/5.  On 8/6 the patient had worsening shortness of breath and was transition back to high-flow nasal cannula.  Today, 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia.  MICU was called and the patient was emergently intubated for acute hypoxic respiratory failure.     Past Medical History He has a past medical history of CKD (chronic kidney disease), stage IV (CMS/HCC), Gout, and Hypertension.  Assessment and Plan:  The patient is a 53 yo M with CKD4,HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    ARDS  COVID-19 PNA (POA) Pneumomediastinum, worsening  -XR chest with B/L peripheral and bibasilar opacities  -Inflammatory markers were up trending, will continue to monitor -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia, official read pending -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 124 PLAN:  - Evaluate to repeat CT chest with patient clinical decline.  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - ABG -Continue dexamethasone 6 mg daily (D6/10) -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx    AKI on CKD stage V not on Dialysis (POA) Hyperkalemia (POA) Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant PLAN:  -Nephrology following on floor, will notify of transfer to the ICU - Place Udall-- > IHD to start 8/7.  -Continue sodium bicarb 1300 TID, calcitriol and vitamin D2 at same doses -Strict I&O, Daily weights - Foley    Seizure-like activity - Patient with right-sided upper extremity and lower-extremity tonic activity following intubation.  - Prior to intubation, patient had EMV 15, appropriate and no focal deficits.  - Likely metabolic in nature, patient with BUN >100, sepsis, COVID  - No past history of seizures.  PLAN:  - TSH, B12, ammonia - EEG   Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:  -STOP coreg , HOLD home amlodipine  -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP today and as needed.    Suspected orthostatic syncope related to COVID-19 infection -Started prior to admission in the setting of ongoing diarrhea, nausea and poor PO intake -No episodes since, symptoms improved with adequate fluid resuscitation -EKG on admission with sinus tachycardia with no significant ST-T changes -PT/OT, recs home with assistance  Obesity (POA) - BMI 35.8, complicates all aspects of care.   Hospitalization Admit Date/Time: 7/29/2021 3:55 PM Admitting Attending:  Discharge Date: 08/14/21 Discharge Attending Physician:    8/9/2021 Assessment and Plan   The patient is a 53 yo M with CKD4, HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    Acute Respiratory Failure Requiring Mechanical Ventilation  Moderate ARDS  COVID-19 PNA (POA) Pneumomediastinum, stable Pneumopericardium, stable  HAP  -XR chest with B/L peripheral and bibasilar opacities  -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 127 - Started NMB on 8/8  PLAN:  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - DC nimbex today, PF ratio increased to 164 after paralytic  -Continue dexamethasone 6 mg daily (stop date 8/11)  -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx  -Empiric Cefepime for HAP--Follow up cultures from 8/7 - DC vanc    AKI on CKD stage V(POA) Hyperkalemia (POA)--resolving Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant -8/7: udall, failed IHD and converted to CRRT. PLAN:  - Nephrology following, appreciate recs  - Continue CRRT with goal net even  - Dose meds for CRRT  -Strict I&O, Daily weights   Shock, multifactorial  - Medication and sepsis related, stress induced CM - Received approx. 2 L IVF  - Cortisol 9.7 on 8/7 PLAN:  - Levophed for MAP >65 - Treatment of infections  - Defer stress steroids while on Dex, can evaluate to start stress HC Once steroids complete for Dex-ARDS.    Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:   -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP improving, weekly checks.    DM type 2 (POA) - Diet controlled at home.  PLAN:  - Start insulin gtt today, monitoring per protocol.    Hypertension - Hold Home meds until clinically appropriate.    Obesity (POA)- BMI 35.8, complicates all aspects of care  discharge note Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to UK ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and with reported syncopal events. Patient was treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab.     On 8/6 the patient had worsening shortness of breath with increasing oxygen requirements.  On 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia ultimately requiring intubation. Furthermore, a dialysis catheter was placed and CRRT was initiated. Broad spectrum ABX were continued. On 8/8, he required addition of NMB for continued ventilator dys-synchrony. He completed the dex-ARDS protocol on 8/10. The patient had a decline on 8/11 with a fever, worsening shock. He was started back on broad spectrum antibiotics, vasopressin in addition to levophed, and stress dose steroids. Unfortunately, Pt remained with persistent and profound hemodynamic instability. His response to aggressive live saving measures was minimal. WBC up to 80 with no infectious source able to be identified, escalation of ABX still continued. CT scans unable to be obtained secondary to risk of fatal event occurring if moved and/or transported to scanner. On 8/13, Pt going into arrythmias which further exacerbated further instability, required cardioversions X 3 and antiarrhythmic medications. Goals of care discussions completed with wife. Despite attempting to give Pt more time to possibly respond to treatments, his status remained critical. Wife came to see her husband at bedside to be with him briefly before he passed away. Pt passed away on 8/14 at 8:11.""
	"1655677-1"	"1655677-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"50-59 years"	"50-59"	""patient vaccinated 7/23/2021, admitted 7/29/2021, tested positive for covid 7/29/2021. discharged 8/14/2021, patient expired  Patient received Pfizer vaccine L deltoid lot numberFA6780 on 7/23/2021. Tested positive on 7/29/2021 after exposure. Writing  report since patient received vaccine and now critically ill and intubated to follow procedure. Patient intubated 8/7/2021  History Of Present Illness Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and the following day began having diarrhea and ""passed out"" 4 times since symptoms developed.  While on the floor the patient had been treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab, and had been improving, weaned from HFNC to 4L NC on 8/5.  On 8/6 the patient had worsening shortness of breath and was transition back to high-flow nasal cannula.  Today, 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia.  MICU was called and the patient was emergently intubated for acute hypoxic respiratory failure.     Past Medical History He has a past medical history of CKD (chronic kidney disease), stage IV (CMS/HCC), Gout, and Hypertension.  Assessment and Plan:  The patient is a 53 yo M with CKD4,HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    ARDS  COVID-19 PNA (POA) Pneumomediastinum, worsening  -XR chest with B/L peripheral and bibasilar opacities  -Inflammatory markers were up trending, will continue to monitor -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia, official read pending -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 124 PLAN:  - Evaluate to repeat CT chest with patient clinical decline.  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - ABG -Continue dexamethasone 6 mg daily (D6/10) -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx    AKI on CKD stage V not on Dialysis (POA) Hyperkalemia (POA) Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant PLAN:  -Nephrology following on floor, will notify of transfer to the ICU - Place Udall-- > IHD to start 8/7.  -Continue sodium bicarb 1300 TID, calcitriol and vitamin D2 at same doses -Strict I&O, Daily weights - Foley    Seizure-like activity - Patient with right-sided upper extremity and lower-extremity tonic activity following intubation.  - Prior to intubation, patient had EMV 15, appropriate and no focal deficits.  - Likely metabolic in nature, patient with BUN >100, sepsis, COVID  - No past history of seizures.  PLAN:  - TSH, B12, ammonia - EEG   Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:  -STOP coreg , HOLD home amlodipine  -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP today and as needed.    Suspected orthostatic syncope related to COVID-19 infection -Started prior to admission in the setting of ongoing diarrhea, nausea and poor PO intake -No episodes since, symptoms improved with adequate fluid resuscitation -EKG on admission with sinus tachycardia with no significant ST-T changes -PT/OT, recs home with assistance  Obesity (POA) - BMI 35.8, complicates all aspects of care.   Hospitalization Admit Date/Time: 7/29/2021 3:55 PM Admitting Attending:  Discharge Date: 08/14/21 Discharge Attending Physician:    8/9/2021 Assessment and Plan   The patient is a 53 yo M with CKD4, HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    Acute Respiratory Failure Requiring Mechanical Ventilation  Moderate ARDS  COVID-19 PNA (POA) Pneumomediastinum, stable Pneumopericardium, stable  HAP  -XR chest with B/L peripheral and bibasilar opacities  -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 127 - Started NMB on 8/8  PLAN:  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - DC nimbex today, PF ratio increased to 164 after paralytic  -Continue dexamethasone 6 mg daily (stop date 8/11)  -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx  -Empiric Cefepime for HAP--Follow up cultures from 8/7 - DC vanc    AKI on CKD stage V(POA) Hyperkalemia (POA)--resolving Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant -8/7: udall, failed IHD and converted to CRRT. PLAN:  - Nephrology following, appreciate recs  - Continue CRRT with goal net even  - Dose meds for CRRT  -Strict I&O, Daily weights   Shock, multifactorial  - Medication and sepsis related, stress induced CM - Received approx. 2 L IVF  - Cortisol 9.7 on 8/7 PLAN:  - Levophed for MAP >65 - Treatment of infections  - Defer stress steroids while on Dex, can evaluate to start stress HC Once steroids complete for Dex-ARDS.    Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:   -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP improving, weekly checks.    DM type 2 (POA) - Diet controlled at home.  PLAN:  - Start insulin gtt today, monitoring per protocol.    Hypertension - Hold Home meds until clinically appropriate.    Obesity (POA)- BMI 35.8, complicates all aspects of care  discharge note Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to UK ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and with reported syncopal events. Patient was treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab.     On 8/6 the patient had worsening shortness of breath with increasing oxygen requirements.  On 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia ultimately requiring intubation. Furthermore, a dialysis catheter was placed and CRRT was initiated. Broad spectrum ABX were continued. On 8/8, he required addition of NMB for continued ventilator dys-synchrony. He completed the dex-ARDS protocol on 8/10. The patient had a decline on 8/11 with a fever, worsening shock. He was started back on broad spectrum antibiotics, vasopressin in addition to levophed, and stress dose steroids. Unfortunately, Pt remained with persistent and profound hemodynamic instability. His response to aggressive live saving measures was minimal. WBC up to 80 with no infectious source able to be identified, escalation of ABX still continued. CT scans unable to be obtained secondary to risk of fatal event occurring if moved and/or transported to scanner. On 8/13, Pt going into arrythmias which further exacerbated further instability, required cardioversions X 3 and antiarrhythmic medications. Goals of care discussions completed with wife. Despite attempting to give Pt more time to possibly respond to treatments, his status remained critical. Wife came to see her husband at bedside to be with him briefly before he passed away. Pt passed away on 8/14 at 8:11.""
	"1655677-1"	"1655677-1"	"FATIGUE"	"10016256"	"50-59 years"	"50-59"	""patient vaccinated 7/23/2021, admitted 7/29/2021, tested positive for covid 7/29/2021. discharged 8/14/2021, patient expired  Patient received Pfizer vaccine L deltoid lot numberFA6780 on 7/23/2021. Tested positive on 7/29/2021 after exposure. Writing  report since patient received vaccine and now critically ill and intubated to follow procedure. Patient intubated 8/7/2021  History Of Present Illness Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and the following day began having diarrhea and ""passed out"" 4 times since symptoms developed.  While on the floor the patient had been treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab, and had been improving, weaned from HFNC to 4L NC on 8/5.  On 8/6 the patient had worsening shortness of breath and was transition back to high-flow nasal cannula.  Today, 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia.  MICU was called and the patient was emergently intubated for acute hypoxic respiratory failure.     Past Medical History He has a past medical history of CKD (chronic kidney disease), stage IV (CMS/HCC), Gout, and Hypertension.  Assessment and Plan:  The patient is a 53 yo M with CKD4,HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    ARDS  COVID-19 PNA (POA) Pneumomediastinum, worsening  -XR chest with B/L peripheral and bibasilar opacities  -Inflammatory markers were up trending, will continue to monitor -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia, official read pending -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 124 PLAN:  - Evaluate to repeat CT chest with patient clinical decline.  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - ABG -Continue dexamethasone 6 mg daily (D6/10) -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx    AKI on CKD stage V not on Dialysis (POA) Hyperkalemia (POA) Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant PLAN:  -Nephrology following on floor, will notify of transfer to the ICU - Place Udall-- > IHD to start 8/7.  -Continue sodium bicarb 1300 TID, calcitriol and vitamin D2 at same doses -Strict I&O, Daily weights - Foley    Seizure-like activity - Patient with right-sided upper extremity and lower-extremity tonic activity following intubation.  - Prior to intubation, patient had EMV 15, appropriate and no focal deficits.  - Likely metabolic in nature, patient with BUN >100, sepsis, COVID  - No past history of seizures.  PLAN:  - TSH, B12, ammonia - EEG   Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:  -STOP coreg , HOLD home amlodipine  -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP today and as needed.    Suspected orthostatic syncope related to COVID-19 infection -Started prior to admission in the setting of ongoing diarrhea, nausea and poor PO intake -No episodes since, symptoms improved with adequate fluid resuscitation -EKG on admission with sinus tachycardia with no significant ST-T changes -PT/OT, recs home with assistance  Obesity (POA) - BMI 35.8, complicates all aspects of care.   Hospitalization Admit Date/Time: 7/29/2021 3:55 PM Admitting Attending:  Discharge Date: 08/14/21 Discharge Attending Physician:    8/9/2021 Assessment and Plan   The patient is a 53 yo M with CKD4, HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    Acute Respiratory Failure Requiring Mechanical Ventilation  Moderate ARDS  COVID-19 PNA (POA) Pneumomediastinum, stable Pneumopericardium, stable  HAP  -XR chest with B/L peripheral and bibasilar opacities  -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 127 - Started NMB on 8/8  PLAN:  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - DC nimbex today, PF ratio increased to 164 after paralytic  -Continue dexamethasone 6 mg daily (stop date 8/11)  -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx  -Empiric Cefepime for HAP--Follow up cultures from 8/7 - DC vanc    AKI on CKD stage V(POA) Hyperkalemia (POA)--resolving Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant -8/7: udall, failed IHD and converted to CRRT. PLAN:  - Nephrology following, appreciate recs  - Continue CRRT with goal net even  - Dose meds for CRRT  -Strict I&O, Daily weights   Shock, multifactorial  - Medication and sepsis related, stress induced CM - Received approx. 2 L IVF  - Cortisol 9.7 on 8/7 PLAN:  - Levophed for MAP >65 - Treatment of infections  - Defer stress steroids while on Dex, can evaluate to start stress HC Once steroids complete for Dex-ARDS.    Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:   -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP improving, weekly checks.    DM type 2 (POA) - Diet controlled at home.  PLAN:  - Start insulin gtt today, monitoring per protocol.    Hypertension - Hold Home meds until clinically appropriate.    Obesity (POA)- BMI 35.8, complicates all aspects of care  discharge note Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to UK ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and with reported syncopal events. Patient was treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab.     On 8/6 the patient had worsening shortness of breath with increasing oxygen requirements.  On 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia ultimately requiring intubation. Furthermore, a dialysis catheter was placed and CRRT was initiated. Broad spectrum ABX were continued. On 8/8, he required addition of NMB for continued ventilator dys-synchrony. He completed the dex-ARDS protocol on 8/10. The patient had a decline on 8/11 with a fever, worsening shock. He was started back on broad spectrum antibiotics, vasopressin in addition to levophed, and stress dose steroids. Unfortunately, Pt remained with persistent and profound hemodynamic instability. His response to aggressive live saving measures was minimal. WBC up to 80 with no infectious source able to be identified, escalation of ABX still continued. CT scans unable to be obtained secondary to risk of fatal event occurring if moved and/or transported to scanner. On 8/13, Pt going into arrythmias which further exacerbated further instability, required cardioversions X 3 and antiarrhythmic medications. Goals of care discussions completed with wife. Despite attempting to give Pt more time to possibly respond to treatments, his status remained critical. Wife came to see her husband at bedside to be with him briefly before he passed away. Pt passed away on 8/14 at 8:11.""
	"1655677-1"	"1655677-1"	"GENERAL PHYSICAL HEALTH DETERIORATION"	"10049438"	"50-59 years"	"50-59"	""patient vaccinated 7/23/2021, admitted 7/29/2021, tested positive for covid 7/29/2021. discharged 8/14/2021, patient expired  Patient received Pfizer vaccine L deltoid lot numberFA6780 on 7/23/2021. Tested positive on 7/29/2021 after exposure. Writing  report since patient received vaccine and now critically ill and intubated to follow procedure. Patient intubated 8/7/2021  History Of Present Illness Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and the following day began having diarrhea and ""passed out"" 4 times since symptoms developed.  While on the floor the patient had been treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab, and had been improving, weaned from HFNC to 4L NC on 8/5.  On 8/6 the patient had worsening shortness of breath and was transition back to high-flow nasal cannula.  Today, 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia.  MICU was called and the patient was emergently intubated for acute hypoxic respiratory failure.     Past Medical History He has a past medical history of CKD (chronic kidney disease), stage IV (CMS/HCC), Gout, and Hypertension.  Assessment and Plan:  The patient is a 53 yo M with CKD4,HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    ARDS  COVID-19 PNA (POA) Pneumomediastinum, worsening  -XR chest with B/L peripheral and bibasilar opacities  -Inflammatory markers were up trending, will continue to monitor -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia, official read pending -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 124 PLAN:  - Evaluate to repeat CT chest with patient clinical decline.  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - ABG -Continue dexamethasone 6 mg daily (D6/10) -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx    AKI on CKD stage V not on Dialysis (POA) Hyperkalemia (POA) Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant PLAN:  -Nephrology following on floor, will notify of transfer to the ICU - Place Udall-- > IHD to start 8/7.  -Continue sodium bicarb 1300 TID, calcitriol and vitamin D2 at same doses -Strict I&O, Daily weights - Foley    Seizure-like activity - Patient with right-sided upper extremity and lower-extremity tonic activity following intubation.  - Prior to intubation, patient had EMV 15, appropriate and no focal deficits.  - Likely metabolic in nature, patient with BUN >100, sepsis, COVID  - No past history of seizures.  PLAN:  - TSH, B12, ammonia - EEG   Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:  -STOP coreg , HOLD home amlodipine  -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP today and as needed.    Suspected orthostatic syncope related to COVID-19 infection -Started prior to admission in the setting of ongoing diarrhea, nausea and poor PO intake -No episodes since, symptoms improved with adequate fluid resuscitation -EKG on admission with sinus tachycardia with no significant ST-T changes -PT/OT, recs home with assistance  Obesity (POA) - BMI 35.8, complicates all aspects of care.   Hospitalization Admit Date/Time: 7/29/2021 3:55 PM Admitting Attending:  Discharge Date: 08/14/21 Discharge Attending Physician:    8/9/2021 Assessment and Plan   The patient is a 53 yo M with CKD4, HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    Acute Respiratory Failure Requiring Mechanical Ventilation  Moderate ARDS  COVID-19 PNA (POA) Pneumomediastinum, stable Pneumopericardium, stable  HAP  -XR chest with B/L peripheral and bibasilar opacities  -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 127 - Started NMB on 8/8  PLAN:  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - DC nimbex today, PF ratio increased to 164 after paralytic  -Continue dexamethasone 6 mg daily (stop date 8/11)  -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx  -Empiric Cefepime for HAP--Follow up cultures from 8/7 - DC vanc    AKI on CKD stage V(POA) Hyperkalemia (POA)--resolving Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant -8/7: udall, failed IHD and converted to CRRT. PLAN:  - Nephrology following, appreciate recs  - Continue CRRT with goal net even  - Dose meds for CRRT  -Strict I&O, Daily weights   Shock, multifactorial  - Medication and sepsis related, stress induced CM - Received approx. 2 L IVF  - Cortisol 9.7 on 8/7 PLAN:  - Levophed for MAP >65 - Treatment of infections  - Defer stress steroids while on Dex, can evaluate to start stress HC Once steroids complete for Dex-ARDS.    Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:   -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP improving, weekly checks.    DM type 2 (POA) - Diet controlled at home.  PLAN:  - Start insulin gtt today, monitoring per protocol.    Hypertension - Hold Home meds until clinically appropriate.    Obesity (POA)- BMI 35.8, complicates all aspects of care  discharge note Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to UK ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and with reported syncopal events. Patient was treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab.     On 8/6 the patient had worsening shortness of breath with increasing oxygen requirements.  On 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia ultimately requiring intubation. Furthermore, a dialysis catheter was placed and CRRT was initiated. Broad spectrum ABX were continued. On 8/8, he required addition of NMB for continued ventilator dys-synchrony. He completed the dex-ARDS protocol on 8/10. The patient had a decline on 8/11 with a fever, worsening shock. He was started back on broad spectrum antibiotics, vasopressin in addition to levophed, and stress dose steroids. Unfortunately, Pt remained with persistent and profound hemodynamic instability. His response to aggressive live saving measures was minimal. WBC up to 80 with no infectious source able to be identified, escalation of ABX still continued. CT scans unable to be obtained secondary to risk of fatal event occurring if moved and/or transported to scanner. On 8/13, Pt going into arrythmias which further exacerbated further instability, required cardioversions X 3 and antiarrhythmic medications. Goals of care discussions completed with wife. Despite attempting to give Pt more time to possibly respond to treatments, his status remained critical. Wife came to see her husband at bedside to be with him briefly before he passed away. Pt passed away on 8/14 at 8:11.""
	"1655677-1"	"1655677-1"	"HAEMODYNAMIC INSTABILITY"	"10052076"	"50-59 years"	"50-59"	""patient vaccinated 7/23/2021, admitted 7/29/2021, tested positive for covid 7/29/2021. discharged 8/14/2021, patient expired  Patient received Pfizer vaccine L deltoid lot numberFA6780 on 7/23/2021. Tested positive on 7/29/2021 after exposure. Writing  report since patient received vaccine and now critically ill and intubated to follow procedure. Patient intubated 8/7/2021  History Of Present Illness Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and the following day began having diarrhea and ""passed out"" 4 times since symptoms developed.  While on the floor the patient had been treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab, and had been improving, weaned from HFNC to 4L NC on 8/5.  On 8/6 the patient had worsening shortness of breath and was transition back to high-flow nasal cannula.  Today, 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia.  MICU was called and the patient was emergently intubated for acute hypoxic respiratory failure.     Past Medical History He has a past medical history of CKD (chronic kidney disease), stage IV (CMS/HCC), Gout, and Hypertension.  Assessment and Plan:  The patient is a 53 yo M with CKD4,HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    ARDS  COVID-19 PNA (POA) Pneumomediastinum, worsening  -XR chest with B/L peripheral and bibasilar opacities  -Inflammatory markers were up trending, will continue to monitor -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia, official read pending -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 124 PLAN:  - Evaluate to repeat CT chest with patient clinical decline.  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - ABG -Continue dexamethasone 6 mg daily (D6/10) -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx    AKI on CKD stage V not on Dialysis (POA) Hyperkalemia (POA) Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant PLAN:  -Nephrology following on floor, will notify of transfer to the ICU - Place Udall-- > IHD to start 8/7.  -Continue sodium bicarb 1300 TID, calcitriol and vitamin D2 at same doses -Strict I&O, Daily weights - Foley    Seizure-like activity - Patient with right-sided upper extremity and lower-extremity tonic activity following intubation.  - Prior to intubation, patient had EMV 15, appropriate and no focal deficits.  - Likely metabolic in nature, patient with BUN >100, sepsis, COVID  - No past history of seizures.  PLAN:  - TSH, B12, ammonia - EEG   Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:  -STOP coreg , HOLD home amlodipine  -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP today and as needed.    Suspected orthostatic syncope related to COVID-19 infection -Started prior to admission in the setting of ongoing diarrhea, nausea and poor PO intake -No episodes since, symptoms improved with adequate fluid resuscitation -EKG on admission with sinus tachycardia with no significant ST-T changes -PT/OT, recs home with assistance  Obesity (POA) - BMI 35.8, complicates all aspects of care.   Hospitalization Admit Date/Time: 7/29/2021 3:55 PM Admitting Attending:  Discharge Date: 08/14/21 Discharge Attending Physician:    8/9/2021 Assessment and Plan   The patient is a 53 yo M with CKD4, HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    Acute Respiratory Failure Requiring Mechanical Ventilation  Moderate ARDS  COVID-19 PNA (POA) Pneumomediastinum, stable Pneumopericardium, stable  HAP  -XR chest with B/L peripheral and bibasilar opacities  -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 127 - Started NMB on 8/8  PLAN:  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - DC nimbex today, PF ratio increased to 164 after paralytic  -Continue dexamethasone 6 mg daily (stop date 8/11)  -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx  -Empiric Cefepime for HAP--Follow up cultures from 8/7 - DC vanc    AKI on CKD stage V(POA) Hyperkalemia (POA)--resolving Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant -8/7: udall, failed IHD and converted to CRRT. PLAN:  - Nephrology following, appreciate recs  - Continue CRRT with goal net even  - Dose meds for CRRT  -Strict I&O, Daily weights   Shock, multifactorial  - Medication and sepsis related, stress induced CM - Received approx. 2 L IVF  - Cortisol 9.7 on 8/7 PLAN:  - Levophed for MAP >65 - Treatment of infections  - Defer stress steroids while on Dex, can evaluate to start stress HC Once steroids complete for Dex-ARDS.    Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:   -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP improving, weekly checks.    DM type 2 (POA) - Diet controlled at home.  PLAN:  - Start insulin gtt today, monitoring per protocol.    Hypertension - Hold Home meds until clinically appropriate.    Obesity (POA)- BMI 35.8, complicates all aspects of care  discharge note Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to UK ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and with reported syncopal events. Patient was treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab.     On 8/6 the patient had worsening shortness of breath with increasing oxygen requirements.  On 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia ultimately requiring intubation. Furthermore, a dialysis catheter was placed and CRRT was initiated. Broad spectrum ABX were continued. On 8/8, he required addition of NMB for continued ventilator dys-synchrony. He completed the dex-ARDS protocol on 8/10. The patient had a decline on 8/11 with a fever, worsening shock. He was started back on broad spectrum antibiotics, vasopressin in addition to levophed, and stress dose steroids. Unfortunately, Pt remained with persistent and profound hemodynamic instability. His response to aggressive live saving measures was minimal. WBC up to 80 with no infectious source able to be identified, escalation of ABX still continued. CT scans unable to be obtained secondary to risk of fatal event occurring if moved and/or transported to scanner. On 8/13, Pt going into arrythmias which further exacerbated further instability, required cardioversions X 3 and antiarrhythmic medications. Goals of care discussions completed with wife. Despite attempting to give Pt more time to possibly respond to treatments, his status remained critical. Wife came to see her husband at bedside to be with him briefly before he passed away. Pt passed away on 8/14 at 8:11.""
	"1655677-1"	"1655677-1"	"HYPOXIA"	"10021143"	"50-59 years"	"50-59"	""patient vaccinated 7/23/2021, admitted 7/29/2021, tested positive for covid 7/29/2021. discharged 8/14/2021, patient expired  Patient received Pfizer vaccine L deltoid lot numberFA6780 on 7/23/2021. Tested positive on 7/29/2021 after exposure. Writing  report since patient received vaccine and now critically ill and intubated to follow procedure. Patient intubated 8/7/2021  History Of Present Illness Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and the following day began having diarrhea and ""passed out"" 4 times since symptoms developed.  While on the floor the patient had been treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab, and had been improving, weaned from HFNC to 4L NC on 8/5.  On 8/6 the patient had worsening shortness of breath and was transition back to high-flow nasal cannula.  Today, 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia.  MICU was called and the patient was emergently intubated for acute hypoxic respiratory failure.     Past Medical History He has a past medical history of CKD (chronic kidney disease), stage IV (CMS/HCC), Gout, and Hypertension.  Assessment and Plan:  The patient is a 53 yo M with CKD4,HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    ARDS  COVID-19 PNA (POA) Pneumomediastinum, worsening  -XR chest with B/L peripheral and bibasilar opacities  -Inflammatory markers were up trending, will continue to monitor -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia, official read pending -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 124 PLAN:  - Evaluate to repeat CT chest with patient clinical decline.  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - ABG -Continue dexamethasone 6 mg daily (D6/10) -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx    AKI on CKD stage V not on Dialysis (POA) Hyperkalemia (POA) Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant PLAN:  -Nephrology following on floor, will notify of transfer to the ICU - Place Udall-- > IHD to start 8/7.  -Continue sodium bicarb 1300 TID, calcitriol and vitamin D2 at same doses -Strict I&O, Daily weights - Foley    Seizure-like activity - Patient with right-sided upper extremity and lower-extremity tonic activity following intubation.  - Prior to intubation, patient had EMV 15, appropriate and no focal deficits.  - Likely metabolic in nature, patient with BUN >100, sepsis, COVID  - No past history of seizures.  PLAN:  - TSH, B12, ammonia - EEG   Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:  -STOP coreg , HOLD home amlodipine  -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP today and as needed.    Suspected orthostatic syncope related to COVID-19 infection -Started prior to admission in the setting of ongoing diarrhea, nausea and poor PO intake -No episodes since, symptoms improved with adequate fluid resuscitation -EKG on admission with sinus tachycardia with no significant ST-T changes -PT/OT, recs home with assistance  Obesity (POA) - BMI 35.8, complicates all aspects of care.   Hospitalization Admit Date/Time: 7/29/2021 3:55 PM Admitting Attending:  Discharge Date: 08/14/21 Discharge Attending Physician:    8/9/2021 Assessment and Plan   The patient is a 53 yo M with CKD4, HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    Acute Respiratory Failure Requiring Mechanical Ventilation  Moderate ARDS  COVID-19 PNA (POA) Pneumomediastinum, stable Pneumopericardium, stable  HAP  -XR chest with B/L peripheral and bibasilar opacities  -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 127 - Started NMB on 8/8  PLAN:  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - DC nimbex today, PF ratio increased to 164 after paralytic  -Continue dexamethasone 6 mg daily (stop date 8/11)  -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx  -Empiric Cefepime for HAP--Follow up cultures from 8/7 - DC vanc    AKI on CKD stage V(POA) Hyperkalemia (POA)--resolving Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant -8/7: udall, failed IHD and converted to CRRT. PLAN:  - Nephrology following, appreciate recs  - Continue CRRT with goal net even  - Dose meds for CRRT  -Strict I&O, Daily weights   Shock, multifactorial  - Medication and sepsis related, stress induced CM - Received approx. 2 L IVF  - Cortisol 9.7 on 8/7 PLAN:  - Levophed for MAP >65 - Treatment of infections  - Defer stress steroids while on Dex, can evaluate to start stress HC Once steroids complete for Dex-ARDS.    Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:   -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP improving, weekly checks.    DM type 2 (POA) - Diet controlled at home.  PLAN:  - Start insulin gtt today, monitoring per protocol.    Hypertension - Hold Home meds until clinically appropriate.    Obesity (POA)- BMI 35.8, complicates all aspects of care  discharge note Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to UK ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and with reported syncopal events. Patient was treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab.     On 8/6 the patient had worsening shortness of breath with increasing oxygen requirements.  On 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia ultimately requiring intubation. Furthermore, a dialysis catheter was placed and CRRT was initiated. Broad spectrum ABX were continued. On 8/8, he required addition of NMB for continued ventilator dys-synchrony. He completed the dex-ARDS protocol on 8/10. The patient had a decline on 8/11 with a fever, worsening shock. He was started back on broad spectrum antibiotics, vasopressin in addition to levophed, and stress dose steroids. Unfortunately, Pt remained with persistent and profound hemodynamic instability. His response to aggressive live saving measures was minimal. WBC up to 80 with no infectious source able to be identified, escalation of ABX still continued. CT scans unable to be obtained secondary to risk of fatal event occurring if moved and/or transported to scanner. On 8/13, Pt going into arrythmias which further exacerbated further instability, required cardioversions X 3 and antiarrhythmic medications. Goals of care discussions completed with wife. Despite attempting to give Pt more time to possibly respond to treatments, his status remained critical. Wife came to see her husband at bedside to be with him briefly before he passed away. Pt passed away on 8/14 at 8:11.""
	"1655677-1"	"1655677-1"	"INFLAMMATORY MARKER INCREASED"	"10069826"	"50-59 years"	"50-59"	""patient vaccinated 7/23/2021, admitted 7/29/2021, tested positive for covid 7/29/2021. discharged 8/14/2021, patient expired  Patient received Pfizer vaccine L deltoid lot numberFA6780 on 7/23/2021. Tested positive on 7/29/2021 after exposure. Writing  report since patient received vaccine and now critically ill and intubated to follow procedure. Patient intubated 8/7/2021  History Of Present Illness Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and the following day began having diarrhea and ""passed out"" 4 times since symptoms developed.  While on the floor the patient had been treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab, and had been improving, weaned from HFNC to 4L NC on 8/5.  On 8/6 the patient had worsening shortness of breath and was transition back to high-flow nasal cannula.  Today, 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia.  MICU was called and the patient was emergently intubated for acute hypoxic respiratory failure.     Past Medical History He has a past medical history of CKD (chronic kidney disease), stage IV (CMS/HCC), Gout, and Hypertension.  Assessment and Plan:  The patient is a 53 yo M with CKD4,HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    ARDS  COVID-19 PNA (POA) Pneumomediastinum, worsening  -XR chest with B/L peripheral and bibasilar opacities  -Inflammatory markers were up trending, will continue to monitor -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia, official read pending -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 124 PLAN:  - Evaluate to repeat CT chest with patient clinical decline.  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - ABG -Continue dexamethasone 6 mg daily (D6/10) -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx    AKI on CKD stage V not on Dialysis (POA) Hyperkalemia (POA) Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant PLAN:  -Nephrology following on floor, will notify of transfer to the ICU - Place Udall-- > IHD to start 8/7.  -Continue sodium bicarb 1300 TID, calcitriol and vitamin D2 at same doses -Strict I&O, Daily weights - Foley    Seizure-like activity - Patient with right-sided upper extremity and lower-extremity tonic activity following intubation.  - Prior to intubation, patient had EMV 15, appropriate and no focal deficits.  - Likely metabolic in nature, patient with BUN >100, sepsis, COVID  - No past history of seizures.  PLAN:  - TSH, B12, ammonia - EEG   Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:  -STOP coreg , HOLD home amlodipine  -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP today and as needed.    Suspected orthostatic syncope related to COVID-19 infection -Started prior to admission in the setting of ongoing diarrhea, nausea and poor PO intake -No episodes since, symptoms improved with adequate fluid resuscitation -EKG on admission with sinus tachycardia with no significant ST-T changes -PT/OT, recs home with assistance  Obesity (POA) - BMI 35.8, complicates all aspects of care.   Hospitalization Admit Date/Time: 7/29/2021 3:55 PM Admitting Attending:  Discharge Date: 08/14/21 Discharge Attending Physician:    8/9/2021 Assessment and Plan   The patient is a 53 yo M with CKD4, HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    Acute Respiratory Failure Requiring Mechanical Ventilation  Moderate ARDS  COVID-19 PNA (POA) Pneumomediastinum, stable Pneumopericardium, stable  HAP  -XR chest with B/L peripheral and bibasilar opacities  -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 127 - Started NMB on 8/8  PLAN:  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - DC nimbex today, PF ratio increased to 164 after paralytic  -Continue dexamethasone 6 mg daily (stop date 8/11)  -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx  -Empiric Cefepime for HAP--Follow up cultures from 8/7 - DC vanc    AKI on CKD stage V(POA) Hyperkalemia (POA)--resolving Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant -8/7: udall, failed IHD and converted to CRRT. PLAN:  - Nephrology following, appreciate recs  - Continue CRRT with goal net even  - Dose meds for CRRT  -Strict I&O, Daily weights   Shock, multifactorial  - Medication and sepsis related, stress induced CM - Received approx. 2 L IVF  - Cortisol 9.7 on 8/7 PLAN:  - Levophed for MAP >65 - Treatment of infections  - Defer stress steroids while on Dex, can evaluate to start stress HC Once steroids complete for Dex-ARDS.    Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:   -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP improving, weekly checks.    DM type 2 (POA) - Diet controlled at home.  PLAN:  - Start insulin gtt today, monitoring per protocol.    Hypertension - Hold Home meds until clinically appropriate.    Obesity (POA)- BMI 35.8, complicates all aspects of care  discharge note Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to UK ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and with reported syncopal events. Patient was treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab.     On 8/6 the patient had worsening shortness of breath with increasing oxygen requirements.  On 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia ultimately requiring intubation. Furthermore, a dialysis catheter was placed and CRRT was initiated. Broad spectrum ABX were continued. On 8/8, he required addition of NMB for continued ventilator dys-synchrony. He completed the dex-ARDS protocol on 8/10. The patient had a decline on 8/11 with a fever, worsening shock. He was started back on broad spectrum antibiotics, vasopressin in addition to levophed, and stress dose steroids. Unfortunately, Pt remained with persistent and profound hemodynamic instability. His response to aggressive live saving measures was minimal. WBC up to 80 with no infectious source able to be identified, escalation of ABX still continued. CT scans unable to be obtained secondary to risk of fatal event occurring if moved and/or transported to scanner. On 8/13, Pt going into arrythmias which further exacerbated further instability, required cardioversions X 3 and antiarrhythmic medications. Goals of care discussions completed with wife. Despite attempting to give Pt more time to possibly respond to treatments, his status remained critical. Wife came to see her husband at bedside to be with him briefly before he passed away. Pt passed away on 8/14 at 8:11.""
	"1655677-1"	"1655677-1"	"INTENSIVE CARE"	"10022519"	"50-59 years"	"50-59"	""patient vaccinated 7/23/2021, admitted 7/29/2021, tested positive for covid 7/29/2021. discharged 8/14/2021, patient expired  Patient received Pfizer vaccine L deltoid lot numberFA6780 on 7/23/2021. Tested positive on 7/29/2021 after exposure. Writing  report since patient received vaccine and now critically ill and intubated to follow procedure. Patient intubated 8/7/2021  History Of Present Illness Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and the following day began having diarrhea and ""passed out"" 4 times since symptoms developed.  While on the floor the patient had been treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab, and had been improving, weaned from HFNC to 4L NC on 8/5.  On 8/6 the patient had worsening shortness of breath and was transition back to high-flow nasal cannula.  Today, 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia.  MICU was called and the patient was emergently intubated for acute hypoxic respiratory failure.     Past Medical History He has a past medical history of CKD (chronic kidney disease), stage IV (CMS/HCC), Gout, and Hypertension.  Assessment and Plan:  The patient is a 53 yo M with CKD4,HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    ARDS  COVID-19 PNA (POA) Pneumomediastinum, worsening  -XR chest with B/L peripheral and bibasilar opacities  -Inflammatory markers were up trending, will continue to monitor -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia, official read pending -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 124 PLAN:  - Evaluate to repeat CT chest with patient clinical decline.  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - ABG -Continue dexamethasone 6 mg daily (D6/10) -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx    AKI on CKD stage V not on Dialysis (POA) Hyperkalemia (POA) Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant PLAN:  -Nephrology following on floor, will notify of transfer to the ICU - Place Udall-- > IHD to start 8/7.  -Continue sodium bicarb 1300 TID, calcitriol and vitamin D2 at same doses -Strict I&O, Daily weights - Foley    Seizure-like activity - Patient with right-sided upper extremity and lower-extremity tonic activity following intubation.  - Prior to intubation, patient had EMV 15, appropriate and no focal deficits.  - Likely metabolic in nature, patient with BUN >100, sepsis, COVID  - No past history of seizures.  PLAN:  - TSH, B12, ammonia - EEG   Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:  -STOP coreg , HOLD home amlodipine  -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP today and as needed.    Suspected orthostatic syncope related to COVID-19 infection -Started prior to admission in the setting of ongoing diarrhea, nausea and poor PO intake -No episodes since, symptoms improved with adequate fluid resuscitation -EKG on admission with sinus tachycardia with no significant ST-T changes -PT/OT, recs home with assistance  Obesity (POA) - BMI 35.8, complicates all aspects of care.   Hospitalization Admit Date/Time: 7/29/2021 3:55 PM Admitting Attending:  Discharge Date: 08/14/21 Discharge Attending Physician:    8/9/2021 Assessment and Plan   The patient is a 53 yo M with CKD4, HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    Acute Respiratory Failure Requiring Mechanical Ventilation  Moderate ARDS  COVID-19 PNA (POA) Pneumomediastinum, stable Pneumopericardium, stable  HAP  -XR chest with B/L peripheral and bibasilar opacities  -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 127 - Started NMB on 8/8  PLAN:  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - DC nimbex today, PF ratio increased to 164 after paralytic  -Continue dexamethasone 6 mg daily (stop date 8/11)  -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx  -Empiric Cefepime for HAP--Follow up cultures from 8/7 - DC vanc    AKI on CKD stage V(POA) Hyperkalemia (POA)--resolving Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant -8/7: udall, failed IHD and converted to CRRT. PLAN:  - Nephrology following, appreciate recs  - Continue CRRT with goal net even  - Dose meds for CRRT  -Strict I&O, Daily weights   Shock, multifactorial  - Medication and sepsis related, stress induced CM - Received approx. 2 L IVF  - Cortisol 9.7 on 8/7 PLAN:  - Levophed for MAP >65 - Treatment of infections  - Defer stress steroids while on Dex, can evaluate to start stress HC Once steroids complete for Dex-ARDS.    Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:   -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP improving, weekly checks.    DM type 2 (POA) - Diet controlled at home.  PLAN:  - Start insulin gtt today, monitoring per protocol.    Hypertension - Hold Home meds until clinically appropriate.    Obesity (POA)- BMI 35.8, complicates all aspects of care  discharge note Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to UK ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and with reported syncopal events. Patient was treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab.     On 8/6 the patient had worsening shortness of breath with increasing oxygen requirements.  On 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia ultimately requiring intubation. Furthermore, a dialysis catheter was placed and CRRT was initiated. Broad spectrum ABX were continued. On 8/8, he required addition of NMB for continued ventilator dys-synchrony. He completed the dex-ARDS protocol on 8/10. The patient had a decline on 8/11 with a fever, worsening shock. He was started back on broad spectrum antibiotics, vasopressin in addition to levophed, and stress dose steroids. Unfortunately, Pt remained with persistent and profound hemodynamic instability. His response to aggressive live saving measures was minimal. WBC up to 80 with no infectious source able to be identified, escalation of ABX still continued. CT scans unable to be obtained secondary to risk of fatal event occurring if moved and/or transported to scanner. On 8/13, Pt going into arrythmias which further exacerbated further instability, required cardioversions X 3 and antiarrhythmic medications. Goals of care discussions completed with wife. Despite attempting to give Pt more time to possibly respond to treatments, his status remained critical. Wife came to see her husband at bedside to be with him briefly before he passed away. Pt passed away on 8/14 at 8:11.""
	"1655677-1"	"1655677-1"	"LOSS OF CONSCIOUSNESS"	"10024855"	"50-59 years"	"50-59"	""patient vaccinated 7/23/2021, admitted 7/29/2021, tested positive for covid 7/29/2021. discharged 8/14/2021, patient expired  Patient received Pfizer vaccine L deltoid lot numberFA6780 on 7/23/2021. Tested positive on 7/29/2021 after exposure. Writing  report since patient received vaccine and now critically ill and intubated to follow procedure. Patient intubated 8/7/2021  History Of Present Illness Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and the following day began having diarrhea and ""passed out"" 4 times since symptoms developed.  While on the floor the patient had been treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab, and had been improving, weaned from HFNC to 4L NC on 8/5.  On 8/6 the patient had worsening shortness of breath and was transition back to high-flow nasal cannula.  Today, 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia.  MICU was called and the patient was emergently intubated for acute hypoxic respiratory failure.     Past Medical History He has a past medical history of CKD (chronic kidney disease), stage IV (CMS/HCC), Gout, and Hypertension.  Assessment and Plan:  The patient is a 53 yo M with CKD4,HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    ARDS  COVID-19 PNA (POA) Pneumomediastinum, worsening  -XR chest with B/L peripheral and bibasilar opacities  -Inflammatory markers were up trending, will continue to monitor -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia, official read pending -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 124 PLAN:  - Evaluate to repeat CT chest with patient clinical decline.  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - ABG -Continue dexamethasone 6 mg daily (D6/10) -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx    AKI on CKD stage V not on Dialysis (POA) Hyperkalemia (POA) Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant PLAN:  -Nephrology following on floor, will notify of transfer to the ICU - Place Udall-- > IHD to start 8/7.  -Continue sodium bicarb 1300 TID, calcitriol and vitamin D2 at same doses -Strict I&O, Daily weights - Foley    Seizure-like activity - Patient with right-sided upper extremity and lower-extremity tonic activity following intubation.  - Prior to intubation, patient had EMV 15, appropriate and no focal deficits.  - Likely metabolic in nature, patient with BUN >100, sepsis, COVID  - No past history of seizures.  PLAN:  - TSH, B12, ammonia - EEG   Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:  -STOP coreg , HOLD home amlodipine  -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP today and as needed.    Suspected orthostatic syncope related to COVID-19 infection -Started prior to admission in the setting of ongoing diarrhea, nausea and poor PO intake -No episodes since, symptoms improved with adequate fluid resuscitation -EKG on admission with sinus tachycardia with no significant ST-T changes -PT/OT, recs home with assistance  Obesity (POA) - BMI 35.8, complicates all aspects of care.   Hospitalization Admit Date/Time: 7/29/2021 3:55 PM Admitting Attending:  Discharge Date: 08/14/21 Discharge Attending Physician:    8/9/2021 Assessment and Plan   The patient is a 53 yo M with CKD4, HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    Acute Respiratory Failure Requiring Mechanical Ventilation  Moderate ARDS  COVID-19 PNA (POA) Pneumomediastinum, stable Pneumopericardium, stable  HAP  -XR chest with B/L peripheral and bibasilar opacities  -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 127 - Started NMB on 8/8  PLAN:  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - DC nimbex today, PF ratio increased to 164 after paralytic  -Continue dexamethasone 6 mg daily (stop date 8/11)  -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx  -Empiric Cefepime for HAP--Follow up cultures from 8/7 - DC vanc    AKI on CKD stage V(POA) Hyperkalemia (POA)--resolving Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant -8/7: udall, failed IHD and converted to CRRT. PLAN:  - Nephrology following, appreciate recs  - Continue CRRT with goal net even  - Dose meds for CRRT  -Strict I&O, Daily weights   Shock, multifactorial  - Medication and sepsis related, stress induced CM - Received approx. 2 L IVF  - Cortisol 9.7 on 8/7 PLAN:  - Levophed for MAP >65 - Treatment of infections  - Defer stress steroids while on Dex, can evaluate to start stress HC Once steroids complete for Dex-ARDS.    Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:   -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP improving, weekly checks.    DM type 2 (POA) - Diet controlled at home.  PLAN:  - Start insulin gtt today, monitoring per protocol.    Hypertension - Hold Home meds until clinically appropriate.    Obesity (POA)- BMI 35.8, complicates all aspects of care  discharge note Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to UK ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and with reported syncopal events. Patient was treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab.     On 8/6 the patient had worsening shortness of breath with increasing oxygen requirements.  On 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia ultimately requiring intubation. Furthermore, a dialysis catheter was placed and CRRT was initiated. Broad spectrum ABX were continued. On 8/8, he required addition of NMB for continued ventilator dys-synchrony. He completed the dex-ARDS protocol on 8/10. The patient had a decline on 8/11 with a fever, worsening shock. He was started back on broad spectrum antibiotics, vasopressin in addition to levophed, and stress dose steroids. Unfortunately, Pt remained with persistent and profound hemodynamic instability. His response to aggressive live saving measures was minimal. WBC up to 80 with no infectious source able to be identified, escalation of ABX still continued. CT scans unable to be obtained secondary to risk of fatal event occurring if moved and/or transported to scanner. On 8/13, Pt going into arrythmias which further exacerbated further instability, required cardioversions X 3 and antiarrhythmic medications. Goals of care discussions completed with wife. Despite attempting to give Pt more time to possibly respond to treatments, his status remained critical. Wife came to see her husband at bedside to be with him briefly before he passed away. Pt passed away on 8/14 at 8:11.""
	"1655677-1"	"1655677-1"	"LUNG INFILTRATION"	"10025102"	"50-59 years"	"50-59"	""patient vaccinated 7/23/2021, admitted 7/29/2021, tested positive for covid 7/29/2021. discharged 8/14/2021, patient expired  Patient received Pfizer vaccine L deltoid lot numberFA6780 on 7/23/2021. Tested positive on 7/29/2021 after exposure. Writing  report since patient received vaccine and now critically ill and intubated to follow procedure. Patient intubated 8/7/2021  History Of Present Illness Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and the following day began having diarrhea and ""passed out"" 4 times since symptoms developed.  While on the floor the patient had been treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab, and had been improving, weaned from HFNC to 4L NC on 8/5.  On 8/6 the patient had worsening shortness of breath and was transition back to high-flow nasal cannula.  Today, 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia.  MICU was called and the patient was emergently intubated for acute hypoxic respiratory failure.     Past Medical History He has a past medical history of CKD (chronic kidney disease), stage IV (CMS/HCC), Gout, and Hypertension.  Assessment and Plan:  The patient is a 53 yo M with CKD4,HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    ARDS  COVID-19 PNA (POA) Pneumomediastinum, worsening  -XR chest with B/L peripheral and bibasilar opacities  -Inflammatory markers were up trending, will continue to monitor -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia, official read pending -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 124 PLAN:  - Evaluate to repeat CT chest with patient clinical decline.  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - ABG -Continue dexamethasone 6 mg daily (D6/10) -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx    AKI on CKD stage V not on Dialysis (POA) Hyperkalemia (POA) Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant PLAN:  -Nephrology following on floor, will notify of transfer to the ICU - Place Udall-- > IHD to start 8/7.  -Continue sodium bicarb 1300 TID, calcitriol and vitamin D2 at same doses -Strict I&O, Daily weights - Foley    Seizure-like activity - Patient with right-sided upper extremity and lower-extremity tonic activity following intubation.  - Prior to intubation, patient had EMV 15, appropriate and no focal deficits.  - Likely metabolic in nature, patient with BUN >100, sepsis, COVID  - No past history of seizures.  PLAN:  - TSH, B12, ammonia - EEG   Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:  -STOP coreg , HOLD home amlodipine  -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP today and as needed.    Suspected orthostatic syncope related to COVID-19 infection -Started prior to admission in the setting of ongoing diarrhea, nausea and poor PO intake -No episodes since, symptoms improved with adequate fluid resuscitation -EKG on admission with sinus tachycardia with no significant ST-T changes -PT/OT, recs home with assistance  Obesity (POA) - BMI 35.8, complicates all aspects of care.   Hospitalization Admit Date/Time: 7/29/2021 3:55 PM Admitting Attending:  Discharge Date: 08/14/21 Discharge Attending Physician:    8/9/2021 Assessment and Plan   The patient is a 53 yo M with CKD4, HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    Acute Respiratory Failure Requiring Mechanical Ventilation  Moderate ARDS  COVID-19 PNA (POA) Pneumomediastinum, stable Pneumopericardium, stable  HAP  -XR chest with B/L peripheral and bibasilar opacities  -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 127 - Started NMB on 8/8  PLAN:  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - DC nimbex today, PF ratio increased to 164 after paralytic  -Continue dexamethasone 6 mg daily (stop date 8/11)  -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx  -Empiric Cefepime for HAP--Follow up cultures from 8/7 - DC vanc    AKI on CKD stage V(POA) Hyperkalemia (POA)--resolving Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant -8/7: udall, failed IHD and converted to CRRT. PLAN:  - Nephrology following, appreciate recs  - Continue CRRT with goal net even  - Dose meds for CRRT  -Strict I&O, Daily weights   Shock, multifactorial  - Medication and sepsis related, stress induced CM - Received approx. 2 L IVF  - Cortisol 9.7 on 8/7 PLAN:  - Levophed for MAP >65 - Treatment of infections  - Defer stress steroids while on Dex, can evaluate to start stress HC Once steroids complete for Dex-ARDS.    Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:   -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP improving, weekly checks.    DM type 2 (POA) - Diet controlled at home.  PLAN:  - Start insulin gtt today, monitoring per protocol.    Hypertension - Hold Home meds until clinically appropriate.    Obesity (POA)- BMI 35.8, complicates all aspects of care  discharge note Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to UK ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and with reported syncopal events. Patient was treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab.     On 8/6 the patient had worsening shortness of breath with increasing oxygen requirements.  On 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia ultimately requiring intubation. Furthermore, a dialysis catheter was placed and CRRT was initiated. Broad spectrum ABX were continued. On 8/8, he required addition of NMB for continued ventilator dys-synchrony. He completed the dex-ARDS protocol on 8/10. The patient had a decline on 8/11 with a fever, worsening shock. He was started back on broad spectrum antibiotics, vasopressin in addition to levophed, and stress dose steroids. Unfortunately, Pt remained with persistent and profound hemodynamic instability. His response to aggressive live saving measures was minimal. WBC up to 80 with no infectious source able to be identified, escalation of ABX still continued. CT scans unable to be obtained secondary to risk of fatal event occurring if moved and/or transported to scanner. On 8/13, Pt going into arrythmias which further exacerbated further instability, required cardioversions X 3 and antiarrhythmic medications. Goals of care discussions completed with wife. Despite attempting to give Pt more time to possibly respond to treatments, his status remained critical. Wife came to see her husband at bedside to be with him briefly before he passed away. Pt passed away on 8/14 at 8:11.""
	"1655677-1"	"1655677-1"	"LUNG OPACITY"	"10081792"	"50-59 years"	"50-59"	""patient vaccinated 7/23/2021, admitted 7/29/2021, tested positive for covid 7/29/2021. discharged 8/14/2021, patient expired  Patient received Pfizer vaccine L deltoid lot numberFA6780 on 7/23/2021. Tested positive on 7/29/2021 after exposure. Writing  report since patient received vaccine and now critically ill and intubated to follow procedure. Patient intubated 8/7/2021  History Of Present Illness Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and the following day began having diarrhea and ""passed out"" 4 times since symptoms developed.  While on the floor the patient had been treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab, and had been improving, weaned from HFNC to 4L NC on 8/5.  On 8/6 the patient had worsening shortness of breath and was transition back to high-flow nasal cannula.  Today, 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia.  MICU was called and the patient was emergently intubated for acute hypoxic respiratory failure.     Past Medical History He has a past medical history of CKD (chronic kidney disease), stage IV (CMS/HCC), Gout, and Hypertension.  Assessment and Plan:  The patient is a 53 yo M with CKD4,HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    ARDS  COVID-19 PNA (POA) Pneumomediastinum, worsening  -XR chest with B/L peripheral and bibasilar opacities  -Inflammatory markers were up trending, will continue to monitor -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia, official read pending -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 124 PLAN:  - Evaluate to repeat CT chest with patient clinical decline.  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - ABG -Continue dexamethasone 6 mg daily (D6/10) -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx    AKI on CKD stage V not on Dialysis (POA) Hyperkalemia (POA) Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant PLAN:  -Nephrology following on floor, will notify of transfer to the ICU - Place Udall-- > IHD to start 8/7.  -Continue sodium bicarb 1300 TID, calcitriol and vitamin D2 at same doses -Strict I&O, Daily weights - Foley    Seizure-like activity - Patient with right-sided upper extremity and lower-extremity tonic activity following intubation.  - Prior to intubation, patient had EMV 15, appropriate and no focal deficits.  - Likely metabolic in nature, patient with BUN >100, sepsis, COVID  - No past history of seizures.  PLAN:  - TSH, B12, ammonia - EEG   Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:  -STOP coreg , HOLD home amlodipine  -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP today and as needed.    Suspected orthostatic syncope related to COVID-19 infection -Started prior to admission in the setting of ongoing diarrhea, nausea and poor PO intake -No episodes since, symptoms improved with adequate fluid resuscitation -EKG on admission with sinus tachycardia with no significant ST-T changes -PT/OT, recs home with assistance  Obesity (POA) - BMI 35.8, complicates all aspects of care.   Hospitalization Admit Date/Time: 7/29/2021 3:55 PM Admitting Attending:  Discharge Date: 08/14/21 Discharge Attending Physician:    8/9/2021 Assessment and Plan   The patient is a 53 yo M with CKD4, HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    Acute Respiratory Failure Requiring Mechanical Ventilation  Moderate ARDS  COVID-19 PNA (POA) Pneumomediastinum, stable Pneumopericardium, stable  HAP  -XR chest with B/L peripheral and bibasilar opacities  -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 127 - Started NMB on 8/8  PLAN:  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - DC nimbex today, PF ratio increased to 164 after paralytic  -Continue dexamethasone 6 mg daily (stop date 8/11)  -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx  -Empiric Cefepime for HAP--Follow up cultures from 8/7 - DC vanc    AKI on CKD stage V(POA) Hyperkalemia (POA)--resolving Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant -8/7: udall, failed IHD and converted to CRRT. PLAN:  - Nephrology following, appreciate recs  - Continue CRRT with goal net even  - Dose meds for CRRT  -Strict I&O, Daily weights   Shock, multifactorial  - Medication and sepsis related, stress induced CM - Received approx. 2 L IVF  - Cortisol 9.7 on 8/7 PLAN:  - Levophed for MAP >65 - Treatment of infections  - Defer stress steroids while on Dex, can evaluate to start stress HC Once steroids complete for Dex-ARDS.    Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:   -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP improving, weekly checks.    DM type 2 (POA) - Diet controlled at home.  PLAN:  - Start insulin gtt today, monitoring per protocol.    Hypertension - Hold Home meds until clinically appropriate.    Obesity (POA)- BMI 35.8, complicates all aspects of care  discharge note Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to UK ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and with reported syncopal events. Patient was treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab.     On 8/6 the patient had worsening shortness of breath with increasing oxygen requirements.  On 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia ultimately requiring intubation. Furthermore, a dialysis catheter was placed and CRRT was initiated. Broad spectrum ABX were continued. On 8/8, he required addition of NMB for continued ventilator dys-synchrony. He completed the dex-ARDS protocol on 8/10. The patient had a decline on 8/11 with a fever, worsening shock. He was started back on broad spectrum antibiotics, vasopressin in addition to levophed, and stress dose steroids. Unfortunately, Pt remained with persistent and profound hemodynamic instability. His response to aggressive live saving measures was minimal. WBC up to 80 with no infectious source able to be identified, escalation of ABX still continued. CT scans unable to be obtained secondary to risk of fatal event occurring if moved and/or transported to scanner. On 8/13, Pt going into arrythmias which further exacerbated further instability, required cardioversions X 3 and antiarrhythmic medications. Goals of care discussions completed with wife. Despite attempting to give Pt more time to possibly respond to treatments, his status remained critical. Wife came to see her husband at bedside to be with him briefly before he passed away. Pt passed away on 8/14 at 8:11.""
	"1655677-1"	"1655677-1"	"MECHANICAL VENTILATION"	"10067221"	"50-59 years"	"50-59"	""patient vaccinated 7/23/2021, admitted 7/29/2021, tested positive for covid 7/29/2021. discharged 8/14/2021, patient expired  Patient received Pfizer vaccine L deltoid lot numberFA6780 on 7/23/2021. Tested positive on 7/29/2021 after exposure. Writing  report since patient received vaccine and now critically ill and intubated to follow procedure. Patient intubated 8/7/2021  History Of Present Illness Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and the following day began having diarrhea and ""passed out"" 4 times since symptoms developed.  While on the floor the patient had been treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab, and had been improving, weaned from HFNC to 4L NC on 8/5.  On 8/6 the patient had worsening shortness of breath and was transition back to high-flow nasal cannula.  Today, 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia.  MICU was called and the patient was emergently intubated for acute hypoxic respiratory failure.     Past Medical History He has a past medical history of CKD (chronic kidney disease), stage IV (CMS/HCC), Gout, and Hypertension.  Assessment and Plan:  The patient is a 53 yo M with CKD4,HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    ARDS  COVID-19 PNA (POA) Pneumomediastinum, worsening  -XR chest with B/L peripheral and bibasilar opacities  -Inflammatory markers were up trending, will continue to monitor -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia, official read pending -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 124 PLAN:  - Evaluate to repeat CT chest with patient clinical decline.  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - ABG -Continue dexamethasone 6 mg daily (D6/10) -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx    AKI on CKD stage V not on Dialysis (POA) Hyperkalemia (POA) Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant PLAN:  -Nephrology following on floor, will notify of transfer to the ICU - Place Udall-- > IHD to start 8/7.  -Continue sodium bicarb 1300 TID, calcitriol and vitamin D2 at same doses -Strict I&O, Daily weights - Foley    Seizure-like activity - Patient with right-sided upper extremity and lower-extremity tonic activity following intubation.  - Prior to intubation, patient had EMV 15, appropriate and no focal deficits.  - Likely metabolic in nature, patient with BUN >100, sepsis, COVID  - No past history of seizures.  PLAN:  - TSH, B12, ammonia - EEG   Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:  -STOP coreg , HOLD home amlodipine  -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP today and as needed.    Suspected orthostatic syncope related to COVID-19 infection -Started prior to admission in the setting of ongoing diarrhea, nausea and poor PO intake -No episodes since, symptoms improved with adequate fluid resuscitation -EKG on admission with sinus tachycardia with no significant ST-T changes -PT/OT, recs home with assistance  Obesity (POA) - BMI 35.8, complicates all aspects of care.   Hospitalization Admit Date/Time: 7/29/2021 3:55 PM Admitting Attending:  Discharge Date: 08/14/21 Discharge Attending Physician:    8/9/2021 Assessment and Plan   The patient is a 53 yo M with CKD4, HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    Acute Respiratory Failure Requiring Mechanical Ventilation  Moderate ARDS  COVID-19 PNA (POA) Pneumomediastinum, stable Pneumopericardium, stable  HAP  -XR chest with B/L peripheral and bibasilar opacities  -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 127 - Started NMB on 8/8  PLAN:  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - DC nimbex today, PF ratio increased to 164 after paralytic  -Continue dexamethasone 6 mg daily (stop date 8/11)  -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx  -Empiric Cefepime for HAP--Follow up cultures from 8/7 - DC vanc    AKI on CKD stage V(POA) Hyperkalemia (POA)--resolving Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant -8/7: udall, failed IHD and converted to CRRT. PLAN:  - Nephrology following, appreciate recs  - Continue CRRT with goal net even  - Dose meds for CRRT  -Strict I&O, Daily weights   Shock, multifactorial  - Medication and sepsis related, stress induced CM - Received approx. 2 L IVF  - Cortisol 9.7 on 8/7 PLAN:  - Levophed for MAP >65 - Treatment of infections  - Defer stress steroids while on Dex, can evaluate to start stress HC Once steroids complete for Dex-ARDS.    Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:   -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP improving, weekly checks.    DM type 2 (POA) - Diet controlled at home.  PLAN:  - Start insulin gtt today, monitoring per protocol.    Hypertension - Hold Home meds until clinically appropriate.    Obesity (POA)- BMI 35.8, complicates all aspects of care  discharge note Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to UK ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and with reported syncopal events. Patient was treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab.     On 8/6 the patient had worsening shortness of breath with increasing oxygen requirements.  On 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia ultimately requiring intubation. Furthermore, a dialysis catheter was placed and CRRT was initiated. Broad spectrum ABX were continued. On 8/8, he required addition of NMB for continued ventilator dys-synchrony. He completed the dex-ARDS protocol on 8/10. The patient had a decline on 8/11 with a fever, worsening shock. He was started back on broad spectrum antibiotics, vasopressin in addition to levophed, and stress dose steroids. Unfortunately, Pt remained with persistent and profound hemodynamic instability. His response to aggressive live saving measures was minimal. WBC up to 80 with no infectious source able to be identified, escalation of ABX still continued. CT scans unable to be obtained secondary to risk of fatal event occurring if moved and/or transported to scanner. On 8/13, Pt going into arrythmias which further exacerbated further instability, required cardioversions X 3 and antiarrhythmic medications. Goals of care discussions completed with wife. Despite attempting to give Pt more time to possibly respond to treatments, his status remained critical. Wife came to see her husband at bedside to be with him briefly before he passed away. Pt passed away on 8/14 at 8:11.""
	"1655677-1"	"1655677-1"	"METABOLIC ACIDOSIS"	"10027417"	"50-59 years"	"50-59"	""patient vaccinated 7/23/2021, admitted 7/29/2021, tested positive for covid 7/29/2021. discharged 8/14/2021, patient expired  Patient received Pfizer vaccine L deltoid lot numberFA6780 on 7/23/2021. Tested positive on 7/29/2021 after exposure. Writing  report since patient received vaccine and now critically ill and intubated to follow procedure. Patient intubated 8/7/2021  History Of Present Illness Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and the following day began having diarrhea and ""passed out"" 4 times since symptoms developed.  While on the floor the patient had been treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab, and had been improving, weaned from HFNC to 4L NC on 8/5.  On 8/6 the patient had worsening shortness of breath and was transition back to high-flow nasal cannula.  Today, 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia.  MICU was called and the patient was emergently intubated for acute hypoxic respiratory failure.     Past Medical History He has a past medical history of CKD (chronic kidney disease), stage IV (CMS/HCC), Gout, and Hypertension.  Assessment and Plan:  The patient is a 53 yo M with CKD4,HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    ARDS  COVID-19 PNA (POA) Pneumomediastinum, worsening  -XR chest with B/L peripheral and bibasilar opacities  -Inflammatory markers were up trending, will continue to monitor -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia, official read pending -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 124 PLAN:  - Evaluate to repeat CT chest with patient clinical decline.  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - ABG -Continue dexamethasone 6 mg daily (D6/10) -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx    AKI on CKD stage V not on Dialysis (POA) Hyperkalemia (POA) Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant PLAN:  -Nephrology following on floor, will notify of transfer to the ICU - Place Udall-- > IHD to start 8/7.  -Continue sodium bicarb 1300 TID, calcitriol and vitamin D2 at same doses -Strict I&O, Daily weights - Foley    Seizure-like activity - Patient with right-sided upper extremity and lower-extremity tonic activity following intubation.  - Prior to intubation, patient had EMV 15, appropriate and no focal deficits.  - Likely metabolic in nature, patient with BUN >100, sepsis, COVID  - No past history of seizures.  PLAN:  - TSH, B12, ammonia - EEG   Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:  -STOP coreg , HOLD home amlodipine  -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP today and as needed.    Suspected orthostatic syncope related to COVID-19 infection -Started prior to admission in the setting of ongoing diarrhea, nausea and poor PO intake -No episodes since, symptoms improved with adequate fluid resuscitation -EKG on admission with sinus tachycardia with no significant ST-T changes -PT/OT, recs home with assistance  Obesity (POA) - BMI 35.8, complicates all aspects of care.   Hospitalization Admit Date/Time: 7/29/2021 3:55 PM Admitting Attending:  Discharge Date: 08/14/21 Discharge Attending Physician:    8/9/2021 Assessment and Plan   The patient is a 53 yo M with CKD4, HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    Acute Respiratory Failure Requiring Mechanical Ventilation  Moderate ARDS  COVID-19 PNA (POA) Pneumomediastinum, stable Pneumopericardium, stable  HAP  -XR chest with B/L peripheral and bibasilar opacities  -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 127 - Started NMB on 8/8  PLAN:  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - DC nimbex today, PF ratio increased to 164 after paralytic  -Continue dexamethasone 6 mg daily (stop date 8/11)  -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx  -Empiric Cefepime for HAP--Follow up cultures from 8/7 - DC vanc    AKI on CKD stage V(POA) Hyperkalemia (POA)--resolving Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant -8/7: udall, failed IHD and converted to CRRT. PLAN:  - Nephrology following, appreciate recs  - Continue CRRT with goal net even  - Dose meds for CRRT  -Strict I&O, Daily weights   Shock, multifactorial  - Medication and sepsis related, stress induced CM - Received approx. 2 L IVF  - Cortisol 9.7 on 8/7 PLAN:  - Levophed for MAP >65 - Treatment of infections  - Defer stress steroids while on Dex, can evaluate to start stress HC Once steroids complete for Dex-ARDS.    Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:   -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP improving, weekly checks.    DM type 2 (POA) - Diet controlled at home.  PLAN:  - Start insulin gtt today, monitoring per protocol.    Hypertension - Hold Home meds until clinically appropriate.    Obesity (POA)- BMI 35.8, complicates all aspects of care  discharge note Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to UK ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and with reported syncopal events. Patient was treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab.     On 8/6 the patient had worsening shortness of breath with increasing oxygen requirements.  On 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia ultimately requiring intubation. Furthermore, a dialysis catheter was placed and CRRT was initiated. Broad spectrum ABX were continued. On 8/8, he required addition of NMB for continued ventilator dys-synchrony. He completed the dex-ARDS protocol on 8/10. The patient had a decline on 8/11 with a fever, worsening shock. He was started back on broad spectrum antibiotics, vasopressin in addition to levophed, and stress dose steroids. Unfortunately, Pt remained with persistent and profound hemodynamic instability. His response to aggressive live saving measures was minimal. WBC up to 80 with no infectious source able to be identified, escalation of ABX still continued. CT scans unable to be obtained secondary to risk of fatal event occurring if moved and/or transported to scanner. On 8/13, Pt going into arrythmias which further exacerbated further instability, required cardioversions X 3 and antiarrhythmic medications. Goals of care discussions completed with wife. Despite attempting to give Pt more time to possibly respond to treatments, his status remained critical. Wife came to see her husband at bedside to be with him briefly before he passed away. Pt passed away on 8/14 at 8:11.""
	"1655677-1"	"1655677-1"	"METABOLIC FUNCTION TEST"	"10062191"	"50-59 years"	"50-59"	""patient vaccinated 7/23/2021, admitted 7/29/2021, tested positive for covid 7/29/2021. discharged 8/14/2021, patient expired  Patient received Pfizer vaccine L deltoid lot numberFA6780 on 7/23/2021. Tested positive on 7/29/2021 after exposure. Writing  report since patient received vaccine and now critically ill and intubated to follow procedure. Patient intubated 8/7/2021  History Of Present Illness Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and the following day began having diarrhea and ""passed out"" 4 times since symptoms developed.  While on the floor the patient had been treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab, and had been improving, weaned from HFNC to 4L NC on 8/5.  On 8/6 the patient had worsening shortness of breath and was transition back to high-flow nasal cannula.  Today, 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia.  MICU was called and the patient was emergently intubated for acute hypoxic respiratory failure.     Past Medical History He has a past medical history of CKD (chronic kidney disease), stage IV (CMS/HCC), Gout, and Hypertension.  Assessment and Plan:  The patient is a 53 yo M with CKD4,HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    ARDS  COVID-19 PNA (POA) Pneumomediastinum, worsening  -XR chest with B/L peripheral and bibasilar opacities  -Inflammatory markers were up trending, will continue to monitor -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia, official read pending -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 124 PLAN:  - Evaluate to repeat CT chest with patient clinical decline.  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - ABG -Continue dexamethasone 6 mg daily (D6/10) -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx    AKI on CKD stage V not on Dialysis (POA) Hyperkalemia (POA) Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant PLAN:  -Nephrology following on floor, will notify of transfer to the ICU - Place Udall-- > IHD to start 8/7.  -Continue sodium bicarb 1300 TID, calcitriol and vitamin D2 at same doses -Strict I&O, Daily weights - Foley    Seizure-like activity - Patient with right-sided upper extremity and lower-extremity tonic activity following intubation.  - Prior to intubation, patient had EMV 15, appropriate and no focal deficits.  - Likely metabolic in nature, patient with BUN >100, sepsis, COVID  - No past history of seizures.  PLAN:  - TSH, B12, ammonia - EEG   Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:  -STOP coreg , HOLD home amlodipine  -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP today and as needed.    Suspected orthostatic syncope related to COVID-19 infection -Started prior to admission in the setting of ongoing diarrhea, nausea and poor PO intake -No episodes since, symptoms improved with adequate fluid resuscitation -EKG on admission with sinus tachycardia with no significant ST-T changes -PT/OT, recs home with assistance  Obesity (POA) - BMI 35.8, complicates all aspects of care.   Hospitalization Admit Date/Time: 7/29/2021 3:55 PM Admitting Attending:  Discharge Date: 08/14/21 Discharge Attending Physician:    8/9/2021 Assessment and Plan   The patient is a 53 yo M with CKD4, HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    Acute Respiratory Failure Requiring Mechanical Ventilation  Moderate ARDS  COVID-19 PNA (POA) Pneumomediastinum, stable Pneumopericardium, stable  HAP  -XR chest with B/L peripheral and bibasilar opacities  -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 127 - Started NMB on 8/8  PLAN:  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - DC nimbex today, PF ratio increased to 164 after paralytic  -Continue dexamethasone 6 mg daily (stop date 8/11)  -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx  -Empiric Cefepime for HAP--Follow up cultures from 8/7 - DC vanc    AKI on CKD stage V(POA) Hyperkalemia (POA)--resolving Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant -8/7: udall, failed IHD and converted to CRRT. PLAN:  - Nephrology following, appreciate recs  - Continue CRRT with goal net even  - Dose meds for CRRT  -Strict I&O, Daily weights   Shock, multifactorial  - Medication and sepsis related, stress induced CM - Received approx. 2 L IVF  - Cortisol 9.7 on 8/7 PLAN:  - Levophed for MAP >65 - Treatment of infections  - Defer stress steroids while on Dex, can evaluate to start stress HC Once steroids complete for Dex-ARDS.    Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:   -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP improving, weekly checks.    DM type 2 (POA) - Diet controlled at home.  PLAN:  - Start insulin gtt today, monitoring per protocol.    Hypertension - Hold Home meds until clinically appropriate.    Obesity (POA)- BMI 35.8, complicates all aspects of care  discharge note Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to UK ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and with reported syncopal events. Patient was treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab.     On 8/6 the patient had worsening shortness of breath with increasing oxygen requirements.  On 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia ultimately requiring intubation. Furthermore, a dialysis catheter was placed and CRRT was initiated. Broad spectrum ABX were continued. On 8/8, he required addition of NMB for continued ventilator dys-synchrony. He completed the dex-ARDS protocol on 8/10. The patient had a decline on 8/11 with a fever, worsening shock. He was started back on broad spectrum antibiotics, vasopressin in addition to levophed, and stress dose steroids. Unfortunately, Pt remained with persistent and profound hemodynamic instability. His response to aggressive live saving measures was minimal. WBC up to 80 with no infectious source able to be identified, escalation of ABX still continued. CT scans unable to be obtained secondary to risk of fatal event occurring if moved and/or transported to scanner. On 8/13, Pt going into arrythmias which further exacerbated further instability, required cardioversions X 3 and antiarrhythmic medications. Goals of care discussions completed with wife. Despite attempting to give Pt more time to possibly respond to treatments, his status remained critical. Wife came to see her husband at bedside to be with him briefly before he passed away. Pt passed away on 8/14 at 8:11.""
	"1655677-1"	"1655677-1"	"PERITONEAL CATHETER INSERTION"	"10085095"	"50-59 years"	"50-59"	""patient vaccinated 7/23/2021, admitted 7/29/2021, tested positive for covid 7/29/2021. discharged 8/14/2021, patient expired  Patient received Pfizer vaccine L deltoid lot numberFA6780 on 7/23/2021. Tested positive on 7/29/2021 after exposure. Writing  report since patient received vaccine and now critically ill and intubated to follow procedure. Patient intubated 8/7/2021  History Of Present Illness Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and the following day began having diarrhea and ""passed out"" 4 times since symptoms developed.  While on the floor the patient had been treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab, and had been improving, weaned from HFNC to 4L NC on 8/5.  On 8/6 the patient had worsening shortness of breath and was transition back to high-flow nasal cannula.  Today, 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia.  MICU was called and the patient was emergently intubated for acute hypoxic respiratory failure.     Past Medical History He has a past medical history of CKD (chronic kidney disease), stage IV (CMS/HCC), Gout, and Hypertension.  Assessment and Plan:  The patient is a 53 yo M with CKD4,HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    ARDS  COVID-19 PNA (POA) Pneumomediastinum, worsening  -XR chest with B/L peripheral and bibasilar opacities  -Inflammatory markers were up trending, will continue to monitor -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia, official read pending -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 124 PLAN:  - Evaluate to repeat CT chest with patient clinical decline.  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - ABG -Continue dexamethasone 6 mg daily (D6/10) -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx    AKI on CKD stage V not on Dialysis (POA) Hyperkalemia (POA) Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant PLAN:  -Nephrology following on floor, will notify of transfer to the ICU - Place Udall-- > IHD to start 8/7.  -Continue sodium bicarb 1300 TID, calcitriol and vitamin D2 at same doses -Strict I&O, Daily weights - Foley    Seizure-like activity - Patient with right-sided upper extremity and lower-extremity tonic activity following intubation.  - Prior to intubation, patient had EMV 15, appropriate and no focal deficits.  - Likely metabolic in nature, patient with BUN >100, sepsis, COVID  - No past history of seizures.  PLAN:  - TSH, B12, ammonia - EEG   Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:  -STOP coreg , HOLD home amlodipine  -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP today and as needed.    Suspected orthostatic syncope related to COVID-19 infection -Started prior to admission in the setting of ongoing diarrhea, nausea and poor PO intake -No episodes since, symptoms improved with adequate fluid resuscitation -EKG on admission with sinus tachycardia with no significant ST-T changes -PT/OT, recs home with assistance  Obesity (POA) - BMI 35.8, complicates all aspects of care.   Hospitalization Admit Date/Time: 7/29/2021 3:55 PM Admitting Attending:  Discharge Date: 08/14/21 Discharge Attending Physician:    8/9/2021 Assessment and Plan   The patient is a 53 yo M with CKD4, HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    Acute Respiratory Failure Requiring Mechanical Ventilation  Moderate ARDS  COVID-19 PNA (POA) Pneumomediastinum, stable Pneumopericardium, stable  HAP  -XR chest with B/L peripheral and bibasilar opacities  -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 127 - Started NMB on 8/8  PLAN:  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - DC nimbex today, PF ratio increased to 164 after paralytic  -Continue dexamethasone 6 mg daily (stop date 8/11)  -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx  -Empiric Cefepime for HAP--Follow up cultures from 8/7 - DC vanc    AKI on CKD stage V(POA) Hyperkalemia (POA)--resolving Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant -8/7: udall, failed IHD and converted to CRRT. PLAN:  - Nephrology following, appreciate recs  - Continue CRRT with goal net even  - Dose meds for CRRT  -Strict I&O, Daily weights   Shock, multifactorial  - Medication and sepsis related, stress induced CM - Received approx. 2 L IVF  - Cortisol 9.7 on 8/7 PLAN:  - Levophed for MAP >65 - Treatment of infections  - Defer stress steroids while on Dex, can evaluate to start stress HC Once steroids complete for Dex-ARDS.    Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:   -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP improving, weekly checks.    DM type 2 (POA) - Diet controlled at home.  PLAN:  - Start insulin gtt today, monitoring per protocol.    Hypertension - Hold Home meds until clinically appropriate.    Obesity (POA)- BMI 35.8, complicates all aspects of care  discharge note Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to UK ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and with reported syncopal events. Patient was treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab.     On 8/6 the patient had worsening shortness of breath with increasing oxygen requirements.  On 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia ultimately requiring intubation. Furthermore, a dialysis catheter was placed and CRRT was initiated. Broad spectrum ABX were continued. On 8/8, he required addition of NMB for continued ventilator dys-synchrony. He completed the dex-ARDS protocol on 8/10. The patient had a decline on 8/11 with a fever, worsening shock. He was started back on broad spectrum antibiotics, vasopressin in addition to levophed, and stress dose steroids. Unfortunately, Pt remained with persistent and profound hemodynamic instability. His response to aggressive live saving measures was minimal. WBC up to 80 with no infectious source able to be identified, escalation of ABX still continued. CT scans unable to be obtained secondary to risk of fatal event occurring if moved and/or transported to scanner. On 8/13, Pt going into arrythmias which further exacerbated further instability, required cardioversions X 3 and antiarrhythmic medications. Goals of care discussions completed with wife. Despite attempting to give Pt more time to possibly respond to treatments, his status remained critical. Wife came to see her husband at bedside to be with him briefly before he passed away. Pt passed away on 8/14 at 8:11.""
	"1655677-1"	"1655677-1"	"PNEUMOMEDIASTINUM"	"10050184"	"50-59 years"	"50-59"	""patient vaccinated 7/23/2021, admitted 7/29/2021, tested positive for covid 7/29/2021. discharged 8/14/2021, patient expired  Patient received Pfizer vaccine L deltoid lot numberFA6780 on 7/23/2021. Tested positive on 7/29/2021 after exposure. Writing  report since patient received vaccine and now critically ill and intubated to follow procedure. Patient intubated 8/7/2021  History Of Present Illness Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and the following day began having diarrhea and ""passed out"" 4 times since symptoms developed.  While on the floor the patient had been treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab, and had been improving, weaned from HFNC to 4L NC on 8/5.  On 8/6 the patient had worsening shortness of breath and was transition back to high-flow nasal cannula.  Today, 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia.  MICU was called and the patient was emergently intubated for acute hypoxic respiratory failure.     Past Medical History He has a past medical history of CKD (chronic kidney disease), stage IV (CMS/HCC), Gout, and Hypertension.  Assessment and Plan:  The patient is a 53 yo M with CKD4,HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    ARDS  COVID-19 PNA (POA) Pneumomediastinum, worsening  -XR chest with B/L peripheral and bibasilar opacities  -Inflammatory markers were up trending, will continue to monitor -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia, official read pending -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 124 PLAN:  - Evaluate to repeat CT chest with patient clinical decline.  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - ABG -Continue dexamethasone 6 mg daily (D6/10) -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx    AKI on CKD stage V not on Dialysis (POA) Hyperkalemia (POA) Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant PLAN:  -Nephrology following on floor, will notify of transfer to the ICU - Place Udall-- > IHD to start 8/7.  -Continue sodium bicarb 1300 TID, calcitriol and vitamin D2 at same doses -Strict I&O, Daily weights - Foley    Seizure-like activity - Patient with right-sided upper extremity and lower-extremity tonic activity following intubation.  - Prior to intubation, patient had EMV 15, appropriate and no focal deficits.  - Likely metabolic in nature, patient with BUN >100, sepsis, COVID  - No past history of seizures.  PLAN:  - TSH, B12, ammonia - EEG   Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:  -STOP coreg , HOLD home amlodipine  -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP today and as needed.    Suspected orthostatic syncope related to COVID-19 infection -Started prior to admission in the setting of ongoing diarrhea, nausea and poor PO intake -No episodes since, symptoms improved with adequate fluid resuscitation -EKG on admission with sinus tachycardia with no significant ST-T changes -PT/OT, recs home with assistance  Obesity (POA) - BMI 35.8, complicates all aspects of care.   Hospitalization Admit Date/Time: 7/29/2021 3:55 PM Admitting Attending:  Discharge Date: 08/14/21 Discharge Attending Physician:    8/9/2021 Assessment and Plan   The patient is a 53 yo M with CKD4, HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    Acute Respiratory Failure Requiring Mechanical Ventilation  Moderate ARDS  COVID-19 PNA (POA) Pneumomediastinum, stable Pneumopericardium, stable  HAP  -XR chest with B/L peripheral and bibasilar opacities  -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 127 - Started NMB on 8/8  PLAN:  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - DC nimbex today, PF ratio increased to 164 after paralytic  -Continue dexamethasone 6 mg daily (stop date 8/11)  -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx  -Empiric Cefepime for HAP--Follow up cultures from 8/7 - DC vanc    AKI on CKD stage V(POA) Hyperkalemia (POA)--resolving Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant -8/7: udall, failed IHD and converted to CRRT. PLAN:  - Nephrology following, appreciate recs  - Continue CRRT with goal net even  - Dose meds for CRRT  -Strict I&O, Daily weights   Shock, multifactorial  - Medication and sepsis related, stress induced CM - Received approx. 2 L IVF  - Cortisol 9.7 on 8/7 PLAN:  - Levophed for MAP >65 - Treatment of infections  - Defer stress steroids while on Dex, can evaluate to start stress HC Once steroids complete for Dex-ARDS.    Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:   -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP improving, weekly checks.    DM type 2 (POA) - Diet controlled at home.  PLAN:  - Start insulin gtt today, monitoring per protocol.    Hypertension - Hold Home meds until clinically appropriate.    Obesity (POA)- BMI 35.8, complicates all aspects of care  discharge note Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to UK ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and with reported syncopal events. Patient was treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab.     On 8/6 the patient had worsening shortness of breath with increasing oxygen requirements.  On 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia ultimately requiring intubation. Furthermore, a dialysis catheter was placed and CRRT was initiated. Broad spectrum ABX were continued. On 8/8, he required addition of NMB for continued ventilator dys-synchrony. He completed the dex-ARDS protocol on 8/10. The patient had a decline on 8/11 with a fever, worsening shock. He was started back on broad spectrum antibiotics, vasopressin in addition to levophed, and stress dose steroids. Unfortunately, Pt remained with persistent and profound hemodynamic instability. His response to aggressive live saving measures was minimal. WBC up to 80 with no infectious source able to be identified, escalation of ABX still continued. CT scans unable to be obtained secondary to risk of fatal event occurring if moved and/or transported to scanner. On 8/13, Pt going into arrythmias which further exacerbated further instability, required cardioversions X 3 and antiarrhythmic medications. Goals of care discussions completed with wife. Despite attempting to give Pt more time to possibly respond to treatments, his status remained critical. Wife came to see her husband at bedside to be with him briefly before he passed away. Pt passed away on 8/14 at 8:11.""
	"1655677-1"	"1655677-1"	"PNEUMONIA"	"10035664"	"50-59 years"	"50-59"	""patient vaccinated 7/23/2021, admitted 7/29/2021, tested positive for covid 7/29/2021. discharged 8/14/2021, patient expired  Patient received Pfizer vaccine L deltoid lot numberFA6780 on 7/23/2021. Tested positive on 7/29/2021 after exposure. Writing  report since patient received vaccine and now critically ill and intubated to follow procedure. Patient intubated 8/7/2021  History Of Present Illness Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and the following day began having diarrhea and ""passed out"" 4 times since symptoms developed.  While on the floor the patient had been treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab, and had been improving, weaned from HFNC to 4L NC on 8/5.  On 8/6 the patient had worsening shortness of breath and was transition back to high-flow nasal cannula.  Today, 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia.  MICU was called and the patient was emergently intubated for acute hypoxic respiratory failure.     Past Medical History He has a past medical history of CKD (chronic kidney disease), stage IV (CMS/HCC), Gout, and Hypertension.  Assessment and Plan:  The patient is a 53 yo M with CKD4,HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    ARDS  COVID-19 PNA (POA) Pneumomediastinum, worsening  -XR chest with B/L peripheral and bibasilar opacities  -Inflammatory markers were up trending, will continue to monitor -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia, official read pending -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 124 PLAN:  - Evaluate to repeat CT chest with patient clinical decline.  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - ABG -Continue dexamethasone 6 mg daily (D6/10) -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx    AKI on CKD stage V not on Dialysis (POA) Hyperkalemia (POA) Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant PLAN:  -Nephrology following on floor, will notify of transfer to the ICU - Place Udall-- > IHD to start 8/7.  -Continue sodium bicarb 1300 TID, calcitriol and vitamin D2 at same doses -Strict I&O, Daily weights - Foley    Seizure-like activity - Patient with right-sided upper extremity and lower-extremity tonic activity following intubation.  - Prior to intubation, patient had EMV 15, appropriate and no focal deficits.  - Likely metabolic in nature, patient with BUN >100, sepsis, COVID  - No past history of seizures.  PLAN:  - TSH, B12, ammonia - EEG   Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:  -STOP coreg , HOLD home amlodipine  -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP today and as needed.    Suspected orthostatic syncope related to COVID-19 infection -Started prior to admission in the setting of ongoing diarrhea, nausea and poor PO intake -No episodes since, symptoms improved with adequate fluid resuscitation -EKG on admission with sinus tachycardia with no significant ST-T changes -PT/OT, recs home with assistance  Obesity (POA) - BMI 35.8, complicates all aspects of care.   Hospitalization Admit Date/Time: 7/29/2021 3:55 PM Admitting Attending:  Discharge Date: 08/14/21 Discharge Attending Physician:    8/9/2021 Assessment and Plan   The patient is a 53 yo M with CKD4, HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    Acute Respiratory Failure Requiring Mechanical Ventilation  Moderate ARDS  COVID-19 PNA (POA) Pneumomediastinum, stable Pneumopericardium, stable  HAP  -XR chest with B/L peripheral and bibasilar opacities  -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 127 - Started NMB on 8/8  PLAN:  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - DC nimbex today, PF ratio increased to 164 after paralytic  -Continue dexamethasone 6 mg daily (stop date 8/11)  -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx  -Empiric Cefepime for HAP--Follow up cultures from 8/7 - DC vanc    AKI on CKD stage V(POA) Hyperkalemia (POA)--resolving Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant -8/7: udall, failed IHD and converted to CRRT. PLAN:  - Nephrology following, appreciate recs  - Continue CRRT with goal net even  - Dose meds for CRRT  -Strict I&O, Daily weights   Shock, multifactorial  - Medication and sepsis related, stress induced CM - Received approx. 2 L IVF  - Cortisol 9.7 on 8/7 PLAN:  - Levophed for MAP >65 - Treatment of infections  - Defer stress steroids while on Dex, can evaluate to start stress HC Once steroids complete for Dex-ARDS.    Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:   -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP improving, weekly checks.    DM type 2 (POA) - Diet controlled at home.  PLAN:  - Start insulin gtt today, monitoring per protocol.    Hypertension - Hold Home meds until clinically appropriate.    Obesity (POA)- BMI 35.8, complicates all aspects of care  discharge note Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to UK ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and with reported syncopal events. Patient was treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab.     On 8/6 the patient had worsening shortness of breath with increasing oxygen requirements.  On 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia ultimately requiring intubation. Furthermore, a dialysis catheter was placed and CRRT was initiated. Broad spectrum ABX were continued. On 8/8, he required addition of NMB for continued ventilator dys-synchrony. He completed the dex-ARDS protocol on 8/10. The patient had a decline on 8/11 with a fever, worsening shock. He was started back on broad spectrum antibiotics, vasopressin in addition to levophed, and stress dose steroids. Unfortunately, Pt remained with persistent and profound hemodynamic instability. His response to aggressive live saving measures was minimal. WBC up to 80 with no infectious source able to be identified, escalation of ABX still continued. CT scans unable to be obtained secondary to risk of fatal event occurring if moved and/or transported to scanner. On 8/13, Pt going into arrythmias which further exacerbated further instability, required cardioversions X 3 and antiarrhythmic medications. Goals of care discussions completed with wife. Despite attempting to give Pt more time to possibly respond to treatments, his status remained critical. Wife came to see her husband at bedside to be with him briefly before he passed away. Pt passed away on 8/14 at 8:11.""
	"1655677-1"	"1655677-1"	"PYREXIA"	"10037660"	"50-59 years"	"50-59"	""patient vaccinated 7/23/2021, admitted 7/29/2021, tested positive for covid 7/29/2021. discharged 8/14/2021, patient expired  Patient received Pfizer vaccine L deltoid lot numberFA6780 on 7/23/2021. Tested positive on 7/29/2021 after exposure. Writing  report since patient received vaccine and now critically ill and intubated to follow procedure. Patient intubated 8/7/2021  History Of Present Illness Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and the following day began having diarrhea and ""passed out"" 4 times since symptoms developed.  While on the floor the patient had been treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab, and had been improving, weaned from HFNC to 4L NC on 8/5.  On 8/6 the patient had worsening shortness of breath and was transition back to high-flow nasal cannula.  Today, 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia.  MICU was called and the patient was emergently intubated for acute hypoxic respiratory failure.     Past Medical History He has a past medical history of CKD (chronic kidney disease), stage IV (CMS/HCC), Gout, and Hypertension.  Assessment and Plan:  The patient is a 53 yo M with CKD4,HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    ARDS  COVID-19 PNA (POA) Pneumomediastinum, worsening  -XR chest with B/L peripheral and bibasilar opacities  -Inflammatory markers were up trending, will continue to monitor -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia, official read pending -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 124 PLAN:  - Evaluate to repeat CT chest with patient clinical decline.  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - ABG -Continue dexamethasone 6 mg daily (D6/10) -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx    AKI on CKD stage V not on Dialysis (POA) Hyperkalemia (POA) Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant PLAN:  -Nephrology following on floor, will notify of transfer to the ICU - Place Udall-- > IHD to start 8/7.  -Continue sodium bicarb 1300 TID, calcitriol and vitamin D2 at same doses -Strict I&O, Daily weights - Foley    Seizure-like activity - Patient with right-sided upper extremity and lower-extremity tonic activity following intubation.  - Prior to intubation, patient had EMV 15, appropriate and no focal deficits.  - Likely metabolic in nature, patient with BUN >100, sepsis, COVID  - No past history of seizures.  PLAN:  - TSH, B12, ammonia - EEG   Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:  -STOP coreg , HOLD home amlodipine  -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP today and as needed.    Suspected orthostatic syncope related to COVID-19 infection -Started prior to admission in the setting of ongoing diarrhea, nausea and poor PO intake -No episodes since, symptoms improved with adequate fluid resuscitation -EKG on admission with sinus tachycardia with no significant ST-T changes -PT/OT, recs home with assistance  Obesity (POA) - BMI 35.8, complicates all aspects of care.   Hospitalization Admit Date/Time: 7/29/2021 3:55 PM Admitting Attending:  Discharge Date: 08/14/21 Discharge Attending Physician:    8/9/2021 Assessment and Plan   The patient is a 53 yo M with CKD4, HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    Acute Respiratory Failure Requiring Mechanical Ventilation  Moderate ARDS  COVID-19 PNA (POA) Pneumomediastinum, stable Pneumopericardium, stable  HAP  -XR chest with B/L peripheral and bibasilar opacities  -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 127 - Started NMB on 8/8  PLAN:  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - DC nimbex today, PF ratio increased to 164 after paralytic  -Continue dexamethasone 6 mg daily (stop date 8/11)  -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx  -Empiric Cefepime for HAP--Follow up cultures from 8/7 - DC vanc    AKI on CKD stage V(POA) Hyperkalemia (POA)--resolving Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant -8/7: udall, failed IHD and converted to CRRT. PLAN:  - Nephrology following, appreciate recs  - Continue CRRT with goal net even  - Dose meds for CRRT  -Strict I&O, Daily weights   Shock, multifactorial  - Medication and sepsis related, stress induced CM - Received approx. 2 L IVF  - Cortisol 9.7 on 8/7 PLAN:  - Levophed for MAP >65 - Treatment of infections  - Defer stress steroids while on Dex, can evaluate to start stress HC Once steroids complete for Dex-ARDS.    Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:   -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP improving, weekly checks.    DM type 2 (POA) - Diet controlled at home.  PLAN:  - Start insulin gtt today, monitoring per protocol.    Hypertension - Hold Home meds until clinically appropriate.    Obesity (POA)- BMI 35.8, complicates all aspects of care  discharge note Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to UK ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and with reported syncopal events. Patient was treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab.     On 8/6 the patient had worsening shortness of breath with increasing oxygen requirements.  On 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia ultimately requiring intubation. Furthermore, a dialysis catheter was placed and CRRT was initiated. Broad spectrum ABX were continued. On 8/8, he required addition of NMB for continued ventilator dys-synchrony. He completed the dex-ARDS protocol on 8/10. The patient had a decline on 8/11 with a fever, worsening shock. He was started back on broad spectrum antibiotics, vasopressin in addition to levophed, and stress dose steroids. Unfortunately, Pt remained with persistent and profound hemodynamic instability. His response to aggressive live saving measures was minimal. WBC up to 80 with no infectious source able to be identified, escalation of ABX still continued. CT scans unable to be obtained secondary to risk of fatal event occurring if moved and/or transported to scanner. On 8/13, Pt going into arrythmias which further exacerbated further instability, required cardioversions X 3 and antiarrhythmic medications. Goals of care discussions completed with wife. Despite attempting to give Pt more time to possibly respond to treatments, his status remained critical. Wife came to see her husband at bedside to be with him briefly before he passed away. Pt passed away on 8/14 at 8:11.""
	"1655677-1"	"1655677-1"	"RENAL REPLACEMENT THERAPY"	"10074746"	"50-59 years"	"50-59"	""patient vaccinated 7/23/2021, admitted 7/29/2021, tested positive for covid 7/29/2021. discharged 8/14/2021, patient expired  Patient received Pfizer vaccine L deltoid lot numberFA6780 on 7/23/2021. Tested positive on 7/29/2021 after exposure. Writing  report since patient received vaccine and now critically ill and intubated to follow procedure. Patient intubated 8/7/2021  History Of Present Illness Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and the following day began having diarrhea and ""passed out"" 4 times since symptoms developed.  While on the floor the patient had been treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab, and had been improving, weaned from HFNC to 4L NC on 8/5.  On 8/6 the patient had worsening shortness of breath and was transition back to high-flow nasal cannula.  Today, 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia.  MICU was called and the patient was emergently intubated for acute hypoxic respiratory failure.     Past Medical History He has a past medical history of CKD (chronic kidney disease), stage IV (CMS/HCC), Gout, and Hypertension.  Assessment and Plan:  The patient is a 53 yo M with CKD4,HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    ARDS  COVID-19 PNA (POA) Pneumomediastinum, worsening  -XR chest with B/L peripheral and bibasilar opacities  -Inflammatory markers were up trending, will continue to monitor -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia, official read pending -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 124 PLAN:  - Evaluate to repeat CT chest with patient clinical decline.  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - ABG -Continue dexamethasone 6 mg daily (D6/10) -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx    AKI on CKD stage V not on Dialysis (POA) Hyperkalemia (POA) Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant PLAN:  -Nephrology following on floor, will notify of transfer to the ICU - Place Udall-- > IHD to start 8/7.  -Continue sodium bicarb 1300 TID, calcitriol and vitamin D2 at same doses -Strict I&O, Daily weights - Foley    Seizure-like activity - Patient with right-sided upper extremity and lower-extremity tonic activity following intubation.  - Prior to intubation, patient had EMV 15, appropriate and no focal deficits.  - Likely metabolic in nature, patient with BUN >100, sepsis, COVID  - No past history of seizures.  PLAN:  - TSH, B12, ammonia - EEG   Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:  -STOP coreg , HOLD home amlodipine  -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP today and as needed.    Suspected orthostatic syncope related to COVID-19 infection -Started prior to admission in the setting of ongoing diarrhea, nausea and poor PO intake -No episodes since, symptoms improved with adequate fluid resuscitation -EKG on admission with sinus tachycardia with no significant ST-T changes -PT/OT, recs home with assistance  Obesity (POA) - BMI 35.8, complicates all aspects of care.   Hospitalization Admit Date/Time: 7/29/2021 3:55 PM Admitting Attending:  Discharge Date: 08/14/21 Discharge Attending Physician:    8/9/2021 Assessment and Plan   The patient is a 53 yo M with CKD4, HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    Acute Respiratory Failure Requiring Mechanical Ventilation  Moderate ARDS  COVID-19 PNA (POA) Pneumomediastinum, stable Pneumopericardium, stable  HAP  -XR chest with B/L peripheral and bibasilar opacities  -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 127 - Started NMB on 8/8  PLAN:  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - DC nimbex today, PF ratio increased to 164 after paralytic  -Continue dexamethasone 6 mg daily (stop date 8/11)  -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx  -Empiric Cefepime for HAP--Follow up cultures from 8/7 - DC vanc    AKI on CKD stage V(POA) Hyperkalemia (POA)--resolving Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant -8/7: udall, failed IHD and converted to CRRT. PLAN:  - Nephrology following, appreciate recs  - Continue CRRT with goal net even  - Dose meds for CRRT  -Strict I&O, Daily weights   Shock, multifactorial  - Medication and sepsis related, stress induced CM - Received approx. 2 L IVF  - Cortisol 9.7 on 8/7 PLAN:  - Levophed for MAP >65 - Treatment of infections  - Defer stress steroids while on Dex, can evaluate to start stress HC Once steroids complete for Dex-ARDS.    Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:   -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP improving, weekly checks.    DM type 2 (POA) - Diet controlled at home.  PLAN:  - Start insulin gtt today, monitoring per protocol.    Hypertension - Hold Home meds until clinically appropriate.    Obesity (POA)- BMI 35.8, complicates all aspects of care  discharge note Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to UK ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and with reported syncopal events. Patient was treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab.     On 8/6 the patient had worsening shortness of breath with increasing oxygen requirements.  On 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia ultimately requiring intubation. Furthermore, a dialysis catheter was placed and CRRT was initiated. Broad spectrum ABX were continued. On 8/8, he required addition of NMB for continued ventilator dys-synchrony. He completed the dex-ARDS protocol on 8/10. The patient had a decline on 8/11 with a fever, worsening shock. He was started back on broad spectrum antibiotics, vasopressin in addition to levophed, and stress dose steroids. Unfortunately, Pt remained with persistent and profound hemodynamic instability. His response to aggressive live saving measures was minimal. WBC up to 80 with no infectious source able to be identified, escalation of ABX still continued. CT scans unable to be obtained secondary to risk of fatal event occurring if moved and/or transported to scanner. On 8/13, Pt going into arrythmias which further exacerbated further instability, required cardioversions X 3 and antiarrhythmic medications. Goals of care discussions completed with wife. Despite attempting to give Pt more time to possibly respond to treatments, his status remained critical. Wife came to see her husband at bedside to be with him briefly before he passed away. Pt passed away on 8/14 at 8:11.""
	"1655677-1"	"1655677-1"	"RESPIRATORY DISTRESS"	"10038687"	"50-59 years"	"50-59"	""patient vaccinated 7/23/2021, admitted 7/29/2021, tested positive for covid 7/29/2021. discharged 8/14/2021, patient expired  Patient received Pfizer vaccine L deltoid lot numberFA6780 on 7/23/2021. Tested positive on 7/29/2021 after exposure. Writing  report since patient received vaccine and now critically ill and intubated to follow procedure. Patient intubated 8/7/2021  History Of Present Illness Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and the following day began having diarrhea and ""passed out"" 4 times since symptoms developed.  While on the floor the patient had been treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab, and had been improving, weaned from HFNC to 4L NC on 8/5.  On 8/6 the patient had worsening shortness of breath and was transition back to high-flow nasal cannula.  Today, 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia.  MICU was called and the patient was emergently intubated for acute hypoxic respiratory failure.     Past Medical History He has a past medical history of CKD (chronic kidney disease), stage IV (CMS/HCC), Gout, and Hypertension.  Assessment and Plan:  The patient is a 53 yo M with CKD4,HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    ARDS  COVID-19 PNA (POA) Pneumomediastinum, worsening  -XR chest with B/L peripheral and bibasilar opacities  -Inflammatory markers were up trending, will continue to monitor -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia, official read pending -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 124 PLAN:  - Evaluate to repeat CT chest with patient clinical decline.  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - ABG -Continue dexamethasone 6 mg daily (D6/10) -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx    AKI on CKD stage V not on Dialysis (POA) Hyperkalemia (POA) Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant PLAN:  -Nephrology following on floor, will notify of transfer to the ICU - Place Udall-- > IHD to start 8/7.  -Continue sodium bicarb 1300 TID, calcitriol and vitamin D2 at same doses -Strict I&O, Daily weights - Foley    Seizure-like activity - Patient with right-sided upper extremity and lower-extremity tonic activity following intubation.  - Prior to intubation, patient had EMV 15, appropriate and no focal deficits.  - Likely metabolic in nature, patient with BUN >100, sepsis, COVID  - No past history of seizures.  PLAN:  - TSH, B12, ammonia - EEG   Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:  -STOP coreg , HOLD home amlodipine  -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP today and as needed.    Suspected orthostatic syncope related to COVID-19 infection -Started prior to admission in the setting of ongoing diarrhea, nausea and poor PO intake -No episodes since, symptoms improved with adequate fluid resuscitation -EKG on admission with sinus tachycardia with no significant ST-T changes -PT/OT, recs home with assistance  Obesity (POA) - BMI 35.8, complicates all aspects of care.   Hospitalization Admit Date/Time: 7/29/2021 3:55 PM Admitting Attending:  Discharge Date: 08/14/21 Discharge Attending Physician:    8/9/2021 Assessment and Plan   The patient is a 53 yo M with CKD4, HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    Acute Respiratory Failure Requiring Mechanical Ventilation  Moderate ARDS  COVID-19 PNA (POA) Pneumomediastinum, stable Pneumopericardium, stable  HAP  -XR chest with B/L peripheral and bibasilar opacities  -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 127 - Started NMB on 8/8  PLAN:  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - DC nimbex today, PF ratio increased to 164 after paralytic  -Continue dexamethasone 6 mg daily (stop date 8/11)  -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx  -Empiric Cefepime for HAP--Follow up cultures from 8/7 - DC vanc    AKI on CKD stage V(POA) Hyperkalemia (POA)--resolving Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant -8/7: udall, failed IHD and converted to CRRT. PLAN:  - Nephrology following, appreciate recs  - Continue CRRT with goal net even  - Dose meds for CRRT  -Strict I&O, Daily weights   Shock, multifactorial  - Medication and sepsis related, stress induced CM - Received approx. 2 L IVF  - Cortisol 9.7 on 8/7 PLAN:  - Levophed for MAP >65 - Treatment of infections  - Defer stress steroids while on Dex, can evaluate to start stress HC Once steroids complete for Dex-ARDS.    Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:   -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP improving, weekly checks.    DM type 2 (POA) - Diet controlled at home.  PLAN:  - Start insulin gtt today, monitoring per protocol.    Hypertension - Hold Home meds until clinically appropriate.    Obesity (POA)- BMI 35.8, complicates all aspects of care  discharge note Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to UK ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and with reported syncopal events. Patient was treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab.     On 8/6 the patient had worsening shortness of breath with increasing oxygen requirements.  On 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia ultimately requiring intubation. Furthermore, a dialysis catheter was placed and CRRT was initiated. Broad spectrum ABX were continued. On 8/8, he required addition of NMB for continued ventilator dys-synchrony. He completed the dex-ARDS protocol on 8/10. The patient had a decline on 8/11 with a fever, worsening shock. He was started back on broad spectrum antibiotics, vasopressin in addition to levophed, and stress dose steroids. Unfortunately, Pt remained with persistent and profound hemodynamic instability. His response to aggressive live saving measures was minimal. WBC up to 80 with no infectious source able to be identified, escalation of ABX still continued. CT scans unable to be obtained secondary to risk of fatal event occurring if moved and/or transported to scanner. On 8/13, Pt going into arrythmias which further exacerbated further instability, required cardioversions X 3 and antiarrhythmic medications. Goals of care discussions completed with wife. Despite attempting to give Pt more time to possibly respond to treatments, his status remained critical. Wife came to see her husband at bedside to be with him briefly before he passed away. Pt passed away on 8/14 at 8:11.""
	"1655677-1"	"1655677-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	""patient vaccinated 7/23/2021, admitted 7/29/2021, tested positive for covid 7/29/2021. discharged 8/14/2021, patient expired  Patient received Pfizer vaccine L deltoid lot numberFA6780 on 7/23/2021. Tested positive on 7/29/2021 after exposure. Writing  report since patient received vaccine and now critically ill and intubated to follow procedure. Patient intubated 8/7/2021  History Of Present Illness Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and the following day began having diarrhea and ""passed out"" 4 times since symptoms developed.  While on the floor the patient had been treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab, and had been improving, weaned from HFNC to 4L NC on 8/5.  On 8/6 the patient had worsening shortness of breath and was transition back to high-flow nasal cannula.  Today, 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia.  MICU was called and the patient was emergently intubated for acute hypoxic respiratory failure.     Past Medical History He has a past medical history of CKD (chronic kidney disease), stage IV (CMS/HCC), Gout, and Hypertension.  Assessment and Plan:  The patient is a 53 yo M with CKD4,HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    ARDS  COVID-19 PNA (POA) Pneumomediastinum, worsening  -XR chest with B/L peripheral and bibasilar opacities  -Inflammatory markers were up trending, will continue to monitor -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia, official read pending -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 124 PLAN:  - Evaluate to repeat CT chest with patient clinical decline.  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - ABG -Continue dexamethasone 6 mg daily (D6/10) -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx    AKI on CKD stage V not on Dialysis (POA) Hyperkalemia (POA) Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant PLAN:  -Nephrology following on floor, will notify of transfer to the ICU - Place Udall-- > IHD to start 8/7.  -Continue sodium bicarb 1300 TID, calcitriol and vitamin D2 at same doses -Strict I&O, Daily weights - Foley    Seizure-like activity - Patient with right-sided upper extremity and lower-extremity tonic activity following intubation.  - Prior to intubation, patient had EMV 15, appropriate and no focal deficits.  - Likely metabolic in nature, patient with BUN >100, sepsis, COVID  - No past history of seizures.  PLAN:  - TSH, B12, ammonia - EEG   Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:  -STOP coreg , HOLD home amlodipine  -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP today and as needed.    Suspected orthostatic syncope related to COVID-19 infection -Started prior to admission in the setting of ongoing diarrhea, nausea and poor PO intake -No episodes since, symptoms improved with adequate fluid resuscitation -EKG on admission with sinus tachycardia with no significant ST-T changes -PT/OT, recs home with assistance  Obesity (POA) - BMI 35.8, complicates all aspects of care.   Hospitalization Admit Date/Time: 7/29/2021 3:55 PM Admitting Attending:  Discharge Date: 08/14/21 Discharge Attending Physician:    8/9/2021 Assessment and Plan   The patient is a 53 yo M with CKD4, HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    Acute Respiratory Failure Requiring Mechanical Ventilation  Moderate ARDS  COVID-19 PNA (POA) Pneumomediastinum, stable Pneumopericardium, stable  HAP  -XR chest with B/L peripheral and bibasilar opacities  -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 127 - Started NMB on 8/8  PLAN:  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - DC nimbex today, PF ratio increased to 164 after paralytic  -Continue dexamethasone 6 mg daily (stop date 8/11)  -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx  -Empiric Cefepime for HAP--Follow up cultures from 8/7 - DC vanc    AKI on CKD stage V(POA) Hyperkalemia (POA)--resolving Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant -8/7: udall, failed IHD and converted to CRRT. PLAN:  - Nephrology following, appreciate recs  - Continue CRRT with goal net even  - Dose meds for CRRT  -Strict I&O, Daily weights   Shock, multifactorial  - Medication and sepsis related, stress induced CM - Received approx. 2 L IVF  - Cortisol 9.7 on 8/7 PLAN:  - Levophed for MAP >65 - Treatment of infections  - Defer stress steroids while on Dex, can evaluate to start stress HC Once steroids complete for Dex-ARDS.    Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:   -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP improving, weekly checks.    DM type 2 (POA) - Diet controlled at home.  PLAN:  - Start insulin gtt today, monitoring per protocol.    Hypertension - Hold Home meds until clinically appropriate.    Obesity (POA)- BMI 35.8, complicates all aspects of care  discharge note Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to UK ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and with reported syncopal events. Patient was treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab.     On 8/6 the patient had worsening shortness of breath with increasing oxygen requirements.  On 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia ultimately requiring intubation. Furthermore, a dialysis catheter was placed and CRRT was initiated. Broad spectrum ABX were continued. On 8/8, he required addition of NMB for continued ventilator dys-synchrony. He completed the dex-ARDS protocol on 8/10. The patient had a decline on 8/11 with a fever, worsening shock. He was started back on broad spectrum antibiotics, vasopressin in addition to levophed, and stress dose steroids. Unfortunately, Pt remained with persistent and profound hemodynamic instability. His response to aggressive live saving measures was minimal. WBC up to 80 with no infectious source able to be identified, escalation of ABX still continued. CT scans unable to be obtained secondary to risk of fatal event occurring if moved and/or transported to scanner. On 8/13, Pt going into arrythmias which further exacerbated further instability, required cardioversions X 3 and antiarrhythmic medications. Goals of care discussions completed with wife. Despite attempting to give Pt more time to possibly respond to treatments, his status remained critical. Wife came to see her husband at bedside to be with him briefly before he passed away. Pt passed away on 8/14 at 8:11.""
	"1655677-1"	"1655677-1"	"SEIZURE LIKE PHENOMENA"	"10071048"	"50-59 years"	"50-59"	""patient vaccinated 7/23/2021, admitted 7/29/2021, tested positive for covid 7/29/2021. discharged 8/14/2021, patient expired  Patient received Pfizer vaccine L deltoid lot numberFA6780 on 7/23/2021. Tested positive on 7/29/2021 after exposure. Writing  report since patient received vaccine and now critically ill and intubated to follow procedure. Patient intubated 8/7/2021  History Of Present Illness Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and the following day began having diarrhea and ""passed out"" 4 times since symptoms developed.  While on the floor the patient had been treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab, and had been improving, weaned from HFNC to 4L NC on 8/5.  On 8/6 the patient had worsening shortness of breath and was transition back to high-flow nasal cannula.  Today, 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia.  MICU was called and the patient was emergently intubated for acute hypoxic respiratory failure.     Past Medical History He has a past medical history of CKD (chronic kidney disease), stage IV (CMS/HCC), Gout, and Hypertension.  Assessment and Plan:  The patient is a 53 yo M with CKD4,HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    ARDS  COVID-19 PNA (POA) Pneumomediastinum, worsening  -XR chest with B/L peripheral and bibasilar opacities  -Inflammatory markers were up trending, will continue to monitor -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia, official read pending -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 124 PLAN:  - Evaluate to repeat CT chest with patient clinical decline.  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - ABG -Continue dexamethasone 6 mg daily (D6/10) -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx    AKI on CKD stage V not on Dialysis (POA) Hyperkalemia (POA) Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant PLAN:  -Nephrology following on floor, will notify of transfer to the ICU - Place Udall-- > IHD to start 8/7.  -Continue sodium bicarb 1300 TID, calcitriol and vitamin D2 at same doses -Strict I&O, Daily weights - Foley    Seizure-like activity - Patient with right-sided upper extremity and lower-extremity tonic activity following intubation.  - Prior to intubation, patient had EMV 15, appropriate and no focal deficits.  - Likely metabolic in nature, patient with BUN >100, sepsis, COVID  - No past history of seizures.  PLAN:  - TSH, B12, ammonia - EEG   Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:  -STOP coreg , HOLD home amlodipine  -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP today and as needed.    Suspected orthostatic syncope related to COVID-19 infection -Started prior to admission in the setting of ongoing diarrhea, nausea and poor PO intake -No episodes since, symptoms improved with adequate fluid resuscitation -EKG on admission with sinus tachycardia with no significant ST-T changes -PT/OT, recs home with assistance  Obesity (POA) - BMI 35.8, complicates all aspects of care.   Hospitalization Admit Date/Time: 7/29/2021 3:55 PM Admitting Attending:  Discharge Date: 08/14/21 Discharge Attending Physician:    8/9/2021 Assessment and Plan   The patient is a 53 yo M with CKD4, HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    Acute Respiratory Failure Requiring Mechanical Ventilation  Moderate ARDS  COVID-19 PNA (POA) Pneumomediastinum, stable Pneumopericardium, stable  HAP  -XR chest with B/L peripheral and bibasilar opacities  -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 127 - Started NMB on 8/8  PLAN:  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - DC nimbex today, PF ratio increased to 164 after paralytic  -Continue dexamethasone 6 mg daily (stop date 8/11)  -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx  -Empiric Cefepime for HAP--Follow up cultures from 8/7 - DC vanc    AKI on CKD stage V(POA) Hyperkalemia (POA)--resolving Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant -8/7: udall, failed IHD and converted to CRRT. PLAN:  - Nephrology following, appreciate recs  - Continue CRRT with goal net even  - Dose meds for CRRT  -Strict I&O, Daily weights   Shock, multifactorial  - Medication and sepsis related, stress induced CM - Received approx. 2 L IVF  - Cortisol 9.7 on 8/7 PLAN:  - Levophed for MAP >65 - Treatment of infections  - Defer stress steroids while on Dex, can evaluate to start stress HC Once steroids complete for Dex-ARDS.    Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:   -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP improving, weekly checks.    DM type 2 (POA) - Diet controlled at home.  PLAN:  - Start insulin gtt today, monitoring per protocol.    Hypertension - Hold Home meds until clinically appropriate.    Obesity (POA)- BMI 35.8, complicates all aspects of care  discharge note Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to UK ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and with reported syncopal events. Patient was treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab.     On 8/6 the patient had worsening shortness of breath with increasing oxygen requirements.  On 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia ultimately requiring intubation. Furthermore, a dialysis catheter was placed and CRRT was initiated. Broad spectrum ABX were continued. On 8/8, he required addition of NMB for continued ventilator dys-synchrony. He completed the dex-ARDS protocol on 8/10. The patient had a decline on 8/11 with a fever, worsening shock. He was started back on broad spectrum antibiotics, vasopressin in addition to levophed, and stress dose steroids. Unfortunately, Pt remained with persistent and profound hemodynamic instability. His response to aggressive live saving measures was minimal. WBC up to 80 with no infectious source able to be identified, escalation of ABX still continued. CT scans unable to be obtained secondary to risk of fatal event occurring if moved and/or transported to scanner. On 8/13, Pt going into arrythmias which further exacerbated further instability, required cardioversions X 3 and antiarrhythmic medications. Goals of care discussions completed with wife. Despite attempting to give Pt more time to possibly respond to treatments, his status remained critical. Wife came to see her husband at bedside to be with him briefly before he passed away. Pt passed away on 8/14 at 8:11.""
	"1655677-1"	"1655677-1"	"SEPSIS"	"10040047"	"50-59 years"	"50-59"	""patient vaccinated 7/23/2021, admitted 7/29/2021, tested positive for covid 7/29/2021. discharged 8/14/2021, patient expired  Patient received Pfizer vaccine L deltoid lot numberFA6780 on 7/23/2021. Tested positive on 7/29/2021 after exposure. Writing  report since patient received vaccine and now critically ill and intubated to follow procedure. Patient intubated 8/7/2021  History Of Present Illness Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and the following day began having diarrhea and ""passed out"" 4 times since symptoms developed.  While on the floor the patient had been treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab, and had been improving, weaned from HFNC to 4L NC on 8/5.  On 8/6 the patient had worsening shortness of breath and was transition back to high-flow nasal cannula.  Today, 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia.  MICU was called and the patient was emergently intubated for acute hypoxic respiratory failure.     Past Medical History He has a past medical history of CKD (chronic kidney disease), stage IV (CMS/HCC), Gout, and Hypertension.  Assessment and Plan:  The patient is a 53 yo M with CKD4,HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    ARDS  COVID-19 PNA (POA) Pneumomediastinum, worsening  -XR chest with B/L peripheral and bibasilar opacities  -Inflammatory markers were up trending, will continue to monitor -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia, official read pending -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 124 PLAN:  - Evaluate to repeat CT chest with patient clinical decline.  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - ABG -Continue dexamethasone 6 mg daily (D6/10) -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx    AKI on CKD stage V not on Dialysis (POA) Hyperkalemia (POA) Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant PLAN:  -Nephrology following on floor, will notify of transfer to the ICU - Place Udall-- > IHD to start 8/7.  -Continue sodium bicarb 1300 TID, calcitriol and vitamin D2 at same doses -Strict I&O, Daily weights - Foley    Seizure-like activity - Patient with right-sided upper extremity and lower-extremity tonic activity following intubation.  - Prior to intubation, patient had EMV 15, appropriate and no focal deficits.  - Likely metabolic in nature, patient with BUN >100, sepsis, COVID  - No past history of seizures.  PLAN:  - TSH, B12, ammonia - EEG   Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:  -STOP coreg , HOLD home amlodipine  -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP today and as needed.    Suspected orthostatic syncope related to COVID-19 infection -Started prior to admission in the setting of ongoing diarrhea, nausea and poor PO intake -No episodes since, symptoms improved with adequate fluid resuscitation -EKG on admission with sinus tachycardia with no significant ST-T changes -PT/OT, recs home with assistance  Obesity (POA) - BMI 35.8, complicates all aspects of care.   Hospitalization Admit Date/Time: 7/29/2021 3:55 PM Admitting Attending:  Discharge Date: 08/14/21 Discharge Attending Physician:    8/9/2021 Assessment and Plan   The patient is a 53 yo M with CKD4, HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    Acute Respiratory Failure Requiring Mechanical Ventilation  Moderate ARDS  COVID-19 PNA (POA) Pneumomediastinum, stable Pneumopericardium, stable  HAP  -XR chest with B/L peripheral and bibasilar opacities  -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 127 - Started NMB on 8/8  PLAN:  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - DC nimbex today, PF ratio increased to 164 after paralytic  -Continue dexamethasone 6 mg daily (stop date 8/11)  -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx  -Empiric Cefepime for HAP--Follow up cultures from 8/7 - DC vanc    AKI on CKD stage V(POA) Hyperkalemia (POA)--resolving Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant -8/7: udall, failed IHD and converted to CRRT. PLAN:  - Nephrology following, appreciate recs  - Continue CRRT with goal net even  - Dose meds for CRRT  -Strict I&O, Daily weights   Shock, multifactorial  - Medication and sepsis related, stress induced CM - Received approx. 2 L IVF  - Cortisol 9.7 on 8/7 PLAN:  - Levophed for MAP >65 - Treatment of infections  - Defer stress steroids while on Dex, can evaluate to start stress HC Once steroids complete for Dex-ARDS.    Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:   -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP improving, weekly checks.    DM type 2 (POA) - Diet controlled at home.  PLAN:  - Start insulin gtt today, monitoring per protocol.    Hypertension - Hold Home meds until clinically appropriate.    Obesity (POA)- BMI 35.8, complicates all aspects of care  discharge note Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to UK ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and with reported syncopal events. Patient was treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab.     On 8/6 the patient had worsening shortness of breath with increasing oxygen requirements.  On 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia ultimately requiring intubation. Furthermore, a dialysis catheter was placed and CRRT was initiated. Broad spectrum ABX were continued. On 8/8, he required addition of NMB for continued ventilator dys-synchrony. He completed the dex-ARDS protocol on 8/10. The patient had a decline on 8/11 with a fever, worsening shock. He was started back on broad spectrum antibiotics, vasopressin in addition to levophed, and stress dose steroids. Unfortunately, Pt remained with persistent and profound hemodynamic instability. His response to aggressive live saving measures was minimal. WBC up to 80 with no infectious source able to be identified, escalation of ABX still continued. CT scans unable to be obtained secondary to risk of fatal event occurring if moved and/or transported to scanner. On 8/13, Pt going into arrythmias which further exacerbated further instability, required cardioversions X 3 and antiarrhythmic medications. Goals of care discussions completed with wife. Despite attempting to give Pt more time to possibly respond to treatments, his status remained critical. Wife came to see her husband at bedside to be with him briefly before he passed away. Pt passed away on 8/14 at 8:11.""
	"1655677-1"	"1655677-1"	"SHOCK"	"10040560"	"50-59 years"	"50-59"	""patient vaccinated 7/23/2021, admitted 7/29/2021, tested positive for covid 7/29/2021. discharged 8/14/2021, patient expired  Patient received Pfizer vaccine L deltoid lot numberFA6780 on 7/23/2021. Tested positive on 7/29/2021 after exposure. Writing  report since patient received vaccine and now critically ill and intubated to follow procedure. Patient intubated 8/7/2021  History Of Present Illness Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and the following day began having diarrhea and ""passed out"" 4 times since symptoms developed.  While on the floor the patient had been treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab, and had been improving, weaned from HFNC to 4L NC on 8/5.  On 8/6 the patient had worsening shortness of breath and was transition back to high-flow nasal cannula.  Today, 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia.  MICU was called and the patient was emergently intubated for acute hypoxic respiratory failure.     Past Medical History He has a past medical history of CKD (chronic kidney disease), stage IV (CMS/HCC), Gout, and Hypertension.  Assessment and Plan:  The patient is a 53 yo M with CKD4,HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    ARDS  COVID-19 PNA (POA) Pneumomediastinum, worsening  -XR chest with B/L peripheral and bibasilar opacities  -Inflammatory markers were up trending, will continue to monitor -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia, official read pending -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 124 PLAN:  - Evaluate to repeat CT chest with patient clinical decline.  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - ABG -Continue dexamethasone 6 mg daily (D6/10) -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx    AKI on CKD stage V not on Dialysis (POA) Hyperkalemia (POA) Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant PLAN:  -Nephrology following on floor, will notify of transfer to the ICU - Place Udall-- > IHD to start 8/7.  -Continue sodium bicarb 1300 TID, calcitriol and vitamin D2 at same doses -Strict I&O, Daily weights - Foley    Seizure-like activity - Patient with right-sided upper extremity and lower-extremity tonic activity following intubation.  - Prior to intubation, patient had EMV 15, appropriate and no focal deficits.  - Likely metabolic in nature, patient with BUN >100, sepsis, COVID  - No past history of seizures.  PLAN:  - TSH, B12, ammonia - EEG   Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:  -STOP coreg , HOLD home amlodipine  -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP today and as needed.    Suspected orthostatic syncope related to COVID-19 infection -Started prior to admission in the setting of ongoing diarrhea, nausea and poor PO intake -No episodes since, symptoms improved with adequate fluid resuscitation -EKG on admission with sinus tachycardia with no significant ST-T changes -PT/OT, recs home with assistance  Obesity (POA) - BMI 35.8, complicates all aspects of care.   Hospitalization Admit Date/Time: 7/29/2021 3:55 PM Admitting Attending:  Discharge Date: 08/14/21 Discharge Attending Physician:    8/9/2021 Assessment and Plan   The patient is a 53 yo M with CKD4, HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    Acute Respiratory Failure Requiring Mechanical Ventilation  Moderate ARDS  COVID-19 PNA (POA) Pneumomediastinum, stable Pneumopericardium, stable  HAP  -XR chest with B/L peripheral and bibasilar opacities  -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 127 - Started NMB on 8/8  PLAN:  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - DC nimbex today, PF ratio increased to 164 after paralytic  -Continue dexamethasone 6 mg daily (stop date 8/11)  -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx  -Empiric Cefepime for HAP--Follow up cultures from 8/7 - DC vanc    AKI on CKD stage V(POA) Hyperkalemia (POA)--resolving Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant -8/7: udall, failed IHD and converted to CRRT. PLAN:  - Nephrology following, appreciate recs  - Continue CRRT with goal net even  - Dose meds for CRRT  -Strict I&O, Daily weights   Shock, multifactorial  - Medication and sepsis related, stress induced CM - Received approx. 2 L IVF  - Cortisol 9.7 on 8/7 PLAN:  - Levophed for MAP >65 - Treatment of infections  - Defer stress steroids while on Dex, can evaluate to start stress HC Once steroids complete for Dex-ARDS.    Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:   -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP improving, weekly checks.    DM type 2 (POA) - Diet controlled at home.  PLAN:  - Start insulin gtt today, monitoring per protocol.    Hypertension - Hold Home meds until clinically appropriate.    Obesity (POA)- BMI 35.8, complicates all aspects of care  discharge note Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to UK ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and with reported syncopal events. Patient was treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab.     On 8/6 the patient had worsening shortness of breath with increasing oxygen requirements.  On 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia ultimately requiring intubation. Furthermore, a dialysis catheter was placed and CRRT was initiated. Broad spectrum ABX were continued. On 8/8, he required addition of NMB for continued ventilator dys-synchrony. He completed the dex-ARDS protocol on 8/10. The patient had a decline on 8/11 with a fever, worsening shock. He was started back on broad spectrum antibiotics, vasopressin in addition to levophed, and stress dose steroids. Unfortunately, Pt remained with persistent and profound hemodynamic instability. His response to aggressive live saving measures was minimal. WBC up to 80 with no infectious source able to be identified, escalation of ABX still continued. CT scans unable to be obtained secondary to risk of fatal event occurring if moved and/or transported to scanner. On 8/13, Pt going into arrythmias which further exacerbated further instability, required cardioversions X 3 and antiarrhythmic medications. Goals of care discussions completed with wife. Despite attempting to give Pt more time to possibly respond to treatments, his status remained critical. Wife came to see her husband at bedside to be with him briefly before he passed away. Pt passed away on 8/14 at 8:11.""
	"1655677-1"	"1655677-1"	"SINUS TACHYCARDIA"	"10040752"	"50-59 years"	"50-59"	""patient vaccinated 7/23/2021, admitted 7/29/2021, tested positive for covid 7/29/2021. discharged 8/14/2021, patient expired  Patient received Pfizer vaccine L deltoid lot numberFA6780 on 7/23/2021. Tested positive on 7/29/2021 after exposure. Writing  report since patient received vaccine and now critically ill and intubated to follow procedure. Patient intubated 8/7/2021  History Of Present Illness Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and the following day began having diarrhea and ""passed out"" 4 times since symptoms developed.  While on the floor the patient had been treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab, and had been improving, weaned from HFNC to 4L NC on 8/5.  On 8/6 the patient had worsening shortness of breath and was transition back to high-flow nasal cannula.  Today, 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia.  MICU was called and the patient was emergently intubated for acute hypoxic respiratory failure.     Past Medical History He has a past medical history of CKD (chronic kidney disease), stage IV (CMS/HCC), Gout, and Hypertension.  Assessment and Plan:  The patient is a 53 yo M with CKD4,HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    ARDS  COVID-19 PNA (POA) Pneumomediastinum, worsening  -XR chest with B/L peripheral and bibasilar opacities  -Inflammatory markers were up trending, will continue to monitor -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia, official read pending -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 124 PLAN:  - Evaluate to repeat CT chest with patient clinical decline.  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - ABG -Continue dexamethasone 6 mg daily (D6/10) -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx    AKI on CKD stage V not on Dialysis (POA) Hyperkalemia (POA) Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant PLAN:  -Nephrology following on floor, will notify of transfer to the ICU - Place Udall-- > IHD to start 8/7.  -Continue sodium bicarb 1300 TID, calcitriol and vitamin D2 at same doses -Strict I&O, Daily weights - Foley    Seizure-like activity - Patient with right-sided upper extremity and lower-extremity tonic activity following intubation.  - Prior to intubation, patient had EMV 15, appropriate and no focal deficits.  - Likely metabolic in nature, patient with BUN >100, sepsis, COVID  - No past history of seizures.  PLAN:  - TSH, B12, ammonia - EEG   Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:  -STOP coreg , HOLD home amlodipine  -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP today and as needed.    Suspected orthostatic syncope related to COVID-19 infection -Started prior to admission in the setting of ongoing diarrhea, nausea and poor PO intake -No episodes since, symptoms improved with adequate fluid resuscitation -EKG on admission with sinus tachycardia with no significant ST-T changes -PT/OT, recs home with assistance  Obesity (POA) - BMI 35.8, complicates all aspects of care.   Hospitalization Admit Date/Time: 7/29/2021 3:55 PM Admitting Attending:  Discharge Date: 08/14/21 Discharge Attending Physician:    8/9/2021 Assessment and Plan   The patient is a 53 yo M with CKD4, HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    Acute Respiratory Failure Requiring Mechanical Ventilation  Moderate ARDS  COVID-19 PNA (POA) Pneumomediastinum, stable Pneumopericardium, stable  HAP  -XR chest with B/L peripheral and bibasilar opacities  -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 127 - Started NMB on 8/8  PLAN:  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - DC nimbex today, PF ratio increased to 164 after paralytic  -Continue dexamethasone 6 mg daily (stop date 8/11)  -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx  -Empiric Cefepime for HAP--Follow up cultures from 8/7 - DC vanc    AKI on CKD stage V(POA) Hyperkalemia (POA)--resolving Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant -8/7: udall, failed IHD and converted to CRRT. PLAN:  - Nephrology following, appreciate recs  - Continue CRRT with goal net even  - Dose meds for CRRT  -Strict I&O, Daily weights   Shock, multifactorial  - Medication and sepsis related, stress induced CM - Received approx. 2 L IVF  - Cortisol 9.7 on 8/7 PLAN:  - Levophed for MAP >65 - Treatment of infections  - Defer stress steroids while on Dex, can evaluate to start stress HC Once steroids complete for Dex-ARDS.    Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:   -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP improving, weekly checks.    DM type 2 (POA) - Diet controlled at home.  PLAN:  - Start insulin gtt today, monitoring per protocol.    Hypertension - Hold Home meds until clinically appropriate.    Obesity (POA)- BMI 35.8, complicates all aspects of care  discharge note Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to UK ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and with reported syncopal events. Patient was treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab.     On 8/6 the patient had worsening shortness of breath with increasing oxygen requirements.  On 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia ultimately requiring intubation. Furthermore, a dialysis catheter was placed and CRRT was initiated. Broad spectrum ABX were continued. On 8/8, he required addition of NMB for continued ventilator dys-synchrony. He completed the dex-ARDS protocol on 8/10. The patient had a decline on 8/11 with a fever, worsening shock. He was started back on broad spectrum antibiotics, vasopressin in addition to levophed, and stress dose steroids. Unfortunately, Pt remained with persistent and profound hemodynamic instability. His response to aggressive live saving measures was minimal. WBC up to 80 with no infectious source able to be identified, escalation of ABX still continued. CT scans unable to be obtained secondary to risk of fatal event occurring if moved and/or transported to scanner. On 8/13, Pt going into arrythmias which further exacerbated further instability, required cardioversions X 3 and antiarrhythmic medications. Goals of care discussions completed with wife. Despite attempting to give Pt more time to possibly respond to treatments, his status remained critical. Wife came to see her husband at bedside to be with him briefly before he passed away. Pt passed away on 8/14 at 8:11.""
	"1655677-1"	"1655677-1"	"TRANSAMINASES INCREASED"	"10054889"	"50-59 years"	"50-59"	""patient vaccinated 7/23/2021, admitted 7/29/2021, tested positive for covid 7/29/2021. discharged 8/14/2021, patient expired  Patient received Pfizer vaccine L deltoid lot numberFA6780 on 7/23/2021. Tested positive on 7/29/2021 after exposure. Writing  report since patient received vaccine and now critically ill and intubated to follow procedure. Patient intubated 8/7/2021  History Of Present Illness Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and the following day began having diarrhea and ""passed out"" 4 times since symptoms developed.  While on the floor the patient had been treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab, and had been improving, weaned from HFNC to 4L NC on 8/5.  On 8/6 the patient had worsening shortness of breath and was transition back to high-flow nasal cannula.  Today, 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia.  MICU was called and the patient was emergently intubated for acute hypoxic respiratory failure.     Past Medical History He has a past medical history of CKD (chronic kidney disease), stage IV (CMS/HCC), Gout, and Hypertension.  Assessment and Plan:  The patient is a 53 yo M with CKD4,HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    ARDS  COVID-19 PNA (POA) Pneumomediastinum, worsening  -XR chest with B/L peripheral and bibasilar opacities  -Inflammatory markers were up trending, will continue to monitor -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia, official read pending -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 124 PLAN:  - Evaluate to repeat CT chest with patient clinical decline.  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - ABG -Continue dexamethasone 6 mg daily (D6/10) -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx    AKI on CKD stage V not on Dialysis (POA) Hyperkalemia (POA) Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant PLAN:  -Nephrology following on floor, will notify of transfer to the ICU - Place Udall-- > IHD to start 8/7.  -Continue sodium bicarb 1300 TID, calcitriol and vitamin D2 at same doses -Strict I&O, Daily weights - Foley    Seizure-like activity - Patient with right-sided upper extremity and lower-extremity tonic activity following intubation.  - Prior to intubation, patient had EMV 15, appropriate and no focal deficits.  - Likely metabolic in nature, patient with BUN >100, sepsis, COVID  - No past history of seizures.  PLAN:  - TSH, B12, ammonia - EEG   Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:  -STOP coreg , HOLD home amlodipine  -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP today and as needed.    Suspected orthostatic syncope related to COVID-19 infection -Started prior to admission in the setting of ongoing diarrhea, nausea and poor PO intake -No episodes since, symptoms improved with adequate fluid resuscitation -EKG on admission with sinus tachycardia with no significant ST-T changes -PT/OT, recs home with assistance  Obesity (POA) - BMI 35.8, complicates all aspects of care.   Hospitalization Admit Date/Time: 7/29/2021 3:55 PM Admitting Attending:  Discharge Date: 08/14/21 Discharge Attending Physician:    8/9/2021 Assessment and Plan   The patient is a 53 yo M with CKD4, HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    Acute Respiratory Failure Requiring Mechanical Ventilation  Moderate ARDS  COVID-19 PNA (POA) Pneumomediastinum, stable Pneumopericardium, stable  HAP  -XR chest with B/L peripheral and bibasilar opacities  -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 127 - Started NMB on 8/8  PLAN:  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - DC nimbex today, PF ratio increased to 164 after paralytic  -Continue dexamethasone 6 mg daily (stop date 8/11)  -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx  -Empiric Cefepime for HAP--Follow up cultures from 8/7 - DC vanc    AKI on CKD stage V(POA) Hyperkalemia (POA)--resolving Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant -8/7: udall, failed IHD and converted to CRRT. PLAN:  - Nephrology following, appreciate recs  - Continue CRRT with goal net even  - Dose meds for CRRT  -Strict I&O, Daily weights   Shock, multifactorial  - Medication and sepsis related, stress induced CM - Received approx. 2 L IVF  - Cortisol 9.7 on 8/7 PLAN:  - Levophed for MAP >65 - Treatment of infections  - Defer stress steroids while on Dex, can evaluate to start stress HC Once steroids complete for Dex-ARDS.    Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:   -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP improving, weekly checks.    DM type 2 (POA) - Diet controlled at home.  PLAN:  - Start insulin gtt today, monitoring per protocol.    Hypertension - Hold Home meds until clinically appropriate.    Obesity (POA)- BMI 35.8, complicates all aspects of care  discharge note Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to UK ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and with reported syncopal events. Patient was treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab.     On 8/6 the patient had worsening shortness of breath with increasing oxygen requirements.  On 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia ultimately requiring intubation. Furthermore, a dialysis catheter was placed and CRRT was initiated. Broad spectrum ABX were continued. On 8/8, he required addition of NMB for continued ventilator dys-synchrony. He completed the dex-ARDS protocol on 8/10. The patient had a decline on 8/11 with a fever, worsening shock. He was started back on broad spectrum antibiotics, vasopressin in addition to levophed, and stress dose steroids. Unfortunately, Pt remained with persistent and profound hemodynamic instability. His response to aggressive live saving measures was minimal. WBC up to 80 with no infectious source able to be identified, escalation of ABX still continued. CT scans unable to be obtained secondary to risk of fatal event occurring if moved and/or transported to scanner. On 8/13, Pt going into arrythmias which further exacerbated further instability, required cardioversions X 3 and antiarrhythmic medications. Goals of care discussions completed with wife. Despite attempting to give Pt more time to possibly respond to treatments, his status remained critical. Wife came to see her husband at bedside to be with him briefly before he passed away. Pt passed away on 8/14 at 8:11.""
	"1655677-1"	"1655677-1"	"VENTRICULAR HYPOKINESIA"	"10050510"	"50-59 years"	"50-59"	""patient vaccinated 7/23/2021, admitted 7/29/2021, tested positive for covid 7/29/2021. discharged 8/14/2021, patient expired  Patient received Pfizer vaccine L deltoid lot numberFA6780 on 7/23/2021. Tested positive on 7/29/2021 after exposure. Writing  report since patient received vaccine and now critically ill and intubated to follow procedure. Patient intubated 8/7/2021  History Of Present Illness Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and the following day began having diarrhea and ""passed out"" 4 times since symptoms developed.  While on the floor the patient had been treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab, and had been improving, weaned from HFNC to 4L NC on 8/5.  On 8/6 the patient had worsening shortness of breath and was transition back to high-flow nasal cannula.  Today, 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia.  MICU was called and the patient was emergently intubated for acute hypoxic respiratory failure.     Past Medical History He has a past medical history of CKD (chronic kidney disease), stage IV (CMS/HCC), Gout, and Hypertension.  Assessment and Plan:  The patient is a 53 yo M with CKD4,HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    ARDS  COVID-19 PNA (POA) Pneumomediastinum, worsening  -XR chest with B/L peripheral and bibasilar opacities  -Inflammatory markers were up trending, will continue to monitor -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia, official read pending -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 124 PLAN:  - Evaluate to repeat CT chest with patient clinical decline.  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - ABG -Continue dexamethasone 6 mg daily (D6/10) -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx    AKI on CKD stage V not on Dialysis (POA) Hyperkalemia (POA) Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant PLAN:  -Nephrology following on floor, will notify of transfer to the ICU - Place Udall-- > IHD to start 8/7.  -Continue sodium bicarb 1300 TID, calcitriol and vitamin D2 at same doses -Strict I&O, Daily weights - Foley    Seizure-like activity - Patient with right-sided upper extremity and lower-extremity tonic activity following intubation.  - Prior to intubation, patient had EMV 15, appropriate and no focal deficits.  - Likely metabolic in nature, patient with BUN >100, sepsis, COVID  - No past history of seizures.  PLAN:  - TSH, B12, ammonia - EEG   Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:  -STOP coreg , HOLD home amlodipine  -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP today and as needed.    Suspected orthostatic syncope related to COVID-19 infection -Started prior to admission in the setting of ongoing diarrhea, nausea and poor PO intake -No episodes since, symptoms improved with adequate fluid resuscitation -EKG on admission with sinus tachycardia with no significant ST-T changes -PT/OT, recs home with assistance  Obesity (POA) - BMI 35.8, complicates all aspects of care.   Hospitalization Admit Date/Time: 7/29/2021 3:55 PM Admitting Attending:  Discharge Date: 08/14/21 Discharge Attending Physician:    8/9/2021 Assessment and Plan   The patient is a 53 yo M with CKD4, HTN that presents to UKMC on 7/29 and was diagnosed with COVID at this time. Progressive hypoxic RF that required HFNC, and on 8/7/21 required intubation with mechanical ventilation. Hospital course complicated by pneumomediastinum, transaminitis, and AKI secondary to COVID.    Acute Respiratory Failure Requiring Mechanical Ventilation  Moderate ARDS  COVID-19 PNA (POA) Pneumomediastinum, stable Pneumopericardium, stable  HAP  -XR chest with B/L peripheral and bibasilar opacities  -CXR 8/6: showed air around heart borders and into mediastinum suggestive of pneumomediastinum -8/6: CT chest: significant pneumomediastinum, multifocal pulmonary infiltrates likely 2/2 COVID-19 pneumonia -Thoracic surgery consulted: no interventions at this time unless the patient was to clinically decline. -S/p 5-day course of remdesivir finished on 8/6 -ID consulted, tocilizumab 800 mg one dose given 8/2/21 - PF ratio at time of transfer to the unit: 127 - Started NMB on 8/8  PLAN:  - Low PEEP ventilation with CT imaging indicating likely BPF at the area of the lingula.  - Minimize coughing and desynchrony while on mechanical ventilation: Propofol and Dilaudid gtts.  - DC nimbex today, PF ratio increased to 164 after paralytic  -Continue dexamethasone 6 mg daily (stop date 8/11)  -Albuterol inhaler Q 4 hrs. -Heparin 7500 U q8hrs for DVT ppx  -Empiric Cefepime for HAP--Follow up cultures from 8/7 - DC vanc    AKI on CKD stage V(POA) Hyperkalemia (POA)--resolving Mixed AGMA and NAGMA (POA) -Unknown baseline Cr, close to 6.8 upon admission with peak at 7.5, now stable/improving - Multifactorial acidosis: BUN, diarrheal illness, and  -K stable with lokelma as recommended per renal -Follows up with his nephrologist OP and was supposed to be referred for kidney transplant -8/7: udall, failed IHD and converted to CRRT. PLAN:  - Nephrology following, appreciate recs  - Continue CRRT with goal net even  - Dose meds for CRRT  -Strict I&O, Daily weights   Shock, multifactorial  - Medication and sepsis related, stress induced CM - Received approx. 2 L IVF  - Cortisol 9.7 on 8/7 PLAN:  - Levophed for MAP >65 - Treatment of infections  - Defer stress steroids while on Dex, can evaluate to start stress HC Once steroids complete for Dex-ARDS.    Newly diagnosed HFrEF (POA) -TTE with 40-50% EF and global LV hypokinesis PLAN:   -OP follow up with cardiology for further workup given COVID  positive status   Transaminitis (POA) - Possibly multifactorial 2/2 volume depletion but also possible drug effect from remdesivir PLAN:  - CMP improving, weekly checks.    DM type 2 (POA) - Diet controlled at home.  PLAN:  - Start insulin gtt today, monitoring per protocol.    Hypertension - Hold Home meds until clinically appropriate.    Obesity (POA)- BMI 35.8, complicates all aspects of care  discharge note Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 53-year-old patient with a PMH of CKD4 and HTN who presented to UK ED on 7/29 with complaints of fatigue, diarrhea, weakness, and loss of taste and smell.  Patient stated he was exposed to COVID on 7/20 and received his 1st COVID-19 vaccine on 7/23.  On presentation to the ED the Pt stated on 07/24 he began to have subjective fevers, weakness and fatigue, and with reported syncopal events. Patient was treated with dexamethasone 6 mg daily, remdesivir, and tocilizumab.     On 8/6 the patient had worsening shortness of breath with increasing oxygen requirements.  On 8/7, the patient had worsening respiratory distress and increasing oxygen requirements 100% & 70L HFNC as well as 100% non-rebreather with persistent hypoxia ultimately requiring intubation. Furthermore, a dialysis catheter was placed and CRRT was initiated. Broad spectrum ABX were continued. On 8/8, he required addition of NMB for continued ventilator dys-synchrony. He completed the dex-ARDS protocol on 8/10. The patient had a decline on 8/11 with a fever, worsening shock. He was started back on broad spectrum antibiotics, vasopressin in addition to levophed, and stress dose steroids. Unfortunately, Pt remained with persistent and profound hemodynamic instability. His response to aggressive live saving measures was minimal. WBC up to 80 with no infectious source able to be identified, escalation of ABX still continued. CT scans unable to be obtained secondary to risk of fatal event occurring if moved and/or transported to scanner. On 8/13, Pt going into arrythmias which further exacerbated further instability, required cardioversions X 3 and antiarrhythmic medications. Goals of care discussions completed with wife. Despite attempting to give Pt more time to possibly respond to treatments, his status remained critical. Wife came to see her husband at bedside to be with him briefly before he passed away. Pt passed away on 8/14 at 8:11.""
	"1655721-1"	"1655721-1"	"CONDITION AGGRAVATED"	"10010264"	"50-59 years"	"50-59"	"Covid + August 2 nad had been hospitalized elsewhere for 2 days and discharged on rooma ir and decadron. Presented to Medical Center on 8/16/21 with )2 sat of 50% on room air. Admitted  and completed course of decadron and 5 day course of remdesivir. Aslo given broad spectrum antibioitcs and anifungal.  Complications of renal failure with hemodialysis started on 8/23/21 and ileus.  Unable to wean from ventilator. Decision for comfort care. Expired from COVID pneumonia with severe sepsis with shock."
	"1655721-1"	"1655721-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Covid + August 2 nad had been hospitalized elsewhere for 2 days and discharged on rooma ir and decadron. Presented to Medical Center on 8/16/21 with )2 sat of 50% on room air. Admitted  and completed course of decadron and 5 day course of remdesivir. Aslo given broad spectrum antibioitcs and anifungal.  Complications of renal failure with hemodialysis started on 8/23/21 and ileus.  Unable to wean from ventilator. Decision for comfort care. Expired from COVID pneumonia with severe sepsis with shock."
	"1655721-1"	"1655721-1"	"COVID-19 PNEUMONIA"	"10084380"	"50-59 years"	"50-59"	"Covid + August 2 nad had been hospitalized elsewhere for 2 days and discharged on rooma ir and decadron. Presented to Medical Center on 8/16/21 with )2 sat of 50% on room air. Admitted  and completed course of decadron and 5 day course of remdesivir. Aslo given broad spectrum antibioitcs and anifungal.  Complications of renal failure with hemodialysis started on 8/23/21 and ileus.  Unable to wean from ventilator. Decision for comfort care. Expired from COVID pneumonia with severe sepsis with shock."
	"1655721-1"	"1655721-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Covid + August 2 nad had been hospitalized elsewhere for 2 days and discharged on rooma ir and decadron. Presented to Medical Center on 8/16/21 with )2 sat of 50% on room air. Admitted  and completed course of decadron and 5 day course of remdesivir. Aslo given broad spectrum antibioitcs and anifungal.  Complications of renal failure with hemodialysis started on 8/23/21 and ileus.  Unable to wean from ventilator. Decision for comfort care. Expired from COVID pneumonia with severe sepsis with shock."
	"1655721-1"	"1655721-1"	"HAEMODIALYSIS"	"10018875"	"50-59 years"	"50-59"	"Covid + August 2 nad had been hospitalized elsewhere for 2 days and discharged on rooma ir and decadron. Presented to Medical Center on 8/16/21 with )2 sat of 50% on room air. Admitted  and completed course of decadron and 5 day course of remdesivir. Aslo given broad spectrum antibioitcs and anifungal.  Complications of renal failure with hemodialysis started on 8/23/21 and ileus.  Unable to wean from ventilator. Decision for comfort care. Expired from COVID pneumonia with severe sepsis with shock."
	"1655721-1"	"1655721-1"	"ILEUS"	"10021328"	"50-59 years"	"50-59"	"Covid + August 2 nad had been hospitalized elsewhere for 2 days and discharged on rooma ir and decadron. Presented to Medical Center on 8/16/21 with )2 sat of 50% on room air. Admitted  and completed course of decadron and 5 day course of remdesivir. Aslo given broad spectrum antibioitcs and anifungal.  Complications of renal failure with hemodialysis started on 8/23/21 and ileus.  Unable to wean from ventilator. Decision for comfort care. Expired from COVID pneumonia with severe sepsis with shock."
	"1655721-1"	"1655721-1"	"MECHANICAL VENTILATION"	"10067221"	"50-59 years"	"50-59"	"Covid + August 2 nad had been hospitalized elsewhere for 2 days and discharged on rooma ir and decadron. Presented to Medical Center on 8/16/21 with )2 sat of 50% on room air. Admitted  and completed course of decadron and 5 day course of remdesivir. Aslo given broad spectrum antibioitcs and anifungal.  Complications of renal failure with hemodialysis started on 8/23/21 and ileus.  Unable to wean from ventilator. Decision for comfort care. Expired from COVID pneumonia with severe sepsis with shock."
	"1655721-1"	"1655721-1"	"RENAL FAILURE"	"10038435"	"50-59 years"	"50-59"	"Covid + August 2 nad had been hospitalized elsewhere for 2 days and discharged on rooma ir and decadron. Presented to Medical Center on 8/16/21 with )2 sat of 50% on room air. Admitted  and completed course of decadron and 5 day course of remdesivir. Aslo given broad spectrum antibioitcs and anifungal.  Complications of renal failure with hemodialysis started on 8/23/21 and ileus.  Unable to wean from ventilator. Decision for comfort care. Expired from COVID pneumonia with severe sepsis with shock."
	"1655721-1"	"1655721-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"Covid + August 2 nad had been hospitalized elsewhere for 2 days and discharged on rooma ir and decadron. Presented to Medical Center on 8/16/21 with )2 sat of 50% on room air. Admitted  and completed course of decadron and 5 day course of remdesivir. Aslo given broad spectrum antibioitcs and anifungal.  Complications of renal failure with hemodialysis started on 8/23/21 and ileus.  Unable to wean from ventilator. Decision for comfort care. Expired from COVID pneumonia with severe sepsis with shock."
	"1655721-1"	"1655721-1"	"SEPTIC SHOCK"	"10040070"	"50-59 years"	"50-59"	"Covid + August 2 nad had been hospitalized elsewhere for 2 days and discharged on rooma ir and decadron. Presented to Medical Center on 8/16/21 with )2 sat of 50% on room air. Admitted  and completed course of decadron and 5 day course of remdesivir. Aslo given broad spectrum antibioitcs and anifungal.  Complications of renal failure with hemodialysis started on 8/23/21 and ileus.  Unable to wean from ventilator. Decision for comfort care. Expired from COVID pneumonia with severe sepsis with shock."
	"1655831-1"	"1655831-1"	"AUTOPSY"	"10050117"	"50-59 years"	"50-59"	"The patient died from COVID 19 symptoms.  His body was being taken to be autopsied on 08/27/2021.  I was notified after he had passed."
	"1655831-1"	"1655831-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"The patient died from COVID 19 symptoms.  His body was being taken to be autopsied on 08/27/2021.  I was notified after he had passed."
	"1655831-1"	"1655831-1"	"MALAISE"	"10025482"	"50-59 years"	"50-59"	"The patient died from COVID 19 symptoms.  His body was being taken to be autopsied on 08/27/2021.  I was notified after he had passed."
	"1655865-1"	"1655865-1"	"ACUTE KIDNEY INJURY"	"10069339"	"50-59 years"	"50-59"	"Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 4/21/2021 and 5/18/2021. Patient admitted on 7/31/2021 for cardiogenic shock complicated by acute renal failure, coagulopathy and acute respiratory failure. To assist in management of the cardiogenic shock pt was placed on axillary IABP and dobutamine for inotropic support. Pt was decongested with combination of aquadex and diuretics with improvement in filling conditions. Unfortunately, patient developed persistent fever on 8/11 and was placed on broad spectrum antibiotics, ID was consulted and underwent extensive infectious evaluation.She did have MRSA in pneumonia PCR and candida albicans has grown in urine culture. On 8/16/21 morning pt decompensated hemodynamicallly requiring levophed and vasopressin and continued evaluation revealed that pt had positive IgM COVID antibodies and it was suspected that pt developed a new COVID infection. She continued to decline over the next 48 hours with worsening hemodynamics and renal function and therefore a dialsysis catheter was placed and pt was started on renal replacement therapy. Family was kept uptodate about the patients clinical status and at this point decided to transition focus of care to comfort. Pt then expired the morning of 8/18/21."
	"1655865-1"	"1655865-1"	"ACUTE RESPIRATORY FAILURE"	"10001053"	"50-59 years"	"50-59"	"Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 4/21/2021 and 5/18/2021. Patient admitted on 7/31/2021 for cardiogenic shock complicated by acute renal failure, coagulopathy and acute respiratory failure. To assist in management of the cardiogenic shock pt was placed on axillary IABP and dobutamine for inotropic support. Pt was decongested with combination of aquadex and diuretics with improvement in filling conditions. Unfortunately, patient developed persistent fever on 8/11 and was placed on broad spectrum antibiotics, ID was consulted and underwent extensive infectious evaluation.She did have MRSA in pneumonia PCR and candida albicans has grown in urine culture. On 8/16/21 morning pt decompensated hemodynamicallly requiring levophed and vasopressin and continued evaluation revealed that pt had positive IgM COVID antibodies and it was suspected that pt developed a new COVID infection. She continued to decline over the next 48 hours with worsening hemodynamics and renal function and therefore a dialsysis catheter was placed and pt was started on renal replacement therapy. Family was kept uptodate about the patients clinical status and at this point decided to transition focus of care to comfort. Pt then expired the morning of 8/18/21."
	"1655865-1"	"1655865-1"	"CANDIDA INFECTION"	"10074170"	"50-59 years"	"50-59"	"Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 4/21/2021 and 5/18/2021. Patient admitted on 7/31/2021 for cardiogenic shock complicated by acute renal failure, coagulopathy and acute respiratory failure. To assist in management of the cardiogenic shock pt was placed on axillary IABP and dobutamine for inotropic support. Pt was decongested with combination of aquadex and diuretics with improvement in filling conditions. Unfortunately, patient developed persistent fever on 8/11 and was placed on broad spectrum antibiotics, ID was consulted and underwent extensive infectious evaluation.She did have MRSA in pneumonia PCR and candida albicans has grown in urine culture. On 8/16/21 morning pt decompensated hemodynamicallly requiring levophed and vasopressin and continued evaluation revealed that pt had positive IgM COVID antibodies and it was suspected that pt developed a new COVID infection. She continued to decline over the next 48 hours with worsening hemodynamics and renal function and therefore a dialsysis catheter was placed and pt was started on renal replacement therapy. Family was kept uptodate about the patients clinical status and at this point decided to transition focus of care to comfort. Pt then expired the morning of 8/18/21."
	"1655865-1"	"1655865-1"	"CARDIOGENIC SHOCK"	"10007625"	"50-59 years"	"50-59"	"Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 4/21/2021 and 5/18/2021. Patient admitted on 7/31/2021 for cardiogenic shock complicated by acute renal failure, coagulopathy and acute respiratory failure. To assist in management of the cardiogenic shock pt was placed on axillary IABP and dobutamine for inotropic support. Pt was decongested with combination of aquadex and diuretics with improvement in filling conditions. Unfortunately, patient developed persistent fever on 8/11 and was placed on broad spectrum antibiotics, ID was consulted and underwent extensive infectious evaluation.She did have MRSA in pneumonia PCR and candida albicans has grown in urine culture. On 8/16/21 morning pt decompensated hemodynamicallly requiring levophed and vasopressin and continued evaluation revealed that pt had positive IgM COVID antibodies and it was suspected that pt developed a new COVID infection. She continued to decline over the next 48 hours with worsening hemodynamics and renal function and therefore a dialsysis catheter was placed and pt was started on renal replacement therapy. Family was kept uptodate about the patients clinical status and at this point decided to transition focus of care to comfort. Pt then expired the morning of 8/18/21."
	"1655865-1"	"1655865-1"	"CATHETER PLACEMENT"	"10052915"	"50-59 years"	"50-59"	"Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 4/21/2021 and 5/18/2021. Patient admitted on 7/31/2021 for cardiogenic shock complicated by acute renal failure, coagulopathy and acute respiratory failure. To assist in management of the cardiogenic shock pt was placed on axillary IABP and dobutamine for inotropic support. Pt was decongested with combination of aquadex and diuretics with improvement in filling conditions. Unfortunately, patient developed persistent fever on 8/11 and was placed on broad spectrum antibiotics, ID was consulted and underwent extensive infectious evaluation.She did have MRSA in pneumonia PCR and candida albicans has grown in urine culture. On 8/16/21 morning pt decompensated hemodynamicallly requiring levophed and vasopressin and continued evaluation revealed that pt had positive IgM COVID antibodies and it was suspected that pt developed a new COVID infection. She continued to decline over the next 48 hours with worsening hemodynamics and renal function and therefore a dialsysis catheter was placed and pt was started on renal replacement therapy. Family was kept uptodate about the patients clinical status and at this point decided to transition focus of care to comfort. Pt then expired the morning of 8/18/21."
	"1655865-1"	"1655865-1"	"COAGULOPATHY"	"10009802"	"50-59 years"	"50-59"	"Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 4/21/2021 and 5/18/2021. Patient admitted on 7/31/2021 for cardiogenic shock complicated by acute renal failure, coagulopathy and acute respiratory failure. To assist in management of the cardiogenic shock pt was placed on axillary IABP and dobutamine for inotropic support. Pt was decongested with combination of aquadex and diuretics with improvement in filling conditions. Unfortunately, patient developed persistent fever on 8/11 and was placed on broad spectrum antibiotics, ID was consulted and underwent extensive infectious evaluation.She did have MRSA in pneumonia PCR and candida albicans has grown in urine culture. On 8/16/21 morning pt decompensated hemodynamicallly requiring levophed and vasopressin and continued evaluation revealed that pt had positive IgM COVID antibodies and it was suspected that pt developed a new COVID infection. She continued to decline over the next 48 hours with worsening hemodynamics and renal function and therefore a dialsysis catheter was placed and pt was started on renal replacement therapy. Family was kept uptodate about the patients clinical status and at this point decided to transition focus of care to comfort. Pt then expired the morning of 8/18/21."
	"1655865-1"	"1655865-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 4/21/2021 and 5/18/2021. Patient admitted on 7/31/2021 for cardiogenic shock complicated by acute renal failure, coagulopathy and acute respiratory failure. To assist in management of the cardiogenic shock pt was placed on axillary IABP and dobutamine for inotropic support. Pt was decongested with combination of aquadex and diuretics with improvement in filling conditions. Unfortunately, patient developed persistent fever on 8/11 and was placed on broad spectrum antibiotics, ID was consulted and underwent extensive infectious evaluation.She did have MRSA in pneumonia PCR and candida albicans has grown in urine culture. On 8/16/21 morning pt decompensated hemodynamicallly requiring levophed and vasopressin and continued evaluation revealed that pt had positive IgM COVID antibodies and it was suspected that pt developed a new COVID infection. She continued to decline over the next 48 hours with worsening hemodynamics and renal function and therefore a dialsysis catheter was placed and pt was started on renal replacement therapy. Family was kept uptodate about the patients clinical status and at this point decided to transition focus of care to comfort. Pt then expired the morning of 8/18/21."
	"1655865-1"	"1655865-1"	"CULTURE URINE POSITIVE"	"10011640"	"50-59 years"	"50-59"	"Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 4/21/2021 and 5/18/2021. Patient admitted on 7/31/2021 for cardiogenic shock complicated by acute renal failure, coagulopathy and acute respiratory failure. To assist in management of the cardiogenic shock pt was placed on axillary IABP and dobutamine for inotropic support. Pt was decongested with combination of aquadex and diuretics with improvement in filling conditions. Unfortunately, patient developed persistent fever on 8/11 and was placed on broad spectrum antibiotics, ID was consulted and underwent extensive infectious evaluation.She did have MRSA in pneumonia PCR and candida albicans has grown in urine culture. On 8/16/21 morning pt decompensated hemodynamicallly requiring levophed and vasopressin and continued evaluation revealed that pt had positive IgM COVID antibodies and it was suspected that pt developed a new COVID infection. She continued to decline over the next 48 hours with worsening hemodynamics and renal function and therefore a dialsysis catheter was placed and pt was started on renal replacement therapy. Family was kept uptodate about the patients clinical status and at this point decided to transition focus of care to comfort. Pt then expired the morning of 8/18/21."
	"1655865-1"	"1655865-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 4/21/2021 and 5/18/2021. Patient admitted on 7/31/2021 for cardiogenic shock complicated by acute renal failure, coagulopathy and acute respiratory failure. To assist in management of the cardiogenic shock pt was placed on axillary IABP and dobutamine for inotropic support. Pt was decongested with combination of aquadex and diuretics with improvement in filling conditions. Unfortunately, patient developed persistent fever on 8/11 and was placed on broad spectrum antibiotics, ID was consulted and underwent extensive infectious evaluation.She did have MRSA in pneumonia PCR and candida albicans has grown in urine culture. On 8/16/21 morning pt decompensated hemodynamicallly requiring levophed and vasopressin and continued evaluation revealed that pt had positive IgM COVID antibodies and it was suspected that pt developed a new COVID infection. She continued to decline over the next 48 hours with worsening hemodynamics and renal function and therefore a dialsysis catheter was placed and pt was started on renal replacement therapy. Family was kept uptodate about the patients clinical status and at this point decided to transition focus of care to comfort. Pt then expired the morning of 8/18/21."
	"1655865-1"	"1655865-1"	"INTRA-AORTIC BALLOON PLACEMENT"	"10052989"	"50-59 years"	"50-59"	"Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 4/21/2021 and 5/18/2021. Patient admitted on 7/31/2021 for cardiogenic shock complicated by acute renal failure, coagulopathy and acute respiratory failure. To assist in management of the cardiogenic shock pt was placed on axillary IABP and dobutamine for inotropic support. Pt was decongested with combination of aquadex and diuretics with improvement in filling conditions. Unfortunately, patient developed persistent fever on 8/11 and was placed on broad spectrum antibiotics, ID was consulted and underwent extensive infectious evaluation.She did have MRSA in pneumonia PCR and candida albicans has grown in urine culture. On 8/16/21 morning pt decompensated hemodynamicallly requiring levophed and vasopressin and continued evaluation revealed that pt had positive IgM COVID antibodies and it was suspected that pt developed a new COVID infection. She continued to decline over the next 48 hours with worsening hemodynamics and renal function and therefore a dialsysis catheter was placed and pt was started on renal replacement therapy. Family was kept uptodate about the patients clinical status and at this point decided to transition focus of care to comfort. Pt then expired the morning of 8/18/21."
	"1655865-1"	"1655865-1"	"PNEUMONIA STAPHYLOCOCCAL"	"10035734"	"50-59 years"	"50-59"	"Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 4/21/2021 and 5/18/2021. Patient admitted on 7/31/2021 for cardiogenic shock complicated by acute renal failure, coagulopathy and acute respiratory failure. To assist in management of the cardiogenic shock pt was placed on axillary IABP and dobutamine for inotropic support. Pt was decongested with combination of aquadex and diuretics with improvement in filling conditions. Unfortunately, patient developed persistent fever on 8/11 and was placed on broad spectrum antibiotics, ID was consulted and underwent extensive infectious evaluation.She did have MRSA in pneumonia PCR and candida albicans has grown in urine culture. On 8/16/21 morning pt decompensated hemodynamicallly requiring levophed and vasopressin and continued evaluation revealed that pt had positive IgM COVID antibodies and it was suspected that pt developed a new COVID infection. She continued to decline over the next 48 hours with worsening hemodynamics and renal function and therefore a dialsysis catheter was placed and pt was started on renal replacement therapy. Family was kept uptodate about the patients clinical status and at this point decided to transition focus of care to comfort. Pt then expired the morning of 8/18/21."
	"1655865-1"	"1655865-1"	"PYREXIA"	"10037660"	"50-59 years"	"50-59"	"Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 4/21/2021 and 5/18/2021. Patient admitted on 7/31/2021 for cardiogenic shock complicated by acute renal failure, coagulopathy and acute respiratory failure. To assist in management of the cardiogenic shock pt was placed on axillary IABP and dobutamine for inotropic support. Pt was decongested with combination of aquadex and diuretics with improvement in filling conditions. Unfortunately, patient developed persistent fever on 8/11 and was placed on broad spectrum antibiotics, ID was consulted and underwent extensive infectious evaluation.She did have MRSA in pneumonia PCR and candida albicans has grown in urine culture. On 8/16/21 morning pt decompensated hemodynamicallly requiring levophed and vasopressin and continued evaluation revealed that pt had positive IgM COVID antibodies and it was suspected that pt developed a new COVID infection. She continued to decline over the next 48 hours with worsening hemodynamics and renal function and therefore a dialsysis catheter was placed and pt was started on renal replacement therapy. Family was kept uptodate about the patients clinical status and at this point decided to transition focus of care to comfort. Pt then expired the morning of 8/18/21."
	"1655865-1"	"1655865-1"	"RENAL IMPAIRMENT"	"10062237"	"50-59 years"	"50-59"	"Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 4/21/2021 and 5/18/2021. Patient admitted on 7/31/2021 for cardiogenic shock complicated by acute renal failure, coagulopathy and acute respiratory failure. To assist in management of the cardiogenic shock pt was placed on axillary IABP and dobutamine for inotropic support. Pt was decongested with combination of aquadex and diuretics with improvement in filling conditions. Unfortunately, patient developed persistent fever on 8/11 and was placed on broad spectrum antibiotics, ID was consulted and underwent extensive infectious evaluation.She did have MRSA in pneumonia PCR and candida albicans has grown in urine culture. On 8/16/21 morning pt decompensated hemodynamicallly requiring levophed and vasopressin and continued evaluation revealed that pt had positive IgM COVID antibodies and it was suspected that pt developed a new COVID infection. She continued to decline over the next 48 hours with worsening hemodynamics and renal function and therefore a dialsysis catheter was placed and pt was started on renal replacement therapy. Family was kept uptodate about the patients clinical status and at this point decided to transition focus of care to comfort. Pt then expired the morning of 8/18/21."
	"1655865-1"	"1655865-1"	"RENAL REPLACEMENT THERAPY"	"10074746"	"50-59 years"	"50-59"	"Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 4/21/2021 and 5/18/2021. Patient admitted on 7/31/2021 for cardiogenic shock complicated by acute renal failure, coagulopathy and acute respiratory failure. To assist in management of the cardiogenic shock pt was placed on axillary IABP and dobutamine for inotropic support. Pt was decongested with combination of aquadex and diuretics with improvement in filling conditions. Unfortunately, patient developed persistent fever on 8/11 and was placed on broad spectrum antibiotics, ID was consulted and underwent extensive infectious evaluation.She did have MRSA in pneumonia PCR and candida albicans has grown in urine culture. On 8/16/21 morning pt decompensated hemodynamicallly requiring levophed and vasopressin and continued evaluation revealed that pt had positive IgM COVID antibodies and it was suspected that pt developed a new COVID infection. She continued to decline over the next 48 hours with worsening hemodynamics and renal function and therefore a dialsysis catheter was placed and pt was started on renal replacement therapy. Family was kept uptodate about the patients clinical status and at this point decided to transition focus of care to comfort. Pt then expired the morning of 8/18/21."
	"1655865-1"	"1655865-1"	"SARS-COV-2 ANTIBODY TEST POSITIVE"	"10084491"	"50-59 years"	"50-59"	"Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 4/21/2021 and 5/18/2021. Patient admitted on 7/31/2021 for cardiogenic shock complicated by acute renal failure, coagulopathy and acute respiratory failure. To assist in management of the cardiogenic shock pt was placed on axillary IABP and dobutamine for inotropic support. Pt was decongested with combination of aquadex and diuretics with improvement in filling conditions. Unfortunately, patient developed persistent fever on 8/11 and was placed on broad spectrum antibiotics, ID was consulted and underwent extensive infectious evaluation.She did have MRSA in pneumonia PCR and candida albicans has grown in urine culture. On 8/16/21 morning pt decompensated hemodynamicallly requiring levophed and vasopressin and continued evaluation revealed that pt had positive IgM COVID antibodies and it was suspected that pt developed a new COVID infection. She continued to decline over the next 48 hours with worsening hemodynamics and renal function and therefore a dialsysis catheter was placed and pt was started on renal replacement therapy. Family was kept uptodate about the patients clinical status and at this point decided to transition focus of care to comfort. Pt then expired the morning of 8/18/21."
	"1655865-1"	"1655865-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 4/21/2021 and 5/18/2021. Patient admitted on 7/31/2021 for cardiogenic shock complicated by acute renal failure, coagulopathy and acute respiratory failure. To assist in management of the cardiogenic shock pt was placed on axillary IABP and dobutamine for inotropic support. Pt was decongested with combination of aquadex and diuretics with improvement in filling conditions. Unfortunately, patient developed persistent fever on 8/11 and was placed on broad spectrum antibiotics, ID was consulted and underwent extensive infectious evaluation.She did have MRSA in pneumonia PCR and candida albicans has grown in urine culture. On 8/16/21 morning pt decompensated hemodynamicallly requiring levophed and vasopressin and continued evaluation revealed that pt had positive IgM COVID antibodies and it was suspected that pt developed a new COVID infection. She continued to decline over the next 48 hours with worsening hemodynamics and renal function and therefore a dialsysis catheter was placed and pt was started on renal replacement therapy. Family was kept uptodate about the patients clinical status and at this point decided to transition focus of care to comfort. Pt then expired the morning of 8/18/21."
	"1655925-1"	"1655925-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"patient came to the ED in cardiac arrest, patient expired"
	"1655925-1"	"1655925-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"patient came to the ED in cardiac arrest, patient expired"
	"1656114-1"	"1656114-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"DEATH"
	"1656560-1"	"1656560-1"	"ANTICOAGULANT THERAPY"	"10053468"	"50-59 years"	"50-59"	"Janssen (J&J) COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 07/10/2021. Patient started having symptoms on 7/31/2021 and presented to ED on 8/2/2021. Patient received dexamethasone and enoxaparin at outside hospital. Patient rapidly declined eventually requiring mechanical ventilation and was then transfered to ED on 8/5/2021. Patient was diagnosed with bilateral pulmonary embolisms. Patient received dexamethasone, enoxaparin, remdesivir, & ceftriaxone. Hospital course progressed without meaningful recovery of lung function ad patient expired on 8/18/2021."
	"1656560-1"	"1656560-1"	"COMPUTERISED TOMOGRAM THORAX ABNORMAL"	"10057799"	"50-59 years"	"50-59"	"Janssen (J&J) COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 07/10/2021. Patient started having symptoms on 7/31/2021 and presented to ED on 8/2/2021. Patient received dexamethasone and enoxaparin at outside hospital. Patient rapidly declined eventually requiring mechanical ventilation and was then transfered to ED on 8/5/2021. Patient was diagnosed with bilateral pulmonary embolisms. Patient received dexamethasone, enoxaparin, remdesivir, & ceftriaxone. Hospital course progressed without meaningful recovery of lung function ad patient expired on 8/18/2021."
	"1656560-1"	"1656560-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Janssen (J&J) COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 07/10/2021. Patient started having symptoms on 7/31/2021 and presented to ED on 8/2/2021. Patient received dexamethasone and enoxaparin at outside hospital. Patient rapidly declined eventually requiring mechanical ventilation and was then transfered to ED on 8/5/2021. Patient was diagnosed with bilateral pulmonary embolisms. Patient received dexamethasone, enoxaparin, remdesivir, & ceftriaxone. Hospital course progressed without meaningful recovery of lung function ad patient expired on 8/18/2021."
	"1656560-1"	"1656560-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Janssen (J&J) COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 07/10/2021. Patient started having symptoms on 7/31/2021 and presented to ED on 8/2/2021. Patient received dexamethasone and enoxaparin at outside hospital. Patient rapidly declined eventually requiring mechanical ventilation and was then transfered to ED on 8/5/2021. Patient was diagnosed with bilateral pulmonary embolisms. Patient received dexamethasone, enoxaparin, remdesivir, & ceftriaxone. Hospital course progressed without meaningful recovery of lung function ad patient expired on 8/18/2021."
	"1656560-1"	"1656560-1"	"GENERAL PHYSICAL HEALTH DETERIORATION"	"10049438"	"50-59 years"	"50-59"	"Janssen (J&J) COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 07/10/2021. Patient started having symptoms on 7/31/2021 and presented to ED on 8/2/2021. Patient received dexamethasone and enoxaparin at outside hospital. Patient rapidly declined eventually requiring mechanical ventilation and was then transfered to ED on 8/5/2021. Patient was diagnosed with bilateral pulmonary embolisms. Patient received dexamethasone, enoxaparin, remdesivir, & ceftriaxone. Hospital course progressed without meaningful recovery of lung function ad patient expired on 8/18/2021."
	"1656560-1"	"1656560-1"	"LUNG INFILTRATION"	"10025102"	"50-59 years"	"50-59"	"Janssen (J&J) COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 07/10/2021. Patient started having symptoms on 7/31/2021 and presented to ED on 8/2/2021. Patient received dexamethasone and enoxaparin at outside hospital. Patient rapidly declined eventually requiring mechanical ventilation and was then transfered to ED on 8/5/2021. Patient was diagnosed with bilateral pulmonary embolisms. Patient received dexamethasone, enoxaparin, remdesivir, & ceftriaxone. Hospital course progressed without meaningful recovery of lung function ad patient expired on 8/18/2021."
	"1656560-1"	"1656560-1"	"MECHANICAL VENTILATION"	"10067221"	"50-59 years"	"50-59"	"Janssen (J&J) COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 07/10/2021. Patient started having symptoms on 7/31/2021 and presented to ED on 8/2/2021. Patient received dexamethasone and enoxaparin at outside hospital. Patient rapidly declined eventually requiring mechanical ventilation and was then transfered to ED on 8/5/2021. Patient was diagnosed with bilateral pulmonary embolisms. Patient received dexamethasone, enoxaparin, remdesivir, & ceftriaxone. Hospital course progressed without meaningful recovery of lung function ad patient expired on 8/18/2021."
	"1656560-1"	"1656560-1"	"PULMONARY EMBOLISM"	"10037377"	"50-59 years"	"50-59"	"Janssen (J&J) COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 07/10/2021. Patient started having symptoms on 7/31/2021 and presented to ED on 8/2/2021. Patient received dexamethasone and enoxaparin at outside hospital. Patient rapidly declined eventually requiring mechanical ventilation and was then transfered to ED on 8/5/2021. Patient was diagnosed with bilateral pulmonary embolisms. Patient received dexamethasone, enoxaparin, remdesivir, & ceftriaxone. Hospital course progressed without meaningful recovery of lung function ad patient expired on 8/18/2021."
	"1656560-1"	"1656560-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"Janssen (J&J) COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 07/10/2021. Patient started having symptoms on 7/31/2021 and presented to ED on 8/2/2021. Patient received dexamethasone and enoxaparin at outside hospital. Patient rapidly declined eventually requiring mechanical ventilation and was then transfered to ED on 8/5/2021. Patient was diagnosed with bilateral pulmonary embolisms. Patient received dexamethasone, enoxaparin, remdesivir, & ceftriaxone. Hospital course progressed without meaningful recovery of lung function ad patient expired on 8/18/2021."
	"1656560-1"	"1656560-1"	"TROPONIN INCREASED"	"10058267"	"50-59 years"	"50-59"	"Janssen (J&J) COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 07/10/2021. Patient started having symptoms on 7/31/2021 and presented to ED on 8/2/2021. Patient received dexamethasone and enoxaparin at outside hospital. Patient rapidly declined eventually requiring mechanical ventilation and was then transfered to ED on 8/5/2021. Patient was diagnosed with bilateral pulmonary embolisms. Patient received dexamethasone, enoxaparin, remdesivir, & ceftriaxone. Hospital course progressed without meaningful recovery of lung function ad patient expired on 8/18/2021."
	"1658553-1"	"1658553-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Janssen on 8/17. Positive 8/29. death at end hospital stay"
	"1658553-1"	"1658553-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Janssen on 8/17. Positive 8/29. death at end hospital stay"
	"1658553-1"	"1658553-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"Janssen on 8/17. Positive 8/29. death at end hospital stay"
	"1658919-1"	"1658919-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Death- 7-24-2021   Myocarditis"
	"1658919-1"	"1658919-1"	"MYOCARDITIS"	"10028606"	"50-59 years"	"50-59"	"Death- 7-24-2021   Myocarditis"
	"1659940-1"	"1659940-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"After the 1st 24 hours from his shot, he was having  trouble breathing,  by the third day his skin color was looking grayish, but he thought this was all from him being recently diagnosed  with COPD. He did not show up for work on Friday and when his coworker went to his home to check on him and found him unresponsive, she called 911. They tried to revive him, but was unable to. I sadly have to report he passed away."
	"1659940-1"	"1659940-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"After the 1st 24 hours from his shot, he was having  trouble breathing,  by the third day his skin color was looking grayish, but he thought this was all from him being recently diagnosed  with COPD. He did not show up for work on Friday and when his coworker went to his home to check on him and found him unresponsive, she called 911. They tried to revive him, but was unable to. I sadly have to report he passed away."
	"1659940-1"	"1659940-1"	"RESUSCITATION"	"10038749"	"50-59 years"	"50-59"	"After the 1st 24 hours from his shot, he was having  trouble breathing,  by the third day his skin color was looking grayish, but he thought this was all from him being recently diagnosed  with COPD. He did not show up for work on Friday and when his coworker went to his home to check on him and found him unresponsive, she called 911. They tried to revive him, but was unable to. I sadly have to report he passed away."
	"1659940-1"	"1659940-1"	"SKIN DISCOLOURATION"	"10040829"	"50-59 years"	"50-59"	"After the 1st 24 hours from his shot, he was having  trouble breathing,  by the third day his skin color was looking grayish, but he thought this was all from him being recently diagnosed  with COPD. He did not show up for work on Friday and when his coworker went to his home to check on him and found him unresponsive, she called 911. They tried to revive him, but was unable to. I sadly have to report he passed away."
	"1659940-1"	"1659940-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"50-59 years"	"50-59"	"After the 1st 24 hours from his shot, he was having  trouble breathing,  by the third day his skin color was looking grayish, but he thought this was all from him being recently diagnosed  with COPD. He did not show up for work on Friday and when his coworker went to his home to check on him and found him unresponsive, she called 911. They tried to revive him, but was unable to. I sadly have to report he passed away."
	"1660763-1"	"1660763-1"	"ACCIDENTAL OVERDOSE"	"10000381"	"50-59 years"	"50-59"	"Wrong diagnosis Dr told us hiv barely detectable then said gallbladder then walked in ov stating well good news its not cancer . he told patient he had no choice but to get the covid vaccine even tho he didn't want or understand it at all he offered no info no time and threatened patient he would not prescribe his hiv pills unless he was vaccinated fully . patient had too much trust . Dr gave him two different types and he was scheduling athird patient side affects were ignored and told it was normal due to injection he soon after was hospitallzed having lymph nodes cancer and all the tests ran by Dr were not found abbott said well I never looked at imaging and we we re sure it is acid reflex . another doctor a specialist said he shpuld not have given him that type of vaccine with his medical jistory and allergies. Dr told us at hospital dont try goodbye because patient had only 6 months if that to live he walked put two weeks later we went to specialost who said he was wrong and didnt know why Dr said that but to cover his butt because of the wrong dying of covid vaccines. Patient died and the hospital staff said either vaccine caused this or overdose when shift change happened because he was given too many pain meds and three kinds . no one even knew je was in the room he was peed even tho they said he couldnt he had food on him all over and he was on liquod diet he was dirty no water no machines hooled up not even an IV help we need justice story gets more detailed I have pics and med rec this doctor wwas wrong abiut it all even vaccine ."
	"1660763-1"	"1660763-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Wrong diagnosis Dr told us hiv barely detectable then said gallbladder then walked in ov stating well good news its not cancer . he told patient he had no choice but to get the covid vaccine even tho he didn't want or understand it at all he offered no info no time and threatened patient he would not prescribe his hiv pills unless he was vaccinated fully . patient had too much trust . Dr gave him two different types and he was scheduling athird patient side affects were ignored and told it was normal due to injection he soon after was hospitallzed having lymph nodes cancer and all the tests ran by Dr were not found abbott said well I never looked at imaging and we we re sure it is acid reflex . another doctor a specialist said he shpuld not have given him that type of vaccine with his medical jistory and allergies. Dr told us at hospital dont try goodbye because patient had only 6 months if that to live he walked put two weeks later we went to specialost who said he was wrong and didnt know why Dr said that but to cover his butt because of the wrong dying of covid vaccines. Patient died and the hospital staff said either vaccine caused this or overdose when shift change happened because he was given too many pain meds and three kinds . no one even knew je was in the room he was peed even tho they said he couldnt he had food on him all over and he was on liquod diet he was dirty no water no machines hooled up not even an IV help we need justice story gets more detailed I have pics and med rec this doctor wwas wrong abiut it all even vaccine ."
	"1660763-1"	"1660763-1"	"GASTROOESOPHAGEAL REFLUX DISEASE"	"10017885"	"50-59 years"	"50-59"	"Wrong diagnosis Dr told us hiv barely detectable then said gallbladder then walked in ov stating well good news its not cancer . he told patient he had no choice but to get the covid vaccine even tho he didn't want or understand it at all he offered no info no time and threatened patient he would not prescribe his hiv pills unless he was vaccinated fully . patient had too much trust . Dr gave him two different types and he was scheduling athird patient side affects were ignored and told it was normal due to injection he soon after was hospitallzed having lymph nodes cancer and all the tests ran by Dr were not found abbott said well I never looked at imaging and we we re sure it is acid reflex . another doctor a specialist said he shpuld not have given him that type of vaccine with his medical jistory and allergies. Dr told us at hospital dont try goodbye because patient had only 6 months if that to live he walked put two weeks later we went to specialost who said he was wrong and didnt know why Dr said that but to cover his butt because of the wrong dying of covid vaccines. Patient died and the hospital staff said either vaccine caused this or overdose when shift change happened because he was given too many pain meds and three kinds . no one even knew je was in the room he was peed even tho they said he couldnt he had food on him all over and he was on liquod diet he was dirty no water no machines hooled up not even an IV help we need justice story gets more detailed I have pics and med rec this doctor wwas wrong abiut it all even vaccine ."
	"1660763-1"	"1660763-1"	"INTERCHANGE OF VACCINE PRODUCTS"	"10070574"	"50-59 years"	"50-59"	"Wrong diagnosis Dr told us hiv barely detectable then said gallbladder then walked in ov stating well good news its not cancer . he told patient he had no choice but to get the covid vaccine even tho he didn't want or understand it at all he offered no info no time and threatened patient he would not prescribe his hiv pills unless he was vaccinated fully . patient had too much trust . Dr gave him two different types and he was scheduling athird patient side affects were ignored and told it was normal due to injection he soon after was hospitallzed having lymph nodes cancer and all the tests ran by Dr were not found abbott said well I never looked at imaging and we we re sure it is acid reflex . another doctor a specialist said he shpuld not have given him that type of vaccine with his medical jistory and allergies. Dr told us at hospital dont try goodbye because patient had only 6 months if that to live he walked put two weeks later we went to specialost who said he was wrong and didnt know why Dr said that but to cover his butt because of the wrong dying of covid vaccines. Patient died and the hospital staff said either vaccine caused this or overdose when shift change happened because he was given too many pain meds and three kinds . no one even knew je was in the room he was peed even tho they said he couldnt he had food on him all over and he was on liquod diet he was dirty no water no machines hooled up not even an IV help we need justice story gets more detailed I have pics and med rec this doctor wwas wrong abiut it all even vaccine ."
	"1660763-1"	"1660763-1"	"LYMPHOMA"	"10025310"	"50-59 years"	"50-59"	"Wrong diagnosis Dr told us hiv barely detectable then said gallbladder then walked in ov stating well good news its not cancer . he told patient he had no choice but to get the covid vaccine even tho he didn't want or understand it at all he offered no info no time and threatened patient he would not prescribe his hiv pills unless he was vaccinated fully . patient had too much trust . Dr gave him two different types and he was scheduling athird patient side affects were ignored and told it was normal due to injection he soon after was hospitallzed having lymph nodes cancer and all the tests ran by Dr were not found abbott said well I never looked at imaging and we we re sure it is acid reflex . another doctor a specialist said he shpuld not have given him that type of vaccine with his medical jistory and allergies. Dr told us at hospital dont try goodbye because patient had only 6 months if that to live he walked put two weeks later we went to specialost who said he was wrong and didnt know why Dr said that but to cover his butt because of the wrong dying of covid vaccines. Patient died and the hospital staff said either vaccine caused this or overdose when shift change happened because he was given too many pain meds and three kinds . no one even knew je was in the room he was peed even tho they said he couldnt he had food on him all over and he was on liquod diet he was dirty no water no machines hooled up not even an IV help we need justice story gets more detailed I have pics and med rec this doctor wwas wrong abiut it all even vaccine ."
	"1660763-1"	"1660763-1"	"VICTIM OF ABUSE"	"10058984"	"50-59 years"	"50-59"	"Wrong diagnosis Dr told us hiv barely detectable then said gallbladder then walked in ov stating well good news its not cancer . he told patient he had no choice but to get the covid vaccine even tho he didn't want or understand it at all he offered no info no time and threatened patient he would not prescribe his hiv pills unless he was vaccinated fully . patient had too much trust . Dr gave him two different types and he was scheduling athird patient side affects were ignored and told it was normal due to injection he soon after was hospitallzed having lymph nodes cancer and all the tests ran by Dr were not found abbott said well I never looked at imaging and we we re sure it is acid reflex . another doctor a specialist said he shpuld not have given him that type of vaccine with his medical jistory and allergies. Dr told us at hospital dont try goodbye because patient had only 6 months if that to live he walked put two weeks later we went to specialost who said he was wrong and didnt know why Dr said that but to cover his butt because of the wrong dying of covid vaccines. Patient died and the hospital staff said either vaccine caused this or overdose when shift change happened because he was given too many pain meds and three kinds . no one even knew je was in the room he was peed even tho they said he couldnt he had food on him all over and he was on liquod diet he was dirty no water no machines hooled up not even an IV help we need justice story gets more detailed I have pics and med rec this doctor wwas wrong abiut it all even vaccine ."
	"1662253-1"	"1662253-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Hospitalization/death due to COVID-19 Reported per Pfizer COVID-19 Vaccine EUA"
	"1662253-1"	"1662253-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Hospitalization/death due to COVID-19 Reported per Pfizer COVID-19 Vaccine EUA"
	"1662882-1"	"1662882-1"	"RESUSCITATION"	"10038749"	"50-59 years"	"50-59"	"PT was found unresponsive in the back of his vehicle. Last know alive when he spoke to mother regarding receiving the vaccination in the morning/early afternoon.  ACLS resuscitative efforts performed. Not successful. NO recent health complaints known"
	"1662882-1"	"1662882-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"50-59 years"	"50-59"	"PT was found unresponsive in the back of his vehicle. Last know alive when he spoke to mother regarding receiving the vaccination in the morning/early afternoon.  ACLS resuscitative efforts performed. Not successful. NO recent health complaints known"
	"1670157-1"	"1670157-1"	"ARTHRALGIA"	"10003239"	"50-59 years"	"50-59"	"Client's husband reported client received a flu shot on 7/27/21 when symptoms began.  ( does not indicate client received the influenza vaccine and last documented shot was given on 8/23/16.)  Symptoms included fatigue, aches mostly in hip, dehydration, and breathing difficulties, which continued to get worse throughout the week.  On 8/6/21 husband found client on floor in the bathroom.  When paramedics arrived, client refused to go to the hospital.  On 8/7/21, husband physically brought client to Hospital where she was admitted with COVID pneumonia.   She was in the ICU, ventilated and passed away on 8/30/21."
	"1670157-1"	"1670157-1"	"COVID-19 PNEUMONIA"	"10084380"	"50-59 years"	"50-59"	"Client's husband reported client received a flu shot on 7/27/21 when symptoms began.  ( does not indicate client received the influenza vaccine and last documented shot was given on 8/23/16.)  Symptoms included fatigue, aches mostly in hip, dehydration, and breathing difficulties, which continued to get worse throughout the week.  On 8/6/21 husband found client on floor in the bathroom.  When paramedics arrived, client refused to go to the hospital.  On 8/7/21, husband physically brought client to Hospital where she was admitted with COVID pneumonia.   She was in the ICU, ventilated and passed away on 8/30/21."
	"1670157-1"	"1670157-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Client's husband reported client received a flu shot on 7/27/21 when symptoms began.  ( does not indicate client received the influenza vaccine and last documented shot was given on 8/23/16.)  Symptoms included fatigue, aches mostly in hip, dehydration, and breathing difficulties, which continued to get worse throughout the week.  On 8/6/21 husband found client on floor in the bathroom.  When paramedics arrived, client refused to go to the hospital.  On 8/7/21, husband physically brought client to Hospital where she was admitted with COVID pneumonia.   She was in the ICU, ventilated and passed away on 8/30/21."
	"1670157-1"	"1670157-1"	"DEHYDRATION"	"10012174"	"50-59 years"	"50-59"	"Client's husband reported client received a flu shot on 7/27/21 when symptoms began.  ( does not indicate client received the influenza vaccine and last documented shot was given on 8/23/16.)  Symptoms included fatigue, aches mostly in hip, dehydration, and breathing difficulties, which continued to get worse throughout the week.  On 8/6/21 husband found client on floor in the bathroom.  When paramedics arrived, client refused to go to the hospital.  On 8/7/21, husband physically brought client to Hospital where she was admitted with COVID pneumonia.   She was in the ICU, ventilated and passed away on 8/30/21."
	"1670157-1"	"1670157-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"Client's husband reported client received a flu shot on 7/27/21 when symptoms began.  ( does not indicate client received the influenza vaccine and last documented shot was given on 8/23/16.)  Symptoms included fatigue, aches mostly in hip, dehydration, and breathing difficulties, which continued to get worse throughout the week.  On 8/6/21 husband found client on floor in the bathroom.  When paramedics arrived, client refused to go to the hospital.  On 8/7/21, husband physically brought client to Hospital where she was admitted with COVID pneumonia.   She was in the ICU, ventilated and passed away on 8/30/21."
	"1670157-1"	"1670157-1"	"FATIGUE"	"10016256"	"50-59 years"	"50-59"	"Client's husband reported client received a flu shot on 7/27/21 when symptoms began.  ( does not indicate client received the influenza vaccine and last documented shot was given on 8/23/16.)  Symptoms included fatigue, aches mostly in hip, dehydration, and breathing difficulties, which continued to get worse throughout the week.  On 8/6/21 husband found client on floor in the bathroom.  When paramedics arrived, client refused to go to the hospital.  On 8/7/21, husband physically brought client to Hospital where she was admitted with COVID pneumonia.   She was in the ICU, ventilated and passed away on 8/30/21."
	"1670157-1"	"1670157-1"	"INTENSIVE CARE"	"10022519"	"50-59 years"	"50-59"	"Client's husband reported client received a flu shot on 7/27/21 when symptoms began.  ( does not indicate client received the influenza vaccine and last documented shot was given on 8/23/16.)  Symptoms included fatigue, aches mostly in hip, dehydration, and breathing difficulties, which continued to get worse throughout the week.  On 8/6/21 husband found client on floor in the bathroom.  When paramedics arrived, client refused to go to the hospital.  On 8/7/21, husband physically brought client to Hospital where she was admitted with COVID pneumonia.   She was in the ICU, ventilated and passed away on 8/30/21."
	"1670157-1"	"1670157-1"	"MECHANICAL VENTILATION"	"10067221"	"50-59 years"	"50-59"	"Client's husband reported client received a flu shot on 7/27/21 when symptoms began.  ( does not indicate client received the influenza vaccine and last documented shot was given on 8/23/16.)  Symptoms included fatigue, aches mostly in hip, dehydration, and breathing difficulties, which continued to get worse throughout the week.  On 8/6/21 husband found client on floor in the bathroom.  When paramedics arrived, client refused to go to the hospital.  On 8/7/21, husband physically brought client to Hospital where she was admitted with COVID pneumonia.   She was in the ICU, ventilated and passed away on 8/30/21."
	"1670812-1"	"1670812-1"	"BLOOD GLUCOSE NORMAL"	"10005558"	"50-59 years"	"50-59"	""ACCORDING TO DAUGHTER & SISTER: THE DECEASED HAD NO RECENT COMPLAINTS. THEY HAD A HISTORY OF HTN FOR, WHICH THEY WERE TAKING MEDICATION, BUT NO KNOWN CARDIAC ISSUES. THEY WERE AT WORK WHEN THEY HAD ""SEIZURE-LIKE"" ACTIVITY & COLLAPSED TO THE GROUND. EMS WAS CALLED. SHE WAS NOTED BY EMS TO BE IN ASYSTOLE AND ACLS BEGAN. EMS ADMINISTERED 3MG OF EPINEPHRINE AND CONTINUED COMPRESSIONS UNTIL THEIR ARRIVAL TO ED AT 11:38AM ON 8/22/21. WHILE IN THE ED, SHE RECEIVED MAGNESIUM SULFATE, AMIODARONE, CALCIUM CHLORIDE, SODIUM BICARBONATE, AND ADDITIONAL DOSES OF EPINEPHRINE. BEDSIDE CARDIAC US REVEALED NO CARDIAC WALL MOTION. A CENTRAL VENOUS CATHETER WAS PLACED AND tPA WAS ADMINISTERED. CPR WAS CONTINUED. DESPITE ALL EFFORTS, SHE REMAINED IN ASYSTOLE. REPEAT BEDSIDE CARDIAC US AGAIN REVEALED NO CARDIAC WALL MOTION. SHE WAS PRONOUNCED AT 12:11PM.""
	"1670812-1"	"1670812-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	""ACCORDING TO DAUGHTER & SISTER: THE DECEASED HAD NO RECENT COMPLAINTS. THEY HAD A HISTORY OF HTN FOR, WHICH THEY WERE TAKING MEDICATION, BUT NO KNOWN CARDIAC ISSUES. THEY WERE AT WORK WHEN THEY HAD ""SEIZURE-LIKE"" ACTIVITY & COLLAPSED TO THE GROUND. EMS WAS CALLED. SHE WAS NOTED BY EMS TO BE IN ASYSTOLE AND ACLS BEGAN. EMS ADMINISTERED 3MG OF EPINEPHRINE AND CONTINUED COMPRESSIONS UNTIL THEIR ARRIVAL TO ED AT 11:38AM ON 8/22/21. WHILE IN THE ED, SHE RECEIVED MAGNESIUM SULFATE, AMIODARONE, CALCIUM CHLORIDE, SODIUM BICARBONATE, AND ADDITIONAL DOSES OF EPINEPHRINE. BEDSIDE CARDIAC US REVEALED NO CARDIAC WALL MOTION. A CENTRAL VENOUS CATHETER WAS PLACED AND tPA WAS ADMINISTERED. CPR WAS CONTINUED. DESPITE ALL EFFORTS, SHE REMAINED IN ASYSTOLE. REPEAT BEDSIDE CARDIAC US AGAIN REVEALED NO CARDIAC WALL MOTION. SHE WAS PRONOUNCED AT 12:11PM.""
	"1670812-1"	"1670812-1"	"CENTRAL VENOUS CATHETERISATION"	"10053377"	"50-59 years"	"50-59"	""ACCORDING TO DAUGHTER & SISTER: THE DECEASED HAD NO RECENT COMPLAINTS. THEY HAD A HISTORY OF HTN FOR, WHICH THEY WERE TAKING MEDICATION, BUT NO KNOWN CARDIAC ISSUES. THEY WERE AT WORK WHEN THEY HAD ""SEIZURE-LIKE"" ACTIVITY & COLLAPSED TO THE GROUND. EMS WAS CALLED. SHE WAS NOTED BY EMS TO BE IN ASYSTOLE AND ACLS BEGAN. EMS ADMINISTERED 3MG OF EPINEPHRINE AND CONTINUED COMPRESSIONS UNTIL THEIR ARRIVAL TO ED AT 11:38AM ON 8/22/21. WHILE IN THE ED, SHE RECEIVED MAGNESIUM SULFATE, AMIODARONE, CALCIUM CHLORIDE, SODIUM BICARBONATE, AND ADDITIONAL DOSES OF EPINEPHRINE. BEDSIDE CARDIAC US REVEALED NO CARDIAC WALL MOTION. A CENTRAL VENOUS CATHETER WAS PLACED AND tPA WAS ADMINISTERED. CPR WAS CONTINUED. DESPITE ALL EFFORTS, SHE REMAINED IN ASYSTOLE. REPEAT BEDSIDE CARDIAC US AGAIN REVEALED NO CARDIAC WALL MOTION. SHE WAS PRONOUNCED AT 12:11PM.""
	"1670812-1"	"1670812-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	""ACCORDING TO DAUGHTER & SISTER: THE DECEASED HAD NO RECENT COMPLAINTS. THEY HAD A HISTORY OF HTN FOR, WHICH THEY WERE TAKING MEDICATION, BUT NO KNOWN CARDIAC ISSUES. THEY WERE AT WORK WHEN THEY HAD ""SEIZURE-LIKE"" ACTIVITY & COLLAPSED TO THE GROUND. EMS WAS CALLED. SHE WAS NOTED BY EMS TO BE IN ASYSTOLE AND ACLS BEGAN. EMS ADMINISTERED 3MG OF EPINEPHRINE AND CONTINUED COMPRESSIONS UNTIL THEIR ARRIVAL TO ED AT 11:38AM ON 8/22/21. WHILE IN THE ED, SHE RECEIVED MAGNESIUM SULFATE, AMIODARONE, CALCIUM CHLORIDE, SODIUM BICARBONATE, AND ADDITIONAL DOSES OF EPINEPHRINE. BEDSIDE CARDIAC US REVEALED NO CARDIAC WALL MOTION. A CENTRAL VENOUS CATHETER WAS PLACED AND tPA WAS ADMINISTERED. CPR WAS CONTINUED. DESPITE ALL EFFORTS, SHE REMAINED IN ASYSTOLE. REPEAT BEDSIDE CARDIAC US AGAIN REVEALED NO CARDIAC WALL MOTION. SHE WAS PRONOUNCED AT 12:11PM.""
	"1670812-1"	"1670812-1"	"ECHOCARDIOGRAM"	"10014113"	"50-59 years"	"50-59"	""ACCORDING TO DAUGHTER & SISTER: THE DECEASED HAD NO RECENT COMPLAINTS. THEY HAD A HISTORY OF HTN FOR, WHICH THEY WERE TAKING MEDICATION, BUT NO KNOWN CARDIAC ISSUES. THEY WERE AT WORK WHEN THEY HAD ""SEIZURE-LIKE"" ACTIVITY & COLLAPSED TO THE GROUND. EMS WAS CALLED. SHE WAS NOTED BY EMS TO BE IN ASYSTOLE AND ACLS BEGAN. EMS ADMINISTERED 3MG OF EPINEPHRINE AND CONTINUED COMPRESSIONS UNTIL THEIR ARRIVAL TO ED AT 11:38AM ON 8/22/21. WHILE IN THE ED, SHE RECEIVED MAGNESIUM SULFATE, AMIODARONE, CALCIUM CHLORIDE, SODIUM BICARBONATE, AND ADDITIONAL DOSES OF EPINEPHRINE. BEDSIDE CARDIAC US REVEALED NO CARDIAC WALL MOTION. A CENTRAL VENOUS CATHETER WAS PLACED AND tPA WAS ADMINISTERED. CPR WAS CONTINUED. DESPITE ALL EFFORTS, SHE REMAINED IN ASYSTOLE. REPEAT BEDSIDE CARDIAC US AGAIN REVEALED NO CARDIAC WALL MOTION. SHE WAS PRONOUNCED AT 12:11PM.""
	"1670812-1"	"1670812-1"	"INFLUENZA A VIRUS TEST NEGATIVE"	"10070417"	"50-59 years"	"50-59"	""ACCORDING TO DAUGHTER & SISTER: THE DECEASED HAD NO RECENT COMPLAINTS. THEY HAD A HISTORY OF HTN FOR, WHICH THEY WERE TAKING MEDICATION, BUT NO KNOWN CARDIAC ISSUES. THEY WERE AT WORK WHEN THEY HAD ""SEIZURE-LIKE"" ACTIVITY & COLLAPSED TO THE GROUND. EMS WAS CALLED. SHE WAS NOTED BY EMS TO BE IN ASYSTOLE AND ACLS BEGAN. EMS ADMINISTERED 3MG OF EPINEPHRINE AND CONTINUED COMPRESSIONS UNTIL THEIR ARRIVAL TO ED AT 11:38AM ON 8/22/21. WHILE IN THE ED, SHE RECEIVED MAGNESIUM SULFATE, AMIODARONE, CALCIUM CHLORIDE, SODIUM BICARBONATE, AND ADDITIONAL DOSES OF EPINEPHRINE. BEDSIDE CARDIAC US REVEALED NO CARDIAC WALL MOTION. A CENTRAL VENOUS CATHETER WAS PLACED AND tPA WAS ADMINISTERED. CPR WAS CONTINUED. DESPITE ALL EFFORTS, SHE REMAINED IN ASYSTOLE. REPEAT BEDSIDE CARDIAC US AGAIN REVEALED NO CARDIAC WALL MOTION. SHE WAS PRONOUNCED AT 12:11PM.""
	"1670812-1"	"1670812-1"	"INFLUENZA B VIRUS TEST POSITIVE"	"10070208"	"50-59 years"	"50-59"	""ACCORDING TO DAUGHTER & SISTER: THE DECEASED HAD NO RECENT COMPLAINTS. THEY HAD A HISTORY OF HTN FOR, WHICH THEY WERE TAKING MEDICATION, BUT NO KNOWN CARDIAC ISSUES. THEY WERE AT WORK WHEN THEY HAD ""SEIZURE-LIKE"" ACTIVITY & COLLAPSED TO THE GROUND. EMS WAS CALLED. SHE WAS NOTED BY EMS TO BE IN ASYSTOLE AND ACLS BEGAN. EMS ADMINISTERED 3MG OF EPINEPHRINE AND CONTINUED COMPRESSIONS UNTIL THEIR ARRIVAL TO ED AT 11:38AM ON 8/22/21. WHILE IN THE ED, SHE RECEIVED MAGNESIUM SULFATE, AMIODARONE, CALCIUM CHLORIDE, SODIUM BICARBONATE, AND ADDITIONAL DOSES OF EPINEPHRINE. BEDSIDE CARDIAC US REVEALED NO CARDIAC WALL MOTION. A CENTRAL VENOUS CATHETER WAS PLACED AND tPA WAS ADMINISTERED. CPR WAS CONTINUED. DESPITE ALL EFFORTS, SHE REMAINED IN ASYSTOLE. REPEAT BEDSIDE CARDIAC US AGAIN REVEALED NO CARDIAC WALL MOTION. SHE WAS PRONOUNCED AT 12:11PM.""
	"1670812-1"	"1670812-1"	"RESUSCITATION"	"10038749"	"50-59 years"	"50-59"	""ACCORDING TO DAUGHTER & SISTER: THE DECEASED HAD NO RECENT COMPLAINTS. THEY HAD A HISTORY OF HTN FOR, WHICH THEY WERE TAKING MEDICATION, BUT NO KNOWN CARDIAC ISSUES. THEY WERE AT WORK WHEN THEY HAD ""SEIZURE-LIKE"" ACTIVITY & COLLAPSED TO THE GROUND. EMS WAS CALLED. SHE WAS NOTED BY EMS TO BE IN ASYSTOLE AND ACLS BEGAN. EMS ADMINISTERED 3MG OF EPINEPHRINE AND CONTINUED COMPRESSIONS UNTIL THEIR ARRIVAL TO ED AT 11:38AM ON 8/22/21. WHILE IN THE ED, SHE RECEIVED MAGNESIUM SULFATE, AMIODARONE, CALCIUM CHLORIDE, SODIUM BICARBONATE, AND ADDITIONAL DOSES OF EPINEPHRINE. BEDSIDE CARDIAC US REVEALED NO CARDIAC WALL MOTION. A CENTRAL VENOUS CATHETER WAS PLACED AND tPA WAS ADMINISTERED. CPR WAS CONTINUED. DESPITE ALL EFFORTS, SHE REMAINED IN ASYSTOLE. REPEAT BEDSIDE CARDIAC US AGAIN REVEALED NO CARDIAC WALL MOTION. SHE WAS PRONOUNCED AT 12:11PM.""
	"1670812-1"	"1670812-1"	"SARS-COV-2 TEST NEGATIVE"	"10084273"	"50-59 years"	"50-59"	""ACCORDING TO DAUGHTER & SISTER: THE DECEASED HAD NO RECENT COMPLAINTS. THEY HAD A HISTORY OF HTN FOR, WHICH THEY WERE TAKING MEDICATION, BUT NO KNOWN CARDIAC ISSUES. THEY WERE AT WORK WHEN THEY HAD ""SEIZURE-LIKE"" ACTIVITY & COLLAPSED TO THE GROUND. EMS WAS CALLED. SHE WAS NOTED BY EMS TO BE IN ASYSTOLE AND ACLS BEGAN. EMS ADMINISTERED 3MG OF EPINEPHRINE AND CONTINUED COMPRESSIONS UNTIL THEIR ARRIVAL TO ED AT 11:38AM ON 8/22/21. WHILE IN THE ED, SHE RECEIVED MAGNESIUM SULFATE, AMIODARONE, CALCIUM CHLORIDE, SODIUM BICARBONATE, AND ADDITIONAL DOSES OF EPINEPHRINE. BEDSIDE CARDIAC US REVEALED NO CARDIAC WALL MOTION. A CENTRAL VENOUS CATHETER WAS PLACED AND tPA WAS ADMINISTERED. CPR WAS CONTINUED. DESPITE ALL EFFORTS, SHE REMAINED IN ASYSTOLE. REPEAT BEDSIDE CARDIAC US AGAIN REVEALED NO CARDIAC WALL MOTION. SHE WAS PRONOUNCED AT 12:11PM.""
	"1670812-1"	"1670812-1"	"SEIZURE LIKE PHENOMENA"	"10071048"	"50-59 years"	"50-59"	""ACCORDING TO DAUGHTER & SISTER: THE DECEASED HAD NO RECENT COMPLAINTS. THEY HAD A HISTORY OF HTN FOR, WHICH THEY WERE TAKING MEDICATION, BUT NO KNOWN CARDIAC ISSUES. THEY WERE AT WORK WHEN THEY HAD ""SEIZURE-LIKE"" ACTIVITY & COLLAPSED TO THE GROUND. EMS WAS CALLED. SHE WAS NOTED BY EMS TO BE IN ASYSTOLE AND ACLS BEGAN. EMS ADMINISTERED 3MG OF EPINEPHRINE AND CONTINUED COMPRESSIONS UNTIL THEIR ARRIVAL TO ED AT 11:38AM ON 8/22/21. WHILE IN THE ED, SHE RECEIVED MAGNESIUM SULFATE, AMIODARONE, CALCIUM CHLORIDE, SODIUM BICARBONATE, AND ADDITIONAL DOSES OF EPINEPHRINE. BEDSIDE CARDIAC US REVEALED NO CARDIAC WALL MOTION. A CENTRAL VENOUS CATHETER WAS PLACED AND tPA WAS ADMINISTERED. CPR WAS CONTINUED. DESPITE ALL EFFORTS, SHE REMAINED IN ASYSTOLE. REPEAT BEDSIDE CARDIAC US AGAIN REVEALED NO CARDIAC WALL MOTION. SHE WAS PRONOUNCED AT 12:11PM.""
	"1670812-1"	"1670812-1"	"SYNCOPE"	"10042772"	"50-59 years"	"50-59"	""ACCORDING TO DAUGHTER & SISTER: THE DECEASED HAD NO RECENT COMPLAINTS. THEY HAD A HISTORY OF HTN FOR, WHICH THEY WERE TAKING MEDICATION, BUT NO KNOWN CARDIAC ISSUES. THEY WERE AT WORK WHEN THEY HAD ""SEIZURE-LIKE"" ACTIVITY & COLLAPSED TO THE GROUND. EMS WAS CALLED. SHE WAS NOTED BY EMS TO BE IN ASYSTOLE AND ACLS BEGAN. EMS ADMINISTERED 3MG OF EPINEPHRINE AND CONTINUED COMPRESSIONS UNTIL THEIR ARRIVAL TO ED AT 11:38AM ON 8/22/21. WHILE IN THE ED, SHE RECEIVED MAGNESIUM SULFATE, AMIODARONE, CALCIUM CHLORIDE, SODIUM BICARBONATE, AND ADDITIONAL DOSES OF EPINEPHRINE. BEDSIDE CARDIAC US REVEALED NO CARDIAC WALL MOTION. A CENTRAL VENOUS CATHETER WAS PLACED AND tPA WAS ADMINISTERED. CPR WAS CONTINUED. DESPITE ALL EFFORTS, SHE REMAINED IN ASYSTOLE. REPEAT BEDSIDE CARDIAC US AGAIN REVEALED NO CARDIAC WALL MOTION. SHE WAS PRONOUNCED AT 12:11PM.""
	"1674474-1"	"1674474-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"My father received the shot on Sunday May 23rd in the late afternoon, on Tuesday May 25th he had an artery embolism and passed away that morning."
	"1674474-1"	"1674474-1"	"EMBOLISM ARTERIAL"	"10014513"	"50-59 years"	"50-59"	"My father received the shot on Sunday May 23rd in the late afternoon, on Tuesday May 25th he had an artery embolism and passed away that morning."
	"1678330-1"	"1678330-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"See Attachments"
	"1678502-1"	"1678502-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"PT EXPIRED OF COVID-19 ON 9/5/2021; BREAKTHROUGH CASE"
	"1678502-1"	"1678502-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"PT EXPIRED OF COVID-19 ON 9/5/2021; BREAKTHROUGH CASE"
	"1678502-1"	"1678502-1"	"VACCINE BREAKTHROUGH INFECTION"	"10067923"	"50-59 years"	"50-59"	"PT EXPIRED OF COVID-19 ON 9/5/2021; BREAKTHROUGH CASE"
	"1679301-1"	"1679301-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Wife claims that patient was coughing up blood after they received the shot and passed away, not much else was described"
	"1679301-1"	"1679301-1"	"HAEMOPTYSIS"	"10018964"	"50-59 years"	"50-59"	"Wife claims that patient was coughing up blood after they received the shot and passed away, not much else was described"
	"1682967-1"	"1682967-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient death."
	"1683133-1"	"1683133-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"SOB; HYPOXIC; PNEUMONIA, POSTIVE COVID TEST"
	"1683133-1"	"1683133-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"SOB; HYPOXIC; PNEUMONIA, POSTIVE COVID TEST"
	"1683133-1"	"1683133-1"	"HYPOXIA"	"10021143"	"50-59 years"	"50-59"	"SOB; HYPOXIC; PNEUMONIA, POSTIVE COVID TEST"
	"1683133-1"	"1683133-1"	"PNEUMONIA"	"10035664"	"50-59 years"	"50-59"	"SOB; HYPOXIC; PNEUMONIA, POSTIVE COVID TEST"
	"1683133-1"	"1683133-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"SOB; HYPOXIC; PNEUMONIA, POSTIVE COVID TEST"
	"1683226-1"	"1683226-1"	"SUDDEN CARDIAC DEATH"	"10049418"	"50-59 years"	"50-59"	"6 months later died of suddenly when heart stopped"
	"1683357-1"	"1683357-1"	"ACUTE KIDNEY INJURY"	"10069339"	"50-59 years"	"50-59"	"Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Moderna Vaccines on 3/25/2021 and 4/29/2021. Presented to ED on 8/12/2021 with complaints of dyspnea for 1 week requiring oxygen. Patient was placed on oxygen and eventually required mechanical ventilation. Patient had septic shock and acute kidney injury. Medications administered: dexamethasone, ascorbic acid, ceftriaxone, azithromycin, micafungin, remdesivir, piperacillin/tazobactam, tocilizumab, prednisone, and vancomycin. Patient continued to decompensate and expired at 14:44 on 8/29/2021."
	"1683357-1"	"1683357-1"	"BLOOD CREATININE INCREASED"	"10005483"	"50-59 years"	"50-59"	"Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Moderna Vaccines on 3/25/2021 and 4/29/2021. Presented to ED on 8/12/2021 with complaints of dyspnea for 1 week requiring oxygen. Patient was placed on oxygen and eventually required mechanical ventilation. Patient had septic shock and acute kidney injury. Medications administered: dexamethasone, ascorbic acid, ceftriaxone, azithromycin, micafungin, remdesivir, piperacillin/tazobactam, tocilizumab, prednisone, and vancomycin. Patient continued to decompensate and expired at 14:44 on 8/29/2021."
	"1683357-1"	"1683357-1"	"CHEST X-RAY ABNORMAL"	"10008499"	"50-59 years"	"50-59"	"Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Moderna Vaccines on 3/25/2021 and 4/29/2021. Presented to ED on 8/12/2021 with complaints of dyspnea for 1 week requiring oxygen. Patient was placed on oxygen and eventually required mechanical ventilation. Patient had septic shock and acute kidney injury. Medications administered: dexamethasone, ascorbic acid, ceftriaxone, azithromycin, micafungin, remdesivir, piperacillin/tazobactam, tocilizumab, prednisone, and vancomycin. Patient continued to decompensate and expired at 14:44 on 8/29/2021."
	"1683357-1"	"1683357-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Moderna Vaccines on 3/25/2021 and 4/29/2021. Presented to ED on 8/12/2021 with complaints of dyspnea for 1 week requiring oxygen. Patient was placed on oxygen and eventually required mechanical ventilation. Patient had septic shock and acute kidney injury. Medications administered: dexamethasone, ascorbic acid, ceftriaxone, azithromycin, micafungin, remdesivir, piperacillin/tazobactam, tocilizumab, prednisone, and vancomycin. Patient continued to decompensate and expired at 14:44 on 8/29/2021."
	"1683357-1"	"1683357-1"	"CULTURE URINE POSITIVE"	"10011640"	"50-59 years"	"50-59"	"Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Moderna Vaccines on 3/25/2021 and 4/29/2021. Presented to ED on 8/12/2021 with complaints of dyspnea for 1 week requiring oxygen. Patient was placed on oxygen and eventually required mechanical ventilation. Patient had septic shock and acute kidney injury. Medications administered: dexamethasone, ascorbic acid, ceftriaxone, azithromycin, micafungin, remdesivir, piperacillin/tazobactam, tocilizumab, prednisone, and vancomycin. Patient continued to decompensate and expired at 14:44 on 8/29/2021."
	"1683357-1"	"1683357-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Moderna Vaccines on 3/25/2021 and 4/29/2021. Presented to ED on 8/12/2021 with complaints of dyspnea for 1 week requiring oxygen. Patient was placed on oxygen and eventually required mechanical ventilation. Patient had septic shock and acute kidney injury. Medications administered: dexamethasone, ascorbic acid, ceftriaxone, azithromycin, micafungin, remdesivir, piperacillin/tazobactam, tocilizumab, prednisone, and vancomycin. Patient continued to decompensate and expired at 14:44 on 8/29/2021."
	"1683357-1"	"1683357-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Moderna Vaccines on 3/25/2021 and 4/29/2021. Presented to ED on 8/12/2021 with complaints of dyspnea for 1 week requiring oxygen. Patient was placed on oxygen and eventually required mechanical ventilation. Patient had septic shock and acute kidney injury. Medications administered: dexamethasone, ascorbic acid, ceftriaxone, azithromycin, micafungin, remdesivir, piperacillin/tazobactam, tocilizumab, prednisone, and vancomycin. Patient continued to decompensate and expired at 14:44 on 8/29/2021."
	"1683357-1"	"1683357-1"	"GENERAL PHYSICAL HEALTH DETERIORATION"	"10049438"	"50-59 years"	"50-59"	"Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Moderna Vaccines on 3/25/2021 and 4/29/2021. Presented to ED on 8/12/2021 with complaints of dyspnea for 1 week requiring oxygen. Patient was placed on oxygen and eventually required mechanical ventilation. Patient had septic shock and acute kidney injury. Medications administered: dexamethasone, ascorbic acid, ceftriaxone, azithromycin, micafungin, remdesivir, piperacillin/tazobactam, tocilizumab, prednisone, and vancomycin. Patient continued to decompensate and expired at 14:44 on 8/29/2021."
	"1683357-1"	"1683357-1"	"LUNG OPACITY"	"10081792"	"50-59 years"	"50-59"	"Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Moderna Vaccines on 3/25/2021 and 4/29/2021. Presented to ED on 8/12/2021 with complaints of dyspnea for 1 week requiring oxygen. Patient was placed on oxygen and eventually required mechanical ventilation. Patient had septic shock and acute kidney injury. Medications administered: dexamethasone, ascorbic acid, ceftriaxone, azithromycin, micafungin, remdesivir, piperacillin/tazobactam, tocilizumab, prednisone, and vancomycin. Patient continued to decompensate and expired at 14:44 on 8/29/2021."
	"1683357-1"	"1683357-1"	"MECHANICAL VENTILATION"	"10067221"	"50-59 years"	"50-59"	"Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Moderna Vaccines on 3/25/2021 and 4/29/2021. Presented to ED on 8/12/2021 with complaints of dyspnea for 1 week requiring oxygen. Patient was placed on oxygen and eventually required mechanical ventilation. Patient had septic shock and acute kidney injury. Medications administered: dexamethasone, ascorbic acid, ceftriaxone, azithromycin, micafungin, remdesivir, piperacillin/tazobactam, tocilizumab, prednisone, and vancomycin. Patient continued to decompensate and expired at 14:44 on 8/29/2021."
	"1683357-1"	"1683357-1"	"PSEUDOMONAS INFECTION"	"10061471"	"50-59 years"	"50-59"	"Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Moderna Vaccines on 3/25/2021 and 4/29/2021. Presented to ED on 8/12/2021 with complaints of dyspnea for 1 week requiring oxygen. Patient was placed on oxygen and eventually required mechanical ventilation. Patient had septic shock and acute kidney injury. Medications administered: dexamethasone, ascorbic acid, ceftriaxone, azithromycin, micafungin, remdesivir, piperacillin/tazobactam, tocilizumab, prednisone, and vancomycin. Patient continued to decompensate and expired at 14:44 on 8/29/2021."
	"1683357-1"	"1683357-1"	"PSEUDOMONAS TEST POSITIVE"	"10070135"	"50-59 years"	"50-59"	"Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Moderna Vaccines on 3/25/2021 and 4/29/2021. Presented to ED on 8/12/2021 with complaints of dyspnea for 1 week requiring oxygen. Patient was placed on oxygen and eventually required mechanical ventilation. Patient had septic shock and acute kidney injury. Medications administered: dexamethasone, ascorbic acid, ceftriaxone, azithromycin, micafungin, remdesivir, piperacillin/tazobactam, tocilizumab, prednisone, and vancomycin. Patient continued to decompensate and expired at 14:44 on 8/29/2021."
	"1683357-1"	"1683357-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Moderna Vaccines on 3/25/2021 and 4/29/2021. Presented to ED on 8/12/2021 with complaints of dyspnea for 1 week requiring oxygen. Patient was placed on oxygen and eventually required mechanical ventilation. Patient had septic shock and acute kidney injury. Medications administered: dexamethasone, ascorbic acid, ceftriaxone, azithromycin, micafungin, remdesivir, piperacillin/tazobactam, tocilizumab, prednisone, and vancomycin. Patient continued to decompensate and expired at 14:44 on 8/29/2021."
	"1683357-1"	"1683357-1"	"SEPTIC SHOCK"	"10040070"	"50-59 years"	"50-59"	"Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Moderna Vaccines on 3/25/2021 and 4/29/2021. Presented to ED on 8/12/2021 with complaints of dyspnea for 1 week requiring oxygen. Patient was placed on oxygen and eventually required mechanical ventilation. Patient had septic shock and acute kidney injury. Medications administered: dexamethasone, ascorbic acid, ceftriaxone, azithromycin, micafungin, remdesivir, piperacillin/tazobactam, tocilizumab, prednisone, and vancomycin. Patient continued to decompensate and expired at 14:44 on 8/29/2021."
	"1683357-1"	"1683357-1"	"SPUTUM CULTURE POSITIVE"	"10051612"	"50-59 years"	"50-59"	"Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Moderna Vaccines on 3/25/2021 and 4/29/2021. Presented to ED on 8/12/2021 with complaints of dyspnea for 1 week requiring oxygen. Patient was placed on oxygen and eventually required mechanical ventilation. Patient had septic shock and acute kidney injury. Medications administered: dexamethasone, ascorbic acid, ceftriaxone, azithromycin, micafungin, remdesivir, piperacillin/tazobactam, tocilizumab, prednisone, and vancomycin. Patient continued to decompensate and expired at 14:44 on 8/29/2021."
	"1683357-1"	"1683357-1"	"STAPHYLOCOCCAL INFECTION"	"10058080"	"50-59 years"	"50-59"	"Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Moderna Vaccines on 3/25/2021 and 4/29/2021. Presented to ED on 8/12/2021 with complaints of dyspnea for 1 week requiring oxygen. Patient was placed on oxygen and eventually required mechanical ventilation. Patient had septic shock and acute kidney injury. Medications administered: dexamethasone, ascorbic acid, ceftriaxone, azithromycin, micafungin, remdesivir, piperacillin/tazobactam, tocilizumab, prednisone, and vancomycin. Patient continued to decompensate and expired at 14:44 on 8/29/2021."
	"1683449-1"	"1683449-1"	"ATRIAL FIBRILLATION"	"10003658"	"50-59 years"	"50-59"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Jannsen Vaccine on 4/01/2021 and 3/23/2021. Presented to facility of 8/28/2021 with a chief complaint of cough without SOB, with room sats of 85%,  fever, and COVID positive. Patient required intubation on 8/30/2021 during a cardiac arrest. On 8/31/2021 patient transferred to facility. On arrival with air transport, patient is hemodynamically stable, sedated on propofol.  Patient is connected to MV with settings CMV 20/450/.70 +10. On 9/2/2021, spontaneous movement but not following commands.  Remains in prone position.  HD yesterday."
	"1683449-1"	"1683449-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Jannsen Vaccine on 4/01/2021 and 3/23/2021. Presented to facility of 8/28/2021 with a chief complaint of cough without SOB, with room sats of 85%,  fever, and COVID positive. Patient required intubation on 8/30/2021 during a cardiac arrest. On 8/31/2021 patient transferred to facility. On arrival with air transport, patient is hemodynamically stable, sedated on propofol.  Patient is connected to MV with settings CMV 20/450/.70 +10. On 9/2/2021, spontaneous movement but not following commands.  Remains in prone position.  HD yesterday."
	"1683449-1"	"1683449-1"	"COUGH"	"10011224"	"50-59 years"	"50-59"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Jannsen Vaccine on 4/01/2021 and 3/23/2021. Presented to facility of 8/28/2021 with a chief complaint of cough without SOB, with room sats of 85%,  fever, and COVID positive. Patient required intubation on 8/30/2021 during a cardiac arrest. On 8/31/2021 patient transferred to facility. On arrival with air transport, patient is hemodynamically stable, sedated on propofol.  Patient is connected to MV with settings CMV 20/450/.70 +10. On 9/2/2021, spontaneous movement but not following commands.  Remains in prone position.  HD yesterday."
	"1683449-1"	"1683449-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Jannsen Vaccine on 4/01/2021 and 3/23/2021. Presented to facility of 8/28/2021 with a chief complaint of cough without SOB, with room sats of 85%,  fever, and COVID positive. Patient required intubation on 8/30/2021 during a cardiac arrest. On 8/31/2021 patient transferred to facility. On arrival with air transport, patient is hemodynamically stable, sedated on propofol.  Patient is connected to MV with settings CMV 20/450/.70 +10. On 9/2/2021, spontaneous movement but not following commands.  Remains in prone position.  HD yesterday."
	"1683449-1"	"1683449-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Jannsen Vaccine on 4/01/2021 and 3/23/2021. Presented to facility of 8/28/2021 with a chief complaint of cough without SOB, with room sats of 85%,  fever, and COVID positive. Patient required intubation on 8/30/2021 during a cardiac arrest. On 8/31/2021 patient transferred to facility. On arrival with air transport, patient is hemodynamically stable, sedated on propofol.  Patient is connected to MV with settings CMV 20/450/.70 +10. On 9/2/2021, spontaneous movement but not following commands.  Remains in prone position.  HD yesterday."
	"1683449-1"	"1683449-1"	"DYSKINESIA"	"10013916"	"50-59 years"	"50-59"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Jannsen Vaccine on 4/01/2021 and 3/23/2021. Presented to facility of 8/28/2021 with a chief complaint of cough without SOB, with room sats of 85%,  fever, and COVID positive. Patient required intubation on 8/30/2021 during a cardiac arrest. On 8/31/2021 patient transferred to facility. On arrival with air transport, patient is hemodynamically stable, sedated on propofol.  Patient is connected to MV with settings CMV 20/450/.70 +10. On 9/2/2021, spontaneous movement but not following commands.  Remains in prone position.  HD yesterday."
	"1683449-1"	"1683449-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"50-59 years"	"50-59"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Jannsen Vaccine on 4/01/2021 and 3/23/2021. Presented to facility of 8/28/2021 with a chief complaint of cough without SOB, with room sats of 85%,  fever, and COVID positive. Patient required intubation on 8/30/2021 during a cardiac arrest. On 8/31/2021 patient transferred to facility. On arrival with air transport, patient is hemodynamically stable, sedated on propofol.  Patient is connected to MV with settings CMV 20/450/.70 +10. On 9/2/2021, spontaneous movement but not following commands.  Remains in prone position.  HD yesterday."
	"1683449-1"	"1683449-1"	"HAEMODIALYSIS"	"10018875"	"50-59 years"	"50-59"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Jannsen Vaccine on 4/01/2021 and 3/23/2021. Presented to facility of 8/28/2021 with a chief complaint of cough without SOB, with room sats of 85%,  fever, and COVID positive. Patient required intubation on 8/30/2021 during a cardiac arrest. On 8/31/2021 patient transferred to facility. On arrival with air transport, patient is hemodynamically stable, sedated on propofol.  Patient is connected to MV with settings CMV 20/450/.70 +10. On 9/2/2021, spontaneous movement but not following commands.  Remains in prone position.  HD yesterday."
	"1683449-1"	"1683449-1"	"HYPONATRAEMIA"	"10021036"	"50-59 years"	"50-59"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Jannsen Vaccine on 4/01/2021 and 3/23/2021. Presented to facility of 8/28/2021 with a chief complaint of cough without SOB, with room sats of 85%,  fever, and COVID positive. Patient required intubation on 8/30/2021 during a cardiac arrest. On 8/31/2021 patient transferred to facility. On arrival with air transport, patient is hemodynamically stable, sedated on propofol.  Patient is connected to MV with settings CMV 20/450/.70 +10. On 9/2/2021, spontaneous movement but not following commands.  Remains in prone position.  HD yesterday."
	"1683449-1"	"1683449-1"	"MECHANICAL VENTILATION"	"10067221"	"50-59 years"	"50-59"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Jannsen Vaccine on 4/01/2021 and 3/23/2021. Presented to facility of 8/28/2021 with a chief complaint of cough without SOB, with room sats of 85%,  fever, and COVID positive. Patient required intubation on 8/30/2021 during a cardiac arrest. On 8/31/2021 patient transferred to facility. On arrival with air transport, patient is hemodynamically stable, sedated on propofol.  Patient is connected to MV with settings CMV 20/450/.70 +10. On 9/2/2021, spontaneous movement but not following commands.  Remains in prone position.  HD yesterday."
	"1683449-1"	"1683449-1"	"NEUTROPENIA"	"10029354"	"50-59 years"	"50-59"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Jannsen Vaccine on 4/01/2021 and 3/23/2021. Presented to facility of 8/28/2021 with a chief complaint of cough without SOB, with room sats of 85%,  fever, and COVID positive. Patient required intubation on 8/30/2021 during a cardiac arrest. On 8/31/2021 patient transferred to facility. On arrival with air transport, patient is hemodynamically stable, sedated on propofol.  Patient is connected to MV with settings CMV 20/450/.70 +10. On 9/2/2021, spontaneous movement but not following commands.  Remains in prone position.  HD yesterday."
	"1683449-1"	"1683449-1"	"OXYGEN SATURATION DECREASED"	"10033318"	"50-59 years"	"50-59"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Jannsen Vaccine on 4/01/2021 and 3/23/2021. Presented to facility of 8/28/2021 with a chief complaint of cough without SOB, with room sats of 85%,  fever, and COVID positive. Patient required intubation on 8/30/2021 during a cardiac arrest. On 8/31/2021 patient transferred to facility. On arrival with air transport, patient is hemodynamically stable, sedated on propofol.  Patient is connected to MV with settings CMV 20/450/.70 +10. On 9/2/2021, spontaneous movement but not following commands.  Remains in prone position.  HD yesterday."
	"1683449-1"	"1683449-1"	"PYREXIA"	"10037660"	"50-59 years"	"50-59"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Jannsen Vaccine on 4/01/2021 and 3/23/2021. Presented to facility of 8/28/2021 with a chief complaint of cough without SOB, with room sats of 85%,  fever, and COVID positive. Patient required intubation on 8/30/2021 during a cardiac arrest. On 8/31/2021 patient transferred to facility. On arrival with air transport, patient is hemodynamically stable, sedated on propofol.  Patient is connected to MV with settings CMV 20/450/.70 +10. On 9/2/2021, spontaneous movement but not following commands.  Remains in prone position.  HD yesterday."
	"1683449-1"	"1683449-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Jannsen Vaccine on 4/01/2021 and 3/23/2021. Presented to facility of 8/28/2021 with a chief complaint of cough without SOB, with room sats of 85%,  fever, and COVID positive. Patient required intubation on 8/30/2021 during a cardiac arrest. On 8/31/2021 patient transferred to facility. On arrival with air transport, patient is hemodynamically stable, sedated on propofol.  Patient is connected to MV with settings CMV 20/450/.70 +10. On 9/2/2021, spontaneous movement but not following commands.  Remains in prone position.  HD yesterday."
	"1683449-1"	"1683449-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"50-59 years"	"50-59"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Jannsen Vaccine on 4/01/2021 and 3/23/2021. Presented to facility of 8/28/2021 with a chief complaint of cough without SOB, with room sats of 85%,  fever, and COVID positive. Patient required intubation on 8/30/2021 during a cardiac arrest. On 8/31/2021 patient transferred to facility. On arrival with air transport, patient is hemodynamically stable, sedated on propofol.  Patient is connected to MV with settings CMV 20/450/.70 +10. On 9/2/2021, spontaneous movement but not following commands.  Remains in prone position.  HD yesterday."
	"1683454-1"	"1683454-1"	"CHEST X-RAY ABNORMAL"	"10008499"	"50-59 years"	"50-59"	"Pfizer-BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 1/29/2021 and 2/21/2021. Presented to ED on 8/17/2021 with complaints of fever and shortness of breath for 2 days with increased oxygen requirements. Medications administered: dexamethasone, methylprednisolone, ceftriaxone, cefepime, azithromycin, remdesivir, epoprostenol, and vancomycin. Patient continued to decompensate requiring more oxygen. On 8/29/2021 patient's mental status declined while on BiPAP. Patient expired at 13:44 on 8/29/2021."
	"1683454-1"	"1683454-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Pfizer-BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 1/29/2021 and 2/21/2021. Presented to ED on 8/17/2021 with complaints of fever and shortness of breath for 2 days with increased oxygen requirements. Medications administered: dexamethasone, methylprednisolone, ceftriaxone, cefepime, azithromycin, remdesivir, epoprostenol, and vancomycin. Patient continued to decompensate requiring more oxygen. On 8/29/2021 patient's mental status declined while on BiPAP. Patient expired at 13:44 on 8/29/2021."
	"1683454-1"	"1683454-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Pfizer-BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 1/29/2021 and 2/21/2021. Presented to ED on 8/17/2021 with complaints of fever and shortness of breath for 2 days with increased oxygen requirements. Medications administered: dexamethasone, methylprednisolone, ceftriaxone, cefepime, azithromycin, remdesivir, epoprostenol, and vancomycin. Patient continued to decompensate requiring more oxygen. On 8/29/2021 patient's mental status declined while on BiPAP. Patient expired at 13:44 on 8/29/2021."
	"1683454-1"	"1683454-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"Pfizer-BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 1/29/2021 and 2/21/2021. Presented to ED on 8/17/2021 with complaints of fever and shortness of breath for 2 days with increased oxygen requirements. Medications administered: dexamethasone, methylprednisolone, ceftriaxone, cefepime, azithromycin, remdesivir, epoprostenol, and vancomycin. Patient continued to decompensate requiring more oxygen. On 8/29/2021 patient's mental status declined while on BiPAP. Patient expired at 13:44 on 8/29/2021."
	"1683454-1"	"1683454-1"	"LUNG OPACITY"	"10081792"	"50-59 years"	"50-59"	"Pfizer-BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 1/29/2021 and 2/21/2021. Presented to ED on 8/17/2021 with complaints of fever and shortness of breath for 2 days with increased oxygen requirements. Medications administered: dexamethasone, methylprednisolone, ceftriaxone, cefepime, azithromycin, remdesivir, epoprostenol, and vancomycin. Patient continued to decompensate requiring more oxygen. On 8/29/2021 patient's mental status declined while on BiPAP. Patient expired at 13:44 on 8/29/2021."
	"1683454-1"	"1683454-1"	"MENTAL STATUS CHANGES"	"10048294"	"50-59 years"	"50-59"	"Pfizer-BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 1/29/2021 and 2/21/2021. Presented to ED on 8/17/2021 with complaints of fever and shortness of breath for 2 days with increased oxygen requirements. Medications administered: dexamethasone, methylprednisolone, ceftriaxone, cefepime, azithromycin, remdesivir, epoprostenol, and vancomycin. Patient continued to decompensate requiring more oxygen. On 8/29/2021 patient's mental status declined while on BiPAP. Patient expired at 13:44 on 8/29/2021."
	"1683454-1"	"1683454-1"	"POSITIVE AIRWAY PRESSURE THERAPY"	"10086397"	"50-59 years"	"50-59"	"Pfizer-BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 1/29/2021 and 2/21/2021. Presented to ED on 8/17/2021 with complaints of fever and shortness of breath for 2 days with increased oxygen requirements. Medications administered: dexamethasone, methylprednisolone, ceftriaxone, cefepime, azithromycin, remdesivir, epoprostenol, and vancomycin. Patient continued to decompensate requiring more oxygen. On 8/29/2021 patient's mental status declined while on BiPAP. Patient expired at 13:44 on 8/29/2021."
	"1683454-1"	"1683454-1"	"PYREXIA"	"10037660"	"50-59 years"	"50-59"	"Pfizer-BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 1/29/2021 and 2/21/2021. Presented to ED on 8/17/2021 with complaints of fever and shortness of breath for 2 days with increased oxygen requirements. Medications administered: dexamethasone, methylprednisolone, ceftriaxone, cefepime, azithromycin, remdesivir, epoprostenol, and vancomycin. Patient continued to decompensate requiring more oxygen. On 8/29/2021 patient's mental status declined while on BiPAP. Patient expired at 13:44 on 8/29/2021."
	"1683454-1"	"1683454-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"Pfizer-BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 1/29/2021 and 2/21/2021. Presented to ED on 8/17/2021 with complaints of fever and shortness of breath for 2 days with increased oxygen requirements. Medications administered: dexamethasone, methylprednisolone, ceftriaxone, cefepime, azithromycin, remdesivir, epoprostenol, and vancomycin. Patient continued to decompensate requiring more oxygen. On 8/29/2021 patient's mental status declined while on BiPAP. Patient expired at 13:44 on 8/29/2021."
	"1685242-1"	"1685242-1"	"CEREBROVASCULAR ACCIDENT"	"10008190"	"50-59 years"	"50-59"	"54-year-old female who was diagnosed with Covid several weeks prior presented to outside hospital due to facial numbness/tingling. She was found to have evidence of MCA stroke and was given TPA, she was transferred here for further management. Upon arrival here she was found to have evidence of bilateral MCA strokes, given that the patient was intubated and there is no likelihood of meaningful recovery goals of care discussions were had with neurology and the recommendation was to proceed with comfort care measures. The patient was extubated and transitioned to comfort care measures. Patient expired on 8/31/2021, cause of death was bilateral MCA strokes."
	"1685242-1"	"1685242-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"54-year-old female who was diagnosed with Covid several weeks prior presented to outside hospital due to facial numbness/tingling. She was found to have evidence of MCA stroke and was given TPA, she was transferred here for further management. Upon arrival here she was found to have evidence of bilateral MCA strokes, given that the patient was intubated and there is no likelihood of meaningful recovery goals of care discussions were had with neurology and the recommendation was to proceed with comfort care measures. The patient was extubated and transitioned to comfort care measures. Patient expired on 8/31/2021, cause of death was bilateral MCA strokes."
	"1685242-1"	"1685242-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"54-year-old female who was diagnosed with Covid several weeks prior presented to outside hospital due to facial numbness/tingling. She was found to have evidence of MCA stroke and was given TPA, she was transferred here for further management. Upon arrival here she was found to have evidence of bilateral MCA strokes, given that the patient was intubated and there is no likelihood of meaningful recovery goals of care discussions were had with neurology and the recommendation was to proceed with comfort care measures. The patient was extubated and transitioned to comfort care measures. Patient expired on 8/31/2021, cause of death was bilateral MCA strokes."
	"1685242-1"	"1685242-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"50-59 years"	"50-59"	"54-year-old female who was diagnosed with Covid several weeks prior presented to outside hospital due to facial numbness/tingling. She was found to have evidence of MCA stroke and was given TPA, she was transferred here for further management. Upon arrival here she was found to have evidence of bilateral MCA strokes, given that the patient was intubated and there is no likelihood of meaningful recovery goals of care discussions were had with neurology and the recommendation was to proceed with comfort care measures. The patient was extubated and transitioned to comfort care measures. Patient expired on 8/31/2021, cause of death was bilateral MCA strokes."
	"1685242-1"	"1685242-1"	"EXTUBATION"	"10015894"	"50-59 years"	"50-59"	"54-year-old female who was diagnosed with Covid several weeks prior presented to outside hospital due to facial numbness/tingling. She was found to have evidence of MCA stroke and was given TPA, she was transferred here for further management. Upon arrival here she was found to have evidence of bilateral MCA strokes, given that the patient was intubated and there is no likelihood of meaningful recovery goals of care discussions were had with neurology and the recommendation was to proceed with comfort care measures. The patient was extubated and transitioned to comfort care measures. Patient expired on 8/31/2021, cause of death was bilateral MCA strokes."
	"1685242-1"	"1685242-1"	"HYPOAESTHESIA"	"10020937"	"50-59 years"	"50-59"	"54-year-old female who was diagnosed with Covid several weeks prior presented to outside hospital due to facial numbness/tingling. She was found to have evidence of MCA stroke and was given TPA, she was transferred here for further management. Upon arrival here she was found to have evidence of bilateral MCA strokes, given that the patient was intubated and there is no likelihood of meaningful recovery goals of care discussions were had with neurology and the recommendation was to proceed with comfort care measures. The patient was extubated and transitioned to comfort care measures. Patient expired on 8/31/2021, cause of death was bilateral MCA strokes."
	"1685242-1"	"1685242-1"	"PARAESTHESIA"	"10033775"	"50-59 years"	"50-59"	"54-year-old female who was diagnosed with Covid several weeks prior presented to outside hospital due to facial numbness/tingling. She was found to have evidence of MCA stroke and was given TPA, she was transferred here for further management. Upon arrival here she was found to have evidence of bilateral MCA strokes, given that the patient was intubated and there is no likelihood of meaningful recovery goals of care discussions were had with neurology and the recommendation was to proceed with comfort care measures. The patient was extubated and transitioned to comfort care measures. Patient expired on 8/31/2021, cause of death was bilateral MCA strokes."
	"1685607-1"	"1685607-1"	"CHEST DISCOMFORT"	"10008469"	"50-59 years"	"50-59"	"chest tightness, shortness of breath after walking short distances, on 23rd collapsed at work and died"
	"1685607-1"	"1685607-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"chest tightness, shortness of breath after walking short distances, on 23rd collapsed at work and died"
	"1685607-1"	"1685607-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"chest tightness, shortness of breath after walking short distances, on 23rd collapsed at work and died"
	"1685607-1"	"1685607-1"	"DYSPNOEA EXERTIONAL"	"10013971"	"50-59 years"	"50-59"	"chest tightness, shortness of breath after walking short distances, on 23rd collapsed at work and died"
	"1685607-1"	"1685607-1"	"ELECTROCARDIOGRAM NORMAL"	"10014373"	"50-59 years"	"50-59"	"chest tightness, shortness of breath after walking short distances, on 23rd collapsed at work and died"
	"1685607-1"	"1685607-1"	"SYNCOPE"	"10042772"	"50-59 years"	"50-59"	"chest tightness, shortness of breath after walking short distances, on 23rd collapsed at work and died"
	"1689182-1"	"1689182-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient was sleeping, rolled over siezed up body postured with arms drawn. Called 911.Patient was unconscious and appeared to take his last breath as medics arrived. Medics and sheriffs arrived. I verified patient did not hit his head, fall or have any injury. They worked on the patient and transferred him to the hospital. Patient  was pronounced Dead at the hospital."
	"1689182-1"	"1689182-1"	"LOSS OF CONSCIOUSNESS"	"10024855"	"50-59 years"	"50-59"	"Patient was sleeping, rolled over siezed up body postured with arms drawn. Called 911.Patient was unconscious and appeared to take his last breath as medics arrived. Medics and sheriffs arrived. I verified patient did not hit his head, fall or have any injury. They worked on the patient and transferred him to the hospital. Patient  was pronounced Dead at the hospital."
	"1689182-1"	"1689182-1"	"POSTURING"	"10036437"	"50-59 years"	"50-59"	"Patient was sleeping, rolled over siezed up body postured with arms drawn. Called 911.Patient was unconscious and appeared to take his last breath as medics arrived. Medics and sheriffs arrived. I verified patient did not hit his head, fall or have any injury. They worked on the patient and transferred him to the hospital. Patient  was pronounced Dead at the hospital."
	"1689182-1"	"1689182-1"	"SEIZURE"	"10039906"	"50-59 years"	"50-59"	"Patient was sleeping, rolled over siezed up body postured with arms drawn. Called 911.Patient was unconscious and appeared to take his last breath as medics arrived. Medics and sheriffs arrived. I verified patient did not hit his head, fall or have any injury. They worked on the patient and transferred him to the hospital. Patient  was pronounced Dead at the hospital."
	"1689932-1"	"1689932-1"	"ACUTE RESPIRATORY DISTRESS SYNDROME"	"10001052"	"50-59 years"	"50-59"	"Transferred from another hospital. Presented there on 7/14/2021 with shortness of breath. While at outside hospital (OSH), pt with BP of 103/54, HR of 65, RR 20.  Upon presentation there, pt with oxygen saturation of 77%.  He was started on Optiflow with 25 L at 85%; pt now with spO2 of 91%.  Pt had elevated D-dimer, so CT angio chest done.  It showed multifocal pneumonia; no PE. He had nl trop and EKG.  Pt was given Azithromycin and Decadron while there.  Request for transfer made given pt's need for Optiflow. When received at our hospital, patient was resumed on dexamethasone, started remdesivir, ceftriaxone and doxycycline. He continued to have acute hypoxemic respiratory distress requiring mechanical ventilation.  Developed septic shock was requiring pressors had low blood pressure and was found to have septic shock from COVID pneumonia, with superimposed likely Gram-negative bacterial infection. received  Steroids, Rocephin, doxycycline, remdesivir.  Received 1 dose of Actemra. Course complicated by rhabdomyolysis, new onset atrial fibrillation. Passed away on 8/16/2021"
	"1689932-1"	"1689932-1"	"ANGIOGRAM PULMONARY ABNORMAL"	"10002441"	"50-59 years"	"50-59"	"Transferred from another hospital. Presented there on 7/14/2021 with shortness of breath. While at outside hospital (OSH), pt with BP of 103/54, HR of 65, RR 20.  Upon presentation there, pt with oxygen saturation of 77%.  He was started on Optiflow with 25 L at 85%; pt now with spO2 of 91%.  Pt had elevated D-dimer, so CT angio chest done.  It showed multifocal pneumonia; no PE. He had nl trop and EKG.  Pt was given Azithromycin and Decadron while there.  Request for transfer made given pt's need for Optiflow. When received at our hospital, patient was resumed on dexamethasone, started remdesivir, ceftriaxone and doxycycline. He continued to have acute hypoxemic respiratory distress requiring mechanical ventilation.  Developed septic shock was requiring pressors had low blood pressure and was found to have septic shock from COVID pneumonia, with superimposed likely Gram-negative bacterial infection. received  Steroids, Rocephin, doxycycline, remdesivir.  Received 1 dose of Actemra. Course complicated by rhabdomyolysis, new onset atrial fibrillation. Passed away on 8/16/2021"
	"1689932-1"	"1689932-1"	"ATRIAL FIBRILLATION"	"10003658"	"50-59 years"	"50-59"	"Transferred from another hospital. Presented there on 7/14/2021 with shortness of breath. While at outside hospital (OSH), pt with BP of 103/54, HR of 65, RR 20.  Upon presentation there, pt with oxygen saturation of 77%.  He was started on Optiflow with 25 L at 85%; pt now with spO2 of 91%.  Pt had elevated D-dimer, so CT angio chest done.  It showed multifocal pneumonia; no PE. He had nl trop and EKG.  Pt was given Azithromycin and Decadron while there.  Request for transfer made given pt's need for Optiflow. When received at our hospital, patient was resumed on dexamethasone, started remdesivir, ceftriaxone and doxycycline. He continued to have acute hypoxemic respiratory distress requiring mechanical ventilation.  Developed septic shock was requiring pressors had low blood pressure and was found to have septic shock from COVID pneumonia, with superimposed likely Gram-negative bacterial infection. received  Steroids, Rocephin, doxycycline, remdesivir.  Received 1 dose of Actemra. Course complicated by rhabdomyolysis, new onset atrial fibrillation. Passed away on 8/16/2021"
	"1689932-1"	"1689932-1"	"BACTERAEMIA"	"10003997"	"50-59 years"	"50-59"	"Transferred from another hospital. Presented there on 7/14/2021 with shortness of breath. While at outside hospital (OSH), pt with BP of 103/54, HR of 65, RR 20.  Upon presentation there, pt with oxygen saturation of 77%.  He was started on Optiflow with 25 L at 85%; pt now with spO2 of 91%.  Pt had elevated D-dimer, so CT angio chest done.  It showed multifocal pneumonia; no PE. He had nl trop and EKG.  Pt was given Azithromycin and Decadron while there.  Request for transfer made given pt's need for Optiflow. When received at our hospital, patient was resumed on dexamethasone, started remdesivir, ceftriaxone and doxycycline. He continued to have acute hypoxemic respiratory distress requiring mechanical ventilation.  Developed septic shock was requiring pressors had low blood pressure and was found to have septic shock from COVID pneumonia, with superimposed likely Gram-negative bacterial infection. received  Steroids, Rocephin, doxycycline, remdesivir.  Received 1 dose of Actemra. Course complicated by rhabdomyolysis, new onset atrial fibrillation. Passed away on 8/16/2021"
	"1689932-1"	"1689932-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Transferred from another hospital. Presented there on 7/14/2021 with shortness of breath. While at outside hospital (OSH), pt with BP of 103/54, HR of 65, RR 20.  Upon presentation there, pt with oxygen saturation of 77%.  He was started on Optiflow with 25 L at 85%; pt now with spO2 of 91%.  Pt had elevated D-dimer, so CT angio chest done.  It showed multifocal pneumonia; no PE. He had nl trop and EKG.  Pt was given Azithromycin and Decadron while there.  Request for transfer made given pt's need for Optiflow. When received at our hospital, patient was resumed on dexamethasone, started remdesivir, ceftriaxone and doxycycline. He continued to have acute hypoxemic respiratory distress requiring mechanical ventilation.  Developed septic shock was requiring pressors had low blood pressure and was found to have septic shock from COVID pneumonia, with superimposed likely Gram-negative bacterial infection. received  Steroids, Rocephin, doxycycline, remdesivir.  Received 1 dose of Actemra. Course complicated by rhabdomyolysis, new onset atrial fibrillation. Passed away on 8/16/2021"
	"1689932-1"	"1689932-1"	"COVID-19 PNEUMONIA"	"10084380"	"50-59 years"	"50-59"	"Transferred from another hospital. Presented there on 7/14/2021 with shortness of breath. While at outside hospital (OSH), pt with BP of 103/54, HR of 65, RR 20.  Upon presentation there, pt with oxygen saturation of 77%.  He was started on Optiflow with 25 L at 85%; pt now with spO2 of 91%.  Pt had elevated D-dimer, so CT angio chest done.  It showed multifocal pneumonia; no PE. He had nl trop and EKG.  Pt was given Azithromycin and Decadron while there.  Request for transfer made given pt's need for Optiflow. When received at our hospital, patient was resumed on dexamethasone, started remdesivir, ceftriaxone and doxycycline. He continued to have acute hypoxemic respiratory distress requiring mechanical ventilation.  Developed septic shock was requiring pressors had low blood pressure and was found to have septic shock from COVID pneumonia, with superimposed likely Gram-negative bacterial infection. received  Steroids, Rocephin, doxycycline, remdesivir.  Received 1 dose of Actemra. Course complicated by rhabdomyolysis, new onset atrial fibrillation. Passed away on 8/16/2021"
	"1689932-1"	"1689932-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"Transferred from another hospital. Presented there on 7/14/2021 with shortness of breath. While at outside hospital (OSH), pt with BP of 103/54, HR of 65, RR 20.  Upon presentation there, pt with oxygen saturation of 77%.  He was started on Optiflow with 25 L at 85%; pt now with spO2 of 91%.  Pt had elevated D-dimer, so CT angio chest done.  It showed multifocal pneumonia; no PE. He had nl trop and EKG.  Pt was given Azithromycin and Decadron while there.  Request for transfer made given pt's need for Optiflow. When received at our hospital, patient was resumed on dexamethasone, started remdesivir, ceftriaxone and doxycycline. He continued to have acute hypoxemic respiratory distress requiring mechanical ventilation.  Developed septic shock was requiring pressors had low blood pressure and was found to have septic shock from COVID pneumonia, with superimposed likely Gram-negative bacterial infection. received  Steroids, Rocephin, doxycycline, remdesivir.  Received 1 dose of Actemra. Course complicated by rhabdomyolysis, new onset atrial fibrillation. Passed away on 8/16/2021"
	"1689932-1"	"1689932-1"	"ELECTROCARDIOGRAM"	"10014362"	"50-59 years"	"50-59"	"Transferred from another hospital. Presented there on 7/14/2021 with shortness of breath. While at outside hospital (OSH), pt with BP of 103/54, HR of 65, RR 20.  Upon presentation there, pt with oxygen saturation of 77%.  He was started on Optiflow with 25 L at 85%; pt now with spO2 of 91%.  Pt had elevated D-dimer, so CT angio chest done.  It showed multifocal pneumonia; no PE. He had nl trop and EKG.  Pt was given Azithromycin and Decadron while there.  Request for transfer made given pt's need for Optiflow. When received at our hospital, patient was resumed on dexamethasone, started remdesivir, ceftriaxone and doxycycline. He continued to have acute hypoxemic respiratory distress requiring mechanical ventilation.  Developed septic shock was requiring pressors had low blood pressure and was found to have septic shock from COVID pneumonia, with superimposed likely Gram-negative bacterial infection. received  Steroids, Rocephin, doxycycline, remdesivir.  Received 1 dose of Actemra. Course complicated by rhabdomyolysis, new onset atrial fibrillation. Passed away on 8/16/2021"
	"1689932-1"	"1689932-1"	"FIBRIN D DIMER INCREASED"	"10016581"	"50-59 years"	"50-59"	"Transferred from another hospital. Presented there on 7/14/2021 with shortness of breath. While at outside hospital (OSH), pt with BP of 103/54, HR of 65, RR 20.  Upon presentation there, pt with oxygen saturation of 77%.  He was started on Optiflow with 25 L at 85%; pt now with spO2 of 91%.  Pt had elevated D-dimer, so CT angio chest done.  It showed multifocal pneumonia; no PE. He had nl trop and EKG.  Pt was given Azithromycin and Decadron while there.  Request for transfer made given pt's need for Optiflow. When received at our hospital, patient was resumed on dexamethasone, started remdesivir, ceftriaxone and doxycycline. He continued to have acute hypoxemic respiratory distress requiring mechanical ventilation.  Developed septic shock was requiring pressors had low blood pressure and was found to have septic shock from COVID pneumonia, with superimposed likely Gram-negative bacterial infection. received  Steroids, Rocephin, doxycycline, remdesivir.  Received 1 dose of Actemra. Course complicated by rhabdomyolysis, new onset atrial fibrillation. Passed away on 8/16/2021"
	"1689932-1"	"1689932-1"	"HYPOTENSION"	"10021097"	"50-59 years"	"50-59"	"Transferred from another hospital. Presented there on 7/14/2021 with shortness of breath. While at outside hospital (OSH), pt with BP of 103/54, HR of 65, RR 20.  Upon presentation there, pt with oxygen saturation of 77%.  He was started on Optiflow with 25 L at 85%; pt now with spO2 of 91%.  Pt had elevated D-dimer, so CT angio chest done.  It showed multifocal pneumonia; no PE. He had nl trop and EKG.  Pt was given Azithromycin and Decadron while there.  Request for transfer made given pt's need for Optiflow. When received at our hospital, patient was resumed on dexamethasone, started remdesivir, ceftriaxone and doxycycline. He continued to have acute hypoxemic respiratory distress requiring mechanical ventilation.  Developed septic shock was requiring pressors had low blood pressure and was found to have septic shock from COVID pneumonia, with superimposed likely Gram-negative bacterial infection. received  Steroids, Rocephin, doxycycline, remdesivir.  Received 1 dose of Actemra. Course complicated by rhabdomyolysis, new onset atrial fibrillation. Passed away on 8/16/2021"
	"1689932-1"	"1689932-1"	"HYPOXIA"	"10021143"	"50-59 years"	"50-59"	"Transferred from another hospital. Presented there on 7/14/2021 with shortness of breath. While at outside hospital (OSH), pt with BP of 103/54, HR of 65, RR 20.  Upon presentation there, pt with oxygen saturation of 77%.  He was started on Optiflow with 25 L at 85%; pt now with spO2 of 91%.  Pt had elevated D-dimer, so CT angio chest done.  It showed multifocal pneumonia; no PE. He had nl trop and EKG.  Pt was given Azithromycin and Decadron while there.  Request for transfer made given pt's need for Optiflow. When received at our hospital, patient was resumed on dexamethasone, started remdesivir, ceftriaxone and doxycycline. He continued to have acute hypoxemic respiratory distress requiring mechanical ventilation.  Developed septic shock was requiring pressors had low blood pressure and was found to have septic shock from COVID pneumonia, with superimposed likely Gram-negative bacterial infection. received  Steroids, Rocephin, doxycycline, remdesivir.  Received 1 dose of Actemra. Course complicated by rhabdomyolysis, new onset atrial fibrillation. Passed away on 8/16/2021"
	"1689932-1"	"1689932-1"	"MECHANICAL VENTILATION"	"10067221"	"50-59 years"	"50-59"	"Transferred from another hospital. Presented there on 7/14/2021 with shortness of breath. While at outside hospital (OSH), pt with BP of 103/54, HR of 65, RR 20.  Upon presentation there, pt with oxygen saturation of 77%.  He was started on Optiflow with 25 L at 85%; pt now with spO2 of 91%.  Pt had elevated D-dimer, so CT angio chest done.  It showed multifocal pneumonia; no PE. He had nl trop and EKG.  Pt was given Azithromycin and Decadron while there.  Request for transfer made given pt's need for Optiflow. When received at our hospital, patient was resumed on dexamethasone, started remdesivir, ceftriaxone and doxycycline. He continued to have acute hypoxemic respiratory distress requiring mechanical ventilation.  Developed septic shock was requiring pressors had low blood pressure and was found to have septic shock from COVID pneumonia, with superimposed likely Gram-negative bacterial infection. received  Steroids, Rocephin, doxycycline, remdesivir.  Received 1 dose of Actemra. Course complicated by rhabdomyolysis, new onset atrial fibrillation. Passed away on 8/16/2021"
	"1689932-1"	"1689932-1"	"PNEUMONIA"	"10035664"	"50-59 years"	"50-59"	"Transferred from another hospital. Presented there on 7/14/2021 with shortness of breath. While at outside hospital (OSH), pt with BP of 103/54, HR of 65, RR 20.  Upon presentation there, pt with oxygen saturation of 77%.  He was started on Optiflow with 25 L at 85%; pt now with spO2 of 91%.  Pt had elevated D-dimer, so CT angio chest done.  It showed multifocal pneumonia; no PE. He had nl trop and EKG.  Pt was given Azithromycin and Decadron while there.  Request for transfer made given pt's need for Optiflow. When received at our hospital, patient was resumed on dexamethasone, started remdesivir, ceftriaxone and doxycycline. He continued to have acute hypoxemic respiratory distress requiring mechanical ventilation.  Developed septic shock was requiring pressors had low blood pressure and was found to have septic shock from COVID pneumonia, with superimposed likely Gram-negative bacterial infection. received  Steroids, Rocephin, doxycycline, remdesivir.  Received 1 dose of Actemra. Course complicated by rhabdomyolysis, new onset atrial fibrillation. Passed away on 8/16/2021"
	"1689932-1"	"1689932-1"	"RESPIRATORY DISTRESS"	"10038687"	"50-59 years"	"50-59"	"Transferred from another hospital. Presented there on 7/14/2021 with shortness of breath. While at outside hospital (OSH), pt with BP of 103/54, HR of 65, RR 20.  Upon presentation there, pt with oxygen saturation of 77%.  He was started on Optiflow with 25 L at 85%; pt now with spO2 of 91%.  Pt had elevated D-dimer, so CT angio chest done.  It showed multifocal pneumonia; no PE. He had nl trop and EKG.  Pt was given Azithromycin and Decadron while there.  Request for transfer made given pt's need for Optiflow. When received at our hospital, patient was resumed on dexamethasone, started remdesivir, ceftriaxone and doxycycline. He continued to have acute hypoxemic respiratory distress requiring mechanical ventilation.  Developed septic shock was requiring pressors had low blood pressure and was found to have septic shock from COVID pneumonia, with superimposed likely Gram-negative bacterial infection. received  Steroids, Rocephin, doxycycline, remdesivir.  Received 1 dose of Actemra. Course complicated by rhabdomyolysis, new onset atrial fibrillation. Passed away on 8/16/2021"
	"1689932-1"	"1689932-1"	"RHABDOMYOLYSIS"	"10039020"	"50-59 years"	"50-59"	"Transferred from another hospital. Presented there on 7/14/2021 with shortness of breath. While at outside hospital (OSH), pt with BP of 103/54, HR of 65, RR 20.  Upon presentation there, pt with oxygen saturation of 77%.  He was started on Optiflow with 25 L at 85%; pt now with spO2 of 91%.  Pt had elevated D-dimer, so CT angio chest done.  It showed multifocal pneumonia; no PE. He had nl trop and EKG.  Pt was given Azithromycin and Decadron while there.  Request for transfer made given pt's need for Optiflow. When received at our hospital, patient was resumed on dexamethasone, started remdesivir, ceftriaxone and doxycycline. He continued to have acute hypoxemic respiratory distress requiring mechanical ventilation.  Developed septic shock was requiring pressors had low blood pressure and was found to have septic shock from COVID pneumonia, with superimposed likely Gram-negative bacterial infection. received  Steroids, Rocephin, doxycycline, remdesivir.  Received 1 dose of Actemra. Course complicated by rhabdomyolysis, new onset atrial fibrillation. Passed away on 8/16/2021"
	"1689932-1"	"1689932-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"Transferred from another hospital. Presented there on 7/14/2021 with shortness of breath. While at outside hospital (OSH), pt with BP of 103/54, HR of 65, RR 20.  Upon presentation there, pt with oxygen saturation of 77%.  He was started on Optiflow with 25 L at 85%; pt now with spO2 of 91%.  Pt had elevated D-dimer, so CT angio chest done.  It showed multifocal pneumonia; no PE. He had nl trop and EKG.  Pt was given Azithromycin and Decadron while there.  Request for transfer made given pt's need for Optiflow. When received at our hospital, patient was resumed on dexamethasone, started remdesivir, ceftriaxone and doxycycline. He continued to have acute hypoxemic respiratory distress requiring mechanical ventilation.  Developed septic shock was requiring pressors had low blood pressure and was found to have septic shock from COVID pneumonia, with superimposed likely Gram-negative bacterial infection. received  Steroids, Rocephin, doxycycline, remdesivir.  Received 1 dose of Actemra. Course complicated by rhabdomyolysis, new onset atrial fibrillation. Passed away on 8/16/2021"
	"1689932-1"	"1689932-1"	"SEPTIC SHOCK"	"10040070"	"50-59 years"	"50-59"	"Transferred from another hospital. Presented there on 7/14/2021 with shortness of breath. While at outside hospital (OSH), pt with BP of 103/54, HR of 65, RR 20.  Upon presentation there, pt with oxygen saturation of 77%.  He was started on Optiflow with 25 L at 85%; pt now with spO2 of 91%.  Pt had elevated D-dimer, so CT angio chest done.  It showed multifocal pneumonia; no PE. He had nl trop and EKG.  Pt was given Azithromycin and Decadron while there.  Request for transfer made given pt's need for Optiflow. When received at our hospital, patient was resumed on dexamethasone, started remdesivir, ceftriaxone and doxycycline. He continued to have acute hypoxemic respiratory distress requiring mechanical ventilation.  Developed septic shock was requiring pressors had low blood pressure and was found to have septic shock from COVID pneumonia, with superimposed likely Gram-negative bacterial infection. received  Steroids, Rocephin, doxycycline, remdesivir.  Received 1 dose of Actemra. Course complicated by rhabdomyolysis, new onset atrial fibrillation. Passed away on 8/16/2021"
	"1689932-1"	"1689932-1"	"TROPONIN"	"10061576"	"50-59 years"	"50-59"	"Transferred from another hospital. Presented there on 7/14/2021 with shortness of breath. While at outside hospital (OSH), pt with BP of 103/54, HR of 65, RR 20.  Upon presentation there, pt with oxygen saturation of 77%.  He was started on Optiflow with 25 L at 85%; pt now with spO2 of 91%.  Pt had elevated D-dimer, so CT angio chest done.  It showed multifocal pneumonia; no PE. He had nl trop and EKG.  Pt was given Azithromycin and Decadron while there.  Request for transfer made given pt's need for Optiflow. When received at our hospital, patient was resumed on dexamethasone, started remdesivir, ceftriaxone and doxycycline. He continued to have acute hypoxemic respiratory distress requiring mechanical ventilation.  Developed septic shock was requiring pressors had low blood pressure and was found to have septic shock from COVID pneumonia, with superimposed likely Gram-negative bacterial infection. received  Steroids, Rocephin, doxycycline, remdesivir.  Received 1 dose of Actemra. Course complicated by rhabdomyolysis, new onset atrial fibrillation. Passed away on 8/16/2021"
	"1689932-1"	"1689932-1"	"ULTRASOUND DOPPLER NORMAL"	"10045414"	"50-59 years"	"50-59"	"Transferred from another hospital. Presented there on 7/14/2021 with shortness of breath. While at outside hospital (OSH), pt with BP of 103/54, HR of 65, RR 20.  Upon presentation there, pt with oxygen saturation of 77%.  He was started on Optiflow with 25 L at 85%; pt now with spO2 of 91%.  Pt had elevated D-dimer, so CT angio chest done.  It showed multifocal pneumonia; no PE. He had nl trop and EKG.  Pt was given Azithromycin and Decadron while there.  Request for transfer made given pt's need for Optiflow. When received at our hospital, patient was resumed on dexamethasone, started remdesivir, ceftriaxone and doxycycline. He continued to have acute hypoxemic respiratory distress requiring mechanical ventilation.  Developed septic shock was requiring pressors had low blood pressure and was found to have septic shock from COVID pneumonia, with superimposed likely Gram-negative bacterial infection. received  Steroids, Rocephin, doxycycline, remdesivir.  Received 1 dose of Actemra. Course complicated by rhabdomyolysis, new onset atrial fibrillation. Passed away on 8/16/2021"
	"1693272-1"	"1693272-1"	"CHEST DISCOMFORT"	"10008469"	"50-59 years"	"50-59"	""Patient  verbally reported to me (spouse) that since receiving the vaccine he would have on and off ""weird"" feelings in his chest at times. He never sought medical attention for this particular issue despite his medical history.  He received his first dose of the Pfizer - BioNTech vaccine on 03/25/2021 Lots number EP6955. Second dose was as noted on 04/15/2021 Lot number EP0153""
	"1694121-1"	"1694121-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"PATIENT EXPIRED ON 09/05/2021"
	"1694456-1"	"1694456-1"	"CHILLS"	"10008531"	"50-59 years"	"50-59"	"Within 3-4 hours was having mild side effects such as fatigue, soreness. The next 2 days his symptoms became more severe with nausea, chills, diarrhea. The 2nd day he developed a blood clot in his stomach and died as a result."
	"1694456-1"	"1694456-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Within 3-4 hours was having mild side effects such as fatigue, soreness. The next 2 days his symptoms became more severe with nausea, chills, diarrhea. The 2nd day he developed a blood clot in his stomach and died as a result."
	"1694456-1"	"1694456-1"	"DIARRHOEA"	"10012735"	"50-59 years"	"50-59"	"Within 3-4 hours was having mild side effects such as fatigue, soreness. The next 2 days his symptoms became more severe with nausea, chills, diarrhea. The 2nd day he developed a blood clot in his stomach and died as a result."
	"1694456-1"	"1694456-1"	"FATIGUE"	"10016256"	"50-59 years"	"50-59"	"Within 3-4 hours was having mild side effects such as fatigue, soreness. The next 2 days his symptoms became more severe with nausea, chills, diarrhea. The 2nd day he developed a blood clot in his stomach and died as a result."
	"1694456-1"	"1694456-1"	"NAUSEA"	"10028813"	"50-59 years"	"50-59"	"Within 3-4 hours was having mild side effects such as fatigue, soreness. The next 2 days his symptoms became more severe with nausea, chills, diarrhea. The 2nd day he developed a blood clot in his stomach and died as a result."
	"1694456-1"	"1694456-1"	"PAIN"	"10033371"	"50-59 years"	"50-59"	"Within 3-4 hours was having mild side effects such as fatigue, soreness. The next 2 days his symptoms became more severe with nausea, chills, diarrhea. The 2nd day he developed a blood clot in his stomach and died as a result."
	"1694456-1"	"1694456-1"	"THROMBOSIS"	"10043607"	"50-59 years"	"50-59"	"Within 3-4 hours was having mild side effects such as fatigue, soreness. The next 2 days his symptoms became more severe with nausea, chills, diarrhea. The 2nd day he developed a blood clot in his stomach and died as a result."
	"1694602-1"	"1694602-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"Dose 1 Pfizer 2/26/2021  lot # EN6205  Pt had a cardiac arrest at home 9/7/2021, died in the Emergency Room on 9/7/2021. Not a Covid related death."
	"1694602-1"	"1694602-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Dose 1 Pfizer 2/26/2021  lot # EN6205  Pt had a cardiac arrest at home 9/7/2021, died in the Emergency Room on 9/7/2021. Not a Covid related death."
	"1696698-1"	"1696698-1"	"CONDITION AGGRAVATED"	"10010264"	"50-59 years"	"50-59"	"Patient passed away on 7/28. Previous to this, he was COVID positive on  7/21 which he believes he got from his wife. Patient did have symptoms."
	"1696698-1"	"1696698-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Patient passed away on 7/28. Previous to this, he was COVID positive on  7/21 which he believes he got from his wife. Patient did have symptoms."
	"1696698-1"	"1696698-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient passed away on 7/28. Previous to this, he was COVID positive on  7/21 which he believes he got from his wife. Patient did have symptoms."
	"1696698-1"	"1696698-1"	"MALAISE"	"10025482"	"50-59 years"	"50-59"	"Patient passed away on 7/28. Previous to this, he was COVID positive on  7/21 which he believes he got from his wife. Patient did have symptoms."
	"1696812-1"	"1696812-1"	"CHILLS"	"10008531"	"50-59 years"	"50-59"	"The patient presents with 8 day hx of viral symptoms. Pt reports to have been experiencing fevers, chills, cough, shortness of breath, myalgia, headache, nasal congestion, rhinorrhea, and headache. Recent sick contacts and COVID-19 exposure. Has administered with over the counter cold medicine. Denies all other acute systemic symptoms.  The onset was 8  days ago. Associated symptoms: fevers, chills, cough, shortness of breath, myalgia, headache, nasal congestion, rhinorrhea, and headache, denies chest pain, denies abdominal pain, denies nausea, denies vomiting, denies dizziness and denies back pain."
	"1696812-1"	"1696812-1"	"COUGH"	"10011224"	"50-59 years"	"50-59"	"The patient presents with 8 day hx of viral symptoms. Pt reports to have been experiencing fevers, chills, cough, shortness of breath, myalgia, headache, nasal congestion, rhinorrhea, and headache. Recent sick contacts and COVID-19 exposure. Has administered with over the counter cold medicine. Denies all other acute systemic symptoms.  The onset was 8  days ago. Associated symptoms: fevers, chills, cough, shortness of breath, myalgia, headache, nasal congestion, rhinorrhea, and headache, denies chest pain, denies abdominal pain, denies nausea, denies vomiting, denies dizziness and denies back pain."
	"1696812-1"	"1696812-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"The patient presents with 8 day hx of viral symptoms. Pt reports to have been experiencing fevers, chills, cough, shortness of breath, myalgia, headache, nasal congestion, rhinorrhea, and headache. Recent sick contacts and COVID-19 exposure. Has administered with over the counter cold medicine. Denies all other acute systemic symptoms.  The onset was 8  days ago. Associated symptoms: fevers, chills, cough, shortness of breath, myalgia, headache, nasal congestion, rhinorrhea, and headache, denies chest pain, denies abdominal pain, denies nausea, denies vomiting, denies dizziness and denies back pain."
	"1696812-1"	"1696812-1"	"EXPOSURE TO SARS-COV-2"	"10084456"	"50-59 years"	"50-59"	"The patient presents with 8 day hx of viral symptoms. Pt reports to have been experiencing fevers, chills, cough, shortness of breath, myalgia, headache, nasal congestion, rhinorrhea, and headache. Recent sick contacts and COVID-19 exposure. Has administered with over the counter cold medicine. Denies all other acute systemic symptoms.  The onset was 8  days ago. Associated symptoms: fevers, chills, cough, shortness of breath, myalgia, headache, nasal congestion, rhinorrhea, and headache, denies chest pain, denies abdominal pain, denies nausea, denies vomiting, denies dizziness and denies back pain."
	"1696812-1"	"1696812-1"	"HEADACHE"	"10019211"	"50-59 years"	"50-59"	"The patient presents with 8 day hx of viral symptoms. Pt reports to have been experiencing fevers, chills, cough, shortness of breath, myalgia, headache, nasal congestion, rhinorrhea, and headache. Recent sick contacts and COVID-19 exposure. Has administered with over the counter cold medicine. Denies all other acute systemic symptoms.  The onset was 8  days ago. Associated symptoms: fevers, chills, cough, shortness of breath, myalgia, headache, nasal congestion, rhinorrhea, and headache, denies chest pain, denies abdominal pain, denies nausea, denies vomiting, denies dizziness and denies back pain."
	"1696812-1"	"1696812-1"	"MYALGIA"	"10028411"	"50-59 years"	"50-59"	"The patient presents with 8 day hx of viral symptoms. Pt reports to have been experiencing fevers, chills, cough, shortness of breath, myalgia, headache, nasal congestion, rhinorrhea, and headache. Recent sick contacts and COVID-19 exposure. Has administered with over the counter cold medicine. Denies all other acute systemic symptoms.  The onset was 8  days ago. Associated symptoms: fevers, chills, cough, shortness of breath, myalgia, headache, nasal congestion, rhinorrhea, and headache, denies chest pain, denies abdominal pain, denies nausea, denies vomiting, denies dizziness and denies back pain."
	"1696812-1"	"1696812-1"	"NASAL CONGESTION"	"10028735"	"50-59 years"	"50-59"	"The patient presents with 8 day hx of viral symptoms. Pt reports to have been experiencing fevers, chills, cough, shortness of breath, myalgia, headache, nasal congestion, rhinorrhea, and headache. Recent sick contacts and COVID-19 exposure. Has administered with over the counter cold medicine. Denies all other acute systemic symptoms.  The onset was 8  days ago. Associated symptoms: fevers, chills, cough, shortness of breath, myalgia, headache, nasal congestion, rhinorrhea, and headache, denies chest pain, denies abdominal pain, denies nausea, denies vomiting, denies dizziness and denies back pain."
	"1696812-1"	"1696812-1"	"PYREXIA"	"10037660"	"50-59 years"	"50-59"	"The patient presents with 8 day hx of viral symptoms. Pt reports to have been experiencing fevers, chills, cough, shortness of breath, myalgia, headache, nasal congestion, rhinorrhea, and headache. Recent sick contacts and COVID-19 exposure. Has administered with over the counter cold medicine. Denies all other acute systemic symptoms.  The onset was 8  days ago. Associated symptoms: fevers, chills, cough, shortness of breath, myalgia, headache, nasal congestion, rhinorrhea, and headache, denies chest pain, denies abdominal pain, denies nausea, denies vomiting, denies dizziness and denies back pain."
	"1696812-1"	"1696812-1"	"RHINORRHOEA"	"10039101"	"50-59 years"	"50-59"	"The patient presents with 8 day hx of viral symptoms. Pt reports to have been experiencing fevers, chills, cough, shortness of breath, myalgia, headache, nasal congestion, rhinorrhea, and headache. Recent sick contacts and COVID-19 exposure. Has administered with over the counter cold medicine. Denies all other acute systemic symptoms.  The onset was 8  days ago. Associated symptoms: fevers, chills, cough, shortness of breath, myalgia, headache, nasal congestion, rhinorrhea, and headache, denies chest pain, denies abdominal pain, denies nausea, denies vomiting, denies dizziness and denies back pain."
	"1696812-1"	"1696812-1"	"SARS-COV-2 TEST"	"10084354"	"50-59 years"	"50-59"	"The patient presents with 8 day hx of viral symptoms. Pt reports to have been experiencing fevers, chills, cough, shortness of breath, myalgia, headache, nasal congestion, rhinorrhea, and headache. Recent sick contacts and COVID-19 exposure. Has administered with over the counter cold medicine. Denies all other acute systemic symptoms.  The onset was 8  days ago. Associated symptoms: fevers, chills, cough, shortness of breath, myalgia, headache, nasal congestion, rhinorrhea, and headache, denies chest pain, denies abdominal pain, denies nausea, denies vomiting, denies dizziness and denies back pain."
	"1696822-1"	"1696822-1"	"BRONCHOALVEOLAR LAVAGE"	"10049413"	"50-59 years"	"50-59"	"Pfizer-BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 1/27/2021 and 2/24/2021. Patient presented to ED on 8/14/2021 with complaints of shortness of breath. Medications administered: ascorbic acid, azithromycin, baricitinib, ceftriaxone, dexamethasone, epoprostenol, fluconazole, remdesivir, zosyn, vancomycin, and zinc. Throughout hospitalization patient continued to decompensate eventually requiring mechanical ventilation. Patient had brief episode of cardiac arrest. After family discussion, patient was taken off life support and expired on 9/9/2021."
	"1696822-1"	"1696822-1"	"CANDIDA TEST POSITIVE"	"10070451"	"50-59 years"	"50-59"	"Pfizer-BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 1/27/2021 and 2/24/2021. Patient presented to ED on 8/14/2021 with complaints of shortness of breath. Medications administered: ascorbic acid, azithromycin, baricitinib, ceftriaxone, dexamethasone, epoprostenol, fluconazole, remdesivir, zosyn, vancomycin, and zinc. Throughout hospitalization patient continued to decompensate eventually requiring mechanical ventilation. Patient had brief episode of cardiac arrest. After family discussion, patient was taken off life support and expired on 9/9/2021."
	"1696822-1"	"1696822-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"Pfizer-BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 1/27/2021 and 2/24/2021. Patient presented to ED on 8/14/2021 with complaints of shortness of breath. Medications administered: ascorbic acid, azithromycin, baricitinib, ceftriaxone, dexamethasone, epoprostenol, fluconazole, remdesivir, zosyn, vancomycin, and zinc. Throughout hospitalization patient continued to decompensate eventually requiring mechanical ventilation. Patient had brief episode of cardiac arrest. After family discussion, patient was taken off life support and expired on 9/9/2021."
	"1696822-1"	"1696822-1"	"CHEST X-RAY ABNORMAL"	"10008499"	"50-59 years"	"50-59"	"Pfizer-BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 1/27/2021 and 2/24/2021. Patient presented to ED on 8/14/2021 with complaints of shortness of breath. Medications administered: ascorbic acid, azithromycin, baricitinib, ceftriaxone, dexamethasone, epoprostenol, fluconazole, remdesivir, zosyn, vancomycin, and zinc. Throughout hospitalization patient continued to decompensate eventually requiring mechanical ventilation. Patient had brief episode of cardiac arrest. After family discussion, patient was taken off life support and expired on 9/9/2021."
	"1696822-1"	"1696822-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Pfizer-BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 1/27/2021 and 2/24/2021. Patient presented to ED on 8/14/2021 with complaints of shortness of breath. Medications administered: ascorbic acid, azithromycin, baricitinib, ceftriaxone, dexamethasone, epoprostenol, fluconazole, remdesivir, zosyn, vancomycin, and zinc. Throughout hospitalization patient continued to decompensate eventually requiring mechanical ventilation. Patient had brief episode of cardiac arrest. After family discussion, patient was taken off life support and expired on 9/9/2021."
	"1696822-1"	"1696822-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Pfizer-BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 1/27/2021 and 2/24/2021. Patient presented to ED on 8/14/2021 with complaints of shortness of breath. Medications administered: ascorbic acid, azithromycin, baricitinib, ceftriaxone, dexamethasone, epoprostenol, fluconazole, remdesivir, zosyn, vancomycin, and zinc. Throughout hospitalization patient continued to decompensate eventually requiring mechanical ventilation. Patient had brief episode of cardiac arrest. After family discussion, patient was taken off life support and expired on 9/9/2021."
	"1696822-1"	"1696822-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"Pfizer-BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 1/27/2021 and 2/24/2021. Patient presented to ED on 8/14/2021 with complaints of shortness of breath. Medications administered: ascorbic acid, azithromycin, baricitinib, ceftriaxone, dexamethasone, epoprostenol, fluconazole, remdesivir, zosyn, vancomycin, and zinc. Throughout hospitalization patient continued to decompensate eventually requiring mechanical ventilation. Patient had brief episode of cardiac arrest. After family discussion, patient was taken off life support and expired on 9/9/2021."
	"1696822-1"	"1696822-1"	"LIFE SUPPORT"	"10024447"	"50-59 years"	"50-59"	"Pfizer-BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 1/27/2021 and 2/24/2021. Patient presented to ED on 8/14/2021 with complaints of shortness of breath. Medications administered: ascorbic acid, azithromycin, baricitinib, ceftriaxone, dexamethasone, epoprostenol, fluconazole, remdesivir, zosyn, vancomycin, and zinc. Throughout hospitalization patient continued to decompensate eventually requiring mechanical ventilation. Patient had brief episode of cardiac arrest. After family discussion, patient was taken off life support and expired on 9/9/2021."
	"1696822-1"	"1696822-1"	"LUNG CONSOLIDATION"	"10025080"	"50-59 years"	"50-59"	"Pfizer-BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 1/27/2021 and 2/24/2021. Patient presented to ED on 8/14/2021 with complaints of shortness of breath. Medications administered: ascorbic acid, azithromycin, baricitinib, ceftriaxone, dexamethasone, epoprostenol, fluconazole, remdesivir, zosyn, vancomycin, and zinc. Throughout hospitalization patient continued to decompensate eventually requiring mechanical ventilation. Patient had brief episode of cardiac arrest. After family discussion, patient was taken off life support and expired on 9/9/2021."
	"1696822-1"	"1696822-1"	"LUNG INFILTRATION"	"10025102"	"50-59 years"	"50-59"	"Pfizer-BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 1/27/2021 and 2/24/2021. Patient presented to ED on 8/14/2021 with complaints of shortness of breath. Medications administered: ascorbic acid, azithromycin, baricitinib, ceftriaxone, dexamethasone, epoprostenol, fluconazole, remdesivir, zosyn, vancomycin, and zinc. Throughout hospitalization patient continued to decompensate eventually requiring mechanical ventilation. Patient had brief episode of cardiac arrest. After family discussion, patient was taken off life support and expired on 9/9/2021."
	"1696822-1"	"1696822-1"	"MECHANICAL VENTILATION"	"10067221"	"50-59 years"	"50-59"	"Pfizer-BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 1/27/2021 and 2/24/2021. Patient presented to ED on 8/14/2021 with complaints of shortness of breath. Medications administered: ascorbic acid, azithromycin, baricitinib, ceftriaxone, dexamethasone, epoprostenol, fluconazole, remdesivir, zosyn, vancomycin, and zinc. Throughout hospitalization patient continued to decompensate eventually requiring mechanical ventilation. Patient had brief episode of cardiac arrest. After family discussion, patient was taken off life support and expired on 9/9/2021."
	"1696822-1"	"1696822-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"Pfizer-BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 1/27/2021 and 2/24/2021. Patient presented to ED on 8/14/2021 with complaints of shortness of breath. Medications administered: ascorbic acid, azithromycin, baricitinib, ceftriaxone, dexamethasone, epoprostenol, fluconazole, remdesivir, zosyn, vancomycin, and zinc. Throughout hospitalization patient continued to decompensate eventually requiring mechanical ventilation. Patient had brief episode of cardiac arrest. After family discussion, patient was taken off life support and expired on 9/9/2021."
	"1697946-1"	"1697946-1"	"ANGIOCARDIOGRAM"	"10080743"	"50-59 years"	"50-59"	"Day 2 after injection complaining of chest pain...day 3 went to urgent care was sent home, told she just needed rest. Day 5 heart attack rushed to hospital. Day 6 testing, Day seven heart surgury for blockage...doctors refused to discuss what blockage was...no prior heart, blood pressure issues or cholesterol issues. Day 7 in recovery up and walking due to be released in 48 hours...Day 8 recovering then at 9pm suddenly full cardiac arrest unable to revive and died at 10:38 pm"
	"1697946-1"	"1697946-1"	"ATRIOVENTRICULAR BLOCK"	"10003671"	"50-59 years"	"50-59"	"Day 2 after injection complaining of chest pain...day 3 went to urgent care was sent home, told she just needed rest. Day 5 heart attack rushed to hospital. Day 6 testing, Day seven heart surgury for blockage...doctors refused to discuss what blockage was...no prior heart, blood pressure issues or cholesterol issues. Day 7 in recovery up and walking due to be released in 48 hours...Day 8 recovering then at 9pm suddenly full cardiac arrest unable to revive and died at 10:38 pm"
	"1697946-1"	"1697946-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"Day 2 after injection complaining of chest pain...day 3 went to urgent care was sent home, told she just needed rest. Day 5 heart attack rushed to hospital. Day 6 testing, Day seven heart surgury for blockage...doctors refused to discuss what blockage was...no prior heart, blood pressure issues or cholesterol issues. Day 7 in recovery up and walking due to be released in 48 hours...Day 8 recovering then at 9pm suddenly full cardiac arrest unable to revive and died at 10:38 pm"
	"1697946-1"	"1697946-1"	"CARDIAC FUNCTION TEST"	"10058470"	"50-59 years"	"50-59"	"Day 2 after injection complaining of chest pain...day 3 went to urgent care was sent home, told she just needed rest. Day 5 heart attack rushed to hospital. Day 6 testing, Day seven heart surgury for blockage...doctors refused to discuss what blockage was...no prior heart, blood pressure issues or cholesterol issues. Day 7 in recovery up and walking due to be released in 48 hours...Day 8 recovering then at 9pm suddenly full cardiac arrest unable to revive and died at 10:38 pm"
	"1697946-1"	"1697946-1"	"CARDIAC OPERATION"	"10061026"	"50-59 years"	"50-59"	"Day 2 after injection complaining of chest pain...day 3 went to urgent care was sent home, told she just needed rest. Day 5 heart attack rushed to hospital. Day 6 testing, Day seven heart surgury for blockage...doctors refused to discuss what blockage was...no prior heart, blood pressure issues or cholesterol issues. Day 7 in recovery up and walking due to be released in 48 hours...Day 8 recovering then at 9pm suddenly full cardiac arrest unable to revive and died at 10:38 pm"
	"1697946-1"	"1697946-1"	"CHEST PAIN"	"10008479"	"50-59 years"	"50-59"	"Day 2 after injection complaining of chest pain...day 3 went to urgent care was sent home, told she just needed rest. Day 5 heart attack rushed to hospital. Day 6 testing, Day seven heart surgury for blockage...doctors refused to discuss what blockage was...no prior heart, blood pressure issues or cholesterol issues. Day 7 in recovery up and walking due to be released in 48 hours...Day 8 recovering then at 9pm suddenly full cardiac arrest unable to revive and died at 10:38 pm"
	"1697946-1"	"1697946-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Day 2 after injection complaining of chest pain...day 3 went to urgent care was sent home, told she just needed rest. Day 5 heart attack rushed to hospital. Day 6 testing, Day seven heart surgury for blockage...doctors refused to discuss what blockage was...no prior heart, blood pressure issues or cholesterol issues. Day 7 in recovery up and walking due to be released in 48 hours...Day 8 recovering then at 9pm suddenly full cardiac arrest unable to revive and died at 10:38 pm"
	"1697946-1"	"1697946-1"	"LABORATORY TEST"	"10059938"	"50-59 years"	"50-59"	"Day 2 after injection complaining of chest pain...day 3 went to urgent care was sent home, told she just needed rest. Day 5 heart attack rushed to hospital. Day 6 testing, Day seven heart surgury for blockage...doctors refused to discuss what blockage was...no prior heart, blood pressure issues or cholesterol issues. Day 7 in recovery up and walking due to be released in 48 hours...Day 8 recovering then at 9pm suddenly full cardiac arrest unable to revive and died at 10:38 pm"
	"1697946-1"	"1697946-1"	"MYOCARDIAL INFARCTION"	"10028596"	"50-59 years"	"50-59"	"Day 2 after injection complaining of chest pain...day 3 went to urgent care was sent home, told she just needed rest. Day 5 heart attack rushed to hospital. Day 6 testing, Day seven heart surgury for blockage...doctors refused to discuss what blockage was...no prior heart, blood pressure issues or cholesterol issues. Day 7 in recovery up and walking due to be released in 48 hours...Day 8 recovering then at 9pm suddenly full cardiac arrest unable to revive and died at 10:38 pm"
	"1700799-1"	"1700799-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	""Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 4/7/2021. Patient had a preoperative COVID-19 screening test performed on 9/6/2021 that resulted positive. On 9/8/2021 patient requested telemedicine visit due to relentless cough interfering with sleep and hemoptysis.  Also noted that wife and son are also COVID positive with symptoms. Patient was prescribed Casirivimab+Imdevimab which was administered on 9/10/2021, with a noted SpO2 of 98% on room air. On 9/13/2021 patient was transported to ED for evaluation of cardiac arrest. Patient had a witnessed arrest with CPR initiated while awaiting EMS. The treatment prior to presentation was 6mg Epinephrine, 450mg Amiodarone, 600 ml fluid, and 100 Fentanyl per EMS. The patient was shocked x2 before cardioverting. The patient was intubated by EMS. EMS states that the patient was taking a shower and started to feel ""crummy"" when he became unresponsive. This is when his wife started CPR and called EMS. Total CPR time per EMS was 30 minutes. Patient was initiated on therapeutic hypothermia and was unresponsive after his event. Unfortunately he experienced a recurrent cardiac arrest in the ER with Ventricular Fibrillation that was refractory to again prolonged CPR and resuscitative efforts. After prolonged efforts he was pronounced deceased in the ER by the ER physician on duty at 0354 on 9/14/2021.""
	"1700799-1"	"1700799-1"	"CARDIOVERSION"	"10007661"	"50-59 years"	"50-59"	""Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 4/7/2021. Patient had a preoperative COVID-19 screening test performed on 9/6/2021 that resulted positive. On 9/8/2021 patient requested telemedicine visit due to relentless cough interfering with sleep and hemoptysis.  Also noted that wife and son are also COVID positive with symptoms. Patient was prescribed Casirivimab+Imdevimab which was administered on 9/10/2021, with a noted SpO2 of 98% on room air. On 9/13/2021 patient was transported to ED for evaluation of cardiac arrest. Patient had a witnessed arrest with CPR initiated while awaiting EMS. The treatment prior to presentation was 6mg Epinephrine, 450mg Amiodarone, 600 ml fluid, and 100 Fentanyl per EMS. The patient was shocked x2 before cardioverting. The patient was intubated by EMS. EMS states that the patient was taking a shower and started to feel ""crummy"" when he became unresponsive. This is when his wife started CPR and called EMS. Total CPR time per EMS was 30 minutes. Patient was initiated on therapeutic hypothermia and was unresponsive after his event. Unfortunately he experienced a recurrent cardiac arrest in the ER with Ventricular Fibrillation that was refractory to again prolonged CPR and resuscitative efforts. After prolonged efforts he was pronounced deceased in the ER by the ER physician on duty at 0354 on 9/14/2021.""
	"1700799-1"	"1700799-1"	"COUGH"	"10011224"	"50-59 years"	"50-59"	""Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 4/7/2021. Patient had a preoperative COVID-19 screening test performed on 9/6/2021 that resulted positive. On 9/8/2021 patient requested telemedicine visit due to relentless cough interfering with sleep and hemoptysis.  Also noted that wife and son are also COVID positive with symptoms. Patient was prescribed Casirivimab+Imdevimab which was administered on 9/10/2021, with a noted SpO2 of 98% on room air. On 9/13/2021 patient was transported to ED for evaluation of cardiac arrest. Patient had a witnessed arrest with CPR initiated while awaiting EMS. The treatment prior to presentation was 6mg Epinephrine, 450mg Amiodarone, 600 ml fluid, and 100 Fentanyl per EMS. The patient was shocked x2 before cardioverting. The patient was intubated by EMS. EMS states that the patient was taking a shower and started to feel ""crummy"" when he became unresponsive. This is when his wife started CPR and called EMS. Total CPR time per EMS was 30 minutes. Patient was initiated on therapeutic hypothermia and was unresponsive after his event. Unfortunately he experienced a recurrent cardiac arrest in the ER with Ventricular Fibrillation that was refractory to again prolonged CPR and resuscitative efforts. After prolonged efforts he was pronounced deceased in the ER by the ER physician on duty at 0354 on 9/14/2021.""
	"1700799-1"	"1700799-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	""Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 4/7/2021. Patient had a preoperative COVID-19 screening test performed on 9/6/2021 that resulted positive. On 9/8/2021 patient requested telemedicine visit due to relentless cough interfering with sleep and hemoptysis.  Also noted that wife and son are also COVID positive with symptoms. Patient was prescribed Casirivimab+Imdevimab which was administered on 9/10/2021, with a noted SpO2 of 98% on room air. On 9/13/2021 patient was transported to ED for evaluation of cardiac arrest. Patient had a witnessed arrest with CPR initiated while awaiting EMS. The treatment prior to presentation was 6mg Epinephrine, 450mg Amiodarone, 600 ml fluid, and 100 Fentanyl per EMS. The patient was shocked x2 before cardioverting. The patient was intubated by EMS. EMS states that the patient was taking a shower and started to feel ""crummy"" when he became unresponsive. This is when his wife started CPR and called EMS. Total CPR time per EMS was 30 minutes. Patient was initiated on therapeutic hypothermia and was unresponsive after his event. Unfortunately he experienced a recurrent cardiac arrest in the ER with Ventricular Fibrillation that was refractory to again prolonged CPR and resuscitative efforts. After prolonged efforts he was pronounced deceased in the ER by the ER physician on duty at 0354 on 9/14/2021.""
	"1700799-1"	"1700799-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	""Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 4/7/2021. Patient had a preoperative COVID-19 screening test performed on 9/6/2021 that resulted positive. On 9/8/2021 patient requested telemedicine visit due to relentless cough interfering with sleep and hemoptysis.  Also noted that wife and son are also COVID positive with symptoms. Patient was prescribed Casirivimab+Imdevimab which was administered on 9/10/2021, with a noted SpO2 of 98% on room air. On 9/13/2021 patient was transported to ED for evaluation of cardiac arrest. Patient had a witnessed arrest with CPR initiated while awaiting EMS. The treatment prior to presentation was 6mg Epinephrine, 450mg Amiodarone, 600 ml fluid, and 100 Fentanyl per EMS. The patient was shocked x2 before cardioverting. The patient was intubated by EMS. EMS states that the patient was taking a shower and started to feel ""crummy"" when he became unresponsive. This is when his wife started CPR and called EMS. Total CPR time per EMS was 30 minutes. Patient was initiated on therapeutic hypothermia and was unresponsive after his event. Unfortunately he experienced a recurrent cardiac arrest in the ER with Ventricular Fibrillation that was refractory to again prolonged CPR and resuscitative efforts. After prolonged efforts he was pronounced deceased in the ER by the ER physician on duty at 0354 on 9/14/2021.""
	"1700799-1"	"1700799-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"50-59 years"	"50-59"	""Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 4/7/2021. Patient had a preoperative COVID-19 screening test performed on 9/6/2021 that resulted positive. On 9/8/2021 patient requested telemedicine visit due to relentless cough interfering with sleep and hemoptysis.  Also noted that wife and son are also COVID positive with symptoms. Patient was prescribed Casirivimab+Imdevimab which was administered on 9/10/2021, with a noted SpO2 of 98% on room air. On 9/13/2021 patient was transported to ED for evaluation of cardiac arrest. Patient had a witnessed arrest with CPR initiated while awaiting EMS. The treatment prior to presentation was 6mg Epinephrine, 450mg Amiodarone, 600 ml fluid, and 100 Fentanyl per EMS. The patient was shocked x2 before cardioverting. The patient was intubated by EMS. EMS states that the patient was taking a shower and started to feel ""crummy"" when he became unresponsive. This is when his wife started CPR and called EMS. Total CPR time per EMS was 30 minutes. Patient was initiated on therapeutic hypothermia and was unresponsive after his event. Unfortunately he experienced a recurrent cardiac arrest in the ER with Ventricular Fibrillation that was refractory to again prolonged CPR and resuscitative efforts. After prolonged efforts he was pronounced deceased in the ER by the ER physician on duty at 0354 on 9/14/2021.""
	"1700799-1"	"1700799-1"	"EXPOSURE TO SARS-COV-2"	"10084456"	"50-59 years"	"50-59"	""Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 4/7/2021. Patient had a preoperative COVID-19 screening test performed on 9/6/2021 that resulted positive. On 9/8/2021 patient requested telemedicine visit due to relentless cough interfering with sleep and hemoptysis.  Also noted that wife and son are also COVID positive with symptoms. Patient was prescribed Casirivimab+Imdevimab which was administered on 9/10/2021, with a noted SpO2 of 98% on room air. On 9/13/2021 patient was transported to ED for evaluation of cardiac arrest. Patient had a witnessed arrest with CPR initiated while awaiting EMS. The treatment prior to presentation was 6mg Epinephrine, 450mg Amiodarone, 600 ml fluid, and 100 Fentanyl per EMS. The patient was shocked x2 before cardioverting. The patient was intubated by EMS. EMS states that the patient was taking a shower and started to feel ""crummy"" when he became unresponsive. This is when his wife started CPR and called EMS. Total CPR time per EMS was 30 minutes. Patient was initiated on therapeutic hypothermia and was unresponsive after his event. Unfortunately he experienced a recurrent cardiac arrest in the ER with Ventricular Fibrillation that was refractory to again prolonged CPR and resuscitative efforts. After prolonged efforts he was pronounced deceased in the ER by the ER physician on duty at 0354 on 9/14/2021.""
	"1700799-1"	"1700799-1"	"FEELING ABNORMAL"	"10016322"	"50-59 years"	"50-59"	""Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 4/7/2021. Patient had a preoperative COVID-19 screening test performed on 9/6/2021 that resulted positive. On 9/8/2021 patient requested telemedicine visit due to relentless cough interfering with sleep and hemoptysis.  Also noted that wife and son are also COVID positive with symptoms. Patient was prescribed Casirivimab+Imdevimab which was administered on 9/10/2021, with a noted SpO2 of 98% on room air. On 9/13/2021 patient was transported to ED for evaluation of cardiac arrest. Patient had a witnessed arrest with CPR initiated while awaiting EMS. The treatment prior to presentation was 6mg Epinephrine, 450mg Amiodarone, 600 ml fluid, and 100 Fentanyl per EMS. The patient was shocked x2 before cardioverting. The patient was intubated by EMS. EMS states that the patient was taking a shower and started to feel ""crummy"" when he became unresponsive. This is when his wife started CPR and called EMS. Total CPR time per EMS was 30 minutes. Patient was initiated on therapeutic hypothermia and was unresponsive after his event. Unfortunately he experienced a recurrent cardiac arrest in the ER with Ventricular Fibrillation that was refractory to again prolonged CPR and resuscitative efforts. After prolonged efforts he was pronounced deceased in the ER by the ER physician on duty at 0354 on 9/14/2021.""
	"1700799-1"	"1700799-1"	"HAEMOPTYSIS"	"10018964"	"50-59 years"	"50-59"	""Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 4/7/2021. Patient had a preoperative COVID-19 screening test performed on 9/6/2021 that resulted positive. On 9/8/2021 patient requested telemedicine visit due to relentless cough interfering with sleep and hemoptysis.  Also noted that wife and son are also COVID positive with symptoms. Patient was prescribed Casirivimab+Imdevimab which was administered on 9/10/2021, with a noted SpO2 of 98% on room air. On 9/13/2021 patient was transported to ED for evaluation of cardiac arrest. Patient had a witnessed arrest with CPR initiated while awaiting EMS. The treatment prior to presentation was 6mg Epinephrine, 450mg Amiodarone, 600 ml fluid, and 100 Fentanyl per EMS. The patient was shocked x2 before cardioverting. The patient was intubated by EMS. EMS states that the patient was taking a shower and started to feel ""crummy"" when he became unresponsive. This is when his wife started CPR and called EMS. Total CPR time per EMS was 30 minutes. Patient was initiated on therapeutic hypothermia and was unresponsive after his event. Unfortunately he experienced a recurrent cardiac arrest in the ER with Ventricular Fibrillation that was refractory to again prolonged CPR and resuscitative efforts. After prolonged efforts he was pronounced deceased in the ER by the ER physician on duty at 0354 on 9/14/2021.""
	"1700799-1"	"1700799-1"	"RESUSCITATION"	"10038749"	"50-59 years"	"50-59"	""Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 4/7/2021. Patient had a preoperative COVID-19 screening test performed on 9/6/2021 that resulted positive. On 9/8/2021 patient requested telemedicine visit due to relentless cough interfering with sleep and hemoptysis.  Also noted that wife and son are also COVID positive with symptoms. Patient was prescribed Casirivimab+Imdevimab which was administered on 9/10/2021, with a noted SpO2 of 98% on room air. On 9/13/2021 patient was transported to ED for evaluation of cardiac arrest. Patient had a witnessed arrest with CPR initiated while awaiting EMS. The treatment prior to presentation was 6mg Epinephrine, 450mg Amiodarone, 600 ml fluid, and 100 Fentanyl per EMS. The patient was shocked x2 before cardioverting. The patient was intubated by EMS. EMS states that the patient was taking a shower and started to feel ""crummy"" when he became unresponsive. This is when his wife started CPR and called EMS. Total CPR time per EMS was 30 minutes. Patient was initiated on therapeutic hypothermia and was unresponsive after his event. Unfortunately he experienced a recurrent cardiac arrest in the ER with Ventricular Fibrillation that was refractory to again prolonged CPR and resuscitative efforts. After prolonged efforts he was pronounced deceased in the ER by the ER physician on duty at 0354 on 9/14/2021.""
	"1700799-1"	"1700799-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	""Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 4/7/2021. Patient had a preoperative COVID-19 screening test performed on 9/6/2021 that resulted positive. On 9/8/2021 patient requested telemedicine visit due to relentless cough interfering with sleep and hemoptysis.  Also noted that wife and son are also COVID positive with symptoms. Patient was prescribed Casirivimab+Imdevimab which was administered on 9/10/2021, with a noted SpO2 of 98% on room air. On 9/13/2021 patient was transported to ED for evaluation of cardiac arrest. Patient had a witnessed arrest with CPR initiated while awaiting EMS. The treatment prior to presentation was 6mg Epinephrine, 450mg Amiodarone, 600 ml fluid, and 100 Fentanyl per EMS. The patient was shocked x2 before cardioverting. The patient was intubated by EMS. EMS states that the patient was taking a shower and started to feel ""crummy"" when he became unresponsive. This is when his wife started CPR and called EMS. Total CPR time per EMS was 30 minutes. Patient was initiated on therapeutic hypothermia and was unresponsive after his event. Unfortunately he experienced a recurrent cardiac arrest in the ER with Ventricular Fibrillation that was refractory to again prolonged CPR and resuscitative efforts. After prolonged efforts he was pronounced deceased in the ER by the ER physician on duty at 0354 on 9/14/2021.""
	"1700799-1"	"1700799-1"	"SLEEP DISORDER"	"10040984"	"50-59 years"	"50-59"	""Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 4/7/2021. Patient had a preoperative COVID-19 screening test performed on 9/6/2021 that resulted positive. On 9/8/2021 patient requested telemedicine visit due to relentless cough interfering with sleep and hemoptysis.  Also noted that wife and son are also COVID positive with symptoms. Patient was prescribed Casirivimab+Imdevimab which was administered on 9/10/2021, with a noted SpO2 of 98% on room air. On 9/13/2021 patient was transported to ED for evaluation of cardiac arrest. Patient had a witnessed arrest with CPR initiated while awaiting EMS. The treatment prior to presentation was 6mg Epinephrine, 450mg Amiodarone, 600 ml fluid, and 100 Fentanyl per EMS. The patient was shocked x2 before cardioverting. The patient was intubated by EMS. EMS states that the patient was taking a shower and started to feel ""crummy"" when he became unresponsive. This is when his wife started CPR and called EMS. Total CPR time per EMS was 30 minutes. Patient was initiated on therapeutic hypothermia and was unresponsive after his event. Unfortunately he experienced a recurrent cardiac arrest in the ER with Ventricular Fibrillation that was refractory to again prolonged CPR and resuscitative efforts. After prolonged efforts he was pronounced deceased in the ER by the ER physician on duty at 0354 on 9/14/2021.""
	"1700799-1"	"1700799-1"	"THERAPEUTIC HYPOTHERMIA"	"10059485"	"50-59 years"	"50-59"	""Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 4/7/2021. Patient had a preoperative COVID-19 screening test performed on 9/6/2021 that resulted positive. On 9/8/2021 patient requested telemedicine visit due to relentless cough interfering with sleep and hemoptysis.  Also noted that wife and son are also COVID positive with symptoms. Patient was prescribed Casirivimab+Imdevimab which was administered on 9/10/2021, with a noted SpO2 of 98% on room air. On 9/13/2021 patient was transported to ED for evaluation of cardiac arrest. Patient had a witnessed arrest with CPR initiated while awaiting EMS. The treatment prior to presentation was 6mg Epinephrine, 450mg Amiodarone, 600 ml fluid, and 100 Fentanyl per EMS. The patient was shocked x2 before cardioverting. The patient was intubated by EMS. EMS states that the patient was taking a shower and started to feel ""crummy"" when he became unresponsive. This is when his wife started CPR and called EMS. Total CPR time per EMS was 30 minutes. Patient was initiated on therapeutic hypothermia and was unresponsive after his event. Unfortunately he experienced a recurrent cardiac arrest in the ER with Ventricular Fibrillation that was refractory to again prolonged CPR and resuscitative efforts. After prolonged efforts he was pronounced deceased in the ER by the ER physician on duty at 0354 on 9/14/2021.""
	"1700799-1"	"1700799-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"50-59 years"	"50-59"	""Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 4/7/2021. Patient had a preoperative COVID-19 screening test performed on 9/6/2021 that resulted positive. On 9/8/2021 patient requested telemedicine visit due to relentless cough interfering with sleep and hemoptysis.  Also noted that wife and son are also COVID positive with symptoms. Patient was prescribed Casirivimab+Imdevimab which was administered on 9/10/2021, with a noted SpO2 of 98% on room air. On 9/13/2021 patient was transported to ED for evaluation of cardiac arrest. Patient had a witnessed arrest with CPR initiated while awaiting EMS. The treatment prior to presentation was 6mg Epinephrine, 450mg Amiodarone, 600 ml fluid, and 100 Fentanyl per EMS. The patient was shocked x2 before cardioverting. The patient was intubated by EMS. EMS states that the patient was taking a shower and started to feel ""crummy"" when he became unresponsive. This is when his wife started CPR and called EMS. Total CPR time per EMS was 30 minutes. Patient was initiated on therapeutic hypothermia and was unresponsive after his event. Unfortunately he experienced a recurrent cardiac arrest in the ER with Ventricular Fibrillation that was refractory to again prolonged CPR and resuscitative efforts. After prolonged efforts he was pronounced deceased in the ER by the ER physician on duty at 0354 on 9/14/2021.""
	"1700799-1"	"1700799-1"	"VENTRICULAR FIBRILLATION"	"10047290"	"50-59 years"	"50-59"	""Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 4/7/2021. Patient had a preoperative COVID-19 screening test performed on 9/6/2021 that resulted positive. On 9/8/2021 patient requested telemedicine visit due to relentless cough interfering with sleep and hemoptysis.  Also noted that wife and son are also COVID positive with symptoms. Patient was prescribed Casirivimab+Imdevimab which was administered on 9/10/2021, with a noted SpO2 of 98% on room air. On 9/13/2021 patient was transported to ED for evaluation of cardiac arrest. Patient had a witnessed arrest with CPR initiated while awaiting EMS. The treatment prior to presentation was 6mg Epinephrine, 450mg Amiodarone, 600 ml fluid, and 100 Fentanyl per EMS. The patient was shocked x2 before cardioverting. The patient was intubated by EMS. EMS states that the patient was taking a shower and started to feel ""crummy"" when he became unresponsive. This is when his wife started CPR and called EMS. Total CPR time per EMS was 30 minutes. Patient was initiated on therapeutic hypothermia and was unresponsive after his event. Unfortunately he experienced a recurrent cardiac arrest in the ER with Ventricular Fibrillation that was refractory to again prolonged CPR and resuscitative efforts. After prolonged efforts he was pronounced deceased in the ER by the ER physician on duty at 0354 on 9/14/2021.""
	"1704209-1"	"1704209-1"	"COUGH"	"10011224"	"50-59 years"	"50-59"	"presented to ED with hx of positive COVID test earlier in the week; mild SOB, cough, diarrhea; pneumonia COVID related; end-stage renal disease (hemodialysis 3xwk); fld overload"
	"1704209-1"	"1704209-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"presented to ED with hx of positive COVID test earlier in the week; mild SOB, cough, diarrhea; pneumonia COVID related; end-stage renal disease (hemodialysis 3xwk); fld overload"
	"1704209-1"	"1704209-1"	"COVID-19 PNEUMONIA"	"10084380"	"50-59 years"	"50-59"	"presented to ED with hx of positive COVID test earlier in the week; mild SOB, cough, diarrhea; pneumonia COVID related; end-stage renal disease (hemodialysis 3xwk); fld overload"
	"1704209-1"	"1704209-1"	"DIARRHOEA"	"10012735"	"50-59 years"	"50-59"	"presented to ED with hx of positive COVID test earlier in the week; mild SOB, cough, diarrhea; pneumonia COVID related; end-stage renal disease (hemodialysis 3xwk); fld overload"
	"1704209-1"	"1704209-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"presented to ED with hx of positive COVID test earlier in the week; mild SOB, cough, diarrhea; pneumonia COVID related; end-stage renal disease (hemodialysis 3xwk); fld overload"
	"1704209-1"	"1704209-1"	"END STAGE RENAL DISEASE"	"10077512"	"50-59 years"	"50-59"	"presented to ED with hx of positive COVID test earlier in the week; mild SOB, cough, diarrhea; pneumonia COVID related; end-stage renal disease (hemodialysis 3xwk); fld overload"
	"1704209-1"	"1704209-1"	"HAEMODIALYSIS"	"10018875"	"50-59 years"	"50-59"	"presented to ED with hx of positive COVID test earlier in the week; mild SOB, cough, diarrhea; pneumonia COVID related; end-stage renal disease (hemodialysis 3xwk); fld overload"
	"1704209-1"	"1704209-1"	"HYPERVOLAEMIA"	"10020919"	"50-59 years"	"50-59"	"presented to ED with hx of positive COVID test earlier in the week; mild SOB, cough, diarrhea; pneumonia COVID related; end-stage renal disease (hemodialysis 3xwk); fld overload"
	"1704209-1"	"1704209-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"presented to ED with hx of positive COVID test earlier in the week; mild SOB, cough, diarrhea; pneumonia COVID related; end-stage renal disease (hemodialysis 3xwk); fld overload"
	"1704289-1"	"1704289-1"	"SUDDEN DEATH"	"10042434"	"50-59 years"	"50-59"	"sudden death"
	"1704317-1"	"1704317-1"	"ACUTE RESPIRATORY FAILURE"	"10001053"	"50-59 years"	"50-59"	"positive COVID test on 8/14/21; presented to ED from infusion center where she's been receiving antibody infusions since 8/18/21; presented with increasing fever, chills, cough, SOB, and diarrhea; hx of diabetes mellitus type 2; acute hypoxemic respiratory failure due to COVID"
	"1704317-1"	"1704317-1"	"CHILLS"	"10008531"	"50-59 years"	"50-59"	"positive COVID test on 8/14/21; presented to ED from infusion center where she's been receiving antibody infusions since 8/18/21; presented with increasing fever, chills, cough, SOB, and diarrhea; hx of diabetes mellitus type 2; acute hypoxemic respiratory failure due to COVID"
	"1704317-1"	"1704317-1"	"COUGH"	"10011224"	"50-59 years"	"50-59"	"positive COVID test on 8/14/21; presented to ED from infusion center where she's been receiving antibody infusions since 8/18/21; presented with increasing fever, chills, cough, SOB, and diarrhea; hx of diabetes mellitus type 2; acute hypoxemic respiratory failure due to COVID"
	"1704317-1"	"1704317-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"positive COVID test on 8/14/21; presented to ED from infusion center where she's been receiving antibody infusions since 8/18/21; presented with increasing fever, chills, cough, SOB, and diarrhea; hx of diabetes mellitus type 2; acute hypoxemic respiratory failure due to COVID"
	"1704317-1"	"1704317-1"	"DIARRHOEA"	"10012735"	"50-59 years"	"50-59"	"positive COVID test on 8/14/21; presented to ED from infusion center where she's been receiving antibody infusions since 8/18/21; presented with increasing fever, chills, cough, SOB, and diarrhea; hx of diabetes mellitus type 2; acute hypoxemic respiratory failure due to COVID"
	"1704317-1"	"1704317-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"positive COVID test on 8/14/21; presented to ED from infusion center where she's been receiving antibody infusions since 8/18/21; presented with increasing fever, chills, cough, SOB, and diarrhea; hx of diabetes mellitus type 2; acute hypoxemic respiratory failure due to COVID"
	"1704317-1"	"1704317-1"	"INFUSION"	"10060345"	"50-59 years"	"50-59"	"positive COVID test on 8/14/21; presented to ED from infusion center where she's been receiving antibody infusions since 8/18/21; presented with increasing fever, chills, cough, SOB, and diarrhea; hx of diabetes mellitus type 2; acute hypoxemic respiratory failure due to COVID"
	"1704317-1"	"1704317-1"	"PYREXIA"	"10037660"	"50-59 years"	"50-59"	"positive COVID test on 8/14/21; presented to ED from infusion center where she's been receiving antibody infusions since 8/18/21; presented with increasing fever, chills, cough, SOB, and diarrhea; hx of diabetes mellitus type 2; acute hypoxemic respiratory failure due to COVID"
	"1704317-1"	"1704317-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"positive COVID test on 8/14/21; presented to ED from infusion center where she's been receiving antibody infusions since 8/18/21; presented with increasing fever, chills, cough, SOB, and diarrhea; hx of diabetes mellitus type 2; acute hypoxemic respiratory failure due to COVID"
	"1704452-1"	"1704452-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"my daughter was complaining of loss of movement in both arms and legs, along with pain, approximately 1 hour after administration of the second dose of Moderna.  she took tylenol, and went to sleep at approxiamately 5 pm, and never woke back up."
	"1704452-1"	"1704452-1"	"MOVEMENT DISORDER"	"10028035"	"50-59 years"	"50-59"	"my daughter was complaining of loss of movement in both arms and legs, along with pain, approximately 1 hour after administration of the second dose of Moderna.  she took tylenol, and went to sleep at approxiamately 5 pm, and never woke back up."
	"1704452-1"	"1704452-1"	"PAIN"	"10033371"	"50-59 years"	"50-59"	"my daughter was complaining of loss of movement in both arms and legs, along with pain, approximately 1 hour after administration of the second dose of Moderna.  she took tylenol, and went to sleep at approxiamately 5 pm, and never woke back up."
	"1713331-1"	"1713331-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient death"
	"1714934-1"	"1714934-1"	"ADENOVIRUS TEST"	"10050991"	"50-59 years"	"50-59"	"Reportedly experienced shortness of breath beginning after vaccination between 8/4-8/6. Traveled by car to drop daughter off at college and on the return trip began to feel unwell and stopped in a Truck stop, where he became unresponsive. He was transported by EMS to the hospital where he was pronounced deceased at 23:07 on 8/9/2021."
	"1714934-1"	"1714934-1"	"ANTI-PLATELET FACTOR 4 ANTIBODY NEGATIVE"	"10086160"	"50-59 years"	"50-59"	"Reportedly experienced shortness of breath beginning after vaccination between 8/4-8/6. Traveled by car to drop daughter off at college and on the return trip began to feel unwell and stopped in a Truck stop, where he became unresponsive. He was transported by EMS to the hospital where he was pronounced deceased at 23:07 on 8/9/2021."
	"1714934-1"	"1714934-1"	"ARTERIOSCLEROSIS"	"10003210"	"50-59 years"	"50-59"	"Reportedly experienced shortness of breath beginning after vaccination between 8/4-8/6. Traveled by car to drop daughter off at college and on the return trip began to feel unwell and stopped in a Truck stop, where he became unresponsive. He was transported by EMS to the hospital where he was pronounced deceased at 23:07 on 8/9/2021."
	"1714934-1"	"1714934-1"	"AUTOPSY"	"10050117"	"50-59 years"	"50-59"	"Reportedly experienced shortness of breath beginning after vaccination between 8/4-8/6. Traveled by car to drop daughter off at college and on the return trip began to feel unwell and stopped in a Truck stop, where he became unresponsive. He was transported by EMS to the hospital where he was pronounced deceased at 23:07 on 8/9/2021."
	"1714934-1"	"1714934-1"	"BLOOD CHLORIDE INCREASED"	"10005420"	"50-59 years"	"50-59"	"Reportedly experienced shortness of breath beginning after vaccination between 8/4-8/6. Traveled by car to drop daughter off at college and on the return trip began to feel unwell and stopped in a Truck stop, where he became unresponsive. He was transported by EMS to the hospital where he was pronounced deceased at 23:07 on 8/9/2021."
	"1714934-1"	"1714934-1"	"BLOOD CREATININE INCREASED"	"10005483"	"50-59 years"	"50-59"	"Reportedly experienced shortness of breath beginning after vaccination between 8/4-8/6. Traveled by car to drop daughter off at college and on the return trip began to feel unwell and stopped in a Truck stop, where he became unresponsive. He was transported by EMS to the hospital where he was pronounced deceased at 23:07 on 8/9/2021."
	"1714934-1"	"1714934-1"	"BLOOD GLUCOSE DECREASED"	"10005555"	"50-59 years"	"50-59"	"Reportedly experienced shortness of breath beginning after vaccination between 8/4-8/6. Traveled by car to drop daughter off at college and on the return trip began to feel unwell and stopped in a Truck stop, where he became unresponsive. He was transported by EMS to the hospital where he was pronounced deceased at 23:07 on 8/9/2021."
	"1714934-1"	"1714934-1"	"BLOOD POTASSIUM INCREASED"	"10005725"	"50-59 years"	"50-59"	"Reportedly experienced shortness of breath beginning after vaccination between 8/4-8/6. Traveled by car to drop daughter off at college and on the return trip began to feel unwell and stopped in a Truck stop, where he became unresponsive. He was transported by EMS to the hospital where he was pronounced deceased at 23:07 on 8/9/2021."
	"1714934-1"	"1714934-1"	"BLOOD SODIUM NORMAL"	"10005804"	"50-59 years"	"50-59"	"Reportedly experienced shortness of breath beginning after vaccination between 8/4-8/6. Traveled by car to drop daughter off at college and on the return trip began to feel unwell and stopped in a Truck stop, where he became unresponsive. He was transported by EMS to the hospital where he was pronounced deceased at 23:07 on 8/9/2021."
	"1714934-1"	"1714934-1"	"BLOOD UREA INCREASED"	"10005851"	"50-59 years"	"50-59"	"Reportedly experienced shortness of breath beginning after vaccination between 8/4-8/6. Traveled by car to drop daughter off at college and on the return trip began to feel unwell and stopped in a Truck stop, where he became unresponsive. He was transported by EMS to the hospital where he was pronounced deceased at 23:07 on 8/9/2021."
	"1714934-1"	"1714934-1"	"CARDIOMEGALY"	"10007632"	"50-59 years"	"50-59"	"Reportedly experienced shortness of breath beginning after vaccination between 8/4-8/6. Traveled by car to drop daughter off at college and on the return trip began to feel unwell and stopped in a Truck stop, where he became unresponsive. He was transported by EMS to the hospital where he was pronounced deceased at 23:07 on 8/9/2021."
	"1714934-1"	"1714934-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Reportedly experienced shortness of breath beginning after vaccination between 8/4-8/6. Traveled by car to drop daughter off at college and on the return trip began to feel unwell and stopped in a Truck stop, where he became unresponsive. He was transported by EMS to the hospital where he was pronounced deceased at 23:07 on 8/9/2021."
	"1714934-1"	"1714934-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"Reportedly experienced shortness of breath beginning after vaccination between 8/4-8/6. Traveled by car to drop daughter off at college and on the return trip began to feel unwell and stopped in a Truck stop, where he became unresponsive. He was transported by EMS to the hospital where he was pronounced deceased at 23:07 on 8/9/2021."
	"1714934-1"	"1714934-1"	"MALAISE"	"10025482"	"50-59 years"	"50-59"	"Reportedly experienced shortness of breath beginning after vaccination between 8/4-8/6. Traveled by car to drop daughter off at college and on the return trip began to feel unwell and stopped in a Truck stop, where he became unresponsive. He was transported by EMS to the hospital where he was pronounced deceased at 23:07 on 8/9/2021."
	"1714934-1"	"1714934-1"	"MULTIPATHOGEN PCR TEST"	"10077018"	"50-59 years"	"50-59"	"Reportedly experienced shortness of breath beginning after vaccination between 8/4-8/6. Traveled by car to drop daughter off at college and on the return trip began to feel unwell and stopped in a Truck stop, where he became unresponsive. He was transported by EMS to the hospital where he was pronounced deceased at 23:07 on 8/9/2021."
	"1714934-1"	"1714934-1"	"PULMONARY ARTERY OCCLUSION"	"10078201"	"50-59 years"	"50-59"	"Reportedly experienced shortness of breath beginning after vaccination between 8/4-8/6. Traveled by car to drop daughter off at college and on the return trip began to feel unwell and stopped in a Truck stop, where he became unresponsive. He was transported by EMS to the hospital where he was pronounced deceased at 23:07 on 8/9/2021."
	"1714934-1"	"1714934-1"	"RESPIRATORY VIRAL PANEL"	"10075165"	"50-59 years"	"50-59"	"Reportedly experienced shortness of breath beginning after vaccination between 8/4-8/6. Traveled by car to drop daughter off at college and on the return trip began to feel unwell and stopped in a Truck stop, where he became unresponsive. He was transported by EMS to the hospital where he was pronounced deceased at 23:07 on 8/9/2021."
	"1714934-1"	"1714934-1"	"TOXICOLOGIC TEST ABNORMAL"	"10061382"	"50-59 years"	"50-59"	"Reportedly experienced shortness of breath beginning after vaccination between 8/4-8/6. Traveled by car to drop daughter off at college and on the return trip began to feel unwell and stopped in a Truck stop, where he became unresponsive. He was transported by EMS to the hospital where he was pronounced deceased at 23:07 on 8/9/2021."
	"1714934-1"	"1714934-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"50-59 years"	"50-59"	"Reportedly experienced shortness of breath beginning after vaccination between 8/4-8/6. Traveled by car to drop daughter off at college and on the return trip began to feel unwell and stopped in a Truck stop, where he became unresponsive. He was transported by EMS to the hospital where he was pronounced deceased at 23:07 on 8/9/2021."
	"1715804-1"	"1715804-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"presented to ED with decrease in appetite, nausea, vomiting x approximately 1 wk; tested positive for COVID; fever and fatigue, decreased oxygen saturation; intubated on 8/7/21; condition worsened where she passed away at the hospital"
	"1715804-1"	"1715804-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"presented to ED with decrease in appetite, nausea, vomiting x approximately 1 wk; tested positive for COVID; fever and fatigue, decreased oxygen saturation; intubated on 8/7/21; condition worsened where she passed away at the hospital"
	"1715804-1"	"1715804-1"	"DECREASED APPETITE"	"10061428"	"50-59 years"	"50-59"	"presented to ED with decrease in appetite, nausea, vomiting x approximately 1 wk; tested positive for COVID; fever and fatigue, decreased oxygen saturation; intubated on 8/7/21; condition worsened where she passed away at the hospital"
	"1715804-1"	"1715804-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"50-59 years"	"50-59"	"presented to ED with decrease in appetite, nausea, vomiting x approximately 1 wk; tested positive for COVID; fever and fatigue, decreased oxygen saturation; intubated on 8/7/21; condition worsened where she passed away at the hospital"
	"1715804-1"	"1715804-1"	"FATIGUE"	"10016256"	"50-59 years"	"50-59"	"presented to ED with decrease in appetite, nausea, vomiting x approximately 1 wk; tested positive for COVID; fever and fatigue, decreased oxygen saturation; intubated on 8/7/21; condition worsened where she passed away at the hospital"
	"1715804-1"	"1715804-1"	"NAUSEA"	"10028813"	"50-59 years"	"50-59"	"presented to ED with decrease in appetite, nausea, vomiting x approximately 1 wk; tested positive for COVID; fever and fatigue, decreased oxygen saturation; intubated on 8/7/21; condition worsened where she passed away at the hospital"
	"1715804-1"	"1715804-1"	"OXYGEN SATURATION DECREASED"	"10033318"	"50-59 years"	"50-59"	"presented to ED with decrease in appetite, nausea, vomiting x approximately 1 wk; tested positive for COVID; fever and fatigue, decreased oxygen saturation; intubated on 8/7/21; condition worsened where she passed away at the hospital"
	"1715804-1"	"1715804-1"	"PYREXIA"	"10037660"	"50-59 years"	"50-59"	"presented to ED with decrease in appetite, nausea, vomiting x approximately 1 wk; tested positive for COVID; fever and fatigue, decreased oxygen saturation; intubated on 8/7/21; condition worsened where she passed away at the hospital"
	"1715804-1"	"1715804-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"presented to ED with decrease in appetite, nausea, vomiting x approximately 1 wk; tested positive for COVID; fever and fatigue, decreased oxygen saturation; intubated on 8/7/21; condition worsened where she passed away at the hospital"
	"1715804-1"	"1715804-1"	"VOMITING"	"10047700"	"50-59 years"	"50-59"	"presented to ED with decrease in appetite, nausea, vomiting x approximately 1 wk; tested positive for COVID; fever and fatigue, decreased oxygen saturation; intubated on 8/7/21; condition worsened where she passed away at the hospital"
	"1718958-1"	"1718958-1"	"CARDIOMEGALY"	"10007632"	"50-59 years"	"50-59"	""Patient passed away on May 29th due to ""Sudden Cardiac Death due to Cardiomegaly.""
	"1718958-1"	"1718958-1"	"FEELING ABNORMAL"	"10016322"	"50-59 years"	"50-59"	""Patient passed away on May 29th due to ""Sudden Cardiac Death due to Cardiomegaly.""
	"1718958-1"	"1718958-1"	"SUDDEN CARDIAC DEATH"	"10049418"	"50-59 years"	"50-59"	""Patient passed away on May 29th due to ""Sudden Cardiac Death due to Cardiomegaly.""
	"1719230-1"	"1719230-1"	"COUGH"	"10011224"	"50-59 years"	"50-59"	"On September 5 the patient started showing signs of a heavy chest cold.  She was sick for the next week with heavy cough, on and off fever, extreme fatigue, shortness of breath.  She kept insisting she just had a strong chest cold.  On September 12 I found her barely conscious, foaming at the mouth, with extreme labored breathing.  Emergency medical services took her to the ER.  She was in ICU intubated for one week, then died on September 19."
	"1719230-1"	"1719230-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"On September 5 the patient started showing signs of a heavy chest cold.  She was sick for the next week with heavy cough, on and off fever, extreme fatigue, shortness of breath.  She kept insisting she just had a strong chest cold.  On September 12 I found her barely conscious, foaming at the mouth, with extreme labored breathing.  Emergency medical services took her to the ER.  She was in ICU intubated for one week, then died on September 19."
	"1719230-1"	"1719230-1"	"DEPRESSED LEVEL OF CONSCIOUSNESS"	"10012373"	"50-59 years"	"50-59"	"On September 5 the patient started showing signs of a heavy chest cold.  She was sick for the next week with heavy cough, on and off fever, extreme fatigue, shortness of breath.  She kept insisting she just had a strong chest cold.  On September 12 I found her barely conscious, foaming at the mouth, with extreme labored breathing.  Emergency medical services took her to the ER.  She was in ICU intubated for one week, then died on September 19."
	"1719230-1"	"1719230-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"On September 5 the patient started showing signs of a heavy chest cold.  She was sick for the next week with heavy cough, on and off fever, extreme fatigue, shortness of breath.  She kept insisting she just had a strong chest cold.  On September 12 I found her barely conscious, foaming at the mouth, with extreme labored breathing.  Emergency medical services took her to the ER.  She was in ICU intubated for one week, then died on September 19."
	"1719230-1"	"1719230-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"50-59 years"	"50-59"	"On September 5 the patient started showing signs of a heavy chest cold.  She was sick for the next week with heavy cough, on and off fever, extreme fatigue, shortness of breath.  She kept insisting she just had a strong chest cold.  On September 12 I found her barely conscious, foaming at the mouth, with extreme labored breathing.  Emergency medical services took her to the ER.  She was in ICU intubated for one week, then died on September 19."
	"1719230-1"	"1719230-1"	"FATIGUE"	"10016256"	"50-59 years"	"50-59"	"On September 5 the patient started showing signs of a heavy chest cold.  She was sick for the next week with heavy cough, on and off fever, extreme fatigue, shortness of breath.  She kept insisting she just had a strong chest cold.  On September 12 I found her barely conscious, foaming at the mouth, with extreme labored breathing.  Emergency medical services took her to the ER.  She was in ICU intubated for one week, then died on September 19."
	"1719230-1"	"1719230-1"	"FOAMING AT MOUTH"	"10062654"	"50-59 years"	"50-59"	"On September 5 the patient started showing signs of a heavy chest cold.  She was sick for the next week with heavy cough, on and off fever, extreme fatigue, shortness of breath.  She kept insisting she just had a strong chest cold.  On September 12 I found her barely conscious, foaming at the mouth, with extreme labored breathing.  Emergency medical services took her to the ER.  She was in ICU intubated for one week, then died on September 19."
	"1719230-1"	"1719230-1"	"INTENSIVE CARE"	"10022519"	"50-59 years"	"50-59"	"On September 5 the patient started showing signs of a heavy chest cold.  She was sick for the next week with heavy cough, on and off fever, extreme fatigue, shortness of breath.  She kept insisting she just had a strong chest cold.  On September 12 I found her barely conscious, foaming at the mouth, with extreme labored breathing.  Emergency medical services took her to the ER.  She was in ICU intubated for one week, then died on September 19."
	"1719230-1"	"1719230-1"	"LOWER RESPIRATORY TRACT INFECTION"	"10024968"	"50-59 years"	"50-59"	"On September 5 the patient started showing signs of a heavy chest cold.  She was sick for the next week with heavy cough, on and off fever, extreme fatigue, shortness of breath.  She kept insisting she just had a strong chest cold.  On September 12 I found her barely conscious, foaming at the mouth, with extreme labored breathing.  Emergency medical services took her to the ER.  She was in ICU intubated for one week, then died on September 19."
	"1719230-1"	"1719230-1"	"MALAISE"	"10025482"	"50-59 years"	"50-59"	"On September 5 the patient started showing signs of a heavy chest cold.  She was sick for the next week with heavy cough, on and off fever, extreme fatigue, shortness of breath.  She kept insisting she just had a strong chest cold.  On September 12 I found her barely conscious, foaming at the mouth, with extreme labored breathing.  Emergency medical services took her to the ER.  She was in ICU intubated for one week, then died on September 19."
	"1719230-1"	"1719230-1"	"PYREXIA"	"10037660"	"50-59 years"	"50-59"	"On September 5 the patient started showing signs of a heavy chest cold.  She was sick for the next week with heavy cough, on and off fever, extreme fatigue, shortness of breath.  She kept insisting she just had a strong chest cold.  On September 12 I found her barely conscious, foaming at the mouth, with extreme labored breathing.  Emergency medical services took her to the ER.  She was in ICU intubated for one week, then died on September 19."
	"1722748-1"	"1722748-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient died on 09/20/2021"
	"1723190-1"	"1723190-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Case fully vaccinated with Moderna vaccine. Tested positive for COVID on 9/8/2021. Admitted to Medical Center on 8/29/2021 and expired while still hospitalized on 9/19/2021."
	"1723190-1"	"1723190-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Case fully vaccinated with Moderna vaccine. Tested positive for COVID on 9/8/2021. Admitted to Medical Center on 8/29/2021 and expired while still hospitalized on 9/19/2021."
	"1723190-1"	"1723190-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"Case fully vaccinated with Moderna vaccine. Tested positive for COVID on 9/8/2021. Admitted to Medical Center on 8/29/2021 and expired while still hospitalized on 9/19/2021."
	"1726435-1"	"1726435-1"	"ANTICOAGULANT THERAPY"	"10053468"	"50-59 years"	"50-59"	"Initially diagnosed with COVID-19 pneumonia.  He required intubation shortly after arrival to the ED.  He required significantly elevated ventilatory support since the beginning.  He has required high ventilatory settings since the beginning of his ventilation course.  Throughout his course he was treated aggressively with COVID-19 treatments, his baracitinib was stopped due to concern for concomitant bacterial infection.  He remained on steroids and was increased to higher doses of steroids due to continued lack of improvement.   He was started on therapeutic anticoagulation due to high concern for PE.  He was never stable enough for CT scan unfortunately.   He had difficult to control blood sugars during his course and was at one point in time on an insulin infusion.   On the morning of 9/22/21 he had worsening of his oxygenation into the low 80s with a po2 of 51.  Despite no changes to his ventilator and attempts to diurese he continued to decline.  His sats dropped to the 70s and his po2 dropped to 41.   He continued to decline throughout the morning with persistent hypoxemia and worsening hypotension despite pressor support and early afternoon and became bradycardic and subsequently asystole."
	"1726435-1"	"1726435-1"	"BRADYCARDIA"	"10006093"	"50-59 years"	"50-59"	"Initially diagnosed with COVID-19 pneumonia.  He required intubation shortly after arrival to the ED.  He required significantly elevated ventilatory support since the beginning.  He has required high ventilatory settings since the beginning of his ventilation course.  Throughout his course he was treated aggressively with COVID-19 treatments, his baracitinib was stopped due to concern for concomitant bacterial infection.  He remained on steroids and was increased to higher doses of steroids due to continued lack of improvement.   He was started on therapeutic anticoagulation due to high concern for PE.  He was never stable enough for CT scan unfortunately.   He had difficult to control blood sugars during his course and was at one point in time on an insulin infusion.   On the morning of 9/22/21 he had worsening of his oxygenation into the low 80s with a po2 of 51.  Despite no changes to his ventilator and attempts to diurese he continued to decline.  His sats dropped to the 70s and his po2 dropped to 41.   He continued to decline throughout the morning with persistent hypoxemia and worsening hypotension despite pressor support and early afternoon and became bradycardic and subsequently asystole."
	"1726435-1"	"1726435-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"Initially diagnosed with COVID-19 pneumonia.  He required intubation shortly after arrival to the ED.  He required significantly elevated ventilatory support since the beginning.  He has required high ventilatory settings since the beginning of his ventilation course.  Throughout his course he was treated aggressively with COVID-19 treatments, his baracitinib was stopped due to concern for concomitant bacterial infection.  He remained on steroids and was increased to higher doses of steroids due to continued lack of improvement.   He was started on therapeutic anticoagulation due to high concern for PE.  He was never stable enough for CT scan unfortunately.   He had difficult to control blood sugars during his course and was at one point in time on an insulin infusion.   On the morning of 9/22/21 he had worsening of his oxygenation into the low 80s with a po2 of 51.  Despite no changes to his ventilator and attempts to diurese he continued to decline.  His sats dropped to the 70s and his po2 dropped to 41.   He continued to decline throughout the morning with persistent hypoxemia and worsening hypotension despite pressor support and early afternoon and became bradycardic and subsequently asystole."
	"1726435-1"	"1726435-1"	"COVID-19 PNEUMONIA"	"10084380"	"50-59 years"	"50-59"	"Initially diagnosed with COVID-19 pneumonia.  He required intubation shortly after arrival to the ED.  He required significantly elevated ventilatory support since the beginning.  He has required high ventilatory settings since the beginning of his ventilation course.  Throughout his course he was treated aggressively with COVID-19 treatments, his baracitinib was stopped due to concern for concomitant bacterial infection.  He remained on steroids and was increased to higher doses of steroids due to continued lack of improvement.   He was started on therapeutic anticoagulation due to high concern for PE.  He was never stable enough for CT scan unfortunately.   He had difficult to control blood sugars during his course and was at one point in time on an insulin infusion.   On the morning of 9/22/21 he had worsening of his oxygenation into the low 80s with a po2 of 51.  Despite no changes to his ventilator and attempts to diurese he continued to decline.  His sats dropped to the 70s and his po2 dropped to 41.   He continued to decline throughout the morning with persistent hypoxemia and worsening hypotension despite pressor support and early afternoon and became bradycardic and subsequently asystole."
	"1726435-1"	"1726435-1"	"DIABETES MELLITUS INADEQUATE CONTROL"	"10012607"	"50-59 years"	"50-59"	"Initially diagnosed with COVID-19 pneumonia.  He required intubation shortly after arrival to the ED.  He required significantly elevated ventilatory support since the beginning.  He has required high ventilatory settings since the beginning of his ventilation course.  Throughout his course he was treated aggressively with COVID-19 treatments, his baracitinib was stopped due to concern for concomitant bacterial infection.  He remained on steroids and was increased to higher doses of steroids due to continued lack of improvement.   He was started on therapeutic anticoagulation due to high concern for PE.  He was never stable enough for CT scan unfortunately.   He had difficult to control blood sugars during his course and was at one point in time on an insulin infusion.   On the morning of 9/22/21 he had worsening of his oxygenation into the low 80s with a po2 of 51.  Despite no changes to his ventilator and attempts to diurese he continued to decline.  His sats dropped to the 70s and his po2 dropped to 41.   He continued to decline throughout the morning with persistent hypoxemia and worsening hypotension despite pressor support and early afternoon and became bradycardic and subsequently asystole."
	"1726435-1"	"1726435-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"50-59 years"	"50-59"	"Initially diagnosed with COVID-19 pneumonia.  He required intubation shortly after arrival to the ED.  He required significantly elevated ventilatory support since the beginning.  He has required high ventilatory settings since the beginning of his ventilation course.  Throughout his course he was treated aggressively with COVID-19 treatments, his baracitinib was stopped due to concern for concomitant bacterial infection.  He remained on steroids and was increased to higher doses of steroids due to continued lack of improvement.   He was started on therapeutic anticoagulation due to high concern for PE.  He was never stable enough for CT scan unfortunately.   He had difficult to control blood sugars during his course and was at one point in time on an insulin infusion.   On the morning of 9/22/21 he had worsening of his oxygenation into the low 80s with a po2 of 51.  Despite no changes to his ventilator and attempts to diurese he continued to decline.  His sats dropped to the 70s and his po2 dropped to 41.   He continued to decline throughout the morning with persistent hypoxemia and worsening hypotension despite pressor support and early afternoon and became bradycardic and subsequently asystole."
	"1726435-1"	"1726435-1"	"HYPOTENSION"	"10021097"	"50-59 years"	"50-59"	"Initially diagnosed with COVID-19 pneumonia.  He required intubation shortly after arrival to the ED.  He required significantly elevated ventilatory support since the beginning.  He has required high ventilatory settings since the beginning of his ventilation course.  Throughout his course he was treated aggressively with COVID-19 treatments, his baracitinib was stopped due to concern for concomitant bacterial infection.  He remained on steroids and was increased to higher doses of steroids due to continued lack of improvement.   He was started on therapeutic anticoagulation due to high concern for PE.  He was never stable enough for CT scan unfortunately.   He had difficult to control blood sugars during his course and was at one point in time on an insulin infusion.   On the morning of 9/22/21 he had worsening of his oxygenation into the low 80s with a po2 of 51.  Despite no changes to his ventilator and attempts to diurese he continued to decline.  His sats dropped to the 70s and his po2 dropped to 41.   He continued to decline throughout the morning with persistent hypoxemia and worsening hypotension despite pressor support and early afternoon and became bradycardic and subsequently asystole."
	"1726435-1"	"1726435-1"	"HYPOXIA"	"10021143"	"50-59 years"	"50-59"	"Initially diagnosed with COVID-19 pneumonia.  He required intubation shortly after arrival to the ED.  He required significantly elevated ventilatory support since the beginning.  He has required high ventilatory settings since the beginning of his ventilation course.  Throughout his course he was treated aggressively with COVID-19 treatments, his baracitinib was stopped due to concern for concomitant bacterial infection.  He remained on steroids and was increased to higher doses of steroids due to continued lack of improvement.   He was started on therapeutic anticoagulation due to high concern for PE.  He was never stable enough for CT scan unfortunately.   He had difficult to control blood sugars during his course and was at one point in time on an insulin infusion.   On the morning of 9/22/21 he had worsening of his oxygenation into the low 80s with a po2 of 51.  Despite no changes to his ventilator and attempts to diurese he continued to decline.  His sats dropped to the 70s and his po2 dropped to 41.   He continued to decline throughout the morning with persistent hypoxemia and worsening hypotension despite pressor support and early afternoon and became bradycardic and subsequently asystole."
	"1726435-1"	"1726435-1"	"MECHANICAL VENTILATION"	"10067221"	"50-59 years"	"50-59"	"Initially diagnosed with COVID-19 pneumonia.  He required intubation shortly after arrival to the ED.  He required significantly elevated ventilatory support since the beginning.  He has required high ventilatory settings since the beginning of his ventilation course.  Throughout his course he was treated aggressively with COVID-19 treatments, his baracitinib was stopped due to concern for concomitant bacterial infection.  He remained on steroids and was increased to higher doses of steroids due to continued lack of improvement.   He was started on therapeutic anticoagulation due to high concern for PE.  He was never stable enough for CT scan unfortunately.   He had difficult to control blood sugars during his course and was at one point in time on an insulin infusion.   On the morning of 9/22/21 he had worsening of his oxygenation into the low 80s with a po2 of 51.  Despite no changes to his ventilator and attempts to diurese he continued to decline.  His sats dropped to the 70s and his po2 dropped to 41.   He continued to decline throughout the morning with persistent hypoxemia and worsening hypotension despite pressor support and early afternoon and became bradycardic and subsequently asystole."
	"1726435-1"	"1726435-1"	"OXYGEN SATURATION DECREASED"	"10033318"	"50-59 years"	"50-59"	"Initially diagnosed with COVID-19 pneumonia.  He required intubation shortly after arrival to the ED.  He required significantly elevated ventilatory support since the beginning.  He has required high ventilatory settings since the beginning of his ventilation course.  Throughout his course he was treated aggressively with COVID-19 treatments, his baracitinib was stopped due to concern for concomitant bacterial infection.  He remained on steroids and was increased to higher doses of steroids due to continued lack of improvement.   He was started on therapeutic anticoagulation due to high concern for PE.  He was never stable enough for CT scan unfortunately.   He had difficult to control blood sugars during his course and was at one point in time on an insulin infusion.   On the morning of 9/22/21 he had worsening of his oxygenation into the low 80s with a po2 of 51.  Despite no changes to his ventilator and attempts to diurese he continued to decline.  His sats dropped to the 70s and his po2 dropped to 41.   He continued to decline throughout the morning with persistent hypoxemia and worsening hypotension despite pressor support and early afternoon and became bradycardic and subsequently asystole."
	"1726435-1"	"1726435-1"	"PO2 DECREASED"	"10035768"	"50-59 years"	"50-59"	"Initially diagnosed with COVID-19 pneumonia.  He required intubation shortly after arrival to the ED.  He required significantly elevated ventilatory support since the beginning.  He has required high ventilatory settings since the beginning of his ventilation course.  Throughout his course he was treated aggressively with COVID-19 treatments, his baracitinib was stopped due to concern for concomitant bacterial infection.  He remained on steroids and was increased to higher doses of steroids due to continued lack of improvement.   He was started on therapeutic anticoagulation due to high concern for PE.  He was never stable enough for CT scan unfortunately.   He had difficult to control blood sugars during his course and was at one point in time on an insulin infusion.   On the morning of 9/22/21 he had worsening of his oxygenation into the low 80s with a po2 of 51.  Despite no changes to his ventilator and attempts to diurese he continued to decline.  His sats dropped to the 70s and his po2 dropped to 41.   He continued to decline throughout the morning with persistent hypoxemia and worsening hypotension despite pressor support and early afternoon and became bradycardic and subsequently asystole."
	"1730909-1"	"1730909-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"My friend was fully vaccinated got covid on ventilator 14 days then died - how can you say it is safe and effective if you can still get it and die?  Stop this madness of this vaccine NOW!"
	"1730909-1"	"1730909-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"My friend was fully vaccinated got covid on ventilator 14 days then died - how can you say it is safe and effective if you can still get it and die?  Stop this madness of this vaccine NOW!"
	"1730909-1"	"1730909-1"	"MECHANICAL VENTILATION"	"10067221"	"50-59 years"	"50-59"	"My friend was fully vaccinated got covid on ventilator 14 days then died - how can you say it is safe and effective if you can still get it and die?  Stop this madness of this vaccine NOW!"
	"1731564-1"	"1731564-1"	"ASTHENIA"	"10003549"	"50-59 years"	"50-59"	"Breakthrough COVID-19 case with unknown symptom onset: sob/difficulty breathing, nausea or vomiting, generalized weakness.  Hospitalized 8/9/2021 to 8/16/2021. Death 8/16/2021. COD respiratory arrest, COVID-19. Place of death: HOSPITAL.  CERTIFIED BY PRONOUNCING AND CERTIFYING PHYSICIAN"
	"1731564-1"	"1731564-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Breakthrough COVID-19 case with unknown symptom onset: sob/difficulty breathing, nausea or vomiting, generalized weakness.  Hospitalized 8/9/2021 to 8/16/2021. Death 8/16/2021. COD respiratory arrest, COVID-19. Place of death: HOSPITAL.  CERTIFIED BY PRONOUNCING AND CERTIFYING PHYSICIAN"
	"1731564-1"	"1731564-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Breakthrough COVID-19 case with unknown symptom onset: sob/difficulty breathing, nausea or vomiting, generalized weakness.  Hospitalized 8/9/2021 to 8/16/2021. Death 8/16/2021. COD respiratory arrest, COVID-19. Place of death: HOSPITAL.  CERTIFIED BY PRONOUNCING AND CERTIFYING PHYSICIAN"
	"1731564-1"	"1731564-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"Breakthrough COVID-19 case with unknown symptom onset: sob/difficulty breathing, nausea or vomiting, generalized weakness.  Hospitalized 8/9/2021 to 8/16/2021. Death 8/16/2021. COD respiratory arrest, COVID-19. Place of death: HOSPITAL.  CERTIFIED BY PRONOUNCING AND CERTIFYING PHYSICIAN"
	"1731564-1"	"1731564-1"	"NAUSEA"	"10028813"	"50-59 years"	"50-59"	"Breakthrough COVID-19 case with unknown symptom onset: sob/difficulty breathing, nausea or vomiting, generalized weakness.  Hospitalized 8/9/2021 to 8/16/2021. Death 8/16/2021. COD respiratory arrest, COVID-19. Place of death: HOSPITAL.  CERTIFIED BY PRONOUNCING AND CERTIFYING PHYSICIAN"
	"1731564-1"	"1731564-1"	"RESPIRATORY ARREST"	"10038669"	"50-59 years"	"50-59"	"Breakthrough COVID-19 case with unknown symptom onset: sob/difficulty breathing, nausea or vomiting, generalized weakness.  Hospitalized 8/9/2021 to 8/16/2021. Death 8/16/2021. COD respiratory arrest, COVID-19. Place of death: HOSPITAL.  CERTIFIED BY PRONOUNCING AND CERTIFYING PHYSICIAN"
	"1731564-1"	"1731564-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"Breakthrough COVID-19 case with unknown symptom onset: sob/difficulty breathing, nausea or vomiting, generalized weakness.  Hospitalized 8/9/2021 to 8/16/2021. Death 8/16/2021. COD respiratory arrest, COVID-19. Place of death: HOSPITAL.  CERTIFIED BY PRONOUNCING AND CERTIFYING PHYSICIAN"
	"1731564-1"	"1731564-1"	"VACCINE BREAKTHROUGH INFECTION"	"10067923"	"50-59 years"	"50-59"	"Breakthrough COVID-19 case with unknown symptom onset: sob/difficulty breathing, nausea or vomiting, generalized weakness.  Hospitalized 8/9/2021 to 8/16/2021. Death 8/16/2021. COD respiratory arrest, COVID-19. Place of death: HOSPITAL.  CERTIFIED BY PRONOUNCING AND CERTIFYING PHYSICIAN"
	"1731564-1"	"1731564-1"	"VOMITING"	"10047700"	"50-59 years"	"50-59"	"Breakthrough COVID-19 case with unknown symptom onset: sob/difficulty breathing, nausea or vomiting, generalized weakness.  Hospitalized 8/9/2021 to 8/16/2021. Death 8/16/2021. COD respiratory arrest, COVID-19. Place of death: HOSPITAL.  CERTIFIED BY PRONOUNCING AND CERTIFYING PHYSICIAN"
	"1733185-1"	"1733185-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Death"
	"1735547-1"	"1735547-1"	"BLOOD TEST"	"10061726"	"50-59 years"	"50-59"	"My husband developed sclerosis of the live followed by a heart attach and then kidney failure.  My husband was complaining about feeling exhausted and ache all over.  He fell the following day and was transported to the emergency room on 8/5/2021 and admitted later that day.  My husband never left the hospital and passed away on 8/11/2021."
	"1735547-1"	"1735547-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"My husband developed sclerosis of the live followed by a heart attach and then kidney failure.  My husband was complaining about feeling exhausted and ache all over.  He fell the following day and was transported to the emergency room on 8/5/2021 and admitted later that day.  My husband never left the hospital and passed away on 8/11/2021."
	"1735547-1"	"1735547-1"	"FALL"	"10016173"	"50-59 years"	"50-59"	"My husband developed sclerosis of the live followed by a heart attach and then kidney failure.  My husband was complaining about feeling exhausted and ache all over.  He fell the following day and was transported to the emergency room on 8/5/2021 and admitted later that day.  My husband never left the hospital and passed away on 8/11/2021."
	"1735547-1"	"1735547-1"	"FATIGUE"	"10016256"	"50-59 years"	"50-59"	"My husband developed sclerosis of the live followed by a heart attach and then kidney failure.  My husband was complaining about feeling exhausted and ache all over.  He fell the following day and was transported to the emergency room on 8/5/2021 and admitted later that day.  My husband never left the hospital and passed away on 8/11/2021."
	"1735547-1"	"1735547-1"	"HEPATIC FIBROSIS"	"10019668"	"50-59 years"	"50-59"	"My husband developed sclerosis of the live followed by a heart attach and then kidney failure.  My husband was complaining about feeling exhausted and ache all over.  He fell the following day and was transported to the emergency room on 8/5/2021 and admitted later that day.  My husband never left the hospital and passed away on 8/11/2021."
	"1735547-1"	"1735547-1"	"MYOCARDIAL INFARCTION"	"10028596"	"50-59 years"	"50-59"	"My husband developed sclerosis of the live followed by a heart attach and then kidney failure.  My husband was complaining about feeling exhausted and ache all over.  He fell the following day and was transported to the emergency room on 8/5/2021 and admitted later that day.  My husband never left the hospital and passed away on 8/11/2021."
	"1735547-1"	"1735547-1"	"PAIN"	"10033371"	"50-59 years"	"50-59"	"My husband developed sclerosis of the live followed by a heart attach and then kidney failure.  My husband was complaining about feeling exhausted and ache all over.  He fell the following day and was transported to the emergency room on 8/5/2021 and admitted later that day.  My husband never left the hospital and passed away on 8/11/2021."
	"1735547-1"	"1735547-1"	"PARACENTESIS"	"10061905"	"50-59 years"	"50-59"	"My husband developed sclerosis of the live followed by a heart attach and then kidney failure.  My husband was complaining about feeling exhausted and ache all over.  He fell the following day and was transported to the emergency room on 8/5/2021 and admitted later that day.  My husband never left the hospital and passed away on 8/11/2021."
	"1735547-1"	"1735547-1"	"RENAL FAILURE"	"10038435"	"50-59 years"	"50-59"	"My husband developed sclerosis of the live followed by a heart attach and then kidney failure.  My husband was complaining about feeling exhausted and ache all over.  He fell the following day and was transported to the emergency room on 8/5/2021 and admitted later that day.  My husband never left the hospital and passed away on 8/11/2021."
	"1735547-1"	"1735547-1"	"SARS-COV-2 TEST"	"10084354"	"50-59 years"	"50-59"	"My husband developed sclerosis of the live followed by a heart attach and then kidney failure.  My husband was complaining about feeling exhausted and ache all over.  He fell the following day and was transported to the emergency room on 8/5/2021 and admitted later that day.  My husband never left the hospital and passed away on 8/11/2021."
	"1735547-1"	"1735547-1"	"SCAN"	"10061498"	"50-59 years"	"50-59"	"My husband developed sclerosis of the live followed by a heart attach and then kidney failure.  My husband was complaining about feeling exhausted and ache all over.  He fell the following day and was transported to the emergency room on 8/5/2021 and admitted later that day.  My husband never left the hospital and passed away on 8/11/2021."
	"1735547-1"	"1735547-1"	"X-RAY"	"10048064"	"50-59 years"	"50-59"	"My husband developed sclerosis of the live followed by a heart attach and then kidney failure.  My husband was complaining about feeling exhausted and ache all over.  He fell the following day and was transported to the emergency room on 8/5/2021 and admitted later that day.  My husband never left the hospital and passed away on 8/11/2021."
	"1736918-1"	"1736918-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"Shortness of breath"
	"1736918-1"	"1736918-1"	"TROPONIN INCREASED"	"10058267"	"50-59 years"	"50-59"	"Shortness of breath"
	"1737079-1"	"1737079-1"	"ANEURYSM"	"10002329"	"50-59 years"	"50-59"	"Severe headache within 4 hours of shot and after 4 days of feeling very unwell Pt stood up and fell over instantly of and aneurysm and died  .I lost my partner of 23 years due to vaccination"
	"1737079-1"	"1737079-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Severe headache within 4 hours of shot and after 4 days of feeling very unwell Pt stood up and fell over instantly of and aneurysm and died  .I lost my partner of 23 years due to vaccination"
	"1737079-1"	"1737079-1"	"FALL"	"10016173"	"50-59 years"	"50-59"	"Severe headache within 4 hours of shot and after 4 days of feeling very unwell Pt stood up and fell over instantly of and aneurysm and died  .I lost my partner of 23 years due to vaccination"
	"1737079-1"	"1737079-1"	"HEADACHE"	"10019211"	"50-59 years"	"50-59"	"Severe headache within 4 hours of shot and after 4 days of feeling very unwell Pt stood up and fell over instantly of and aneurysm and died  .I lost my partner of 23 years due to vaccination"
	"1737079-1"	"1737079-1"	"MALAISE"	"10025482"	"50-59 years"	"50-59"	"Severe headache within 4 hours of shot and after 4 days of feeling very unwell Pt stood up and fell over instantly of and aneurysm and died  .I lost my partner of 23 years due to vaccination"
	"1738037-1"	"1738037-1"	"ABDOMINAL DISCOMFORT"	"10000059"	"50-59 years"	"50-59"	"Death on 9/24/21. Pfizer administered on 9/10/21. Jand J on 3/12/2021"
	"1738037-1"	"1738037-1"	"COUGH"	"10011224"	"50-59 years"	"50-59"	"Death on 9/24/21. Pfizer administered on 9/10/21. Jand J on 3/12/2021"
	"1738037-1"	"1738037-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Death on 9/24/21. Pfizer administered on 9/10/21. Jand J on 3/12/2021"
	"1738037-1"	"1738037-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Death on 9/24/21. Pfizer administered on 9/10/21. Jand J on 3/12/2021"
	"1738037-1"	"1738037-1"	"EXTRA DOSE ADMINISTERED"	"10064366"	"50-59 years"	"50-59"	"Death on 9/24/21. Pfizer administered on 9/10/21. Jand J on 3/12/2021"
	"1738037-1"	"1738037-1"	"INTERCHANGE OF VACCINE PRODUCTS"	"10070574"	"50-59 years"	"50-59"	"Death on 9/24/21. Pfizer administered on 9/10/21. Jand J on 3/12/2021"
	"1738037-1"	"1738037-1"	"OROPHARYNGEAL PAIN"	"10068319"	"50-59 years"	"50-59"	"Death on 9/24/21. Pfizer administered on 9/10/21. Jand J on 3/12/2021"
	"1738037-1"	"1738037-1"	"RESPIRATORY TRACT CONGESTION"	"10052251"	"50-59 years"	"50-59"	"Death on 9/24/21. Pfizer administered on 9/10/21. Jand J on 3/12/2021"
	"1738037-1"	"1738037-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"Death on 9/24/21. Pfizer administered on 9/10/21. Jand J on 3/12/2021"
	"1738037-1"	"1738037-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"50-59 years"	"50-59"	"Death on 9/24/21. Pfizer administered on 9/10/21. Jand J on 3/12/2021"
	"1738037-1"	"1738037-1"	"VOMITING"	"10047700"	"50-59 years"	"50-59"	"Death on 9/24/21. Pfizer administered on 9/10/21. Jand J on 3/12/2021"
	"1740865-1"	"1740865-1"	"DECREASED APPETITE"	"10061428"	"50-59 years"	"50-59"	"felt sick tired and no appetite, and headache the day after the vaccine the next day felt ok no complaints still no real appetite the third day had coffee got up to do dishes and apparently just dropped where she stood and died."
	"1740865-1"	"1740865-1"	"FATIGUE"	"10016256"	"50-59 years"	"50-59"	"felt sick tired and no appetite, and headache the day after the vaccine the next day felt ok no complaints still no real appetite the third day had coffee got up to do dishes and apparently just dropped where she stood and died."
	"1740865-1"	"1740865-1"	"HEADACHE"	"10019211"	"50-59 years"	"50-59"	"felt sick tired and no appetite, and headache the day after the vaccine the next day felt ok no complaints still no real appetite the third day had coffee got up to do dishes and apparently just dropped where she stood and died."
	"1740865-1"	"1740865-1"	"MALAISE"	"10025482"	"50-59 years"	"50-59"	"felt sick tired and no appetite, and headache the day after the vaccine the next day felt ok no complaints still no real appetite the third day had coffee got up to do dishes and apparently just dropped where she stood and died."
	"1740865-1"	"1740865-1"	"SUDDEN DEATH"	"10042434"	"50-59 years"	"50-59"	"felt sick tired and no appetite, and headache the day after the vaccine the next day felt ok no complaints still no real appetite the third day had coffee got up to do dishes and apparently just dropped where she stood and died."
	"1741085-1"	"1741085-1"	"ACUTE RESPIRATORY FAILURE"	"10001053"	"50-59 years"	"50-59"	"Developed Acute Respiratory Failure leading to intubation and death."
	"1741085-1"	"1741085-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Developed Acute Respiratory Failure leading to intubation and death."
	"1741085-1"	"1741085-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Developed Acute Respiratory Failure leading to intubation and death."
	"1741085-1"	"1741085-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"50-59 years"	"50-59"	"Developed Acute Respiratory Failure leading to intubation and death."
	"1741085-1"	"1741085-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"Developed Acute Respiratory Failure leading to intubation and death."
	"1741118-1"	"1741118-1"	"ACUTE KIDNEY INJURY"	"10069339"	"50-59 years"	"50-59"	"Admitted on 9/7/2021 with COVID-19 and sever hypoxia. Known COVID contact several days prior. Treated with remdesivir, dexamethasone, ceftriaxone, and azithromycin. Also started on barictnib on 9/9 but stopped due to ARF. Echocardiogram showed EF of 25-50% with moderately severe LV function. Started on heparin and continued throughout hospital stay. DVT in right lower leg. Seen by infectious disease and continued on cefepime and levofloxacin for 14 days. Underwent cryo-amputation of right ischemic lower extremity and then BKA by vascular surgery. Prognosis poor and not improving. Family elected comfort care."
	"1741118-1"	"1741118-1"	"ANTICOAGULANT THERAPY"	"10053468"	"50-59 years"	"50-59"	"Admitted on 9/7/2021 with COVID-19 and sever hypoxia. Known COVID contact several days prior. Treated with remdesivir, dexamethasone, ceftriaxone, and azithromycin. Also started on barictnib on 9/9 but stopped due to ARF. Echocardiogram showed EF of 25-50% with moderately severe LV function. Started on heparin and continued throughout hospital stay. DVT in right lower leg. Seen by infectious disease and continued on cefepime and levofloxacin for 14 days. Underwent cryo-amputation of right ischemic lower extremity and then BKA by vascular surgery. Prognosis poor and not improving. Family elected comfort care."
	"1741118-1"	"1741118-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Admitted on 9/7/2021 with COVID-19 and sever hypoxia. Known COVID contact several days prior. Treated with remdesivir, dexamethasone, ceftriaxone, and azithromycin. Also started on barictnib on 9/9 but stopped due to ARF. Echocardiogram showed EF of 25-50% with moderately severe LV function. Started on heparin and continued throughout hospital stay. DVT in right lower leg. Seen by infectious disease and continued on cefepime and levofloxacin for 14 days. Underwent cryo-amputation of right ischemic lower extremity and then BKA by vascular surgery. Prognosis poor and not improving. Family elected comfort care."
	"1741118-1"	"1741118-1"	"CRYOTHERAPY"	"10011483"	"50-59 years"	"50-59"	"Admitted on 9/7/2021 with COVID-19 and sever hypoxia. Known COVID contact several days prior. Treated with remdesivir, dexamethasone, ceftriaxone, and azithromycin. Also started on barictnib on 9/9 but stopped due to ARF. Echocardiogram showed EF of 25-50% with moderately severe LV function. Started on heparin and continued throughout hospital stay. DVT in right lower leg. Seen by infectious disease and continued on cefepime and levofloxacin for 14 days. Underwent cryo-amputation of right ischemic lower extremity and then BKA by vascular surgery. Prognosis poor and not improving. Family elected comfort care."
	"1741118-1"	"1741118-1"	"DEEP VEIN THROMBOSIS"	"10051055"	"50-59 years"	"50-59"	"Admitted on 9/7/2021 with COVID-19 and sever hypoxia. Known COVID contact several days prior. Treated with remdesivir, dexamethasone, ceftriaxone, and azithromycin. Also started on barictnib on 9/9 but stopped due to ARF. Echocardiogram showed EF of 25-50% with moderately severe LV function. Started on heparin and continued throughout hospital stay. DVT in right lower leg. Seen by infectious disease and continued on cefepime and levofloxacin for 14 days. Underwent cryo-amputation of right ischemic lower extremity and then BKA by vascular surgery. Prognosis poor and not improving. Family elected comfort care."
	"1741118-1"	"1741118-1"	"ECHOCARDIOGRAM ABNORMAL"	"10061593"	"50-59 years"	"50-59"	"Admitted on 9/7/2021 with COVID-19 and sever hypoxia. Known COVID contact several days prior. Treated with remdesivir, dexamethasone, ceftriaxone, and azithromycin. Also started on barictnib on 9/9 but stopped due to ARF. Echocardiogram showed EF of 25-50% with moderately severe LV function. Started on heparin and continued throughout hospital stay. DVT in right lower leg. Seen by infectious disease and continued on cefepime and levofloxacin for 14 days. Underwent cryo-amputation of right ischemic lower extremity and then BKA by vascular surgery. Prognosis poor and not improving. Family elected comfort care."
	"1741118-1"	"1741118-1"	"EJECTION FRACTION DECREASED"	"10050528"	"50-59 years"	"50-59"	"Admitted on 9/7/2021 with COVID-19 and sever hypoxia. Known COVID contact several days prior. Treated with remdesivir, dexamethasone, ceftriaxone, and azithromycin. Also started on barictnib on 9/9 but stopped due to ARF. Echocardiogram showed EF of 25-50% with moderately severe LV function. Started on heparin and continued throughout hospital stay. DVT in right lower leg. Seen by infectious disease and continued on cefepime and levofloxacin for 14 days. Underwent cryo-amputation of right ischemic lower extremity and then BKA by vascular surgery. Prognosis poor and not improving. Family elected comfort care."
	"1741118-1"	"1741118-1"	"EXPOSURE TO SARS-COV-2"	"10084456"	"50-59 years"	"50-59"	"Admitted on 9/7/2021 with COVID-19 and sever hypoxia. Known COVID contact several days prior. Treated with remdesivir, dexamethasone, ceftriaxone, and azithromycin. Also started on barictnib on 9/9 but stopped due to ARF. Echocardiogram showed EF of 25-50% with moderately severe LV function. Started on heparin and continued throughout hospital stay. DVT in right lower leg. Seen by infectious disease and continued on cefepime and levofloxacin for 14 days. Underwent cryo-amputation of right ischemic lower extremity and then BKA by vascular surgery. Prognosis poor and not improving. Family elected comfort care."
	"1741118-1"	"1741118-1"	"GENERAL PHYSICAL HEALTH DETERIORATION"	"10049438"	"50-59 years"	"50-59"	"Admitted on 9/7/2021 with COVID-19 and sever hypoxia. Known COVID contact several days prior. Treated with remdesivir, dexamethasone, ceftriaxone, and azithromycin. Also started on barictnib on 9/9 but stopped due to ARF. Echocardiogram showed EF of 25-50% with moderately severe LV function. Started on heparin and continued throughout hospital stay. DVT in right lower leg. Seen by infectious disease and continued on cefepime and levofloxacin for 14 days. Underwent cryo-amputation of right ischemic lower extremity and then BKA by vascular surgery. Prognosis poor and not improving. Family elected comfort care."
	"1741118-1"	"1741118-1"	"HYPOXIA"	"10021143"	"50-59 years"	"50-59"	"Admitted on 9/7/2021 with COVID-19 and sever hypoxia. Known COVID contact several days prior. Treated with remdesivir, dexamethasone, ceftriaxone, and azithromycin. Also started on barictnib on 9/9 but stopped due to ARF. Echocardiogram showed EF of 25-50% with moderately severe LV function. Started on heparin and continued throughout hospital stay. DVT in right lower leg. Seen by infectious disease and continued on cefepime and levofloxacin for 14 days. Underwent cryo-amputation of right ischemic lower extremity and then BKA by vascular surgery. Prognosis poor and not improving. Family elected comfort care."
	"1741118-1"	"1741118-1"	"LEFT VENTRICULAR DYSFUNCTION"	"10049694"	"50-59 years"	"50-59"	"Admitted on 9/7/2021 with COVID-19 and sever hypoxia. Known COVID contact several days prior. Treated with remdesivir, dexamethasone, ceftriaxone, and azithromycin. Also started on barictnib on 9/9 but stopped due to ARF. Echocardiogram showed EF of 25-50% with moderately severe LV function. Started on heparin and continued throughout hospital stay. DVT in right lower leg. Seen by infectious disease and continued on cefepime and levofloxacin for 14 days. Underwent cryo-amputation of right ischemic lower extremity and then BKA by vascular surgery. Prognosis poor and not improving. Family elected comfort care."
	"1741118-1"	"1741118-1"	"LEG AMPUTATION"	"10024124"	"50-59 years"	"50-59"	"Admitted on 9/7/2021 with COVID-19 and sever hypoxia. Known COVID contact several days prior. Treated with remdesivir, dexamethasone, ceftriaxone, and azithromycin. Also started on barictnib on 9/9 but stopped due to ARF. Echocardiogram showed EF of 25-50% with moderately severe LV function. Started on heparin and continued throughout hospital stay. DVT in right lower leg. Seen by infectious disease and continued on cefepime and levofloxacin for 14 days. Underwent cryo-amputation of right ischemic lower extremity and then BKA by vascular surgery. Prognosis poor and not improving. Family elected comfort care."
	"1741118-1"	"1741118-1"	"PERIPHERAL ISCHAEMIA"	"10034576"	"50-59 years"	"50-59"	"Admitted on 9/7/2021 with COVID-19 and sever hypoxia. Known COVID contact several days prior. Treated with remdesivir, dexamethasone, ceftriaxone, and azithromycin. Also started on barictnib on 9/9 but stopped due to ARF. Echocardiogram showed EF of 25-50% with moderately severe LV function. Started on heparin and continued throughout hospital stay. DVT in right lower leg. Seen by infectious disease and continued on cefepime and levofloxacin for 14 days. Underwent cryo-amputation of right ischemic lower extremity and then BKA by vascular surgery. Prognosis poor and not improving. Family elected comfort care."
	"1741359-1"	"1741359-1"	"ANXIETY"	"10002855"	"50-59 years"	"50-59"	"Patient is a  57 y.o. male with a history of testing testing diabetes, bronchitis, hypertension and recent COVID-19 infection presenting with worsening shortness of breath and fever at 102. Initially treated outpatient with antibiotics steroids without improvement.  Patient presented today with decreased oxygen saturations at 84% on 4L.  Reports dyspnea.  Reports fatigue.  Reports fever.  Denies nausea vomiting diarrhea.  Reports recently tested positive COVID-19 on August 31st.  Patient admitted to hospitalist service.  History was obtained from patient who seemed an accurate and reliable historian.  Significant other was present.  From Pulmonary/Critical Care Consult:  Patient is a  57 y.o. male who initially presented to the emergency department on 9/13/2021 with worsening respiratory status. Pt provides some information, majority of info provided by significant other that is at the bedside.    Pt was diagnosed with 8/31 with COVID 19 in the emergency department. He was sent home with home oxygen and managed by his fiance. His status waxed and waned. He presented back to the ED on 9/13 with increased dyspnea, increased fatigue, decreased oxygen saturation, and fever. Pt was then admitted to the pulmonary floor to the hospitalist services.    He remained on the pulmonary floor. He did require more supplemental oxygen and was eventually receiving maximum amounts of oxygen via heated high flow NC with a nonrebreather on top. He was also started on IV dexamethasone on admission. Decision was made to transfer the patient to the ICU for AVAPS.    Pt arrived to the ICU. He was placed on NIV. He did become anxious with application, so he was started on precedex. Pt is alert and oriented. His fiance is at bedside.    Hospital Course:  Patient was transferred to the ICU on 9/19/2021 due to worsening respiratory status and was transition to noninvasive ventilatory support.  He required a dexmedetomidine infusion for anxiety.  He further decompensated on 9/23/2021 and required intubation.  He suffered a spontaneous left pneumothorax and a chest tube was placed.  He required paralytic infusion as well.  He was initiated on broad-spectrum antibiotics while in the ICU for a possible secondary bacterial infection.  Unfortunately, the patient continued to decompensate despite maximal mechanical support.  On the evening of 9/26/2021, the patient's family mid determination to transition to comfort measures and terminal extubation.  Patient did succumb to his critical illness on the evening of 9/26/2021 at 1910 hr, may he rest in peace.   Disposition: Deceased; time of death 1910 hr, 9/26/2021"
	"1741359-1"	"1741359-1"	"CHEST TUBE INSERTION"	"10050522"	"50-59 years"	"50-59"	"Patient is a  57 y.o. male with a history of testing testing diabetes, bronchitis, hypertension and recent COVID-19 infection presenting with worsening shortness of breath and fever at 102. Initially treated outpatient with antibiotics steroids without improvement.  Patient presented today with decreased oxygen saturations at 84% on 4L.  Reports dyspnea.  Reports fatigue.  Reports fever.  Denies nausea vomiting diarrhea.  Reports recently tested positive COVID-19 on August 31st.  Patient admitted to hospitalist service.  History was obtained from patient who seemed an accurate and reliable historian.  Significant other was present.  From Pulmonary/Critical Care Consult:  Patient is a  57 y.o. male who initially presented to the emergency department on 9/13/2021 with worsening respiratory status. Pt provides some information, majority of info provided by significant other that is at the bedside.    Pt was diagnosed with 8/31 with COVID 19 in the emergency department. He was sent home with home oxygen and managed by his fiance. His status waxed and waned. He presented back to the ED on 9/13 with increased dyspnea, increased fatigue, decreased oxygen saturation, and fever. Pt was then admitted to the pulmonary floor to the hospitalist services.    He remained on the pulmonary floor. He did require more supplemental oxygen and was eventually receiving maximum amounts of oxygen via heated high flow NC with a nonrebreather on top. He was also started on IV dexamethasone on admission. Decision was made to transfer the patient to the ICU for AVAPS.    Pt arrived to the ICU. He was placed on NIV. He did become anxious with application, so he was started on precedex. Pt is alert and oriented. His fiance is at bedside.    Hospital Course:  Patient was transferred to the ICU on 9/19/2021 due to worsening respiratory status and was transition to noninvasive ventilatory support.  He required a dexmedetomidine infusion for anxiety.  He further decompensated on 9/23/2021 and required intubation.  He suffered a spontaneous left pneumothorax and a chest tube was placed.  He required paralytic infusion as well.  He was initiated on broad-spectrum antibiotics while in the ICU for a possible secondary bacterial infection.  Unfortunately, the patient continued to decompensate despite maximal mechanical support.  On the evening of 9/26/2021, the patient's family mid determination to transition to comfort measures and terminal extubation.  Patient did succumb to his critical illness on the evening of 9/26/2021 at 1910 hr, may he rest in peace.   Disposition: Deceased; time of death 1910 hr, 9/26/2021"
	"1741359-1"	"1741359-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Patient is a  57 y.o. male with a history of testing testing diabetes, bronchitis, hypertension and recent COVID-19 infection presenting with worsening shortness of breath and fever at 102. Initially treated outpatient with antibiotics steroids without improvement.  Patient presented today with decreased oxygen saturations at 84% on 4L.  Reports dyspnea.  Reports fatigue.  Reports fever.  Denies nausea vomiting diarrhea.  Reports recently tested positive COVID-19 on August 31st.  Patient admitted to hospitalist service.  History was obtained from patient who seemed an accurate and reliable historian.  Significant other was present.  From Pulmonary/Critical Care Consult:  Patient is a  57 y.o. male who initially presented to the emergency department on 9/13/2021 with worsening respiratory status. Pt provides some information, majority of info provided by significant other that is at the bedside.    Pt was diagnosed with 8/31 with COVID 19 in the emergency department. He was sent home with home oxygen and managed by his fiance. His status waxed and waned. He presented back to the ED on 9/13 with increased dyspnea, increased fatigue, decreased oxygen saturation, and fever. Pt was then admitted to the pulmonary floor to the hospitalist services.    He remained on the pulmonary floor. He did require more supplemental oxygen and was eventually receiving maximum amounts of oxygen via heated high flow NC with a nonrebreather on top. He was also started on IV dexamethasone on admission. Decision was made to transfer the patient to the ICU for AVAPS.    Pt arrived to the ICU. He was placed on NIV. He did become anxious with application, so he was started on precedex. Pt is alert and oriented. His fiance is at bedside.    Hospital Course:  Patient was transferred to the ICU on 9/19/2021 due to worsening respiratory status and was transition to noninvasive ventilatory support.  He required a dexmedetomidine infusion for anxiety.  He further decompensated on 9/23/2021 and required intubation.  He suffered a spontaneous left pneumothorax and a chest tube was placed.  He required paralytic infusion as well.  He was initiated on broad-spectrum antibiotics while in the ICU for a possible secondary bacterial infection.  Unfortunately, the patient continued to decompensate despite maximal mechanical support.  On the evening of 9/26/2021, the patient's family mid determination to transition to comfort measures and terminal extubation.  Patient did succumb to his critical illness on the evening of 9/26/2021 at 1910 hr, may he rest in peace.   Disposition: Deceased; time of death 1910 hr, 9/26/2021"
	"1741359-1"	"1741359-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient is a  57 y.o. male with a history of testing testing diabetes, bronchitis, hypertension and recent COVID-19 infection presenting with worsening shortness of breath and fever at 102. Initially treated outpatient with antibiotics steroids without improvement.  Patient presented today with decreased oxygen saturations at 84% on 4L.  Reports dyspnea.  Reports fatigue.  Reports fever.  Denies nausea vomiting diarrhea.  Reports recently tested positive COVID-19 on August 31st.  Patient admitted to hospitalist service.  History was obtained from patient who seemed an accurate and reliable historian.  Significant other was present.  From Pulmonary/Critical Care Consult:  Patient is a  57 y.o. male who initially presented to the emergency department on 9/13/2021 with worsening respiratory status. Pt provides some information, majority of info provided by significant other that is at the bedside.    Pt was diagnosed with 8/31 with COVID 19 in the emergency department. He was sent home with home oxygen and managed by his fiance. His status waxed and waned. He presented back to the ED on 9/13 with increased dyspnea, increased fatigue, decreased oxygen saturation, and fever. Pt was then admitted to the pulmonary floor to the hospitalist services.    He remained on the pulmonary floor. He did require more supplemental oxygen and was eventually receiving maximum amounts of oxygen via heated high flow NC with a nonrebreather on top. He was also started on IV dexamethasone on admission. Decision was made to transfer the patient to the ICU for AVAPS.    Pt arrived to the ICU. He was placed on NIV. He did become anxious with application, so he was started on precedex. Pt is alert and oriented. His fiance is at bedside.    Hospital Course:  Patient was transferred to the ICU on 9/19/2021 due to worsening respiratory status and was transition to noninvasive ventilatory support.  He required a dexmedetomidine infusion for anxiety.  He further decompensated on 9/23/2021 and required intubation.  He suffered a spontaneous left pneumothorax and a chest tube was placed.  He required paralytic infusion as well.  He was initiated on broad-spectrum antibiotics while in the ICU for a possible secondary bacterial infection.  Unfortunately, the patient continued to decompensate despite maximal mechanical support.  On the evening of 9/26/2021, the patient's family mid determination to transition to comfort measures and terminal extubation.  Patient did succumb to his critical illness on the evening of 9/26/2021 at 1910 hr, may he rest in peace.   Disposition: Deceased; time of death 1910 hr, 9/26/2021"
	"1741359-1"	"1741359-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"Patient is a  57 y.o. male with a history of testing testing diabetes, bronchitis, hypertension and recent COVID-19 infection presenting with worsening shortness of breath and fever at 102. Initially treated outpatient with antibiotics steroids without improvement.  Patient presented today with decreased oxygen saturations at 84% on 4L.  Reports dyspnea.  Reports fatigue.  Reports fever.  Denies nausea vomiting diarrhea.  Reports recently tested positive COVID-19 on August 31st.  Patient admitted to hospitalist service.  History was obtained from patient who seemed an accurate and reliable historian.  Significant other was present.  From Pulmonary/Critical Care Consult:  Patient is a  57 y.o. male who initially presented to the emergency department on 9/13/2021 with worsening respiratory status. Pt provides some information, majority of info provided by significant other that is at the bedside.    Pt was diagnosed with 8/31 with COVID 19 in the emergency department. He was sent home with home oxygen and managed by his fiance. His status waxed and waned. He presented back to the ED on 9/13 with increased dyspnea, increased fatigue, decreased oxygen saturation, and fever. Pt was then admitted to the pulmonary floor to the hospitalist services.    He remained on the pulmonary floor. He did require more supplemental oxygen and was eventually receiving maximum amounts of oxygen via heated high flow NC with a nonrebreather on top. He was also started on IV dexamethasone on admission. Decision was made to transfer the patient to the ICU for AVAPS.    Pt arrived to the ICU. He was placed on NIV. He did become anxious with application, so he was started on precedex. Pt is alert and oriented. His fiance is at bedside.    Hospital Course:  Patient was transferred to the ICU on 9/19/2021 due to worsening respiratory status and was transition to noninvasive ventilatory support.  He required a dexmedetomidine infusion for anxiety.  He further decompensated on 9/23/2021 and required intubation.  He suffered a spontaneous left pneumothorax and a chest tube was placed.  He required paralytic infusion as well.  He was initiated on broad-spectrum antibiotics while in the ICU for a possible secondary bacterial infection.  Unfortunately, the patient continued to decompensate despite maximal mechanical support.  On the evening of 9/26/2021, the patient's family mid determination to transition to comfort measures and terminal extubation.  Patient did succumb to his critical illness on the evening of 9/26/2021 at 1910 hr, may he rest in peace.   Disposition: Deceased; time of death 1910 hr, 9/26/2021"
	"1741359-1"	"1741359-1"	"FATIGUE"	"10016256"	"50-59 years"	"50-59"	"Patient is a  57 y.o. male with a history of testing testing diabetes, bronchitis, hypertension and recent COVID-19 infection presenting with worsening shortness of breath and fever at 102. Initially treated outpatient with antibiotics steroids without improvement.  Patient presented today with decreased oxygen saturations at 84% on 4L.  Reports dyspnea.  Reports fatigue.  Reports fever.  Denies nausea vomiting diarrhea.  Reports recently tested positive COVID-19 on August 31st.  Patient admitted to hospitalist service.  History was obtained from patient who seemed an accurate and reliable historian.  Significant other was present.  From Pulmonary/Critical Care Consult:  Patient is a  57 y.o. male who initially presented to the emergency department on 9/13/2021 with worsening respiratory status. Pt provides some information, majority of info provided by significant other that is at the bedside.    Pt was diagnosed with 8/31 with COVID 19 in the emergency department. He was sent home with home oxygen and managed by his fiance. His status waxed and waned. He presented back to the ED on 9/13 with increased dyspnea, increased fatigue, decreased oxygen saturation, and fever. Pt was then admitted to the pulmonary floor to the hospitalist services.    He remained on the pulmonary floor. He did require more supplemental oxygen and was eventually receiving maximum amounts of oxygen via heated high flow NC with a nonrebreather on top. He was also started on IV dexamethasone on admission. Decision was made to transfer the patient to the ICU for AVAPS.    Pt arrived to the ICU. He was placed on NIV. He did become anxious with application, so he was started on precedex. Pt is alert and oriented. His fiance is at bedside.    Hospital Course:  Patient was transferred to the ICU on 9/19/2021 due to worsening respiratory status and was transition to noninvasive ventilatory support.  He required a dexmedetomidine infusion for anxiety.  He further decompensated on 9/23/2021 and required intubation.  He suffered a spontaneous left pneumothorax and a chest tube was placed.  He required paralytic infusion as well.  He was initiated on broad-spectrum antibiotics while in the ICU for a possible secondary bacterial infection.  Unfortunately, the patient continued to decompensate despite maximal mechanical support.  On the evening of 9/26/2021, the patient's family mid determination to transition to comfort measures and terminal extubation.  Patient did succumb to his critical illness on the evening of 9/26/2021 at 1910 hr, may he rest in peace.   Disposition: Deceased; time of death 1910 hr, 9/26/2021"
	"1741359-1"	"1741359-1"	"GENERAL PHYSICAL HEALTH DETERIORATION"	"10049438"	"50-59 years"	"50-59"	"Patient is a  57 y.o. male with a history of testing testing diabetes, bronchitis, hypertension and recent COVID-19 infection presenting with worsening shortness of breath and fever at 102. Initially treated outpatient with antibiotics steroids without improvement.  Patient presented today with decreased oxygen saturations at 84% on 4L.  Reports dyspnea.  Reports fatigue.  Reports fever.  Denies nausea vomiting diarrhea.  Reports recently tested positive COVID-19 on August 31st.  Patient admitted to hospitalist service.  History was obtained from patient who seemed an accurate and reliable historian.  Significant other was present.  From Pulmonary/Critical Care Consult:  Patient is a  57 y.o. male who initially presented to the emergency department on 9/13/2021 with worsening respiratory status. Pt provides some information, majority of info provided by significant other that is at the bedside.    Pt was diagnosed with 8/31 with COVID 19 in the emergency department. He was sent home with home oxygen and managed by his fiance. His status waxed and waned. He presented back to the ED on 9/13 with increased dyspnea, increased fatigue, decreased oxygen saturation, and fever. Pt was then admitted to the pulmonary floor to the hospitalist services.    He remained on the pulmonary floor. He did require more supplemental oxygen and was eventually receiving maximum amounts of oxygen via heated high flow NC with a nonrebreather on top. He was also started on IV dexamethasone on admission. Decision was made to transfer the patient to the ICU for AVAPS.    Pt arrived to the ICU. He was placed on NIV. He did become anxious with application, so he was started on precedex. Pt is alert and oriented. His fiance is at bedside.    Hospital Course:  Patient was transferred to the ICU on 9/19/2021 due to worsening respiratory status and was transition to noninvasive ventilatory support.  He required a dexmedetomidine infusion for anxiety.  He further decompensated on 9/23/2021 and required intubation.  He suffered a spontaneous left pneumothorax and a chest tube was placed.  He required paralytic infusion as well.  He was initiated on broad-spectrum antibiotics while in the ICU for a possible secondary bacterial infection.  Unfortunately, the patient continued to decompensate despite maximal mechanical support.  On the evening of 9/26/2021, the patient's family mid determination to transition to comfort measures and terminal extubation.  Patient did succumb to his critical illness on the evening of 9/26/2021 at 1910 hr, may he rest in peace.   Disposition: Deceased; time of death 1910 hr, 9/26/2021"
	"1741359-1"	"1741359-1"	"INTENSIVE CARE"	"10022519"	"50-59 years"	"50-59"	"Patient is a  57 y.o. male with a history of testing testing diabetes, bronchitis, hypertension and recent COVID-19 infection presenting with worsening shortness of breath and fever at 102. Initially treated outpatient with antibiotics steroids without improvement.  Patient presented today with decreased oxygen saturations at 84% on 4L.  Reports dyspnea.  Reports fatigue.  Reports fever.  Denies nausea vomiting diarrhea.  Reports recently tested positive COVID-19 on August 31st.  Patient admitted to hospitalist service.  History was obtained from patient who seemed an accurate and reliable historian.  Significant other was present.  From Pulmonary/Critical Care Consult:  Patient is a  57 y.o. male who initially presented to the emergency department on 9/13/2021 with worsening respiratory status. Pt provides some information, majority of info provided by significant other that is at the bedside.    Pt was diagnosed with 8/31 with COVID 19 in the emergency department. He was sent home with home oxygen and managed by his fiance. His status waxed and waned. He presented back to the ED on 9/13 with increased dyspnea, increased fatigue, decreased oxygen saturation, and fever. Pt was then admitted to the pulmonary floor to the hospitalist services.    He remained on the pulmonary floor. He did require more supplemental oxygen and was eventually receiving maximum amounts of oxygen via heated high flow NC with a nonrebreather on top. He was also started on IV dexamethasone on admission. Decision was made to transfer the patient to the ICU for AVAPS.    Pt arrived to the ICU. He was placed on NIV. He did become anxious with application, so he was started on precedex. Pt is alert and oriented. His fiance is at bedside.    Hospital Course:  Patient was transferred to the ICU on 9/19/2021 due to worsening respiratory status and was transition to noninvasive ventilatory support.  He required a dexmedetomidine infusion for anxiety.  He further decompensated on 9/23/2021 and required intubation.  He suffered a spontaneous left pneumothorax and a chest tube was placed.  He required paralytic infusion as well.  He was initiated on broad-spectrum antibiotics while in the ICU for a possible secondary bacterial infection.  Unfortunately, the patient continued to decompensate despite maximal mechanical support.  On the evening of 9/26/2021, the patient's family mid determination to transition to comfort measures and terminal extubation.  Patient did succumb to his critical illness on the evening of 9/26/2021 at 1910 hr, may he rest in peace.   Disposition: Deceased; time of death 1910 hr, 9/26/2021"
	"1741359-1"	"1741359-1"	"MECHANICAL VENTILATION"	"10067221"	"50-59 years"	"50-59"	"Patient is a  57 y.o. male with a history of testing testing diabetes, bronchitis, hypertension and recent COVID-19 infection presenting with worsening shortness of breath and fever at 102. Initially treated outpatient with antibiotics steroids without improvement.  Patient presented today with decreased oxygen saturations at 84% on 4L.  Reports dyspnea.  Reports fatigue.  Reports fever.  Denies nausea vomiting diarrhea.  Reports recently tested positive COVID-19 on August 31st.  Patient admitted to hospitalist service.  History was obtained from patient who seemed an accurate and reliable historian.  Significant other was present.  From Pulmonary/Critical Care Consult:  Patient is a  57 y.o. male who initially presented to the emergency department on 9/13/2021 with worsening respiratory status. Pt provides some information, majority of info provided by significant other that is at the bedside.    Pt was diagnosed with 8/31 with COVID 19 in the emergency department. He was sent home with home oxygen and managed by his fiance. His status waxed and waned. He presented back to the ED on 9/13 with increased dyspnea, increased fatigue, decreased oxygen saturation, and fever. Pt was then admitted to the pulmonary floor to the hospitalist services.    He remained on the pulmonary floor. He did require more supplemental oxygen and was eventually receiving maximum amounts of oxygen via heated high flow NC with a nonrebreather on top. He was also started on IV dexamethasone on admission. Decision was made to transfer the patient to the ICU for AVAPS.    Pt arrived to the ICU. He was placed on NIV. He did become anxious with application, so he was started on precedex. Pt is alert and oriented. His fiance is at bedside.    Hospital Course:  Patient was transferred to the ICU on 9/19/2021 due to worsening respiratory status and was transition to noninvasive ventilatory support.  He required a dexmedetomidine infusion for anxiety.  He further decompensated on 9/23/2021 and required intubation.  He suffered a spontaneous left pneumothorax and a chest tube was placed.  He required paralytic infusion as well.  He was initiated on broad-spectrum antibiotics while in the ICU for a possible secondary bacterial infection.  Unfortunately, the patient continued to decompensate despite maximal mechanical support.  On the evening of 9/26/2021, the patient's family mid determination to transition to comfort measures and terminal extubation.  Patient did succumb to his critical illness on the evening of 9/26/2021 at 1910 hr, may he rest in peace.   Disposition: Deceased; time of death 1910 hr, 9/26/2021"
	"1741359-1"	"1741359-1"	"OXYGEN SATURATION DECREASED"	"10033318"	"50-59 years"	"50-59"	"Patient is a  57 y.o. male with a history of testing testing diabetes, bronchitis, hypertension and recent COVID-19 infection presenting with worsening shortness of breath and fever at 102. Initially treated outpatient with antibiotics steroids without improvement.  Patient presented today with decreased oxygen saturations at 84% on 4L.  Reports dyspnea.  Reports fatigue.  Reports fever.  Denies nausea vomiting diarrhea.  Reports recently tested positive COVID-19 on August 31st.  Patient admitted to hospitalist service.  History was obtained from patient who seemed an accurate and reliable historian.  Significant other was present.  From Pulmonary/Critical Care Consult:  Patient is a  57 y.o. male who initially presented to the emergency department on 9/13/2021 with worsening respiratory status. Pt provides some information, majority of info provided by significant other that is at the bedside.    Pt was diagnosed with 8/31 with COVID 19 in the emergency department. He was sent home with home oxygen and managed by his fiance. His status waxed and waned. He presented back to the ED on 9/13 with increased dyspnea, increased fatigue, decreased oxygen saturation, and fever. Pt was then admitted to the pulmonary floor to the hospitalist services.    He remained on the pulmonary floor. He did require more supplemental oxygen and was eventually receiving maximum amounts of oxygen via heated high flow NC with a nonrebreather on top. He was also started on IV dexamethasone on admission. Decision was made to transfer the patient to the ICU for AVAPS.    Pt arrived to the ICU. He was placed on NIV. He did become anxious with application, so he was started on precedex. Pt is alert and oriented. His fiance is at bedside.    Hospital Course:  Patient was transferred to the ICU on 9/19/2021 due to worsening respiratory status and was transition to noninvasive ventilatory support.  He required a dexmedetomidine infusion for anxiety.  He further decompensated on 9/23/2021 and required intubation.  He suffered a spontaneous left pneumothorax and a chest tube was placed.  He required paralytic infusion as well.  He was initiated on broad-spectrum antibiotics while in the ICU for a possible secondary bacterial infection.  Unfortunately, the patient continued to decompensate despite maximal mechanical support.  On the evening of 9/26/2021, the patient's family mid determination to transition to comfort measures and terminal extubation.  Patient did succumb to his critical illness on the evening of 9/26/2021 at 1910 hr, may he rest in peace.   Disposition: Deceased; time of death 1910 hr, 9/26/2021"
	"1741359-1"	"1741359-1"	"PNEUMOTHORAX SPONTANEOUS"	"10035763"	"50-59 years"	"50-59"	"Patient is a  57 y.o. male with a history of testing testing diabetes, bronchitis, hypertension and recent COVID-19 infection presenting with worsening shortness of breath and fever at 102. Initially treated outpatient with antibiotics steroids without improvement.  Patient presented today with decreased oxygen saturations at 84% on 4L.  Reports dyspnea.  Reports fatigue.  Reports fever.  Denies nausea vomiting diarrhea.  Reports recently tested positive COVID-19 on August 31st.  Patient admitted to hospitalist service.  History was obtained from patient who seemed an accurate and reliable historian.  Significant other was present.  From Pulmonary/Critical Care Consult:  Patient is a  57 y.o. male who initially presented to the emergency department on 9/13/2021 with worsening respiratory status. Pt provides some information, majority of info provided by significant other that is at the bedside.    Pt was diagnosed with 8/31 with COVID 19 in the emergency department. He was sent home with home oxygen and managed by his fiance. His status waxed and waned. He presented back to the ED on 9/13 with increased dyspnea, increased fatigue, decreased oxygen saturation, and fever. Pt was then admitted to the pulmonary floor to the hospitalist services.    He remained on the pulmonary floor. He did require more supplemental oxygen and was eventually receiving maximum amounts of oxygen via heated high flow NC with a nonrebreather on top. He was also started on IV dexamethasone on admission. Decision was made to transfer the patient to the ICU for AVAPS.    Pt arrived to the ICU. He was placed on NIV. He did become anxious with application, so he was started on precedex. Pt is alert and oriented. His fiance is at bedside.    Hospital Course:  Patient was transferred to the ICU on 9/19/2021 due to worsening respiratory status and was transition to noninvasive ventilatory support.  He required a dexmedetomidine infusion for anxiety.  He further decompensated on 9/23/2021 and required intubation.  He suffered a spontaneous left pneumothorax and a chest tube was placed.  He required paralytic infusion as well.  He was initiated on broad-spectrum antibiotics while in the ICU for a possible secondary bacterial infection.  Unfortunately, the patient continued to decompensate despite maximal mechanical support.  On the evening of 9/26/2021, the patient's family mid determination to transition to comfort measures and terminal extubation.  Patient did succumb to his critical illness on the evening of 9/26/2021 at 1910 hr, may he rest in peace.   Disposition: Deceased; time of death 1910 hr, 9/26/2021"
	"1741359-1"	"1741359-1"	"PYREXIA"	"10037660"	"50-59 years"	"50-59"	"Patient is a  57 y.o. male with a history of testing testing diabetes, bronchitis, hypertension and recent COVID-19 infection presenting with worsening shortness of breath and fever at 102. Initially treated outpatient with antibiotics steroids without improvement.  Patient presented today with decreased oxygen saturations at 84% on 4L.  Reports dyspnea.  Reports fatigue.  Reports fever.  Denies nausea vomiting diarrhea.  Reports recently tested positive COVID-19 on August 31st.  Patient admitted to hospitalist service.  History was obtained from patient who seemed an accurate and reliable historian.  Significant other was present.  From Pulmonary/Critical Care Consult:  Patient is a  57 y.o. male who initially presented to the emergency department on 9/13/2021 with worsening respiratory status. Pt provides some information, majority of info provided by significant other that is at the bedside.    Pt was diagnosed with 8/31 with COVID 19 in the emergency department. He was sent home with home oxygen and managed by his fiance. His status waxed and waned. He presented back to the ED on 9/13 with increased dyspnea, increased fatigue, decreased oxygen saturation, and fever. Pt was then admitted to the pulmonary floor to the hospitalist services.    He remained on the pulmonary floor. He did require more supplemental oxygen and was eventually receiving maximum amounts of oxygen via heated high flow NC with a nonrebreather on top. He was also started on IV dexamethasone on admission. Decision was made to transfer the patient to the ICU for AVAPS.    Pt arrived to the ICU. He was placed on NIV. He did become anxious with application, so he was started on precedex. Pt is alert and oriented. His fiance is at bedside.    Hospital Course:  Patient was transferred to the ICU on 9/19/2021 due to worsening respiratory status and was transition to noninvasive ventilatory support.  He required a dexmedetomidine infusion for anxiety.  He further decompensated on 9/23/2021 and required intubation.  He suffered a spontaneous left pneumothorax and a chest tube was placed.  He required paralytic infusion as well.  He was initiated on broad-spectrum antibiotics while in the ICU for a possible secondary bacterial infection.  Unfortunately, the patient continued to decompensate despite maximal mechanical support.  On the evening of 9/26/2021, the patient's family mid determination to transition to comfort measures and terminal extubation.  Patient did succumb to his critical illness on the evening of 9/26/2021 at 1910 hr, may he rest in peace.   Disposition: Deceased; time of death 1910 hr, 9/26/2021"
	"1741359-1"	"1741359-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"Patient is a  57 y.o. male with a history of testing testing diabetes, bronchitis, hypertension and recent COVID-19 infection presenting with worsening shortness of breath and fever at 102. Initially treated outpatient with antibiotics steroids without improvement.  Patient presented today with decreased oxygen saturations at 84% on 4L.  Reports dyspnea.  Reports fatigue.  Reports fever.  Denies nausea vomiting diarrhea.  Reports recently tested positive COVID-19 on August 31st.  Patient admitted to hospitalist service.  History was obtained from patient who seemed an accurate and reliable historian.  Significant other was present.  From Pulmonary/Critical Care Consult:  Patient is a  57 y.o. male who initially presented to the emergency department on 9/13/2021 with worsening respiratory status. Pt provides some information, majority of info provided by significant other that is at the bedside.    Pt was diagnosed with 8/31 with COVID 19 in the emergency department. He was sent home with home oxygen and managed by his fiance. His status waxed and waned. He presented back to the ED on 9/13 with increased dyspnea, increased fatigue, decreased oxygen saturation, and fever. Pt was then admitted to the pulmonary floor to the hospitalist services.    He remained on the pulmonary floor. He did require more supplemental oxygen and was eventually receiving maximum amounts of oxygen via heated high flow NC with a nonrebreather on top. He was also started on IV dexamethasone on admission. Decision was made to transfer the patient to the ICU for AVAPS.    Pt arrived to the ICU. He was placed on NIV. He did become anxious with application, so he was started on precedex. Pt is alert and oriented. His fiance is at bedside.    Hospital Course:  Patient was transferred to the ICU on 9/19/2021 due to worsening respiratory status and was transition to noninvasive ventilatory support.  He required a dexmedetomidine infusion for anxiety.  He further decompensated on 9/23/2021 and required intubation.  He suffered a spontaneous left pneumothorax and a chest tube was placed.  He required paralytic infusion as well.  He was initiated on broad-spectrum antibiotics while in the ICU for a possible secondary bacterial infection.  Unfortunately, the patient continued to decompensate despite maximal mechanical support.  On the evening of 9/26/2021, the patient's family mid determination to transition to comfort measures and terminal extubation.  Patient did succumb to his critical illness on the evening of 9/26/2021 at 1910 hr, may he rest in peace.   Disposition: Deceased; time of death 1910 hr, 9/26/2021"
	"1741705-1"	"1741705-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Case fully vaccinated with one dose of Janseen vaccine on 3/10/2021. Tested positive for COVID on 8/18/2021. Case was admitted to hospital on 8/22/2021 and expired on 9/24/2021 while still hospitalized."
	"1741705-1"	"1741705-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Case fully vaccinated with one dose of Janseen vaccine on 3/10/2021. Tested positive for COVID on 8/18/2021. Case was admitted to hospital on 8/22/2021 and expired on 9/24/2021 while still hospitalized."
	"1741705-1"	"1741705-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"Case fully vaccinated with one dose of Janseen vaccine on 3/10/2021. Tested positive for COVID on 8/18/2021. Case was admitted to hospital on 8/22/2021 and expired on 9/24/2021 while still hospitalized."
	"1745080-1"	"1745080-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Patient hospitalized 9/13/21, diagnosed with COVID19 9/14/21, deceased 9/25/21"
	"1745080-1"	"1745080-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient hospitalized 9/13/21, diagnosed with COVID19 9/14/21, deceased 9/25/21"
	"1745080-1"	"1745080-1"	"SARS-COV-2 TEST"	"10084354"	"50-59 years"	"50-59"	"Patient hospitalized 9/13/21, diagnosed with COVID19 9/14/21, deceased 9/25/21"
	"1745477-1"	"1745477-1"	"SUDDEN DEATH"	"10042434"	"50-59 years"	"50-59"	"Patient died suddenly 5 days after taking her second pfizer covid vaccine."
	"1745544-1"	"1745544-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Death SEPTIC SHOCK, HYPOTENSION, DIABETES MELLITUS TYPE 2, RHEUMATOID NODULAR FIBROSIS"
	"1745544-1"	"1745544-1"	"FIBROSIS"	"10016642"	"50-59 years"	"50-59"	"Death SEPTIC SHOCK, HYPOTENSION, DIABETES MELLITUS TYPE 2, RHEUMATOID NODULAR FIBROSIS"
	"1745544-1"	"1745544-1"	"HYPOTENSION"	"10021097"	"50-59 years"	"50-59"	"Death SEPTIC SHOCK, HYPOTENSION, DIABETES MELLITUS TYPE 2, RHEUMATOID NODULAR FIBROSIS"
	"1745544-1"	"1745544-1"	"RHEUMATOID NODULE"	"10048694"	"50-59 years"	"50-59"	"Death SEPTIC SHOCK, HYPOTENSION, DIABETES MELLITUS TYPE 2, RHEUMATOID NODULAR FIBROSIS"
	"1745544-1"	"1745544-1"	"SEPTIC SHOCK"	"10040070"	"50-59 years"	"50-59"	"Death SEPTIC SHOCK, HYPOTENSION, DIABETES MELLITUS TYPE 2, RHEUMATOID NODULAR FIBROSIS"
	"1745544-1"	"1745544-1"	"TYPE 2 DIABETES MELLITUS"	"10067585"	"50-59 years"	"50-59"	"Death SEPTIC SHOCK, HYPOTENSION, DIABETES MELLITUS TYPE 2, RHEUMATOID NODULAR FIBROSIS"
	"1749656-1"	"1749656-1"	"ADENOCARCINOMA"	"10001141"	"50-59 years"	"50-59"	"Dose 1 04/22/2021 Lot # EW0172 Pfizer   Pt died on 9/30/2021 in the ED from complications with her end stage adenocarcinoma. This was not a Covid illness related death"
	"1749656-1"	"1749656-1"	"CONDITION AGGRAVATED"	"10010264"	"50-59 years"	"50-59"	"Dose 1 04/22/2021 Lot # EW0172 Pfizer   Pt died on 9/30/2021 in the ED from complications with her end stage adenocarcinoma. This was not a Covid illness related death"
	"1749656-1"	"1749656-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Dose 1 04/22/2021 Lot # EW0172 Pfizer   Pt died on 9/30/2021 in the ED from complications with her end stage adenocarcinoma. This was not a Covid illness related death"
	"1749730-1"	"1749730-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient found passed away in his sleep on 9/16/2021"
	"1753284-1"	"1753284-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"COVID infection. Specimen collected on 8/11/21. Patient died on 8/13/21."
	"1753284-1"	"1753284-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"COVID infection. Specimen collected on 8/11/21. Patient died on 8/13/21."
	"1753284-1"	"1753284-1"	"LABORATORY TEST"	"10059938"	"50-59 years"	"50-59"	"COVID infection. Specimen collected on 8/11/21. Patient died on 8/13/21."
	"1753324-1"	"1753324-1"	"ACUTE RESPIRATORY FAILURE"	"10001053"	"50-59 years"	"50-59"	"Patient has expired / died (9.28.21);  Hospitalized (9.15.21);  COVID positive (9.9.21);  fully vaccinated  Discharge Provider:  Admission Date: 9/15/2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: COVID-19 virus infection [U07.1] COVID-19 [U07.1] Acute respiratory failure with hypoxia  [J96.01] Acute respiratory failure due to COVID-19 [U07.1, J96.00]   HOSPITAL COURSE: Patient is  a 57 year old with asthma, MS (ocrelizumab q 6 months), tobacco abuse (30pkyr), and congenitally absent left kidney.  He was COVID (+) 9/9 (was vaccinated in the spring).  He presented 9/15 with 10 days cough/SOB/fevers.  In the ED, he was hypoxemic and would desaturate with activity.  CXR showed patchy bilateral opacities.  He was admitted and treated with Decadron, remdesivir, and empiric antibiotics. On 9/18, he was transferred requiring HFNC/NRB.  On 9/19, he required intubation, NMB (until 9/22), and proning (until 9/21).  Doppler US 9/20 showed acute right IJ and right SC DVTs.  He was extubated 9/26 and initially tolerated low-flow NC oxygen but was profoundly weak.  He decompensated requiring BiPAP.  He had been made DNR by family then comfort measures.  He passed away on 9/28 while this attending was off service and at home Date of Death: 9/28/21 Time of Death:  8:07 PM Preliminary Cause of Death: Acute respiratory failure due to COVID-19"
	"1753324-1"	"1753324-1"	"ASTHENIA"	"10003549"	"50-59 years"	"50-59"	"Patient has expired / died (9.28.21);  Hospitalized (9.15.21);  COVID positive (9.9.21);  fully vaccinated  Discharge Provider:  Admission Date: 9/15/2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: COVID-19 virus infection [U07.1] COVID-19 [U07.1] Acute respiratory failure with hypoxia  [J96.01] Acute respiratory failure due to COVID-19 [U07.1, J96.00]   HOSPITAL COURSE: Patient is  a 57 year old with asthma, MS (ocrelizumab q 6 months), tobacco abuse (30pkyr), and congenitally absent left kidney.  He was COVID (+) 9/9 (was vaccinated in the spring).  He presented 9/15 with 10 days cough/SOB/fevers.  In the ED, he was hypoxemic and would desaturate with activity.  CXR showed patchy bilateral opacities.  He was admitted and treated with Decadron, remdesivir, and empiric antibiotics. On 9/18, he was transferred requiring HFNC/NRB.  On 9/19, he required intubation, NMB (until 9/22), and proning (until 9/21).  Doppler US 9/20 showed acute right IJ and right SC DVTs.  He was extubated 9/26 and initially tolerated low-flow NC oxygen but was profoundly weak.  He decompensated requiring BiPAP.  He had been made DNR by family then comfort measures.  He passed away on 9/28 while this attending was off service and at home Date of Death: 9/28/21 Time of Death:  8:07 PM Preliminary Cause of Death: Acute respiratory failure due to COVID-19"
	"1753324-1"	"1753324-1"	"CHEST X-RAY ABNORMAL"	"10008499"	"50-59 years"	"50-59"	"Patient has expired / died (9.28.21);  Hospitalized (9.15.21);  COVID positive (9.9.21);  fully vaccinated  Discharge Provider:  Admission Date: 9/15/2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: COVID-19 virus infection [U07.1] COVID-19 [U07.1] Acute respiratory failure with hypoxia  [J96.01] Acute respiratory failure due to COVID-19 [U07.1, J96.00]   HOSPITAL COURSE: Patient is  a 57 year old with asthma, MS (ocrelizumab q 6 months), tobacco abuse (30pkyr), and congenitally absent left kidney.  He was COVID (+) 9/9 (was vaccinated in the spring).  He presented 9/15 with 10 days cough/SOB/fevers.  In the ED, he was hypoxemic and would desaturate with activity.  CXR showed patchy bilateral opacities.  He was admitted and treated with Decadron, remdesivir, and empiric antibiotics. On 9/18, he was transferred requiring HFNC/NRB.  On 9/19, he required intubation, NMB (until 9/22), and proning (until 9/21).  Doppler US 9/20 showed acute right IJ and right SC DVTs.  He was extubated 9/26 and initially tolerated low-flow NC oxygen but was profoundly weak.  He decompensated requiring BiPAP.  He had been made DNR by family then comfort measures.  He passed away on 9/28 while this attending was off service and at home Date of Death: 9/28/21 Time of Death:  8:07 PM Preliminary Cause of Death: Acute respiratory failure due to COVID-19"
	"1753324-1"	"1753324-1"	"COUGH"	"10011224"	"50-59 years"	"50-59"	"Patient has expired / died (9.28.21);  Hospitalized (9.15.21);  COVID positive (9.9.21);  fully vaccinated  Discharge Provider:  Admission Date: 9/15/2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: COVID-19 virus infection [U07.1] COVID-19 [U07.1] Acute respiratory failure with hypoxia  [J96.01] Acute respiratory failure due to COVID-19 [U07.1, J96.00]   HOSPITAL COURSE: Patient is  a 57 year old with asthma, MS (ocrelizumab q 6 months), tobacco abuse (30pkyr), and congenitally absent left kidney.  He was COVID (+) 9/9 (was vaccinated in the spring).  He presented 9/15 with 10 days cough/SOB/fevers.  In the ED, he was hypoxemic and would desaturate with activity.  CXR showed patchy bilateral opacities.  He was admitted and treated with Decadron, remdesivir, and empiric antibiotics. On 9/18, he was transferred requiring HFNC/NRB.  On 9/19, he required intubation, NMB (until 9/22), and proning (until 9/21).  Doppler US 9/20 showed acute right IJ and right SC DVTs.  He was extubated 9/26 and initially tolerated low-flow NC oxygen but was profoundly weak.  He decompensated requiring BiPAP.  He had been made DNR by family then comfort measures.  He passed away on 9/28 while this attending was off service and at home Date of Death: 9/28/21 Time of Death:  8:07 PM Preliminary Cause of Death: Acute respiratory failure due to COVID-19"
	"1753324-1"	"1753324-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Patient has expired / died (9.28.21);  Hospitalized (9.15.21);  COVID positive (9.9.21);  fully vaccinated  Discharge Provider:  Admission Date: 9/15/2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: COVID-19 virus infection [U07.1] COVID-19 [U07.1] Acute respiratory failure with hypoxia  [J96.01] Acute respiratory failure due to COVID-19 [U07.1, J96.00]   HOSPITAL COURSE: Patient is  a 57 year old with asthma, MS (ocrelizumab q 6 months), tobacco abuse (30pkyr), and congenitally absent left kidney.  He was COVID (+) 9/9 (was vaccinated in the spring).  He presented 9/15 with 10 days cough/SOB/fevers.  In the ED, he was hypoxemic and would desaturate with activity.  CXR showed patchy bilateral opacities.  He was admitted and treated with Decadron, remdesivir, and empiric antibiotics. On 9/18, he was transferred requiring HFNC/NRB.  On 9/19, he required intubation, NMB (until 9/22), and proning (until 9/21).  Doppler US 9/20 showed acute right IJ and right SC DVTs.  He was extubated 9/26 and initially tolerated low-flow NC oxygen but was profoundly weak.  He decompensated requiring BiPAP.  He had been made DNR by family then comfort measures.  He passed away on 9/28 while this attending was off service and at home Date of Death: 9/28/21 Time of Death:  8:07 PM Preliminary Cause of Death: Acute respiratory failure due to COVID-19"
	"1753324-1"	"1753324-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient has expired / died (9.28.21);  Hospitalized (9.15.21);  COVID positive (9.9.21);  fully vaccinated  Discharge Provider:  Admission Date: 9/15/2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: COVID-19 virus infection [U07.1] COVID-19 [U07.1] Acute respiratory failure with hypoxia  [J96.01] Acute respiratory failure due to COVID-19 [U07.1, J96.00]   HOSPITAL COURSE: Patient is  a 57 year old with asthma, MS (ocrelizumab q 6 months), tobacco abuse (30pkyr), and congenitally absent left kidney.  He was COVID (+) 9/9 (was vaccinated in the spring).  He presented 9/15 with 10 days cough/SOB/fevers.  In the ED, he was hypoxemic and would desaturate with activity.  CXR showed patchy bilateral opacities.  He was admitted and treated with Decadron, remdesivir, and empiric antibiotics. On 9/18, he was transferred requiring HFNC/NRB.  On 9/19, he required intubation, NMB (until 9/22), and proning (until 9/21).  Doppler US 9/20 showed acute right IJ and right SC DVTs.  He was extubated 9/26 and initially tolerated low-flow NC oxygen but was profoundly weak.  He decompensated requiring BiPAP.  He had been made DNR by family then comfort measures.  He passed away on 9/28 while this attending was off service and at home Date of Death: 9/28/21 Time of Death:  8:07 PM Preliminary Cause of Death: Acute respiratory failure due to COVID-19"
	"1753324-1"	"1753324-1"	"DEEP VEIN THROMBOSIS"	"10051055"	"50-59 years"	"50-59"	"Patient has expired / died (9.28.21);  Hospitalized (9.15.21);  COVID positive (9.9.21);  fully vaccinated  Discharge Provider:  Admission Date: 9/15/2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: COVID-19 virus infection [U07.1] COVID-19 [U07.1] Acute respiratory failure with hypoxia  [J96.01] Acute respiratory failure due to COVID-19 [U07.1, J96.00]   HOSPITAL COURSE: Patient is  a 57 year old with asthma, MS (ocrelizumab q 6 months), tobacco abuse (30pkyr), and congenitally absent left kidney.  He was COVID (+) 9/9 (was vaccinated in the spring).  He presented 9/15 with 10 days cough/SOB/fevers.  In the ED, he was hypoxemic and would desaturate with activity.  CXR showed patchy bilateral opacities.  He was admitted and treated with Decadron, remdesivir, and empiric antibiotics. On 9/18, he was transferred requiring HFNC/NRB.  On 9/19, he required intubation, NMB (until 9/22), and proning (until 9/21).  Doppler US 9/20 showed acute right IJ and right SC DVTs.  He was extubated 9/26 and initially tolerated low-flow NC oxygen but was profoundly weak.  He decompensated requiring BiPAP.  He had been made DNR by family then comfort measures.  He passed away on 9/28 while this attending was off service and at home Date of Death: 9/28/21 Time of Death:  8:07 PM Preliminary Cause of Death: Acute respiratory failure due to COVID-19"
	"1753324-1"	"1753324-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"Patient has expired / died (9.28.21);  Hospitalized (9.15.21);  COVID positive (9.9.21);  fully vaccinated  Discharge Provider:  Admission Date: 9/15/2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: COVID-19 virus infection [U07.1] COVID-19 [U07.1] Acute respiratory failure with hypoxia  [J96.01] Acute respiratory failure due to COVID-19 [U07.1, J96.00]   HOSPITAL COURSE: Patient is  a 57 year old with asthma, MS (ocrelizumab q 6 months), tobacco abuse (30pkyr), and congenitally absent left kidney.  He was COVID (+) 9/9 (was vaccinated in the spring).  He presented 9/15 with 10 days cough/SOB/fevers.  In the ED, he was hypoxemic and would desaturate with activity.  CXR showed patchy bilateral opacities.  He was admitted and treated with Decadron, remdesivir, and empiric antibiotics. On 9/18, he was transferred requiring HFNC/NRB.  On 9/19, he required intubation, NMB (until 9/22), and proning (until 9/21).  Doppler US 9/20 showed acute right IJ and right SC DVTs.  He was extubated 9/26 and initially tolerated low-flow NC oxygen but was profoundly weak.  He decompensated requiring BiPAP.  He had been made DNR by family then comfort measures.  He passed away on 9/28 while this attending was off service and at home Date of Death: 9/28/21 Time of Death:  8:07 PM Preliminary Cause of Death: Acute respiratory failure due to COVID-19"
	"1753324-1"	"1753324-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"50-59 years"	"50-59"	"Patient has expired / died (9.28.21);  Hospitalized (9.15.21);  COVID positive (9.9.21);  fully vaccinated  Discharge Provider:  Admission Date: 9/15/2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: COVID-19 virus infection [U07.1] COVID-19 [U07.1] Acute respiratory failure with hypoxia  [J96.01] Acute respiratory failure due to COVID-19 [U07.1, J96.00]   HOSPITAL COURSE: Patient is  a 57 year old with asthma, MS (ocrelizumab q 6 months), tobacco abuse (30pkyr), and congenitally absent left kidney.  He was COVID (+) 9/9 (was vaccinated in the spring).  He presented 9/15 with 10 days cough/SOB/fevers.  In the ED, he was hypoxemic and would desaturate with activity.  CXR showed patchy bilateral opacities.  He was admitted and treated with Decadron, remdesivir, and empiric antibiotics. On 9/18, he was transferred requiring HFNC/NRB.  On 9/19, he required intubation, NMB (until 9/22), and proning (until 9/21).  Doppler US 9/20 showed acute right IJ and right SC DVTs.  He was extubated 9/26 and initially tolerated low-flow NC oxygen but was profoundly weak.  He decompensated requiring BiPAP.  He had been made DNR by family then comfort measures.  He passed away on 9/28 while this attending was off service and at home Date of Death: 9/28/21 Time of Death:  8:07 PM Preliminary Cause of Death: Acute respiratory failure due to COVID-19"
	"1753324-1"	"1753324-1"	"EXTUBATION"	"10015894"	"50-59 years"	"50-59"	"Patient has expired / died (9.28.21);  Hospitalized (9.15.21);  COVID positive (9.9.21);  fully vaccinated  Discharge Provider:  Admission Date: 9/15/2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: COVID-19 virus infection [U07.1] COVID-19 [U07.1] Acute respiratory failure with hypoxia  [J96.01] Acute respiratory failure due to COVID-19 [U07.1, J96.00]   HOSPITAL COURSE: Patient is  a 57 year old with asthma, MS (ocrelizumab q 6 months), tobacco abuse (30pkyr), and congenitally absent left kidney.  He was COVID (+) 9/9 (was vaccinated in the spring).  He presented 9/15 with 10 days cough/SOB/fevers.  In the ED, he was hypoxemic and would desaturate with activity.  CXR showed patchy bilateral opacities.  He was admitted and treated with Decadron, remdesivir, and empiric antibiotics. On 9/18, he was transferred requiring HFNC/NRB.  On 9/19, he required intubation, NMB (until 9/22), and proning (until 9/21).  Doppler US 9/20 showed acute right IJ and right SC DVTs.  He was extubated 9/26 and initially tolerated low-flow NC oxygen but was profoundly weak.  He decompensated requiring BiPAP.  He had been made DNR by family then comfort measures.  He passed away on 9/28 while this attending was off service and at home Date of Death: 9/28/21 Time of Death:  8:07 PM Preliminary Cause of Death: Acute respiratory failure due to COVID-19"
	"1753324-1"	"1753324-1"	"GAIT DISTURBANCE"	"10017577"	"50-59 years"	"50-59"	"Patient has expired / died (9.28.21);  Hospitalized (9.15.21);  COVID positive (9.9.21);  fully vaccinated  Discharge Provider:  Admission Date: 9/15/2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: COVID-19 virus infection [U07.1] COVID-19 [U07.1] Acute respiratory failure with hypoxia  [J96.01] Acute respiratory failure due to COVID-19 [U07.1, J96.00]   HOSPITAL COURSE: Patient is  a 57 year old with asthma, MS (ocrelizumab q 6 months), tobacco abuse (30pkyr), and congenitally absent left kidney.  He was COVID (+) 9/9 (was vaccinated in the spring).  He presented 9/15 with 10 days cough/SOB/fevers.  In the ED, he was hypoxemic and would desaturate with activity.  CXR showed patchy bilateral opacities.  He was admitted and treated with Decadron, remdesivir, and empiric antibiotics. On 9/18, he was transferred requiring HFNC/NRB.  On 9/19, he required intubation, NMB (until 9/22), and proning (until 9/21).  Doppler US 9/20 showed acute right IJ and right SC DVTs.  He was extubated 9/26 and initially tolerated low-flow NC oxygen but was profoundly weak.  He decompensated requiring BiPAP.  He had been made DNR by family then comfort measures.  He passed away on 9/28 while this attending was off service and at home Date of Death: 9/28/21 Time of Death:  8:07 PM Preliminary Cause of Death: Acute respiratory failure due to COVID-19"
	"1753324-1"	"1753324-1"	"HYPOXIA"	"10021143"	"50-59 years"	"50-59"	"Patient has expired / died (9.28.21);  Hospitalized (9.15.21);  COVID positive (9.9.21);  fully vaccinated  Discharge Provider:  Admission Date: 9/15/2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: COVID-19 virus infection [U07.1] COVID-19 [U07.1] Acute respiratory failure with hypoxia  [J96.01] Acute respiratory failure due to COVID-19 [U07.1, J96.00]   HOSPITAL COURSE: Patient is  a 57 year old with asthma, MS (ocrelizumab q 6 months), tobacco abuse (30pkyr), and congenitally absent left kidney.  He was COVID (+) 9/9 (was vaccinated in the spring).  He presented 9/15 with 10 days cough/SOB/fevers.  In the ED, he was hypoxemic and would desaturate with activity.  CXR showed patchy bilateral opacities.  He was admitted and treated with Decadron, remdesivir, and empiric antibiotics. On 9/18, he was transferred requiring HFNC/NRB.  On 9/19, he required intubation, NMB (until 9/22), and proning (until 9/21).  Doppler US 9/20 showed acute right IJ and right SC DVTs.  He was extubated 9/26 and initially tolerated low-flow NC oxygen but was profoundly weak.  He decompensated requiring BiPAP.  He had been made DNR by family then comfort measures.  He passed away on 9/28 while this attending was off service and at home Date of Death: 9/28/21 Time of Death:  8:07 PM Preliminary Cause of Death: Acute respiratory failure due to COVID-19"
	"1753324-1"	"1753324-1"	"JUGULAR VEIN OCCLUSION"	"10076835"	"50-59 years"	"50-59"	"Patient has expired / died (9.28.21);  Hospitalized (9.15.21);  COVID positive (9.9.21);  fully vaccinated  Discharge Provider:  Admission Date: 9/15/2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: COVID-19 virus infection [U07.1] COVID-19 [U07.1] Acute respiratory failure with hypoxia  [J96.01] Acute respiratory failure due to COVID-19 [U07.1, J96.00]   HOSPITAL COURSE: Patient is  a 57 year old with asthma, MS (ocrelizumab q 6 months), tobacco abuse (30pkyr), and congenitally absent left kidney.  He was COVID (+) 9/9 (was vaccinated in the spring).  He presented 9/15 with 10 days cough/SOB/fevers.  In the ED, he was hypoxemic and would desaturate with activity.  CXR showed patchy bilateral opacities.  He was admitted and treated with Decadron, remdesivir, and empiric antibiotics. On 9/18, he was transferred requiring HFNC/NRB.  On 9/19, he required intubation, NMB (until 9/22), and proning (until 9/21).  Doppler US 9/20 showed acute right IJ and right SC DVTs.  He was extubated 9/26 and initially tolerated low-flow NC oxygen but was profoundly weak.  He decompensated requiring BiPAP.  He had been made DNR by family then comfort measures.  He passed away on 9/28 while this attending was off service and at home Date of Death: 9/28/21 Time of Death:  8:07 PM Preliminary Cause of Death: Acute respiratory failure due to COVID-19"
	"1753324-1"	"1753324-1"	"LUNG OPACITY"	"10081792"	"50-59 years"	"50-59"	"Patient has expired / died (9.28.21);  Hospitalized (9.15.21);  COVID positive (9.9.21);  fully vaccinated  Discharge Provider:  Admission Date: 9/15/2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: COVID-19 virus infection [U07.1] COVID-19 [U07.1] Acute respiratory failure with hypoxia  [J96.01] Acute respiratory failure due to COVID-19 [U07.1, J96.00]   HOSPITAL COURSE: Patient is  a 57 year old with asthma, MS (ocrelizumab q 6 months), tobacco abuse (30pkyr), and congenitally absent left kidney.  He was COVID (+) 9/9 (was vaccinated in the spring).  He presented 9/15 with 10 days cough/SOB/fevers.  In the ED, he was hypoxemic and would desaturate with activity.  CXR showed patchy bilateral opacities.  He was admitted and treated with Decadron, remdesivir, and empiric antibiotics. On 9/18, he was transferred requiring HFNC/NRB.  On 9/19, he required intubation, NMB (until 9/22), and proning (until 9/21).  Doppler US 9/20 showed acute right IJ and right SC DVTs.  He was extubated 9/26 and initially tolerated low-flow NC oxygen but was profoundly weak.  He decompensated requiring BiPAP.  He had been made DNR by family then comfort measures.  He passed away on 9/28 while this attending was off service and at home Date of Death: 9/28/21 Time of Death:  8:07 PM Preliminary Cause of Death: Acute respiratory failure due to COVID-19"
	"1753324-1"	"1753324-1"	"OXYGEN SATURATION DECREASED"	"10033318"	"50-59 years"	"50-59"	"Patient has expired / died (9.28.21);  Hospitalized (9.15.21);  COVID positive (9.9.21);  fully vaccinated  Discharge Provider:  Admission Date: 9/15/2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: COVID-19 virus infection [U07.1] COVID-19 [U07.1] Acute respiratory failure with hypoxia  [J96.01] Acute respiratory failure due to COVID-19 [U07.1, J96.00]   HOSPITAL COURSE: Patient is  a 57 year old with asthma, MS (ocrelizumab q 6 months), tobacco abuse (30pkyr), and congenitally absent left kidney.  He was COVID (+) 9/9 (was vaccinated in the spring).  He presented 9/15 with 10 days cough/SOB/fevers.  In the ED, he was hypoxemic and would desaturate with activity.  CXR showed patchy bilateral opacities.  He was admitted and treated with Decadron, remdesivir, and empiric antibiotics. On 9/18, he was transferred requiring HFNC/NRB.  On 9/19, he required intubation, NMB (until 9/22), and proning (until 9/21).  Doppler US 9/20 showed acute right IJ and right SC DVTs.  He was extubated 9/26 and initially tolerated low-flow NC oxygen but was profoundly weak.  He decompensated requiring BiPAP.  He had been made DNR by family then comfort measures.  He passed away on 9/28 while this attending was off service and at home Date of Death: 9/28/21 Time of Death:  8:07 PM Preliminary Cause of Death: Acute respiratory failure due to COVID-19"
	"1753324-1"	"1753324-1"	"PERIPHERAL COLDNESS"	"10034568"	"50-59 years"	"50-59"	"Patient has expired / died (9.28.21);  Hospitalized (9.15.21);  COVID positive (9.9.21);  fully vaccinated  Discharge Provider:  Admission Date: 9/15/2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: COVID-19 virus infection [U07.1] COVID-19 [U07.1] Acute respiratory failure with hypoxia  [J96.01] Acute respiratory failure due to COVID-19 [U07.1, J96.00]   HOSPITAL COURSE: Patient is  a 57 year old with asthma, MS (ocrelizumab q 6 months), tobacco abuse (30pkyr), and congenitally absent left kidney.  He was COVID (+) 9/9 (was vaccinated in the spring).  He presented 9/15 with 10 days cough/SOB/fevers.  In the ED, he was hypoxemic and would desaturate with activity.  CXR showed patchy bilateral opacities.  He was admitted and treated with Decadron, remdesivir, and empiric antibiotics. On 9/18, he was transferred requiring HFNC/NRB.  On 9/19, he required intubation, NMB (until 9/22), and proning (until 9/21).  Doppler US 9/20 showed acute right IJ and right SC DVTs.  He was extubated 9/26 and initially tolerated low-flow NC oxygen but was profoundly weak.  He decompensated requiring BiPAP.  He had been made DNR by family then comfort measures.  He passed away on 9/28 while this attending was off service and at home Date of Death: 9/28/21 Time of Death:  8:07 PM Preliminary Cause of Death: Acute respiratory failure due to COVID-19"
	"1753324-1"	"1753324-1"	"PHYSICAL DECONDITIONING"	"10051588"	"50-59 years"	"50-59"	"Patient has expired / died (9.28.21);  Hospitalized (9.15.21);  COVID positive (9.9.21);  fully vaccinated  Discharge Provider:  Admission Date: 9/15/2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: COVID-19 virus infection [U07.1] COVID-19 [U07.1] Acute respiratory failure with hypoxia  [J96.01] Acute respiratory failure due to COVID-19 [U07.1, J96.00]   HOSPITAL COURSE: Patient is  a 57 year old with asthma, MS (ocrelizumab q 6 months), tobacco abuse (30pkyr), and congenitally absent left kidney.  He was COVID (+) 9/9 (was vaccinated in the spring).  He presented 9/15 with 10 days cough/SOB/fevers.  In the ED, he was hypoxemic and would desaturate with activity.  CXR showed patchy bilateral opacities.  He was admitted and treated with Decadron, remdesivir, and empiric antibiotics. On 9/18, he was transferred requiring HFNC/NRB.  On 9/19, he required intubation, NMB (until 9/22), and proning (until 9/21).  Doppler US 9/20 showed acute right IJ and right SC DVTs.  He was extubated 9/26 and initially tolerated low-flow NC oxygen but was profoundly weak.  He decompensated requiring BiPAP.  He had been made DNR by family then comfort measures.  He passed away on 9/28 while this attending was off service and at home Date of Death: 9/28/21 Time of Death:  8:07 PM Preliminary Cause of Death: Acute respiratory failure due to COVID-19"
	"1753324-1"	"1753324-1"	"POSITIVE AIRWAY PRESSURE THERAPY"	"10086397"	"50-59 years"	"50-59"	"Patient has expired / died (9.28.21);  Hospitalized (9.15.21);  COVID positive (9.9.21);  fully vaccinated  Discharge Provider:  Admission Date: 9/15/2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: COVID-19 virus infection [U07.1] COVID-19 [U07.1] Acute respiratory failure with hypoxia  [J96.01] Acute respiratory failure due to COVID-19 [U07.1, J96.00]   HOSPITAL COURSE: Patient is  a 57 year old with asthma, MS (ocrelizumab q 6 months), tobacco abuse (30pkyr), and congenitally absent left kidney.  He was COVID (+) 9/9 (was vaccinated in the spring).  He presented 9/15 with 10 days cough/SOB/fevers.  In the ED, he was hypoxemic and would desaturate with activity.  CXR showed patchy bilateral opacities.  He was admitted and treated with Decadron, remdesivir, and empiric antibiotics. On 9/18, he was transferred requiring HFNC/NRB.  On 9/19, he required intubation, NMB (until 9/22), and proning (until 9/21).  Doppler US 9/20 showed acute right IJ and right SC DVTs.  He was extubated 9/26 and initially tolerated low-flow NC oxygen but was profoundly weak.  He decompensated requiring BiPAP.  He had been made DNR by family then comfort measures.  He passed away on 9/28 while this attending was off service and at home Date of Death: 9/28/21 Time of Death:  8:07 PM Preliminary Cause of Death: Acute respiratory failure due to COVID-19"
	"1753324-1"	"1753324-1"	"PRONE POSITION"	"10074744"	"50-59 years"	"50-59"	"Patient has expired / died (9.28.21);  Hospitalized (9.15.21);  COVID positive (9.9.21);  fully vaccinated  Discharge Provider:  Admission Date: 9/15/2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: COVID-19 virus infection [U07.1] COVID-19 [U07.1] Acute respiratory failure with hypoxia  [J96.01] Acute respiratory failure due to COVID-19 [U07.1, J96.00]   HOSPITAL COURSE: Patient is  a 57 year old with asthma, MS (ocrelizumab q 6 months), tobacco abuse (30pkyr), and congenitally absent left kidney.  He was COVID (+) 9/9 (was vaccinated in the spring).  He presented 9/15 with 10 days cough/SOB/fevers.  In the ED, he was hypoxemic and would desaturate with activity.  CXR showed patchy bilateral opacities.  He was admitted and treated with Decadron, remdesivir, and empiric antibiotics. On 9/18, he was transferred requiring HFNC/NRB.  On 9/19, he required intubation, NMB (until 9/22), and proning (until 9/21).  Doppler US 9/20 showed acute right IJ and right SC DVTs.  He was extubated 9/26 and initially tolerated low-flow NC oxygen but was profoundly weak.  He decompensated requiring BiPAP.  He had been made DNR by family then comfort measures.  He passed away on 9/28 while this attending was off service and at home Date of Death: 9/28/21 Time of Death:  8:07 PM Preliminary Cause of Death: Acute respiratory failure due to COVID-19"
	"1753324-1"	"1753324-1"	"PYREXIA"	"10037660"	"50-59 years"	"50-59"	"Patient has expired / died (9.28.21);  Hospitalized (9.15.21);  COVID positive (9.9.21);  fully vaccinated  Discharge Provider:  Admission Date: 9/15/2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: COVID-19 virus infection [U07.1] COVID-19 [U07.1] Acute respiratory failure with hypoxia  [J96.01] Acute respiratory failure due to COVID-19 [U07.1, J96.00]   HOSPITAL COURSE: Patient is  a 57 year old with asthma, MS (ocrelizumab q 6 months), tobacco abuse (30pkyr), and congenitally absent left kidney.  He was COVID (+) 9/9 (was vaccinated in the spring).  He presented 9/15 with 10 days cough/SOB/fevers.  In the ED, he was hypoxemic and would desaturate with activity.  CXR showed patchy bilateral opacities.  He was admitted and treated with Decadron, remdesivir, and empiric antibiotics. On 9/18, he was transferred requiring HFNC/NRB.  On 9/19, he required intubation, NMB (until 9/22), and proning (until 9/21).  Doppler US 9/20 showed acute right IJ and right SC DVTs.  He was extubated 9/26 and initially tolerated low-flow NC oxygen but was profoundly weak.  He decompensated requiring BiPAP.  He had been made DNR by family then comfort measures.  He passed away on 9/28 while this attending was off service and at home Date of Death: 9/28/21 Time of Death:  8:07 PM Preliminary Cause of Death: Acute respiratory failure due to COVID-19"
	"1753324-1"	"1753324-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"Patient has expired / died (9.28.21);  Hospitalized (9.15.21);  COVID positive (9.9.21);  fully vaccinated  Discharge Provider:  Admission Date: 9/15/2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: COVID-19 virus infection [U07.1] COVID-19 [U07.1] Acute respiratory failure with hypoxia  [J96.01] Acute respiratory failure due to COVID-19 [U07.1, J96.00]   HOSPITAL COURSE: Patient is  a 57 year old with asthma, MS (ocrelizumab q 6 months), tobacco abuse (30pkyr), and congenitally absent left kidney.  He was COVID (+) 9/9 (was vaccinated in the spring).  He presented 9/15 with 10 days cough/SOB/fevers.  In the ED, he was hypoxemic and would desaturate with activity.  CXR showed patchy bilateral opacities.  He was admitted and treated with Decadron, remdesivir, and empiric antibiotics. On 9/18, he was transferred requiring HFNC/NRB.  On 9/19, he required intubation, NMB (until 9/22), and proning (until 9/21).  Doppler US 9/20 showed acute right IJ and right SC DVTs.  He was extubated 9/26 and initially tolerated low-flow NC oxygen but was profoundly weak.  He decompensated requiring BiPAP.  He had been made DNR by family then comfort measures.  He passed away on 9/28 while this attending was off service and at home Date of Death: 9/28/21 Time of Death:  8:07 PM Preliminary Cause of Death: Acute respiratory failure due to COVID-19"
	"1753324-1"	"1753324-1"	"SUBCLAVIAN VEIN THROMBOSIS"	"10049446"	"50-59 years"	"50-59"	"Patient has expired / died (9.28.21);  Hospitalized (9.15.21);  COVID positive (9.9.21);  fully vaccinated  Discharge Provider:  Admission Date: 9/15/2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: COVID-19 virus infection [U07.1] COVID-19 [U07.1] Acute respiratory failure with hypoxia  [J96.01] Acute respiratory failure due to COVID-19 [U07.1, J96.00]   HOSPITAL COURSE: Patient is  a 57 year old with asthma, MS (ocrelizumab q 6 months), tobacco abuse (30pkyr), and congenitally absent left kidney.  He was COVID (+) 9/9 (was vaccinated in the spring).  He presented 9/15 with 10 days cough/SOB/fevers.  In the ED, he was hypoxemic and would desaturate with activity.  CXR showed patchy bilateral opacities.  He was admitted and treated with Decadron, remdesivir, and empiric antibiotics. On 9/18, he was transferred requiring HFNC/NRB.  On 9/19, he required intubation, NMB (until 9/22), and proning (until 9/21).  Doppler US 9/20 showed acute right IJ and right SC DVTs.  He was extubated 9/26 and initially tolerated low-flow NC oxygen but was profoundly weak.  He decompensated requiring BiPAP.  He had been made DNR by family then comfort measures.  He passed away on 9/28 while this attending was off service and at home Date of Death: 9/28/21 Time of Death:  8:07 PM Preliminary Cause of Death: Acute respiratory failure due to COVID-19"
	"1753324-1"	"1753324-1"	"ULTRASOUND DOPPLER ABNORMAL"	"10045413"	"50-59 years"	"50-59"	"Patient has expired / died (9.28.21);  Hospitalized (9.15.21);  COVID positive (9.9.21);  fully vaccinated  Discharge Provider:  Admission Date: 9/15/2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: COVID-19 virus infection [U07.1] COVID-19 [U07.1] Acute respiratory failure with hypoxia  [J96.01] Acute respiratory failure due to COVID-19 [U07.1, J96.00]   HOSPITAL COURSE: Patient is  a 57 year old with asthma, MS (ocrelizumab q 6 months), tobacco abuse (30pkyr), and congenitally absent left kidney.  He was COVID (+) 9/9 (was vaccinated in the spring).  He presented 9/15 with 10 days cough/SOB/fevers.  In the ED, he was hypoxemic and would desaturate with activity.  CXR showed patchy bilateral opacities.  He was admitted and treated with Decadron, remdesivir, and empiric antibiotics. On 9/18, he was transferred requiring HFNC/NRB.  On 9/19, he required intubation, NMB (until 9/22), and proning (until 9/21).  Doppler US 9/20 showed acute right IJ and right SC DVTs.  He was extubated 9/26 and initially tolerated low-flow NC oxygen but was profoundly weak.  He decompensated requiring BiPAP.  He had been made DNR by family then comfort measures.  He passed away on 9/28 while this attending was off service and at home Date of Death: 9/28/21 Time of Death:  8:07 PM Preliminary Cause of Death: Acute respiratory failure due to COVID-19"
	"1753893-1"	"1753893-1"	"ANTICOAGULANT THERAPY"	"10053468"	"50-59 years"	"50-59"	"10 days after receiving the first dose of Moderna, patient presented at the ER with difficulty breathing. CT revealed bi-lateral pulmonary embolisms. A few days on anti-coagulants and was released. She returned a couple days later with worsening breathing.  Patient received bi-pap oxygen then underwent procedure to place filter to prevent blood clots from traveling. Patient was intubated and placed on mechanical ventilation and diagnosed with multiple system organ failure. Patient succumbed to the vaccine injury September 29, 2021."
	"1753893-1"	"1753893-1"	"COMPUTERISED TOMOGRAM THORAX ABNORMAL"	"10057799"	"50-59 years"	"50-59"	"10 days after receiving the first dose of Moderna, patient presented at the ER with difficulty breathing. CT revealed bi-lateral pulmonary embolisms. A few days on anti-coagulants and was released. She returned a couple days later with worsening breathing.  Patient received bi-pap oxygen then underwent procedure to place filter to prevent blood clots from traveling. Patient was intubated and placed on mechanical ventilation and diagnosed with multiple system organ failure. Patient succumbed to the vaccine injury September 29, 2021."
	"1753893-1"	"1753893-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"10 days after receiving the first dose of Moderna, patient presented at the ER with difficulty breathing. CT revealed bi-lateral pulmonary embolisms. A few days on anti-coagulants and was released. She returned a couple days later with worsening breathing.  Patient received bi-pap oxygen then underwent procedure to place filter to prevent blood clots from traveling. Patient was intubated and placed on mechanical ventilation and diagnosed with multiple system organ failure. Patient succumbed to the vaccine injury September 29, 2021."
	"1753893-1"	"1753893-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"50-59 years"	"50-59"	"10 days after receiving the first dose of Moderna, patient presented at the ER with difficulty breathing. CT revealed bi-lateral pulmonary embolisms. A few days on anti-coagulants and was released. She returned a couple days later with worsening breathing.  Patient received bi-pap oxygen then underwent procedure to place filter to prevent blood clots from traveling. Patient was intubated and placed on mechanical ventilation and diagnosed with multiple system organ failure. Patient succumbed to the vaccine injury September 29, 2021."
	"1753893-1"	"1753893-1"	"MECHANICAL VENTILATION"	"10067221"	"50-59 years"	"50-59"	"10 days after receiving the first dose of Moderna, patient presented at the ER with difficulty breathing. CT revealed bi-lateral pulmonary embolisms. A few days on anti-coagulants and was released. She returned a couple days later with worsening breathing.  Patient received bi-pap oxygen then underwent procedure to place filter to prevent blood clots from traveling. Patient was intubated and placed on mechanical ventilation and diagnosed with multiple system organ failure. Patient succumbed to the vaccine injury September 29, 2021."
	"1753893-1"	"1753893-1"	"MULTIPLE ORGAN DYSFUNCTION SYNDROME"	"10077361"	"50-59 years"	"50-59"	"10 days after receiving the first dose of Moderna, patient presented at the ER with difficulty breathing. CT revealed bi-lateral pulmonary embolisms. A few days on anti-coagulants and was released. She returned a couple days later with worsening breathing.  Patient received bi-pap oxygen then underwent procedure to place filter to prevent blood clots from traveling. Patient was intubated and placed on mechanical ventilation and diagnosed with multiple system organ failure. Patient succumbed to the vaccine injury September 29, 2021."
	"1753893-1"	"1753893-1"	"POSITIVE AIRWAY PRESSURE THERAPY"	"10086397"	"50-59 years"	"50-59"	"10 days after receiving the first dose of Moderna, patient presented at the ER with difficulty breathing. CT revealed bi-lateral pulmonary embolisms. A few days on anti-coagulants and was released. She returned a couple days later with worsening breathing.  Patient received bi-pap oxygen then underwent procedure to place filter to prevent blood clots from traveling. Patient was intubated and placed on mechanical ventilation and diagnosed with multiple system organ failure. Patient succumbed to the vaccine injury September 29, 2021."
	"1753893-1"	"1753893-1"	"PULMONARY EMBOLISM"	"10037377"	"50-59 years"	"50-59"	"10 days after receiving the first dose of Moderna, patient presented at the ER with difficulty breathing. CT revealed bi-lateral pulmonary embolisms. A few days on anti-coagulants and was released. She returned a couple days later with worsening breathing.  Patient received bi-pap oxygen then underwent procedure to place filter to prevent blood clots from traveling. Patient was intubated and placed on mechanical ventilation and diagnosed with multiple system organ failure. Patient succumbed to the vaccine injury September 29, 2021."
	"1753893-1"	"1753893-1"	"VENA CAVA FILTER INSERTION"	"10048932"	"50-59 years"	"50-59"	"10 days after receiving the first dose of Moderna, patient presented at the ER with difficulty breathing. CT revealed bi-lateral pulmonary embolisms. A few days on anti-coagulants and was released. She returned a couple days later with worsening breathing.  Patient received bi-pap oxygen then underwent procedure to place filter to prevent blood clots from traveling. Patient was intubated and placed on mechanical ventilation and diagnosed with multiple system organ failure. Patient succumbed to the vaccine injury September 29, 2021."
	"1756099-1"	"1756099-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"They said it was cardiac arrest; but the caller thinks it was a pulmonary embolism; collapsed in the bathroom at 10pm; He was having trouble breathing. He collapsed in the bathroom at 10pm; he wasn't feeling well; This is a spontaneous report from a contactable consumer (patient's son). A 57-year-old male patient received bnt162b2 (BNT162B2), dose 1 via an unspecified route of administration on 14Sep2021 (Batch/Lot number was not reported) as DOSE 1, SINGLE for covid-19 immunisation at the age of 57-year-old. Medical history included alcoholism, seizures. There were no concomitant medications. The patient experienced cardiac arrest on 23Sep2021, pulmonary embolism on 23Sep2021, trouble breathing and collapsed in the bathroom at 10pm in Sep2021, wasn't feeling well in Sep2021. The patient died on 23Sep2021. An autopsy was not performed. The outcome of wasn't feeling well was unknown, outcome of other events was fatal. The clinical course was reported as: his father died yesterday, and the only difference recently in his health was that he got the COVID vaccine. His father died 9 days later on 23Sep2021. The coroner denied an autopsy. The hospital denied an autopsy. His father was not obese or diabetic, and he was only 57 as healthy as a horse. His father had gotten the vaccine, and said he wasn't feeling well to his girlfriend. He was having trouble breathing. He collapsed in the bathroom at 10pm. They called an ambulance who did everything they could do to bring him back. They pronounced his dad dead 23 minutes after midnight on 23Sep2021. They said it was cardiac arrest, but the reporter thinks it was a pulmonary embolism. His dad was not COVID positive. His father did have a history of alcoholism. Any time he would try to quit drinking, he would drink too much water out of compulsion since he couldn't drink beer. He would flush his system so much that he would deplete his sodium. His dad would get seizures every time he quit drinking. He tried to tell his dad that he needed to drink the normal amount of water. He can't just sit there and drink that much water to replace all the beer he drank. It would flush his system of all that sodium.   The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow-up.; Reported Cause(s) of Death: They said it was cardiac arrest; but the caller thinks it was a pulmonary embolism; He was having trouble breathing. He collapsed in the bathroom at 10pm"
	"1756099-1"	"1756099-1"	"CIRCULATORY COLLAPSE"	"10009192"	"50-59 years"	"50-59"	"They said it was cardiac arrest; but the caller thinks it was a pulmonary embolism; collapsed in the bathroom at 10pm; He was having trouble breathing. He collapsed in the bathroom at 10pm; he wasn't feeling well; This is a spontaneous report from a contactable consumer (patient's son). A 57-year-old male patient received bnt162b2 (BNT162B2), dose 1 via an unspecified route of administration on 14Sep2021 (Batch/Lot number was not reported) as DOSE 1, SINGLE for covid-19 immunisation at the age of 57-year-old. Medical history included alcoholism, seizures. There were no concomitant medications. The patient experienced cardiac arrest on 23Sep2021, pulmonary embolism on 23Sep2021, trouble breathing and collapsed in the bathroom at 10pm in Sep2021, wasn't feeling well in Sep2021. The patient died on 23Sep2021. An autopsy was not performed. The outcome of wasn't feeling well was unknown, outcome of other events was fatal. The clinical course was reported as: his father died yesterday, and the only difference recently in his health was that he got the COVID vaccine. His father died 9 days later on 23Sep2021. The coroner denied an autopsy. The hospital denied an autopsy. His father was not obese or diabetic, and he was only 57 as healthy as a horse. His father had gotten the vaccine, and said he wasn't feeling well to his girlfriend. He was having trouble breathing. He collapsed in the bathroom at 10pm. They called an ambulance who did everything they could do to bring him back. They pronounced his dad dead 23 minutes after midnight on 23Sep2021. They said it was cardiac arrest, but the reporter thinks it was a pulmonary embolism. His dad was not COVID positive. His father did have a history of alcoholism. Any time he would try to quit drinking, he would drink too much water out of compulsion since he couldn't drink beer. He would flush his system so much that he would deplete his sodium. His dad would get seizures every time he quit drinking. He tried to tell his dad that he needed to drink the normal amount of water. He can't just sit there and drink that much water to replace all the beer he drank. It would flush his system of all that sodium.   The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow-up.; Reported Cause(s) of Death: They said it was cardiac arrest; but the caller thinks it was a pulmonary embolism; He was having trouble breathing. He collapsed in the bathroom at 10pm"
	"1756099-1"	"1756099-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"They said it was cardiac arrest; but the caller thinks it was a pulmonary embolism; collapsed in the bathroom at 10pm; He was having trouble breathing. He collapsed in the bathroom at 10pm; he wasn't feeling well; This is a spontaneous report from a contactable consumer (patient's son). A 57-year-old male patient received bnt162b2 (BNT162B2), dose 1 via an unspecified route of administration on 14Sep2021 (Batch/Lot number was not reported) as DOSE 1, SINGLE for covid-19 immunisation at the age of 57-year-old. Medical history included alcoholism, seizures. There were no concomitant medications. The patient experienced cardiac arrest on 23Sep2021, pulmonary embolism on 23Sep2021, trouble breathing and collapsed in the bathroom at 10pm in Sep2021, wasn't feeling well in Sep2021. The patient died on 23Sep2021. An autopsy was not performed. The outcome of wasn't feeling well was unknown, outcome of other events was fatal. The clinical course was reported as: his father died yesterday, and the only difference recently in his health was that he got the COVID vaccine. His father died 9 days later on 23Sep2021. The coroner denied an autopsy. The hospital denied an autopsy. His father was not obese or diabetic, and he was only 57 as healthy as a horse. His father had gotten the vaccine, and said he wasn't feeling well to his girlfriend. He was having trouble breathing. He collapsed in the bathroom at 10pm. They called an ambulance who did everything they could do to bring him back. They pronounced his dad dead 23 minutes after midnight on 23Sep2021. They said it was cardiac arrest, but the reporter thinks it was a pulmonary embolism. His dad was not COVID positive. His father did have a history of alcoholism. Any time he would try to quit drinking, he would drink too much water out of compulsion since he couldn't drink beer. He would flush his system so much that he would deplete his sodium. His dad would get seizures every time he quit drinking. He tried to tell his dad that he needed to drink the normal amount of water. He can't just sit there and drink that much water to replace all the beer he drank. It would flush his system of all that sodium.   The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow-up.; Reported Cause(s) of Death: They said it was cardiac arrest; but the caller thinks it was a pulmonary embolism; He was having trouble breathing. He collapsed in the bathroom at 10pm"
	"1756099-1"	"1756099-1"	"MALAISE"	"10025482"	"50-59 years"	"50-59"	"They said it was cardiac arrest; but the caller thinks it was a pulmonary embolism; collapsed in the bathroom at 10pm; He was having trouble breathing. He collapsed in the bathroom at 10pm; he wasn't feeling well; This is a spontaneous report from a contactable consumer (patient's son). A 57-year-old male patient received bnt162b2 (BNT162B2), dose 1 via an unspecified route of administration on 14Sep2021 (Batch/Lot number was not reported) as DOSE 1, SINGLE for covid-19 immunisation at the age of 57-year-old. Medical history included alcoholism, seizures. There were no concomitant medications. The patient experienced cardiac arrest on 23Sep2021, pulmonary embolism on 23Sep2021, trouble breathing and collapsed in the bathroom at 10pm in Sep2021, wasn't feeling well in Sep2021. The patient died on 23Sep2021. An autopsy was not performed. The outcome of wasn't feeling well was unknown, outcome of other events was fatal. The clinical course was reported as: his father died yesterday, and the only difference recently in his health was that he got the COVID vaccine. His father died 9 days later on 23Sep2021. The coroner denied an autopsy. The hospital denied an autopsy. His father was not obese or diabetic, and he was only 57 as healthy as a horse. His father had gotten the vaccine, and said he wasn't feeling well to his girlfriend. He was having trouble breathing. He collapsed in the bathroom at 10pm. They called an ambulance who did everything they could do to bring him back. They pronounced his dad dead 23 minutes after midnight on 23Sep2021. They said it was cardiac arrest, but the reporter thinks it was a pulmonary embolism. His dad was not COVID positive. His father did have a history of alcoholism. Any time he would try to quit drinking, he would drink too much water out of compulsion since he couldn't drink beer. He would flush his system so much that he would deplete his sodium. His dad would get seizures every time he quit drinking. He tried to tell his dad that he needed to drink the normal amount of water. He can't just sit there and drink that much water to replace all the beer he drank. It would flush his system of all that sodium.   The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow-up.; Reported Cause(s) of Death: They said it was cardiac arrest; but the caller thinks it was a pulmonary embolism; He was having trouble breathing. He collapsed in the bathroom at 10pm"
	"1756099-1"	"1756099-1"	"PULMONARY EMBOLISM"	"10037377"	"50-59 years"	"50-59"	"They said it was cardiac arrest; but the caller thinks it was a pulmonary embolism; collapsed in the bathroom at 10pm; He was having trouble breathing. He collapsed in the bathroom at 10pm; he wasn't feeling well; This is a spontaneous report from a contactable consumer (patient's son). A 57-year-old male patient received bnt162b2 (BNT162B2), dose 1 via an unspecified route of administration on 14Sep2021 (Batch/Lot number was not reported) as DOSE 1, SINGLE for covid-19 immunisation at the age of 57-year-old. Medical history included alcoholism, seizures. There were no concomitant medications. The patient experienced cardiac arrest on 23Sep2021, pulmonary embolism on 23Sep2021, trouble breathing and collapsed in the bathroom at 10pm in Sep2021, wasn't feeling well in Sep2021. The patient died on 23Sep2021. An autopsy was not performed. The outcome of wasn't feeling well was unknown, outcome of other events was fatal. The clinical course was reported as: his father died yesterday, and the only difference recently in his health was that he got the COVID vaccine. His father died 9 days later on 23Sep2021. The coroner denied an autopsy. The hospital denied an autopsy. His father was not obese or diabetic, and he was only 57 as healthy as a horse. His father had gotten the vaccine, and said he wasn't feeling well to his girlfriend. He was having trouble breathing. He collapsed in the bathroom at 10pm. They called an ambulance who did everything they could do to bring him back. They pronounced his dad dead 23 minutes after midnight on 23Sep2021. They said it was cardiac arrest, but the reporter thinks it was a pulmonary embolism. His dad was not COVID positive. His father did have a history of alcoholism. Any time he would try to quit drinking, he would drink too much water out of compulsion since he couldn't drink beer. He would flush his system so much that he would deplete his sodium. His dad would get seizures every time he quit drinking. He tried to tell his dad that he needed to drink the normal amount of water. He can't just sit there and drink that much water to replace all the beer he drank. It would flush his system of all that sodium.   The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow-up.; Reported Cause(s) of Death: They said it was cardiac arrest; but the caller thinks it was a pulmonary embolism; He was having trouble breathing. He collapsed in the bathroom at 10pm"
	"1758805-1"	"1758805-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"shortness of breath patient Deceased"
	"1758805-1"	"1758805-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"shortness of breath patient Deceased"
	"1761541-1"	"1761541-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"unknown patient representative contacted pharmacy to report the patient had died hours after getting the moderna vaccination"
	"1761787-1"	"1761787-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient passed away on 09/25/2021."
	"1762703-1"	"1762703-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	""Pt received vaccines at our pharmacy the morning of 10/4/21. She was monitored for 15 minutes after vaccination and no reactions were noted or observed in the patient waiting time. She left without any known complications. On 10/5/21, the Coroner came to the pharmacy with documents to retrieve medical records for the patient as she had ""went into cardiac arrest yesterday and needed these records for the autopsy investigation."" After contacting my direct supervisor and he contacted necessary persons to confirm the release of the PHI, we called him back to inform him he could come to pick up records. There was no communication in between the time the patient left the pharmacy without complications from the vaccines and the time the coroner came to pharmacy to retrieve patient records for her death.""
	"1762703-1"	"1762703-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	""Pt received vaccines at our pharmacy the morning of 10/4/21. She was monitored for 15 minutes after vaccination and no reactions were noted or observed in the patient waiting time. She left without any known complications. On 10/5/21, the Coroner came to the pharmacy with documents to retrieve medical records for the patient as she had ""went into cardiac arrest yesterday and needed these records for the autopsy investigation."" After contacting my direct supervisor and he contacted necessary persons to confirm the release of the PHI, we called him back to inform him he could come to pick up records. There was no communication in between the time the patient left the pharmacy without complications from the vaccines and the time the coroner came to pharmacy to retrieve patient records for her death.""
	"1762892-1"	"1762892-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"None stated."
	"1763094-1"	"1763094-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Death within 48 hours of vaccine"
	"1763098-1"	"1763098-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Death within 7 days of vaccine"
	"1763115-1"	"1763115-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Death within 7 days of receiving vaccine"
	"1766330-1"	"1766330-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"9/9/21 pos for covid 9/15/21: admitted to hospital and put on steroids and had 1 dose of tocilizumab pt intubated and put on ventilator pt expired on 9/20/21 of COVID"
	"1766330-1"	"1766330-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"9/9/21 pos for covid 9/15/21: admitted to hospital and put on steroids and had 1 dose of tocilizumab pt intubated and put on ventilator pt expired on 9/20/21 of COVID"
	"1766330-1"	"1766330-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"50-59 years"	"50-59"	"9/9/21 pos for covid 9/15/21: admitted to hospital and put on steroids and had 1 dose of tocilizumab pt intubated and put on ventilator pt expired on 9/20/21 of COVID"
	"1766330-1"	"1766330-1"	"MECHANICAL VENTILATION"	"10067221"	"50-59 years"	"50-59"	"9/9/21 pos for covid 9/15/21: admitted to hospital and put on steroids and had 1 dose of tocilizumab pt intubated and put on ventilator pt expired on 9/20/21 of COVID"
	"1766330-1"	"1766330-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"9/9/21 pos for covid 9/15/21: admitted to hospital and put on steroids and had 1 dose of tocilizumab pt intubated and put on ventilator pt expired on 9/20/21 of COVID"
	"1767952-1"	"1767952-1"	"ACUTE RESPIRATORY DISTRESS SYNDROME"	"10001052"	"50-59 years"	"50-59"	"Pt is a 55 y.o. male who presents with Acute respiratory distress syndrome (ARDS) due to 2019 novel coronavirus (CMS/HCC)   Pulmonary:     Effort: He is intubated.     Breath sounds: Decreased breath sounds and rhonchi present.     Comments: On mechanical ventilation and ecmo  (Principal) Pneumonia due to 2019 novel coronavirus  Initially tested positive for Covid on 8/3 Intubated and cannulated for VV ECMO on 8/20 Bivent w/ 50% FiO2; ECMO 100%, sweep 4 On Veletri: ECHO EF 60-80%, RV mildly dilated, fxn normal Wean settings as able Continue q4hr and PRN ABG's CXR as needed Continue diuresis with lasix drip  Patient presented as a transfer for management of Covid pneumonitis with ECMO.   He was supported for a short time,  But 6 days later a CT of the Brain revealed multiple intracranial hemorrhages with midline shift.  With these findings, comfort measures were undertaken, and he expired shortly after that."
	"1767952-1"	"1767952-1"	"BLOOD GASES"	"10005537"	"50-59 years"	"50-59"	"Pt is a 55 y.o. male who presents with Acute respiratory distress syndrome (ARDS) due to 2019 novel coronavirus (CMS/HCC)   Pulmonary:     Effort: He is intubated.     Breath sounds: Decreased breath sounds and rhonchi present.     Comments: On mechanical ventilation and ecmo  (Principal) Pneumonia due to 2019 novel coronavirus  Initially tested positive for Covid on 8/3 Intubated and cannulated for VV ECMO on 8/20 Bivent w/ 50% FiO2; ECMO 100%, sweep 4 On Veletri: ECHO EF 60-80%, RV mildly dilated, fxn normal Wean settings as able Continue q4hr and PRN ABG's CXR as needed Continue diuresis with lasix drip  Patient presented as a transfer for management of Covid pneumonitis with ECMO.   He was supported for a short time,  But 6 days later a CT of the Brain revealed multiple intracranial hemorrhages with midline shift.  With these findings, comfort measures were undertaken, and he expired shortly after that."
	"1767952-1"	"1767952-1"	"BREATH SOUNDS ABNORMAL"	"10064780"	"50-59 years"	"50-59"	"Pt is a 55 y.o. male who presents with Acute respiratory distress syndrome (ARDS) due to 2019 novel coronavirus (CMS/HCC)   Pulmonary:     Effort: He is intubated.     Breath sounds: Decreased breath sounds and rhonchi present.     Comments: On mechanical ventilation and ecmo  (Principal) Pneumonia due to 2019 novel coronavirus  Initially tested positive for Covid on 8/3 Intubated and cannulated for VV ECMO on 8/20 Bivent w/ 50% FiO2; ECMO 100%, sweep 4 On Veletri: ECHO EF 60-80%, RV mildly dilated, fxn normal Wean settings as able Continue q4hr and PRN ABG's CXR as needed Continue diuresis with lasix drip  Patient presented as a transfer for management of Covid pneumonitis with ECMO.   He was supported for a short time,  But 6 days later a CT of the Brain revealed multiple intracranial hemorrhages with midline shift.  With these findings, comfort measures were undertaken, and he expired shortly after that."
	"1767952-1"	"1767952-1"	"CEREBRAL MASS EFFECT"	"10067086"	"50-59 years"	"50-59"	"Pt is a 55 y.o. male who presents with Acute respiratory distress syndrome (ARDS) due to 2019 novel coronavirus (CMS/HCC)   Pulmonary:     Effort: He is intubated.     Breath sounds: Decreased breath sounds and rhonchi present.     Comments: On mechanical ventilation and ecmo  (Principal) Pneumonia due to 2019 novel coronavirus  Initially tested positive for Covid on 8/3 Intubated and cannulated for VV ECMO on 8/20 Bivent w/ 50% FiO2; ECMO 100%, sweep 4 On Veletri: ECHO EF 60-80%, RV mildly dilated, fxn normal Wean settings as able Continue q4hr and PRN ABG's CXR as needed Continue diuresis with lasix drip  Patient presented as a transfer for management of Covid pneumonitis with ECMO.   He was supported for a short time,  But 6 days later a CT of the Brain revealed multiple intracranial hemorrhages with midline shift.  With these findings, comfort measures were undertaken, and he expired shortly after that."
	"1767952-1"	"1767952-1"	"CHEST X-RAY"	"10008498"	"50-59 years"	"50-59"	"Pt is a 55 y.o. male who presents with Acute respiratory distress syndrome (ARDS) due to 2019 novel coronavirus (CMS/HCC)   Pulmonary:     Effort: He is intubated.     Breath sounds: Decreased breath sounds and rhonchi present.     Comments: On mechanical ventilation and ecmo  (Principal) Pneumonia due to 2019 novel coronavirus  Initially tested positive for Covid on 8/3 Intubated and cannulated for VV ECMO on 8/20 Bivent w/ 50% FiO2; ECMO 100%, sweep 4 On Veletri: ECHO EF 60-80%, RV mildly dilated, fxn normal Wean settings as able Continue q4hr and PRN ABG's CXR as needed Continue diuresis with lasix drip  Patient presented as a transfer for management of Covid pneumonitis with ECMO.   He was supported for a short time,  But 6 days later a CT of the Brain revealed multiple intracranial hemorrhages with midline shift.  With these findings, comfort measures were undertaken, and he expired shortly after that."
	"1767952-1"	"1767952-1"	"COMPUTERISED TOMOGRAM HEAD ABNORMAL"	"10072168"	"50-59 years"	"50-59"	"Pt is a 55 y.o. male who presents with Acute respiratory distress syndrome (ARDS) due to 2019 novel coronavirus (CMS/HCC)   Pulmonary:     Effort: He is intubated.     Breath sounds: Decreased breath sounds and rhonchi present.     Comments: On mechanical ventilation and ecmo  (Principal) Pneumonia due to 2019 novel coronavirus  Initially tested positive for Covid on 8/3 Intubated and cannulated for VV ECMO on 8/20 Bivent w/ 50% FiO2; ECMO 100%, sweep 4 On Veletri: ECHO EF 60-80%, RV mildly dilated, fxn normal Wean settings as able Continue q4hr and PRN ABG's CXR as needed Continue diuresis with lasix drip  Patient presented as a transfer for management of Covid pneumonitis with ECMO.   He was supported for a short time,  But 6 days later a CT of the Brain revealed multiple intracranial hemorrhages with midline shift.  With these findings, comfort measures were undertaken, and he expired shortly after that."
	"1767952-1"	"1767952-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Pt is a 55 y.o. male who presents with Acute respiratory distress syndrome (ARDS) due to 2019 novel coronavirus (CMS/HCC)   Pulmonary:     Effort: He is intubated.     Breath sounds: Decreased breath sounds and rhonchi present.     Comments: On mechanical ventilation and ecmo  (Principal) Pneumonia due to 2019 novel coronavirus  Initially tested positive for Covid on 8/3 Intubated and cannulated for VV ECMO on 8/20 Bivent w/ 50% FiO2; ECMO 100%, sweep 4 On Veletri: ECHO EF 60-80%, RV mildly dilated, fxn normal Wean settings as able Continue q4hr and PRN ABG's CXR as needed Continue diuresis with lasix drip  Patient presented as a transfer for management of Covid pneumonitis with ECMO.   He was supported for a short time,  But 6 days later a CT of the Brain revealed multiple intracranial hemorrhages with midline shift.  With these findings, comfort measures were undertaken, and he expired shortly after that."
	"1767952-1"	"1767952-1"	"COVID-19 PNEUMONIA"	"10084380"	"50-59 years"	"50-59"	"Pt is a 55 y.o. male who presents with Acute respiratory distress syndrome (ARDS) due to 2019 novel coronavirus (CMS/HCC)   Pulmonary:     Effort: He is intubated.     Breath sounds: Decreased breath sounds and rhonchi present.     Comments: On mechanical ventilation and ecmo  (Principal) Pneumonia due to 2019 novel coronavirus  Initially tested positive for Covid on 8/3 Intubated and cannulated for VV ECMO on 8/20 Bivent w/ 50% FiO2; ECMO 100%, sweep 4 On Veletri: ECHO EF 60-80%, RV mildly dilated, fxn normal Wean settings as able Continue q4hr and PRN ABG's CXR as needed Continue diuresis with lasix drip  Patient presented as a transfer for management of Covid pneumonitis with ECMO.   He was supported for a short time,  But 6 days later a CT of the Brain revealed multiple intracranial hemorrhages with midline shift.  With these findings, comfort measures were undertaken, and he expired shortly after that."
	"1767952-1"	"1767952-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Pt is a 55 y.o. male who presents with Acute respiratory distress syndrome (ARDS) due to 2019 novel coronavirus (CMS/HCC)   Pulmonary:     Effort: He is intubated.     Breath sounds: Decreased breath sounds and rhonchi present.     Comments: On mechanical ventilation and ecmo  (Principal) Pneumonia due to 2019 novel coronavirus  Initially tested positive for Covid on 8/3 Intubated and cannulated for VV ECMO on 8/20 Bivent w/ 50% FiO2; ECMO 100%, sweep 4 On Veletri: ECHO EF 60-80%, RV mildly dilated, fxn normal Wean settings as able Continue q4hr and PRN ABG's CXR as needed Continue diuresis with lasix drip  Patient presented as a transfer for management of Covid pneumonitis with ECMO.   He was supported for a short time,  But 6 days later a CT of the Brain revealed multiple intracranial hemorrhages with midline shift.  With these findings, comfort measures were undertaken, and he expired shortly after that."
	"1767952-1"	"1767952-1"	"ECHOCARDIOGRAM ABNORMAL"	"10061593"	"50-59 years"	"50-59"	"Pt is a 55 y.o. male who presents with Acute respiratory distress syndrome (ARDS) due to 2019 novel coronavirus (CMS/HCC)   Pulmonary:     Effort: He is intubated.     Breath sounds: Decreased breath sounds and rhonchi present.     Comments: On mechanical ventilation and ecmo  (Principal) Pneumonia due to 2019 novel coronavirus  Initially tested positive for Covid on 8/3 Intubated and cannulated for VV ECMO on 8/20 Bivent w/ 50% FiO2; ECMO 100%, sweep 4 On Veletri: ECHO EF 60-80%, RV mildly dilated, fxn normal Wean settings as able Continue q4hr and PRN ABG's CXR as needed Continue diuresis with lasix drip  Patient presented as a transfer for management of Covid pneumonitis with ECMO.   He was supported for a short time,  But 6 days later a CT of the Brain revealed multiple intracranial hemorrhages with midline shift.  With these findings, comfort measures were undertaken, and he expired shortly after that."
	"1767952-1"	"1767952-1"	"EJECTION FRACTION"	"10050527"	"50-59 years"	"50-59"	"Pt is a 55 y.o. male who presents with Acute respiratory distress syndrome (ARDS) due to 2019 novel coronavirus (CMS/HCC)   Pulmonary:     Effort: He is intubated.     Breath sounds: Decreased breath sounds and rhonchi present.     Comments: On mechanical ventilation and ecmo  (Principal) Pneumonia due to 2019 novel coronavirus  Initially tested positive for Covid on 8/3 Intubated and cannulated for VV ECMO on 8/20 Bivent w/ 50% FiO2; ECMO 100%, sweep 4 On Veletri: ECHO EF 60-80%, RV mildly dilated, fxn normal Wean settings as able Continue q4hr and PRN ABG's CXR as needed Continue diuresis with lasix drip  Patient presented as a transfer for management of Covid pneumonitis with ECMO.   He was supported for a short time,  But 6 days later a CT of the Brain revealed multiple intracranial hemorrhages with midline shift.  With these findings, comfort measures were undertaken, and he expired shortly after that."
	"1767952-1"	"1767952-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"50-59 years"	"50-59"	"Pt is a 55 y.o. male who presents with Acute respiratory distress syndrome (ARDS) due to 2019 novel coronavirus (CMS/HCC)   Pulmonary:     Effort: He is intubated.     Breath sounds: Decreased breath sounds and rhonchi present.     Comments: On mechanical ventilation and ecmo  (Principal) Pneumonia due to 2019 novel coronavirus  Initially tested positive for Covid on 8/3 Intubated and cannulated for VV ECMO on 8/20 Bivent w/ 50% FiO2; ECMO 100%, sweep 4 On Veletri: ECHO EF 60-80%, RV mildly dilated, fxn normal Wean settings as able Continue q4hr and PRN ABG's CXR as needed Continue diuresis with lasix drip  Patient presented as a transfer for management of Covid pneumonitis with ECMO.   He was supported for a short time,  But 6 days later a CT of the Brain revealed multiple intracranial hemorrhages with midline shift.  With these findings, comfort measures were undertaken, and he expired shortly after that."
	"1767952-1"	"1767952-1"	"HAEMORRHAGE INTRACRANIAL"	"10018985"	"50-59 years"	"50-59"	"Pt is a 55 y.o. male who presents with Acute respiratory distress syndrome (ARDS) due to 2019 novel coronavirus (CMS/HCC)   Pulmonary:     Effort: He is intubated.     Breath sounds: Decreased breath sounds and rhonchi present.     Comments: On mechanical ventilation and ecmo  (Principal) Pneumonia due to 2019 novel coronavirus  Initially tested positive for Covid on 8/3 Intubated and cannulated for VV ECMO on 8/20 Bivent w/ 50% FiO2; ECMO 100%, sweep 4 On Veletri: ECHO EF 60-80%, RV mildly dilated, fxn normal Wean settings as able Continue q4hr and PRN ABG's CXR as needed Continue diuresis with lasix drip  Patient presented as a transfer for management of Covid pneumonitis with ECMO.   He was supported for a short time,  But 6 days later a CT of the Brain revealed multiple intracranial hemorrhages with midline shift.  With these findings, comfort measures were undertaken, and he expired shortly after that."
	"1767952-1"	"1767952-1"	"LUNG ASSIST DEVICE THERAPY"	"10082527"	"50-59 years"	"50-59"	"Pt is a 55 y.o. male who presents with Acute respiratory distress syndrome (ARDS) due to 2019 novel coronavirus (CMS/HCC)   Pulmonary:     Effort: He is intubated.     Breath sounds: Decreased breath sounds and rhonchi present.     Comments: On mechanical ventilation and ecmo  (Principal) Pneumonia due to 2019 novel coronavirus  Initially tested positive for Covid on 8/3 Intubated and cannulated for VV ECMO on 8/20 Bivent w/ 50% FiO2; ECMO 100%, sweep 4 On Veletri: ECHO EF 60-80%, RV mildly dilated, fxn normal Wean settings as able Continue q4hr and PRN ABG's CXR as needed Continue diuresis with lasix drip  Patient presented as a transfer for management of Covid pneumonitis with ECMO.   He was supported for a short time,  But 6 days later a CT of the Brain revealed multiple intracranial hemorrhages with midline shift.  With these findings, comfort measures were undertaken, and he expired shortly after that."
	"1767952-1"	"1767952-1"	"MECHANICAL VENTILATION"	"10067221"	"50-59 years"	"50-59"	"Pt is a 55 y.o. male who presents with Acute respiratory distress syndrome (ARDS) due to 2019 novel coronavirus (CMS/HCC)   Pulmonary:     Effort: He is intubated.     Breath sounds: Decreased breath sounds and rhonchi present.     Comments: On mechanical ventilation and ecmo  (Principal) Pneumonia due to 2019 novel coronavirus  Initially tested positive for Covid on 8/3 Intubated and cannulated for VV ECMO on 8/20 Bivent w/ 50% FiO2; ECMO 100%, sweep 4 On Veletri: ECHO EF 60-80%, RV mildly dilated, fxn normal Wean settings as able Continue q4hr and PRN ABG's CXR as needed Continue diuresis with lasix drip  Patient presented as a transfer for management of Covid pneumonitis with ECMO.   He was supported for a short time,  But 6 days later a CT of the Brain revealed multiple intracranial hemorrhages with midline shift.  With these findings, comfort measures were undertaken, and he expired shortly after that."
	"1767952-1"	"1767952-1"	"POLYURIA"	"10036142"	"50-59 years"	"50-59"	"Pt is a 55 y.o. male who presents with Acute respiratory distress syndrome (ARDS) due to 2019 novel coronavirus (CMS/HCC)   Pulmonary:     Effort: He is intubated.     Breath sounds: Decreased breath sounds and rhonchi present.     Comments: On mechanical ventilation and ecmo  (Principal) Pneumonia due to 2019 novel coronavirus  Initially tested positive for Covid on 8/3 Intubated and cannulated for VV ECMO on 8/20 Bivent w/ 50% FiO2; ECMO 100%, sweep 4 On Veletri: ECHO EF 60-80%, RV mildly dilated, fxn normal Wean settings as able Continue q4hr and PRN ABG's CXR as needed Continue diuresis with lasix drip  Patient presented as a transfer for management of Covid pneumonitis with ECMO.   He was supported for a short time,  But 6 days later a CT of the Brain revealed multiple intracranial hemorrhages with midline shift.  With these findings, comfort measures were undertaken, and he expired shortly after that."
	"1767952-1"	"1767952-1"	"RHONCHI"	"10039109"	"50-59 years"	"50-59"	"Pt is a 55 y.o. male who presents with Acute respiratory distress syndrome (ARDS) due to 2019 novel coronavirus (CMS/HCC)   Pulmonary:     Effort: He is intubated.     Breath sounds: Decreased breath sounds and rhonchi present.     Comments: On mechanical ventilation and ecmo  (Principal) Pneumonia due to 2019 novel coronavirus  Initially tested positive for Covid on 8/3 Intubated and cannulated for VV ECMO on 8/20 Bivent w/ 50% FiO2; ECMO 100%, sweep 4 On Veletri: ECHO EF 60-80%, RV mildly dilated, fxn normal Wean settings as able Continue q4hr and PRN ABG's CXR as needed Continue diuresis with lasix drip  Patient presented as a transfer for management of Covid pneumonitis with ECMO.   He was supported for a short time,  But 6 days later a CT of the Brain revealed multiple intracranial hemorrhages with midline shift.  With these findings, comfort measures were undertaken, and he expired shortly after that."
	"1767952-1"	"1767952-1"	"RIGHT VENTRICULAR DILATATION"	"10074222"	"50-59 years"	"50-59"	"Pt is a 55 y.o. male who presents with Acute respiratory distress syndrome (ARDS) due to 2019 novel coronavirus (CMS/HCC)   Pulmonary:     Effort: He is intubated.     Breath sounds: Decreased breath sounds and rhonchi present.     Comments: On mechanical ventilation and ecmo  (Principal) Pneumonia due to 2019 novel coronavirus  Initially tested positive for Covid on 8/3 Intubated and cannulated for VV ECMO on 8/20 Bivent w/ 50% FiO2; ECMO 100%, sweep 4 On Veletri: ECHO EF 60-80%, RV mildly dilated, fxn normal Wean settings as able Continue q4hr and PRN ABG's CXR as needed Continue diuresis with lasix drip  Patient presented as a transfer for management of Covid pneumonitis with ECMO.   He was supported for a short time,  But 6 days later a CT of the Brain revealed multiple intracranial hemorrhages with midline shift.  With these findings, comfort measures were undertaken, and he expired shortly after that."
	"1767952-1"	"1767952-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"Pt is a 55 y.o. male who presents with Acute respiratory distress syndrome (ARDS) due to 2019 novel coronavirus (CMS/HCC)   Pulmonary:     Effort: He is intubated.     Breath sounds: Decreased breath sounds and rhonchi present.     Comments: On mechanical ventilation and ecmo  (Principal) Pneumonia due to 2019 novel coronavirus  Initially tested positive for Covid on 8/3 Intubated and cannulated for VV ECMO on 8/20 Bivent w/ 50% FiO2; ECMO 100%, sweep 4 On Veletri: ECHO EF 60-80%, RV mildly dilated, fxn normal Wean settings as able Continue q4hr and PRN ABG's CXR as needed Continue diuresis with lasix drip  Patient presented as a transfer for management of Covid pneumonitis with ECMO.   He was supported for a short time,  But 6 days later a CT of the Brain revealed multiple intracranial hemorrhages with midline shift.  With these findings, comfort measures were undertaken, and he expired shortly after that."
	"1768225-1"	"1768225-1"	"ACUTE RESPIRATORY FAILURE"	"10001053"	"50-59 years"	"50-59"	"Fever, Aches, Shortness of breath/difficulty breathing, Cough Cause of death: ACUTE HYPOXIC RESPIRATORY FAILURE, COVID PNEUMONIA"
	"1768225-1"	"1768225-1"	"COUGH"	"10011224"	"50-59 years"	"50-59"	"Fever, Aches, Shortness of breath/difficulty breathing, Cough Cause of death: ACUTE HYPOXIC RESPIRATORY FAILURE, COVID PNEUMONIA"
	"1768225-1"	"1768225-1"	"COVID-19 PNEUMONIA"	"10084380"	"50-59 years"	"50-59"	"Fever, Aches, Shortness of breath/difficulty breathing, Cough Cause of death: ACUTE HYPOXIC RESPIRATORY FAILURE, COVID PNEUMONIA"
	"1768225-1"	"1768225-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Fever, Aches, Shortness of breath/difficulty breathing, Cough Cause of death: ACUTE HYPOXIC RESPIRATORY FAILURE, COVID PNEUMONIA"
	"1768225-1"	"1768225-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"Fever, Aches, Shortness of breath/difficulty breathing, Cough Cause of death: ACUTE HYPOXIC RESPIRATORY FAILURE, COVID PNEUMONIA"
	"1768225-1"	"1768225-1"	"PAIN"	"10033371"	"50-59 years"	"50-59"	"Fever, Aches, Shortness of breath/difficulty breathing, Cough Cause of death: ACUTE HYPOXIC RESPIRATORY FAILURE, COVID PNEUMONIA"
	"1768225-1"	"1768225-1"	"PYREXIA"	"10037660"	"50-59 years"	"50-59"	"Fever, Aches, Shortness of breath/difficulty breathing, Cough Cause of death: ACUTE HYPOXIC RESPIRATORY FAILURE, COVID PNEUMONIA"
	"1768576-1"	"1768576-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"death E87.1 - Hyponatremia"
	"1768576-1"	"1768576-1"	"HYPONATRAEMIA"	"10021036"	"50-59 years"	"50-59"	"death E87.1 - Hyponatremia"
	"1768972-1"	"1768972-1"	"CHEST X-RAY NORMAL"	"10008500"	"50-59 years"	"50-59"	"Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Moderna Vaccines on 3/31/2021 and 4/27/2021. Presented to ED on 9/10/2021 with complaint of confusion, as per family this happens when patient has urinary tract infection. Patient stated that she took a home urinary tract infection test kit which resulted positive. She was evaluated for urinary tract infection, but urinalysis was unremarkable.  Chest x-ray was normal, but she underwent CT of the abdomen and pelvis which did show findings in the lung bases consistent with pneumonia versus pneumonitis.  She was prescribed doxycycline, but stopped taking it after 2 days due to nausea. Subsequently changed to levofloxacin on 9/14/2021 during follow-up clinic visit. On 9/16/2021 patient presented to ED with shortness of breath, labored breathing, fever and chills. Placed on 6L O2 NC. Despite aggressive treatment, she has deteriorated and is no longer alert but is obtunded. Family has decided to transition to comfort care. Patient expired 9/25/2021."
	"1768972-1"	"1768972-1"	"CHILLS"	"10008531"	"50-59 years"	"50-59"	"Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Moderna Vaccines on 3/31/2021 and 4/27/2021. Presented to ED on 9/10/2021 with complaint of confusion, as per family this happens when patient has urinary tract infection. Patient stated that she took a home urinary tract infection test kit which resulted positive. She was evaluated for urinary tract infection, but urinalysis was unremarkable.  Chest x-ray was normal, but she underwent CT of the abdomen and pelvis which did show findings in the lung bases consistent with pneumonia versus pneumonitis.  She was prescribed doxycycline, but stopped taking it after 2 days due to nausea. Subsequently changed to levofloxacin on 9/14/2021 during follow-up clinic visit. On 9/16/2021 patient presented to ED with shortness of breath, labored breathing, fever and chills. Placed on 6L O2 NC. Despite aggressive treatment, she has deteriorated and is no longer alert but is obtunded. Family has decided to transition to comfort care. Patient expired 9/25/2021."
	"1768972-1"	"1768972-1"	"COMPUTERISED TOMOGRAM ABDOMEN ABNORMAL"	"10057798"	"50-59 years"	"50-59"	"Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Moderna Vaccines on 3/31/2021 and 4/27/2021. Presented to ED on 9/10/2021 with complaint of confusion, as per family this happens when patient has urinary tract infection. Patient stated that she took a home urinary tract infection test kit which resulted positive. She was evaluated for urinary tract infection, but urinalysis was unremarkable.  Chest x-ray was normal, but she underwent CT of the abdomen and pelvis which did show findings in the lung bases consistent with pneumonia versus pneumonitis.  She was prescribed doxycycline, but stopped taking it after 2 days due to nausea. Subsequently changed to levofloxacin on 9/14/2021 during follow-up clinic visit. On 9/16/2021 patient presented to ED with shortness of breath, labored breathing, fever and chills. Placed on 6L O2 NC. Despite aggressive treatment, she has deteriorated and is no longer alert but is obtunded. Family has decided to transition to comfort care. Patient expired 9/25/2021."
	"1768972-1"	"1768972-1"	"CONFUSIONAL STATE"	"10010305"	"50-59 years"	"50-59"	"Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Moderna Vaccines on 3/31/2021 and 4/27/2021. Presented to ED on 9/10/2021 with complaint of confusion, as per family this happens when patient has urinary tract infection. Patient stated that she took a home urinary tract infection test kit which resulted positive. She was evaluated for urinary tract infection, but urinalysis was unremarkable.  Chest x-ray was normal, but she underwent CT of the abdomen and pelvis which did show findings in the lung bases consistent with pneumonia versus pneumonitis.  She was prescribed doxycycline, but stopped taking it after 2 days due to nausea. Subsequently changed to levofloxacin on 9/14/2021 during follow-up clinic visit. On 9/16/2021 patient presented to ED with shortness of breath, labored breathing, fever and chills. Placed on 6L O2 NC. Despite aggressive treatment, she has deteriorated and is no longer alert but is obtunded. Family has decided to transition to comfort care. Patient expired 9/25/2021."
	"1768972-1"	"1768972-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Moderna Vaccines on 3/31/2021 and 4/27/2021. Presented to ED on 9/10/2021 with complaint of confusion, as per family this happens when patient has urinary tract infection. Patient stated that she took a home urinary tract infection test kit which resulted positive. She was evaluated for urinary tract infection, but urinalysis was unremarkable.  Chest x-ray was normal, but she underwent CT of the abdomen and pelvis which did show findings in the lung bases consistent with pneumonia versus pneumonitis.  She was prescribed doxycycline, but stopped taking it after 2 days due to nausea. Subsequently changed to levofloxacin on 9/14/2021 during follow-up clinic visit. On 9/16/2021 patient presented to ED with shortness of breath, labored breathing, fever and chills. Placed on 6L O2 NC. Despite aggressive treatment, she has deteriorated and is no longer alert but is obtunded. Family has decided to transition to comfort care. Patient expired 9/25/2021."
	"1768972-1"	"1768972-1"	"DEPRESSED LEVEL OF CONSCIOUSNESS"	"10012373"	"50-59 years"	"50-59"	"Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Moderna Vaccines on 3/31/2021 and 4/27/2021. Presented to ED on 9/10/2021 with complaint of confusion, as per family this happens when patient has urinary tract infection. Patient stated that she took a home urinary tract infection test kit which resulted positive. She was evaluated for urinary tract infection, but urinalysis was unremarkable.  Chest x-ray was normal, but she underwent CT of the abdomen and pelvis which did show findings in the lung bases consistent with pneumonia versus pneumonitis.  She was prescribed doxycycline, but stopped taking it after 2 days due to nausea. Subsequently changed to levofloxacin on 9/14/2021 during follow-up clinic visit. On 9/16/2021 patient presented to ED with shortness of breath, labored breathing, fever and chills. Placed on 6L O2 NC. Despite aggressive treatment, she has deteriorated and is no longer alert but is obtunded. Family has decided to transition to comfort care. Patient expired 9/25/2021."
	"1768972-1"	"1768972-1"	"DISTURBANCE IN ATTENTION"	"10013496"	"50-59 years"	"50-59"	"Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Moderna Vaccines on 3/31/2021 and 4/27/2021. Presented to ED on 9/10/2021 with complaint of confusion, as per family this happens when patient has urinary tract infection. Patient stated that she took a home urinary tract infection test kit which resulted positive. She was evaluated for urinary tract infection, but urinalysis was unremarkable.  Chest x-ray was normal, but she underwent CT of the abdomen and pelvis which did show findings in the lung bases consistent with pneumonia versus pneumonitis.  She was prescribed doxycycline, but stopped taking it after 2 days due to nausea. Subsequently changed to levofloxacin on 9/14/2021 during follow-up clinic visit. On 9/16/2021 patient presented to ED with shortness of breath, labored breathing, fever and chills. Placed on 6L O2 NC. Despite aggressive treatment, she has deteriorated and is no longer alert but is obtunded. Family has decided to transition to comfort care. Patient expired 9/25/2021."
	"1768972-1"	"1768972-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Moderna Vaccines on 3/31/2021 and 4/27/2021. Presented to ED on 9/10/2021 with complaint of confusion, as per family this happens when patient has urinary tract infection. Patient stated that she took a home urinary tract infection test kit which resulted positive. She was evaluated for urinary tract infection, but urinalysis was unremarkable.  Chest x-ray was normal, but she underwent CT of the abdomen and pelvis which did show findings in the lung bases consistent with pneumonia versus pneumonitis.  She was prescribed doxycycline, but stopped taking it after 2 days due to nausea. Subsequently changed to levofloxacin on 9/14/2021 during follow-up clinic visit. On 9/16/2021 patient presented to ED with shortness of breath, labored breathing, fever and chills. Placed on 6L O2 NC. Despite aggressive treatment, she has deteriorated and is no longer alert but is obtunded. Family has decided to transition to comfort care. Patient expired 9/25/2021."
	"1768972-1"	"1768972-1"	"GENERAL PHYSICAL HEALTH DETERIORATION"	"10049438"	"50-59 years"	"50-59"	"Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Moderna Vaccines on 3/31/2021 and 4/27/2021. Presented to ED on 9/10/2021 with complaint of confusion, as per family this happens when patient has urinary tract infection. Patient stated that she took a home urinary tract infection test kit which resulted positive. She was evaluated for urinary tract infection, but urinalysis was unremarkable.  Chest x-ray was normal, but she underwent CT of the abdomen and pelvis which did show findings in the lung bases consistent with pneumonia versus pneumonitis.  She was prescribed doxycycline, but stopped taking it after 2 days due to nausea. Subsequently changed to levofloxacin on 9/14/2021 during follow-up clinic visit. On 9/16/2021 patient presented to ED with shortness of breath, labored breathing, fever and chills. Placed on 6L O2 NC. Despite aggressive treatment, she has deteriorated and is no longer alert but is obtunded. Family has decided to transition to comfort care. Patient expired 9/25/2021."
	"1768972-1"	"1768972-1"	"PNEUMONIA"	"10035664"	"50-59 years"	"50-59"	"Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Moderna Vaccines on 3/31/2021 and 4/27/2021. Presented to ED on 9/10/2021 with complaint of confusion, as per family this happens when patient has urinary tract infection. Patient stated that she took a home urinary tract infection test kit which resulted positive. She was evaluated for urinary tract infection, but urinalysis was unremarkable.  Chest x-ray was normal, but she underwent CT of the abdomen and pelvis which did show findings in the lung bases consistent with pneumonia versus pneumonitis.  She was prescribed doxycycline, but stopped taking it after 2 days due to nausea. Subsequently changed to levofloxacin on 9/14/2021 during follow-up clinic visit. On 9/16/2021 patient presented to ED with shortness of breath, labored breathing, fever and chills. Placed on 6L O2 NC. Despite aggressive treatment, she has deteriorated and is no longer alert but is obtunded. Family has decided to transition to comfort care. Patient expired 9/25/2021."
	"1768972-1"	"1768972-1"	"PNEUMONITIS"	"10035742"	"50-59 years"	"50-59"	"Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Moderna Vaccines on 3/31/2021 and 4/27/2021. Presented to ED on 9/10/2021 with complaint of confusion, as per family this happens when patient has urinary tract infection. Patient stated that she took a home urinary tract infection test kit which resulted positive. She was evaluated for urinary tract infection, but urinalysis was unremarkable.  Chest x-ray was normal, but she underwent CT of the abdomen and pelvis which did show findings in the lung bases consistent with pneumonia versus pneumonitis.  She was prescribed doxycycline, but stopped taking it after 2 days due to nausea. Subsequently changed to levofloxacin on 9/14/2021 during follow-up clinic visit. On 9/16/2021 patient presented to ED with shortness of breath, labored breathing, fever and chills. Placed on 6L O2 NC. Despite aggressive treatment, she has deteriorated and is no longer alert but is obtunded. Family has decided to transition to comfort care. Patient expired 9/25/2021."
	"1768972-1"	"1768972-1"	"PYREXIA"	"10037660"	"50-59 years"	"50-59"	"Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Moderna Vaccines on 3/31/2021 and 4/27/2021. Presented to ED on 9/10/2021 with complaint of confusion, as per family this happens when patient has urinary tract infection. Patient stated that she took a home urinary tract infection test kit which resulted positive. She was evaluated for urinary tract infection, but urinalysis was unremarkable.  Chest x-ray was normal, but she underwent CT of the abdomen and pelvis which did show findings in the lung bases consistent with pneumonia versus pneumonitis.  She was prescribed doxycycline, but stopped taking it after 2 days due to nausea. Subsequently changed to levofloxacin on 9/14/2021 during follow-up clinic visit. On 9/16/2021 patient presented to ED with shortness of breath, labored breathing, fever and chills. Placed on 6L O2 NC. Despite aggressive treatment, she has deteriorated and is no longer alert but is obtunded. Family has decided to transition to comfort care. Patient expired 9/25/2021."
	"1768972-1"	"1768972-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Moderna Vaccines on 3/31/2021 and 4/27/2021. Presented to ED on 9/10/2021 with complaint of confusion, as per family this happens when patient has urinary tract infection. Patient stated that she took a home urinary tract infection test kit which resulted positive. She was evaluated for urinary tract infection, but urinalysis was unremarkable.  Chest x-ray was normal, but she underwent CT of the abdomen and pelvis which did show findings in the lung bases consistent with pneumonia versus pneumonitis.  She was prescribed doxycycline, but stopped taking it after 2 days due to nausea. Subsequently changed to levofloxacin on 9/14/2021 during follow-up clinic visit. On 9/16/2021 patient presented to ED with shortness of breath, labored breathing, fever and chills. Placed on 6L O2 NC. Despite aggressive treatment, she has deteriorated and is no longer alert but is obtunded. Family has decided to transition to comfort care. Patient expired 9/25/2021."
	"1768972-1"	"1768972-1"	"URINE ANALYSIS"	"10046614"	"50-59 years"	"50-59"	"Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Moderna Vaccines on 3/31/2021 and 4/27/2021. Presented to ED on 9/10/2021 with complaint of confusion, as per family this happens when patient has urinary tract infection. Patient stated that she took a home urinary tract infection test kit which resulted positive. She was evaluated for urinary tract infection, but urinalysis was unremarkable.  Chest x-ray was normal, but she underwent CT of the abdomen and pelvis which did show findings in the lung bases consistent with pneumonia versus pneumonitis.  She was prescribed doxycycline, but stopped taking it after 2 days due to nausea. Subsequently changed to levofloxacin on 9/14/2021 during follow-up clinic visit. On 9/16/2021 patient presented to ED with shortness of breath, labored breathing, fever and chills. Placed on 6L O2 NC. Despite aggressive treatment, she has deteriorated and is no longer alert but is obtunded. Family has decided to transition to comfort care. Patient expired 9/25/2021."
	"1768972-1"	"1768972-1"	"URINE ANALYSIS NORMAL"	"10061578"	"50-59 years"	"50-59"	"Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Moderna Vaccines on 3/31/2021 and 4/27/2021. Presented to ED on 9/10/2021 with complaint of confusion, as per family this happens when patient has urinary tract infection. Patient stated that she took a home urinary tract infection test kit which resulted positive. She was evaluated for urinary tract infection, but urinalysis was unremarkable.  Chest x-ray was normal, but she underwent CT of the abdomen and pelvis which did show findings in the lung bases consistent with pneumonia versus pneumonitis.  She was prescribed doxycycline, but stopped taking it after 2 days due to nausea. Subsequently changed to levofloxacin on 9/14/2021 during follow-up clinic visit. On 9/16/2021 patient presented to ED with shortness of breath, labored breathing, fever and chills. Placed on 6L O2 NC. Despite aggressive treatment, she has deteriorated and is no longer alert but is obtunded. Family has decided to transition to comfort care. Patient expired 9/25/2021."
	"1771570-1"	"1771570-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Patient expired with COVID-19 after COVID-19 vaccination"
	"1771570-1"	"1771570-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient expired with COVID-19 after COVID-19 vaccination"
	"1771570-1"	"1771570-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"Patient expired with COVID-19 after COVID-19 vaccination"
	"1775206-1"	"1775206-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"myocardial infarction resulting in death"
	"1775206-1"	"1775206-1"	"MYOCARDIAL INFARCTION"	"10028596"	"50-59 years"	"50-59"	"myocardial infarction resulting in death"
	"1776306-1"	"1776306-1"	"APNOEA"	"10002974"	"50-59 years"	"50-59"	"On 09/10/21:  Patient is a 57 y.o. male with recent COVID infection, HFpEF, NASH cirrhosis, CKD IIIb, and IDDM2 who presented to ED via EMS post-code after PEA arrest. According to patient's wife, he developed acutely worsening shortness of breath early this morning. Wife called EMS after his shortness of breath did not improve upon resuming his home oxygen 3L NC which he had discontinued two days prior due to subjective improvement. Family estimates he stopped breathing less than 5 minutes prior to EMS arrival. EMS reports patient was apneic and in wide-complex PEA on arrival. He was coded for 20 minutes before ROSC. He arrived intubated and on levophed.    Cardiogenic etiology considered due to transient hypoxia; however troponins without significant delta, EKG did not show ST abnormalities concerning for ischemia, or MI. Bedside echo without concerning findings. Infectious workup negative. Aggressively diuresed patient with minimal renal recovery. On exam patient was lacking gag reflex and pupils unreactive. Due to concern for severe anoxic encephalopathy and PVS, all sedation was stopped. Patient remained without any purposeful movement, without gag reflex, and without reactive pupils after >48 hours of complete cessation of sedating agents. Poor prognosis discussed with wife (NOK) and daughter. They both stated he has previously said he would not want to continue with current measures in this type of situation. Wife (NOK) ultimately decided to withdrawal care and pursue comfort care. Patient was terminally extubated and discharged to inpatient hospice"
	"1776306-1"	"1776306-1"	"AREFLEXIA"	"10003084"	"50-59 years"	"50-59"	"On 09/10/21:  Patient is a 57 y.o. male with recent COVID infection, HFpEF, NASH cirrhosis, CKD IIIb, and IDDM2 who presented to ED via EMS post-code after PEA arrest. According to patient's wife, he developed acutely worsening shortness of breath early this morning. Wife called EMS after his shortness of breath did not improve upon resuming his home oxygen 3L NC which he had discontinued two days prior due to subjective improvement. Family estimates he stopped breathing less than 5 minutes prior to EMS arrival. EMS reports patient was apneic and in wide-complex PEA on arrival. He was coded for 20 minutes before ROSC. He arrived intubated and on levophed.    Cardiogenic etiology considered due to transient hypoxia; however troponins without significant delta, EKG did not show ST abnormalities concerning for ischemia, or MI. Bedside echo without concerning findings. Infectious workup negative. Aggressively diuresed patient with minimal renal recovery. On exam patient was lacking gag reflex and pupils unreactive. Due to concern for severe anoxic encephalopathy and PVS, all sedation was stopped. Patient remained without any purposeful movement, without gag reflex, and without reactive pupils after >48 hours of complete cessation of sedating agents. Poor prognosis discussed with wife (NOK) and daughter. They both stated he has previously said he would not want to continue with current measures in this type of situation. Wife (NOK) ultimately decided to withdrawal care and pursue comfort care. Patient was terminally extubated and discharged to inpatient hospice"
	"1776306-1"	"1776306-1"	"CARDIO-RESPIRATORY ARREST"	"10007617"	"50-59 years"	"50-59"	"On 09/10/21:  Patient is a 57 y.o. male with recent COVID infection, HFpEF, NASH cirrhosis, CKD IIIb, and IDDM2 who presented to ED via EMS post-code after PEA arrest. According to patient's wife, he developed acutely worsening shortness of breath early this morning. Wife called EMS after his shortness of breath did not improve upon resuming his home oxygen 3L NC which he had discontinued two days prior due to subjective improvement. Family estimates he stopped breathing less than 5 minutes prior to EMS arrival. EMS reports patient was apneic and in wide-complex PEA on arrival. He was coded for 20 minutes before ROSC. He arrived intubated and on levophed.    Cardiogenic etiology considered due to transient hypoxia; however troponins without significant delta, EKG did not show ST abnormalities concerning for ischemia, or MI. Bedside echo without concerning findings. Infectious workup negative. Aggressively diuresed patient with minimal renal recovery. On exam patient was lacking gag reflex and pupils unreactive. Due to concern for severe anoxic encephalopathy and PVS, all sedation was stopped. Patient remained without any purposeful movement, without gag reflex, and without reactive pupils after >48 hours of complete cessation of sedating agents. Poor prognosis discussed with wife (NOK) and daughter. They both stated he has previously said he would not want to continue with current measures in this type of situation. Wife (NOK) ultimately decided to withdrawal care and pursue comfort care. Patient was terminally extubated and discharged to inpatient hospice"
	"1776306-1"	"1776306-1"	"CELLULITIS"	"10007882"	"50-59 years"	"50-59"	"On 09/10/21:  Patient is a 57 y.o. male with recent COVID infection, HFpEF, NASH cirrhosis, CKD IIIb, and IDDM2 who presented to ED via EMS post-code after PEA arrest. According to patient's wife, he developed acutely worsening shortness of breath early this morning. Wife called EMS after his shortness of breath did not improve upon resuming his home oxygen 3L NC which he had discontinued two days prior due to subjective improvement. Family estimates he stopped breathing less than 5 minutes prior to EMS arrival. EMS reports patient was apneic and in wide-complex PEA on arrival. He was coded for 20 minutes before ROSC. He arrived intubated and on levophed.    Cardiogenic etiology considered due to transient hypoxia; however troponins without significant delta, EKG did not show ST abnormalities concerning for ischemia, or MI. Bedside echo without concerning findings. Infectious workup negative. Aggressively diuresed patient with minimal renal recovery. On exam patient was lacking gag reflex and pupils unreactive. Due to concern for severe anoxic encephalopathy and PVS, all sedation was stopped. Patient remained without any purposeful movement, without gag reflex, and without reactive pupils after >48 hours of complete cessation of sedating agents. Poor prognosis discussed with wife (NOK) and daughter. They both stated he has previously said he would not want to continue with current measures in this type of situation. Wife (NOK) ultimately decided to withdrawal care and pursue comfort care. Patient was terminally extubated and discharged to inpatient hospice"
	"1776306-1"	"1776306-1"	"CHRONIC KIDNEY DISEASE"	"10064848"	"50-59 years"	"50-59"	"On 09/10/21:  Patient is a 57 y.o. male with recent COVID infection, HFpEF, NASH cirrhosis, CKD IIIb, and IDDM2 who presented to ED via EMS post-code after PEA arrest. According to patient's wife, he developed acutely worsening shortness of breath early this morning. Wife called EMS after his shortness of breath did not improve upon resuming his home oxygen 3L NC which he had discontinued two days prior due to subjective improvement. Family estimates he stopped breathing less than 5 minutes prior to EMS arrival. EMS reports patient was apneic and in wide-complex PEA on arrival. He was coded for 20 minutes before ROSC. He arrived intubated and on levophed.    Cardiogenic etiology considered due to transient hypoxia; however troponins without significant delta, EKG did not show ST abnormalities concerning for ischemia, or MI. Bedside echo without concerning findings. Infectious workup negative. Aggressively diuresed patient with minimal renal recovery. On exam patient was lacking gag reflex and pupils unreactive. Due to concern for severe anoxic encephalopathy and PVS, all sedation was stopped. Patient remained without any purposeful movement, without gag reflex, and without reactive pupils after >48 hours of complete cessation of sedating agents. Poor prognosis discussed with wife (NOK) and daughter. They both stated he has previously said he would not want to continue with current measures in this type of situation. Wife (NOK) ultimately decided to withdrawal care and pursue comfort care. Patient was terminally extubated and discharged to inpatient hospice"
	"1776306-1"	"1776306-1"	"CONDITION AGGRAVATED"	"10010264"	"50-59 years"	"50-59"	"On 09/10/21:  Patient is a 57 y.o. male with recent COVID infection, HFpEF, NASH cirrhosis, CKD IIIb, and IDDM2 who presented to ED via EMS post-code after PEA arrest. According to patient's wife, he developed acutely worsening shortness of breath early this morning. Wife called EMS after his shortness of breath did not improve upon resuming his home oxygen 3L NC which he had discontinued two days prior due to subjective improvement. Family estimates he stopped breathing less than 5 minutes prior to EMS arrival. EMS reports patient was apneic and in wide-complex PEA on arrival. He was coded for 20 minutes before ROSC. He arrived intubated and on levophed.    Cardiogenic etiology considered due to transient hypoxia; however troponins without significant delta, EKG did not show ST abnormalities concerning for ischemia, or MI. Bedside echo without concerning findings. Infectious workup negative. Aggressively diuresed patient with minimal renal recovery. On exam patient was lacking gag reflex and pupils unreactive. Due to concern for severe anoxic encephalopathy and PVS, all sedation was stopped. Patient remained without any purposeful movement, without gag reflex, and without reactive pupils after >48 hours of complete cessation of sedating agents. Poor prognosis discussed with wife (NOK) and daughter. They both stated he has previously said he would not want to continue with current measures in this type of situation. Wife (NOK) ultimately decided to withdrawal care and pursue comfort care. Patient was terminally extubated and discharged to inpatient hospice"
	"1776306-1"	"1776306-1"	"COUGH"	"10011224"	"50-59 years"	"50-59"	"On 09/10/21:  Patient is a 57 y.o. male with recent COVID infection, HFpEF, NASH cirrhosis, CKD IIIb, and IDDM2 who presented to ED via EMS post-code after PEA arrest. According to patient's wife, he developed acutely worsening shortness of breath early this morning. Wife called EMS after his shortness of breath did not improve upon resuming his home oxygen 3L NC which he had discontinued two days prior due to subjective improvement. Family estimates he stopped breathing less than 5 minutes prior to EMS arrival. EMS reports patient was apneic and in wide-complex PEA on arrival. He was coded for 20 minutes before ROSC. He arrived intubated and on levophed.    Cardiogenic etiology considered due to transient hypoxia; however troponins without significant delta, EKG did not show ST abnormalities concerning for ischemia, or MI. Bedside echo without concerning findings. Infectious workup negative. Aggressively diuresed patient with minimal renal recovery. On exam patient was lacking gag reflex and pupils unreactive. Due to concern for severe anoxic encephalopathy and PVS, all sedation was stopped. Patient remained without any purposeful movement, without gag reflex, and without reactive pupils after >48 hours of complete cessation of sedating agents. Poor prognosis discussed with wife (NOK) and daughter. They both stated he has previously said he would not want to continue with current measures in this type of situation. Wife (NOK) ultimately decided to withdrawal care and pursue comfort care. Patient was terminally extubated and discharged to inpatient hospice"
	"1776306-1"	"1776306-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"On 09/10/21:  Patient is a 57 y.o. male with recent COVID infection, HFpEF, NASH cirrhosis, CKD IIIb, and IDDM2 who presented to ED via EMS post-code after PEA arrest. According to patient's wife, he developed acutely worsening shortness of breath early this morning. Wife called EMS after his shortness of breath did not improve upon resuming his home oxygen 3L NC which he had discontinued two days prior due to subjective improvement. Family estimates he stopped breathing less than 5 minutes prior to EMS arrival. EMS reports patient was apneic and in wide-complex PEA on arrival. He was coded for 20 minutes before ROSC. He arrived intubated and on levophed.    Cardiogenic etiology considered due to transient hypoxia; however troponins without significant delta, EKG did not show ST abnormalities concerning for ischemia, or MI. Bedside echo without concerning findings. Infectious workup negative. Aggressively diuresed patient with minimal renal recovery. On exam patient was lacking gag reflex and pupils unreactive. Due to concern for severe anoxic encephalopathy and PVS, all sedation was stopped. Patient remained without any purposeful movement, without gag reflex, and without reactive pupils after >48 hours of complete cessation of sedating agents. Poor prognosis discussed with wife (NOK) and daughter. They both stated he has previously said he would not want to continue with current measures in this type of situation. Wife (NOK) ultimately decided to withdrawal care and pursue comfort care. Patient was terminally extubated and discharged to inpatient hospice"
	"1776306-1"	"1776306-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"On 09/10/21:  Patient is a 57 y.o. male with recent COVID infection, HFpEF, NASH cirrhosis, CKD IIIb, and IDDM2 who presented to ED via EMS post-code after PEA arrest. According to patient's wife, he developed acutely worsening shortness of breath early this morning. Wife called EMS after his shortness of breath did not improve upon resuming his home oxygen 3L NC which he had discontinued two days prior due to subjective improvement. Family estimates he stopped breathing less than 5 minutes prior to EMS arrival. EMS reports patient was apneic and in wide-complex PEA on arrival. He was coded for 20 minutes before ROSC. He arrived intubated and on levophed.    Cardiogenic etiology considered due to transient hypoxia; however troponins without significant delta, EKG did not show ST abnormalities concerning for ischemia, or MI. Bedside echo without concerning findings. Infectious workup negative. Aggressively diuresed patient with minimal renal recovery. On exam patient was lacking gag reflex and pupils unreactive. Due to concern for severe anoxic encephalopathy and PVS, all sedation was stopped. Patient remained without any purposeful movement, without gag reflex, and without reactive pupils after >48 hours of complete cessation of sedating agents. Poor prognosis discussed with wife (NOK) and daughter. They both stated he has previously said he would not want to continue with current measures in this type of situation. Wife (NOK) ultimately decided to withdrawal care and pursue comfort care. Patient was terminally extubated and discharged to inpatient hospice"
	"1776306-1"	"1776306-1"	"ECHOCARDIOGRAM NORMAL"	"10014115"	"50-59 years"	"50-59"	"On 09/10/21:  Patient is a 57 y.o. male with recent COVID infection, HFpEF, NASH cirrhosis, CKD IIIb, and IDDM2 who presented to ED via EMS post-code after PEA arrest. According to patient's wife, he developed acutely worsening shortness of breath early this morning. Wife called EMS after his shortness of breath did not improve upon resuming his home oxygen 3L NC which he had discontinued two days prior due to subjective improvement. Family estimates he stopped breathing less than 5 minutes prior to EMS arrival. EMS reports patient was apneic and in wide-complex PEA on arrival. He was coded for 20 minutes before ROSC. He arrived intubated and on levophed.    Cardiogenic etiology considered due to transient hypoxia; however troponins without significant delta, EKG did not show ST abnormalities concerning for ischemia, or MI. Bedside echo without concerning findings. Infectious workup negative. Aggressively diuresed patient with minimal renal recovery. On exam patient was lacking gag reflex and pupils unreactive. Due to concern for severe anoxic encephalopathy and PVS, all sedation was stopped. Patient remained without any purposeful movement, without gag reflex, and without reactive pupils after >48 hours of complete cessation of sedating agents. Poor prognosis discussed with wife (NOK) and daughter. They both stated he has previously said he would not want to continue with current measures in this type of situation. Wife (NOK) ultimately decided to withdrawal care and pursue comfort care. Patient was terminally extubated and discharged to inpatient hospice"
	"1776306-1"	"1776306-1"	"ELECTROCARDIOGRAM NORMAL"	"10014373"	"50-59 years"	"50-59"	"On 09/10/21:  Patient is a 57 y.o. male with recent COVID infection, HFpEF, NASH cirrhosis, CKD IIIb, and IDDM2 who presented to ED via EMS post-code after PEA arrest. According to patient's wife, he developed acutely worsening shortness of breath early this morning. Wife called EMS after his shortness of breath did not improve upon resuming his home oxygen 3L NC which he had discontinued two days prior due to subjective improvement. Family estimates he stopped breathing less than 5 minutes prior to EMS arrival. EMS reports patient was apneic and in wide-complex PEA on arrival. He was coded for 20 minutes before ROSC. He arrived intubated and on levophed.    Cardiogenic etiology considered due to transient hypoxia; however troponins without significant delta, EKG did not show ST abnormalities concerning for ischemia, or MI. Bedside echo without concerning findings. Infectious workup negative. Aggressively diuresed patient with minimal renal recovery. On exam patient was lacking gag reflex and pupils unreactive. Due to concern for severe anoxic encephalopathy and PVS, all sedation was stopped. Patient remained without any purposeful movement, without gag reflex, and without reactive pupils after >48 hours of complete cessation of sedating agents. Poor prognosis discussed with wife (NOK) and daughter. They both stated he has previously said he would not want to continue with current measures in this type of situation. Wife (NOK) ultimately decided to withdrawal care and pursue comfort care. Patient was terminally extubated and discharged to inpatient hospice"
	"1776306-1"	"1776306-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"50-59 years"	"50-59"	"On 09/10/21:  Patient is a 57 y.o. male with recent COVID infection, HFpEF, NASH cirrhosis, CKD IIIb, and IDDM2 who presented to ED via EMS post-code after PEA arrest. According to patient's wife, he developed acutely worsening shortness of breath early this morning. Wife called EMS after his shortness of breath did not improve upon resuming his home oxygen 3L NC which he had discontinued two days prior due to subjective improvement. Family estimates he stopped breathing less than 5 minutes prior to EMS arrival. EMS reports patient was apneic and in wide-complex PEA on arrival. He was coded for 20 minutes before ROSC. He arrived intubated and on levophed.    Cardiogenic etiology considered due to transient hypoxia; however troponins without significant delta, EKG did not show ST abnormalities concerning for ischemia, or MI. Bedside echo without concerning findings. Infectious workup negative. Aggressively diuresed patient with minimal renal recovery. On exam patient was lacking gag reflex and pupils unreactive. Due to concern for severe anoxic encephalopathy and PVS, all sedation was stopped. Patient remained without any purposeful movement, without gag reflex, and without reactive pupils after >48 hours of complete cessation of sedating agents. Poor prognosis discussed with wife (NOK) and daughter. They both stated he has previously said he would not want to continue with current measures in this type of situation. Wife (NOK) ultimately decided to withdrawal care and pursue comfort care. Patient was terminally extubated and discharged to inpatient hospice"
	"1776306-1"	"1776306-1"	"HYPERVOLAEMIA"	"10020919"	"50-59 years"	"50-59"	"On 09/10/21:  Patient is a 57 y.o. male with recent COVID infection, HFpEF, NASH cirrhosis, CKD IIIb, and IDDM2 who presented to ED via EMS post-code after PEA arrest. According to patient's wife, he developed acutely worsening shortness of breath early this morning. Wife called EMS after his shortness of breath did not improve upon resuming his home oxygen 3L NC which he had discontinued two days prior due to subjective improvement. Family estimates he stopped breathing less than 5 minutes prior to EMS arrival. EMS reports patient was apneic and in wide-complex PEA on arrival. He was coded for 20 minutes before ROSC. He arrived intubated and on levophed.    Cardiogenic etiology considered due to transient hypoxia; however troponins without significant delta, EKG did not show ST abnormalities concerning for ischemia, or MI. Bedside echo without concerning findings. Infectious workup negative. Aggressively diuresed patient with minimal renal recovery. On exam patient was lacking gag reflex and pupils unreactive. Due to concern for severe anoxic encephalopathy and PVS, all sedation was stopped. Patient remained without any purposeful movement, without gag reflex, and without reactive pupils after >48 hours of complete cessation of sedating agents. Poor prognosis discussed with wife (NOK) and daughter. They both stated he has previously said he would not want to continue with current measures in this type of situation. Wife (NOK) ultimately decided to withdrawal care and pursue comfort care. Patient was terminally extubated and discharged to inpatient hospice"
	"1776306-1"	"1776306-1"	"HYPOXIA"	"10021143"	"50-59 years"	"50-59"	"On 09/10/21:  Patient is a 57 y.o. male with recent COVID infection, HFpEF, NASH cirrhosis, CKD IIIb, and IDDM2 who presented to ED via EMS post-code after PEA arrest. According to patient's wife, he developed acutely worsening shortness of breath early this morning. Wife called EMS after his shortness of breath did not improve upon resuming his home oxygen 3L NC which he had discontinued two days prior due to subjective improvement. Family estimates he stopped breathing less than 5 minutes prior to EMS arrival. EMS reports patient was apneic and in wide-complex PEA on arrival. He was coded for 20 minutes before ROSC. He arrived intubated and on levophed.    Cardiogenic etiology considered due to transient hypoxia; however troponins without significant delta, EKG did not show ST abnormalities concerning for ischemia, or MI. Bedside echo without concerning findings. Infectious workup negative. Aggressively diuresed patient with minimal renal recovery. On exam patient was lacking gag reflex and pupils unreactive. Due to concern for severe anoxic encephalopathy and PVS, all sedation was stopped. Patient remained without any purposeful movement, without gag reflex, and without reactive pupils after >48 hours of complete cessation of sedating agents. Poor prognosis discussed with wife (NOK) and daughter. They both stated he has previously said he would not want to continue with current measures in this type of situation. Wife (NOK) ultimately decided to withdrawal care and pursue comfort care. Patient was terminally extubated and discharged to inpatient hospice"
	"1776306-1"	"1776306-1"	"LABORATORY TEST NORMAL"	"10054052"	"50-59 years"	"50-59"	"On 09/10/21:  Patient is a 57 y.o. male with recent COVID infection, HFpEF, NASH cirrhosis, CKD IIIb, and IDDM2 who presented to ED via EMS post-code after PEA arrest. According to patient's wife, he developed acutely worsening shortness of breath early this morning. Wife called EMS after his shortness of breath did not improve upon resuming his home oxygen 3L NC which he had discontinued two days prior due to subjective improvement. Family estimates he stopped breathing less than 5 minutes prior to EMS arrival. EMS reports patient was apneic and in wide-complex PEA on arrival. He was coded for 20 minutes before ROSC. He arrived intubated and on levophed.    Cardiogenic etiology considered due to transient hypoxia; however troponins without significant delta, EKG did not show ST abnormalities concerning for ischemia, or MI. Bedside echo without concerning findings. Infectious workup negative. Aggressively diuresed patient with minimal renal recovery. On exam patient was lacking gag reflex and pupils unreactive. Due to concern for severe anoxic encephalopathy and PVS, all sedation was stopped. Patient remained without any purposeful movement, without gag reflex, and without reactive pupils after >48 hours of complete cessation of sedating agents. Poor prognosis discussed with wife (NOK) and daughter. They both stated he has previously said he would not want to continue with current measures in this type of situation. Wife (NOK) ultimately decided to withdrawal care and pursue comfort care. Patient was terminally extubated and discharged to inpatient hospice"
	"1776306-1"	"1776306-1"	"LIVER DISORDER"	"10024670"	"50-59 years"	"50-59"	"On 09/10/21:  Patient is a 57 y.o. male with recent COVID infection, HFpEF, NASH cirrhosis, CKD IIIb, and IDDM2 who presented to ED via EMS post-code after PEA arrest. According to patient's wife, he developed acutely worsening shortness of breath early this morning. Wife called EMS after his shortness of breath did not improve upon resuming his home oxygen 3L NC which he had discontinued two days prior due to subjective improvement. Family estimates he stopped breathing less than 5 minutes prior to EMS arrival. EMS reports patient was apneic and in wide-complex PEA on arrival. He was coded for 20 minutes before ROSC. He arrived intubated and on levophed.    Cardiogenic etiology considered due to transient hypoxia; however troponins without significant delta, EKG did not show ST abnormalities concerning for ischemia, or MI. Bedside echo without concerning findings. Infectious workup negative. Aggressively diuresed patient with minimal renal recovery. On exam patient was lacking gag reflex and pupils unreactive. Due to concern for severe anoxic encephalopathy and PVS, all sedation was stopped. Patient remained without any purposeful movement, without gag reflex, and without reactive pupils after >48 hours of complete cessation of sedating agents. Poor prognosis discussed with wife (NOK) and daughter. They both stated he has previously said he would not want to continue with current measures in this type of situation. Wife (NOK) ultimately decided to withdrawal care and pursue comfort care. Patient was terminally extubated and discharged to inpatient hospice"
	"1776306-1"	"1776306-1"	"OXYGEN SATURATION DECREASED"	"10033318"	"50-59 years"	"50-59"	"On 09/10/21:  Patient is a 57 y.o. male with recent COVID infection, HFpEF, NASH cirrhosis, CKD IIIb, and IDDM2 who presented to ED via EMS post-code after PEA arrest. According to patient's wife, he developed acutely worsening shortness of breath early this morning. Wife called EMS after his shortness of breath did not improve upon resuming his home oxygen 3L NC which he had discontinued two days prior due to subjective improvement. Family estimates he stopped breathing less than 5 minutes prior to EMS arrival. EMS reports patient was apneic and in wide-complex PEA on arrival. He was coded for 20 minutes before ROSC. He arrived intubated and on levophed.    Cardiogenic etiology considered due to transient hypoxia; however troponins without significant delta, EKG did not show ST abnormalities concerning for ischemia, or MI. Bedside echo without concerning findings. Infectious workup negative. Aggressively diuresed patient with minimal renal recovery. On exam patient was lacking gag reflex and pupils unreactive. Due to concern for severe anoxic encephalopathy and PVS, all sedation was stopped. Patient remained without any purposeful movement, without gag reflex, and without reactive pupils after >48 hours of complete cessation of sedating agents. Poor prognosis discussed with wife (NOK) and daughter. They both stated he has previously said he would not want to continue with current measures in this type of situation. Wife (NOK) ultimately decided to withdrawal care and pursue comfort care. Patient was terminally extubated and discharged to inpatient hospice"
	"1776306-1"	"1776306-1"	"PERIPHERAL SWELLING"	"10048959"	"50-59 years"	"50-59"	"On 09/10/21:  Patient is a 57 y.o. male with recent COVID infection, HFpEF, NASH cirrhosis, CKD IIIb, and IDDM2 who presented to ED via EMS post-code after PEA arrest. According to patient's wife, he developed acutely worsening shortness of breath early this morning. Wife called EMS after his shortness of breath did not improve upon resuming his home oxygen 3L NC which he had discontinued two days prior due to subjective improvement. Family estimates he stopped breathing less than 5 minutes prior to EMS arrival. EMS reports patient was apneic and in wide-complex PEA on arrival. He was coded for 20 minutes before ROSC. He arrived intubated and on levophed.    Cardiogenic etiology considered due to transient hypoxia; however troponins without significant delta, EKG did not show ST abnormalities concerning for ischemia, or MI. Bedside echo without concerning findings. Infectious workup negative. Aggressively diuresed patient with minimal renal recovery. On exam patient was lacking gag reflex and pupils unreactive. Due to concern for severe anoxic encephalopathy and PVS, all sedation was stopped. Patient remained without any purposeful movement, without gag reflex, and without reactive pupils after >48 hours of complete cessation of sedating agents. Poor prognosis discussed with wife (NOK) and daughter. They both stated he has previously said he would not want to continue with current measures in this type of situation. Wife (NOK) ultimately decided to withdrawal care and pursue comfort care. Patient was terminally extubated and discharged to inpatient hospice"
	"1776306-1"	"1776306-1"	"PULMONARY OEDEMA"	"10037423"	"50-59 years"	"50-59"	"On 09/10/21:  Patient is a 57 y.o. male with recent COVID infection, HFpEF, NASH cirrhosis, CKD IIIb, and IDDM2 who presented to ED via EMS post-code after PEA arrest. According to patient's wife, he developed acutely worsening shortness of breath early this morning. Wife called EMS after his shortness of breath did not improve upon resuming his home oxygen 3L NC which he had discontinued two days prior due to subjective improvement. Family estimates he stopped breathing less than 5 minutes prior to EMS arrival. EMS reports patient was apneic and in wide-complex PEA on arrival. He was coded for 20 minutes before ROSC. He arrived intubated and on levophed.    Cardiogenic etiology considered due to transient hypoxia; however troponins without significant delta, EKG did not show ST abnormalities concerning for ischemia, or MI. Bedside echo without concerning findings. Infectious workup negative. Aggressively diuresed patient with minimal renal recovery. On exam patient was lacking gag reflex and pupils unreactive. Due to concern for severe anoxic encephalopathy and PVS, all sedation was stopped. Patient remained without any purposeful movement, without gag reflex, and without reactive pupils after >48 hours of complete cessation of sedating agents. Poor prognosis discussed with wife (NOK) and daughter. They both stated he has previously said he would not want to continue with current measures in this type of situation. Wife (NOK) ultimately decided to withdrawal care and pursue comfort care. Patient was terminally extubated and discharged to inpatient hospice"
	"1776306-1"	"1776306-1"	"PULSELESS ELECTRICAL ACTIVITY"	"10058151"	"50-59 years"	"50-59"	"On 09/10/21:  Patient is a 57 y.o. male with recent COVID infection, HFpEF, NASH cirrhosis, CKD IIIb, and IDDM2 who presented to ED via EMS post-code after PEA arrest. According to patient's wife, he developed acutely worsening shortness of breath early this morning. Wife called EMS after his shortness of breath did not improve upon resuming his home oxygen 3L NC which he had discontinued two days prior due to subjective improvement. Family estimates he stopped breathing less than 5 minutes prior to EMS arrival. EMS reports patient was apneic and in wide-complex PEA on arrival. He was coded for 20 minutes before ROSC. He arrived intubated and on levophed.    Cardiogenic etiology considered due to transient hypoxia; however troponins without significant delta, EKG did not show ST abnormalities concerning for ischemia, or MI. Bedside echo without concerning findings. Infectious workup negative. Aggressively diuresed patient with minimal renal recovery. On exam patient was lacking gag reflex and pupils unreactive. Due to concern for severe anoxic encephalopathy and PVS, all sedation was stopped. Patient remained without any purposeful movement, without gag reflex, and without reactive pupils after >48 hours of complete cessation of sedating agents. Poor prognosis discussed with wife (NOK) and daughter. They both stated he has previously said he would not want to continue with current measures in this type of situation. Wife (NOK) ultimately decided to withdrawal care and pursue comfort care. Patient was terminally extubated and discharged to inpatient hospice"
	"1776306-1"	"1776306-1"	"PUPIL FIXED"	"10037515"	"50-59 years"	"50-59"	"On 09/10/21:  Patient is a 57 y.o. male with recent COVID infection, HFpEF, NASH cirrhosis, CKD IIIb, and IDDM2 who presented to ED via EMS post-code after PEA arrest. According to patient's wife, he developed acutely worsening shortness of breath early this morning. Wife called EMS after his shortness of breath did not improve upon resuming his home oxygen 3L NC which he had discontinued two days prior due to subjective improvement. Family estimates he stopped breathing less than 5 minutes prior to EMS arrival. EMS reports patient was apneic and in wide-complex PEA on arrival. He was coded for 20 minutes before ROSC. He arrived intubated and on levophed.    Cardiogenic etiology considered due to transient hypoxia; however troponins without significant delta, EKG did not show ST abnormalities concerning for ischemia, or MI. Bedside echo without concerning findings. Infectious workup negative. Aggressively diuresed patient with minimal renal recovery. On exam patient was lacking gag reflex and pupils unreactive. Due to concern for severe anoxic encephalopathy and PVS, all sedation was stopped. Patient remained without any purposeful movement, without gag reflex, and without reactive pupils after >48 hours of complete cessation of sedating agents. Poor prognosis discussed with wife (NOK) and daughter. They both stated he has previously said he would not want to continue with current measures in this type of situation. Wife (NOK) ultimately decided to withdrawal care and pursue comfort care. Patient was terminally extubated and discharged to inpatient hospice"
	"1776306-1"	"1776306-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"On 09/10/21:  Patient is a 57 y.o. male with recent COVID infection, HFpEF, NASH cirrhosis, CKD IIIb, and IDDM2 who presented to ED via EMS post-code after PEA arrest. According to patient's wife, he developed acutely worsening shortness of breath early this morning. Wife called EMS after his shortness of breath did not improve upon resuming his home oxygen 3L NC which he had discontinued two days prior due to subjective improvement. Family estimates he stopped breathing less than 5 minutes prior to EMS arrival. EMS reports patient was apneic and in wide-complex PEA on arrival. He was coded for 20 minutes before ROSC. He arrived intubated and on levophed.    Cardiogenic etiology considered due to transient hypoxia; however troponins without significant delta, EKG did not show ST abnormalities concerning for ischemia, or MI. Bedside echo without concerning findings. Infectious workup negative. Aggressively diuresed patient with minimal renal recovery. On exam patient was lacking gag reflex and pupils unreactive. Due to concern for severe anoxic encephalopathy and PVS, all sedation was stopped. Patient remained without any purposeful movement, without gag reflex, and without reactive pupils after >48 hours of complete cessation of sedating agents. Poor prognosis discussed with wife (NOK) and daughter. They both stated he has previously said he would not want to continue with current measures in this type of situation. Wife (NOK) ultimately decided to withdrawal care and pursue comfort care. Patient was terminally extubated and discharged to inpatient hospice"
	"1776306-1"	"1776306-1"	"TROPONIN NORMAL"	"10071322"	"50-59 years"	"50-59"	"On 09/10/21:  Patient is a 57 y.o. male with recent COVID infection, HFpEF, NASH cirrhosis, CKD IIIb, and IDDM2 who presented to ED via EMS post-code after PEA arrest. According to patient's wife, he developed acutely worsening shortness of breath early this morning. Wife called EMS after his shortness of breath did not improve upon resuming his home oxygen 3L NC which he had discontinued two days prior due to subjective improvement. Family estimates he stopped breathing less than 5 minutes prior to EMS arrival. EMS reports patient was apneic and in wide-complex PEA on arrival. He was coded for 20 minutes before ROSC. He arrived intubated and on levophed.    Cardiogenic etiology considered due to transient hypoxia; however troponins without significant delta, EKG did not show ST abnormalities concerning for ischemia, or MI. Bedside echo without concerning findings. Infectious workup negative. Aggressively diuresed patient with minimal renal recovery. On exam patient was lacking gag reflex and pupils unreactive. Due to concern for severe anoxic encephalopathy and PVS, all sedation was stopped. Patient remained without any purposeful movement, without gag reflex, and without reactive pupils after >48 hours of complete cessation of sedating agents. Poor prognosis discussed with wife (NOK) and daughter. They both stated he has previously said he would not want to continue with current measures in this type of situation. Wife (NOK) ultimately decided to withdrawal care and pursue comfort care. Patient was terminally extubated and discharged to inpatient hospice"
	"1779444-1"	"1779444-1"	"AUTOPSY"	"10050117"	"50-59 years"	"50-59"	"Myocarditis resulting in death."
	"1779444-1"	"1779444-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Myocarditis resulting in death."
	"1779444-1"	"1779444-1"	"LABORATORY TEST"	"10059938"	"50-59 years"	"50-59"	"Myocarditis resulting in death."
	"1779444-1"	"1779444-1"	"MYOCARDITIS"	"10028606"	"50-59 years"	"50-59"	"Myocarditis resulting in death."
	"1779504-1"	"1779504-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Admission to critical care hospital with COVID-19 diagnosis on admission. Passed on 9/22/21"
	"1779504-1"	"1779504-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Admission to critical care hospital with COVID-19 diagnosis on admission. Passed on 9/22/21"
	"1779581-1"	"1779581-1"	"AUTOPSY"	"10050117"	"50-59 years"	"50-59"	"Woke up with a fever of 99.4. When I checked on her in the evening she was dead."
	"1779581-1"	"1779581-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Woke up with a fever of 99.4. When I checked on her in the evening she was dead."
	"1779581-1"	"1779581-1"	"PYREXIA"	"10037660"	"50-59 years"	"50-59"	"Woke up with a fever of 99.4. When I checked on her in the evening she was dead."
	"1782334-1"	"1782334-1"	"ANAEMIA"	"10002034"	"50-59 years"	"50-59"	"9/20 noticed increase SOB and went to urgent care on 9/23 for covid swab that was positive. Worsening SOB and EMS took her to Hospital. Stated she received a dose of steroids and antibiotics and discharged home. No improvement so family brought her to Medical Center on 9/24. CXR showed multifocal pneumonia secondary to covid. Transferred tp ICU from 9/28-10/4 due to increase oxygen requirements. Back to regular ward on 10.4-10/10. Being followed by transplant and nephrology and on enoxaparin for DVT. On 10/10 showed symptoms of GI bleed with hypotension, dark stools, anemia and worsening O2 requirements. Transferred back to ICU with O2 desaturation. Intubated for respiratory failure and on vent. Enoxaparin discontinued. Dopplers showed acute right peroneal vein thrombus. Transfused 3 units RBCs and q unit FFP. Cultures obtained and given cefepime, flagyl and zyvox. No further sings of bleeding. Renal function deteriorated rapidly and started on CRRT.  CT revealed bilateral pneumothorax and chest tubes placed. Developed progressive shock requiring high doses of vasopressors. Family chose comfort care on 10/12 and patient passed away."
	"1782334-1"	"1782334-1"	"CHEST TUBE INSERTION"	"10050522"	"50-59 years"	"50-59"	"9/20 noticed increase SOB and went to urgent care on 9/23 for covid swab that was positive. Worsening SOB and EMS took her to Hospital. Stated she received a dose of steroids and antibiotics and discharged home. No improvement so family brought her to Medical Center on 9/24. CXR showed multifocal pneumonia secondary to covid. Transferred tp ICU from 9/28-10/4 due to increase oxygen requirements. Back to regular ward on 10.4-10/10. Being followed by transplant and nephrology and on enoxaparin for DVT. On 10/10 showed symptoms of GI bleed with hypotension, dark stools, anemia and worsening O2 requirements. Transferred back to ICU with O2 desaturation. Intubated for respiratory failure and on vent. Enoxaparin discontinued. Dopplers showed acute right peroneal vein thrombus. Transfused 3 units RBCs and q unit FFP. Cultures obtained and given cefepime, flagyl and zyvox. No further sings of bleeding. Renal function deteriorated rapidly and started on CRRT.  CT revealed bilateral pneumothorax and chest tubes placed. Developed progressive shock requiring high doses of vasopressors. Family chose comfort care on 10/12 and patient passed away."
	"1782334-1"	"1782334-1"	"CHEST X-RAY ABNORMAL"	"10008499"	"50-59 years"	"50-59"	"9/20 noticed increase SOB and went to urgent care on 9/23 for covid swab that was positive. Worsening SOB and EMS took her to Hospital. Stated she received a dose of steroids and antibiotics and discharged home. No improvement so family brought her to Medical Center on 9/24. CXR showed multifocal pneumonia secondary to covid. Transferred tp ICU from 9/28-10/4 due to increase oxygen requirements. Back to regular ward on 10.4-10/10. Being followed by transplant and nephrology and on enoxaparin for DVT. On 10/10 showed symptoms of GI bleed with hypotension, dark stools, anemia and worsening O2 requirements. Transferred back to ICU with O2 desaturation. Intubated for respiratory failure and on vent. Enoxaparin discontinued. Dopplers showed acute right peroneal vein thrombus. Transfused 3 units RBCs and q unit FFP. Cultures obtained and given cefepime, flagyl and zyvox. No further sings of bleeding. Renal function deteriorated rapidly and started on CRRT.  CT revealed bilateral pneumothorax and chest tubes placed. Developed progressive shock requiring high doses of vasopressors. Family chose comfort care on 10/12 and patient passed away."
	"1782334-1"	"1782334-1"	"COMPUTERISED TOMOGRAM THORAX NORMAL"	"10057801"	"50-59 years"	"50-59"	"9/20 noticed increase SOB and went to urgent care on 9/23 for covid swab that was positive. Worsening SOB and EMS took her to Hospital. Stated she received a dose of steroids and antibiotics and discharged home. No improvement so family brought her to Medical Center on 9/24. CXR showed multifocal pneumonia secondary to covid. Transferred tp ICU from 9/28-10/4 due to increase oxygen requirements. Back to regular ward on 10.4-10/10. Being followed by transplant and nephrology and on enoxaparin for DVT. On 10/10 showed symptoms of GI bleed with hypotension, dark stools, anemia and worsening O2 requirements. Transferred back to ICU with O2 desaturation. Intubated for respiratory failure and on vent. Enoxaparin discontinued. Dopplers showed acute right peroneal vein thrombus. Transfused 3 units RBCs and q unit FFP. Cultures obtained and given cefepime, flagyl and zyvox. No further sings of bleeding. Renal function deteriorated rapidly and started on CRRT.  CT revealed bilateral pneumothorax and chest tubes placed. Developed progressive shock requiring high doses of vasopressors. Family chose comfort care on 10/12 and patient passed away."
	"1782334-1"	"1782334-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"9/20 noticed increase SOB and went to urgent care on 9/23 for covid swab that was positive. Worsening SOB and EMS took her to Hospital. Stated she received a dose of steroids and antibiotics and discharged home. No improvement so family brought her to Medical Center on 9/24. CXR showed multifocal pneumonia secondary to covid. Transferred tp ICU from 9/28-10/4 due to increase oxygen requirements. Back to regular ward on 10.4-10/10. Being followed by transplant and nephrology and on enoxaparin for DVT. On 10/10 showed symptoms of GI bleed with hypotension, dark stools, anemia and worsening O2 requirements. Transferred back to ICU with O2 desaturation. Intubated for respiratory failure and on vent. Enoxaparin discontinued. Dopplers showed acute right peroneal vein thrombus. Transfused 3 units RBCs and q unit FFP. Cultures obtained and given cefepime, flagyl and zyvox. No further sings of bleeding. Renal function deteriorated rapidly and started on CRRT.  CT revealed bilateral pneumothorax and chest tubes placed. Developed progressive shock requiring high doses of vasopressors. Family chose comfort care on 10/12 and patient passed away."
	"1782334-1"	"1782334-1"	"COVID-19 PNEUMONIA"	"10084380"	"50-59 years"	"50-59"	"9/20 noticed increase SOB and went to urgent care on 9/23 for covid swab that was positive. Worsening SOB and EMS took her to Hospital. Stated she received a dose of steroids and antibiotics and discharged home. No improvement so family brought her to Medical Center on 9/24. CXR showed multifocal pneumonia secondary to covid. Transferred tp ICU from 9/28-10/4 due to increase oxygen requirements. Back to regular ward on 10.4-10/10. Being followed by transplant and nephrology and on enoxaparin for DVT. On 10/10 showed symptoms of GI bleed with hypotension, dark stools, anemia and worsening O2 requirements. Transferred back to ICU with O2 desaturation. Intubated for respiratory failure and on vent. Enoxaparin discontinued. Dopplers showed acute right peroneal vein thrombus. Transfused 3 units RBCs and q unit FFP. Cultures obtained and given cefepime, flagyl and zyvox. No further sings of bleeding. Renal function deteriorated rapidly and started on CRRT.  CT revealed bilateral pneumothorax and chest tubes placed. Developed progressive shock requiring high doses of vasopressors. Family chose comfort care on 10/12 and patient passed away."
	"1782334-1"	"1782334-1"	"CULTURE"	"10061447"	"50-59 years"	"50-59"	"9/20 noticed increase SOB and went to urgent care on 9/23 for covid swab that was positive. Worsening SOB and EMS took her to Hospital. Stated she received a dose of steroids and antibiotics and discharged home. No improvement so family brought her to Medical Center on 9/24. CXR showed multifocal pneumonia secondary to covid. Transferred tp ICU from 9/28-10/4 due to increase oxygen requirements. Back to regular ward on 10.4-10/10. Being followed by transplant and nephrology and on enoxaparin for DVT. On 10/10 showed symptoms of GI bleed with hypotension, dark stools, anemia and worsening O2 requirements. Transferred back to ICU with O2 desaturation. Intubated for respiratory failure and on vent. Enoxaparin discontinued. Dopplers showed acute right peroneal vein thrombus. Transfused 3 units RBCs and q unit FFP. Cultures obtained and given cefepime, flagyl and zyvox. No further sings of bleeding. Renal function deteriorated rapidly and started on CRRT.  CT revealed bilateral pneumothorax and chest tubes placed. Developed progressive shock requiring high doses of vasopressors. Family chose comfort care on 10/12 and patient passed away."
	"1782334-1"	"1782334-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"9/20 noticed increase SOB and went to urgent care on 9/23 for covid swab that was positive. Worsening SOB and EMS took her to Hospital. Stated she received a dose of steroids and antibiotics and discharged home. No improvement so family brought her to Medical Center on 9/24. CXR showed multifocal pneumonia secondary to covid. Transferred tp ICU from 9/28-10/4 due to increase oxygen requirements. Back to regular ward on 10.4-10/10. Being followed by transplant and nephrology and on enoxaparin for DVT. On 10/10 showed symptoms of GI bleed with hypotension, dark stools, anemia and worsening O2 requirements. Transferred back to ICU with O2 desaturation. Intubated for respiratory failure and on vent. Enoxaparin discontinued. Dopplers showed acute right peroneal vein thrombus. Transfused 3 units RBCs and q unit FFP. Cultures obtained and given cefepime, flagyl and zyvox. No further sings of bleeding. Renal function deteriorated rapidly and started on CRRT.  CT revealed bilateral pneumothorax and chest tubes placed. Developed progressive shock requiring high doses of vasopressors. Family chose comfort care on 10/12 and patient passed away."
	"1782334-1"	"1782334-1"	"DEEP VEIN THROMBOSIS"	"10051055"	"50-59 years"	"50-59"	"9/20 noticed increase SOB and went to urgent care on 9/23 for covid swab that was positive. Worsening SOB and EMS took her to Hospital. Stated she received a dose of steroids and antibiotics and discharged home. No improvement so family brought her to Medical Center on 9/24. CXR showed multifocal pneumonia secondary to covid. Transferred tp ICU from 9/28-10/4 due to increase oxygen requirements. Back to regular ward on 10.4-10/10. Being followed by transplant and nephrology and on enoxaparin for DVT. On 10/10 showed symptoms of GI bleed with hypotension, dark stools, anemia and worsening O2 requirements. Transferred back to ICU with O2 desaturation. Intubated for respiratory failure and on vent. Enoxaparin discontinued. Dopplers showed acute right peroneal vein thrombus. Transfused 3 units RBCs and q unit FFP. Cultures obtained and given cefepime, flagyl and zyvox. No further sings of bleeding. Renal function deteriorated rapidly and started on CRRT.  CT revealed bilateral pneumothorax and chest tubes placed. Developed progressive shock requiring high doses of vasopressors. Family chose comfort care on 10/12 and patient passed away."
	"1782334-1"	"1782334-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"9/20 noticed increase SOB and went to urgent care on 9/23 for covid swab that was positive. Worsening SOB and EMS took her to Hospital. Stated she received a dose of steroids and antibiotics and discharged home. No improvement so family brought her to Medical Center on 9/24. CXR showed multifocal pneumonia secondary to covid. Transferred tp ICU from 9/28-10/4 due to increase oxygen requirements. Back to regular ward on 10.4-10/10. Being followed by transplant and nephrology and on enoxaparin for DVT. On 10/10 showed symptoms of GI bleed with hypotension, dark stools, anemia and worsening O2 requirements. Transferred back to ICU with O2 desaturation. Intubated for respiratory failure and on vent. Enoxaparin discontinued. Dopplers showed acute right peroneal vein thrombus. Transfused 3 units RBCs and q unit FFP. Cultures obtained and given cefepime, flagyl and zyvox. No further sings of bleeding. Renal function deteriorated rapidly and started on CRRT.  CT revealed bilateral pneumothorax and chest tubes placed. Developed progressive shock requiring high doses of vasopressors. Family chose comfort care on 10/12 and patient passed away."
	"1782334-1"	"1782334-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"50-59 years"	"50-59"	"9/20 noticed increase SOB and went to urgent care on 9/23 for covid swab that was positive. Worsening SOB and EMS took her to Hospital. Stated she received a dose of steroids and antibiotics and discharged home. No improvement so family brought her to Medical Center on 9/24. CXR showed multifocal pneumonia secondary to covid. Transferred tp ICU from 9/28-10/4 due to increase oxygen requirements. Back to regular ward on 10.4-10/10. Being followed by transplant and nephrology and on enoxaparin for DVT. On 10/10 showed symptoms of GI bleed with hypotension, dark stools, anemia and worsening O2 requirements. Transferred back to ICU with O2 desaturation. Intubated for respiratory failure and on vent. Enoxaparin discontinued. Dopplers showed acute right peroneal vein thrombus. Transfused 3 units RBCs and q unit FFP. Cultures obtained and given cefepime, flagyl and zyvox. No further sings of bleeding. Renal function deteriorated rapidly and started on CRRT.  CT revealed bilateral pneumothorax and chest tubes placed. Developed progressive shock requiring high doses of vasopressors. Family chose comfort care on 10/12 and patient passed away."
	"1782334-1"	"1782334-1"	"FAECES DISCOLOURED"	"10016100"	"50-59 years"	"50-59"	"9/20 noticed increase SOB and went to urgent care on 9/23 for covid swab that was positive. Worsening SOB and EMS took her to Hospital. Stated she received a dose of steroids and antibiotics and discharged home. No improvement so family brought her to Medical Center on 9/24. CXR showed multifocal pneumonia secondary to covid. Transferred tp ICU from 9/28-10/4 due to increase oxygen requirements. Back to regular ward on 10.4-10/10. Being followed by transplant and nephrology and on enoxaparin for DVT. On 10/10 showed symptoms of GI bleed with hypotension, dark stools, anemia and worsening O2 requirements. Transferred back to ICU with O2 desaturation. Intubated for respiratory failure and on vent. Enoxaparin discontinued. Dopplers showed acute right peroneal vein thrombus. Transfused 3 units RBCs and q unit FFP. Cultures obtained and given cefepime, flagyl and zyvox. No further sings of bleeding. Renal function deteriorated rapidly and started on CRRT.  CT revealed bilateral pneumothorax and chest tubes placed. Developed progressive shock requiring high doses of vasopressors. Family chose comfort care on 10/12 and patient passed away."
	"1782334-1"	"1782334-1"	"GASTROINTESTINAL HAEMORRHAGE"	"10017955"	"50-59 years"	"50-59"	"9/20 noticed increase SOB and went to urgent care on 9/23 for covid swab that was positive. Worsening SOB and EMS took her to Hospital. Stated she received a dose of steroids and antibiotics and discharged home. No improvement so family brought her to Medical Center on 9/24. CXR showed multifocal pneumonia secondary to covid. Transferred tp ICU from 9/28-10/4 due to increase oxygen requirements. Back to regular ward on 10.4-10/10. Being followed by transplant and nephrology and on enoxaparin for DVT. On 10/10 showed symptoms of GI bleed with hypotension, dark stools, anemia and worsening O2 requirements. Transferred back to ICU with O2 desaturation. Intubated for respiratory failure and on vent. Enoxaparin discontinued. Dopplers showed acute right peroneal vein thrombus. Transfused 3 units RBCs and q unit FFP. Cultures obtained and given cefepime, flagyl and zyvox. No further sings of bleeding. Renal function deteriorated rapidly and started on CRRT.  CT revealed bilateral pneumothorax and chest tubes placed. Developed progressive shock requiring high doses of vasopressors. Family chose comfort care on 10/12 and patient passed away."
	"1782334-1"	"1782334-1"	"HAEMOFILTRATION"	"10053090"	"50-59 years"	"50-59"	"9/20 noticed increase SOB and went to urgent care on 9/23 for covid swab that was positive. Worsening SOB and EMS took her to Hospital. Stated she received a dose of steroids and antibiotics and discharged home. No improvement so family brought her to Medical Center on 9/24. CXR showed multifocal pneumonia secondary to covid. Transferred tp ICU from 9/28-10/4 due to increase oxygen requirements. Back to regular ward on 10.4-10/10. Being followed by transplant and nephrology and on enoxaparin for DVT. On 10/10 showed symptoms of GI bleed with hypotension, dark stools, anemia and worsening O2 requirements. Transferred back to ICU with O2 desaturation. Intubated for respiratory failure and on vent. Enoxaparin discontinued. Dopplers showed acute right peroneal vein thrombus. Transfused 3 units RBCs and q unit FFP. Cultures obtained and given cefepime, flagyl and zyvox. No further sings of bleeding. Renal function deteriorated rapidly and started on CRRT.  CT revealed bilateral pneumothorax and chest tubes placed. Developed progressive shock requiring high doses of vasopressors. Family chose comfort care on 10/12 and patient passed away."
	"1782334-1"	"1782334-1"	"HYPOTENSION"	"10021097"	"50-59 years"	"50-59"	"9/20 noticed increase SOB and went to urgent care on 9/23 for covid swab that was positive. Worsening SOB and EMS took her to Hospital. Stated she received a dose of steroids and antibiotics and discharged home. No improvement so family brought her to Medical Center on 9/24. CXR showed multifocal pneumonia secondary to covid. Transferred tp ICU from 9/28-10/4 due to increase oxygen requirements. Back to regular ward on 10.4-10/10. Being followed by transplant and nephrology and on enoxaparin for DVT. On 10/10 showed symptoms of GI bleed with hypotension, dark stools, anemia and worsening O2 requirements. Transferred back to ICU with O2 desaturation. Intubated for respiratory failure and on vent. Enoxaparin discontinued. Dopplers showed acute right peroneal vein thrombus. Transfused 3 units RBCs and q unit FFP. Cultures obtained and given cefepime, flagyl and zyvox. No further sings of bleeding. Renal function deteriorated rapidly and started on CRRT.  CT revealed bilateral pneumothorax and chest tubes placed. Developed progressive shock requiring high doses of vasopressors. Family chose comfort care on 10/12 and patient passed away."
	"1782334-1"	"1782334-1"	"INTENSIVE CARE"	"10022519"	"50-59 years"	"50-59"	"9/20 noticed increase SOB and went to urgent care on 9/23 for covid swab that was positive. Worsening SOB and EMS took her to Hospital. Stated she received a dose of steroids and antibiotics and discharged home. No improvement so family brought her to Medical Center on 9/24. CXR showed multifocal pneumonia secondary to covid. Transferred tp ICU from 9/28-10/4 due to increase oxygen requirements. Back to regular ward on 10.4-10/10. Being followed by transplant and nephrology and on enoxaparin for DVT. On 10/10 showed symptoms of GI bleed with hypotension, dark stools, anemia and worsening O2 requirements. Transferred back to ICU with O2 desaturation. Intubated for respiratory failure and on vent. Enoxaparin discontinued. Dopplers showed acute right peroneal vein thrombus. Transfused 3 units RBCs and q unit FFP. Cultures obtained and given cefepime, flagyl and zyvox. No further sings of bleeding. Renal function deteriorated rapidly and started on CRRT.  CT revealed bilateral pneumothorax and chest tubes placed. Developed progressive shock requiring high doses of vasopressors. Family chose comfort care on 10/12 and patient passed away."
	"1782334-1"	"1782334-1"	"MECHANICAL VENTILATION"	"10067221"	"50-59 years"	"50-59"	"9/20 noticed increase SOB and went to urgent care on 9/23 for covid swab that was positive. Worsening SOB and EMS took her to Hospital. Stated she received a dose of steroids and antibiotics and discharged home. No improvement so family brought her to Medical Center on 9/24. CXR showed multifocal pneumonia secondary to covid. Transferred tp ICU from 9/28-10/4 due to increase oxygen requirements. Back to regular ward on 10.4-10/10. Being followed by transplant and nephrology and on enoxaparin for DVT. On 10/10 showed symptoms of GI bleed with hypotension, dark stools, anemia and worsening O2 requirements. Transferred back to ICU with O2 desaturation. Intubated for respiratory failure and on vent. Enoxaparin discontinued. Dopplers showed acute right peroneal vein thrombus. Transfused 3 units RBCs and q unit FFP. Cultures obtained and given cefepime, flagyl and zyvox. No further sings of bleeding. Renal function deteriorated rapidly and started on CRRT.  CT revealed bilateral pneumothorax and chest tubes placed. Developed progressive shock requiring high doses of vasopressors. Family chose comfort care on 10/12 and patient passed away."
	"1782334-1"	"1782334-1"	"OXYGEN SATURATION DECREASED"	"10033318"	"50-59 years"	"50-59"	"9/20 noticed increase SOB and went to urgent care on 9/23 for covid swab that was positive. Worsening SOB and EMS took her to Hospital. Stated she received a dose of steroids and antibiotics and discharged home. No improvement so family brought her to Medical Center on 9/24. CXR showed multifocal pneumonia secondary to covid. Transferred tp ICU from 9/28-10/4 due to increase oxygen requirements. Back to regular ward on 10.4-10/10. Being followed by transplant and nephrology and on enoxaparin for DVT. On 10/10 showed symptoms of GI bleed with hypotension, dark stools, anemia and worsening O2 requirements. Transferred back to ICU with O2 desaturation. Intubated for respiratory failure and on vent. Enoxaparin discontinued. Dopplers showed acute right peroneal vein thrombus. Transfused 3 units RBCs and q unit FFP. Cultures obtained and given cefepime, flagyl and zyvox. No further sings of bleeding. Renal function deteriorated rapidly and started on CRRT.  CT revealed bilateral pneumothorax and chest tubes placed. Developed progressive shock requiring high doses of vasopressors. Family chose comfort care on 10/12 and patient passed away."
	"1782334-1"	"1782334-1"	"PNEUMOTHORAX"	"10035759"	"50-59 years"	"50-59"	"9/20 noticed increase SOB and went to urgent care on 9/23 for covid swab that was positive. Worsening SOB and EMS took her to Hospital. Stated she received a dose of steroids and antibiotics and discharged home. No improvement so family brought her to Medical Center on 9/24. CXR showed multifocal pneumonia secondary to covid. Transferred tp ICU from 9/28-10/4 due to increase oxygen requirements. Back to regular ward on 10.4-10/10. Being followed by transplant and nephrology and on enoxaparin for DVT. On 10/10 showed symptoms of GI bleed with hypotension, dark stools, anemia and worsening O2 requirements. Transferred back to ICU with O2 desaturation. Intubated for respiratory failure and on vent. Enoxaparin discontinued. Dopplers showed acute right peroneal vein thrombus. Transfused 3 units RBCs and q unit FFP. Cultures obtained and given cefepime, flagyl and zyvox. No further sings of bleeding. Renal function deteriorated rapidly and started on CRRT.  CT revealed bilateral pneumothorax and chest tubes placed. Developed progressive shock requiring high doses of vasopressors. Family chose comfort care on 10/12 and patient passed away."
	"1782334-1"	"1782334-1"	"RENAL IMPAIRMENT"	"10062237"	"50-59 years"	"50-59"	"9/20 noticed increase SOB and went to urgent care on 9/23 for covid swab that was positive. Worsening SOB and EMS took her to Hospital. Stated she received a dose of steroids and antibiotics and discharged home. No improvement so family brought her to Medical Center on 9/24. CXR showed multifocal pneumonia secondary to covid. Transferred tp ICU from 9/28-10/4 due to increase oxygen requirements. Back to regular ward on 10.4-10/10. Being followed by transplant and nephrology and on enoxaparin for DVT. On 10/10 showed symptoms of GI bleed with hypotension, dark stools, anemia and worsening O2 requirements. Transferred back to ICU with O2 desaturation. Intubated for respiratory failure and on vent. Enoxaparin discontinued. Dopplers showed acute right peroneal vein thrombus. Transfused 3 units RBCs and q unit FFP. Cultures obtained and given cefepime, flagyl and zyvox. No further sings of bleeding. Renal function deteriorated rapidly and started on CRRT.  CT revealed bilateral pneumothorax and chest tubes placed. Developed progressive shock requiring high doses of vasopressors. Family chose comfort care on 10/12 and patient passed away."
	"1782334-1"	"1782334-1"	"RESPIRATORY FAILURE"	"10038695"	"50-59 years"	"50-59"	"9/20 noticed increase SOB and went to urgent care on 9/23 for covid swab that was positive. Worsening SOB and EMS took her to Hospital. Stated she received a dose of steroids and antibiotics and discharged home. No improvement so family brought her to Medical Center on 9/24. CXR showed multifocal pneumonia secondary to covid. Transferred tp ICU from 9/28-10/4 due to increase oxygen requirements. Back to regular ward on 10.4-10/10. Being followed by transplant and nephrology and on enoxaparin for DVT. On 10/10 showed symptoms of GI bleed with hypotension, dark stools, anemia and worsening O2 requirements. Transferred back to ICU with O2 desaturation. Intubated for respiratory failure and on vent. Enoxaparin discontinued. Dopplers showed acute right peroneal vein thrombus. Transfused 3 units RBCs and q unit FFP. Cultures obtained and given cefepime, flagyl and zyvox. No further sings of bleeding. Renal function deteriorated rapidly and started on CRRT.  CT revealed bilateral pneumothorax and chest tubes placed. Developed progressive shock requiring high doses of vasopressors. Family chose comfort care on 10/12 and patient passed away."
	"1782334-1"	"1782334-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"9/20 noticed increase SOB and went to urgent care on 9/23 for covid swab that was positive. Worsening SOB and EMS took her to Hospital. Stated she received a dose of steroids and antibiotics and discharged home. No improvement so family brought her to Medical Center on 9/24. CXR showed multifocal pneumonia secondary to covid. Transferred tp ICU from 9/28-10/4 due to increase oxygen requirements. Back to regular ward on 10.4-10/10. Being followed by transplant and nephrology and on enoxaparin for DVT. On 10/10 showed symptoms of GI bleed with hypotension, dark stools, anemia and worsening O2 requirements. Transferred back to ICU with O2 desaturation. Intubated for respiratory failure and on vent. Enoxaparin discontinued. Dopplers showed acute right peroneal vein thrombus. Transfused 3 units RBCs and q unit FFP. Cultures obtained and given cefepime, flagyl and zyvox. No further sings of bleeding. Renal function deteriorated rapidly and started on CRRT.  CT revealed bilateral pneumothorax and chest tubes placed. Developed progressive shock requiring high doses of vasopressors. Family chose comfort care on 10/12 and patient passed away."
	"1782334-1"	"1782334-1"	"SHOCK"	"10040560"	"50-59 years"	"50-59"	"9/20 noticed increase SOB and went to urgent care on 9/23 for covid swab that was positive. Worsening SOB and EMS took her to Hospital. Stated she received a dose of steroids and antibiotics and discharged home. No improvement so family brought her to Medical Center on 9/24. CXR showed multifocal pneumonia secondary to covid. Transferred tp ICU from 9/28-10/4 due to increase oxygen requirements. Back to regular ward on 10.4-10/10. Being followed by transplant and nephrology and on enoxaparin for DVT. On 10/10 showed symptoms of GI bleed with hypotension, dark stools, anemia and worsening O2 requirements. Transferred back to ICU with O2 desaturation. Intubated for respiratory failure and on vent. Enoxaparin discontinued. Dopplers showed acute right peroneal vein thrombus. Transfused 3 units RBCs and q unit FFP. Cultures obtained and given cefepime, flagyl and zyvox. No further sings of bleeding. Renal function deteriorated rapidly and started on CRRT.  CT revealed bilateral pneumothorax and chest tubes placed. Developed progressive shock requiring high doses of vasopressors. Family chose comfort care on 10/12 and patient passed away."
	"1782334-1"	"1782334-1"	"TRANSFUSION"	"10066152"	"50-59 years"	"50-59"	"9/20 noticed increase SOB and went to urgent care on 9/23 for covid swab that was positive. Worsening SOB and EMS took her to Hospital. Stated she received a dose of steroids and antibiotics and discharged home. No improvement so family brought her to Medical Center on 9/24. CXR showed multifocal pneumonia secondary to covid. Transferred tp ICU from 9/28-10/4 due to increase oxygen requirements. Back to regular ward on 10.4-10/10. Being followed by transplant and nephrology and on enoxaparin for DVT. On 10/10 showed symptoms of GI bleed with hypotension, dark stools, anemia and worsening O2 requirements. Transferred back to ICU with O2 desaturation. Intubated for respiratory failure and on vent. Enoxaparin discontinued. Dopplers showed acute right peroneal vein thrombus. Transfused 3 units RBCs and q unit FFP. Cultures obtained and given cefepime, flagyl and zyvox. No further sings of bleeding. Renal function deteriorated rapidly and started on CRRT.  CT revealed bilateral pneumothorax and chest tubes placed. Developed progressive shock requiring high doses of vasopressors. Family chose comfort care on 10/12 and patient passed away."
	"1782334-1"	"1782334-1"	"ULTRASOUND DOPPLER ABNORMAL"	"10045413"	"50-59 years"	"50-59"	"9/20 noticed increase SOB and went to urgent care on 9/23 for covid swab that was positive. Worsening SOB and EMS took her to Hospital. Stated she received a dose of steroids and antibiotics and discharged home. No improvement so family brought her to Medical Center on 9/24. CXR showed multifocal pneumonia secondary to covid. Transferred tp ICU from 9/28-10/4 due to increase oxygen requirements. Back to regular ward on 10.4-10/10. Being followed by transplant and nephrology and on enoxaparin for DVT. On 10/10 showed symptoms of GI bleed with hypotension, dark stools, anemia and worsening O2 requirements. Transferred back to ICU with O2 desaturation. Intubated for respiratory failure and on vent. Enoxaparin discontinued. Dopplers showed acute right peroneal vein thrombus. Transfused 3 units RBCs and q unit FFP. Cultures obtained and given cefepime, flagyl and zyvox. No further sings of bleeding. Renal function deteriorated rapidly and started on CRRT.  CT revealed bilateral pneumothorax and chest tubes placed. Developed progressive shock requiring high doses of vasopressors. Family chose comfort care on 10/12 and patient passed away."
	"1782970-1"	"1782970-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Patient was hospitalized. Died due to COVID-19. Patient was fully vaccinated."
	"1782970-1"	"1782970-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient was hospitalized. Died due to COVID-19. Patient was fully vaccinated."
	"1782988-1"	"1782988-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"1 hour after vaccination patient felt dizzy and collapsed on kitchen floor.  Paramedics were called and patient transported to Medical Center.  Patient died several hours later."
	"1782988-1"	"1782988-1"	"DIZZINESS"	"10013573"	"50-59 years"	"50-59"	"1 hour after vaccination patient felt dizzy and collapsed on kitchen floor.  Paramedics were called and patient transported to Medical Center.  Patient died several hours later."
	"1782988-1"	"1782988-1"	"SYNCOPE"	"10042772"	"50-59 years"	"50-59"	"1 hour after vaccination patient felt dizzy and collapsed on kitchen floor.  Paramedics were called and patient transported to Medical Center.  Patient died several hours later."
	"1783010-1"	"1783010-1"	"BODY TEMPERATURE INCREASED"	"10005911"	"50-59 years"	"50-59"	"Immediately after receiving the second doze my mother told family members that something was not right and she didn't feel well.  At first is started as flu like symptoms but that is to be expected.  On the morning of the July 26th I found her face down, not breathing well and unresponsive.  She was taken to Hospital and has a temperature of 107.  She was immediately placed on a ventilator and her health declined.  She passed away on August 29th."
	"1783010-1"	"1783010-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Immediately after receiving the second doze my mother told family members that something was not right and she didn't feel well.  At first is started as flu like symptoms but that is to be expected.  On the morning of the July 26th I found her face down, not breathing well and unresponsive.  She was taken to Hospital and has a temperature of 107.  She was immediately placed on a ventilator and her health declined.  She passed away on August 29th."
	"1783010-1"	"1783010-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"Immediately after receiving the second doze my mother told family members that something was not right and she didn't feel well.  At first is started as flu like symptoms but that is to be expected.  On the morning of the July 26th I found her face down, not breathing well and unresponsive.  She was taken to Hospital and has a temperature of 107.  She was immediately placed on a ventilator and her health declined.  She passed away on August 29th."
	"1783010-1"	"1783010-1"	"GENERAL PHYSICAL HEALTH DETERIORATION"	"10049438"	"50-59 years"	"50-59"	"Immediately after receiving the second doze my mother told family members that something was not right and she didn't feel well.  At first is started as flu like symptoms but that is to be expected.  On the morning of the July 26th I found her face down, not breathing well and unresponsive.  She was taken to Hospital and has a temperature of 107.  She was immediately placed on a ventilator and her health declined.  She passed away on August 29th."
	"1783010-1"	"1783010-1"	"IMMEDIATE POST-INJECTION REACTION"	"10067142"	"50-59 years"	"50-59"	"Immediately after receiving the second doze my mother told family members that something was not right and she didn't feel well.  At first is started as flu like symptoms but that is to be expected.  On the morning of the July 26th I found her face down, not breathing well and unresponsive.  She was taken to Hospital and has a temperature of 107.  She was immediately placed on a ventilator and her health declined.  She passed away on August 29th."
	"1783010-1"	"1783010-1"	"INFLUENZA LIKE ILLNESS"	"10022004"	"50-59 years"	"50-59"	"Immediately after receiving the second doze my mother told family members that something was not right and she didn't feel well.  At first is started as flu like symptoms but that is to be expected.  On the morning of the July 26th I found her face down, not breathing well and unresponsive.  She was taken to Hospital and has a temperature of 107.  She was immediately placed on a ventilator and her health declined.  She passed away on August 29th."
	"1783010-1"	"1783010-1"	"LABORATORY TEST"	"10059938"	"50-59 years"	"50-59"	"Immediately after receiving the second doze my mother told family members that something was not right and she didn't feel well.  At first is started as flu like symptoms but that is to be expected.  On the morning of the July 26th I found her face down, not breathing well and unresponsive.  She was taken to Hospital and has a temperature of 107.  She was immediately placed on a ventilator and her health declined.  She passed away on August 29th."
	"1783010-1"	"1783010-1"	"MALAISE"	"10025482"	"50-59 years"	"50-59"	"Immediately after receiving the second doze my mother told family members that something was not right and she didn't feel well.  At first is started as flu like symptoms but that is to be expected.  On the morning of the July 26th I found her face down, not breathing well and unresponsive.  She was taken to Hospital and has a temperature of 107.  She was immediately placed on a ventilator and her health declined.  She passed away on August 29th."
	"1783010-1"	"1783010-1"	"MECHANICAL VENTILATION"	"10067221"	"50-59 years"	"50-59"	"Immediately after receiving the second doze my mother told family members that something was not right and she didn't feel well.  At first is started as flu like symptoms but that is to be expected.  On the morning of the July 26th I found her face down, not breathing well and unresponsive.  She was taken to Hospital and has a temperature of 107.  She was immediately placed on a ventilator and her health declined.  She passed away on August 29th."
	"1783010-1"	"1783010-1"	"SARS-COV-2 TEST NEGATIVE"	"10084273"	"50-59 years"	"50-59"	"Immediately after receiving the second doze my mother told family members that something was not right and she didn't feel well.  At first is started as flu like symptoms but that is to be expected.  On the morning of the July 26th I found her face down, not breathing well and unresponsive.  She was taken to Hospital and has a temperature of 107.  She was immediately placed on a ventilator and her health declined.  She passed away on August 29th."
	"1783010-1"	"1783010-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"50-59 years"	"50-59"	"Immediately after receiving the second doze my mother told family members that something was not right and she didn't feel well.  At first is started as flu like symptoms but that is to be expected.  On the morning of the July 26th I found her face down, not breathing well and unresponsive.  She was taken to Hospital and has a temperature of 107.  She was immediately placed on a ventilator and her health declined.  She passed away on August 29th."
	"1783104-1"	"1783104-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 3/7/2021 and 3/28/2021. Presented to the ED on 9/17/2021 with shortness of breath that started yesterday, as well as a 4 day history of nausea and vomiting. Patient was admitted 9/17/21 and initiated on bipap.  She was intubated 9/27/21.  She was on max mechanical ventilation and epoprostenol and despite proning her saturations were consistently in the 70s-80s. Patient treated with remdesivir, tocilizumab, and methylprednisolone.  Her husband elected to make her DNR and then comfort care.  Patient passed  away on 10/8/2021."
	"1783104-1"	"1783104-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 3/7/2021 and 3/28/2021. Presented to the ED on 9/17/2021 with shortness of breath that started yesterday, as well as a 4 day history of nausea and vomiting. Patient was admitted 9/17/21 and initiated on bipap.  She was intubated 9/27/21.  She was on max mechanical ventilation and epoprostenol and despite proning her saturations were consistently in the 70s-80s. Patient treated with remdesivir, tocilizumab, and methylprednisolone.  Her husband elected to make her DNR and then comfort care.  Patient passed  away on 10/8/2021."
	"1783104-1"	"1783104-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 3/7/2021 and 3/28/2021. Presented to the ED on 9/17/2021 with shortness of breath that started yesterday, as well as a 4 day history of nausea and vomiting. Patient was admitted 9/17/21 and initiated on bipap.  She was intubated 9/27/21.  She was on max mechanical ventilation and epoprostenol and despite proning her saturations were consistently in the 70s-80s. Patient treated with remdesivir, tocilizumab, and methylprednisolone.  Her husband elected to make her DNR and then comfort care.  Patient passed  away on 10/8/2021."
	"1783104-1"	"1783104-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 3/7/2021 and 3/28/2021. Presented to the ED on 9/17/2021 with shortness of breath that started yesterday, as well as a 4 day history of nausea and vomiting. Patient was admitted 9/17/21 and initiated on bipap.  She was intubated 9/27/21.  She was on max mechanical ventilation and epoprostenol and despite proning her saturations were consistently in the 70s-80s. Patient treated with remdesivir, tocilizumab, and methylprednisolone.  Her husband elected to make her DNR and then comfort care.  Patient passed  away on 10/8/2021."
	"1783104-1"	"1783104-1"	"MECHANICAL VENTILATION"	"10067221"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 3/7/2021 and 3/28/2021. Presented to the ED on 9/17/2021 with shortness of breath that started yesterday, as well as a 4 day history of nausea and vomiting. Patient was admitted 9/17/21 and initiated on bipap.  She was intubated 9/27/21.  She was on max mechanical ventilation and epoprostenol and despite proning her saturations were consistently in the 70s-80s. Patient treated with remdesivir, tocilizumab, and methylprednisolone.  Her husband elected to make her DNR and then comfort care.  Patient passed  away on 10/8/2021."
	"1783104-1"	"1783104-1"	"NAUSEA"	"10028813"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 3/7/2021 and 3/28/2021. Presented to the ED on 9/17/2021 with shortness of breath that started yesterday, as well as a 4 day history of nausea and vomiting. Patient was admitted 9/17/21 and initiated on bipap.  She was intubated 9/27/21.  She was on max mechanical ventilation and epoprostenol and despite proning her saturations were consistently in the 70s-80s. Patient treated with remdesivir, tocilizumab, and methylprednisolone.  Her husband elected to make her DNR and then comfort care.  Patient passed  away on 10/8/2021."
	"1783104-1"	"1783104-1"	"POSITIVE AIRWAY PRESSURE THERAPY"	"10086397"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 3/7/2021 and 3/28/2021. Presented to the ED on 9/17/2021 with shortness of breath that started yesterday, as well as a 4 day history of nausea and vomiting. Patient was admitted 9/17/21 and initiated on bipap.  She was intubated 9/27/21.  She was on max mechanical ventilation and epoprostenol and despite proning her saturations were consistently in the 70s-80s. Patient treated with remdesivir, tocilizumab, and methylprednisolone.  Her husband elected to make her DNR and then comfort care.  Patient passed  away on 10/8/2021."
	"1783104-1"	"1783104-1"	"PRONE POSITION"	"10074744"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 3/7/2021 and 3/28/2021. Presented to the ED on 9/17/2021 with shortness of breath that started yesterday, as well as a 4 day history of nausea and vomiting. Patient was admitted 9/17/21 and initiated on bipap.  She was intubated 9/27/21.  She was on max mechanical ventilation and epoprostenol and despite proning her saturations were consistently in the 70s-80s. Patient treated with remdesivir, tocilizumab, and methylprednisolone.  Her husband elected to make her DNR and then comfort care.  Patient passed  away on 10/8/2021."
	"1783104-1"	"1783104-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 3/7/2021 and 3/28/2021. Presented to the ED on 9/17/2021 with shortness of breath that started yesterday, as well as a 4 day history of nausea and vomiting. Patient was admitted 9/17/21 and initiated on bipap.  She was intubated 9/27/21.  She was on max mechanical ventilation and epoprostenol and despite proning her saturations were consistently in the 70s-80s. Patient treated with remdesivir, tocilizumab, and methylprednisolone.  Her husband elected to make her DNR and then comfort care.  Patient passed  away on 10/8/2021."
	"1783104-1"	"1783104-1"	"VOMITING"	"10047700"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 3/7/2021 and 3/28/2021. Presented to the ED on 9/17/2021 with shortness of breath that started yesterday, as well as a 4 day history of nausea and vomiting. Patient was admitted 9/17/21 and initiated on bipap.  She was intubated 9/27/21.  She was on max mechanical ventilation and epoprostenol and despite proning her saturations were consistently in the 70s-80s. Patient treated with remdesivir, tocilizumab, and methylprednisolone.  Her husband elected to make her DNR and then comfort care.  Patient passed  away on 10/8/2021."
	"1783817-1"	"1783817-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Patient fully vaccinated and died due to covid related causes.  Patient has a previous medical history of ESRD, anemia of chronic disease, HTN, osteopenia and sarcoidosis. Patient presented to ER on 09/06/2021 with complaints of increasing SOB with productive cough, headache, and occasional nausea. Patient was found to be hypoxic with O2 in 60s on arrival and had to be placed on Bipap. Patient expired on 09/17/2021."
	"1783817-1"	"1783817-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient fully vaccinated and died due to covid related causes.  Patient has a previous medical history of ESRD, anemia of chronic disease, HTN, osteopenia and sarcoidosis. Patient presented to ER on 09/06/2021 with complaints of increasing SOB with productive cough, headache, and occasional nausea. Patient was found to be hypoxic with O2 in 60s on arrival and had to be placed on Bipap. Patient expired on 09/17/2021."
	"1783817-1"	"1783817-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"Patient fully vaccinated and died due to covid related causes.  Patient has a previous medical history of ESRD, anemia of chronic disease, HTN, osteopenia and sarcoidosis. Patient presented to ER on 09/06/2021 with complaints of increasing SOB with productive cough, headache, and occasional nausea. Patient was found to be hypoxic with O2 in 60s on arrival and had to be placed on Bipap. Patient expired on 09/17/2021."
	"1783817-1"	"1783817-1"	"HEADACHE"	"10019211"	"50-59 years"	"50-59"	"Patient fully vaccinated and died due to covid related causes.  Patient has a previous medical history of ESRD, anemia of chronic disease, HTN, osteopenia and sarcoidosis. Patient presented to ER on 09/06/2021 with complaints of increasing SOB with productive cough, headache, and occasional nausea. Patient was found to be hypoxic with O2 in 60s on arrival and had to be placed on Bipap. Patient expired on 09/17/2021."
	"1783817-1"	"1783817-1"	"HYPOXIA"	"10021143"	"50-59 years"	"50-59"	"Patient fully vaccinated and died due to covid related causes.  Patient has a previous medical history of ESRD, anemia of chronic disease, HTN, osteopenia and sarcoidosis. Patient presented to ER on 09/06/2021 with complaints of increasing SOB with productive cough, headache, and occasional nausea. Patient was found to be hypoxic with O2 in 60s on arrival and had to be placed on Bipap. Patient expired on 09/17/2021."
	"1783817-1"	"1783817-1"	"NAUSEA"	"10028813"	"50-59 years"	"50-59"	"Patient fully vaccinated and died due to covid related causes.  Patient has a previous medical history of ESRD, anemia of chronic disease, HTN, osteopenia and sarcoidosis. Patient presented to ER on 09/06/2021 with complaints of increasing SOB with productive cough, headache, and occasional nausea. Patient was found to be hypoxic with O2 in 60s on arrival and had to be placed on Bipap. Patient expired on 09/17/2021."
	"1783817-1"	"1783817-1"	"POSITIVE AIRWAY PRESSURE THERAPY"	"10086397"	"50-59 years"	"50-59"	"Patient fully vaccinated and died due to covid related causes.  Patient has a previous medical history of ESRD, anemia of chronic disease, HTN, osteopenia and sarcoidosis. Patient presented to ER on 09/06/2021 with complaints of increasing SOB with productive cough, headache, and occasional nausea. Patient was found to be hypoxic with O2 in 60s on arrival and had to be placed on Bipap. Patient expired on 09/17/2021."
	"1783817-1"	"1783817-1"	"PRODUCTIVE COUGH"	"10036790"	"50-59 years"	"50-59"	"Patient fully vaccinated and died due to covid related causes.  Patient has a previous medical history of ESRD, anemia of chronic disease, HTN, osteopenia and sarcoidosis. Patient presented to ER on 09/06/2021 with complaints of increasing SOB with productive cough, headache, and occasional nausea. Patient was found to be hypoxic with O2 in 60s on arrival and had to be placed on Bipap. Patient expired on 09/17/2021."
	"1784999-1"	"1784999-1"	"CHILLS"	"10008531"	"50-59 years"	"50-59"	"Per medical records, patient was admitted to hospital on 08/25/2021 denying chronic illness or medications who presented with 3 weeks of gait instability, BUE weakness, subjective fever/chills, nausea, cough with phlegm, and SOB. Patient was a former smoker. Per medical records, the patient was emergently intubated and required admission to the ICU. Patient expired on 09/15/2021. Patient was fully vaccinated with J&J"
	"1784999-1"	"1784999-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Per medical records, patient was admitted to hospital on 08/25/2021 denying chronic illness or medications who presented with 3 weeks of gait instability, BUE weakness, subjective fever/chills, nausea, cough with phlegm, and SOB. Patient was a former smoker. Per medical records, the patient was emergently intubated and required admission to the ICU. Patient expired on 09/15/2021. Patient was fully vaccinated with J&J"
	"1784999-1"	"1784999-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"Per medical records, patient was admitted to hospital on 08/25/2021 denying chronic illness or medications who presented with 3 weeks of gait instability, BUE weakness, subjective fever/chills, nausea, cough with phlegm, and SOB. Patient was a former smoker. Per medical records, the patient was emergently intubated and required admission to the ICU. Patient expired on 09/15/2021. Patient was fully vaccinated with J&J"
	"1784999-1"	"1784999-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"50-59 years"	"50-59"	"Per medical records, patient was admitted to hospital on 08/25/2021 denying chronic illness or medications who presented with 3 weeks of gait instability, BUE weakness, subjective fever/chills, nausea, cough with phlegm, and SOB. Patient was a former smoker. Per medical records, the patient was emergently intubated and required admission to the ICU. Patient expired on 09/15/2021. Patient was fully vaccinated with J&J"
	"1784999-1"	"1784999-1"	"GAIT DISTURBANCE"	"10017577"	"50-59 years"	"50-59"	"Per medical records, patient was admitted to hospital on 08/25/2021 denying chronic illness or medications who presented with 3 weeks of gait instability, BUE weakness, subjective fever/chills, nausea, cough with phlegm, and SOB. Patient was a former smoker. Per medical records, the patient was emergently intubated and required admission to the ICU. Patient expired on 09/15/2021. Patient was fully vaccinated with J&J"
	"1784999-1"	"1784999-1"	"INTENSIVE CARE"	"10022519"	"50-59 years"	"50-59"	"Per medical records, patient was admitted to hospital on 08/25/2021 denying chronic illness or medications who presented with 3 weeks of gait instability, BUE weakness, subjective fever/chills, nausea, cough with phlegm, and SOB. Patient was a former smoker. Per medical records, the patient was emergently intubated and required admission to the ICU. Patient expired on 09/15/2021. Patient was fully vaccinated with J&J"
	"1784999-1"	"1784999-1"	"MUSCULAR WEAKNESS"	"10028372"	"50-59 years"	"50-59"	"Per medical records, patient was admitted to hospital on 08/25/2021 denying chronic illness or medications who presented with 3 weeks of gait instability, BUE weakness, subjective fever/chills, nausea, cough with phlegm, and SOB. Patient was a former smoker. Per medical records, the patient was emergently intubated and required admission to the ICU. Patient expired on 09/15/2021. Patient was fully vaccinated with J&J"
	"1784999-1"	"1784999-1"	"NAUSEA"	"10028813"	"50-59 years"	"50-59"	"Per medical records, patient was admitted to hospital on 08/25/2021 denying chronic illness or medications who presented with 3 weeks of gait instability, BUE weakness, subjective fever/chills, nausea, cough with phlegm, and SOB. Patient was a former smoker. Per medical records, the patient was emergently intubated and required admission to the ICU. Patient expired on 09/15/2021. Patient was fully vaccinated with J&J"
	"1784999-1"	"1784999-1"	"PRODUCTIVE COUGH"	"10036790"	"50-59 years"	"50-59"	"Per medical records, patient was admitted to hospital on 08/25/2021 denying chronic illness or medications who presented with 3 weeks of gait instability, BUE weakness, subjective fever/chills, nausea, cough with phlegm, and SOB. Patient was a former smoker. Per medical records, the patient was emergently intubated and required admission to the ICU. Patient expired on 09/15/2021. Patient was fully vaccinated with J&J"
	"1784999-1"	"1784999-1"	"PYREXIA"	"10037660"	"50-59 years"	"50-59"	"Per medical records, patient was admitted to hospital on 08/25/2021 denying chronic illness or medications who presented with 3 weeks of gait instability, BUE weakness, subjective fever/chills, nausea, cough with phlegm, and SOB. Patient was a former smoker. Per medical records, the patient was emergently intubated and required admission to the ICU. Patient expired on 09/15/2021. Patient was fully vaccinated with J&J"
	"1785015-1"	"1785015-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Patient died due to COVID-19. Patient was fully vaccinated."
	"1785015-1"	"1785015-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient died due to COVID-19. Patient was fully vaccinated."
	"1785175-1"	"1785175-1"	"ACUTE RESPIRATORY FAILURE"	"10001053"	"50-59 years"	"50-59"	"BECAME SYMPTOMATIC AND TESTED COVID POSITIVE ON 8/30/21. DEVELOPED ACUTE HYPOXIC RESPIRATORY FAILURE. DIED 9/30/21"
	"1785175-1"	"1785175-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"BECAME SYMPTOMATIC AND TESTED COVID POSITIVE ON 8/30/21. DEVELOPED ACUTE HYPOXIC RESPIRATORY FAILURE. DIED 9/30/21"
	"1785175-1"	"1785175-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"BECAME SYMPTOMATIC AND TESTED COVID POSITIVE ON 8/30/21. DEVELOPED ACUTE HYPOXIC RESPIRATORY FAILURE. DIED 9/30/21"
	"1785175-1"	"1785175-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"BECAME SYMPTOMATIC AND TESTED COVID POSITIVE ON 8/30/21. DEVELOPED ACUTE HYPOXIC RESPIRATORY FAILURE. DIED 9/30/21"
	"1785447-1"	"1785447-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"BREAKTHROUGH HOSPITALIZATION AND DEATH"
	"1785447-1"	"1785447-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"BREAKTHROUGH HOSPITALIZATION AND DEATH"
	"1785447-1"	"1785447-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"BREAKTHROUGH HOSPITALIZATION AND DEATH"
	"1785447-1"	"1785447-1"	"VACCINE BREAKTHROUGH INFECTION"	"10067923"	"50-59 years"	"50-59"	"BREAKTHROUGH HOSPITALIZATION AND DEATH"
	"1788331-1"	"1788331-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Death"
	"1790508-1"	"1790508-1"	"APNOEA"	"10002974"	"50-59 years"	"50-59"	"two hours later, she was cyanotic, lips, hands, and feet were blue; She had no heartbeat; was not breathing; She was completely unresponsive; They took her to the hospital and worked on her for a couple hours and then pronounced her dead; feeling very tired; an hour later, and she was snoring heavily; This spontaneous case was reported by a consumer and describes the occurrence of CYANOSIS (two hours later, she was cyanotic, lips, hands, and feet were blue), CARDIAC ARREST (She had no heartbeat), APNOEA (was not breathing), LOSS OF CONSCIOUSNESS (She was completely unresponsive) and DEATH (They took her to the hospital and worked on her for a couple hours and then pronounced her dead ) in a 57-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below.     No Medical History information was reported.    On 03-Oct-2021 at 11:00 AM, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 03-Oct-2021, the patient experienced CYANOSIS (two hours later, she was cyanotic, lips, hands, and feet were blue) (seriousness criterion death), FATIGUE (feeling very tired) and SNORING (an hour later, and she was snoring heavily). 03-Oct-2021, the patient experienced CARDIAC ARREST (She had no heartbeat) (seriousness criteria death and medically significant), APNOEA (was not breathing) (seriousness criteria death and medically significant), LOSS OF CONSCIOUSNESS (She was completely unresponsive) (seriousness criteria death and medically significant) and DEATH (They took her to the hospital and worked on her for a couple hours and then pronounced her dead) (seriousness criteria death and medically significant). On 03-Oct-2021, FATIGUE (feeling very tired) and SNORING (an hour later, and she was snoring heavily) outcome was unknown. The patient died on 03-Oct-2021. The cause of death was not reported. It is unknown if an autopsy was performed.            No concomitant medication information were provided. No treatment information were provided. The patient was taken to hospital and after a couple of hours, she was pronounced to be dead.  Company Comment: This case concerns a 57-year-old female with no relevant medical history, who experienced the unexpected event of cyanosis. The event occurred the same day after receiving the first dose of mRNA-1273 (Moderna COVID-19 Vaccine) and had a fatal outcome, with death occurring the same day. The cause of death was not reported. It is unknown if an autopsy was performed. The rechallenge was not applicable, as the event happened after the first dose. The benefit-risk relationship of mRNA-1273 (Moderna COVID-19 Vaccine) is not affected by this report.; Sender's Comments: This case concerns a 57-year-old female with no relevant medical history, who experienced the unexpected event of cyanosis. The event occurred the same day after receiving the first dose of mRNA-1273 (Moderna COVID-19 Vaccine) and had a fatal outcome, with death occurring the same day. The cause of death was not reported. It is unknown if an autopsy was performed. The rechallenge was not applicable, as the event happened after the first dose. The benefit-risk relationship of mRNA-1273 (Moderna COVID-19 Vaccine) is not affected by this report.; Reported Cause(s) of Death: Unknown cause of death"
	"1790508-1"	"1790508-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"two hours later, she was cyanotic, lips, hands, and feet were blue; She had no heartbeat; was not breathing; She was completely unresponsive; They took her to the hospital and worked on her for a couple hours and then pronounced her dead; feeling very tired; an hour later, and she was snoring heavily; This spontaneous case was reported by a consumer and describes the occurrence of CYANOSIS (two hours later, she was cyanotic, lips, hands, and feet were blue), CARDIAC ARREST (She had no heartbeat), APNOEA (was not breathing), LOSS OF CONSCIOUSNESS (She was completely unresponsive) and DEATH (They took her to the hospital and worked on her for a couple hours and then pronounced her dead ) in a 57-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below.     No Medical History information was reported.    On 03-Oct-2021 at 11:00 AM, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 03-Oct-2021, the patient experienced CYANOSIS (two hours later, she was cyanotic, lips, hands, and feet were blue) (seriousness criterion death), FATIGUE (feeling very tired) and SNORING (an hour later, and she was snoring heavily). 03-Oct-2021, the patient experienced CARDIAC ARREST (She had no heartbeat) (seriousness criteria death and medically significant), APNOEA (was not breathing) (seriousness criteria death and medically significant), LOSS OF CONSCIOUSNESS (She was completely unresponsive) (seriousness criteria death and medically significant) and DEATH (They took her to the hospital and worked on her for a couple hours and then pronounced her dead) (seriousness criteria death and medically significant). On 03-Oct-2021, FATIGUE (feeling very tired) and SNORING (an hour later, and she was snoring heavily) outcome was unknown. The patient died on 03-Oct-2021. The cause of death was not reported. It is unknown if an autopsy was performed.            No concomitant medication information were provided. No treatment information were provided. The patient was taken to hospital and after a couple of hours, she was pronounced to be dead.  Company Comment: This case concerns a 57-year-old female with no relevant medical history, who experienced the unexpected event of cyanosis. The event occurred the same day after receiving the first dose of mRNA-1273 (Moderna COVID-19 Vaccine) and had a fatal outcome, with death occurring the same day. The cause of death was not reported. It is unknown if an autopsy was performed. The rechallenge was not applicable, as the event happened after the first dose. The benefit-risk relationship of mRNA-1273 (Moderna COVID-19 Vaccine) is not affected by this report.; Sender's Comments: This case concerns a 57-year-old female with no relevant medical history, who experienced the unexpected event of cyanosis. The event occurred the same day after receiving the first dose of mRNA-1273 (Moderna COVID-19 Vaccine) and had a fatal outcome, with death occurring the same day. The cause of death was not reported. It is unknown if an autopsy was performed. The rechallenge was not applicable, as the event happened after the first dose. The benefit-risk relationship of mRNA-1273 (Moderna COVID-19 Vaccine) is not affected by this report.; Reported Cause(s) of Death: Unknown cause of death"
	"1790508-1"	"1790508-1"	"CYANOSIS"	"10011703"	"50-59 years"	"50-59"	"two hours later, she was cyanotic, lips, hands, and feet were blue; She had no heartbeat; was not breathing; She was completely unresponsive; They took her to the hospital and worked on her for a couple hours and then pronounced her dead; feeling very tired; an hour later, and she was snoring heavily; This spontaneous case was reported by a consumer and describes the occurrence of CYANOSIS (two hours later, she was cyanotic, lips, hands, and feet were blue), CARDIAC ARREST (She had no heartbeat), APNOEA (was not breathing), LOSS OF CONSCIOUSNESS (She was completely unresponsive) and DEATH (They took her to the hospital and worked on her for a couple hours and then pronounced her dead ) in a 57-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below.     No Medical History information was reported.    On 03-Oct-2021 at 11:00 AM, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 03-Oct-2021, the patient experienced CYANOSIS (two hours later, she was cyanotic, lips, hands, and feet were blue) (seriousness criterion death), FATIGUE (feeling very tired) and SNORING (an hour later, and she was snoring heavily). 03-Oct-2021, the patient experienced CARDIAC ARREST (She had no heartbeat) (seriousness criteria death and medically significant), APNOEA (was not breathing) (seriousness criteria death and medically significant), LOSS OF CONSCIOUSNESS (She was completely unresponsive) (seriousness criteria death and medically significant) and DEATH (They took her to the hospital and worked on her for a couple hours and then pronounced her dead) (seriousness criteria death and medically significant). On 03-Oct-2021, FATIGUE (feeling very tired) and SNORING (an hour later, and she was snoring heavily) outcome was unknown. The patient died on 03-Oct-2021. The cause of death was not reported. It is unknown if an autopsy was performed.            No concomitant medication information were provided. No treatment information were provided. The patient was taken to hospital and after a couple of hours, she was pronounced to be dead.  Company Comment: This case concerns a 57-year-old female with no relevant medical history, who experienced the unexpected event of cyanosis. The event occurred the same day after receiving the first dose of mRNA-1273 (Moderna COVID-19 Vaccine) and had a fatal outcome, with death occurring the same day. The cause of death was not reported. It is unknown if an autopsy was performed. The rechallenge was not applicable, as the event happened after the first dose. The benefit-risk relationship of mRNA-1273 (Moderna COVID-19 Vaccine) is not affected by this report.; Sender's Comments: This case concerns a 57-year-old female with no relevant medical history, who experienced the unexpected event of cyanosis. The event occurred the same day after receiving the first dose of mRNA-1273 (Moderna COVID-19 Vaccine) and had a fatal outcome, with death occurring the same day. The cause of death was not reported. It is unknown if an autopsy was performed. The rechallenge was not applicable, as the event happened after the first dose. The benefit-risk relationship of mRNA-1273 (Moderna COVID-19 Vaccine) is not affected by this report.; Reported Cause(s) of Death: Unknown cause of death"
	"1790508-1"	"1790508-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"two hours later, she was cyanotic, lips, hands, and feet were blue; She had no heartbeat; was not breathing; She was completely unresponsive; They took her to the hospital and worked on her for a couple hours and then pronounced her dead; feeling very tired; an hour later, and she was snoring heavily; This spontaneous case was reported by a consumer and describes the occurrence of CYANOSIS (two hours later, she was cyanotic, lips, hands, and feet were blue), CARDIAC ARREST (She had no heartbeat), APNOEA (was not breathing), LOSS OF CONSCIOUSNESS (She was completely unresponsive) and DEATH (They took her to the hospital and worked on her for a couple hours and then pronounced her dead ) in a 57-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below.     No Medical History information was reported.    On 03-Oct-2021 at 11:00 AM, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 03-Oct-2021, the patient experienced CYANOSIS (two hours later, she was cyanotic, lips, hands, and feet were blue) (seriousness criterion death), FATIGUE (feeling very tired) and SNORING (an hour later, and she was snoring heavily). 03-Oct-2021, the patient experienced CARDIAC ARREST (She had no heartbeat) (seriousness criteria death and medically significant), APNOEA (was not breathing) (seriousness criteria death and medically significant), LOSS OF CONSCIOUSNESS (She was completely unresponsive) (seriousness criteria death and medically significant) and DEATH (They took her to the hospital and worked on her for a couple hours and then pronounced her dead) (seriousness criteria death and medically significant). On 03-Oct-2021, FATIGUE (feeling very tired) and SNORING (an hour later, and she was snoring heavily) outcome was unknown. The patient died on 03-Oct-2021. The cause of death was not reported. It is unknown if an autopsy was performed.            No concomitant medication information were provided. No treatment information were provided. The patient was taken to hospital and after a couple of hours, she was pronounced to be dead.  Company Comment: This case concerns a 57-year-old female with no relevant medical history, who experienced the unexpected event of cyanosis. The event occurred the same day after receiving the first dose of mRNA-1273 (Moderna COVID-19 Vaccine) and had a fatal outcome, with death occurring the same day. The cause of death was not reported. It is unknown if an autopsy was performed. The rechallenge was not applicable, as the event happened after the first dose. The benefit-risk relationship of mRNA-1273 (Moderna COVID-19 Vaccine) is not affected by this report.; Sender's Comments: This case concerns a 57-year-old female with no relevant medical history, who experienced the unexpected event of cyanosis. The event occurred the same day after receiving the first dose of mRNA-1273 (Moderna COVID-19 Vaccine) and had a fatal outcome, with death occurring the same day. The cause of death was not reported. It is unknown if an autopsy was performed. The rechallenge was not applicable, as the event happened after the first dose. The benefit-risk relationship of mRNA-1273 (Moderna COVID-19 Vaccine) is not affected by this report.; Reported Cause(s) of Death: Unknown cause of death"
	"1790508-1"	"1790508-1"	"FATIGUE"	"10016256"	"50-59 years"	"50-59"	"two hours later, she was cyanotic, lips, hands, and feet were blue; She had no heartbeat; was not breathing; She was completely unresponsive; They took her to the hospital and worked on her for a couple hours and then pronounced her dead; feeling very tired; an hour later, and she was snoring heavily; This spontaneous case was reported by a consumer and describes the occurrence of CYANOSIS (two hours later, she was cyanotic, lips, hands, and feet were blue), CARDIAC ARREST (She had no heartbeat), APNOEA (was not breathing), LOSS OF CONSCIOUSNESS (She was completely unresponsive) and DEATH (They took her to the hospital and worked on her for a couple hours and then pronounced her dead ) in a 57-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below.     No Medical History information was reported.    On 03-Oct-2021 at 11:00 AM, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 03-Oct-2021, the patient experienced CYANOSIS (two hours later, she was cyanotic, lips, hands, and feet were blue) (seriousness criterion death), FATIGUE (feeling very tired) and SNORING (an hour later, and she was snoring heavily). 03-Oct-2021, the patient experienced CARDIAC ARREST (She had no heartbeat) (seriousness criteria death and medically significant), APNOEA (was not breathing) (seriousness criteria death and medically significant), LOSS OF CONSCIOUSNESS (She was completely unresponsive) (seriousness criteria death and medically significant) and DEATH (They took her to the hospital and worked on her for a couple hours and then pronounced her dead) (seriousness criteria death and medically significant). On 03-Oct-2021, FATIGUE (feeling very tired) and SNORING (an hour later, and she was snoring heavily) outcome was unknown. The patient died on 03-Oct-2021. The cause of death was not reported. It is unknown if an autopsy was performed.            No concomitant medication information were provided. No treatment information were provided. The patient was taken to hospital and after a couple of hours, she was pronounced to be dead.  Company Comment: This case concerns a 57-year-old female with no relevant medical history, who experienced the unexpected event of cyanosis. The event occurred the same day after receiving the first dose of mRNA-1273 (Moderna COVID-19 Vaccine) and had a fatal outcome, with death occurring the same day. The cause of death was not reported. It is unknown if an autopsy was performed. The rechallenge was not applicable, as the event happened after the first dose. The benefit-risk relationship of mRNA-1273 (Moderna COVID-19 Vaccine) is not affected by this report.; Sender's Comments: This case concerns a 57-year-old female with no relevant medical history, who experienced the unexpected event of cyanosis. The event occurred the same day after receiving the first dose of mRNA-1273 (Moderna COVID-19 Vaccine) and had a fatal outcome, with death occurring the same day. The cause of death was not reported. It is unknown if an autopsy was performed. The rechallenge was not applicable, as the event happened after the first dose. The benefit-risk relationship of mRNA-1273 (Moderna COVID-19 Vaccine) is not affected by this report.; Reported Cause(s) of Death: Unknown cause of death"
	"1790508-1"	"1790508-1"	"LOSS OF CONSCIOUSNESS"	"10024855"	"50-59 years"	"50-59"	"two hours later, she was cyanotic, lips, hands, and feet were blue; She had no heartbeat; was not breathing; She was completely unresponsive; They took her to the hospital and worked on her for a couple hours and then pronounced her dead; feeling very tired; an hour later, and she was snoring heavily; This spontaneous case was reported by a consumer and describes the occurrence of CYANOSIS (two hours later, she was cyanotic, lips, hands, and feet were blue), CARDIAC ARREST (She had no heartbeat), APNOEA (was not breathing), LOSS OF CONSCIOUSNESS (She was completely unresponsive) and DEATH (They took her to the hospital and worked on her for a couple hours and then pronounced her dead ) in a 57-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below.     No Medical History information was reported.    On 03-Oct-2021 at 11:00 AM, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 03-Oct-2021, the patient experienced CYANOSIS (two hours later, she was cyanotic, lips, hands, and feet were blue) (seriousness criterion death), FATIGUE (feeling very tired) and SNORING (an hour later, and she was snoring heavily). 03-Oct-2021, the patient experienced CARDIAC ARREST (She had no heartbeat) (seriousness criteria death and medically significant), APNOEA (was not breathing) (seriousness criteria death and medically significant), LOSS OF CONSCIOUSNESS (She was completely unresponsive) (seriousness criteria death and medically significant) and DEATH (They took her to the hospital and worked on her for a couple hours and then pronounced her dead) (seriousness criteria death and medically significant). On 03-Oct-2021, FATIGUE (feeling very tired) and SNORING (an hour later, and she was snoring heavily) outcome was unknown. The patient died on 03-Oct-2021. The cause of death was not reported. It is unknown if an autopsy was performed.            No concomitant medication information were provided. No treatment information were provided. The patient was taken to hospital and after a couple of hours, she was pronounced to be dead.  Company Comment: This case concerns a 57-year-old female with no relevant medical history, who experienced the unexpected event of cyanosis. The event occurred the same day after receiving the first dose of mRNA-1273 (Moderna COVID-19 Vaccine) and had a fatal outcome, with death occurring the same day. The cause of death was not reported. It is unknown if an autopsy was performed. The rechallenge was not applicable, as the event happened after the first dose. The benefit-risk relationship of mRNA-1273 (Moderna COVID-19 Vaccine) is not affected by this report.; Sender's Comments: This case concerns a 57-year-old female with no relevant medical history, who experienced the unexpected event of cyanosis. The event occurred the same day after receiving the first dose of mRNA-1273 (Moderna COVID-19 Vaccine) and had a fatal outcome, with death occurring the same day. The cause of death was not reported. It is unknown if an autopsy was performed. The rechallenge was not applicable, as the event happened after the first dose. The benefit-risk relationship of mRNA-1273 (Moderna COVID-19 Vaccine) is not affected by this report.; Reported Cause(s) of Death: Unknown cause of death"
	"1790508-1"	"1790508-1"	"SNORING"	"10041235"	"50-59 years"	"50-59"	"two hours later, she was cyanotic, lips, hands, and feet were blue; She had no heartbeat; was not breathing; She was completely unresponsive; They took her to the hospital and worked on her for a couple hours and then pronounced her dead; feeling very tired; an hour later, and she was snoring heavily; This spontaneous case was reported by a consumer and describes the occurrence of CYANOSIS (two hours later, she was cyanotic, lips, hands, and feet were blue), CARDIAC ARREST (She had no heartbeat), APNOEA (was not breathing), LOSS OF CONSCIOUSNESS (She was completely unresponsive) and DEATH (They took her to the hospital and worked on her for a couple hours and then pronounced her dead ) in a 57-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below.     No Medical History information was reported.    On 03-Oct-2021 at 11:00 AM, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 03-Oct-2021, the patient experienced CYANOSIS (two hours later, she was cyanotic, lips, hands, and feet were blue) (seriousness criterion death), FATIGUE (feeling very tired) and SNORING (an hour later, and she was snoring heavily). 03-Oct-2021, the patient experienced CARDIAC ARREST (She had no heartbeat) (seriousness criteria death and medically significant), APNOEA (was not breathing) (seriousness criteria death and medically significant), LOSS OF CONSCIOUSNESS (She was completely unresponsive) (seriousness criteria death and medically significant) and DEATH (They took her to the hospital and worked on her for a couple hours and then pronounced her dead) (seriousness criteria death and medically significant). On 03-Oct-2021, FATIGUE (feeling very tired) and SNORING (an hour later, and she was snoring heavily) outcome was unknown. The patient died on 03-Oct-2021. The cause of death was not reported. It is unknown if an autopsy was performed.            No concomitant medication information were provided. No treatment information were provided. The patient was taken to hospital and after a couple of hours, she was pronounced to be dead.  Company Comment: This case concerns a 57-year-old female with no relevant medical history, who experienced the unexpected event of cyanosis. The event occurred the same day after receiving the first dose of mRNA-1273 (Moderna COVID-19 Vaccine) and had a fatal outcome, with death occurring the same day. The cause of death was not reported. It is unknown if an autopsy was performed. The rechallenge was not applicable, as the event happened after the first dose. The benefit-risk relationship of mRNA-1273 (Moderna COVID-19 Vaccine) is not affected by this report.; Sender's Comments: This case concerns a 57-year-old female with no relevant medical history, who experienced the unexpected event of cyanosis. The event occurred the same day after receiving the first dose of mRNA-1273 (Moderna COVID-19 Vaccine) and had a fatal outcome, with death occurring the same day. The cause of death was not reported. It is unknown if an autopsy was performed. The rechallenge was not applicable, as the event happened after the first dose. The benefit-risk relationship of mRNA-1273 (Moderna COVID-19 Vaccine) is not affected by this report.; Reported Cause(s) of Death: Unknown cause of death"
	"1794960-1"	"1794960-1"	"ACUTE KIDNEY INJURY"	"10069339"	"50-59 years"	"50-59"	"10/8/2021 - Patient c/o fatigue, inability to walk, decreased appetite, fever, chills, and low back pain.  Noted CK is elevated (> 12,000).  A CT scan was also done and showed colitis.  Patient is admitted with rhabdomyolysis (possibly due to the COVID vaccine of which the second dose was given on 9/20/2021) and colitis.  Note that she has a PMH of rhabdomyolysis from April 2021.  Patient was admitted to the hospital from 4/30 to 5/19/2021 with rhabdomyolysis and her first COVID vaccine was given on 4/2/2021.  Patient was given IV fluids and continued on the levofloxacin which was started on 10/5/2021 for sinusitis. 10/10/2021:  Patient became hypotensive, was given fluid boluses, transferred to the ICU and started on pressors. 10/11/2021:  C. diff pCR test came back positive and antibiotics were changed to oral vancomycin and IV metronidazole 10/12/2021:  Patient was intubated; coffee ground emesis from OGT after intubation and patient was transfused with PRBCs 10/13/2021:  Hemodynamics worsened, patient developed acute renal failure. CRRT was ordered, but never started due to instability 10/14/2021:  Patient made comfort measure and expired"
	"1794960-1"	"1794960-1"	"BACK PAIN"	"10003988"	"50-59 years"	"50-59"	"10/8/2021 - Patient c/o fatigue, inability to walk, decreased appetite, fever, chills, and low back pain.  Noted CK is elevated (> 12,000).  A CT scan was also done and showed colitis.  Patient is admitted with rhabdomyolysis (possibly due to the COVID vaccine of which the second dose was given on 9/20/2021) and colitis.  Note that she has a PMH of rhabdomyolysis from April 2021.  Patient was admitted to the hospital from 4/30 to 5/19/2021 with rhabdomyolysis and her first COVID vaccine was given on 4/2/2021.  Patient was given IV fluids and continued on the levofloxacin which was started on 10/5/2021 for sinusitis. 10/10/2021:  Patient became hypotensive, was given fluid boluses, transferred to the ICU and started on pressors. 10/11/2021:  C. diff pCR test came back positive and antibiotics were changed to oral vancomycin and IV metronidazole 10/12/2021:  Patient was intubated; coffee ground emesis from OGT after intubation and patient was transfused with PRBCs 10/13/2021:  Hemodynamics worsened, patient developed acute renal failure. CRRT was ordered, but never started due to instability 10/14/2021:  Patient made comfort measure and expired"
	"1794960-1"	"1794960-1"	"BLOOD CREATINE PHOSPHOKINASE INCREASED"	"10005470"	"50-59 years"	"50-59"	"10/8/2021 - Patient c/o fatigue, inability to walk, decreased appetite, fever, chills, and low back pain.  Noted CK is elevated (> 12,000).  A CT scan was also done and showed colitis.  Patient is admitted with rhabdomyolysis (possibly due to the COVID vaccine of which the second dose was given on 9/20/2021) and colitis.  Note that she has a PMH of rhabdomyolysis from April 2021.  Patient was admitted to the hospital from 4/30 to 5/19/2021 with rhabdomyolysis and her first COVID vaccine was given on 4/2/2021.  Patient was given IV fluids and continued on the levofloxacin which was started on 10/5/2021 for sinusitis. 10/10/2021:  Patient became hypotensive, was given fluid boluses, transferred to the ICU and started on pressors. 10/11/2021:  C. diff pCR test came back positive and antibiotics were changed to oral vancomycin and IV metronidazole 10/12/2021:  Patient was intubated; coffee ground emesis from OGT after intubation and patient was transfused with PRBCs 10/13/2021:  Hemodynamics worsened, patient developed acute renal failure. CRRT was ordered, but never started due to instability 10/14/2021:  Patient made comfort measure and expired"
	"1794960-1"	"1794960-1"	"BLOOD CREATININE INCREASED"	"10005483"	"50-59 years"	"50-59"	"10/8/2021 - Patient c/o fatigue, inability to walk, decreased appetite, fever, chills, and low back pain.  Noted CK is elevated (> 12,000).  A CT scan was also done and showed colitis.  Patient is admitted with rhabdomyolysis (possibly due to the COVID vaccine of which the second dose was given on 9/20/2021) and colitis.  Note that she has a PMH of rhabdomyolysis from April 2021.  Patient was admitted to the hospital from 4/30 to 5/19/2021 with rhabdomyolysis and her first COVID vaccine was given on 4/2/2021.  Patient was given IV fluids and continued on the levofloxacin which was started on 10/5/2021 for sinusitis. 10/10/2021:  Patient became hypotensive, was given fluid boluses, transferred to the ICU and started on pressors. 10/11/2021:  C. diff pCR test came back positive and antibiotics were changed to oral vancomycin and IV metronidazole 10/12/2021:  Patient was intubated; coffee ground emesis from OGT after intubation and patient was transfused with PRBCs 10/13/2021:  Hemodynamics worsened, patient developed acute renal failure. CRRT was ordered, but never started due to instability 10/14/2021:  Patient made comfort measure and expired"
	"1794960-1"	"1794960-1"	"CHILLS"	"10008531"	"50-59 years"	"50-59"	"10/8/2021 - Patient c/o fatigue, inability to walk, decreased appetite, fever, chills, and low back pain.  Noted CK is elevated (> 12,000).  A CT scan was also done and showed colitis.  Patient is admitted with rhabdomyolysis (possibly due to the COVID vaccine of which the second dose was given on 9/20/2021) and colitis.  Note that she has a PMH of rhabdomyolysis from April 2021.  Patient was admitted to the hospital from 4/30 to 5/19/2021 with rhabdomyolysis and her first COVID vaccine was given on 4/2/2021.  Patient was given IV fluids and continued on the levofloxacin which was started on 10/5/2021 for sinusitis. 10/10/2021:  Patient became hypotensive, was given fluid boluses, transferred to the ICU and started on pressors. 10/11/2021:  C. diff pCR test came back positive and antibiotics were changed to oral vancomycin and IV metronidazole 10/12/2021:  Patient was intubated; coffee ground emesis from OGT after intubation and patient was transfused with PRBCs 10/13/2021:  Hemodynamics worsened, patient developed acute renal failure. CRRT was ordered, but never started due to instability 10/14/2021:  Patient made comfort measure and expired"
	"1794960-1"	"1794960-1"	"CLOSTRIDIUM TEST POSITIVE"	"10070027"	"50-59 years"	"50-59"	"10/8/2021 - Patient c/o fatigue, inability to walk, decreased appetite, fever, chills, and low back pain.  Noted CK is elevated (> 12,000).  A CT scan was also done and showed colitis.  Patient is admitted with rhabdomyolysis (possibly due to the COVID vaccine of which the second dose was given on 9/20/2021) and colitis.  Note that she has a PMH of rhabdomyolysis from April 2021.  Patient was admitted to the hospital from 4/30 to 5/19/2021 with rhabdomyolysis and her first COVID vaccine was given on 4/2/2021.  Patient was given IV fluids and continued on the levofloxacin which was started on 10/5/2021 for sinusitis. 10/10/2021:  Patient became hypotensive, was given fluid boluses, transferred to the ICU and started on pressors. 10/11/2021:  C. diff pCR test came back positive and antibiotics were changed to oral vancomycin and IV metronidazole 10/12/2021:  Patient was intubated; coffee ground emesis from OGT after intubation and patient was transfused with PRBCs 10/13/2021:  Hemodynamics worsened, patient developed acute renal failure. CRRT was ordered, but never started due to instability 10/14/2021:  Patient made comfort measure and expired"
	"1794960-1"	"1794960-1"	"COLITIS"	"10009887"	"50-59 years"	"50-59"	"10/8/2021 - Patient c/o fatigue, inability to walk, decreased appetite, fever, chills, and low back pain.  Noted CK is elevated (> 12,000).  A CT scan was also done and showed colitis.  Patient is admitted with rhabdomyolysis (possibly due to the COVID vaccine of which the second dose was given on 9/20/2021) and colitis.  Note that she has a PMH of rhabdomyolysis from April 2021.  Patient was admitted to the hospital from 4/30 to 5/19/2021 with rhabdomyolysis and her first COVID vaccine was given on 4/2/2021.  Patient was given IV fluids and continued on the levofloxacin which was started on 10/5/2021 for sinusitis. 10/10/2021:  Patient became hypotensive, was given fluid boluses, transferred to the ICU and started on pressors. 10/11/2021:  C. diff pCR test came back positive and antibiotics were changed to oral vancomycin and IV metronidazole 10/12/2021:  Patient was intubated; coffee ground emesis from OGT after intubation and patient was transfused with PRBCs 10/13/2021:  Hemodynamics worsened, patient developed acute renal failure. CRRT was ordered, but never started due to instability 10/14/2021:  Patient made comfort measure and expired"
	"1794960-1"	"1794960-1"	"COMPUTERISED TOMOGRAM ABNORMAL"	"10010235"	"50-59 years"	"50-59"	"10/8/2021 - Patient c/o fatigue, inability to walk, decreased appetite, fever, chills, and low back pain.  Noted CK is elevated (> 12,000).  A CT scan was also done and showed colitis.  Patient is admitted with rhabdomyolysis (possibly due to the COVID vaccine of which the second dose was given on 9/20/2021) and colitis.  Note that she has a PMH of rhabdomyolysis from April 2021.  Patient was admitted to the hospital from 4/30 to 5/19/2021 with rhabdomyolysis and her first COVID vaccine was given on 4/2/2021.  Patient was given IV fluids and continued on the levofloxacin which was started on 10/5/2021 for sinusitis. 10/10/2021:  Patient became hypotensive, was given fluid boluses, transferred to the ICU and started on pressors. 10/11/2021:  C. diff pCR test came back positive and antibiotics were changed to oral vancomycin and IV metronidazole 10/12/2021:  Patient was intubated; coffee ground emesis from OGT after intubation and patient was transfused with PRBCs 10/13/2021:  Hemodynamics worsened, patient developed acute renal failure. CRRT was ordered, but never started due to instability 10/14/2021:  Patient made comfort measure and expired"
	"1794960-1"	"1794960-1"	"CONDITION AGGRAVATED"	"10010264"	"50-59 years"	"50-59"	"10/8/2021 - Patient c/o fatigue, inability to walk, decreased appetite, fever, chills, and low back pain.  Noted CK is elevated (> 12,000).  A CT scan was also done and showed colitis.  Patient is admitted with rhabdomyolysis (possibly due to the COVID vaccine of which the second dose was given on 9/20/2021) and colitis.  Note that she has a PMH of rhabdomyolysis from April 2021.  Patient was admitted to the hospital from 4/30 to 5/19/2021 with rhabdomyolysis and her first COVID vaccine was given on 4/2/2021.  Patient was given IV fluids and continued on the levofloxacin which was started on 10/5/2021 for sinusitis. 10/10/2021:  Patient became hypotensive, was given fluid boluses, transferred to the ICU and started on pressors. 10/11/2021:  C. diff pCR test came back positive and antibiotics were changed to oral vancomycin and IV metronidazole 10/12/2021:  Patient was intubated; coffee ground emesis from OGT after intubation and patient was transfused with PRBCs 10/13/2021:  Hemodynamics worsened, patient developed acute renal failure. CRRT was ordered, but never started due to instability 10/14/2021:  Patient made comfort measure and expired"
	"1794960-1"	"1794960-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"10/8/2021 - Patient c/o fatigue, inability to walk, decreased appetite, fever, chills, and low back pain.  Noted CK is elevated (> 12,000).  A CT scan was also done and showed colitis.  Patient is admitted with rhabdomyolysis (possibly due to the COVID vaccine of which the second dose was given on 9/20/2021) and colitis.  Note that she has a PMH of rhabdomyolysis from April 2021.  Patient was admitted to the hospital from 4/30 to 5/19/2021 with rhabdomyolysis and her first COVID vaccine was given on 4/2/2021.  Patient was given IV fluids and continued on the levofloxacin which was started on 10/5/2021 for sinusitis. 10/10/2021:  Patient became hypotensive, was given fluid boluses, transferred to the ICU and started on pressors. 10/11/2021:  C. diff pCR test came back positive and antibiotics were changed to oral vancomycin and IV metronidazole 10/12/2021:  Patient was intubated; coffee ground emesis from OGT after intubation and patient was transfused with PRBCs 10/13/2021:  Hemodynamics worsened, patient developed acute renal failure. CRRT was ordered, but never started due to instability 10/14/2021:  Patient made comfort measure and expired"
	"1794960-1"	"1794960-1"	"DECREASED APPETITE"	"10061428"	"50-59 years"	"50-59"	"10/8/2021 - Patient c/o fatigue, inability to walk, decreased appetite, fever, chills, and low back pain.  Noted CK is elevated (> 12,000).  A CT scan was also done and showed colitis.  Patient is admitted with rhabdomyolysis (possibly due to the COVID vaccine of which the second dose was given on 9/20/2021) and colitis.  Note that she has a PMH of rhabdomyolysis from April 2021.  Patient was admitted to the hospital from 4/30 to 5/19/2021 with rhabdomyolysis and her first COVID vaccine was given on 4/2/2021.  Patient was given IV fluids and continued on the levofloxacin which was started on 10/5/2021 for sinusitis. 10/10/2021:  Patient became hypotensive, was given fluid boluses, transferred to the ICU and started on pressors. 10/11/2021:  C. diff pCR test came back positive and antibiotics were changed to oral vancomycin and IV metronidazole 10/12/2021:  Patient was intubated; coffee ground emesis from OGT after intubation and patient was transfused with PRBCs 10/13/2021:  Hemodynamics worsened, patient developed acute renal failure. CRRT was ordered, but never started due to instability 10/14/2021:  Patient made comfort measure and expired"
	"1794960-1"	"1794960-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"50-59 years"	"50-59"	"10/8/2021 - Patient c/o fatigue, inability to walk, decreased appetite, fever, chills, and low back pain.  Noted CK is elevated (> 12,000).  A CT scan was also done and showed colitis.  Patient is admitted with rhabdomyolysis (possibly due to the COVID vaccine of which the second dose was given on 9/20/2021) and colitis.  Note that she has a PMH of rhabdomyolysis from April 2021.  Patient was admitted to the hospital from 4/30 to 5/19/2021 with rhabdomyolysis and her first COVID vaccine was given on 4/2/2021.  Patient was given IV fluids and continued on the levofloxacin which was started on 10/5/2021 for sinusitis. 10/10/2021:  Patient became hypotensive, was given fluid boluses, transferred to the ICU and started on pressors. 10/11/2021:  C. diff pCR test came back positive and antibiotics were changed to oral vancomycin and IV metronidazole 10/12/2021:  Patient was intubated; coffee ground emesis from OGT after intubation and patient was transfused with PRBCs 10/13/2021:  Hemodynamics worsened, patient developed acute renal failure. CRRT was ordered, but never started due to instability 10/14/2021:  Patient made comfort measure and expired"
	"1794960-1"	"1794960-1"	"FATIGUE"	"10016256"	"50-59 years"	"50-59"	"10/8/2021 - Patient c/o fatigue, inability to walk, decreased appetite, fever, chills, and low back pain.  Noted CK is elevated (> 12,000).  A CT scan was also done and showed colitis.  Patient is admitted with rhabdomyolysis (possibly due to the COVID vaccine of which the second dose was given on 9/20/2021) and colitis.  Note that she has a PMH of rhabdomyolysis from April 2021.  Patient was admitted to the hospital from 4/30 to 5/19/2021 with rhabdomyolysis and her first COVID vaccine was given on 4/2/2021.  Patient was given IV fluids and continued on the levofloxacin which was started on 10/5/2021 for sinusitis. 10/10/2021:  Patient became hypotensive, was given fluid boluses, transferred to the ICU and started on pressors. 10/11/2021:  C. diff pCR test came back positive and antibiotics were changed to oral vancomycin and IV metronidazole 10/12/2021:  Patient was intubated; coffee ground emesis from OGT after intubation and patient was transfused with PRBCs 10/13/2021:  Hemodynamics worsened, patient developed acute renal failure. CRRT was ordered, but never started due to instability 10/14/2021:  Patient made comfort measure and expired"
	"1794960-1"	"1794960-1"	"GAIT INABILITY"	"10017581"	"50-59 years"	"50-59"	"10/8/2021 - Patient c/o fatigue, inability to walk, decreased appetite, fever, chills, and low back pain.  Noted CK is elevated (> 12,000).  A CT scan was also done and showed colitis.  Patient is admitted with rhabdomyolysis (possibly due to the COVID vaccine of which the second dose was given on 9/20/2021) and colitis.  Note that she has a PMH of rhabdomyolysis from April 2021.  Patient was admitted to the hospital from 4/30 to 5/19/2021 with rhabdomyolysis and her first COVID vaccine was given on 4/2/2021.  Patient was given IV fluids and continued on the levofloxacin which was started on 10/5/2021 for sinusitis. 10/10/2021:  Patient became hypotensive, was given fluid boluses, transferred to the ICU and started on pressors. 10/11/2021:  C. diff pCR test came back positive and antibiotics were changed to oral vancomycin and IV metronidazole 10/12/2021:  Patient was intubated; coffee ground emesis from OGT after intubation and patient was transfused with PRBCs 10/13/2021:  Hemodynamics worsened, patient developed acute renal failure. CRRT was ordered, but never started due to instability 10/14/2021:  Patient made comfort measure and expired"
	"1794960-1"	"1794960-1"	"GENERAL PHYSICAL HEALTH DETERIORATION"	"10049438"	"50-59 years"	"50-59"	"10/8/2021 - Patient c/o fatigue, inability to walk, decreased appetite, fever, chills, and low back pain.  Noted CK is elevated (> 12,000).  A CT scan was also done and showed colitis.  Patient is admitted with rhabdomyolysis (possibly due to the COVID vaccine of which the second dose was given on 9/20/2021) and colitis.  Note that she has a PMH of rhabdomyolysis from April 2021.  Patient was admitted to the hospital from 4/30 to 5/19/2021 with rhabdomyolysis and her first COVID vaccine was given on 4/2/2021.  Patient was given IV fluids and continued on the levofloxacin which was started on 10/5/2021 for sinusitis. 10/10/2021:  Patient became hypotensive, was given fluid boluses, transferred to the ICU and started on pressors. 10/11/2021:  C. diff pCR test came back positive and antibiotics were changed to oral vancomycin and IV metronidazole 10/12/2021:  Patient was intubated; coffee ground emesis from OGT after intubation and patient was transfused with PRBCs 10/13/2021:  Hemodynamics worsened, patient developed acute renal failure. CRRT was ordered, but never started due to instability 10/14/2021:  Patient made comfort measure and expired"
	"1794960-1"	"1794960-1"	"HAEMATEMESIS"	"10018830"	"50-59 years"	"50-59"	"10/8/2021 - Patient c/o fatigue, inability to walk, decreased appetite, fever, chills, and low back pain.  Noted CK is elevated (> 12,000).  A CT scan was also done and showed colitis.  Patient is admitted with rhabdomyolysis (possibly due to the COVID vaccine of which the second dose was given on 9/20/2021) and colitis.  Note that she has a PMH of rhabdomyolysis from April 2021.  Patient was admitted to the hospital from 4/30 to 5/19/2021 with rhabdomyolysis and her first COVID vaccine was given on 4/2/2021.  Patient was given IV fluids and continued on the levofloxacin which was started on 10/5/2021 for sinusitis. 10/10/2021:  Patient became hypotensive, was given fluid boluses, transferred to the ICU and started on pressors. 10/11/2021:  C. diff pCR test came back positive and antibiotics were changed to oral vancomycin and IV metronidazole 10/12/2021:  Patient was intubated; coffee ground emesis from OGT after intubation and patient was transfused with PRBCs 10/13/2021:  Hemodynamics worsened, patient developed acute renal failure. CRRT was ordered, but never started due to instability 10/14/2021:  Patient made comfort measure and expired"
	"1794960-1"	"1794960-1"	"HYPOTENSION"	"10021097"	"50-59 years"	"50-59"	"10/8/2021 - Patient c/o fatigue, inability to walk, decreased appetite, fever, chills, and low back pain.  Noted CK is elevated (> 12,000).  A CT scan was also done and showed colitis.  Patient is admitted with rhabdomyolysis (possibly due to the COVID vaccine of which the second dose was given on 9/20/2021) and colitis.  Note that she has a PMH of rhabdomyolysis from April 2021.  Patient was admitted to the hospital from 4/30 to 5/19/2021 with rhabdomyolysis and her first COVID vaccine was given on 4/2/2021.  Patient was given IV fluids and continued on the levofloxacin which was started on 10/5/2021 for sinusitis. 10/10/2021:  Patient became hypotensive, was given fluid boluses, transferred to the ICU and started on pressors. 10/11/2021:  C. diff pCR test came back positive and antibiotics were changed to oral vancomycin and IV metronidazole 10/12/2021:  Patient was intubated; coffee ground emesis from OGT after intubation and patient was transfused with PRBCs 10/13/2021:  Hemodynamics worsened, patient developed acute renal failure. CRRT was ordered, but never started due to instability 10/14/2021:  Patient made comfort measure and expired"
	"1794960-1"	"1794960-1"	"INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION"	"10081572"	"50-59 years"	"50-59"	"10/8/2021 - Patient c/o fatigue, inability to walk, decreased appetite, fever, chills, and low back pain.  Noted CK is elevated (> 12,000).  A CT scan was also done and showed colitis.  Patient is admitted with rhabdomyolysis (possibly due to the COVID vaccine of which the second dose was given on 9/20/2021) and colitis.  Note that she has a PMH of rhabdomyolysis from April 2021.  Patient was admitted to the hospital from 4/30 to 5/19/2021 with rhabdomyolysis and her first COVID vaccine was given on 4/2/2021.  Patient was given IV fluids and continued on the levofloxacin which was started on 10/5/2021 for sinusitis. 10/10/2021:  Patient became hypotensive, was given fluid boluses, transferred to the ICU and started on pressors. 10/11/2021:  C. diff pCR test came back positive and antibiotics were changed to oral vancomycin and IV metronidazole 10/12/2021:  Patient was intubated; coffee ground emesis from OGT after intubation and patient was transfused with PRBCs 10/13/2021:  Hemodynamics worsened, patient developed acute renal failure. CRRT was ordered, but never started due to instability 10/14/2021:  Patient made comfort measure and expired"
	"1794960-1"	"1794960-1"	"INTENSIVE CARE"	"10022519"	"50-59 years"	"50-59"	"10/8/2021 - Patient c/o fatigue, inability to walk, decreased appetite, fever, chills, and low back pain.  Noted CK is elevated (> 12,000).  A CT scan was also done and showed colitis.  Patient is admitted with rhabdomyolysis (possibly due to the COVID vaccine of which the second dose was given on 9/20/2021) and colitis.  Note that she has a PMH of rhabdomyolysis from April 2021.  Patient was admitted to the hospital from 4/30 to 5/19/2021 with rhabdomyolysis and her first COVID vaccine was given on 4/2/2021.  Patient was given IV fluids and continued on the levofloxacin which was started on 10/5/2021 for sinusitis. 10/10/2021:  Patient became hypotensive, was given fluid boluses, transferred to the ICU and started on pressors. 10/11/2021:  C. diff pCR test came back positive and antibiotics were changed to oral vancomycin and IV metronidazole 10/12/2021:  Patient was intubated; coffee ground emesis from OGT after intubation and patient was transfused with PRBCs 10/13/2021:  Hemodynamics worsened, patient developed acute renal failure. CRRT was ordered, but never started due to instability 10/14/2021:  Patient made comfort measure and expired"
	"1794960-1"	"1794960-1"	"PACKED RED BLOOD CELL TRANSFUSION"	"10033359"	"50-59 years"	"50-59"	"10/8/2021 - Patient c/o fatigue, inability to walk, decreased appetite, fever, chills, and low back pain.  Noted CK is elevated (> 12,000).  A CT scan was also done and showed colitis.  Patient is admitted with rhabdomyolysis (possibly due to the COVID vaccine of which the second dose was given on 9/20/2021) and colitis.  Note that she has a PMH of rhabdomyolysis from April 2021.  Patient was admitted to the hospital from 4/30 to 5/19/2021 with rhabdomyolysis and her first COVID vaccine was given on 4/2/2021.  Patient was given IV fluids and continued on the levofloxacin which was started on 10/5/2021 for sinusitis. 10/10/2021:  Patient became hypotensive, was given fluid boluses, transferred to the ICU and started on pressors. 10/11/2021:  C. diff pCR test came back positive and antibiotics were changed to oral vancomycin and IV metronidazole 10/12/2021:  Patient was intubated; coffee ground emesis from OGT after intubation and patient was transfused with PRBCs 10/13/2021:  Hemodynamics worsened, patient developed acute renal failure. CRRT was ordered, but never started due to instability 10/14/2021:  Patient made comfort measure and expired"
	"1794960-1"	"1794960-1"	"PYREXIA"	"10037660"	"50-59 years"	"50-59"	"10/8/2021 - Patient c/o fatigue, inability to walk, decreased appetite, fever, chills, and low back pain.  Noted CK is elevated (> 12,000).  A CT scan was also done and showed colitis.  Patient is admitted with rhabdomyolysis (possibly due to the COVID vaccine of which the second dose was given on 9/20/2021) and colitis.  Note that she has a PMH of rhabdomyolysis from April 2021.  Patient was admitted to the hospital from 4/30 to 5/19/2021 with rhabdomyolysis and her first COVID vaccine was given on 4/2/2021.  Patient was given IV fluids and continued on the levofloxacin which was started on 10/5/2021 for sinusitis. 10/10/2021:  Patient became hypotensive, was given fluid boluses, transferred to the ICU and started on pressors. 10/11/2021:  C. diff pCR test came back positive and antibiotics were changed to oral vancomycin and IV metronidazole 10/12/2021:  Patient was intubated; coffee ground emesis from OGT after intubation and patient was transfused with PRBCs 10/13/2021:  Hemodynamics worsened, patient developed acute renal failure. CRRT was ordered, but never started due to instability 10/14/2021:  Patient made comfort measure and expired"
	"1794960-1"	"1794960-1"	"RHABDOMYOLYSIS"	"10039020"	"50-59 years"	"50-59"	"10/8/2021 - Patient c/o fatigue, inability to walk, decreased appetite, fever, chills, and low back pain.  Noted CK is elevated (> 12,000).  A CT scan was also done and showed colitis.  Patient is admitted with rhabdomyolysis (possibly due to the COVID vaccine of which the second dose was given on 9/20/2021) and colitis.  Note that she has a PMH of rhabdomyolysis from April 2021.  Patient was admitted to the hospital from 4/30 to 5/19/2021 with rhabdomyolysis and her first COVID vaccine was given on 4/2/2021.  Patient was given IV fluids and continued on the levofloxacin which was started on 10/5/2021 for sinusitis. 10/10/2021:  Patient became hypotensive, was given fluid boluses, transferred to the ICU and started on pressors. 10/11/2021:  C. diff pCR test came back positive and antibiotics were changed to oral vancomycin and IV metronidazole 10/12/2021:  Patient was intubated; coffee ground emesis from OGT after intubation and patient was transfused with PRBCs 10/13/2021:  Hemodynamics worsened, patient developed acute renal failure. CRRT was ordered, but never started due to instability 10/14/2021:  Patient made comfort measure and expired"
	"1794960-1"	"1794960-1"	"SINUSITIS"	"10040753"	"50-59 years"	"50-59"	"10/8/2021 - Patient c/o fatigue, inability to walk, decreased appetite, fever, chills, and low back pain.  Noted CK is elevated (> 12,000).  A CT scan was also done and showed colitis.  Patient is admitted with rhabdomyolysis (possibly due to the COVID vaccine of which the second dose was given on 9/20/2021) and colitis.  Note that she has a PMH of rhabdomyolysis from April 2021.  Patient was admitted to the hospital from 4/30 to 5/19/2021 with rhabdomyolysis and her first COVID vaccine was given on 4/2/2021.  Patient was given IV fluids and continued on the levofloxacin which was started on 10/5/2021 for sinusitis. 10/10/2021:  Patient became hypotensive, was given fluid boluses, transferred to the ICU and started on pressors. 10/11/2021:  C. diff pCR test came back positive and antibiotics were changed to oral vancomycin and IV metronidazole 10/12/2021:  Patient was intubated; coffee ground emesis from OGT after intubation and patient was transfused with PRBCs 10/13/2021:  Hemodynamics worsened, patient developed acute renal failure. CRRT was ordered, but never started due to instability 10/14/2021:  Patient made comfort measure and expired"
	"1795156-1"	"1795156-1"	"ANGIOGRAM PULMONARY ABNORMAL"	"10002441"	"50-59 years"	"50-59"	"History per chart review and husband. The patient is a 55 Years-old Female with a history of rheumatoid arthritis, anxiety/depression, overweight who presented with acute shortness of breath. 2 weeks prior to admission she filled her routine prescription for hydroxychloroquine for her rheumatoid arthritis, however husband reports that she stopped taking this and started taking a supplement from another country called RT King and reported improvement in arthritis symptoms.  She also had congestion and sore throat around this time and tested herself for Covid with a home test that was negative. Shortly after this she was performing her job as a provider for patient that passed away from Covid and attended the funeral.  On 9/8 she reported difficulty breathing and pain in the chest and back with deep breaths.  This spontaneously resolved.  Then on 9/9 in the evening she had fever, body aches, however she attributed this to her rheumatoid arthritis and the storm pressure changes.  9/12 she felt great then played at the beach with her grandkids running around.  Then 9/12 in the evening she felt ill and took a home Covid test that was positive.  Husband took a home Covid test that was negative.  She did not initiate any outpatient care other than Mucinex and vitamin C.  9/13 in the morning she had difficulty breathing, hyperventilating, blue lips, diffuse body pain, feeling very weak to stand.  She was not drinking or caring for herself.  She was able to walk to the truck.  Her family brought her to the ER freestanding.  At the freestanding ER, she had initiated and tested positive for flu and negative for Covid by antigens.  Covid PCR later returned negative.  She was transferred to the main ER and desaturated during the transport and stopped breathing.  She maintained a pulse.  In the ER she was intubated.  Pressors Were Started to Maintain MAP. CTA was negative for PE, however ED physician and family practice physician clinically suspected PE and that there could be multiple small thrombi in the lungs rather than a large PE detectable by CTA.  She was started on heparin drip.  ICU accepted the patient and began management. She tested negative for COVID IgM antibodies and positive for COVID IgG antibodies. She devloped DIC (disseminated intravascular coagulation) and TTP (thrombotic thrombocytopenic purpura). During the hospital course she had sputum and blood cultures positive for streptoccocus pneumonia. She later had pseudomonas VAP and Enterococcus faecalis bacteremia. She had failure of lungs, liver, and kidneys. She was treated with maximal critical care management including broad spectrum antibiotics, ventilation, continuous renal replacement therapy, blood/platelet transfusions, chest tube, OG tube feedings, and anticoagulation initially that was later discontinued. She had minimal responsiveness to pain only after sedation withdrawal and was unable to breath spontaneously. On 10/9 the family agreed to palliative vent withdrawal and she expired. I suspect her severe illness may have occured due to abrupt discontinuation of hydroxychloroquine for rheumatoid arthritis and antibody dependent enhancement of influenza due to COVID vaccine."
	"1795156-1"	"1795156-1"	"ANTICOAGULANT THERAPY"	"10053468"	"50-59 years"	"50-59"	"History per chart review and husband. The patient is a 55 Years-old Female with a history of rheumatoid arthritis, anxiety/depression, overweight who presented with acute shortness of breath. 2 weeks prior to admission she filled her routine prescription for hydroxychloroquine for her rheumatoid arthritis, however husband reports that she stopped taking this and started taking a supplement from another country called RT King and reported improvement in arthritis symptoms.  She also had congestion and sore throat around this time and tested herself for Covid with a home test that was negative. Shortly after this she was performing her job as a provider for patient that passed away from Covid and attended the funeral.  On 9/8 she reported difficulty breathing and pain in the chest and back with deep breaths.  This spontaneously resolved.  Then on 9/9 in the evening she had fever, body aches, however she attributed this to her rheumatoid arthritis and the storm pressure changes.  9/12 she felt great then played at the beach with her grandkids running around.  Then 9/12 in the evening she felt ill and took a home Covid test that was positive.  Husband took a home Covid test that was negative.  She did not initiate any outpatient care other than Mucinex and vitamin C.  9/13 in the morning she had difficulty breathing, hyperventilating, blue lips, diffuse body pain, feeling very weak to stand.  She was not drinking or caring for herself.  She was able to walk to the truck.  Her family brought her to the ER freestanding.  At the freestanding ER, she had initiated and tested positive for flu and negative for Covid by antigens.  Covid PCR later returned negative.  She was transferred to the main ER and desaturated during the transport and stopped breathing.  She maintained a pulse.  In the ER she was intubated.  Pressors Were Started to Maintain MAP. CTA was negative for PE, however ED physician and family practice physician clinically suspected PE and that there could be multiple small thrombi in the lungs rather than a large PE detectable by CTA.  She was started on heparin drip.  ICU accepted the patient and began management. She tested negative for COVID IgM antibodies and positive for COVID IgG antibodies. She devloped DIC (disseminated intravascular coagulation) and TTP (thrombotic thrombocytopenic purpura). During the hospital course she had sputum and blood cultures positive for streptoccocus pneumonia. She later had pseudomonas VAP and Enterococcus faecalis bacteremia. She had failure of lungs, liver, and kidneys. She was treated with maximal critical care management including broad spectrum antibiotics, ventilation, continuous renal replacement therapy, blood/platelet transfusions, chest tube, OG tube feedings, and anticoagulation initially that was later discontinued. She had minimal responsiveness to pain only after sedation withdrawal and was unable to breath spontaneously. On 10/9 the family agreed to palliative vent withdrawal and she expired. I suspect her severe illness may have occured due to abrupt discontinuation of hydroxychloroquine for rheumatoid arthritis and antibody dependent enhancement of influenza due to COVID vaccine."
	"1795156-1"	"1795156-1"	"ASTHENIA"	"10003549"	"50-59 years"	"50-59"	"History per chart review and husband. The patient is a 55 Years-old Female with a history of rheumatoid arthritis, anxiety/depression, overweight who presented with acute shortness of breath. 2 weeks prior to admission she filled her routine prescription for hydroxychloroquine for her rheumatoid arthritis, however husband reports that she stopped taking this and started taking a supplement from another country called RT King and reported improvement in arthritis symptoms.  She also had congestion and sore throat around this time and tested herself for Covid with a home test that was negative. Shortly after this she was performing her job as a provider for patient that passed away from Covid and attended the funeral.  On 9/8 she reported difficulty breathing and pain in the chest and back with deep breaths.  This spontaneously resolved.  Then on 9/9 in the evening she had fever, body aches, however she attributed this to her rheumatoid arthritis and the storm pressure changes.  9/12 she felt great then played at the beach with her grandkids running around.  Then 9/12 in the evening she felt ill and took a home Covid test that was positive.  Husband took a home Covid test that was negative.  She did not initiate any outpatient care other than Mucinex and vitamin C.  9/13 in the morning she had difficulty breathing, hyperventilating, blue lips, diffuse body pain, feeling very weak to stand.  She was not drinking or caring for herself.  She was able to walk to the truck.  Her family brought her to the ER freestanding.  At the freestanding ER, she had initiated and tested positive for flu and negative for Covid by antigens.  Covid PCR later returned negative.  She was transferred to the main ER and desaturated during the transport and stopped breathing.  She maintained a pulse.  In the ER she was intubated.  Pressors Were Started to Maintain MAP. CTA was negative for PE, however ED physician and family practice physician clinically suspected PE and that there could be multiple small thrombi in the lungs rather than a large PE detectable by CTA.  She was started on heparin drip.  ICU accepted the patient and began management. She tested negative for COVID IgM antibodies and positive for COVID IgG antibodies. She devloped DIC (disseminated intravascular coagulation) and TTP (thrombotic thrombocytopenic purpura). During the hospital course she had sputum and blood cultures positive for streptoccocus pneumonia. She later had pseudomonas VAP and Enterococcus faecalis bacteremia. She had failure of lungs, liver, and kidneys. She was treated with maximal critical care management including broad spectrum antibiotics, ventilation, continuous renal replacement therapy, blood/platelet transfusions, chest tube, OG tube feedings, and anticoagulation initially that was later discontinued. She had minimal responsiveness to pain only after sedation withdrawal and was unable to breath spontaneously. On 10/9 the family agreed to palliative vent withdrawal and she expired. I suspect her severe illness may have occured due to abrupt discontinuation of hydroxychloroquine for rheumatoid arthritis and antibody dependent enhancement of influenza due to COVID vaccine."
	"1795156-1"	"1795156-1"	"ATELECTASIS"	"10003598"	"50-59 years"	"50-59"	"History per chart review and husband. The patient is a 55 Years-old Female with a history of rheumatoid arthritis, anxiety/depression, overweight who presented with acute shortness of breath. 2 weeks prior to admission she filled her routine prescription for hydroxychloroquine for her rheumatoid arthritis, however husband reports that she stopped taking this and started taking a supplement from another country called RT King and reported improvement in arthritis symptoms.  She also had congestion and sore throat around this time and tested herself for Covid with a home test that was negative. Shortly after this she was performing her job as a provider for patient that passed away from Covid and attended the funeral.  On 9/8 she reported difficulty breathing and pain in the chest and back with deep breaths.  This spontaneously resolved.  Then on 9/9 in the evening she had fever, body aches, however she attributed this to her rheumatoid arthritis and the storm pressure changes.  9/12 she felt great then played at the beach with her grandkids running around.  Then 9/12 in the evening she felt ill and took a home Covid test that was positive.  Husband took a home Covid test that was negative.  She did not initiate any outpatient care other than Mucinex and vitamin C.  9/13 in the morning she had difficulty breathing, hyperventilating, blue lips, diffuse body pain, feeling very weak to stand.  She was not drinking or caring for herself.  She was able to walk to the truck.  Her family brought her to the ER freestanding.  At the freestanding ER, she had initiated and tested positive for flu and negative for Covid by antigens.  Covid PCR later returned negative.  She was transferred to the main ER and desaturated during the transport and stopped breathing.  She maintained a pulse.  In the ER she was intubated.  Pressors Were Started to Maintain MAP. CTA was negative for PE, however ED physician and family practice physician clinically suspected PE and that there could be multiple small thrombi in the lungs rather than a large PE detectable by CTA.  She was started on heparin drip.  ICU accepted the patient and began management. She tested negative for COVID IgM antibodies and positive for COVID IgG antibodies. She devloped DIC (disseminated intravascular coagulation) and TTP (thrombotic thrombocytopenic purpura). During the hospital course she had sputum and blood cultures positive for streptoccocus pneumonia. She later had pseudomonas VAP and Enterococcus faecalis bacteremia. She had failure of lungs, liver, and kidneys. She was treated with maximal critical care management including broad spectrum antibiotics, ventilation, continuous renal replacement therapy, blood/platelet transfusions, chest tube, OG tube feedings, and anticoagulation initially that was later discontinued. She had minimal responsiveness to pain only after sedation withdrawal and was unable to breath spontaneously. On 10/9 the family agreed to palliative vent withdrawal and she expired. I suspect her severe illness may have occured due to abrupt discontinuation of hydroxychloroquine for rheumatoid arthritis and antibody dependent enhancement of influenza due to COVID vaccine."
	"1795156-1"	"1795156-1"	"BACK PAIN"	"10003988"	"50-59 years"	"50-59"	"History per chart review and husband. The patient is a 55 Years-old Female with a history of rheumatoid arthritis, anxiety/depression, overweight who presented with acute shortness of breath. 2 weeks prior to admission she filled her routine prescription for hydroxychloroquine for her rheumatoid arthritis, however husband reports that she stopped taking this and started taking a supplement from another country called RT King and reported improvement in arthritis symptoms.  She also had congestion and sore throat around this time and tested herself for Covid with a home test that was negative. Shortly after this she was performing her job as a provider for patient that passed away from Covid and attended the funeral.  On 9/8 she reported difficulty breathing and pain in the chest and back with deep breaths.  This spontaneously resolved.  Then on 9/9 in the evening she had fever, body aches, however she attributed this to her rheumatoid arthritis and the storm pressure changes.  9/12 she felt great then played at the beach with her grandkids running around.  Then 9/12 in the evening she felt ill and took a home Covid test that was positive.  Husband took a home Covid test that was negative.  She did not initiate any outpatient care other than Mucinex and vitamin C.  9/13 in the morning she had difficulty breathing, hyperventilating, blue lips, diffuse body pain, feeling very weak to stand.  She was not drinking or caring for herself.  She was able to walk to the truck.  Her family brought her to the ER freestanding.  At the freestanding ER, she had initiated and tested positive for flu and negative for Covid by antigens.  Covid PCR later returned negative.  She was transferred to the main ER and desaturated during the transport and stopped breathing.  She maintained a pulse.  In the ER she was intubated.  Pressors Were Started to Maintain MAP. CTA was negative for PE, however ED physician and family practice physician clinically suspected PE and that there could be multiple small thrombi in the lungs rather than a large PE detectable by CTA.  She was started on heparin drip.  ICU accepted the patient and began management. She tested negative for COVID IgM antibodies and positive for COVID IgG antibodies. She devloped DIC (disseminated intravascular coagulation) and TTP (thrombotic thrombocytopenic purpura). During the hospital course she had sputum and blood cultures positive for streptoccocus pneumonia. She later had pseudomonas VAP and Enterococcus faecalis bacteremia. She had failure of lungs, liver, and kidneys. She was treated with maximal critical care management including broad spectrum antibiotics, ventilation, continuous renal replacement therapy, blood/platelet transfusions, chest tube, OG tube feedings, and anticoagulation initially that was later discontinued. She had minimal responsiveness to pain only after sedation withdrawal and was unable to breath spontaneously. On 10/9 the family agreed to palliative vent withdrawal and she expired. I suspect her severe illness may have occured due to abrupt discontinuation of hydroxychloroquine for rheumatoid arthritis and antibody dependent enhancement of influenza due to COVID vaccine."
	"1795156-1"	"1795156-1"	"BLOOD CULTURE POSITIVE"	"10005488"	"50-59 years"	"50-59"	"History per chart review and husband. The patient is a 55 Years-old Female with a history of rheumatoid arthritis, anxiety/depression, overweight who presented with acute shortness of breath. 2 weeks prior to admission she filled her routine prescription for hydroxychloroquine for her rheumatoid arthritis, however husband reports that she stopped taking this and started taking a supplement from another country called RT King and reported improvement in arthritis symptoms.  She also had congestion and sore throat around this time and tested herself for Covid with a home test that was negative. Shortly after this she was performing her job as a provider for patient that passed away from Covid and attended the funeral.  On 9/8 she reported difficulty breathing and pain in the chest and back with deep breaths.  This spontaneously resolved.  Then on 9/9 in the evening she had fever, body aches, however she attributed this to her rheumatoid arthritis and the storm pressure changes.  9/12 she felt great then played at the beach with her grandkids running around.  Then 9/12 in the evening she felt ill and took a home Covid test that was positive.  Husband took a home Covid test that was negative.  She did not initiate any outpatient care other than Mucinex and vitamin C.  9/13 in the morning she had difficulty breathing, hyperventilating, blue lips, diffuse body pain, feeling very weak to stand.  She was not drinking or caring for herself.  She was able to walk to the truck.  Her family brought her to the ER freestanding.  At the freestanding ER, she had initiated and tested positive for flu and negative for Covid by antigens.  Covid PCR later returned negative.  She was transferred to the main ER and desaturated during the transport and stopped breathing.  She maintained a pulse.  In the ER she was intubated.  Pressors Were Started to Maintain MAP. CTA was negative for PE, however ED physician and family practice physician clinically suspected PE and that there could be multiple small thrombi in the lungs rather than a large PE detectable by CTA.  She was started on heparin drip.  ICU accepted the patient and began management. She tested negative for COVID IgM antibodies and positive for COVID IgG antibodies. She devloped DIC (disseminated intravascular coagulation) and TTP (thrombotic thrombocytopenic purpura). During the hospital course she had sputum and blood cultures positive for streptoccocus pneumonia. She later had pseudomonas VAP and Enterococcus faecalis bacteremia. She had failure of lungs, liver, and kidneys. She was treated with maximal critical care management including broad spectrum antibiotics, ventilation, continuous renal replacement therapy, blood/platelet transfusions, chest tube, OG tube feedings, and anticoagulation initially that was later discontinued. She had minimal responsiveness to pain only after sedation withdrawal and was unable to breath spontaneously. On 10/9 the family agreed to palliative vent withdrawal and she expired. I suspect her severe illness may have occured due to abrupt discontinuation of hydroxychloroquine for rheumatoid arthritis and antibody dependent enhancement of influenza due to COVID vaccine."
	"1795156-1"	"1795156-1"	"CHEST PAIN"	"10008479"	"50-59 years"	"50-59"	"History per chart review and husband. The patient is a 55 Years-old Female with a history of rheumatoid arthritis, anxiety/depression, overweight who presented with acute shortness of breath. 2 weeks prior to admission she filled her routine prescription for hydroxychloroquine for her rheumatoid arthritis, however husband reports that she stopped taking this and started taking a supplement from another country called RT King and reported improvement in arthritis symptoms.  She also had congestion and sore throat around this time and tested herself for Covid with a home test that was negative. Shortly after this she was performing her job as a provider for patient that passed away from Covid and attended the funeral.  On 9/8 she reported difficulty breathing and pain in the chest and back with deep breaths.  This spontaneously resolved.  Then on 9/9 in the evening she had fever, body aches, however she attributed this to her rheumatoid arthritis and the storm pressure changes.  9/12 she felt great then played at the beach with her grandkids running around.  Then 9/12 in the evening she felt ill and took a home Covid test that was positive.  Husband took a home Covid test that was negative.  She did not initiate any outpatient care other than Mucinex and vitamin C.  9/13 in the morning she had difficulty breathing, hyperventilating, blue lips, diffuse body pain, feeling very weak to stand.  She was not drinking or caring for herself.  She was able to walk to the truck.  Her family brought her to the ER freestanding.  At the freestanding ER, she had initiated and tested positive for flu and negative for Covid by antigens.  Covid PCR later returned negative.  She was transferred to the main ER and desaturated during the transport and stopped breathing.  She maintained a pulse.  In the ER she was intubated.  Pressors Were Started to Maintain MAP. CTA was negative for PE, however ED physician and family practice physician clinically suspected PE and that there could be multiple small thrombi in the lungs rather than a large PE detectable by CTA.  She was started on heparin drip.  ICU accepted the patient and began management. She tested negative for COVID IgM antibodies and positive for COVID IgG antibodies. She devloped DIC (disseminated intravascular coagulation) and TTP (thrombotic thrombocytopenic purpura). During the hospital course she had sputum and blood cultures positive for streptoccocus pneumonia. She later had pseudomonas VAP and Enterococcus faecalis bacteremia. She had failure of lungs, liver, and kidneys. She was treated with maximal critical care management including broad spectrum antibiotics, ventilation, continuous renal replacement therapy, blood/platelet transfusions, chest tube, OG tube feedings, and anticoagulation initially that was later discontinued. She had minimal responsiveness to pain only after sedation withdrawal and was unable to breath spontaneously. On 10/9 the family agreed to palliative vent withdrawal and she expired. I suspect her severe illness may have occured due to abrupt discontinuation of hydroxychloroquine for rheumatoid arthritis and antibody dependent enhancement of influenza due to COVID vaccine."
	"1795156-1"	"1795156-1"	"CHEST TUBE INSERTION"	"10050522"	"50-59 years"	"50-59"	"History per chart review and husband. The patient is a 55 Years-old Female with a history of rheumatoid arthritis, anxiety/depression, overweight who presented with acute shortness of breath. 2 weeks prior to admission she filled her routine prescription for hydroxychloroquine for her rheumatoid arthritis, however husband reports that she stopped taking this and started taking a supplement from another country called RT King and reported improvement in arthritis symptoms.  She also had congestion and sore throat around this time and tested herself for Covid with a home test that was negative. Shortly after this she was performing her job as a provider for patient that passed away from Covid and attended the funeral.  On 9/8 she reported difficulty breathing and pain in the chest and back with deep breaths.  This spontaneously resolved.  Then on 9/9 in the evening she had fever, body aches, however she attributed this to her rheumatoid arthritis and the storm pressure changes.  9/12 she felt great then played at the beach with her grandkids running around.  Then 9/12 in the evening she felt ill and took a home Covid test that was positive.  Husband took a home Covid test that was negative.  She did not initiate any outpatient care other than Mucinex and vitamin C.  9/13 in the morning she had difficulty breathing, hyperventilating, blue lips, diffuse body pain, feeling very weak to stand.  She was not drinking or caring for herself.  She was able to walk to the truck.  Her family brought her to the ER freestanding.  At the freestanding ER, she had initiated and tested positive for flu and negative for Covid by antigens.  Covid PCR later returned negative.  She was transferred to the main ER and desaturated during the transport and stopped breathing.  She maintained a pulse.  In the ER she was intubated.  Pressors Were Started to Maintain MAP. CTA was negative for PE, however ED physician and family practice physician clinically suspected PE and that there could be multiple small thrombi in the lungs rather than a large PE detectable by CTA.  She was started on heparin drip.  ICU accepted the patient and began management. She tested negative for COVID IgM antibodies and positive for COVID IgG antibodies. She devloped DIC (disseminated intravascular coagulation) and TTP (thrombotic thrombocytopenic purpura). During the hospital course she had sputum and blood cultures positive for streptoccocus pneumonia. She later had pseudomonas VAP and Enterococcus faecalis bacteremia. She had failure of lungs, liver, and kidneys. She was treated with maximal critical care management including broad spectrum antibiotics, ventilation, continuous renal replacement therapy, blood/platelet transfusions, chest tube, OG tube feedings, and anticoagulation initially that was later discontinued. She had minimal responsiveness to pain only after sedation withdrawal and was unable to breath spontaneously. On 10/9 the family agreed to palliative vent withdrawal and she expired. I suspect her severe illness may have occured due to abrupt discontinuation of hydroxychloroquine for rheumatoid arthritis and antibody dependent enhancement of influenza due to COVID vaccine."
	"1795156-1"	"1795156-1"	"CONDITION AGGRAVATED"	"10010264"	"50-59 years"	"50-59"	"History per chart review and husband. The patient is a 55 Years-old Female with a history of rheumatoid arthritis, anxiety/depression, overweight who presented with acute shortness of breath. 2 weeks prior to admission she filled her routine prescription for hydroxychloroquine for her rheumatoid arthritis, however husband reports that she stopped taking this and started taking a supplement from another country called RT King and reported improvement in arthritis symptoms.  She also had congestion and sore throat around this time and tested herself for Covid with a home test that was negative. Shortly after this she was performing her job as a provider for patient that passed away from Covid and attended the funeral.  On 9/8 she reported difficulty breathing and pain in the chest and back with deep breaths.  This spontaneously resolved.  Then on 9/9 in the evening she had fever, body aches, however she attributed this to her rheumatoid arthritis and the storm pressure changes.  9/12 she felt great then played at the beach with her grandkids running around.  Then 9/12 in the evening she felt ill and took a home Covid test that was positive.  Husband took a home Covid test that was negative.  She did not initiate any outpatient care other than Mucinex and vitamin C.  9/13 in the morning she had difficulty breathing, hyperventilating, blue lips, diffuse body pain, feeling very weak to stand.  She was not drinking or caring for herself.  She was able to walk to the truck.  Her family brought her to the ER freestanding.  At the freestanding ER, she had initiated and tested positive for flu and negative for Covid by antigens.  Covid PCR later returned negative.  She was transferred to the main ER and desaturated during the transport and stopped breathing.  She maintained a pulse.  In the ER she was intubated.  Pressors Were Started to Maintain MAP. CTA was negative for PE, however ED physician and family practice physician clinically suspected PE and that there could be multiple small thrombi in the lungs rather than a large PE detectable by CTA.  She was started on heparin drip.  ICU accepted the patient and began management. She tested negative for COVID IgM antibodies and positive for COVID IgG antibodies. She devloped DIC (disseminated intravascular coagulation) and TTP (thrombotic thrombocytopenic purpura). During the hospital course she had sputum and blood cultures positive for streptoccocus pneumonia. She later had pseudomonas VAP and Enterococcus faecalis bacteremia. She had failure of lungs, liver, and kidneys. She was treated with maximal critical care management including broad spectrum antibiotics, ventilation, continuous renal replacement therapy, blood/platelet transfusions, chest tube, OG tube feedings, and anticoagulation initially that was later discontinued. She had minimal responsiveness to pain only after sedation withdrawal and was unable to breath spontaneously. On 10/9 the family agreed to palliative vent withdrawal and she expired. I suspect her severe illness may have occured due to abrupt discontinuation of hydroxychloroquine for rheumatoid arthritis and antibody dependent enhancement of influenza due to COVID vaccine."
	"1795156-1"	"1795156-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"History per chart review and husband. The patient is a 55 Years-old Female with a history of rheumatoid arthritis, anxiety/depression, overweight who presented with acute shortness of breath. 2 weeks prior to admission she filled her routine prescription for hydroxychloroquine for her rheumatoid arthritis, however husband reports that she stopped taking this and started taking a supplement from another country called RT King and reported improvement in arthritis symptoms.  She also had congestion and sore throat around this time and tested herself for Covid with a home test that was negative. Shortly after this she was performing her job as a provider for patient that passed away from Covid and attended the funeral.  On 9/8 she reported difficulty breathing and pain in the chest and back with deep breaths.  This spontaneously resolved.  Then on 9/9 in the evening she had fever, body aches, however she attributed this to her rheumatoid arthritis and the storm pressure changes.  9/12 she felt great then played at the beach with her grandkids running around.  Then 9/12 in the evening she felt ill and took a home Covid test that was positive.  Husband took a home Covid test that was negative.  She did not initiate any outpatient care other than Mucinex and vitamin C.  9/13 in the morning she had difficulty breathing, hyperventilating, blue lips, diffuse body pain, feeling very weak to stand.  She was not drinking or caring for herself.  She was able to walk to the truck.  Her family brought her to the ER freestanding.  At the freestanding ER, she had initiated and tested positive for flu and negative for Covid by antigens.  Covid PCR later returned negative.  She was transferred to the main ER and desaturated during the transport and stopped breathing.  She maintained a pulse.  In the ER she was intubated.  Pressors Were Started to Maintain MAP. CTA was negative for PE, however ED physician and family practice physician clinically suspected PE and that there could be multiple small thrombi in the lungs rather than a large PE detectable by CTA.  She was started on heparin drip.  ICU accepted the patient and began management. She tested negative for COVID IgM antibodies and positive for COVID IgG antibodies. She devloped DIC (disseminated intravascular coagulation) and TTP (thrombotic thrombocytopenic purpura). During the hospital course she had sputum and blood cultures positive for streptoccocus pneumonia. She later had pseudomonas VAP and Enterococcus faecalis bacteremia. She had failure of lungs, liver, and kidneys. She was treated with maximal critical care management including broad spectrum antibiotics, ventilation, continuous renal replacement therapy, blood/platelet transfusions, chest tube, OG tube feedings, and anticoagulation initially that was later discontinued. She had minimal responsiveness to pain only after sedation withdrawal and was unable to breath spontaneously. On 10/9 the family agreed to palliative vent withdrawal and she expired. I suspect her severe illness may have occured due to abrupt discontinuation of hydroxychloroquine for rheumatoid arthritis and antibody dependent enhancement of influenza due to COVID vaccine."
	"1795156-1"	"1795156-1"	"CYANOSIS"	"10011703"	"50-59 years"	"50-59"	"History per chart review and husband. The patient is a 55 Years-old Female with a history of rheumatoid arthritis, anxiety/depression, overweight who presented with acute shortness of breath. 2 weeks prior to admission she filled her routine prescription for hydroxychloroquine for her rheumatoid arthritis, however husband reports that she stopped taking this and started taking a supplement from another country called RT King and reported improvement in arthritis symptoms.  She also had congestion and sore throat around this time and tested herself for Covid with a home test that was negative. Shortly after this she was performing her job as a provider for patient that passed away from Covid and attended the funeral.  On 9/8 she reported difficulty breathing and pain in the chest and back with deep breaths.  This spontaneously resolved.  Then on 9/9 in the evening she had fever, body aches, however she attributed this to her rheumatoid arthritis and the storm pressure changes.  9/12 she felt great then played at the beach with her grandkids running around.  Then 9/12 in the evening she felt ill and took a home Covid test that was positive.  Husband took a home Covid test that was negative.  She did not initiate any outpatient care other than Mucinex and vitamin C.  9/13 in the morning she had difficulty breathing, hyperventilating, blue lips, diffuse body pain, feeling very weak to stand.  She was not drinking or caring for herself.  She was able to walk to the truck.  Her family brought her to the ER freestanding.  At the freestanding ER, she had initiated and tested positive for flu and negative for Covid by antigens.  Covid PCR later returned negative.  She was transferred to the main ER and desaturated during the transport and stopped breathing.  She maintained a pulse.  In the ER she was intubated.  Pressors Were Started to Maintain MAP. CTA was negative for PE, however ED physician and family practice physician clinically suspected PE and that there could be multiple small thrombi in the lungs rather than a large PE detectable by CTA.  She was started on heparin drip.  ICU accepted the patient and began management. She tested negative for COVID IgM antibodies and positive for COVID IgG antibodies. She devloped DIC (disseminated intravascular coagulation) and TTP (thrombotic thrombocytopenic purpura). During the hospital course she had sputum and blood cultures positive for streptoccocus pneumonia. She later had pseudomonas VAP and Enterococcus faecalis bacteremia. She had failure of lungs, liver, and kidneys. She was treated with maximal critical care management including broad spectrum antibiotics, ventilation, continuous renal replacement therapy, blood/platelet transfusions, chest tube, OG tube feedings, and anticoagulation initially that was later discontinued. She had minimal responsiveness to pain only after sedation withdrawal and was unable to breath spontaneously. On 10/9 the family agreed to palliative vent withdrawal and she expired. I suspect her severe illness may have occured due to abrupt discontinuation of hydroxychloroquine for rheumatoid arthritis and antibody dependent enhancement of influenza due to COVID vaccine."
	"1795156-1"	"1795156-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"History per chart review and husband. The patient is a 55 Years-old Female with a history of rheumatoid arthritis, anxiety/depression, overweight who presented with acute shortness of breath. 2 weeks prior to admission she filled her routine prescription for hydroxychloroquine for her rheumatoid arthritis, however husband reports that she stopped taking this and started taking a supplement from another country called RT King and reported improvement in arthritis symptoms.  She also had congestion and sore throat around this time and tested herself for Covid with a home test that was negative. Shortly after this she was performing her job as a provider for patient that passed away from Covid and attended the funeral.  On 9/8 she reported difficulty breathing and pain in the chest and back with deep breaths.  This spontaneously resolved.  Then on 9/9 in the evening she had fever, body aches, however she attributed this to her rheumatoid arthritis and the storm pressure changes.  9/12 she felt great then played at the beach with her grandkids running around.  Then 9/12 in the evening she felt ill and took a home Covid test that was positive.  Husband took a home Covid test that was negative.  She did not initiate any outpatient care other than Mucinex and vitamin C.  9/13 in the morning she had difficulty breathing, hyperventilating, blue lips, diffuse body pain, feeling very weak to stand.  She was not drinking or caring for herself.  She was able to walk to the truck.  Her family brought her to the ER freestanding.  At the freestanding ER, she had initiated and tested positive for flu and negative for Covid by antigens.  Covid PCR later returned negative.  She was transferred to the main ER and desaturated during the transport and stopped breathing.  She maintained a pulse.  In the ER she was intubated.  Pressors Were Started to Maintain MAP. CTA was negative for PE, however ED physician and family practice physician clinically suspected PE and that there could be multiple small thrombi in the lungs rather than a large PE detectable by CTA.  She was started on heparin drip.  ICU accepted the patient and began management. She tested negative for COVID IgM antibodies and positive for COVID IgG antibodies. She devloped DIC (disseminated intravascular coagulation) and TTP (thrombotic thrombocytopenic purpura). During the hospital course she had sputum and blood cultures positive for streptoccocus pneumonia. She later had pseudomonas VAP and Enterococcus faecalis bacteremia. She had failure of lungs, liver, and kidneys. She was treated with maximal critical care management including broad spectrum antibiotics, ventilation, continuous renal replacement therapy, blood/platelet transfusions, chest tube, OG tube feedings, and anticoagulation initially that was later discontinued. She had minimal responsiveness to pain only after sedation withdrawal and was unable to breath spontaneously. On 10/9 the family agreed to palliative vent withdrawal and she expired. I suspect her severe illness may have occured due to abrupt discontinuation of hydroxychloroquine for rheumatoid arthritis and antibody dependent enhancement of influenza due to COVID vaccine."
	"1795156-1"	"1795156-1"	"DISSEMINATED INTRAVASCULAR COAGULATION"	"10013442"	"50-59 years"	"50-59"	"History per chart review and husband. The patient is a 55 Years-old Female with a history of rheumatoid arthritis, anxiety/depression, overweight who presented with acute shortness of breath. 2 weeks prior to admission she filled her routine prescription for hydroxychloroquine for her rheumatoid arthritis, however husband reports that she stopped taking this and started taking a supplement from another country called RT King and reported improvement in arthritis symptoms.  She also had congestion and sore throat around this time and tested herself for Covid with a home test that was negative. Shortly after this she was performing her job as a provider for patient that passed away from Covid and attended the funeral.  On 9/8 she reported difficulty breathing and pain in the chest and back with deep breaths.  This spontaneously resolved.  Then on 9/9 in the evening she had fever, body aches, however she attributed this to her rheumatoid arthritis and the storm pressure changes.  9/12 she felt great then played at the beach with her grandkids running around.  Then 9/12 in the evening she felt ill and took a home Covid test that was positive.  Husband took a home Covid test that was negative.  She did not initiate any outpatient care other than Mucinex and vitamin C.  9/13 in the morning she had difficulty breathing, hyperventilating, blue lips, diffuse body pain, feeling very weak to stand.  She was not drinking or caring for herself.  She was able to walk to the truck.  Her family brought her to the ER freestanding.  At the freestanding ER, she had initiated and tested positive for flu and negative for Covid by antigens.  Covid PCR later returned negative.  She was transferred to the main ER and desaturated during the transport and stopped breathing.  She maintained a pulse.  In the ER she was intubated.  Pressors Were Started to Maintain MAP. CTA was negative for PE, however ED physician and family practice physician clinically suspected PE and that there could be multiple small thrombi in the lungs rather than a large PE detectable by CTA.  She was started on heparin drip.  ICU accepted the patient and began management. She tested negative for COVID IgM antibodies and positive for COVID IgG antibodies. She devloped DIC (disseminated intravascular coagulation) and TTP (thrombotic thrombocytopenic purpura). During the hospital course she had sputum and blood cultures positive for streptoccocus pneumonia. She later had pseudomonas VAP and Enterococcus faecalis bacteremia. She had failure of lungs, liver, and kidneys. She was treated with maximal critical care management including broad spectrum antibiotics, ventilation, continuous renal replacement therapy, blood/platelet transfusions, chest tube, OG tube feedings, and anticoagulation initially that was later discontinued. She had minimal responsiveness to pain only after sedation withdrawal and was unable to breath spontaneously. On 10/9 the family agreed to palliative vent withdrawal and she expired. I suspect her severe illness may have occured due to abrupt discontinuation of hydroxychloroquine for rheumatoid arthritis and antibody dependent enhancement of influenza due to COVID vaccine."
	"1795156-1"	"1795156-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"History per chart review and husband. The patient is a 55 Years-old Female with a history of rheumatoid arthritis, anxiety/depression, overweight who presented with acute shortness of breath. 2 weeks prior to admission she filled her routine prescription for hydroxychloroquine for her rheumatoid arthritis, however husband reports that she stopped taking this and started taking a supplement from another country called RT King and reported improvement in arthritis symptoms.  She also had congestion and sore throat around this time and tested herself for Covid with a home test that was negative. Shortly after this she was performing her job as a provider for patient that passed away from Covid and attended the funeral.  On 9/8 she reported difficulty breathing and pain in the chest and back with deep breaths.  This spontaneously resolved.  Then on 9/9 in the evening she had fever, body aches, however she attributed this to her rheumatoid arthritis and the storm pressure changes.  9/12 she felt great then played at the beach with her grandkids running around.  Then 9/12 in the evening she felt ill and took a home Covid test that was positive.  Husband took a home Covid test that was negative.  She did not initiate any outpatient care other than Mucinex and vitamin C.  9/13 in the morning she had difficulty breathing, hyperventilating, blue lips, diffuse body pain, feeling very weak to stand.  She was not drinking or caring for herself.  She was able to walk to the truck.  Her family brought her to the ER freestanding.  At the freestanding ER, she had initiated and tested positive for flu and negative for Covid by antigens.  Covid PCR later returned negative.  She was transferred to the main ER and desaturated during the transport and stopped breathing.  She maintained a pulse.  In the ER she was intubated.  Pressors Were Started to Maintain MAP. CTA was negative for PE, however ED physician and family practice physician clinically suspected PE and that there could be multiple small thrombi in the lungs rather than a large PE detectable by CTA.  She was started on heparin drip.  ICU accepted the patient and began management. She tested negative for COVID IgM antibodies and positive for COVID IgG antibodies. She devloped DIC (disseminated intravascular coagulation) and TTP (thrombotic thrombocytopenic purpura). During the hospital course she had sputum and blood cultures positive for streptoccocus pneumonia. She later had pseudomonas VAP and Enterococcus faecalis bacteremia. She had failure of lungs, liver, and kidneys. She was treated with maximal critical care management including broad spectrum antibiotics, ventilation, continuous renal replacement therapy, blood/platelet transfusions, chest tube, OG tube feedings, and anticoagulation initially that was later discontinued. She had minimal responsiveness to pain only after sedation withdrawal and was unable to breath spontaneously. On 10/9 the family agreed to palliative vent withdrawal and she expired. I suspect her severe illness may have occured due to abrupt discontinuation of hydroxychloroquine for rheumatoid arthritis and antibody dependent enhancement of influenza due to COVID vaccine."
	"1795156-1"	"1795156-1"	"DYSSTASIA"	"10050256"	"50-59 years"	"50-59"	"History per chart review and husband. The patient is a 55 Years-old Female with a history of rheumatoid arthritis, anxiety/depression, overweight who presented with acute shortness of breath. 2 weeks prior to admission she filled her routine prescription for hydroxychloroquine for her rheumatoid arthritis, however husband reports that she stopped taking this and started taking a supplement from another country called RT King and reported improvement in arthritis symptoms.  She also had congestion and sore throat around this time and tested herself for Covid with a home test that was negative. Shortly after this she was performing her job as a provider for patient that passed away from Covid and attended the funeral.  On 9/8 she reported difficulty breathing and pain in the chest and back with deep breaths.  This spontaneously resolved.  Then on 9/9 in the evening she had fever, body aches, however she attributed this to her rheumatoid arthritis and the storm pressure changes.  9/12 she felt great then played at the beach with her grandkids running around.  Then 9/12 in the evening she felt ill and took a home Covid test that was positive.  Husband took a home Covid test that was negative.  She did not initiate any outpatient care other than Mucinex and vitamin C.  9/13 in the morning she had difficulty breathing, hyperventilating, blue lips, diffuse body pain, feeling very weak to stand.  She was not drinking or caring for herself.  She was able to walk to the truck.  Her family brought her to the ER freestanding.  At the freestanding ER, she had initiated and tested positive for flu and negative for Covid by antigens.  Covid PCR later returned negative.  She was transferred to the main ER and desaturated during the transport and stopped breathing.  She maintained a pulse.  In the ER she was intubated.  Pressors Were Started to Maintain MAP. CTA was negative for PE, however ED physician and family practice physician clinically suspected PE and that there could be multiple small thrombi in the lungs rather than a large PE detectable by CTA.  She was started on heparin drip.  ICU accepted the patient and began management. She tested negative for COVID IgM antibodies and positive for COVID IgG antibodies. She devloped DIC (disseminated intravascular coagulation) and TTP (thrombotic thrombocytopenic purpura). During the hospital course she had sputum and blood cultures positive for streptoccocus pneumonia. She later had pseudomonas VAP and Enterococcus faecalis bacteremia. She had failure of lungs, liver, and kidneys. She was treated with maximal critical care management including broad spectrum antibiotics, ventilation, continuous renal replacement therapy, blood/platelet transfusions, chest tube, OG tube feedings, and anticoagulation initially that was later discontinued. She had minimal responsiveness to pain only after sedation withdrawal and was unable to breath spontaneously. On 10/9 the family agreed to palliative vent withdrawal and she expired. I suspect her severe illness may have occured due to abrupt discontinuation of hydroxychloroquine for rheumatoid arthritis and antibody dependent enhancement of influenza due to COVID vaccine."
	"1795156-1"	"1795156-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"50-59 years"	"50-59"	"History per chart review and husband. The patient is a 55 Years-old Female with a history of rheumatoid arthritis, anxiety/depression, overweight who presented with acute shortness of breath. 2 weeks prior to admission she filled her routine prescription for hydroxychloroquine for her rheumatoid arthritis, however husband reports that she stopped taking this and started taking a supplement from another country called RT King and reported improvement in arthritis symptoms.  She also had congestion and sore throat around this time and tested herself for Covid with a home test that was negative. Shortly after this she was performing her job as a provider for patient that passed away from Covid and attended the funeral.  On 9/8 she reported difficulty breathing and pain in the chest and back with deep breaths.  This spontaneously resolved.  Then on 9/9 in the evening she had fever, body aches, however she attributed this to her rheumatoid arthritis and the storm pressure changes.  9/12 she felt great then played at the beach with her grandkids running around.  Then 9/12 in the evening she felt ill and took a home Covid test that was positive.  Husband took a home Covid test that was negative.  She did not initiate any outpatient care other than Mucinex and vitamin C.  9/13 in the morning she had difficulty breathing, hyperventilating, blue lips, diffuse body pain, feeling very weak to stand.  She was not drinking or caring for herself.  She was able to walk to the truck.  Her family brought her to the ER freestanding.  At the freestanding ER, she had initiated and tested positive for flu and negative for Covid by antigens.  Covid PCR later returned negative.  She was transferred to the main ER and desaturated during the transport and stopped breathing.  She maintained a pulse.  In the ER she was intubated.  Pressors Were Started to Maintain MAP. CTA was negative for PE, however ED physician and family practice physician clinically suspected PE and that there could be multiple small thrombi in the lungs rather than a large PE detectable by CTA.  She was started on heparin drip.  ICU accepted the patient and began management. She tested negative for COVID IgM antibodies and positive for COVID IgG antibodies. She devloped DIC (disseminated intravascular coagulation) and TTP (thrombotic thrombocytopenic purpura). During the hospital course she had sputum and blood cultures positive for streptoccocus pneumonia. She later had pseudomonas VAP and Enterococcus faecalis bacteremia. She had failure of lungs, liver, and kidneys. She was treated with maximal critical care management including broad spectrum antibiotics, ventilation, continuous renal replacement therapy, blood/platelet transfusions, chest tube, OG tube feedings, and anticoagulation initially that was later discontinued. She had minimal responsiveness to pain only after sedation withdrawal and was unable to breath spontaneously. On 10/9 the family agreed to palliative vent withdrawal and she expired. I suspect her severe illness may have occured due to abrupt discontinuation of hydroxychloroquine for rheumatoid arthritis and antibody dependent enhancement of influenza due to COVID vaccine."
	"1795156-1"	"1795156-1"	"ENTEROCOCCAL BACTERAEMIA"	"10014885"	"50-59 years"	"50-59"	"History per chart review and husband. The patient is a 55 Years-old Female with a history of rheumatoid arthritis, anxiety/depression, overweight who presented with acute shortness of breath. 2 weeks prior to admission she filled her routine prescription for hydroxychloroquine for her rheumatoid arthritis, however husband reports that she stopped taking this and started taking a supplement from another country called RT King and reported improvement in arthritis symptoms.  She also had congestion and sore throat around this time and tested herself for Covid with a home test that was negative. Shortly after this she was performing her job as a provider for patient that passed away from Covid and attended the funeral.  On 9/8 she reported difficulty breathing and pain in the chest and back with deep breaths.  This spontaneously resolved.  Then on 9/9 in the evening she had fever, body aches, however she attributed this to her rheumatoid arthritis and the storm pressure changes.  9/12 she felt great then played at the beach with her grandkids running around.  Then 9/12 in the evening she felt ill and took a home Covid test that was positive.  Husband took a home Covid test that was negative.  She did not initiate any outpatient care other than Mucinex and vitamin C.  9/13 in the morning she had difficulty breathing, hyperventilating, blue lips, diffuse body pain, feeling very weak to stand.  She was not drinking or caring for herself.  She was able to walk to the truck.  Her family brought her to the ER freestanding.  At the freestanding ER, she had initiated and tested positive for flu and negative for Covid by antigens.  Covid PCR later returned negative.  She was transferred to the main ER and desaturated during the transport and stopped breathing.  She maintained a pulse.  In the ER she was intubated.  Pressors Were Started to Maintain MAP. CTA was negative for PE, however ED physician and family practice physician clinically suspected PE and that there could be multiple small thrombi in the lungs rather than a large PE detectable by CTA.  She was started on heparin drip.  ICU accepted the patient and began management. She tested negative for COVID IgM antibodies and positive for COVID IgG antibodies. She devloped DIC (disseminated intravascular coagulation) and TTP (thrombotic thrombocytopenic purpura). During the hospital course she had sputum and blood cultures positive for streptoccocus pneumonia. She later had pseudomonas VAP and Enterococcus faecalis bacteremia. She had failure of lungs, liver, and kidneys. She was treated with maximal critical care management including broad spectrum antibiotics, ventilation, continuous renal replacement therapy, blood/platelet transfusions, chest tube, OG tube feedings, and anticoagulation initially that was later discontinued. She had minimal responsiveness to pain only after sedation withdrawal and was unable to breath spontaneously. On 10/9 the family agreed to palliative vent withdrawal and she expired. I suspect her severe illness may have occured due to abrupt discontinuation of hydroxychloroquine for rheumatoid arthritis and antibody dependent enhancement of influenza due to COVID vaccine."
	"1795156-1"	"1795156-1"	"FLUID INTAKE REDUCED"	"10056291"	"50-59 years"	"50-59"	"History per chart review and husband. The patient is a 55 Years-old Female with a history of rheumatoid arthritis, anxiety/depression, overweight who presented with acute shortness of breath. 2 weeks prior to admission she filled her routine prescription for hydroxychloroquine for her rheumatoid arthritis, however husband reports that she stopped taking this and started taking a supplement from another country called RT King and reported improvement in arthritis symptoms.  She also had congestion and sore throat around this time and tested herself for Covid with a home test that was negative. Shortly after this she was performing her job as a provider for patient that passed away from Covid and attended the funeral.  On 9/8 she reported difficulty breathing and pain in the chest and back with deep breaths.  This spontaneously resolved.  Then on 9/9 in the evening she had fever, body aches, however she attributed this to her rheumatoid arthritis and the storm pressure changes.  9/12 she felt great then played at the beach with her grandkids running around.  Then 9/12 in the evening she felt ill and took a home Covid test that was positive.  Husband took a home Covid test that was negative.  She did not initiate any outpatient care other than Mucinex and vitamin C.  9/13 in the morning she had difficulty breathing, hyperventilating, blue lips, diffuse body pain, feeling very weak to stand.  She was not drinking or caring for herself.  She was able to walk to the truck.  Her family brought her to the ER freestanding.  At the freestanding ER, she had initiated and tested positive for flu and negative for Covid by antigens.  Covid PCR later returned negative.  She was transferred to the main ER and desaturated during the transport and stopped breathing.  She maintained a pulse.  In the ER she was intubated.  Pressors Were Started to Maintain MAP. CTA was negative for PE, however ED physician and family practice physician clinically suspected PE and that there could be multiple small thrombi in the lungs rather than a large PE detectable by CTA.  She was started on heparin drip.  ICU accepted the patient and began management. She tested negative for COVID IgM antibodies and positive for COVID IgG antibodies. She devloped DIC (disseminated intravascular coagulation) and TTP (thrombotic thrombocytopenic purpura). During the hospital course she had sputum and blood cultures positive for streptoccocus pneumonia. She later had pseudomonas VAP and Enterococcus faecalis bacteremia. She had failure of lungs, liver, and kidneys. She was treated with maximal critical care management including broad spectrum antibiotics, ventilation, continuous renal replacement therapy, blood/platelet transfusions, chest tube, OG tube feedings, and anticoagulation initially that was later discontinued. She had minimal responsiveness to pain only after sedation withdrawal and was unable to breath spontaneously. On 10/9 the family agreed to palliative vent withdrawal and she expired. I suspect her severe illness may have occured due to abrupt discontinuation of hydroxychloroquine for rheumatoid arthritis and antibody dependent enhancement of influenza due to COVID vaccine."
	"1795156-1"	"1795156-1"	"GASTROINTESTINAL TUBE INSERTION"	"10053050"	"50-59 years"	"50-59"	"History per chart review and husband. The patient is a 55 Years-old Female with a history of rheumatoid arthritis, anxiety/depression, overweight who presented with acute shortness of breath. 2 weeks prior to admission she filled her routine prescription for hydroxychloroquine for her rheumatoid arthritis, however husband reports that she stopped taking this and started taking a supplement from another country called RT King and reported improvement in arthritis symptoms.  She also had congestion and sore throat around this time and tested herself for Covid with a home test that was negative. Shortly after this she was performing her job as a provider for patient that passed away from Covid and attended the funeral.  On 9/8 she reported difficulty breathing and pain in the chest and back with deep breaths.  This spontaneously resolved.  Then on 9/9 in the evening she had fever, body aches, however she attributed this to her rheumatoid arthritis and the storm pressure changes.  9/12 she felt great then played at the beach with her grandkids running around.  Then 9/12 in the evening she felt ill and took a home Covid test that was positive.  Husband took a home Covid test that was negative.  She did not initiate any outpatient care other than Mucinex and vitamin C.  9/13 in the morning she had difficulty breathing, hyperventilating, blue lips, diffuse body pain, feeling very weak to stand.  She was not drinking or caring for herself.  She was able to walk to the truck.  Her family brought her to the ER freestanding.  At the freestanding ER, she had initiated and tested positive for flu and negative for Covid by antigens.  Covid PCR later returned negative.  She was transferred to the main ER and desaturated during the transport and stopped breathing.  She maintained a pulse.  In the ER she was intubated.  Pressors Were Started to Maintain MAP. CTA was negative for PE, however ED physician and family practice physician clinically suspected PE and that there could be multiple small thrombi in the lungs rather than a large PE detectable by CTA.  She was started on heparin drip.  ICU accepted the patient and began management. She tested negative for COVID IgM antibodies and positive for COVID IgG antibodies. She devloped DIC (disseminated intravascular coagulation) and TTP (thrombotic thrombocytopenic purpura). During the hospital course she had sputum and blood cultures positive for streptoccocus pneumonia. She later had pseudomonas VAP and Enterococcus faecalis bacteremia. She had failure of lungs, liver, and kidneys. She was treated with maximal critical care management including broad spectrum antibiotics, ventilation, continuous renal replacement therapy, blood/platelet transfusions, chest tube, OG tube feedings, and anticoagulation initially that was later discontinued. She had minimal responsiveness to pain only after sedation withdrawal and was unable to breath spontaneously. On 10/9 the family agreed to palliative vent withdrawal and she expired. I suspect her severe illness may have occured due to abrupt discontinuation of hydroxychloroquine for rheumatoid arthritis and antibody dependent enhancement of influenza due to COVID vaccine."
	"1795156-1"	"1795156-1"	"HEPATIC FAILURE"	"10019663"	"50-59 years"	"50-59"	"History per chart review and husband. The patient is a 55 Years-old Female with a history of rheumatoid arthritis, anxiety/depression, overweight who presented with acute shortness of breath. 2 weeks prior to admission she filled her routine prescription for hydroxychloroquine for her rheumatoid arthritis, however husband reports that she stopped taking this and started taking a supplement from another country called RT King and reported improvement in arthritis symptoms.  She also had congestion and sore throat around this time and tested herself for Covid with a home test that was negative. Shortly after this she was performing her job as a provider for patient that passed away from Covid and attended the funeral.  On 9/8 she reported difficulty breathing and pain in the chest and back with deep breaths.  This spontaneously resolved.  Then on 9/9 in the evening she had fever, body aches, however she attributed this to her rheumatoid arthritis and the storm pressure changes.  9/12 she felt great then played at the beach with her grandkids running around.  Then 9/12 in the evening she felt ill and took a home Covid test that was positive.  Husband took a home Covid test that was negative.  She did not initiate any outpatient care other than Mucinex and vitamin C.  9/13 in the morning she had difficulty breathing, hyperventilating, blue lips, diffuse body pain, feeling very weak to stand.  She was not drinking or caring for herself.  She was able to walk to the truck.  Her family brought her to the ER freestanding.  At the freestanding ER, she had initiated and tested positive for flu and negative for Covid by antigens.  Covid PCR later returned negative.  She was transferred to the main ER and desaturated during the transport and stopped breathing.  She maintained a pulse.  In the ER she was intubated.  Pressors Were Started to Maintain MAP. CTA was negative for PE, however ED physician and family practice physician clinically suspected PE and that there could be multiple small thrombi in the lungs rather than a large PE detectable by CTA.  She was started on heparin drip.  ICU accepted the patient and began management. She tested negative for COVID IgM antibodies and positive for COVID IgG antibodies. She devloped DIC (disseminated intravascular coagulation) and TTP (thrombotic thrombocytopenic purpura). During the hospital course she had sputum and blood cultures positive for streptoccocus pneumonia. She later had pseudomonas VAP and Enterococcus faecalis bacteremia. She had failure of lungs, liver, and kidneys. She was treated with maximal critical care management including broad spectrum antibiotics, ventilation, continuous renal replacement therapy, blood/platelet transfusions, chest tube, OG tube feedings, and anticoagulation initially that was later discontinued. She had minimal responsiveness to pain only after sedation withdrawal and was unable to breath spontaneously. On 10/9 the family agreed to palliative vent withdrawal and she expired. I suspect her severe illness may have occured due to abrupt discontinuation of hydroxychloroquine for rheumatoid arthritis and antibody dependent enhancement of influenza due to COVID vaccine."
	"1795156-1"	"1795156-1"	"HYPERVENTILATION"	"10020910"	"50-59 years"	"50-59"	"History per chart review and husband. The patient is a 55 Years-old Female with a history of rheumatoid arthritis, anxiety/depression, overweight who presented with acute shortness of breath. 2 weeks prior to admission she filled her routine prescription for hydroxychloroquine for her rheumatoid arthritis, however husband reports that she stopped taking this and started taking a supplement from another country called RT King and reported improvement in arthritis symptoms.  She also had congestion and sore throat around this time and tested herself for Covid with a home test that was negative. Shortly after this she was performing her job as a provider for patient that passed away from Covid and attended the funeral.  On 9/8 she reported difficulty breathing and pain in the chest and back with deep breaths.  This spontaneously resolved.  Then on 9/9 in the evening she had fever, body aches, however she attributed this to her rheumatoid arthritis and the storm pressure changes.  9/12 she felt great then played at the beach with her grandkids running around.  Then 9/12 in the evening she felt ill and took a home Covid test that was positive.  Husband took a home Covid test that was negative.  She did not initiate any outpatient care other than Mucinex and vitamin C.  9/13 in the morning she had difficulty breathing, hyperventilating, blue lips, diffuse body pain, feeling very weak to stand.  She was not drinking or caring for herself.  She was able to walk to the truck.  Her family brought her to the ER freestanding.  At the freestanding ER, she had initiated and tested positive for flu and negative for Covid by antigens.  Covid PCR later returned negative.  She was transferred to the main ER and desaturated during the transport and stopped breathing.  She maintained a pulse.  In the ER she was intubated.  Pressors Were Started to Maintain MAP. CTA was negative for PE, however ED physician and family practice physician clinically suspected PE and that there could be multiple small thrombi in the lungs rather than a large PE detectable by CTA.  She was started on heparin drip.  ICU accepted the patient and began management. She tested negative for COVID IgM antibodies and positive for COVID IgG antibodies. She devloped DIC (disseminated intravascular coagulation) and TTP (thrombotic thrombocytopenic purpura). During the hospital course she had sputum and blood cultures positive for streptoccocus pneumonia. She later had pseudomonas VAP and Enterococcus faecalis bacteremia. She had failure of lungs, liver, and kidneys. She was treated with maximal critical care management including broad spectrum antibiotics, ventilation, continuous renal replacement therapy, blood/platelet transfusions, chest tube, OG tube feedings, and anticoagulation initially that was later discontinued. She had minimal responsiveness to pain only after sedation withdrawal and was unable to breath spontaneously. On 10/9 the family agreed to palliative vent withdrawal and she expired. I suspect her severe illness may have occured due to abrupt discontinuation of hydroxychloroquine for rheumatoid arthritis and antibody dependent enhancement of influenza due to COVID vaccine."
	"1795156-1"	"1795156-1"	"ILLNESS"	"10080284"	"50-59 years"	"50-59"	"History per chart review and husband. The patient is a 55 Years-old Female with a history of rheumatoid arthritis, anxiety/depression, overweight who presented with acute shortness of breath. 2 weeks prior to admission she filled her routine prescription for hydroxychloroquine for her rheumatoid arthritis, however husband reports that she stopped taking this and started taking a supplement from another country called RT King and reported improvement in arthritis symptoms.  She also had congestion and sore throat around this time and tested herself for Covid with a home test that was negative. Shortly after this she was performing her job as a provider for patient that passed away from Covid and attended the funeral.  On 9/8 she reported difficulty breathing and pain in the chest and back with deep breaths.  This spontaneously resolved.  Then on 9/9 in the evening she had fever, body aches, however she attributed this to her rheumatoid arthritis and the storm pressure changes.  9/12 she felt great then played at the beach with her grandkids running around.  Then 9/12 in the evening she felt ill and took a home Covid test that was positive.  Husband took a home Covid test that was negative.  She did not initiate any outpatient care other than Mucinex and vitamin C.  9/13 in the morning she had difficulty breathing, hyperventilating, blue lips, diffuse body pain, feeling very weak to stand.  She was not drinking or caring for herself.  She was able to walk to the truck.  Her family brought her to the ER freestanding.  At the freestanding ER, she had initiated and tested positive for flu and negative for Covid by antigens.  Covid PCR later returned negative.  She was transferred to the main ER and desaturated during the transport and stopped breathing.  She maintained a pulse.  In the ER she was intubated.  Pressors Were Started to Maintain MAP. CTA was negative for PE, however ED physician and family practice physician clinically suspected PE and that there could be multiple small thrombi in the lungs rather than a large PE detectable by CTA.  She was started on heparin drip.  ICU accepted the patient and began management. She tested negative for COVID IgM antibodies and positive for COVID IgG antibodies. She devloped DIC (disseminated intravascular coagulation) and TTP (thrombotic thrombocytopenic purpura). During the hospital course she had sputum and blood cultures positive for streptoccocus pneumonia. She later had pseudomonas VAP and Enterococcus faecalis bacteremia. She had failure of lungs, liver, and kidneys. She was treated with maximal critical care management including broad spectrum antibiotics, ventilation, continuous renal replacement therapy, blood/platelet transfusions, chest tube, OG tube feedings, and anticoagulation initially that was later discontinued. She had minimal responsiveness to pain only after sedation withdrawal and was unable to breath spontaneously. On 10/9 the family agreed to palliative vent withdrawal and she expired. I suspect her severe illness may have occured due to abrupt discontinuation of hydroxychloroquine for rheumatoid arthritis and antibody dependent enhancement of influenza due to COVID vaccine."
	"1795156-1"	"1795156-1"	"IMPAIRED SELF-CARE"	"10052404"	"50-59 years"	"50-59"	"History per chart review and husband. The patient is a 55 Years-old Female with a history of rheumatoid arthritis, anxiety/depression, overweight who presented with acute shortness of breath. 2 weeks prior to admission she filled her routine prescription for hydroxychloroquine for her rheumatoid arthritis, however husband reports that she stopped taking this and started taking a supplement from another country called RT King and reported improvement in arthritis symptoms.  She also had congestion and sore throat around this time and tested herself for Covid with a home test that was negative. Shortly after this she was performing her job as a provider for patient that passed away from Covid and attended the funeral.  On 9/8 she reported difficulty breathing and pain in the chest and back with deep breaths.  This spontaneously resolved.  Then on 9/9 in the evening she had fever, body aches, however she attributed this to her rheumatoid arthritis and the storm pressure changes.  9/12 she felt great then played at the beach with her grandkids running around.  Then 9/12 in the evening she felt ill and took a home Covid test that was positive.  Husband took a home Covid test that was negative.  She did not initiate any outpatient care other than Mucinex and vitamin C.  9/13 in the morning she had difficulty breathing, hyperventilating, blue lips, diffuse body pain, feeling very weak to stand.  She was not drinking or caring for herself.  She was able to walk to the truck.  Her family brought her to the ER freestanding.  At the freestanding ER, she had initiated and tested positive for flu and negative for Covid by antigens.  Covid PCR later returned negative.  She was transferred to the main ER and desaturated during the transport and stopped breathing.  She maintained a pulse.  In the ER she was intubated.  Pressors Were Started to Maintain MAP. CTA was negative for PE, however ED physician and family practice physician clinically suspected PE and that there could be multiple small thrombi in the lungs rather than a large PE detectable by CTA.  She was started on heparin drip.  ICU accepted the patient and began management. She tested negative for COVID IgM antibodies and positive for COVID IgG antibodies. She devloped DIC (disseminated intravascular coagulation) and TTP (thrombotic thrombocytopenic purpura). During the hospital course she had sputum and blood cultures positive for streptoccocus pneumonia. She later had pseudomonas VAP and Enterococcus faecalis bacteremia. She had failure of lungs, liver, and kidneys. She was treated with maximal critical care management including broad spectrum antibiotics, ventilation, continuous renal replacement therapy, blood/platelet transfusions, chest tube, OG tube feedings, and anticoagulation initially that was later discontinued. She had minimal responsiveness to pain only after sedation withdrawal and was unable to breath spontaneously. On 10/9 the family agreed to palliative vent withdrawal and she expired. I suspect her severe illness may have occured due to abrupt discontinuation of hydroxychloroquine for rheumatoid arthritis and antibody dependent enhancement of influenza due to COVID vaccine."
	"1795156-1"	"1795156-1"	"INFLUENZA VIRUS TEST POSITIVE"	"10070717"	"50-59 years"	"50-59"	"History per chart review and husband. The patient is a 55 Years-old Female with a history of rheumatoid arthritis, anxiety/depression, overweight who presented with acute shortness of breath. 2 weeks prior to admission she filled her routine prescription for hydroxychloroquine for her rheumatoid arthritis, however husband reports that she stopped taking this and started taking a supplement from another country called RT King and reported improvement in arthritis symptoms.  She also had congestion and sore throat around this time and tested herself for Covid with a home test that was negative. Shortly after this she was performing her job as a provider for patient that passed away from Covid and attended the funeral.  On 9/8 she reported difficulty breathing and pain in the chest and back with deep breaths.  This spontaneously resolved.  Then on 9/9 in the evening she had fever, body aches, however she attributed this to her rheumatoid arthritis and the storm pressure changes.  9/12 she felt great then played at the beach with her grandkids running around.  Then 9/12 in the evening she felt ill and took a home Covid test that was positive.  Husband took a home Covid test that was negative.  She did not initiate any outpatient care other than Mucinex and vitamin C.  9/13 in the morning she had difficulty breathing, hyperventilating, blue lips, diffuse body pain, feeling very weak to stand.  She was not drinking or caring for herself.  She was able to walk to the truck.  Her family brought her to the ER freestanding.  At the freestanding ER, she had initiated and tested positive for flu and negative for Covid by antigens.  Covid PCR later returned negative.  She was transferred to the main ER and desaturated during the transport and stopped breathing.  She maintained a pulse.  In the ER she was intubated.  Pressors Were Started to Maintain MAP. CTA was negative for PE, however ED physician and family practice physician clinically suspected PE and that there could be multiple small thrombi in the lungs rather than a large PE detectable by CTA.  She was started on heparin drip.  ICU accepted the patient and began management. She tested negative for COVID IgM antibodies and positive for COVID IgG antibodies. She devloped DIC (disseminated intravascular coagulation) and TTP (thrombotic thrombocytopenic purpura). During the hospital course she had sputum and blood cultures positive for streptoccocus pneumonia. She later had pseudomonas VAP and Enterococcus faecalis bacteremia. She had failure of lungs, liver, and kidneys. She was treated with maximal critical care management including broad spectrum antibiotics, ventilation, continuous renal replacement therapy, blood/platelet transfusions, chest tube, OG tube feedings, and anticoagulation initially that was later discontinued. She had minimal responsiveness to pain only after sedation withdrawal and was unable to breath spontaneously. On 10/9 the family agreed to palliative vent withdrawal and she expired. I suspect her severe illness may have occured due to abrupt discontinuation of hydroxychloroquine for rheumatoid arthritis and antibody dependent enhancement of influenza due to COVID vaccine."
	"1795156-1"	"1795156-1"	"INTENSIVE CARE"	"10022519"	"50-59 years"	"50-59"	"History per chart review and husband. The patient is a 55 Years-old Female with a history of rheumatoid arthritis, anxiety/depression, overweight who presented with acute shortness of breath. 2 weeks prior to admission she filled her routine prescription for hydroxychloroquine for her rheumatoid arthritis, however husband reports that she stopped taking this and started taking a supplement from another country called RT King and reported improvement in arthritis symptoms.  She also had congestion and sore throat around this time and tested herself for Covid with a home test that was negative. Shortly after this she was performing her job as a provider for patient that passed away from Covid and attended the funeral.  On 9/8 she reported difficulty breathing and pain in the chest and back with deep breaths.  This spontaneously resolved.  Then on 9/9 in the evening she had fever, body aches, however she attributed this to her rheumatoid arthritis and the storm pressure changes.  9/12 she felt great then played at the beach with her grandkids running around.  Then 9/12 in the evening she felt ill and took a home Covid test that was positive.  Husband took a home Covid test that was negative.  She did not initiate any outpatient care other than Mucinex and vitamin C.  9/13 in the morning she had difficulty breathing, hyperventilating, blue lips, diffuse body pain, feeling very weak to stand.  She was not drinking or caring for herself.  She was able to walk to the truck.  Her family brought her to the ER freestanding.  At the freestanding ER, she had initiated and tested positive for flu and negative for Covid by antigens.  Covid PCR later returned negative.  She was transferred to the main ER and desaturated during the transport and stopped breathing.  She maintained a pulse.  In the ER she was intubated.  Pressors Were Started to Maintain MAP. CTA was negative for PE, however ED physician and family practice physician clinically suspected PE and that there could be multiple small thrombi in the lungs rather than a large PE detectable by CTA.  She was started on heparin drip.  ICU accepted the patient and began management. She tested negative for COVID IgM antibodies and positive for COVID IgG antibodies. She devloped DIC (disseminated intravascular coagulation) and TTP (thrombotic thrombocytopenic purpura). During the hospital course she had sputum and blood cultures positive for streptoccocus pneumonia. She later had pseudomonas VAP and Enterococcus faecalis bacteremia. She had failure of lungs, liver, and kidneys. She was treated with maximal critical care management including broad spectrum antibiotics, ventilation, continuous renal replacement therapy, blood/platelet transfusions, chest tube, OG tube feedings, and anticoagulation initially that was later discontinued. She had minimal responsiveness to pain only after sedation withdrawal and was unable to breath spontaneously. On 10/9 the family agreed to palliative vent withdrawal and she expired. I suspect her severe illness may have occured due to abrupt discontinuation of hydroxychloroquine for rheumatoid arthritis and antibody dependent enhancement of influenza due to COVID vaccine."
	"1795156-1"	"1795156-1"	"LUNG INFILTRATION"	"10025102"	"50-59 years"	"50-59"	"History per chart review and husband. The patient is a 55 Years-old Female with a history of rheumatoid arthritis, anxiety/depression, overweight who presented with acute shortness of breath. 2 weeks prior to admission she filled her routine prescription for hydroxychloroquine for her rheumatoid arthritis, however husband reports that she stopped taking this and started taking a supplement from another country called RT King and reported improvement in arthritis symptoms.  She also had congestion and sore throat around this time and tested herself for Covid with a home test that was negative. Shortly after this she was performing her job as a provider for patient that passed away from Covid and attended the funeral.  On 9/8 she reported difficulty breathing and pain in the chest and back with deep breaths.  This spontaneously resolved.  Then on 9/9 in the evening she had fever, body aches, however she attributed this to her rheumatoid arthritis and the storm pressure changes.  9/12 she felt great then played at the beach with her grandkids running around.  Then 9/12 in the evening she felt ill and took a home Covid test that was positive.  Husband took a home Covid test that was negative.  She did not initiate any outpatient care other than Mucinex and vitamin C.  9/13 in the morning she had difficulty breathing, hyperventilating, blue lips, diffuse body pain, feeling very weak to stand.  She was not drinking or caring for herself.  She was able to walk to the truck.  Her family brought her to the ER freestanding.  At the freestanding ER, she had initiated and tested positive for flu and negative for Covid by antigens.  Covid PCR later returned negative.  She was transferred to the main ER and desaturated during the transport and stopped breathing.  She maintained a pulse.  In the ER she was intubated.  Pressors Were Started to Maintain MAP. CTA was negative for PE, however ED physician and family practice physician clinically suspected PE and that there could be multiple small thrombi in the lungs rather than a large PE detectable by CTA.  She was started on heparin drip.  ICU accepted the patient and began management. She tested negative for COVID IgM antibodies and positive for COVID IgG antibodies. She devloped DIC (disseminated intravascular coagulation) and TTP (thrombotic thrombocytopenic purpura). During the hospital course she had sputum and blood cultures positive for streptoccocus pneumonia. She later had pseudomonas VAP and Enterococcus faecalis bacteremia. She had failure of lungs, liver, and kidneys. She was treated with maximal critical care management including broad spectrum antibiotics, ventilation, continuous renal replacement therapy, blood/platelet transfusions, chest tube, OG tube feedings, and anticoagulation initially that was later discontinued. She had minimal responsiveness to pain only after sedation withdrawal and was unable to breath spontaneously. On 10/9 the family agreed to palliative vent withdrawal and she expired. I suspect her severe illness may have occured due to abrupt discontinuation of hydroxychloroquine for rheumatoid arthritis and antibody dependent enhancement of influenza due to COVID vaccine."
	"1795156-1"	"1795156-1"	"MALAISE"	"10025482"	"50-59 years"	"50-59"	"History per chart review and husband. The patient is a 55 Years-old Female with a history of rheumatoid arthritis, anxiety/depression, overweight who presented with acute shortness of breath. 2 weeks prior to admission she filled her routine prescription for hydroxychloroquine for her rheumatoid arthritis, however husband reports that she stopped taking this and started taking a supplement from another country called RT King and reported improvement in arthritis symptoms.  She also had congestion and sore throat around this time and tested herself for Covid with a home test that was negative. Shortly after this she was performing her job as a provider for patient that passed away from Covid and attended the funeral.  On 9/8 she reported difficulty breathing and pain in the chest and back with deep breaths.  This spontaneously resolved.  Then on 9/9 in the evening she had fever, body aches, however she attributed this to her rheumatoid arthritis and the storm pressure changes.  9/12 she felt great then played at the beach with her grandkids running around.  Then 9/12 in the evening she felt ill and took a home Covid test that was positive.  Husband took a home Covid test that was negative.  She did not initiate any outpatient care other than Mucinex and vitamin C.  9/13 in the morning she had difficulty breathing, hyperventilating, blue lips, diffuse body pain, feeling very weak to stand.  She was not drinking or caring for herself.  She was able to walk to the truck.  Her family brought her to the ER freestanding.  At the freestanding ER, she had initiated and tested positive for flu and negative for Covid by antigens.  Covid PCR later returned negative.  She was transferred to the main ER and desaturated during the transport and stopped breathing.  She maintained a pulse.  In the ER she was intubated.  Pressors Were Started to Maintain MAP. CTA was negative for PE, however ED physician and family practice physician clinically suspected PE and that there could be multiple small thrombi in the lungs rather than a large PE detectable by CTA.  She was started on heparin drip.  ICU accepted the patient and began management. She tested negative for COVID IgM antibodies and positive for COVID IgG antibodies. She devloped DIC (disseminated intravascular coagulation) and TTP (thrombotic thrombocytopenic purpura). During the hospital course she had sputum and blood cultures positive for streptoccocus pneumonia. She later had pseudomonas VAP and Enterococcus faecalis bacteremia. She had failure of lungs, liver, and kidneys. She was treated with maximal critical care management including broad spectrum antibiotics, ventilation, continuous renal replacement therapy, blood/platelet transfusions, chest tube, OG tube feedings, and anticoagulation initially that was later discontinued. She had minimal responsiveness to pain only after sedation withdrawal and was unable to breath spontaneously. On 10/9 the family agreed to palliative vent withdrawal and she expired. I suspect her severe illness may have occured due to abrupt discontinuation of hydroxychloroquine for rheumatoid arthritis and antibody dependent enhancement of influenza due to COVID vaccine."
	"1795156-1"	"1795156-1"	"MECHANICAL VENTILATION"	"10067221"	"50-59 years"	"50-59"	"History per chart review and husband. The patient is a 55 Years-old Female with a history of rheumatoid arthritis, anxiety/depression, overweight who presented with acute shortness of breath. 2 weeks prior to admission she filled her routine prescription for hydroxychloroquine for her rheumatoid arthritis, however husband reports that she stopped taking this and started taking a supplement from another country called RT King and reported improvement in arthritis symptoms.  She also had congestion and sore throat around this time and tested herself for Covid with a home test that was negative. Shortly after this she was performing her job as a provider for patient that passed away from Covid and attended the funeral.  On 9/8 she reported difficulty breathing and pain in the chest and back with deep breaths.  This spontaneously resolved.  Then on 9/9 in the evening she had fever, body aches, however she attributed this to her rheumatoid arthritis and the storm pressure changes.  9/12 she felt great then played at the beach with her grandkids running around.  Then 9/12 in the evening she felt ill and took a home Covid test that was positive.  Husband took a home Covid test that was negative.  She did not initiate any outpatient care other than Mucinex and vitamin C.  9/13 in the morning she had difficulty breathing, hyperventilating, blue lips, diffuse body pain, feeling very weak to stand.  She was not drinking or caring for herself.  She was able to walk to the truck.  Her family brought her to the ER freestanding.  At the freestanding ER, she had initiated and tested positive for flu and negative for Covid by antigens.  Covid PCR later returned negative.  She was transferred to the main ER and desaturated during the transport and stopped breathing.  She maintained a pulse.  In the ER she was intubated.  Pressors Were Started to Maintain MAP. CTA was negative for PE, however ED physician and family practice physician clinically suspected PE and that there could be multiple small thrombi in the lungs rather than a large PE detectable by CTA.  She was started on heparin drip.  ICU accepted the patient and began management. She tested negative for COVID IgM antibodies and positive for COVID IgG antibodies. She devloped DIC (disseminated intravascular coagulation) and TTP (thrombotic thrombocytopenic purpura). During the hospital course she had sputum and blood cultures positive for streptoccocus pneumonia. She later had pseudomonas VAP and Enterococcus faecalis bacteremia. She had failure of lungs, liver, and kidneys. She was treated with maximal critical care management including broad spectrum antibiotics, ventilation, continuous renal replacement therapy, blood/platelet transfusions, chest tube, OG tube feedings, and anticoagulation initially that was later discontinued. She had minimal responsiveness to pain only after sedation withdrawal and was unable to breath spontaneously. On 10/9 the family agreed to palliative vent withdrawal and she expired. I suspect her severe illness may have occured due to abrupt discontinuation of hydroxychloroquine for rheumatoid arthritis and antibody dependent enhancement of influenza due to COVID vaccine."
	"1795156-1"	"1795156-1"	"OROPHARYNGEAL PAIN"	"10068319"	"50-59 years"	"50-59"	"History per chart review and husband. The patient is a 55 Years-old Female with a history of rheumatoid arthritis, anxiety/depression, overweight who presented with acute shortness of breath. 2 weeks prior to admission she filled her routine prescription for hydroxychloroquine for her rheumatoid arthritis, however husband reports that she stopped taking this and started taking a supplement from another country called RT King and reported improvement in arthritis symptoms.  She also had congestion and sore throat around this time and tested herself for Covid with a home test that was negative. Shortly after this she was performing her job as a provider for patient that passed away from Covid and attended the funeral.  On 9/8 she reported difficulty breathing and pain in the chest and back with deep breaths.  This spontaneously resolved.  Then on 9/9 in the evening she had fever, body aches, however she attributed this to her rheumatoid arthritis and the storm pressure changes.  9/12 she felt great then played at the beach with her grandkids running around.  Then 9/12 in the evening she felt ill and took a home Covid test that was positive.  Husband took a home Covid test that was negative.  She did not initiate any outpatient care other than Mucinex and vitamin C.  9/13 in the morning she had difficulty breathing, hyperventilating, blue lips, diffuse body pain, feeling very weak to stand.  She was not drinking or caring for herself.  She was able to walk to the truck.  Her family brought her to the ER freestanding.  At the freestanding ER, she had initiated and tested positive for flu and negative for Covid by antigens.  Covid PCR later returned negative.  She was transferred to the main ER and desaturated during the transport and stopped breathing.  She maintained a pulse.  In the ER she was intubated.  Pressors Were Started to Maintain MAP. CTA was negative for PE, however ED physician and family practice physician clinically suspected PE and that there could be multiple small thrombi in the lungs rather than a large PE detectable by CTA.  She was started on heparin drip.  ICU accepted the patient and began management. She tested negative for COVID IgM antibodies and positive for COVID IgG antibodies. She devloped DIC (disseminated intravascular coagulation) and TTP (thrombotic thrombocytopenic purpura). During the hospital course she had sputum and blood cultures positive for streptoccocus pneumonia. She later had pseudomonas VAP and Enterococcus faecalis bacteremia. She had failure of lungs, liver, and kidneys. She was treated with maximal critical care management including broad spectrum antibiotics, ventilation, continuous renal replacement therapy, blood/platelet transfusions, chest tube, OG tube feedings, and anticoagulation initially that was later discontinued. She had minimal responsiveness to pain only after sedation withdrawal and was unable to breath spontaneously. On 10/9 the family agreed to palliative vent withdrawal and she expired. I suspect her severe illness may have occured due to abrupt discontinuation of hydroxychloroquine for rheumatoid arthritis and antibody dependent enhancement of influenza due to COVID vaccine."
	"1795156-1"	"1795156-1"	"OXYGEN SATURATION DECREASED"	"10033318"	"50-59 years"	"50-59"	"History per chart review and husband. The patient is a 55 Years-old Female with a history of rheumatoid arthritis, anxiety/depression, overweight who presented with acute shortness of breath. 2 weeks prior to admission she filled her routine prescription for hydroxychloroquine for her rheumatoid arthritis, however husband reports that she stopped taking this and started taking a supplement from another country called RT King and reported improvement in arthritis symptoms.  She also had congestion and sore throat around this time and tested herself for Covid with a home test that was negative. Shortly after this she was performing her job as a provider for patient that passed away from Covid and attended the funeral.  On 9/8 she reported difficulty breathing and pain in the chest and back with deep breaths.  This spontaneously resolved.  Then on 9/9 in the evening she had fever, body aches, however she attributed this to her rheumatoid arthritis and the storm pressure changes.  9/12 she felt great then played at the beach with her grandkids running around.  Then 9/12 in the evening she felt ill and took a home Covid test that was positive.  Husband took a home Covid test that was negative.  She did not initiate any outpatient care other than Mucinex and vitamin C.  9/13 in the morning she had difficulty breathing, hyperventilating, blue lips, diffuse body pain, feeling very weak to stand.  She was not drinking or caring for herself.  She was able to walk to the truck.  Her family brought her to the ER freestanding.  At the freestanding ER, she had initiated and tested positive for flu and negative for Covid by antigens.  Covid PCR later returned negative.  She was transferred to the main ER and desaturated during the transport and stopped breathing.  She maintained a pulse.  In the ER she was intubated.  Pressors Were Started to Maintain MAP. CTA was negative for PE, however ED physician and family practice physician clinically suspected PE and that there could be multiple small thrombi in the lungs rather than a large PE detectable by CTA.  She was started on heparin drip.  ICU accepted the patient and began management. She tested negative for COVID IgM antibodies and positive for COVID IgG antibodies. She devloped DIC (disseminated intravascular coagulation) and TTP (thrombotic thrombocytopenic purpura). During the hospital course she had sputum and blood cultures positive for streptoccocus pneumonia. She later had pseudomonas VAP and Enterococcus faecalis bacteremia. She had failure of lungs, liver, and kidneys. She was treated with maximal critical care management including broad spectrum antibiotics, ventilation, continuous renal replacement therapy, blood/platelet transfusions, chest tube, OG tube feedings, and anticoagulation initially that was later discontinued. She had minimal responsiveness to pain only after sedation withdrawal and was unable to breath spontaneously. On 10/9 the family agreed to palliative vent withdrawal and she expired. I suspect her severe illness may have occured due to abrupt discontinuation of hydroxychloroquine for rheumatoid arthritis and antibody dependent enhancement of influenza due to COVID vaccine."
	"1795156-1"	"1795156-1"	"PAIN"	"10033371"	"50-59 years"	"50-59"	"History per chart review and husband. The patient is a 55 Years-old Female with a history of rheumatoid arthritis, anxiety/depression, overweight who presented with acute shortness of breath. 2 weeks prior to admission she filled her routine prescription for hydroxychloroquine for her rheumatoid arthritis, however husband reports that she stopped taking this and started taking a supplement from another country called RT King and reported improvement in arthritis symptoms.  She also had congestion and sore throat around this time and tested herself for Covid with a home test that was negative. Shortly after this she was performing her job as a provider for patient that passed away from Covid and attended the funeral.  On 9/8 she reported difficulty breathing and pain in the chest and back with deep breaths.  This spontaneously resolved.  Then on 9/9 in the evening she had fever, body aches, however she attributed this to her rheumatoid arthritis and the storm pressure changes.  9/12 she felt great then played at the beach with her grandkids running around.  Then 9/12 in the evening she felt ill and took a home Covid test that was positive.  Husband took a home Covid test that was negative.  She did not initiate any outpatient care other than Mucinex and vitamin C.  9/13 in the morning she had difficulty breathing, hyperventilating, blue lips, diffuse body pain, feeling very weak to stand.  She was not drinking or caring for herself.  She was able to walk to the truck.  Her family brought her to the ER freestanding.  At the freestanding ER, she had initiated and tested positive for flu and negative for Covid by antigens.  Covid PCR later returned negative.  She was transferred to the main ER and desaturated during the transport and stopped breathing.  She maintained a pulse.  In the ER she was intubated.  Pressors Were Started to Maintain MAP. CTA was negative for PE, however ED physician and family practice physician clinically suspected PE and that there could be multiple small thrombi in the lungs rather than a large PE detectable by CTA.  She was started on heparin drip.  ICU accepted the patient and began management. She tested negative for COVID IgM antibodies and positive for COVID IgG antibodies. She devloped DIC (disseminated intravascular coagulation) and TTP (thrombotic thrombocytopenic purpura). During the hospital course she had sputum and blood cultures positive for streptoccocus pneumonia. She later had pseudomonas VAP and Enterococcus faecalis bacteremia. She had failure of lungs, liver, and kidneys. She was treated with maximal critical care management including broad spectrum antibiotics, ventilation, continuous renal replacement therapy, blood/platelet transfusions, chest tube, OG tube feedings, and anticoagulation initially that was later discontinued. She had minimal responsiveness to pain only after sedation withdrawal and was unable to breath spontaneously. On 10/9 the family agreed to palliative vent withdrawal and she expired. I suspect her severe illness may have occured due to abrupt discontinuation of hydroxychloroquine for rheumatoid arthritis and antibody dependent enhancement of influenza due to COVID vaccine."
	"1795156-1"	"1795156-1"	"PAINFUL RESPIRATION"	"10033517"	"50-59 years"	"50-59"	"History per chart review and husband. The patient is a 55 Years-old Female with a history of rheumatoid arthritis, anxiety/depression, overweight who presented with acute shortness of breath. 2 weeks prior to admission she filled her routine prescription for hydroxychloroquine for her rheumatoid arthritis, however husband reports that she stopped taking this and started taking a supplement from another country called RT King and reported improvement in arthritis symptoms.  She also had congestion and sore throat around this time and tested herself for Covid with a home test that was negative. Shortly after this she was performing her job as a provider for patient that passed away from Covid and attended the funeral.  On 9/8 she reported difficulty breathing and pain in the chest and back with deep breaths.  This spontaneously resolved.  Then on 9/9 in the evening she had fever, body aches, however she attributed this to her rheumatoid arthritis and the storm pressure changes.  9/12 she felt great then played at the beach with her grandkids running around.  Then 9/12 in the evening she felt ill and took a home Covid test that was positive.  Husband took a home Covid test that was negative.  She did not initiate any outpatient care other than Mucinex and vitamin C.  9/13 in the morning she had difficulty breathing, hyperventilating, blue lips, diffuse body pain, feeling very weak to stand.  She was not drinking or caring for herself.  She was able to walk to the truck.  Her family brought her to the ER freestanding.  At the freestanding ER, she had initiated and tested positive for flu and negative for Covid by antigens.  Covid PCR later returned negative.  She was transferred to the main ER and desaturated during the transport and stopped breathing.  She maintained a pulse.  In the ER she was intubated.  Pressors Were Started to Maintain MAP. CTA was negative for PE, however ED physician and family practice physician clinically suspected PE and that there could be multiple small thrombi in the lungs rather than a large PE detectable by CTA.  She was started on heparin drip.  ICU accepted the patient and began management. She tested negative for COVID IgM antibodies and positive for COVID IgG antibodies. She devloped DIC (disseminated intravascular coagulation) and TTP (thrombotic thrombocytopenic purpura). During the hospital course she had sputum and blood cultures positive for streptoccocus pneumonia. She later had pseudomonas VAP and Enterococcus faecalis bacteremia. She had failure of lungs, liver, and kidneys. She was treated with maximal critical care management including broad spectrum antibiotics, ventilation, continuous renal replacement therapy, blood/platelet transfusions, chest tube, OG tube feedings, and anticoagulation initially that was later discontinued. She had minimal responsiveness to pain only after sedation withdrawal and was unable to breath spontaneously. On 10/9 the family agreed to palliative vent withdrawal and she expired. I suspect her severe illness may have occured due to abrupt discontinuation of hydroxychloroquine for rheumatoid arthritis and antibody dependent enhancement of influenza due to COVID vaccine."
	"1795156-1"	"1795156-1"	"PLATELET TRANSFUSION"	"10035543"	"50-59 years"	"50-59"	"History per chart review and husband. The patient is a 55 Years-old Female with a history of rheumatoid arthritis, anxiety/depression, overweight who presented with acute shortness of breath. 2 weeks prior to admission she filled her routine prescription for hydroxychloroquine for her rheumatoid arthritis, however husband reports that she stopped taking this and started taking a supplement from another country called RT King and reported improvement in arthritis symptoms.  She also had congestion and sore throat around this time and tested herself for Covid with a home test that was negative. Shortly after this she was performing her job as a provider for patient that passed away from Covid and attended the funeral.  On 9/8 she reported difficulty breathing and pain in the chest and back with deep breaths.  This spontaneously resolved.  Then on 9/9 in the evening she had fever, body aches, however she attributed this to her rheumatoid arthritis and the storm pressure changes.  9/12 she felt great then played at the beach with her grandkids running around.  Then 9/12 in the evening she felt ill and took a home Covid test that was positive.  Husband took a home Covid test that was negative.  She did not initiate any outpatient care other than Mucinex and vitamin C.  9/13 in the morning she had difficulty breathing, hyperventilating, blue lips, diffuse body pain, feeling very weak to stand.  She was not drinking or caring for herself.  She was able to walk to the truck.  Her family brought her to the ER freestanding.  At the freestanding ER, she had initiated and tested positive for flu and negative for Covid by antigens.  Covid PCR later returned negative.  She was transferred to the main ER and desaturated during the transport and stopped breathing.  She maintained a pulse.  In the ER she was intubated.  Pressors Were Started to Maintain MAP. CTA was negative for PE, however ED physician and family practice physician clinically suspected PE and that there could be multiple small thrombi in the lungs rather than a large PE detectable by CTA.  She was started on heparin drip.  ICU accepted the patient and began management. She tested negative for COVID IgM antibodies and positive for COVID IgG antibodies. She devloped DIC (disseminated intravascular coagulation) and TTP (thrombotic thrombocytopenic purpura). During the hospital course she had sputum and blood cultures positive for streptoccocus pneumonia. She later had pseudomonas VAP and Enterococcus faecalis bacteremia. She had failure of lungs, liver, and kidneys. She was treated with maximal critical care management including broad spectrum antibiotics, ventilation, continuous renal replacement therapy, blood/platelet transfusions, chest tube, OG tube feedings, and anticoagulation initially that was later discontinued. She had minimal responsiveness to pain only after sedation withdrawal and was unable to breath spontaneously. On 10/9 the family agreed to palliative vent withdrawal and she expired. I suspect her severe illness may have occured due to abrupt discontinuation of hydroxychloroquine for rheumatoid arthritis and antibody dependent enhancement of influenza due to COVID vaccine."
	"1795156-1"	"1795156-1"	"PNEUMONIA"	"10035664"	"50-59 years"	"50-59"	"History per chart review and husband. The patient is a 55 Years-old Female with a history of rheumatoid arthritis, anxiety/depression, overweight who presented with acute shortness of breath. 2 weeks prior to admission she filled her routine prescription for hydroxychloroquine for her rheumatoid arthritis, however husband reports that she stopped taking this and started taking a supplement from another country called RT King and reported improvement in arthritis symptoms.  She also had congestion and sore throat around this time and tested herself for Covid with a home test that was negative. Shortly after this she was performing her job as a provider for patient that passed away from Covid and attended the funeral.  On 9/8 she reported difficulty breathing and pain in the chest and back with deep breaths.  This spontaneously resolved.  Then on 9/9 in the evening she had fever, body aches, however she attributed this to her rheumatoid arthritis and the storm pressure changes.  9/12 she felt great then played at the beach with her grandkids running around.  Then 9/12 in the evening she felt ill and took a home Covid test that was positive.  Husband took a home Covid test that was negative.  She did not initiate any outpatient care other than Mucinex and vitamin C.  9/13 in the morning she had difficulty breathing, hyperventilating, blue lips, diffuse body pain, feeling very weak to stand.  She was not drinking or caring for herself.  She was able to walk to the truck.  Her family brought her to the ER freestanding.  At the freestanding ER, she had initiated and tested positive for flu and negative for Covid by antigens.  Covid PCR later returned negative.  She was transferred to the main ER and desaturated during the transport and stopped breathing.  She maintained a pulse.  In the ER she was intubated.  Pressors Were Started to Maintain MAP. CTA was negative for PE, however ED physician and family practice physician clinically suspected PE and that there could be multiple small thrombi in the lungs rather than a large PE detectable by CTA.  She was started on heparin drip.  ICU accepted the patient and began management. She tested negative for COVID IgM antibodies and positive for COVID IgG antibodies. She devloped DIC (disseminated intravascular coagulation) and TTP (thrombotic thrombocytopenic purpura). During the hospital course she had sputum and blood cultures positive for streptoccocus pneumonia. She later had pseudomonas VAP and Enterococcus faecalis bacteremia. She had failure of lungs, liver, and kidneys. She was treated with maximal critical care management including broad spectrum antibiotics, ventilation, continuous renal replacement therapy, blood/platelet transfusions, chest tube, OG tube feedings, and anticoagulation initially that was later discontinued. She had minimal responsiveness to pain only after sedation withdrawal and was unable to breath spontaneously. On 10/9 the family agreed to palliative vent withdrawal and she expired. I suspect her severe illness may have occured due to abrupt discontinuation of hydroxychloroquine for rheumatoid arthritis and antibody dependent enhancement of influenza due to COVID vaccine."
	"1795156-1"	"1795156-1"	"PSEUDOMONAL BACTERAEMIA"	"10058923"	"50-59 years"	"50-59"	"History per chart review and husband. The patient is a 55 Years-old Female with a history of rheumatoid arthritis, anxiety/depression, overweight who presented with acute shortness of breath. 2 weeks prior to admission she filled her routine prescription for hydroxychloroquine for her rheumatoid arthritis, however husband reports that she stopped taking this and started taking a supplement from another country called RT King and reported improvement in arthritis symptoms.  She also had congestion and sore throat around this time and tested herself for Covid with a home test that was negative. Shortly after this she was performing her job as a provider for patient that passed away from Covid and attended the funeral.  On 9/8 she reported difficulty breathing and pain in the chest and back with deep breaths.  This spontaneously resolved.  Then on 9/9 in the evening she had fever, body aches, however she attributed this to her rheumatoid arthritis and the storm pressure changes.  9/12 she felt great then played at the beach with her grandkids running around.  Then 9/12 in the evening she felt ill and took a home Covid test that was positive.  Husband took a home Covid test that was negative.  She did not initiate any outpatient care other than Mucinex and vitamin C.  9/13 in the morning she had difficulty breathing, hyperventilating, blue lips, diffuse body pain, feeling very weak to stand.  She was not drinking or caring for herself.  She was able to walk to the truck.  Her family brought her to the ER freestanding.  At the freestanding ER, she had initiated and tested positive for flu and negative for Covid by antigens.  Covid PCR later returned negative.  She was transferred to the main ER and desaturated during the transport and stopped breathing.  She maintained a pulse.  In the ER she was intubated.  Pressors Were Started to Maintain MAP. CTA was negative for PE, however ED physician and family practice physician clinically suspected PE and that there could be multiple small thrombi in the lungs rather than a large PE detectable by CTA.  She was started on heparin drip.  ICU accepted the patient and began management. She tested negative for COVID IgM antibodies and positive for COVID IgG antibodies. She devloped DIC (disseminated intravascular coagulation) and TTP (thrombotic thrombocytopenic purpura). During the hospital course she had sputum and blood cultures positive for streptoccocus pneumonia. She later had pseudomonas VAP and Enterococcus faecalis bacteremia. She had failure of lungs, liver, and kidneys. She was treated with maximal critical care management including broad spectrum antibiotics, ventilation, continuous renal replacement therapy, blood/platelet transfusions, chest tube, OG tube feedings, and anticoagulation initially that was later discontinued. She had minimal responsiveness to pain only after sedation withdrawal and was unable to breath spontaneously. On 10/9 the family agreed to palliative vent withdrawal and she expired. I suspect her severe illness may have occured due to abrupt discontinuation of hydroxychloroquine for rheumatoid arthritis and antibody dependent enhancement of influenza due to COVID vaccine."
	"1795156-1"	"1795156-1"	"PYREXIA"	"10037660"	"50-59 years"	"50-59"	"History per chart review and husband. The patient is a 55 Years-old Female with a history of rheumatoid arthritis, anxiety/depression, overweight who presented with acute shortness of breath. 2 weeks prior to admission she filled her routine prescription for hydroxychloroquine for her rheumatoid arthritis, however husband reports that she stopped taking this and started taking a supplement from another country called RT King and reported improvement in arthritis symptoms.  She also had congestion and sore throat around this time and tested herself for Covid with a home test that was negative. Shortly after this she was performing her job as a provider for patient that passed away from Covid and attended the funeral.  On 9/8 she reported difficulty breathing and pain in the chest and back with deep breaths.  This spontaneously resolved.  Then on 9/9 in the evening she had fever, body aches, however she attributed this to her rheumatoid arthritis and the storm pressure changes.  9/12 she felt great then played at the beach with her grandkids running around.  Then 9/12 in the evening she felt ill and took a home Covid test that was positive.  Husband took a home Covid test that was negative.  She did not initiate any outpatient care other than Mucinex and vitamin C.  9/13 in the morning she had difficulty breathing, hyperventilating, blue lips, diffuse body pain, feeling very weak to stand.  She was not drinking or caring for herself.  She was able to walk to the truck.  Her family brought her to the ER freestanding.  At the freestanding ER, she had initiated and tested positive for flu and negative for Covid by antigens.  Covid PCR later returned negative.  She was transferred to the main ER and desaturated during the transport and stopped breathing.  She maintained a pulse.  In the ER she was intubated.  Pressors Were Started to Maintain MAP. CTA was negative for PE, however ED physician and family practice physician clinically suspected PE and that there could be multiple small thrombi in the lungs rather than a large PE detectable by CTA.  She was started on heparin drip.  ICU accepted the patient and began management. She tested negative for COVID IgM antibodies and positive for COVID IgG antibodies. She devloped DIC (disseminated intravascular coagulation) and TTP (thrombotic thrombocytopenic purpura). During the hospital course she had sputum and blood cultures positive for streptoccocus pneumonia. She later had pseudomonas VAP and Enterococcus faecalis bacteremia. She had failure of lungs, liver, and kidneys. She was treated with maximal critical care management including broad spectrum antibiotics, ventilation, continuous renal replacement therapy, blood/platelet transfusions, chest tube, OG tube feedings, and anticoagulation initially that was later discontinued. She had minimal responsiveness to pain only after sedation withdrawal and was unable to breath spontaneously. On 10/9 the family agreed to palliative vent withdrawal and she expired. I suspect her severe illness may have occured due to abrupt discontinuation of hydroxychloroquine for rheumatoid arthritis and antibody dependent enhancement of influenza due to COVID vaccine."
	"1795156-1"	"1795156-1"	"RENAL FAILURE"	"10038435"	"50-59 years"	"50-59"	"History per chart review and husband. The patient is a 55 Years-old Female with a history of rheumatoid arthritis, anxiety/depression, overweight who presented with acute shortness of breath. 2 weeks prior to admission she filled her routine prescription for hydroxychloroquine for her rheumatoid arthritis, however husband reports that she stopped taking this and started taking a supplement from another country called RT King and reported improvement in arthritis symptoms.  She also had congestion and sore throat around this time and tested herself for Covid with a home test that was negative. Shortly after this she was performing her job as a provider for patient that passed away from Covid and attended the funeral.  On 9/8 she reported difficulty breathing and pain in the chest and back with deep breaths.  This spontaneously resolved.  Then on 9/9 in the evening she had fever, body aches, however she attributed this to her rheumatoid arthritis and the storm pressure changes.  9/12 she felt great then played at the beach with her grandkids running around.  Then 9/12 in the evening she felt ill and took a home Covid test that was positive.  Husband took a home Covid test that was negative.  She did not initiate any outpatient care other than Mucinex and vitamin C.  9/13 in the morning she had difficulty breathing, hyperventilating, blue lips, diffuse body pain, feeling very weak to stand.  She was not drinking or caring for herself.  She was able to walk to the truck.  Her family brought her to the ER freestanding.  At the freestanding ER, she had initiated and tested positive for flu and negative for Covid by antigens.  Covid PCR later returned negative.  She was transferred to the main ER and desaturated during the transport and stopped breathing.  She maintained a pulse.  In the ER she was intubated.  Pressors Were Started to Maintain MAP. CTA was negative for PE, however ED physician and family practice physician clinically suspected PE and that there could be multiple small thrombi in the lungs rather than a large PE detectable by CTA.  She was started on heparin drip.  ICU accepted the patient and began management. She tested negative for COVID IgM antibodies and positive for COVID IgG antibodies. She devloped DIC (disseminated intravascular coagulation) and TTP (thrombotic thrombocytopenic purpura). During the hospital course she had sputum and blood cultures positive for streptoccocus pneumonia. She later had pseudomonas VAP and Enterococcus faecalis bacteremia. She had failure of lungs, liver, and kidneys. She was treated with maximal critical care management including broad spectrum antibiotics, ventilation, continuous renal replacement therapy, blood/platelet transfusions, chest tube, OG tube feedings, and anticoagulation initially that was later discontinued. She had minimal responsiveness to pain only after sedation withdrawal and was unable to breath spontaneously. On 10/9 the family agreed to palliative vent withdrawal and she expired. I suspect her severe illness may have occured due to abrupt discontinuation of hydroxychloroquine for rheumatoid arthritis and antibody dependent enhancement of influenza due to COVID vaccine."
	"1795156-1"	"1795156-1"	"RESPIRATORY ARREST"	"10038669"	"50-59 years"	"50-59"	"History per chart review and husband. The patient is a 55 Years-old Female with a history of rheumatoid arthritis, anxiety/depression, overweight who presented with acute shortness of breath. 2 weeks prior to admission she filled her routine prescription for hydroxychloroquine for her rheumatoid arthritis, however husband reports that she stopped taking this and started taking a supplement from another country called RT King and reported improvement in arthritis symptoms.  She also had congestion and sore throat around this time and tested herself for Covid with a home test that was negative. Shortly after this she was performing her job as a provider for patient that passed away from Covid and attended the funeral.  On 9/8 she reported difficulty breathing and pain in the chest and back with deep breaths.  This spontaneously resolved.  Then on 9/9 in the evening she had fever, body aches, however she attributed this to her rheumatoid arthritis and the storm pressure changes.  9/12 she felt great then played at the beach with her grandkids running around.  Then 9/12 in the evening she felt ill and took a home Covid test that was positive.  Husband took a home Covid test that was negative.  She did not initiate any outpatient care other than Mucinex and vitamin C.  9/13 in the morning she had difficulty breathing, hyperventilating, blue lips, diffuse body pain, feeling very weak to stand.  She was not drinking or caring for herself.  She was able to walk to the truck.  Her family brought her to the ER freestanding.  At the freestanding ER, she had initiated and tested positive for flu and negative for Covid by antigens.  Covid PCR later returned negative.  She was transferred to the main ER and desaturated during the transport and stopped breathing.  She maintained a pulse.  In the ER she was intubated.  Pressors Were Started to Maintain MAP. CTA was negative for PE, however ED physician and family practice physician clinically suspected PE and that there could be multiple small thrombi in the lungs rather than a large PE detectable by CTA.  She was started on heparin drip.  ICU accepted the patient and began management. She tested negative for COVID IgM antibodies and positive for COVID IgG antibodies. She devloped DIC (disseminated intravascular coagulation) and TTP (thrombotic thrombocytopenic purpura). During the hospital course she had sputum and blood cultures positive for streptoccocus pneumonia. She later had pseudomonas VAP and Enterococcus faecalis bacteremia. She had failure of lungs, liver, and kidneys. She was treated with maximal critical care management including broad spectrum antibiotics, ventilation, continuous renal replacement therapy, blood/platelet transfusions, chest tube, OG tube feedings, and anticoagulation initially that was later discontinued. She had minimal responsiveness to pain only after sedation withdrawal and was unable to breath spontaneously. On 10/9 the family agreed to palliative vent withdrawal and she expired. I suspect her severe illness may have occured due to abrupt discontinuation of hydroxychloroquine for rheumatoid arthritis and antibody dependent enhancement of influenza due to COVID vaccine."
	"1795156-1"	"1795156-1"	"RESPIRATORY FAILURE"	"10038695"	"50-59 years"	"50-59"	"History per chart review and husband. The patient is a 55 Years-old Female with a history of rheumatoid arthritis, anxiety/depression, overweight who presented with acute shortness of breath. 2 weeks prior to admission she filled her routine prescription for hydroxychloroquine for her rheumatoid arthritis, however husband reports that she stopped taking this and started taking a supplement from another country called RT King and reported improvement in arthritis symptoms.  She also had congestion and sore throat around this time and tested herself for Covid with a home test that was negative. Shortly after this she was performing her job as a provider for patient that passed away from Covid and attended the funeral.  On 9/8 she reported difficulty breathing and pain in the chest and back with deep breaths.  This spontaneously resolved.  Then on 9/9 in the evening she had fever, body aches, however she attributed this to her rheumatoid arthritis and the storm pressure changes.  9/12 she felt great then played at the beach with her grandkids running around.  Then 9/12 in the evening she felt ill and took a home Covid test that was positive.  Husband took a home Covid test that was negative.  She did not initiate any outpatient care other than Mucinex and vitamin C.  9/13 in the morning she had difficulty breathing, hyperventilating, blue lips, diffuse body pain, feeling very weak to stand.  She was not drinking or caring for herself.  She was able to walk to the truck.  Her family brought her to the ER freestanding.  At the freestanding ER, she had initiated and tested positive for flu and negative for Covid by antigens.  Covid PCR later returned negative.  She was transferred to the main ER and desaturated during the transport and stopped breathing.  She maintained a pulse.  In the ER she was intubated.  Pressors Were Started to Maintain MAP. CTA was negative for PE, however ED physician and family practice physician clinically suspected PE and that there could be multiple small thrombi in the lungs rather than a large PE detectable by CTA.  She was started on heparin drip.  ICU accepted the patient and began management. She tested negative for COVID IgM antibodies and positive for COVID IgG antibodies. She devloped DIC (disseminated intravascular coagulation) and TTP (thrombotic thrombocytopenic purpura). During the hospital course she had sputum and blood cultures positive for streptoccocus pneumonia. She later had pseudomonas VAP and Enterococcus faecalis bacteremia. She had failure of lungs, liver, and kidneys. She was treated with maximal critical care management including broad spectrum antibiotics, ventilation, continuous renal replacement therapy, blood/platelet transfusions, chest tube, OG tube feedings, and anticoagulation initially that was later discontinued. She had minimal responsiveness to pain only after sedation withdrawal and was unable to breath spontaneously. On 10/9 the family agreed to palliative vent withdrawal and she expired. I suspect her severe illness may have occured due to abrupt discontinuation of hydroxychloroquine for rheumatoid arthritis and antibody dependent enhancement of influenza due to COVID vaccine."
	"1795156-1"	"1795156-1"	"RESPIRATORY TRACT CONGESTION"	"10052251"	"50-59 years"	"50-59"	"History per chart review and husband. The patient is a 55 Years-old Female with a history of rheumatoid arthritis, anxiety/depression, overweight who presented with acute shortness of breath. 2 weeks prior to admission she filled her routine prescription for hydroxychloroquine for her rheumatoid arthritis, however husband reports that she stopped taking this and started taking a supplement from another country called RT King and reported improvement in arthritis symptoms.  She also had congestion and sore throat around this time and tested herself for Covid with a home test that was negative. Shortly after this she was performing her job as a provider for patient that passed away from Covid and attended the funeral.  On 9/8 she reported difficulty breathing and pain in the chest and back with deep breaths.  This spontaneously resolved.  Then on 9/9 in the evening she had fever, body aches, however she attributed this to her rheumatoid arthritis and the storm pressure changes.  9/12 she felt great then played at the beach with her grandkids running around.  Then 9/12 in the evening she felt ill and took a home Covid test that was positive.  Husband took a home Covid test that was negative.  She did not initiate any outpatient care other than Mucinex and vitamin C.  9/13 in the morning she had difficulty breathing, hyperventilating, blue lips, diffuse body pain, feeling very weak to stand.  She was not drinking or caring for herself.  She was able to walk to the truck.  Her family brought her to the ER freestanding.  At the freestanding ER, she had initiated and tested positive for flu and negative for Covid by antigens.  Covid PCR later returned negative.  She was transferred to the main ER and desaturated during the transport and stopped breathing.  She maintained a pulse.  In the ER she was intubated.  Pressors Were Started to Maintain MAP. CTA was negative for PE, however ED physician and family practice physician clinically suspected PE and that there could be multiple small thrombi in the lungs rather than a large PE detectable by CTA.  She was started on heparin drip.  ICU accepted the patient and began management. She tested negative for COVID IgM antibodies and positive for COVID IgG antibodies. She devloped DIC (disseminated intravascular coagulation) and TTP (thrombotic thrombocytopenic purpura). During the hospital course she had sputum and blood cultures positive for streptoccocus pneumonia. She later had pseudomonas VAP and Enterococcus faecalis bacteremia. She had failure of lungs, liver, and kidneys. She was treated with maximal critical care management including broad spectrum antibiotics, ventilation, continuous renal replacement therapy, blood/platelet transfusions, chest tube, OG tube feedings, and anticoagulation initially that was later discontinued. She had minimal responsiveness to pain only after sedation withdrawal and was unable to breath spontaneously. On 10/9 the family agreed to palliative vent withdrawal and she expired. I suspect her severe illness may have occured due to abrupt discontinuation of hydroxychloroquine for rheumatoid arthritis and antibody dependent enhancement of influenza due to COVID vaccine."
	"1795156-1"	"1795156-1"	"RHEUMATOID ARTHRITIS"	"10039073"	"50-59 years"	"50-59"	"History per chart review and husband. The patient is a 55 Years-old Female with a history of rheumatoid arthritis, anxiety/depression, overweight who presented with acute shortness of breath. 2 weeks prior to admission she filled her routine prescription for hydroxychloroquine for her rheumatoid arthritis, however husband reports that she stopped taking this and started taking a supplement from another country called RT King and reported improvement in arthritis symptoms.  She also had congestion and sore throat around this time and tested herself for Covid with a home test that was negative. Shortly after this she was performing her job as a provider for patient that passed away from Covid and attended the funeral.  On 9/8 she reported difficulty breathing and pain in the chest and back with deep breaths.  This spontaneously resolved.  Then on 9/9 in the evening she had fever, body aches, however she attributed this to her rheumatoid arthritis and the storm pressure changes.  9/12 she felt great then played at the beach with her grandkids running around.  Then 9/12 in the evening she felt ill and took a home Covid test that was positive.  Husband took a home Covid test that was negative.  She did not initiate any outpatient care other than Mucinex and vitamin C.  9/13 in the morning she had difficulty breathing, hyperventilating, blue lips, diffuse body pain, feeling very weak to stand.  She was not drinking or caring for herself.  She was able to walk to the truck.  Her family brought her to the ER freestanding.  At the freestanding ER, she had initiated and tested positive for flu and negative for Covid by antigens.  Covid PCR later returned negative.  She was transferred to the main ER and desaturated during the transport and stopped breathing.  She maintained a pulse.  In the ER she was intubated.  Pressors Were Started to Maintain MAP. CTA was negative for PE, however ED physician and family practice physician clinically suspected PE and that there could be multiple small thrombi in the lungs rather than a large PE detectable by CTA.  She was started on heparin drip.  ICU accepted the patient and began management. She tested negative for COVID IgM antibodies and positive for COVID IgG antibodies. She devloped DIC (disseminated intravascular coagulation) and TTP (thrombotic thrombocytopenic purpura). During the hospital course she had sputum and blood cultures positive for streptoccocus pneumonia. She later had pseudomonas VAP and Enterococcus faecalis bacteremia. She had failure of lungs, liver, and kidneys. She was treated with maximal critical care management including broad spectrum antibiotics, ventilation, continuous renal replacement therapy, blood/platelet transfusions, chest tube, OG tube feedings, and anticoagulation initially that was later discontinued. She had minimal responsiveness to pain only after sedation withdrawal and was unable to breath spontaneously. On 10/9 the family agreed to palliative vent withdrawal and she expired. I suspect her severe illness may have occured due to abrupt discontinuation of hydroxychloroquine for rheumatoid arthritis and antibody dependent enhancement of influenza due to COVID vaccine."
	"1795156-1"	"1795156-1"	"SARS-COV-2 ANTIBODY TEST POSITIVE"	"10084491"	"50-59 years"	"50-59"	"History per chart review and husband. The patient is a 55 Years-old Female with a history of rheumatoid arthritis, anxiety/depression, overweight who presented with acute shortness of breath. 2 weeks prior to admission she filled her routine prescription for hydroxychloroquine for her rheumatoid arthritis, however husband reports that she stopped taking this and started taking a supplement from another country called RT King and reported improvement in arthritis symptoms.  She also had congestion and sore throat around this time and tested herself for Covid with a home test that was negative. Shortly after this she was performing her job as a provider for patient that passed away from Covid and attended the funeral.  On 9/8 she reported difficulty breathing and pain in the chest and back with deep breaths.  This spontaneously resolved.  Then on 9/9 in the evening she had fever, body aches, however she attributed this to her rheumatoid arthritis and the storm pressure changes.  9/12 she felt great then played at the beach with her grandkids running around.  Then 9/12 in the evening she felt ill and took a home Covid test that was positive.  Husband took a home Covid test that was negative.  She did not initiate any outpatient care other than Mucinex and vitamin C.  9/13 in the morning she had difficulty breathing, hyperventilating, blue lips, diffuse body pain, feeling very weak to stand.  She was not drinking or caring for herself.  She was able to walk to the truck.  Her family brought her to the ER freestanding.  At the freestanding ER, she had initiated and tested positive for flu and negative for Covid by antigens.  Covid PCR later returned negative.  She was transferred to the main ER and desaturated during the transport and stopped breathing.  She maintained a pulse.  In the ER she was intubated.  Pressors Were Started to Maintain MAP. CTA was negative for PE, however ED physician and family practice physician clinically suspected PE and that there could be multiple small thrombi in the lungs rather than a large PE detectable by CTA.  She was started on heparin drip.  ICU accepted the patient and began management. She tested negative for COVID IgM antibodies and positive for COVID IgG antibodies. She devloped DIC (disseminated intravascular coagulation) and TTP (thrombotic thrombocytopenic purpura). During the hospital course she had sputum and blood cultures positive for streptoccocus pneumonia. She later had pseudomonas VAP and Enterococcus faecalis bacteremia. She had failure of lungs, liver, and kidneys. She was treated with maximal critical care management including broad spectrum antibiotics, ventilation, continuous renal replacement therapy, blood/platelet transfusions, chest tube, OG tube feedings, and anticoagulation initially that was later discontinued. She had minimal responsiveness to pain only after sedation withdrawal and was unable to breath spontaneously. On 10/9 the family agreed to palliative vent withdrawal and she expired. I suspect her severe illness may have occured due to abrupt discontinuation of hydroxychloroquine for rheumatoid arthritis and antibody dependent enhancement of influenza due to COVID vaccine."
	"1795156-1"	"1795156-1"	"SARS-COV-2 TEST NEGATIVE"	"10084273"	"50-59 years"	"50-59"	"History per chart review and husband. The patient is a 55 Years-old Female with a history of rheumatoid arthritis, anxiety/depression, overweight who presented with acute shortness of breath. 2 weeks prior to admission she filled her routine prescription for hydroxychloroquine for her rheumatoid arthritis, however husband reports that she stopped taking this and started taking a supplement from another country called RT King and reported improvement in arthritis symptoms.  She also had congestion and sore throat around this time and tested herself for Covid with a home test that was negative. Shortly after this she was performing her job as a provider for patient that passed away from Covid and attended the funeral.  On 9/8 she reported difficulty breathing and pain in the chest and back with deep breaths.  This spontaneously resolved.  Then on 9/9 in the evening she had fever, body aches, however she attributed this to her rheumatoid arthritis and the storm pressure changes.  9/12 she felt great then played at the beach with her grandkids running around.  Then 9/12 in the evening she felt ill and took a home Covid test that was positive.  Husband took a home Covid test that was negative.  She did not initiate any outpatient care other than Mucinex and vitamin C.  9/13 in the morning she had difficulty breathing, hyperventilating, blue lips, diffuse body pain, feeling very weak to stand.  She was not drinking or caring for herself.  She was able to walk to the truck.  Her family brought her to the ER freestanding.  At the freestanding ER, she had initiated and tested positive for flu and negative for Covid by antigens.  Covid PCR later returned negative.  She was transferred to the main ER and desaturated during the transport and stopped breathing.  She maintained a pulse.  In the ER she was intubated.  Pressors Were Started to Maintain MAP. CTA was negative for PE, however ED physician and family practice physician clinically suspected PE and that there could be multiple small thrombi in the lungs rather than a large PE detectable by CTA.  She was started on heparin drip.  ICU accepted the patient and began management. She tested negative for COVID IgM antibodies and positive for COVID IgG antibodies. She devloped DIC (disseminated intravascular coagulation) and TTP (thrombotic thrombocytopenic purpura). During the hospital course she had sputum and blood cultures positive for streptoccocus pneumonia. She later had pseudomonas VAP and Enterococcus faecalis bacteremia. She had failure of lungs, liver, and kidneys. She was treated with maximal critical care management including broad spectrum antibiotics, ventilation, continuous renal replacement therapy, blood/platelet transfusions, chest tube, OG tube feedings, and anticoagulation initially that was later discontinued. She had minimal responsiveness to pain only after sedation withdrawal and was unable to breath spontaneously. On 10/9 the family agreed to palliative vent withdrawal and she expired. I suspect her severe illness may have occured due to abrupt discontinuation of hydroxychloroquine for rheumatoid arthritis and antibody dependent enhancement of influenza due to COVID vaccine."
	"1795156-1"	"1795156-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"History per chart review and husband. The patient is a 55 Years-old Female with a history of rheumatoid arthritis, anxiety/depression, overweight who presented with acute shortness of breath. 2 weeks prior to admission she filled her routine prescription for hydroxychloroquine for her rheumatoid arthritis, however husband reports that she stopped taking this and started taking a supplement from another country called RT King and reported improvement in arthritis symptoms.  She also had congestion and sore throat around this time and tested herself for Covid with a home test that was negative. Shortly after this she was performing her job as a provider for patient that passed away from Covid and attended the funeral.  On 9/8 she reported difficulty breathing and pain in the chest and back with deep breaths.  This spontaneously resolved.  Then on 9/9 in the evening she had fever, body aches, however she attributed this to her rheumatoid arthritis and the storm pressure changes.  9/12 she felt great then played at the beach with her grandkids running around.  Then 9/12 in the evening she felt ill and took a home Covid test that was positive.  Husband took a home Covid test that was negative.  She did not initiate any outpatient care other than Mucinex and vitamin C.  9/13 in the morning she had difficulty breathing, hyperventilating, blue lips, diffuse body pain, feeling very weak to stand.  She was not drinking or caring for herself.  She was able to walk to the truck.  Her family brought her to the ER freestanding.  At the freestanding ER, she had initiated and tested positive for flu and negative for Covid by antigens.  Covid PCR later returned negative.  She was transferred to the main ER and desaturated during the transport and stopped breathing.  She maintained a pulse.  In the ER she was intubated.  Pressors Were Started to Maintain MAP. CTA was negative for PE, however ED physician and family practice physician clinically suspected PE and that there could be multiple small thrombi in the lungs rather than a large PE detectable by CTA.  She was started on heparin drip.  ICU accepted the patient and began management. She tested negative for COVID IgM antibodies and positive for COVID IgG antibodies. She devloped DIC (disseminated intravascular coagulation) and TTP (thrombotic thrombocytopenic purpura). During the hospital course she had sputum and blood cultures positive for streptoccocus pneumonia. She later had pseudomonas VAP and Enterococcus faecalis bacteremia. She had failure of lungs, liver, and kidneys. She was treated with maximal critical care management including broad spectrum antibiotics, ventilation, continuous renal replacement therapy, blood/platelet transfusions, chest tube, OG tube feedings, and anticoagulation initially that was later discontinued. She had minimal responsiveness to pain only after sedation withdrawal and was unable to breath spontaneously. On 10/9 the family agreed to palliative vent withdrawal and she expired. I suspect her severe illness may have occured due to abrupt discontinuation of hydroxychloroquine for rheumatoid arthritis and antibody dependent enhancement of influenza due to COVID vaccine."
	"1795156-1"	"1795156-1"	"SPUTUM CULTURE POSITIVE"	"10051612"	"50-59 years"	"50-59"	"History per chart review and husband. The patient is a 55 Years-old Female with a history of rheumatoid arthritis, anxiety/depression, overweight who presented with acute shortness of breath. 2 weeks prior to admission she filled her routine prescription for hydroxychloroquine for her rheumatoid arthritis, however husband reports that she stopped taking this and started taking a supplement from another country called RT King and reported improvement in arthritis symptoms.  She also had congestion and sore throat around this time and tested herself for Covid with a home test that was negative. Shortly after this she was performing her job as a provider for patient that passed away from Covid and attended the funeral.  On 9/8 she reported difficulty breathing and pain in the chest and back with deep breaths.  This spontaneously resolved.  Then on 9/9 in the evening she had fever, body aches, however she attributed this to her rheumatoid arthritis and the storm pressure changes.  9/12 she felt great then played at the beach with her grandkids running around.  Then 9/12 in the evening she felt ill and took a home Covid test that was positive.  Husband took a home Covid test that was negative.  She did not initiate any outpatient care other than Mucinex and vitamin C.  9/13 in the morning she had difficulty breathing, hyperventilating, blue lips, diffuse body pain, feeling very weak to stand.  She was not drinking or caring for herself.  She was able to walk to the truck.  Her family brought her to the ER freestanding.  At the freestanding ER, she had initiated and tested positive for flu and negative for Covid by antigens.  Covid PCR later returned negative.  She was transferred to the main ER and desaturated during the transport and stopped breathing.  She maintained a pulse.  In the ER she was intubated.  Pressors Were Started to Maintain MAP. CTA was negative for PE, however ED physician and family practice physician clinically suspected PE and that there could be multiple small thrombi in the lungs rather than a large PE detectable by CTA.  She was started on heparin drip.  ICU accepted the patient and began management. She tested negative for COVID IgM antibodies and positive for COVID IgG antibodies. She devloped DIC (disseminated intravascular coagulation) and TTP (thrombotic thrombocytopenic purpura). During the hospital course she had sputum and blood cultures positive for streptoccocus pneumonia. She later had pseudomonas VAP and Enterococcus faecalis bacteremia. She had failure of lungs, liver, and kidneys. She was treated with maximal critical care management including broad spectrum antibiotics, ventilation, continuous renal replacement therapy, blood/platelet transfusions, chest tube, OG tube feedings, and anticoagulation initially that was later discontinued. She had minimal responsiveness to pain only after sedation withdrawal and was unable to breath spontaneously. On 10/9 the family agreed to palliative vent withdrawal and she expired. I suspect her severe illness may have occured due to abrupt discontinuation of hydroxychloroquine for rheumatoid arthritis and antibody dependent enhancement of influenza due to COVID vaccine."
	"1795156-1"	"1795156-1"	"THROMBOTIC THROMBOCYTOPENIC PURPURA"	"10043648"	"50-59 years"	"50-59"	"History per chart review and husband. The patient is a 55 Years-old Female with a history of rheumatoid arthritis, anxiety/depression, overweight who presented with acute shortness of breath. 2 weeks prior to admission she filled her routine prescription for hydroxychloroquine for her rheumatoid arthritis, however husband reports that she stopped taking this and started taking a supplement from another country called RT King and reported improvement in arthritis symptoms.  She also had congestion and sore throat around this time and tested herself for Covid with a home test that was negative. Shortly after this she was performing her job as a provider for patient that passed away from Covid and attended the funeral.  On 9/8 she reported difficulty breathing and pain in the chest and back with deep breaths.  This spontaneously resolved.  Then on 9/9 in the evening she had fever, body aches, however she attributed this to her rheumatoid arthritis and the storm pressure changes.  9/12 she felt great then played at the beach with her grandkids running around.  Then 9/12 in the evening she felt ill and took a home Covid test that was positive.  Husband took a home Covid test that was negative.  She did not initiate any outpatient care other than Mucinex and vitamin C.  9/13 in the morning she had difficulty breathing, hyperventilating, blue lips, diffuse body pain, feeling very weak to stand.  She was not drinking or caring for herself.  She was able to walk to the truck.  Her family brought her to the ER freestanding.  At the freestanding ER, she had initiated and tested positive for flu and negative for Covid by antigens.  Covid PCR later returned negative.  She was transferred to the main ER and desaturated during the transport and stopped breathing.  She maintained a pulse.  In the ER she was intubated.  Pressors Were Started to Maintain MAP. CTA was negative for PE, however ED physician and family practice physician clinically suspected PE and that there could be multiple small thrombi in the lungs rather than a large PE detectable by CTA.  She was started on heparin drip.  ICU accepted the patient and began management. She tested negative for COVID IgM antibodies and positive for COVID IgG antibodies. She devloped DIC (disseminated intravascular coagulation) and TTP (thrombotic thrombocytopenic purpura). During the hospital course she had sputum and blood cultures positive for streptoccocus pneumonia. She later had pseudomonas VAP and Enterococcus faecalis bacteremia. She had failure of lungs, liver, and kidneys. She was treated with maximal critical care management including broad spectrum antibiotics, ventilation, continuous renal replacement therapy, blood/platelet transfusions, chest tube, OG tube feedings, and anticoagulation initially that was later discontinued. She had minimal responsiveness to pain only after sedation withdrawal and was unable to breath spontaneously. On 10/9 the family agreed to palliative vent withdrawal and she expired. I suspect her severe illness may have occured due to abrupt discontinuation of hydroxychloroquine for rheumatoid arthritis and antibody dependent enhancement of influenza due to COVID vaccine."
	"1795156-1"	"1795156-1"	"TRANSFUSION"	"10066152"	"50-59 years"	"50-59"	"History per chart review and husband. The patient is a 55 Years-old Female with a history of rheumatoid arthritis, anxiety/depression, overweight who presented with acute shortness of breath. 2 weeks prior to admission she filled her routine prescription for hydroxychloroquine for her rheumatoid arthritis, however husband reports that she stopped taking this and started taking a supplement from another country called RT King and reported improvement in arthritis symptoms.  She also had congestion and sore throat around this time and tested herself for Covid with a home test that was negative. Shortly after this she was performing her job as a provider for patient that passed away from Covid and attended the funeral.  On 9/8 she reported difficulty breathing and pain in the chest and back with deep breaths.  This spontaneously resolved.  Then on 9/9 in the evening she had fever, body aches, however she attributed this to her rheumatoid arthritis and the storm pressure changes.  9/12 she felt great then played at the beach with her grandkids running around.  Then 9/12 in the evening she felt ill and took a home Covid test that was positive.  Husband took a home Covid test that was negative.  She did not initiate any outpatient care other than Mucinex and vitamin C.  9/13 in the morning she had difficulty breathing, hyperventilating, blue lips, diffuse body pain, feeling very weak to stand.  She was not drinking or caring for herself.  She was able to walk to the truck.  Her family brought her to the ER freestanding.  At the freestanding ER, she had initiated and tested positive for flu and negative for Covid by antigens.  Covid PCR later returned negative.  She was transferred to the main ER and desaturated during the transport and stopped breathing.  She maintained a pulse.  In the ER she was intubated.  Pressors Were Started to Maintain MAP. CTA was negative for PE, however ED physician and family practice physician clinically suspected PE and that there could be multiple small thrombi in the lungs rather than a large PE detectable by CTA.  She was started on heparin drip.  ICU accepted the patient and began management. She tested negative for COVID IgM antibodies and positive for COVID IgG antibodies. She devloped DIC (disseminated intravascular coagulation) and TTP (thrombotic thrombocytopenic purpura). During the hospital course she had sputum and blood cultures positive for streptoccocus pneumonia. She later had pseudomonas VAP and Enterococcus faecalis bacteremia. She had failure of lungs, liver, and kidneys. She was treated with maximal critical care management including broad spectrum antibiotics, ventilation, continuous renal replacement therapy, blood/platelet transfusions, chest tube, OG tube feedings, and anticoagulation initially that was later discontinued. She had minimal responsiveness to pain only after sedation withdrawal and was unable to breath spontaneously. On 10/9 the family agreed to palliative vent withdrawal and she expired. I suspect her severe illness may have occured due to abrupt discontinuation of hydroxychloroquine for rheumatoid arthritis and antibody dependent enhancement of influenza due to COVID vaccine."
	"1795156-1"	"1795156-1"	"WITHDRAWAL OF LIFE SUPPORT"	"10067595"	"50-59 years"	"50-59"	"History per chart review and husband. The patient is a 55 Years-old Female with a history of rheumatoid arthritis, anxiety/depression, overweight who presented with acute shortness of breath. 2 weeks prior to admission she filled her routine prescription for hydroxychloroquine for her rheumatoid arthritis, however husband reports that she stopped taking this and started taking a supplement from another country called RT King and reported improvement in arthritis symptoms.  She also had congestion and sore throat around this time and tested herself for Covid with a home test that was negative. Shortly after this she was performing her job as a provider for patient that passed away from Covid and attended the funeral.  On 9/8 she reported difficulty breathing and pain in the chest and back with deep breaths.  This spontaneously resolved.  Then on 9/9 in the evening she had fever, body aches, however she attributed this to her rheumatoid arthritis and the storm pressure changes.  9/12 she felt great then played at the beach with her grandkids running around.  Then 9/12 in the evening she felt ill and took a home Covid test that was positive.  Husband took a home Covid test that was negative.  She did not initiate any outpatient care other than Mucinex and vitamin C.  9/13 in the morning she had difficulty breathing, hyperventilating, blue lips, diffuse body pain, feeling very weak to stand.  She was not drinking or caring for herself.  She was able to walk to the truck.  Her family brought her to the ER freestanding.  At the freestanding ER, she had initiated and tested positive for flu and negative for Covid by antigens.  Covid PCR later returned negative.  She was transferred to the main ER and desaturated during the transport and stopped breathing.  She maintained a pulse.  In the ER she was intubated.  Pressors Were Started to Maintain MAP. CTA was negative for PE, however ED physician and family practice physician clinically suspected PE and that there could be multiple small thrombi in the lungs rather than a large PE detectable by CTA.  She was started on heparin drip.  ICU accepted the patient and began management. She tested negative for COVID IgM antibodies and positive for COVID IgG antibodies. She devloped DIC (disseminated intravascular coagulation) and TTP (thrombotic thrombocytopenic purpura). During the hospital course she had sputum and blood cultures positive for streptoccocus pneumonia. She later had pseudomonas VAP and Enterococcus faecalis bacteremia. She had failure of lungs, liver, and kidneys. She was treated with maximal critical care management including broad spectrum antibiotics, ventilation, continuous renal replacement therapy, blood/platelet transfusions, chest tube, OG tube feedings, and anticoagulation initially that was later discontinued. She had minimal responsiveness to pain only after sedation withdrawal and was unable to breath spontaneously. On 10/9 the family agreed to palliative vent withdrawal and she expired. I suspect her severe illness may have occured due to abrupt discontinuation of hydroxychloroquine for rheumatoid arthritis and antibody dependent enhancement of influenza due to COVID vaccine."
	"1799489-1"	"1799489-1"	"ACUTE RESPIRATORY DISTRESS SYNDROME"	"10001052"	"50-59 years"	"50-59"	"She showed signs of shortness of breath and fatigue/ confusion less than 2 weeks after her first dose Was hospitalized and it was determined that she had an infection that was septic  She had cardiovascular damage (blood pressure issues) Fluid build up in her body Nausea Joint and muscle pain Fatigue Injection potentially entered her bloodstream or blood vessel as she received it during her chemotherapy session"
	"1799489-1"	"1799489-1"	"ARTHRALGIA"	"10003239"	"50-59 years"	"50-59"	"She showed signs of shortness of breath and fatigue/ confusion less than 2 weeks after her first dose Was hospitalized and it was determined that she had an infection that was septic  She had cardiovascular damage (blood pressure issues) Fluid build up in her body Nausea Joint and muscle pain Fatigue Injection potentially entered her bloodstream or blood vessel as she received it during her chemotherapy session"
	"1799489-1"	"1799489-1"	"BLOOD PRESSURE ABNORMAL"	"10005728"	"50-59 years"	"50-59"	"She showed signs of shortness of breath and fatigue/ confusion less than 2 weeks after her first dose Was hospitalized and it was determined that she had an infection that was septic  She had cardiovascular damage (blood pressure issues) Fluid build up in her body Nausea Joint and muscle pain Fatigue Injection potentially entered her bloodstream or blood vessel as she received it during her chemotherapy session"
	"1799489-1"	"1799489-1"	"CARDIOVASCULAR DISORDER"	"10007649"	"50-59 years"	"50-59"	"She showed signs of shortness of breath and fatigue/ confusion less than 2 weeks after her first dose Was hospitalized and it was determined that she had an infection that was septic  She had cardiovascular damage (blood pressure issues) Fluid build up in her body Nausea Joint and muscle pain Fatigue Injection potentially entered her bloodstream or blood vessel as she received it during her chemotherapy session"
	"1799489-1"	"1799489-1"	"CONFUSIONAL STATE"	"10010305"	"50-59 years"	"50-59"	"She showed signs of shortness of breath and fatigue/ confusion less than 2 weeks after her first dose Was hospitalized and it was determined that she had an infection that was septic  She had cardiovascular damage (blood pressure issues) Fluid build up in her body Nausea Joint and muscle pain Fatigue Injection potentially entered her bloodstream or blood vessel as she received it during her chemotherapy session"
	"1799489-1"	"1799489-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"She showed signs of shortness of breath and fatigue/ confusion less than 2 weeks after her first dose Was hospitalized and it was determined that she had an infection that was septic  She had cardiovascular damage (blood pressure issues) Fluid build up in her body Nausea Joint and muscle pain Fatigue Injection potentially entered her bloodstream or blood vessel as she received it during her chemotherapy session"
	"1799489-1"	"1799489-1"	"FATIGUE"	"10016256"	"50-59 years"	"50-59"	"She showed signs of shortness of breath and fatigue/ confusion less than 2 weeks after her first dose Was hospitalized and it was determined that she had an infection that was septic  She had cardiovascular damage (blood pressure issues) Fluid build up in her body Nausea Joint and muscle pain Fatigue Injection potentially entered her bloodstream or blood vessel as she received it during her chemotherapy session"
	"1799489-1"	"1799489-1"	"FLUID RETENTION"	"10016807"	"50-59 years"	"50-59"	"She showed signs of shortness of breath and fatigue/ confusion less than 2 weeks after her first dose Was hospitalized and it was determined that she had an infection that was septic  She had cardiovascular damage (blood pressure issues) Fluid build up in her body Nausea Joint and muscle pain Fatigue Injection potentially entered her bloodstream or blood vessel as she received it during her chemotherapy session"
	"1799489-1"	"1799489-1"	"INFECTION"	"10021789"	"50-59 years"	"50-59"	"She showed signs of shortness of breath and fatigue/ confusion less than 2 weeks after her first dose Was hospitalized and it was determined that she had an infection that was septic  She had cardiovascular damage (blood pressure issues) Fluid build up in her body Nausea Joint and muscle pain Fatigue Injection potentially entered her bloodstream or blood vessel as she received it during her chemotherapy session"
	"1799489-1"	"1799489-1"	"INFLAMMATION"	"10061218"	"50-59 years"	"50-59"	"She showed signs of shortness of breath and fatigue/ confusion less than 2 weeks after her first dose Was hospitalized and it was determined that she had an infection that was septic  She had cardiovascular damage (blood pressure issues) Fluid build up in her body Nausea Joint and muscle pain Fatigue Injection potentially entered her bloodstream or blood vessel as she received it during her chemotherapy session"
	"1799489-1"	"1799489-1"	"MYALGIA"	"10028411"	"50-59 years"	"50-59"	"She showed signs of shortness of breath and fatigue/ confusion less than 2 weeks after her first dose Was hospitalized and it was determined that she had an infection that was septic  She had cardiovascular damage (blood pressure issues) Fluid build up in her body Nausea Joint and muscle pain Fatigue Injection potentially entered her bloodstream or blood vessel as she received it during her chemotherapy session"
	"1799489-1"	"1799489-1"	"NAUSEA"	"10028813"	"50-59 years"	"50-59"	"She showed signs of shortness of breath and fatigue/ confusion less than 2 weeks after her first dose Was hospitalized and it was determined that she had an infection that was septic  She had cardiovascular damage (blood pressure issues) Fluid build up in her body Nausea Joint and muscle pain Fatigue Injection potentially entered her bloodstream or blood vessel as she received it during her chemotherapy session"
	"1799489-1"	"1799489-1"	"SEPSIS"	"10040047"	"50-59 years"	"50-59"	"She showed signs of shortness of breath and fatigue/ confusion less than 2 weeks after her first dose Was hospitalized and it was determined that she had an infection that was septic  She had cardiovascular damage (blood pressure issues) Fluid build up in her body Nausea Joint and muscle pain Fatigue Injection potentially entered her bloodstream or blood vessel as she received it during her chemotherapy session"
	"1804254-1"	"1804254-1"	"ABDOMINAL PAIN"	"10000081"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 1/29/2021 and 2/24/2021. Presented to ED on 10/6/2021 complaining of shortness of breath x3 days, diffuse body aches, chills, nausea, vomiting, and abdominal pain. On presentation satting 94% on room air. Patient started on dexamethasone.  Patient's respiratory sats decompensated on 10/9/21, requiring intubation.  Patient continued to decline and expired on 10/16/2021."
	"1804254-1"	"1804254-1"	"CHILLS"	"10008531"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 1/29/2021 and 2/24/2021. Presented to ED on 10/6/2021 complaining of shortness of breath x3 days, diffuse body aches, chills, nausea, vomiting, and abdominal pain. On presentation satting 94% on room air. Patient started on dexamethasone.  Patient's respiratory sats decompensated on 10/9/21, requiring intubation.  Patient continued to decline and expired on 10/16/2021."
	"1804254-1"	"1804254-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 1/29/2021 and 2/24/2021. Presented to ED on 10/6/2021 complaining of shortness of breath x3 days, diffuse body aches, chills, nausea, vomiting, and abdominal pain. On presentation satting 94% on room air. Patient started on dexamethasone.  Patient's respiratory sats decompensated on 10/9/21, requiring intubation.  Patient continued to decline and expired on 10/16/2021."
	"1804254-1"	"1804254-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 1/29/2021 and 2/24/2021. Presented to ED on 10/6/2021 complaining of shortness of breath x3 days, diffuse body aches, chills, nausea, vomiting, and abdominal pain. On presentation satting 94% on room air. Patient started on dexamethasone.  Patient's respiratory sats decompensated on 10/9/21, requiring intubation.  Patient continued to decline and expired on 10/16/2021."
	"1804254-1"	"1804254-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 1/29/2021 and 2/24/2021. Presented to ED on 10/6/2021 complaining of shortness of breath x3 days, diffuse body aches, chills, nausea, vomiting, and abdominal pain. On presentation satting 94% on room air. Patient started on dexamethasone.  Patient's respiratory sats decompensated on 10/9/21, requiring intubation.  Patient continued to decline and expired on 10/16/2021."
	"1804254-1"	"1804254-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 1/29/2021 and 2/24/2021. Presented to ED on 10/6/2021 complaining of shortness of breath x3 days, diffuse body aches, chills, nausea, vomiting, and abdominal pain. On presentation satting 94% on room air. Patient started on dexamethasone.  Patient's respiratory sats decompensated on 10/9/21, requiring intubation.  Patient continued to decline and expired on 10/16/2021."
	"1804254-1"	"1804254-1"	"NAUSEA"	"10028813"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 1/29/2021 and 2/24/2021. Presented to ED on 10/6/2021 complaining of shortness of breath x3 days, diffuse body aches, chills, nausea, vomiting, and abdominal pain. On presentation satting 94% on room air. Patient started on dexamethasone.  Patient's respiratory sats decompensated on 10/9/21, requiring intubation.  Patient continued to decline and expired on 10/16/2021."
	"1804254-1"	"1804254-1"	"PAIN"	"10033371"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 1/29/2021 and 2/24/2021. Presented to ED on 10/6/2021 complaining of shortness of breath x3 days, diffuse body aches, chills, nausea, vomiting, and abdominal pain. On presentation satting 94% on room air. Patient started on dexamethasone.  Patient's respiratory sats decompensated on 10/9/21, requiring intubation.  Patient continued to decline and expired on 10/16/2021."
	"1804254-1"	"1804254-1"	"RESPIRATORY DISORDER"	"10038683"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 1/29/2021 and 2/24/2021. Presented to ED on 10/6/2021 complaining of shortness of breath x3 days, diffuse body aches, chills, nausea, vomiting, and abdominal pain. On presentation satting 94% on room air. Patient started on dexamethasone.  Patient's respiratory sats decompensated on 10/9/21, requiring intubation.  Patient continued to decline and expired on 10/16/2021."
	"1804254-1"	"1804254-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 1/29/2021 and 2/24/2021. Presented to ED on 10/6/2021 complaining of shortness of breath x3 days, diffuse body aches, chills, nausea, vomiting, and abdominal pain. On presentation satting 94% on room air. Patient started on dexamethasone.  Patient's respiratory sats decompensated on 10/9/21, requiring intubation.  Patient continued to decline and expired on 10/16/2021."
	"1804254-1"	"1804254-1"	"VOMITING"	"10047700"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 1/29/2021 and 2/24/2021. Presented to ED on 10/6/2021 complaining of shortness of breath x3 days, diffuse body aches, chills, nausea, vomiting, and abdominal pain. On presentation satting 94% on room air. Patient started on dexamethasone.  Patient's respiratory sats decompensated on 10/9/21, requiring intubation.  Patient continued to decline and expired on 10/16/2021."
	"1804276-1"	"1804276-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Had breakthrough infection and passed away."
	"1804276-1"	"1804276-1"	"LABORATORY TEST"	"10059938"	"50-59 years"	"50-59"	"Had breakthrough infection and passed away."
	"1804276-1"	"1804276-1"	"VACCINE BREAKTHROUGH INFECTION"	"10067923"	"50-59 years"	"50-59"	"Had breakthrough infection and passed away."
	"1804303-1"	"1804303-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"They had a breakthrough infection and passed away."
	"1804303-1"	"1804303-1"	"LABORATORY TEST"	"10059938"	"50-59 years"	"50-59"	"They had a breakthrough infection and passed away."
	"1804303-1"	"1804303-1"	"VACCINE BREAKTHROUGH INFECTION"	"10067923"	"50-59 years"	"50-59"	"They had a breakthrough infection and passed away."
	"1804363-1"	"1804363-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Patient contracted COVID 19 and subsequently passed away."
	"1804363-1"	"1804363-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient contracted COVID 19 and subsequently passed away."
	"1804363-1"	"1804363-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"Patient contracted COVID 19 and subsequently passed away."
	"1804391-1"	"1804391-1"	"ANGIOGRAM PULMONARY ABNORMAL"	"10002441"	"50-59 years"	"50-59"	"10/20/21 1610 patient comes into ED complaining for the past several days has had increasing shortness of breath mild cough back pain.  She has had lightheaded episodes.  Increasing leg pain after which she describes as possible fall.  No head injury.  No nausea no vomiting.  No cough no hemoptysis.  On arrival in the ED her room air pulse ox was between 85 and 88%.  Pulse rate was 120s.  Respiratory rate was in the 30 range.  Lungs were clear soft nontender right extremity has some tenderness in the calf and medial thigh.  Mild edema neuro intact.  Patient states she had her second Pfizer vaccine on Wednesday.  Symptoms started on Monday of gotten worse. Admitted for bilateral PE and right leg DVT. 10/21/21 AM taken to cath lab for pulmonary angiogram with measurement of central venous pressures, mechanical thrombectomy. Cardiac arrest at 0630 10/21/21 in cath lab during procedure. CPR performed for 45 minutes and while being transported to OR for emergent CABG. 10/21/21 1000 patient arrived to ICU with chest still cracked open and physician providing cardiac massage. Time of death called at 1005 10/21/21."
	"1804391-1"	"1804391-1"	"BACK PAIN"	"10003988"	"50-59 years"	"50-59"	"10/20/21 1610 patient comes into ED complaining for the past several days has had increasing shortness of breath mild cough back pain.  She has had lightheaded episodes.  Increasing leg pain after which she describes as possible fall.  No head injury.  No nausea no vomiting.  No cough no hemoptysis.  On arrival in the ED her room air pulse ox was between 85 and 88%.  Pulse rate was 120s.  Respiratory rate was in the 30 range.  Lungs were clear soft nontender right extremity has some tenderness in the calf and medial thigh.  Mild edema neuro intact.  Patient states she had her second Pfizer vaccine on Wednesday.  Symptoms started on Monday of gotten worse. Admitted for bilateral PE and right leg DVT. 10/21/21 AM taken to cath lab for pulmonary angiogram with measurement of central venous pressures, mechanical thrombectomy. Cardiac arrest at 0630 10/21/21 in cath lab during procedure. CPR performed for 45 minutes and while being transported to OR for emergent CABG. 10/21/21 1000 patient arrived to ICU with chest still cracked open and physician providing cardiac massage. Time of death called at 1005 10/21/21."
	"1804391-1"	"1804391-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"10/20/21 1610 patient comes into ED complaining for the past several days has had increasing shortness of breath mild cough back pain.  She has had lightheaded episodes.  Increasing leg pain after which she describes as possible fall.  No head injury.  No nausea no vomiting.  No cough no hemoptysis.  On arrival in the ED her room air pulse ox was between 85 and 88%.  Pulse rate was 120s.  Respiratory rate was in the 30 range.  Lungs were clear soft nontender right extremity has some tenderness in the calf and medial thigh.  Mild edema neuro intact.  Patient states she had her second Pfizer vaccine on Wednesday.  Symptoms started on Monday of gotten worse. Admitted for bilateral PE and right leg DVT. 10/21/21 AM taken to cath lab for pulmonary angiogram with measurement of central venous pressures, mechanical thrombectomy. Cardiac arrest at 0630 10/21/21 in cath lab during procedure. CPR performed for 45 minutes and while being transported to OR for emergent CABG. 10/21/21 1000 patient arrived to ICU with chest still cracked open and physician providing cardiac massage. Time of death called at 1005 10/21/21."
	"1804391-1"	"1804391-1"	"CARDIAC MASSAGE"	"10059163"	"50-59 years"	"50-59"	"10/20/21 1610 patient comes into ED complaining for the past several days has had increasing shortness of breath mild cough back pain.  She has had lightheaded episodes.  Increasing leg pain after which she describes as possible fall.  No head injury.  No nausea no vomiting.  No cough no hemoptysis.  On arrival in the ED her room air pulse ox was between 85 and 88%.  Pulse rate was 120s.  Respiratory rate was in the 30 range.  Lungs were clear soft nontender right extremity has some tenderness in the calf and medial thigh.  Mild edema neuro intact.  Patient states she had her second Pfizer vaccine on Wednesday.  Symptoms started on Monday of gotten worse. Admitted for bilateral PE and right leg DVT. 10/21/21 AM taken to cath lab for pulmonary angiogram with measurement of central venous pressures, mechanical thrombectomy. Cardiac arrest at 0630 10/21/21 in cath lab during procedure. CPR performed for 45 minutes and while being transported to OR for emergent CABG. 10/21/21 1000 patient arrived to ICU with chest still cracked open and physician providing cardiac massage. Time of death called at 1005 10/21/21."
	"1804391-1"	"1804391-1"	"CATHETERISATION CARDIAC ABNORMAL"	"10007816"	"50-59 years"	"50-59"	"10/20/21 1610 patient comes into ED complaining for the past several days has had increasing shortness of breath mild cough back pain.  She has had lightheaded episodes.  Increasing leg pain after which she describes as possible fall.  No head injury.  No nausea no vomiting.  No cough no hemoptysis.  On arrival in the ED her room air pulse ox was between 85 and 88%.  Pulse rate was 120s.  Respiratory rate was in the 30 range.  Lungs were clear soft nontender right extremity has some tenderness in the calf and medial thigh.  Mild edema neuro intact.  Patient states she had her second Pfizer vaccine on Wednesday.  Symptoms started on Monday of gotten worse. Admitted for bilateral PE and right leg DVT. 10/21/21 AM taken to cath lab for pulmonary angiogram with measurement of central venous pressures, mechanical thrombectomy. Cardiac arrest at 0630 10/21/21 in cath lab during procedure. CPR performed for 45 minutes and while being transported to OR for emergent CABG. 10/21/21 1000 patient arrived to ICU with chest still cracked open and physician providing cardiac massage. Time of death called at 1005 10/21/21."
	"1804391-1"	"1804391-1"	"COMPUTERISED TOMOGRAM ABDOMEN ABNORMAL"	"10057798"	"50-59 years"	"50-59"	"10/20/21 1610 patient comes into ED complaining for the past several days has had increasing shortness of breath mild cough back pain.  She has had lightheaded episodes.  Increasing leg pain after which she describes as possible fall.  No head injury.  No nausea no vomiting.  No cough no hemoptysis.  On arrival in the ED her room air pulse ox was between 85 and 88%.  Pulse rate was 120s.  Respiratory rate was in the 30 range.  Lungs were clear soft nontender right extremity has some tenderness in the calf and medial thigh.  Mild edema neuro intact.  Patient states she had her second Pfizer vaccine on Wednesday.  Symptoms started on Monday of gotten worse. Admitted for bilateral PE and right leg DVT. 10/21/21 AM taken to cath lab for pulmonary angiogram with measurement of central venous pressures, mechanical thrombectomy. Cardiac arrest at 0630 10/21/21 in cath lab during procedure. CPR performed for 45 minutes and while being transported to OR for emergent CABG. 10/21/21 1000 patient arrived to ICU with chest still cracked open and physician providing cardiac massage. Time of death called at 1005 10/21/21."
	"1804391-1"	"1804391-1"	"COMPUTERISED TOMOGRAM THORAX ABNORMAL"	"10057799"	"50-59 years"	"50-59"	"10/20/21 1610 patient comes into ED complaining for the past several days has had increasing shortness of breath mild cough back pain.  She has had lightheaded episodes.  Increasing leg pain after which she describes as possible fall.  No head injury.  No nausea no vomiting.  No cough no hemoptysis.  On arrival in the ED her room air pulse ox was between 85 and 88%.  Pulse rate was 120s.  Respiratory rate was in the 30 range.  Lungs were clear soft nontender right extremity has some tenderness in the calf and medial thigh.  Mild edema neuro intact.  Patient states she had her second Pfizer vaccine on Wednesday.  Symptoms started on Monday of gotten worse. Admitted for bilateral PE and right leg DVT. 10/21/21 AM taken to cath lab for pulmonary angiogram with measurement of central venous pressures, mechanical thrombectomy. Cardiac arrest at 0630 10/21/21 in cath lab during procedure. CPR performed for 45 minutes and while being transported to OR for emergent CABG. 10/21/21 1000 patient arrived to ICU with chest still cracked open and physician providing cardiac massage. Time of death called at 1005 10/21/21."
	"1804391-1"	"1804391-1"	"CORONARY ARTERY BYPASS"	"10011077"	"50-59 years"	"50-59"	"10/20/21 1610 patient comes into ED complaining for the past several days has had increasing shortness of breath mild cough back pain.  She has had lightheaded episodes.  Increasing leg pain after which she describes as possible fall.  No head injury.  No nausea no vomiting.  No cough no hemoptysis.  On arrival in the ED her room air pulse ox was between 85 and 88%.  Pulse rate was 120s.  Respiratory rate was in the 30 range.  Lungs were clear soft nontender right extremity has some tenderness in the calf and medial thigh.  Mild edema neuro intact.  Patient states she had her second Pfizer vaccine on Wednesday.  Symptoms started on Monday of gotten worse. Admitted for bilateral PE and right leg DVT. 10/21/21 AM taken to cath lab for pulmonary angiogram with measurement of central venous pressures, mechanical thrombectomy. Cardiac arrest at 0630 10/21/21 in cath lab during procedure. CPR performed for 45 minutes and while being transported to OR for emergent CABG. 10/21/21 1000 patient arrived to ICU with chest still cracked open and physician providing cardiac massage. Time of death called at 1005 10/21/21."
	"1804391-1"	"1804391-1"	"COUGH"	"10011224"	"50-59 years"	"50-59"	"10/20/21 1610 patient comes into ED complaining for the past several days has had increasing shortness of breath mild cough back pain.  She has had lightheaded episodes.  Increasing leg pain after which she describes as possible fall.  No head injury.  No nausea no vomiting.  No cough no hemoptysis.  On arrival in the ED her room air pulse ox was between 85 and 88%.  Pulse rate was 120s.  Respiratory rate was in the 30 range.  Lungs were clear soft nontender right extremity has some tenderness in the calf and medial thigh.  Mild edema neuro intact.  Patient states she had her second Pfizer vaccine on Wednesday.  Symptoms started on Monday of gotten worse. Admitted for bilateral PE and right leg DVT. 10/21/21 AM taken to cath lab for pulmonary angiogram with measurement of central venous pressures, mechanical thrombectomy. Cardiac arrest at 0630 10/21/21 in cath lab during procedure. CPR performed for 45 minutes and while being transported to OR for emergent CABG. 10/21/21 1000 patient arrived to ICU with chest still cracked open and physician providing cardiac massage. Time of death called at 1005 10/21/21."
	"1804391-1"	"1804391-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"10/20/21 1610 patient comes into ED complaining for the past several days has had increasing shortness of breath mild cough back pain.  She has had lightheaded episodes.  Increasing leg pain after which she describes as possible fall.  No head injury.  No nausea no vomiting.  No cough no hemoptysis.  On arrival in the ED her room air pulse ox was between 85 and 88%.  Pulse rate was 120s.  Respiratory rate was in the 30 range.  Lungs were clear soft nontender right extremity has some tenderness in the calf and medial thigh.  Mild edema neuro intact.  Patient states she had her second Pfizer vaccine on Wednesday.  Symptoms started on Monday of gotten worse. Admitted for bilateral PE and right leg DVT. 10/21/21 AM taken to cath lab for pulmonary angiogram with measurement of central venous pressures, mechanical thrombectomy. Cardiac arrest at 0630 10/21/21 in cath lab during procedure. CPR performed for 45 minutes and while being transported to OR for emergent CABG. 10/21/21 1000 patient arrived to ICU with chest still cracked open and physician providing cardiac massage. Time of death called at 1005 10/21/21."
	"1804391-1"	"1804391-1"	"DEEP VEIN THROMBOSIS"	"10051055"	"50-59 years"	"50-59"	"10/20/21 1610 patient comes into ED complaining for the past several days has had increasing shortness of breath mild cough back pain.  She has had lightheaded episodes.  Increasing leg pain after which she describes as possible fall.  No head injury.  No nausea no vomiting.  No cough no hemoptysis.  On arrival in the ED her room air pulse ox was between 85 and 88%.  Pulse rate was 120s.  Respiratory rate was in the 30 range.  Lungs were clear soft nontender right extremity has some tenderness in the calf and medial thigh.  Mild edema neuro intact.  Patient states she had her second Pfizer vaccine on Wednesday.  Symptoms started on Monday of gotten worse. Admitted for bilateral PE and right leg DVT. 10/21/21 AM taken to cath lab for pulmonary angiogram with measurement of central venous pressures, mechanical thrombectomy. Cardiac arrest at 0630 10/21/21 in cath lab during procedure. CPR performed for 45 minutes and while being transported to OR for emergent CABG. 10/21/21 1000 patient arrived to ICU with chest still cracked open and physician providing cardiac massage. Time of death called at 1005 10/21/21."
	"1804391-1"	"1804391-1"	"DIZZINESS"	"10013573"	"50-59 years"	"50-59"	"10/20/21 1610 patient comes into ED complaining for the past several days has had increasing shortness of breath mild cough back pain.  She has had lightheaded episodes.  Increasing leg pain after which she describes as possible fall.  No head injury.  No nausea no vomiting.  No cough no hemoptysis.  On arrival in the ED her room air pulse ox was between 85 and 88%.  Pulse rate was 120s.  Respiratory rate was in the 30 range.  Lungs were clear soft nontender right extremity has some tenderness in the calf and medial thigh.  Mild edema neuro intact.  Patient states she had her second Pfizer vaccine on Wednesday.  Symptoms started on Monday of gotten worse. Admitted for bilateral PE and right leg DVT. 10/21/21 AM taken to cath lab for pulmonary angiogram with measurement of central venous pressures, mechanical thrombectomy. Cardiac arrest at 0630 10/21/21 in cath lab during procedure. CPR performed for 45 minutes and while being transported to OR for emergent CABG. 10/21/21 1000 patient arrived to ICU with chest still cracked open and physician providing cardiac massage. Time of death called at 1005 10/21/21."
	"1804391-1"	"1804391-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"10/20/21 1610 patient comes into ED complaining for the past several days has had increasing shortness of breath mild cough back pain.  She has had lightheaded episodes.  Increasing leg pain after which she describes as possible fall.  No head injury.  No nausea no vomiting.  No cough no hemoptysis.  On arrival in the ED her room air pulse ox was between 85 and 88%.  Pulse rate was 120s.  Respiratory rate was in the 30 range.  Lungs were clear soft nontender right extremity has some tenderness in the calf and medial thigh.  Mild edema neuro intact.  Patient states she had her second Pfizer vaccine on Wednesday.  Symptoms started on Monday of gotten worse. Admitted for bilateral PE and right leg DVT. 10/21/21 AM taken to cath lab for pulmonary angiogram with measurement of central venous pressures, mechanical thrombectomy. Cardiac arrest at 0630 10/21/21 in cath lab during procedure. CPR performed for 45 minutes and while being transported to OR for emergent CABG. 10/21/21 1000 patient arrived to ICU with chest still cracked open and physician providing cardiac massage. Time of death called at 1005 10/21/21."
	"1804391-1"	"1804391-1"	"FIBRIN D DIMER INCREASED"	"10016581"	"50-59 years"	"50-59"	"10/20/21 1610 patient comes into ED complaining for the past several days has had increasing shortness of breath mild cough back pain.  She has had lightheaded episodes.  Increasing leg pain after which she describes as possible fall.  No head injury.  No nausea no vomiting.  No cough no hemoptysis.  On arrival in the ED her room air pulse ox was between 85 and 88%.  Pulse rate was 120s.  Respiratory rate was in the 30 range.  Lungs were clear soft nontender right extremity has some tenderness in the calf and medial thigh.  Mild edema neuro intact.  Patient states she had her second Pfizer vaccine on Wednesday.  Symptoms started on Monday of gotten worse. Admitted for bilateral PE and right leg DVT. 10/21/21 AM taken to cath lab for pulmonary angiogram with measurement of central venous pressures, mechanical thrombectomy. Cardiac arrest at 0630 10/21/21 in cath lab during procedure. CPR performed for 45 minutes and while being transported to OR for emergent CABG. 10/21/21 1000 patient arrived to ICU with chest still cracked open and physician providing cardiac massage. Time of death called at 1005 10/21/21."
	"1804391-1"	"1804391-1"	"INTENSIVE CARE"	"10022519"	"50-59 years"	"50-59"	"10/20/21 1610 patient comes into ED complaining for the past several days has had increasing shortness of breath mild cough back pain.  She has had lightheaded episodes.  Increasing leg pain after which she describes as possible fall.  No head injury.  No nausea no vomiting.  No cough no hemoptysis.  On arrival in the ED her room air pulse ox was between 85 and 88%.  Pulse rate was 120s.  Respiratory rate was in the 30 range.  Lungs were clear soft nontender right extremity has some tenderness in the calf and medial thigh.  Mild edema neuro intact.  Patient states she had her second Pfizer vaccine on Wednesday.  Symptoms started on Monday of gotten worse. Admitted for bilateral PE and right leg DVT. 10/21/21 AM taken to cath lab for pulmonary angiogram with measurement of central venous pressures, mechanical thrombectomy. Cardiac arrest at 0630 10/21/21 in cath lab during procedure. CPR performed for 45 minutes and while being transported to OR for emergent CABG. 10/21/21 1000 patient arrived to ICU with chest still cracked open and physician providing cardiac massage. Time of death called at 1005 10/21/21."
	"1804391-1"	"1804391-1"	"MYOCARDIAL INJURY"	"10085879"	"50-59 years"	"50-59"	"10/20/21 1610 patient comes into ED complaining for the past several days has had increasing shortness of breath mild cough back pain.  She has had lightheaded episodes.  Increasing leg pain after which she describes as possible fall.  No head injury.  No nausea no vomiting.  No cough no hemoptysis.  On arrival in the ED her room air pulse ox was between 85 and 88%.  Pulse rate was 120s.  Respiratory rate was in the 30 range.  Lungs were clear soft nontender right extremity has some tenderness in the calf and medial thigh.  Mild edema neuro intact.  Patient states she had her second Pfizer vaccine on Wednesday.  Symptoms started on Monday of gotten worse. Admitted for bilateral PE and right leg DVT. 10/21/21 AM taken to cath lab for pulmonary angiogram with measurement of central venous pressures, mechanical thrombectomy. Cardiac arrest at 0630 10/21/21 in cath lab during procedure. CPR performed for 45 minutes and while being transported to OR for emergent CABG. 10/21/21 1000 patient arrived to ICU with chest still cracked open and physician providing cardiac massage. Time of death called at 1005 10/21/21."
	"1804391-1"	"1804391-1"	"OEDEMA"	"10030095"	"50-59 years"	"50-59"	"10/20/21 1610 patient comes into ED complaining for the past several days has had increasing shortness of breath mild cough back pain.  She has had lightheaded episodes.  Increasing leg pain after which she describes as possible fall.  No head injury.  No nausea no vomiting.  No cough no hemoptysis.  On arrival in the ED her room air pulse ox was between 85 and 88%.  Pulse rate was 120s.  Respiratory rate was in the 30 range.  Lungs were clear soft nontender right extremity has some tenderness in the calf and medial thigh.  Mild edema neuro intact.  Patient states she had her second Pfizer vaccine on Wednesday.  Symptoms started on Monday of gotten worse. Admitted for bilateral PE and right leg DVT. 10/21/21 AM taken to cath lab for pulmonary angiogram with measurement of central venous pressures, mechanical thrombectomy. Cardiac arrest at 0630 10/21/21 in cath lab during procedure. CPR performed for 45 minutes and while being transported to OR for emergent CABG. 10/21/21 1000 patient arrived to ICU with chest still cracked open and physician providing cardiac massage. Time of death called at 1005 10/21/21."
	"1804391-1"	"1804391-1"	"PAIN IN EXTREMITY"	"10033425"	"50-59 years"	"50-59"	"10/20/21 1610 patient comes into ED complaining for the past several days has had increasing shortness of breath mild cough back pain.  She has had lightheaded episodes.  Increasing leg pain after which she describes as possible fall.  No head injury.  No nausea no vomiting.  No cough no hemoptysis.  On arrival in the ED her room air pulse ox was between 85 and 88%.  Pulse rate was 120s.  Respiratory rate was in the 30 range.  Lungs were clear soft nontender right extremity has some tenderness in the calf and medial thigh.  Mild edema neuro intact.  Patient states she had her second Pfizer vaccine on Wednesday.  Symptoms started on Monday of gotten worse. Admitted for bilateral PE and right leg DVT. 10/21/21 AM taken to cath lab for pulmonary angiogram with measurement of central venous pressures, mechanical thrombectomy. Cardiac arrest at 0630 10/21/21 in cath lab during procedure. CPR performed for 45 minutes and while being transported to OR for emergent CABG. 10/21/21 1000 patient arrived to ICU with chest still cracked open and physician providing cardiac massage. Time of death called at 1005 10/21/21."
	"1804391-1"	"1804391-1"	"PLATELET COUNT DECREASED"	"10035528"	"50-59 years"	"50-59"	"10/20/21 1610 patient comes into ED complaining for the past several days has had increasing shortness of breath mild cough back pain.  She has had lightheaded episodes.  Increasing leg pain after which she describes as possible fall.  No head injury.  No nausea no vomiting.  No cough no hemoptysis.  On arrival in the ED her room air pulse ox was between 85 and 88%.  Pulse rate was 120s.  Respiratory rate was in the 30 range.  Lungs were clear soft nontender right extremity has some tenderness in the calf and medial thigh.  Mild edema neuro intact.  Patient states she had her second Pfizer vaccine on Wednesday.  Symptoms started on Monday of gotten worse. Admitted for bilateral PE and right leg DVT. 10/21/21 AM taken to cath lab for pulmonary angiogram with measurement of central venous pressures, mechanical thrombectomy. Cardiac arrest at 0630 10/21/21 in cath lab during procedure. CPR performed for 45 minutes and while being transported to OR for emergent CABG. 10/21/21 1000 patient arrived to ICU with chest still cracked open and physician providing cardiac massage. Time of death called at 1005 10/21/21."
	"1804391-1"	"1804391-1"	"PULMONARY EMBOLISM"	"10037377"	"50-59 years"	"50-59"	"10/20/21 1610 patient comes into ED complaining for the past several days has had increasing shortness of breath mild cough back pain.  She has had lightheaded episodes.  Increasing leg pain after which she describes as possible fall.  No head injury.  No nausea no vomiting.  No cough no hemoptysis.  On arrival in the ED her room air pulse ox was between 85 and 88%.  Pulse rate was 120s.  Respiratory rate was in the 30 range.  Lungs were clear soft nontender right extremity has some tenderness in the calf and medial thigh.  Mild edema neuro intact.  Patient states she had her second Pfizer vaccine on Wednesday.  Symptoms started on Monday of gotten worse. Admitted for bilateral PE and right leg DVT. 10/21/21 AM taken to cath lab for pulmonary angiogram with measurement of central venous pressures, mechanical thrombectomy. Cardiac arrest at 0630 10/21/21 in cath lab during procedure. CPR performed for 45 minutes and while being transported to OR for emergent CABG. 10/21/21 1000 patient arrived to ICU with chest still cracked open and physician providing cardiac massage. Time of death called at 1005 10/21/21."
	"1804391-1"	"1804391-1"	"RESUSCITATION"	"10038749"	"50-59 years"	"50-59"	"10/20/21 1610 patient comes into ED complaining for the past several days has had increasing shortness of breath mild cough back pain.  She has had lightheaded episodes.  Increasing leg pain after which she describes as possible fall.  No head injury.  No nausea no vomiting.  No cough no hemoptysis.  On arrival in the ED her room air pulse ox was between 85 and 88%.  Pulse rate was 120s.  Respiratory rate was in the 30 range.  Lungs were clear soft nontender right extremity has some tenderness in the calf and medial thigh.  Mild edema neuro intact.  Patient states she had her second Pfizer vaccine on Wednesday.  Symptoms started on Monday of gotten worse. Admitted for bilateral PE and right leg DVT. 10/21/21 AM taken to cath lab for pulmonary angiogram with measurement of central venous pressures, mechanical thrombectomy. Cardiac arrest at 0630 10/21/21 in cath lab during procedure. CPR performed for 45 minutes and while being transported to OR for emergent CABG. 10/21/21 1000 patient arrived to ICU with chest still cracked open and physician providing cardiac massage. Time of death called at 1005 10/21/21."
	"1804391-1"	"1804391-1"	"TENDERNESS"	"10043224"	"50-59 years"	"50-59"	"10/20/21 1610 patient comes into ED complaining for the past several days has had increasing shortness of breath mild cough back pain.  She has had lightheaded episodes.  Increasing leg pain after which she describes as possible fall.  No head injury.  No nausea no vomiting.  No cough no hemoptysis.  On arrival in the ED her room air pulse ox was between 85 and 88%.  Pulse rate was 120s.  Respiratory rate was in the 30 range.  Lungs were clear soft nontender right extremity has some tenderness in the calf and medial thigh.  Mild edema neuro intact.  Patient states she had her second Pfizer vaccine on Wednesday.  Symptoms started on Monday of gotten worse. Admitted for bilateral PE and right leg DVT. 10/21/21 AM taken to cath lab for pulmonary angiogram with measurement of central venous pressures, mechanical thrombectomy. Cardiac arrest at 0630 10/21/21 in cath lab during procedure. CPR performed for 45 minutes and while being transported to OR for emergent CABG. 10/21/21 1000 patient arrived to ICU with chest still cracked open and physician providing cardiac massage. Time of death called at 1005 10/21/21."
	"1804391-1"	"1804391-1"	"THROMBECTOMY"	"10043530"	"50-59 years"	"50-59"	"10/20/21 1610 patient comes into ED complaining for the past several days has had increasing shortness of breath mild cough back pain.  She has had lightheaded episodes.  Increasing leg pain after which she describes as possible fall.  No head injury.  No nausea no vomiting.  No cough no hemoptysis.  On arrival in the ED her room air pulse ox was between 85 and 88%.  Pulse rate was 120s.  Respiratory rate was in the 30 range.  Lungs were clear soft nontender right extremity has some tenderness in the calf and medial thigh.  Mild edema neuro intact.  Patient states she had her second Pfizer vaccine on Wednesday.  Symptoms started on Monday of gotten worse. Admitted for bilateral PE and right leg DVT. 10/21/21 AM taken to cath lab for pulmonary angiogram with measurement of central venous pressures, mechanical thrombectomy. Cardiac arrest at 0630 10/21/21 in cath lab during procedure. CPR performed for 45 minutes and while being transported to OR for emergent CABG. 10/21/21 1000 patient arrived to ICU with chest still cracked open and physician providing cardiac massage. Time of death called at 1005 10/21/21."
	"1804391-1"	"1804391-1"	"ULTRASOUND DOPPLER ABNORMAL"	"10045413"	"50-59 years"	"50-59"	"10/20/21 1610 patient comes into ED complaining for the past several days has had increasing shortness of breath mild cough back pain.  She has had lightheaded episodes.  Increasing leg pain after which she describes as possible fall.  No head injury.  No nausea no vomiting.  No cough no hemoptysis.  On arrival in the ED her room air pulse ox was between 85 and 88%.  Pulse rate was 120s.  Respiratory rate was in the 30 range.  Lungs were clear soft nontender right extremity has some tenderness in the calf and medial thigh.  Mild edema neuro intact.  Patient states she had her second Pfizer vaccine on Wednesday.  Symptoms started on Monday of gotten worse. Admitted for bilateral PE and right leg DVT. 10/21/21 AM taken to cath lab for pulmonary angiogram with measurement of central venous pressures, mechanical thrombectomy. Cardiac arrest at 0630 10/21/21 in cath lab during procedure. CPR performed for 45 minutes and while being transported to OR for emergent CABG. 10/21/21 1000 patient arrived to ICU with chest still cracked open and physician providing cardiac massage. Time of death called at 1005 10/21/21."
	"1804518-1"	"1804518-1"	"ACUTE RESPIRATORY FAILURE"	"10001053"	"50-59 years"	"50-59"	"Prolonged hospitalization with eventual patient death. Acute respiratory failure with hypoxia secondary to COVID pneumonia. BiPAP, hasd previous hospitalization requiring ICU placemtn on Vapotherm and BiPAP, discharged home then hospitalized again with acute hypoxi respiratory failure, IV antibiotic therapy, IV solumendrol, SVT"
	"1804518-1"	"1804518-1"	"CHEST X-RAY ABNORMAL"	"10008499"	"50-59 years"	"50-59"	"Prolonged hospitalization with eventual patient death. Acute respiratory failure with hypoxia secondary to COVID pneumonia. BiPAP, hasd previous hospitalization requiring ICU placemtn on Vapotherm and BiPAP, discharged home then hospitalized again with acute hypoxi respiratory failure, IV antibiotic therapy, IV solumendrol, SVT"
	"1804518-1"	"1804518-1"	"COVID-19 PNEUMONIA"	"10084380"	"50-59 years"	"50-59"	"Prolonged hospitalization with eventual patient death. Acute respiratory failure with hypoxia secondary to COVID pneumonia. BiPAP, hasd previous hospitalization requiring ICU placemtn on Vapotherm and BiPAP, discharged home then hospitalized again with acute hypoxi respiratory failure, IV antibiotic therapy, IV solumendrol, SVT"
	"1804518-1"	"1804518-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Prolonged hospitalization with eventual patient death. Acute respiratory failure with hypoxia secondary to COVID pneumonia. BiPAP, hasd previous hospitalization requiring ICU placemtn on Vapotherm and BiPAP, discharged home then hospitalized again with acute hypoxi respiratory failure, IV antibiotic therapy, IV solumendrol, SVT"
	"1804518-1"	"1804518-1"	"INTENSIVE CARE"	"10022519"	"50-59 years"	"50-59"	"Prolonged hospitalization with eventual patient death. Acute respiratory failure with hypoxia secondary to COVID pneumonia. BiPAP, hasd previous hospitalization requiring ICU placemtn on Vapotherm and BiPAP, discharged home then hospitalized again with acute hypoxi respiratory failure, IV antibiotic therapy, IV solumendrol, SVT"
	"1804518-1"	"1804518-1"	"INTERSTITIAL LUNG DISEASE"	"10022611"	"50-59 years"	"50-59"	"Prolonged hospitalization with eventual patient death. Acute respiratory failure with hypoxia secondary to COVID pneumonia. BiPAP, hasd previous hospitalization requiring ICU placemtn on Vapotherm and BiPAP, discharged home then hospitalized again with acute hypoxi respiratory failure, IV antibiotic therapy, IV solumendrol, SVT"
	"1804518-1"	"1804518-1"	"LUNG INFILTRATION"	"10025102"	"50-59 years"	"50-59"	"Prolonged hospitalization with eventual patient death. Acute respiratory failure with hypoxia secondary to COVID pneumonia. BiPAP, hasd previous hospitalization requiring ICU placemtn on Vapotherm and BiPAP, discharged home then hospitalized again with acute hypoxi respiratory failure, IV antibiotic therapy, IV solumendrol, SVT"
	"1804518-1"	"1804518-1"	"POSITIVE AIRWAY PRESSURE THERAPY"	"10086397"	"50-59 years"	"50-59"	"Prolonged hospitalization with eventual patient death. Acute respiratory failure with hypoxia secondary to COVID pneumonia. BiPAP, hasd previous hospitalization requiring ICU placemtn on Vapotherm and BiPAP, discharged home then hospitalized again with acute hypoxi respiratory failure, IV antibiotic therapy, IV solumendrol, SVT"
	"1804518-1"	"1804518-1"	"SUPRAVENTRICULAR TACHYCARDIA"	"10042604"	"50-59 years"	"50-59"	"Prolonged hospitalization with eventual patient death. Acute respiratory failure with hypoxia secondary to COVID pneumonia. BiPAP, hasd previous hospitalization requiring ICU placemtn on Vapotherm and BiPAP, discharged home then hospitalized again with acute hypoxi respiratory failure, IV antibiotic therapy, IV solumendrol, SVT"
	"1807967-1"	"1807967-1"	"ACUTE RESPIRATORY DISTRESS SYNDROME"	"10001052"	"50-59 years"	"50-59"	"Pt died of Respiratory failure- ARDS, sepsis. This was not a Covid related death"
	"1807967-1"	"1807967-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Pt died of Respiratory failure- ARDS, sepsis. This was not a Covid related death"
	"1807967-1"	"1807967-1"	"RESPIRATORY FAILURE"	"10038695"	"50-59 years"	"50-59"	"Pt died of Respiratory failure- ARDS, sepsis. This was not a Covid related death"
	"1807967-1"	"1807967-1"	"SEPSIS"	"10040047"	"50-59 years"	"50-59"	"Pt died of Respiratory failure- ARDS, sepsis. This was not a Covid related death"
	"1810654-1"	"1810654-1"	"PULMONARY THROMBOSIS"	"10037437"	"50-59 years"	"50-59"	"blood clot in the lungs; This is a spontaneous report from a contactable consumer. A 50-year-old female patient received bnt162b2 (BNT162B2), first single dose via an unspecified route of administration, administered in arm right on 10Sep2021 (Batch/Lot Number: FC3182) for covid-19 immunisation at age of 50-year-old. The patient was not pregnant at vaccination. Medical history included covid-19. No other vaccine received in four weeks. There were no concomitant medications. There was no covid tested post vaccination. The patient experienced blood clot in the lungs (death, life threatening) on 21Sep2021. No treatment received for the event.  The patient died on 21Sep2021. It was unknown if an autopsy was performed.   Follow-up attempts are completed. No further information is expected.; Reported Cause(s) of Death: blood clot in the lungs"
	"1813840-1"	"1813840-1"	"ASTHENIA"	"10003549"	"50-59 years"	"50-59"	"Increasing weakness, diarrhea, urinary incontinence - tried antidiarrheal, fluid boluses, offered hospitalization (refused)"
	"1813840-1"	"1813840-1"	"CONDITION AGGRAVATED"	"10010264"	"50-59 years"	"50-59"	"Increasing weakness, diarrhea, urinary incontinence - tried antidiarrheal, fluid boluses, offered hospitalization (refused)"
	"1813840-1"	"1813840-1"	"DIARRHOEA"	"10012735"	"50-59 years"	"50-59"	"Increasing weakness, diarrhea, urinary incontinence - tried antidiarrheal, fluid boluses, offered hospitalization (refused)"
	"1813840-1"	"1813840-1"	"URINARY INCONTINENCE"	"10046543"	"50-59 years"	"50-59"	"Increasing weakness, diarrhea, urinary incontinence - tried antidiarrheal, fluid boluses, offered hospitalization (refused)"
	"1821230-1"	"1821230-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"pt admitted to hospital in sickle cell crisis after a fall at home; confused; febrile, hypoxic; positive for COVID; increasing O2 requirements (15L NRB); pRBCs given;  hx of HTN,COPD, sickle cell; condition worsened and pt experienced cardiac arrest and expired in the hospital"
	"1821230-1"	"1821230-1"	"CONDITION AGGRAVATED"	"10010264"	"50-59 years"	"50-59"	"pt admitted to hospital in sickle cell crisis after a fall at home; confused; febrile, hypoxic; positive for COVID; increasing O2 requirements (15L NRB); pRBCs given;  hx of HTN,COPD, sickle cell; condition worsened and pt experienced cardiac arrest and expired in the hospital"
	"1821230-1"	"1821230-1"	"CONFUSIONAL STATE"	"10010305"	"50-59 years"	"50-59"	"pt admitted to hospital in sickle cell crisis after a fall at home; confused; febrile, hypoxic; positive for COVID; increasing O2 requirements (15L NRB); pRBCs given;  hx of HTN,COPD, sickle cell; condition worsened and pt experienced cardiac arrest and expired in the hospital"
	"1821230-1"	"1821230-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"pt admitted to hospital in sickle cell crisis after a fall at home; confused; febrile, hypoxic; positive for COVID; increasing O2 requirements (15L NRB); pRBCs given;  hx of HTN,COPD, sickle cell; condition worsened and pt experienced cardiac arrest and expired in the hospital"
	"1821230-1"	"1821230-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"pt admitted to hospital in sickle cell crisis after a fall at home; confused; febrile, hypoxic; positive for COVID; increasing O2 requirements (15L NRB); pRBCs given;  hx of HTN,COPD, sickle cell; condition worsened and pt experienced cardiac arrest and expired in the hospital"
	"1821230-1"	"1821230-1"	"FALL"	"10016173"	"50-59 years"	"50-59"	"pt admitted to hospital in sickle cell crisis after a fall at home; confused; febrile, hypoxic; positive for COVID; increasing O2 requirements (15L NRB); pRBCs given;  hx of HTN,COPD, sickle cell; condition worsened and pt experienced cardiac arrest and expired in the hospital"
	"1821230-1"	"1821230-1"	"HYPOXIA"	"10021143"	"50-59 years"	"50-59"	"pt admitted to hospital in sickle cell crisis after a fall at home; confused; febrile, hypoxic; positive for COVID; increasing O2 requirements (15L NRB); pRBCs given;  hx of HTN,COPD, sickle cell; condition worsened and pt experienced cardiac arrest and expired in the hospital"
	"1821230-1"	"1821230-1"	"PACKED RED BLOOD CELL TRANSFUSION"	"10033359"	"50-59 years"	"50-59"	"pt admitted to hospital in sickle cell crisis after a fall at home; confused; febrile, hypoxic; positive for COVID; increasing O2 requirements (15L NRB); pRBCs given;  hx of HTN,COPD, sickle cell; condition worsened and pt experienced cardiac arrest and expired in the hospital"
	"1821230-1"	"1821230-1"	"PYREXIA"	"10037660"	"50-59 years"	"50-59"	"pt admitted to hospital in sickle cell crisis after a fall at home; confused; febrile, hypoxic; positive for COVID; increasing O2 requirements (15L NRB); pRBCs given;  hx of HTN,COPD, sickle cell; condition worsened and pt experienced cardiac arrest and expired in the hospital"
	"1821230-1"	"1821230-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"pt admitted to hospital in sickle cell crisis after a fall at home; confused; febrile, hypoxic; positive for COVID; increasing O2 requirements (15L NRB); pRBCs given;  hx of HTN,COPD, sickle cell; condition worsened and pt experienced cardiac arrest and expired in the hospital"
	"1821230-1"	"1821230-1"	"SICKLE CELL ANAEMIA WITH CRISIS"	"10040642"	"50-59 years"	"50-59"	"pt admitted to hospital in sickle cell crisis after a fall at home; confused; febrile, hypoxic; positive for COVID; increasing O2 requirements (15L NRB); pRBCs given;  hx of HTN,COPD, sickle cell; condition worsened and pt experienced cardiac arrest and expired in the hospital"
	"1821423-1"	"1821423-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"pt with hx of DMT2, heart and liver transplant; previous CMV viremia; previously tested positive for COVID, placed on antibiotic for pneumonia; presented to ED due to O2 sats at home in the 70s; Optiflow 50L and 70% FiO2; pt's O2 sats worsened; intubated; transitioned to comfort care measures; pt expired in the hospital"
	"1821423-1"	"1821423-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"50-59 years"	"50-59"	"pt with hx of DMT2, heart and liver transplant; previous CMV viremia; previously tested positive for COVID, placed on antibiotic for pneumonia; presented to ED due to O2 sats at home in the 70s; Optiflow 50L and 70% FiO2; pt's O2 sats worsened; intubated; transitioned to comfort care measures; pt expired in the hospital"
	"1821423-1"	"1821423-1"	"OXYGEN SATURATION DECREASED"	"10033318"	"50-59 years"	"50-59"	"pt with hx of DMT2, heart and liver transplant; previous CMV viremia; previously tested positive for COVID, placed on antibiotic for pneumonia; presented to ED due to O2 sats at home in the 70s; Optiflow 50L and 70% FiO2; pt's O2 sats worsened; intubated; transitioned to comfort care measures; pt expired in the hospital"
	"1821651-1"	"1821651-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"death R56.9 - Unspecified convulsions E87.1 - Hypo-osmolality and hyponatremia D69.6 - Thrombocytopenia, unspecified R56.9 - Seizure  J18.9 - Pneumonia"
	"1821651-1"	"1821651-1"	"HYPONATRAEMIA"	"10021036"	"50-59 years"	"50-59"	"death R56.9 - Unspecified convulsions E87.1 - Hypo-osmolality and hyponatremia D69.6 - Thrombocytopenia, unspecified R56.9 - Seizure  J18.9 - Pneumonia"
	"1821651-1"	"1821651-1"	"HYPOOSMOLAR STATE"	"10074867"	"50-59 years"	"50-59"	"death R56.9 - Unspecified convulsions E87.1 - Hypo-osmolality and hyponatremia D69.6 - Thrombocytopenia, unspecified R56.9 - Seizure  J18.9 - Pneumonia"
	"1821651-1"	"1821651-1"	"PNEUMONIA"	"10035664"	"50-59 years"	"50-59"	"death R56.9 - Unspecified convulsions E87.1 - Hypo-osmolality and hyponatremia D69.6 - Thrombocytopenia, unspecified R56.9 - Seizure  J18.9 - Pneumonia"
	"1821651-1"	"1821651-1"	"SEIZURE"	"10039906"	"50-59 years"	"50-59"	"death R56.9 - Unspecified convulsions E87.1 - Hypo-osmolality and hyponatremia D69.6 - Thrombocytopenia, unspecified R56.9 - Seizure  J18.9 - Pneumonia"
	"1821651-1"	"1821651-1"	"THROMBOCYTOPENIA"	"10043554"	"50-59 years"	"50-59"	"death R56.9 - Unspecified convulsions E87.1 - Hypo-osmolality and hyponatremia D69.6 - Thrombocytopenia, unspecified R56.9 - Seizure  J18.9 - Pneumonia"
	"1825790-1"	"1825790-1"	"ATRIAL FIBRILLATION"	"10003658"	"50-59 years"	"50-59"	"5 days prior to hosp, pt tested positive for COVID; admitted with increasing SOB; taking Medrol Dosepak and antibiotic; O2 @ 6L via NC initially; progressed to BiPAP and eventually required intubation; experienced hypotension and A Fib; pt was extubated in palliative manner; she died in the hosp"
	"1825790-1"	"1825790-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"5 days prior to hosp, pt tested positive for COVID; admitted with increasing SOB; taking Medrol Dosepak and antibiotic; O2 @ 6L via NC initially; progressed to BiPAP and eventually required intubation; experienced hypotension and A Fib; pt was extubated in palliative manner; she died in the hosp"
	"1825790-1"	"1825790-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"5 days prior to hosp, pt tested positive for COVID; admitted with increasing SOB; taking Medrol Dosepak and antibiotic; O2 @ 6L via NC initially; progressed to BiPAP and eventually required intubation; experienced hypotension and A Fib; pt was extubated in palliative manner; she died in the hosp"
	"1825790-1"	"1825790-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"5 days prior to hosp, pt tested positive for COVID; admitted with increasing SOB; taking Medrol Dosepak and antibiotic; O2 @ 6L via NC initially; progressed to BiPAP and eventually required intubation; experienced hypotension and A Fib; pt was extubated in palliative manner; she died in the hosp"
	"1825790-1"	"1825790-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"50-59 years"	"50-59"	"5 days prior to hosp, pt tested positive for COVID; admitted with increasing SOB; taking Medrol Dosepak and antibiotic; O2 @ 6L via NC initially; progressed to BiPAP and eventually required intubation; experienced hypotension and A Fib; pt was extubated in palliative manner; she died in the hosp"
	"1825790-1"	"1825790-1"	"EXTUBATION"	"10015894"	"50-59 years"	"50-59"	"5 days prior to hosp, pt tested positive for COVID; admitted with increasing SOB; taking Medrol Dosepak and antibiotic; O2 @ 6L via NC initially; progressed to BiPAP and eventually required intubation; experienced hypotension and A Fib; pt was extubated in palliative manner; she died in the hosp"
	"1825790-1"	"1825790-1"	"HYPOTENSION"	"10021097"	"50-59 years"	"50-59"	"5 days prior to hosp, pt tested positive for COVID; admitted with increasing SOB; taking Medrol Dosepak and antibiotic; O2 @ 6L via NC initially; progressed to BiPAP and eventually required intubation; experienced hypotension and A Fib; pt was extubated in palliative manner; she died in the hosp"
	"1825790-1"	"1825790-1"	"POSITIVE AIRWAY PRESSURE THERAPY"	"10086397"	"50-59 years"	"50-59"	"5 days prior to hosp, pt tested positive for COVID; admitted with increasing SOB; taking Medrol Dosepak and antibiotic; O2 @ 6L via NC initially; progressed to BiPAP and eventually required intubation; experienced hypotension and A Fib; pt was extubated in palliative manner; she died in the hosp"
	"1825790-1"	"1825790-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"5 days prior to hosp, pt tested positive for COVID; admitted with increasing SOB; taking Medrol Dosepak and antibiotic; O2 @ 6L via NC initially; progressed to BiPAP and eventually required intubation; experienced hypotension and A Fib; pt was extubated in palliative manner; she died in the hosp"
	"1826661-1"	"1826661-1"	"AMNESIA"	"10001949"	"50-59 years"	"50-59"	"Shortly after receiving vaccine my mother began to suffer dizziness,  blackouts, and a headache that would not stop no matter what she did. Tylenol, ibuprofen,  fainting spells and brain fog like amnesia.  There were recent visits to the emergency room and never before but the er  had difficulty stopping bleeding from trying to start an iv then sudden death october 24th body found in apartment at 930 pm pacific time."
	"1826661-1"	"1826661-1"	"DIZZINESS"	"10013573"	"50-59 years"	"50-59"	"Shortly after receiving vaccine my mother began to suffer dizziness,  blackouts, and a headache that would not stop no matter what she did. Tylenol, ibuprofen,  fainting spells and brain fog like amnesia.  There were recent visits to the emergency room and never before but the er  had difficulty stopping bleeding from trying to start an iv then sudden death october 24th body found in apartment at 930 pm pacific time."
	"1826661-1"	"1826661-1"	"FEELING ABNORMAL"	"10016322"	"50-59 years"	"50-59"	"Shortly after receiving vaccine my mother began to suffer dizziness,  blackouts, and a headache that would not stop no matter what she did. Tylenol, ibuprofen,  fainting spells and brain fog like amnesia.  There were recent visits to the emergency room and never before but the er  had difficulty stopping bleeding from trying to start an iv then sudden death october 24th body found in apartment at 930 pm pacific time."
	"1826661-1"	"1826661-1"	"HAEMORRHAGE"	"10055798"	"50-59 years"	"50-59"	"Shortly after receiving vaccine my mother began to suffer dizziness,  blackouts, and a headache that would not stop no matter what she did. Tylenol, ibuprofen,  fainting spells and brain fog like amnesia.  There were recent visits to the emergency room and never before but the er  had difficulty stopping bleeding from trying to start an iv then sudden death october 24th body found in apartment at 930 pm pacific time."
	"1826661-1"	"1826661-1"	"HEADACHE"	"10019211"	"50-59 years"	"50-59"	"Shortly after receiving vaccine my mother began to suffer dizziness,  blackouts, and a headache that would not stop no matter what she did. Tylenol, ibuprofen,  fainting spells and brain fog like amnesia.  There were recent visits to the emergency room and never before but the er  had difficulty stopping bleeding from trying to start an iv then sudden death october 24th body found in apartment at 930 pm pacific time."
	"1826661-1"	"1826661-1"	"LOSS OF CONSCIOUSNESS"	"10024855"	"50-59 years"	"50-59"	"Shortly after receiving vaccine my mother began to suffer dizziness,  blackouts, and a headache that would not stop no matter what she did. Tylenol, ibuprofen,  fainting spells and brain fog like amnesia.  There were recent visits to the emergency room and never before but the er  had difficulty stopping bleeding from trying to start an iv then sudden death october 24th body found in apartment at 930 pm pacific time."
	"1826661-1"	"1826661-1"	"SUDDEN DEATH"	"10042434"	"50-59 years"	"50-59"	"Shortly after receiving vaccine my mother began to suffer dizziness,  blackouts, and a headache that would not stop no matter what she did. Tylenol, ibuprofen,  fainting spells and brain fog like amnesia.  There were recent visits to the emergency room and never before but the er  had difficulty stopping bleeding from trying to start an iv then sudden death october 24th body found in apartment at 930 pm pacific time."
	"1826661-1"	"1826661-1"	"SYNCOPE"	"10042772"	"50-59 years"	"50-59"	"Shortly after receiving vaccine my mother began to suffer dizziness,  blackouts, and a headache that would not stop no matter what she did. Tylenol, ibuprofen,  fainting spells and brain fog like amnesia.  There were recent visits to the emergency room and never before but the er  had difficulty stopping bleeding from trying to start an iv then sudden death october 24th body found in apartment at 930 pm pacific time."
	"1829051-1"	"1829051-1"	"ATELECTASIS"	"10003598"	"50-59 years"	"50-59"	"Patient was admitted to the hospital on 09/27/2021. Patient tested COVID positive on 10/08/2021 after cough initiated. He was placed in isolation, On 10/11/2021 CXR was suggestive of infiltrates and became very symptomatic on 10/12/2021 requiring oxygen treatment. Treatment was started on Decadron and remdesevir. On 10/14/2021,  baricitinib was added; on 10/16/2021 his pneumonia worsened and theres was small to moderate effusion; Vancomycin and zosyn IV were added as well. It was noted that he had anasarca and treated with lasix which didn't help his respiratory status. On 10/18/2021, CXR showed continued opacities and RT lung atelectasis; 10/19/2021 he was coughing uncontrollably. Palliative care was recommended and patient transferred to hospice on 10/21/2021 and passed away on 10/22/2021."
	"1829051-1"	"1829051-1"	"CHEST X-RAY ABNORMAL"	"10008499"	"50-59 years"	"50-59"	"Patient was admitted to the hospital on 09/27/2021. Patient tested COVID positive on 10/08/2021 after cough initiated. He was placed in isolation, On 10/11/2021 CXR was suggestive of infiltrates and became very symptomatic on 10/12/2021 requiring oxygen treatment. Treatment was started on Decadron and remdesevir. On 10/14/2021,  baricitinib was added; on 10/16/2021 his pneumonia worsened and theres was small to moderate effusion; Vancomycin and zosyn IV were added as well. It was noted that he had anasarca and treated with lasix which didn't help his respiratory status. On 10/18/2021, CXR showed continued opacities and RT lung atelectasis; 10/19/2021 he was coughing uncontrollably. Palliative care was recommended and patient transferred to hospice on 10/21/2021 and passed away on 10/22/2021."
	"1829051-1"	"1829051-1"	"COUGH"	"10011224"	"50-59 years"	"50-59"	"Patient was admitted to the hospital on 09/27/2021. Patient tested COVID positive on 10/08/2021 after cough initiated. He was placed in isolation, On 10/11/2021 CXR was suggestive of infiltrates and became very symptomatic on 10/12/2021 requiring oxygen treatment. Treatment was started on Decadron and remdesevir. On 10/14/2021,  baricitinib was added; on 10/16/2021 his pneumonia worsened and theres was small to moderate effusion; Vancomycin and zosyn IV were added as well. It was noted that he had anasarca and treated with lasix which didn't help his respiratory status. On 10/18/2021, CXR showed continued opacities and RT lung atelectasis; 10/19/2021 he was coughing uncontrollably. Palliative care was recommended and patient transferred to hospice on 10/21/2021 and passed away on 10/22/2021."
	"1829051-1"	"1829051-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Patient was admitted to the hospital on 09/27/2021. Patient tested COVID positive on 10/08/2021 after cough initiated. He was placed in isolation, On 10/11/2021 CXR was suggestive of infiltrates and became very symptomatic on 10/12/2021 requiring oxygen treatment. Treatment was started on Decadron and remdesevir. On 10/14/2021,  baricitinib was added; on 10/16/2021 his pneumonia worsened and theres was small to moderate effusion; Vancomycin and zosyn IV were added as well. It was noted that he had anasarca and treated with lasix which didn't help his respiratory status. On 10/18/2021, CXR showed continued opacities and RT lung atelectasis; 10/19/2021 he was coughing uncontrollably. Palliative care was recommended and patient transferred to hospice on 10/21/2021 and passed away on 10/22/2021."
	"1829051-1"	"1829051-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient was admitted to the hospital on 09/27/2021. Patient tested COVID positive on 10/08/2021 after cough initiated. He was placed in isolation, On 10/11/2021 CXR was suggestive of infiltrates and became very symptomatic on 10/12/2021 requiring oxygen treatment. Treatment was started on Decadron and remdesevir. On 10/14/2021,  baricitinib was added; on 10/16/2021 his pneumonia worsened and theres was small to moderate effusion; Vancomycin and zosyn IV were added as well. It was noted that he had anasarca and treated with lasix which didn't help his respiratory status. On 10/18/2021, CXR showed continued opacities and RT lung atelectasis; 10/19/2021 he was coughing uncontrollably. Palliative care was recommended and patient transferred to hospice on 10/21/2021 and passed away on 10/22/2021."
	"1829051-1"	"1829051-1"	"EFFUSION"	"10063045"	"50-59 years"	"50-59"	"Patient was admitted to the hospital on 09/27/2021. Patient tested COVID positive on 10/08/2021 after cough initiated. He was placed in isolation, On 10/11/2021 CXR was suggestive of infiltrates and became very symptomatic on 10/12/2021 requiring oxygen treatment. Treatment was started on Decadron and remdesevir. On 10/14/2021,  baricitinib was added; on 10/16/2021 his pneumonia worsened and theres was small to moderate effusion; Vancomycin and zosyn IV were added as well. It was noted that he had anasarca and treated with lasix which didn't help his respiratory status. On 10/18/2021, CXR showed continued opacities and RT lung atelectasis; 10/19/2021 he was coughing uncontrollably. Palliative care was recommended and patient transferred to hospice on 10/21/2021 and passed away on 10/22/2021."
	"1829051-1"	"1829051-1"	"GENERALISED OEDEMA"	"10018092"	"50-59 years"	"50-59"	"Patient was admitted to the hospital on 09/27/2021. Patient tested COVID positive on 10/08/2021 after cough initiated. He was placed in isolation, On 10/11/2021 CXR was suggestive of infiltrates and became very symptomatic on 10/12/2021 requiring oxygen treatment. Treatment was started on Decadron and remdesevir. On 10/14/2021,  baricitinib was added; on 10/16/2021 his pneumonia worsened and theres was small to moderate effusion; Vancomycin and zosyn IV were added as well. It was noted that he had anasarca and treated with lasix which didn't help his respiratory status. On 10/18/2021, CXR showed continued opacities and RT lung atelectasis; 10/19/2021 he was coughing uncontrollably. Palliative care was recommended and patient transferred to hospice on 10/21/2021 and passed away on 10/22/2021."
	"1829051-1"	"1829051-1"	"LUNG INFILTRATION"	"10025102"	"50-59 years"	"50-59"	"Patient was admitted to the hospital on 09/27/2021. Patient tested COVID positive on 10/08/2021 after cough initiated. He was placed in isolation, On 10/11/2021 CXR was suggestive of infiltrates and became very symptomatic on 10/12/2021 requiring oxygen treatment. Treatment was started on Decadron and remdesevir. On 10/14/2021,  baricitinib was added; on 10/16/2021 his pneumonia worsened and theres was small to moderate effusion; Vancomycin and zosyn IV were added as well. It was noted that he had anasarca and treated with lasix which didn't help his respiratory status. On 10/18/2021, CXR showed continued opacities and RT lung atelectasis; 10/19/2021 he was coughing uncontrollably. Palliative care was recommended and patient transferred to hospice on 10/21/2021 and passed away on 10/22/2021."
	"1829051-1"	"1829051-1"	"LUNG OPACITY"	"10081792"	"50-59 years"	"50-59"	"Patient was admitted to the hospital on 09/27/2021. Patient tested COVID positive on 10/08/2021 after cough initiated. He was placed in isolation, On 10/11/2021 CXR was suggestive of infiltrates and became very symptomatic on 10/12/2021 requiring oxygen treatment. Treatment was started on Decadron and remdesevir. On 10/14/2021,  baricitinib was added; on 10/16/2021 his pneumonia worsened and theres was small to moderate effusion; Vancomycin and zosyn IV were added as well. It was noted that he had anasarca and treated with lasix which didn't help his respiratory status. On 10/18/2021, CXR showed continued opacities and RT lung atelectasis; 10/19/2021 he was coughing uncontrollably. Palliative care was recommended and patient transferred to hospice on 10/21/2021 and passed away on 10/22/2021."
	"1829051-1"	"1829051-1"	"MALAISE"	"10025482"	"50-59 years"	"50-59"	"Patient was admitted to the hospital on 09/27/2021. Patient tested COVID positive on 10/08/2021 after cough initiated. He was placed in isolation, On 10/11/2021 CXR was suggestive of infiltrates and became very symptomatic on 10/12/2021 requiring oxygen treatment. Treatment was started on Decadron and remdesevir. On 10/14/2021,  baricitinib was added; on 10/16/2021 his pneumonia worsened and theres was small to moderate effusion; Vancomycin and zosyn IV were added as well. It was noted that he had anasarca and treated with lasix which didn't help his respiratory status. On 10/18/2021, CXR showed continued opacities and RT lung atelectasis; 10/19/2021 he was coughing uncontrollably. Palliative care was recommended and patient transferred to hospice on 10/21/2021 and passed away on 10/22/2021."
	"1829051-1"	"1829051-1"	"PNEUMONIA"	"10035664"	"50-59 years"	"50-59"	"Patient was admitted to the hospital on 09/27/2021. Patient tested COVID positive on 10/08/2021 after cough initiated. He was placed in isolation, On 10/11/2021 CXR was suggestive of infiltrates and became very symptomatic on 10/12/2021 requiring oxygen treatment. Treatment was started on Decadron and remdesevir. On 10/14/2021,  baricitinib was added; on 10/16/2021 his pneumonia worsened and theres was small to moderate effusion; Vancomycin and zosyn IV were added as well. It was noted that he had anasarca and treated with lasix which didn't help his respiratory status. On 10/18/2021, CXR showed continued opacities and RT lung atelectasis; 10/19/2021 he was coughing uncontrollably. Palliative care was recommended and patient transferred to hospice on 10/21/2021 and passed away on 10/22/2021."
	"1829051-1"	"1829051-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"Patient was admitted to the hospital on 09/27/2021. Patient tested COVID positive on 10/08/2021 after cough initiated. He was placed in isolation, On 10/11/2021 CXR was suggestive of infiltrates and became very symptomatic on 10/12/2021 requiring oxygen treatment. Treatment was started on Decadron and remdesevir. On 10/14/2021,  baricitinib was added; on 10/16/2021 his pneumonia worsened and theres was small to moderate effusion; Vancomycin and zosyn IV were added as well. It was noted that he had anasarca and treated with lasix which didn't help his respiratory status. On 10/18/2021, CXR showed continued opacities and RT lung atelectasis; 10/19/2021 he was coughing uncontrollably. Palliative care was recommended and patient transferred to hospice on 10/21/2021 and passed away on 10/22/2021."
	"1829253-1"	"1829253-1"	"BRONCHOPLEURAL FISTULA"	"10053481"	"50-59 years"	"50-59"	"pt presented to ED with 3 days of increasing SOB; positive for COVID in ED; treated with dexamethasone, remdisivir, tocilizumab; on 15 L O2 via NC; oxygenation worsened requiring ICU and intubation; bronchopleural fistula secondary to heavy hx of vaping and cigarette use; was eventually made a DNR;  comfort measures; extubated and patient expired in the hosp"
	"1829253-1"	"1829253-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"pt presented to ED with 3 days of increasing SOB; positive for COVID in ED; treated with dexamethasone, remdisivir, tocilizumab; on 15 L O2 via NC; oxygenation worsened requiring ICU and intubation; bronchopleural fistula secondary to heavy hx of vaping and cigarette use; was eventually made a DNR;  comfort measures; extubated and patient expired in the hosp"
	"1829253-1"	"1829253-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"pt presented to ED with 3 days of increasing SOB; positive for COVID in ED; treated with dexamethasone, remdisivir, tocilizumab; on 15 L O2 via NC; oxygenation worsened requiring ICU and intubation; bronchopleural fistula secondary to heavy hx of vaping and cigarette use; was eventually made a DNR;  comfort measures; extubated and patient expired in the hosp"
	"1829253-1"	"1829253-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"pt presented to ED with 3 days of increasing SOB; positive for COVID in ED; treated with dexamethasone, remdisivir, tocilizumab; on 15 L O2 via NC; oxygenation worsened requiring ICU and intubation; bronchopleural fistula secondary to heavy hx of vaping and cigarette use; was eventually made a DNR;  comfort measures; extubated and patient expired in the hosp"
	"1829253-1"	"1829253-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"50-59 years"	"50-59"	"pt presented to ED with 3 days of increasing SOB; positive for COVID in ED; treated with dexamethasone, remdisivir, tocilizumab; on 15 L O2 via NC; oxygenation worsened requiring ICU and intubation; bronchopleural fistula secondary to heavy hx of vaping and cigarette use; was eventually made a DNR;  comfort measures; extubated and patient expired in the hosp"
	"1829253-1"	"1829253-1"	"INTENSIVE CARE"	"10022519"	"50-59 years"	"50-59"	"pt presented to ED with 3 days of increasing SOB; positive for COVID in ED; treated with dexamethasone, remdisivir, tocilizumab; on 15 L O2 via NC; oxygenation worsened requiring ICU and intubation; bronchopleural fistula secondary to heavy hx of vaping and cigarette use; was eventually made a DNR;  comfort measures; extubated and patient expired in the hosp"
	"1829253-1"	"1829253-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"pt presented to ED with 3 days of increasing SOB; positive for COVID in ED; treated with dexamethasone, remdisivir, tocilizumab; on 15 L O2 via NC; oxygenation worsened requiring ICU and intubation; bronchopleural fistula secondary to heavy hx of vaping and cigarette use; was eventually made a DNR;  comfort measures; extubated and patient expired in the hosp"
	"1832300-1"	"1832300-1"	"ASTHENIA"	"10003549"	"50-59 years"	"50-59"	"weakness, head ache-DEATH"
	"1832300-1"	"1832300-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"weakness, head ache-DEATH"
	"1832300-1"	"1832300-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"weakness, head ache-DEATH"
	"1832300-1"	"1832300-1"	"HEADACHE"	"10019211"	"50-59 years"	"50-59"	"weakness, head ache-DEATH"
	"1832855-1"	"1832855-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Pt died after testing positive for COVID-19 8/2/2021"
	"1832855-1"	"1832855-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Pt died after testing positive for COVID-19 8/2/2021"
	"1832855-1"	"1832855-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"Pt died after testing positive for COVID-19 8/2/2021"
	"1833007-1"	"1833007-1"	"BLOOD CULTURE NEGATIVE"	"10005486"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 4/22/2021 and 5/13/2021. On 8/28/2021 patient presented to a outside facility with complaints of worsening shortness of breath and chest tightness with patient report of positive COVID test on August 20th. On 9/1/2021 patient presented to ED with chest pain and shortness of breath. VS stable; minimally tachycardia. Physical exam overall reassuring. The pt is well appearing, nontoxic, in NAD. Lungs CTAB, no respiratory distress. Labs overall reassuring.  No leukocytosis to concern for sepsis. Troponin negative. BNP normal. ECG w/o ST elevation;"
	"1833007-1"	"1833007-1"	"BRAIN NATRIURETIC PEPTIDE NORMAL"	"10053409"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 4/22/2021 and 5/13/2021. On 8/28/2021 patient presented to a outside facility with complaints of worsening shortness of breath and chest tightness with patient report of positive COVID test on August 20th. On 9/1/2021 patient presented to ED with chest pain and shortness of breath. VS stable; minimally tachycardia. Physical exam overall reassuring. The pt is well appearing, nontoxic, in NAD. Lungs CTAB, no respiratory distress. Labs overall reassuring.  No leukocytosis to concern for sepsis. Troponin negative. BNP normal. ECG w/o ST elevation;"
	"1833007-1"	"1833007-1"	"CHEST DISCOMFORT"	"10008469"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 4/22/2021 and 5/13/2021. On 8/28/2021 patient presented to a outside facility with complaints of worsening shortness of breath and chest tightness with patient report of positive COVID test on August 20th. On 9/1/2021 patient presented to ED with chest pain and shortness of breath. VS stable; minimally tachycardia. Physical exam overall reassuring. The pt is well appearing, nontoxic, in NAD. Lungs CTAB, no respiratory distress. Labs overall reassuring.  No leukocytosis to concern for sepsis. Troponin negative. BNP normal. ECG w/o ST elevation;"
	"1833007-1"	"1833007-1"	"CHEST PAIN"	"10008479"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 4/22/2021 and 5/13/2021. On 8/28/2021 patient presented to a outside facility with complaints of worsening shortness of breath and chest tightness with patient report of positive COVID test on August 20th. On 9/1/2021 patient presented to ED with chest pain and shortness of breath. VS stable; minimally tachycardia. Physical exam overall reassuring. The pt is well appearing, nontoxic, in NAD. Lungs CTAB, no respiratory distress. Labs overall reassuring.  No leukocytosis to concern for sepsis. Troponin negative. BNP normal. ECG w/o ST elevation;"
	"1833007-1"	"1833007-1"	"CHEST X-RAY ABNORMAL"	"10008499"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 4/22/2021 and 5/13/2021. On 8/28/2021 patient presented to a outside facility with complaints of worsening shortness of breath and chest tightness with patient report of positive COVID test on August 20th. On 9/1/2021 patient presented to ED with chest pain and shortness of breath. VS stable; minimally tachycardia. Physical exam overall reassuring. The pt is well appearing, nontoxic, in NAD. Lungs CTAB, no respiratory distress. Labs overall reassuring.  No leukocytosis to concern for sepsis. Troponin negative. BNP normal. ECG w/o ST elevation;"
	"1833007-1"	"1833007-1"	"COMPUTERISED TOMOGRAM THORAX NORMAL"	"10057801"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 4/22/2021 and 5/13/2021. On 8/28/2021 patient presented to a outside facility with complaints of worsening shortness of breath and chest tightness with patient report of positive COVID test on August 20th. On 9/1/2021 patient presented to ED with chest pain and shortness of breath. VS stable; minimally tachycardia. Physical exam overall reassuring. The pt is well appearing, nontoxic, in NAD. Lungs CTAB, no respiratory distress. Labs overall reassuring.  No leukocytosis to concern for sepsis. Troponin negative. BNP normal. ECG w/o ST elevation;"
	"1833007-1"	"1833007-1"	"COUGH"	"10011224"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 4/22/2021 and 5/13/2021. On 8/28/2021 patient presented to a outside facility with complaints of worsening shortness of breath and chest tightness with patient report of positive COVID test on August 20th. On 9/1/2021 patient presented to ED with chest pain and shortness of breath. VS stable; minimally tachycardia. Physical exam overall reassuring. The pt is well appearing, nontoxic, in NAD. Lungs CTAB, no respiratory distress. Labs overall reassuring.  No leukocytosis to concern for sepsis. Troponin negative. BNP normal. ECG w/o ST elevation;"
	"1833007-1"	"1833007-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 4/22/2021 and 5/13/2021. On 8/28/2021 patient presented to a outside facility with complaints of worsening shortness of breath and chest tightness with patient report of positive COVID test on August 20th. On 9/1/2021 patient presented to ED with chest pain and shortness of breath. VS stable; minimally tachycardia. Physical exam overall reassuring. The pt is well appearing, nontoxic, in NAD. Lungs CTAB, no respiratory distress. Labs overall reassuring.  No leukocytosis to concern for sepsis. Troponin negative. BNP normal. ECG w/o ST elevation;"
	"1833007-1"	"1833007-1"	"COVID-19 PNEUMONIA"	"10084380"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 4/22/2021 and 5/13/2021. On 8/28/2021 patient presented to a outside facility with complaints of worsening shortness of breath and chest tightness with patient report of positive COVID test on August 20th. On 9/1/2021 patient presented to ED with chest pain and shortness of breath. VS stable; minimally tachycardia. Physical exam overall reassuring. The pt is well appearing, nontoxic, in NAD. Lungs CTAB, no respiratory distress. Labs overall reassuring.  No leukocytosis to concern for sepsis. Troponin negative. BNP normal. ECG w/o ST elevation;"
	"1833007-1"	"1833007-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 4/22/2021 and 5/13/2021. On 8/28/2021 patient presented to a outside facility with complaints of worsening shortness of breath and chest tightness with patient report of positive COVID test on August 20th. On 9/1/2021 patient presented to ED with chest pain and shortness of breath. VS stable; minimally tachycardia. Physical exam overall reassuring. The pt is well appearing, nontoxic, in NAD. Lungs CTAB, no respiratory distress. Labs overall reassuring.  No leukocytosis to concern for sepsis. Troponin negative. BNP normal. ECG w/o ST elevation;"
	"1833007-1"	"1833007-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 4/22/2021 and 5/13/2021. On 8/28/2021 patient presented to a outside facility with complaints of worsening shortness of breath and chest tightness with patient report of positive COVID test on August 20th. On 9/1/2021 patient presented to ED with chest pain and shortness of breath. VS stable; minimally tachycardia. Physical exam overall reassuring. The pt is well appearing, nontoxic, in NAD. Lungs CTAB, no respiratory distress. Labs overall reassuring.  No leukocytosis to concern for sepsis. Troponin negative. BNP normal. ECG w/o ST elevation;"
	"1833007-1"	"1833007-1"	"ELECTROCARDIOGRAM NORMAL"	"10014373"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 4/22/2021 and 5/13/2021. On 8/28/2021 patient presented to a outside facility with complaints of worsening shortness of breath and chest tightness with patient report of positive COVID test on August 20th. On 9/1/2021 patient presented to ED with chest pain and shortness of breath. VS stable; minimally tachycardia. Physical exam overall reassuring. The pt is well appearing, nontoxic, in NAD. Lungs CTAB, no respiratory distress. Labs overall reassuring.  No leukocytosis to concern for sepsis. Troponin negative. BNP normal. ECG w/o ST elevation;"
	"1833007-1"	"1833007-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 4/22/2021 and 5/13/2021. On 8/28/2021 patient presented to a outside facility with complaints of worsening shortness of breath and chest tightness with patient report of positive COVID test on August 20th. On 9/1/2021 patient presented to ED with chest pain and shortness of breath. VS stable; minimally tachycardia. Physical exam overall reassuring. The pt is well appearing, nontoxic, in NAD. Lungs CTAB, no respiratory distress. Labs overall reassuring.  No leukocytosis to concern for sepsis. Troponin negative. BNP normal. ECG w/o ST elevation;"
	"1833007-1"	"1833007-1"	"HYPOXIA"	"10021143"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 4/22/2021 and 5/13/2021. On 8/28/2021 patient presented to a outside facility with complaints of worsening shortness of breath and chest tightness with patient report of positive COVID test on August 20th. On 9/1/2021 patient presented to ED with chest pain and shortness of breath. VS stable; minimally tachycardia. Physical exam overall reassuring. The pt is well appearing, nontoxic, in NAD. Lungs CTAB, no respiratory distress. Labs overall reassuring.  No leukocytosis to concern for sepsis. Troponin negative. BNP normal. ECG w/o ST elevation;"
	"1833007-1"	"1833007-1"	"LUNG OPACITY"	"10081792"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 4/22/2021 and 5/13/2021. On 8/28/2021 patient presented to a outside facility with complaints of worsening shortness of breath and chest tightness with patient report of positive COVID test on August 20th. On 9/1/2021 patient presented to ED with chest pain and shortness of breath. VS stable; minimally tachycardia. Physical exam overall reassuring. The pt is well appearing, nontoxic, in NAD. Lungs CTAB, no respiratory distress. Labs overall reassuring.  No leukocytosis to concern for sepsis. Troponin negative. BNP normal. ECG w/o ST elevation;"
	"1833007-1"	"1833007-1"	"MECHANICAL VENTILATION"	"10067221"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 4/22/2021 and 5/13/2021. On 8/28/2021 patient presented to a outside facility with complaints of worsening shortness of breath and chest tightness with patient report of positive COVID test on August 20th. On 9/1/2021 patient presented to ED with chest pain and shortness of breath. VS stable; minimally tachycardia. Physical exam overall reassuring. The pt is well appearing, nontoxic, in NAD. Lungs CTAB, no respiratory distress. Labs overall reassuring.  No leukocytosis to concern for sepsis. Troponin negative. BNP normal. ECG w/o ST elevation;"
	"1833007-1"	"1833007-1"	"MENTAL STATUS CHANGES"	"10048294"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 4/22/2021 and 5/13/2021. On 8/28/2021 patient presented to a outside facility with complaints of worsening shortness of breath and chest tightness with patient report of positive COVID test on August 20th. On 9/1/2021 patient presented to ED with chest pain and shortness of breath. VS stable; minimally tachycardia. Physical exam overall reassuring. The pt is well appearing, nontoxic, in NAD. Lungs CTAB, no respiratory distress. Labs overall reassuring.  No leukocytosis to concern for sepsis. Troponin negative. BNP normal. ECG w/o ST elevation;"
	"1833007-1"	"1833007-1"	"PAIN"	"10033371"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 4/22/2021 and 5/13/2021. On 8/28/2021 patient presented to a outside facility with complaints of worsening shortness of breath and chest tightness with patient report of positive COVID test on August 20th. On 9/1/2021 patient presented to ED with chest pain and shortness of breath. VS stable; minimally tachycardia. Physical exam overall reassuring. The pt is well appearing, nontoxic, in NAD. Lungs CTAB, no respiratory distress. Labs overall reassuring.  No leukocytosis to concern for sepsis. Troponin negative. BNP normal. ECG w/o ST elevation;"
	"1833007-1"	"1833007-1"	"PROCALCITONIN INCREASED"	"10067081"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 4/22/2021 and 5/13/2021. On 8/28/2021 patient presented to a outside facility with complaints of worsening shortness of breath and chest tightness with patient report of positive COVID test on August 20th. On 9/1/2021 patient presented to ED with chest pain and shortness of breath. VS stable; minimally tachycardia. Physical exam overall reassuring. The pt is well appearing, nontoxic, in NAD. Lungs CTAB, no respiratory distress. Labs overall reassuring.  No leukocytosis to concern for sepsis. Troponin negative. BNP normal. ECG w/o ST elevation;"
	"1833007-1"	"1833007-1"	"PYREXIA"	"10037660"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 4/22/2021 and 5/13/2021. On 8/28/2021 patient presented to a outside facility with complaints of worsening shortness of breath and chest tightness with patient report of positive COVID test on August 20th. On 9/1/2021 patient presented to ED with chest pain and shortness of breath. VS stable; minimally tachycardia. Physical exam overall reassuring. The pt is well appearing, nontoxic, in NAD. Lungs CTAB, no respiratory distress. Labs overall reassuring.  No leukocytosis to concern for sepsis. Troponin negative. BNP normal. ECG w/o ST elevation;"
	"1833007-1"	"1833007-1"	"RESPIRATORY TRACT CONGESTION"	"10052251"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 4/22/2021 and 5/13/2021. On 8/28/2021 patient presented to a outside facility with complaints of worsening shortness of breath and chest tightness with patient report of positive COVID test on August 20th. On 9/1/2021 patient presented to ED with chest pain and shortness of breath. VS stable; minimally tachycardia. Physical exam overall reassuring. The pt is well appearing, nontoxic, in NAD. Lungs CTAB, no respiratory distress. Labs overall reassuring.  No leukocytosis to concern for sepsis. Troponin negative. BNP normal. ECG w/o ST elevation;"
	"1833007-1"	"1833007-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 4/22/2021 and 5/13/2021. On 8/28/2021 patient presented to a outside facility with complaints of worsening shortness of breath and chest tightness with patient report of positive COVID test on August 20th. On 9/1/2021 patient presented to ED with chest pain and shortness of breath. VS stable; minimally tachycardia. Physical exam overall reassuring. The pt is well appearing, nontoxic, in NAD. Lungs CTAB, no respiratory distress. Labs overall reassuring.  No leukocytosis to concern for sepsis. Troponin negative. BNP normal. ECG w/o ST elevation;"
	"1833007-1"	"1833007-1"	"TACHYCARDIA"	"10043071"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 4/22/2021 and 5/13/2021. On 8/28/2021 patient presented to a outside facility with complaints of worsening shortness of breath and chest tightness with patient report of positive COVID test on August 20th. On 9/1/2021 patient presented to ED with chest pain and shortness of breath. VS stable; minimally tachycardia. Physical exam overall reassuring. The pt is well appearing, nontoxic, in NAD. Lungs CTAB, no respiratory distress. Labs overall reassuring.  No leukocytosis to concern for sepsis. Troponin negative. BNP normal. ECG w/o ST elevation;"
	"1833007-1"	"1833007-1"	"TROPONIN NORMAL"	"10071322"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 4/22/2021 and 5/13/2021. On 8/28/2021 patient presented to a outside facility with complaints of worsening shortness of breath and chest tightness with patient report of positive COVID test on August 20th. On 9/1/2021 patient presented to ED with chest pain and shortness of breath. VS stable; minimally tachycardia. Physical exam overall reassuring. The pt is well appearing, nontoxic, in NAD. Lungs CTAB, no respiratory distress. Labs overall reassuring.  No leukocytosis to concern for sepsis. Troponin negative. BNP normal. ECG w/o ST elevation;"
	"1833526-1"	"1833526-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"pt arrived to hosp via EMS; EMS called due to increasing SOB; O2 sats 60s; placed on CPAP; cyanotic and no improvement; pt gave consent to be intubated in the field; pt was positive for COVID 1 wk before arriving at the hosp, completed remdesivir and steroids; PMH:  chronic respiratory failure, on 10-12 L O2 via NC and astral device at home; in ED pt was severely hypotensive with septic/cardiogenic shock; pt was made a DNR; he arrested in the ED and died"
	"1833526-1"	"1833526-1"	"CARDIOGENIC SHOCK"	"10007625"	"50-59 years"	"50-59"	"pt arrived to hosp via EMS; EMS called due to increasing SOB; O2 sats 60s; placed on CPAP; cyanotic and no improvement; pt gave consent to be intubated in the field; pt was positive for COVID 1 wk before arriving at the hosp, completed remdesivir and steroids; PMH:  chronic respiratory failure, on 10-12 L O2 via NC and astral device at home; in ED pt was severely hypotensive with septic/cardiogenic shock; pt was made a DNR; he arrested in the ED and died"
	"1833526-1"	"1833526-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"pt arrived to hosp via EMS; EMS called due to increasing SOB; O2 sats 60s; placed on CPAP; cyanotic and no improvement; pt gave consent to be intubated in the field; pt was positive for COVID 1 wk before arriving at the hosp, completed remdesivir and steroids; PMH:  chronic respiratory failure, on 10-12 L O2 via NC and astral device at home; in ED pt was severely hypotensive with septic/cardiogenic shock; pt was made a DNR; he arrested in the ED and died"
	"1833526-1"	"1833526-1"	"CYANOSIS"	"10011703"	"50-59 years"	"50-59"	"pt arrived to hosp via EMS; EMS called due to increasing SOB; O2 sats 60s; placed on CPAP; cyanotic and no improvement; pt gave consent to be intubated in the field; pt was positive for COVID 1 wk before arriving at the hosp, completed remdesivir and steroids; PMH:  chronic respiratory failure, on 10-12 L O2 via NC and astral device at home; in ED pt was severely hypotensive with septic/cardiogenic shock; pt was made a DNR; he arrested in the ED and died"
	"1833526-1"	"1833526-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"pt arrived to hosp via EMS; EMS called due to increasing SOB; O2 sats 60s; placed on CPAP; cyanotic and no improvement; pt gave consent to be intubated in the field; pt was positive for COVID 1 wk before arriving at the hosp, completed remdesivir and steroids; PMH:  chronic respiratory failure, on 10-12 L O2 via NC and astral device at home; in ED pt was severely hypotensive with septic/cardiogenic shock; pt was made a DNR; he arrested in the ED and died"
	"1833526-1"	"1833526-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"pt arrived to hosp via EMS; EMS called due to increasing SOB; O2 sats 60s; placed on CPAP; cyanotic and no improvement; pt gave consent to be intubated in the field; pt was positive for COVID 1 wk before arriving at the hosp, completed remdesivir and steroids; PMH:  chronic respiratory failure, on 10-12 L O2 via NC and astral device at home; in ED pt was severely hypotensive with septic/cardiogenic shock; pt was made a DNR; he arrested in the ED and died"
	"1833526-1"	"1833526-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"50-59 years"	"50-59"	"pt arrived to hosp via EMS; EMS called due to increasing SOB; O2 sats 60s; placed on CPAP; cyanotic and no improvement; pt gave consent to be intubated in the field; pt was positive for COVID 1 wk before arriving at the hosp, completed remdesivir and steroids; PMH:  chronic respiratory failure, on 10-12 L O2 via NC and astral device at home; in ED pt was severely hypotensive with septic/cardiogenic shock; pt was made a DNR; he arrested in the ED and died"
	"1833526-1"	"1833526-1"	"HYPOTENSION"	"10021097"	"50-59 years"	"50-59"	"pt arrived to hosp via EMS; EMS called due to increasing SOB; O2 sats 60s; placed on CPAP; cyanotic and no improvement; pt gave consent to be intubated in the field; pt was positive for COVID 1 wk before arriving at the hosp, completed remdesivir and steroids; PMH:  chronic respiratory failure, on 10-12 L O2 via NC and astral device at home; in ED pt was severely hypotensive with septic/cardiogenic shock; pt was made a DNR; he arrested in the ED and died"
	"1833526-1"	"1833526-1"	"POSITIVE AIRWAY PRESSURE THERAPY"	"10086397"	"50-59 years"	"50-59"	"pt arrived to hosp via EMS; EMS called due to increasing SOB; O2 sats 60s; placed on CPAP; cyanotic and no improvement; pt gave consent to be intubated in the field; pt was positive for COVID 1 wk before arriving at the hosp, completed remdesivir and steroids; PMH:  chronic respiratory failure, on 10-12 L O2 via NC and astral device at home; in ED pt was severely hypotensive with septic/cardiogenic shock; pt was made a DNR; he arrested in the ED and died"
	"1833526-1"	"1833526-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"pt arrived to hosp via EMS; EMS called due to increasing SOB; O2 sats 60s; placed on CPAP; cyanotic and no improvement; pt gave consent to be intubated in the field; pt was positive for COVID 1 wk before arriving at the hosp, completed remdesivir and steroids; PMH:  chronic respiratory failure, on 10-12 L O2 via NC and astral device at home; in ED pt was severely hypotensive with septic/cardiogenic shock; pt was made a DNR; he arrested in the ED and died"
	"1833526-1"	"1833526-1"	"SEPTIC SHOCK"	"10040070"	"50-59 years"	"50-59"	"pt arrived to hosp via EMS; EMS called due to increasing SOB; O2 sats 60s; placed on CPAP; cyanotic and no improvement; pt gave consent to be intubated in the field; pt was positive for COVID 1 wk before arriving at the hosp, completed remdesivir and steroids; PMH:  chronic respiratory failure, on 10-12 L O2 via NC and astral device at home; in ED pt was severely hypotensive with septic/cardiogenic shock; pt was made a DNR; he arrested in the ED and died"
	"1836656-1"	"1836656-1"	"AMYOTROPHIC LATERAL SCLEROSIS"	"10002026"	"50-59 years"	"50-59"	"Patient 59 y.o. male who presents the ED today from Hospital for further evaluation of aspiration shortness of breath.  Patient has ALS, states that he feels like he is getting worse slowly, is not having difficulty swallowing, states that he wants to focus on his comfort, and go inpatient hospice route.  Patient is currently DNR and has a power-of-attorney currently, who is at bedside with him today.  Patient denies any symptoms of fever, endorses coughing episodes and severe anxiety, but no other symptoms at this time.  Of note,  contact information for provider who cared for the patient at the outside facility not available in our electronic  health record.   On exam, he is ill appearing, cahectic, in mild respiratory distress, on nasal canula, following commands, has good air entry bilaterally with bilateral rhonchi, normal S1S2, soft abdomen, PEG tube in place, has bilateral feet drop and hands contractures and weakness/spasticity.    1- COVID-19 pneumonia in settings of progressive ALS disease: patient was not hypoxic though he is on some oxygen for comfort. No indication for dexamethasone or remdesivir. He was well determined that he would like to pursue comfort care and not undergo any invasive intervention or active treatment of his disease. We will keep im comfortable, morphine PRN, scopolamine patch, Ativan PRN, and Robinul PRN. We will use CPAP at night as may help to make him more comfortable (recommended by pulmonary as outpatient but did not start using it yet)   Presented with shortness of breath in the setting of ALS/MND and concern for aspiration. He was found to have COVID-19 pneumonia but opted for comfort measures. He was provided comfort medications. He passed away prior to transitioning to a nursing facility to pursue hospice care."
	"1836656-1"	"1836656-1"	"ANXIETY"	"10002855"	"50-59 years"	"50-59"	"Patient 59 y.o. male who presents the ED today from Hospital for further evaluation of aspiration shortness of breath.  Patient has ALS, states that he feels like he is getting worse slowly, is not having difficulty swallowing, states that he wants to focus on his comfort, and go inpatient hospice route.  Patient is currently DNR and has a power-of-attorney currently, who is at bedside with him today.  Patient denies any symptoms of fever, endorses coughing episodes and severe anxiety, but no other symptoms at this time.  Of note,  contact information for provider who cared for the patient at the outside facility not available in our electronic  health record.   On exam, he is ill appearing, cahectic, in mild respiratory distress, on nasal canula, following commands, has good air entry bilaterally with bilateral rhonchi, normal S1S2, soft abdomen, PEG tube in place, has bilateral feet drop and hands contractures and weakness/spasticity.    1- COVID-19 pneumonia in settings of progressive ALS disease: patient was not hypoxic though he is on some oxygen for comfort. No indication for dexamethasone or remdesivir. He was well determined that he would like to pursue comfort care and not undergo any invasive intervention or active treatment of his disease. We will keep im comfortable, morphine PRN, scopolamine patch, Ativan PRN, and Robinul PRN. We will use CPAP at night as may help to make him more comfortable (recommended by pulmonary as outpatient but did not start using it yet)   Presented with shortness of breath in the setting of ALS/MND and concern for aspiration. He was found to have COVID-19 pneumonia but opted for comfort measures. He was provided comfort medications. He passed away prior to transitioning to a nursing facility to pursue hospice care."
	"1836656-1"	"1836656-1"	"ASPIRATION"	"10003504"	"50-59 years"	"50-59"	"Patient 59 y.o. male who presents the ED today from Hospital for further evaluation of aspiration shortness of breath.  Patient has ALS, states that he feels like he is getting worse slowly, is not having difficulty swallowing, states that he wants to focus on his comfort, and go inpatient hospice route.  Patient is currently DNR and has a power-of-attorney currently, who is at bedside with him today.  Patient denies any symptoms of fever, endorses coughing episodes and severe anxiety, but no other symptoms at this time.  Of note,  contact information for provider who cared for the patient at the outside facility not available in our electronic  health record.   On exam, he is ill appearing, cahectic, in mild respiratory distress, on nasal canula, following commands, has good air entry bilaterally with bilateral rhonchi, normal S1S2, soft abdomen, PEG tube in place, has bilateral feet drop and hands contractures and weakness/spasticity.    1- COVID-19 pneumonia in settings of progressive ALS disease: patient was not hypoxic though he is on some oxygen for comfort. No indication for dexamethasone or remdesivir. He was well determined that he would like to pursue comfort care and not undergo any invasive intervention or active treatment of his disease. We will keep im comfortable, morphine PRN, scopolamine patch, Ativan PRN, and Robinul PRN. We will use CPAP at night as may help to make him more comfortable (recommended by pulmonary as outpatient but did not start using it yet)   Presented with shortness of breath in the setting of ALS/MND and concern for aspiration. He was found to have COVID-19 pneumonia but opted for comfort measures. He was provided comfort medications. He passed away prior to transitioning to a nursing facility to pursue hospice care."
	"1836656-1"	"1836656-1"	"ASTHENIA"	"10003549"	"50-59 years"	"50-59"	"Patient 59 y.o. male who presents the ED today from Hospital for further evaluation of aspiration shortness of breath.  Patient has ALS, states that he feels like he is getting worse slowly, is not having difficulty swallowing, states that he wants to focus on his comfort, and go inpatient hospice route.  Patient is currently DNR and has a power-of-attorney currently, who is at bedside with him today.  Patient denies any symptoms of fever, endorses coughing episodes and severe anxiety, but no other symptoms at this time.  Of note,  contact information for provider who cared for the patient at the outside facility not available in our electronic  health record.   On exam, he is ill appearing, cahectic, in mild respiratory distress, on nasal canula, following commands, has good air entry bilaterally with bilateral rhonchi, normal S1S2, soft abdomen, PEG tube in place, has bilateral feet drop and hands contractures and weakness/spasticity.    1- COVID-19 pneumonia in settings of progressive ALS disease: patient was not hypoxic though he is on some oxygen for comfort. No indication for dexamethasone or remdesivir. He was well determined that he would like to pursue comfort care and not undergo any invasive intervention or active treatment of his disease. We will keep im comfortable, morphine PRN, scopolamine patch, Ativan PRN, and Robinul PRN. We will use CPAP at night as may help to make him more comfortable (recommended by pulmonary as outpatient but did not start using it yet)   Presented with shortness of breath in the setting of ALS/MND and concern for aspiration. He was found to have COVID-19 pneumonia but opted for comfort measures. He was provided comfort medications. He passed away prior to transitioning to a nursing facility to pursue hospice care."
	"1836656-1"	"1836656-1"	"BREATH SOUNDS ABNORMAL"	"10064780"	"50-59 years"	"50-59"	"Patient 59 y.o. male who presents the ED today from Hospital for further evaluation of aspiration shortness of breath.  Patient has ALS, states that he feels like he is getting worse slowly, is not having difficulty swallowing, states that he wants to focus on his comfort, and go inpatient hospice route.  Patient is currently DNR and has a power-of-attorney currently, who is at bedside with him today.  Patient denies any symptoms of fever, endorses coughing episodes and severe anxiety, but no other symptoms at this time.  Of note,  contact information for provider who cared for the patient at the outside facility not available in our electronic  health record.   On exam, he is ill appearing, cahectic, in mild respiratory distress, on nasal canula, following commands, has good air entry bilaterally with bilateral rhonchi, normal S1S2, soft abdomen, PEG tube in place, has bilateral feet drop and hands contractures and weakness/spasticity.    1- COVID-19 pneumonia in settings of progressive ALS disease: patient was not hypoxic though he is on some oxygen for comfort. No indication for dexamethasone or remdesivir. He was well determined that he would like to pursue comfort care and not undergo any invasive intervention or active treatment of his disease. We will keep im comfortable, morphine PRN, scopolamine patch, Ativan PRN, and Robinul PRN. We will use CPAP at night as may help to make him more comfortable (recommended by pulmonary as outpatient but did not start using it yet)   Presented with shortness of breath in the setting of ALS/MND and concern for aspiration. He was found to have COVID-19 pneumonia but opted for comfort measures. He was provided comfort medications. He passed away prior to transitioning to a nursing facility to pursue hospice care."
	"1836656-1"	"1836656-1"	"CACHEXIA"	"10006895"	"50-59 years"	"50-59"	"Patient 59 y.o. male who presents the ED today from Hospital for further evaluation of aspiration shortness of breath.  Patient has ALS, states that he feels like he is getting worse slowly, is not having difficulty swallowing, states that he wants to focus on his comfort, and go inpatient hospice route.  Patient is currently DNR and has a power-of-attorney currently, who is at bedside with him today.  Patient denies any symptoms of fever, endorses coughing episodes and severe anxiety, but no other symptoms at this time.  Of note,  contact information for provider who cared for the patient at the outside facility not available in our electronic  health record.   On exam, he is ill appearing, cahectic, in mild respiratory distress, on nasal canula, following commands, has good air entry bilaterally with bilateral rhonchi, normal S1S2, soft abdomen, PEG tube in place, has bilateral feet drop and hands contractures and weakness/spasticity.    1- COVID-19 pneumonia in settings of progressive ALS disease: patient was not hypoxic though he is on some oxygen for comfort. No indication for dexamethasone or remdesivir. He was well determined that he would like to pursue comfort care and not undergo any invasive intervention or active treatment of his disease. We will keep im comfortable, morphine PRN, scopolamine patch, Ativan PRN, and Robinul PRN. We will use CPAP at night as may help to make him more comfortable (recommended by pulmonary as outpatient but did not start using it yet)   Presented with shortness of breath in the setting of ALS/MND and concern for aspiration. He was found to have COVID-19 pneumonia but opted for comfort measures. He was provided comfort medications. He passed away prior to transitioning to a nursing facility to pursue hospice care."
	"1836656-1"	"1836656-1"	"CONDITION AGGRAVATED"	"10010264"	"50-59 years"	"50-59"	"Patient 59 y.o. male who presents the ED today from Hospital for further evaluation of aspiration shortness of breath.  Patient has ALS, states that he feels like he is getting worse slowly, is not having difficulty swallowing, states that he wants to focus on his comfort, and go inpatient hospice route.  Patient is currently DNR and has a power-of-attorney currently, who is at bedside with him today.  Patient denies any symptoms of fever, endorses coughing episodes and severe anxiety, but no other symptoms at this time.  Of note,  contact information for provider who cared for the patient at the outside facility not available in our electronic  health record.   On exam, he is ill appearing, cahectic, in mild respiratory distress, on nasal canula, following commands, has good air entry bilaterally with bilateral rhonchi, normal S1S2, soft abdomen, PEG tube in place, has bilateral feet drop and hands contractures and weakness/spasticity.    1- COVID-19 pneumonia in settings of progressive ALS disease: patient was not hypoxic though he is on some oxygen for comfort. No indication for dexamethasone or remdesivir. He was well determined that he would like to pursue comfort care and not undergo any invasive intervention or active treatment of his disease. We will keep im comfortable, morphine PRN, scopolamine patch, Ativan PRN, and Robinul PRN. We will use CPAP at night as may help to make him more comfortable (recommended by pulmonary as outpatient but did not start using it yet)   Presented with shortness of breath in the setting of ALS/MND and concern for aspiration. He was found to have COVID-19 pneumonia but opted for comfort measures. He was provided comfort medications. He passed away prior to transitioning to a nursing facility to pursue hospice care."
	"1836656-1"	"1836656-1"	"COUGH"	"10011224"	"50-59 years"	"50-59"	"Patient 59 y.o. male who presents the ED today from Hospital for further evaluation of aspiration shortness of breath.  Patient has ALS, states that he feels like he is getting worse slowly, is not having difficulty swallowing, states that he wants to focus on his comfort, and go inpatient hospice route.  Patient is currently DNR and has a power-of-attorney currently, who is at bedside with him today.  Patient denies any symptoms of fever, endorses coughing episodes and severe anxiety, but no other symptoms at this time.  Of note,  contact information for provider who cared for the patient at the outside facility not available in our electronic  health record.   On exam, he is ill appearing, cahectic, in mild respiratory distress, on nasal canula, following commands, has good air entry bilaterally with bilateral rhonchi, normal S1S2, soft abdomen, PEG tube in place, has bilateral feet drop and hands contractures and weakness/spasticity.    1- COVID-19 pneumonia in settings of progressive ALS disease: patient was not hypoxic though he is on some oxygen for comfort. No indication for dexamethasone or remdesivir. He was well determined that he would like to pursue comfort care and not undergo any invasive intervention or active treatment of his disease. We will keep im comfortable, morphine PRN, scopolamine patch, Ativan PRN, and Robinul PRN. We will use CPAP at night as may help to make him more comfortable (recommended by pulmonary as outpatient but did not start using it yet)   Presented with shortness of breath in the setting of ALS/MND and concern for aspiration. He was found to have COVID-19 pneumonia but opted for comfort measures. He was provided comfort medications. He passed away prior to transitioning to a nursing facility to pursue hospice care."
	"1836656-1"	"1836656-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Patient 59 y.o. male who presents the ED today from Hospital for further evaluation of aspiration shortness of breath.  Patient has ALS, states that he feels like he is getting worse slowly, is not having difficulty swallowing, states that he wants to focus on his comfort, and go inpatient hospice route.  Patient is currently DNR and has a power-of-attorney currently, who is at bedside with him today.  Patient denies any symptoms of fever, endorses coughing episodes and severe anxiety, but no other symptoms at this time.  Of note,  contact information for provider who cared for the patient at the outside facility not available in our electronic  health record.   On exam, he is ill appearing, cahectic, in mild respiratory distress, on nasal canula, following commands, has good air entry bilaterally with bilateral rhonchi, normal S1S2, soft abdomen, PEG tube in place, has bilateral feet drop and hands contractures and weakness/spasticity.    1- COVID-19 pneumonia in settings of progressive ALS disease: patient was not hypoxic though he is on some oxygen for comfort. No indication for dexamethasone or remdesivir. He was well determined that he would like to pursue comfort care and not undergo any invasive intervention or active treatment of his disease. We will keep im comfortable, morphine PRN, scopolamine patch, Ativan PRN, and Robinul PRN. We will use CPAP at night as may help to make him more comfortable (recommended by pulmonary as outpatient but did not start using it yet)   Presented with shortness of breath in the setting of ALS/MND and concern for aspiration. He was found to have COVID-19 pneumonia but opted for comfort measures. He was provided comfort medications. He passed away prior to transitioning to a nursing facility to pursue hospice care."
	"1836656-1"	"1836656-1"	"COVID-19 PNEUMONIA"	"10084380"	"50-59 years"	"50-59"	"Patient 59 y.o. male who presents the ED today from Hospital for further evaluation of aspiration shortness of breath.  Patient has ALS, states that he feels like he is getting worse slowly, is not having difficulty swallowing, states that he wants to focus on his comfort, and go inpatient hospice route.  Patient is currently DNR and has a power-of-attorney currently, who is at bedside with him today.  Patient denies any symptoms of fever, endorses coughing episodes and severe anxiety, but no other symptoms at this time.  Of note,  contact information for provider who cared for the patient at the outside facility not available in our electronic  health record.   On exam, he is ill appearing, cahectic, in mild respiratory distress, on nasal canula, following commands, has good air entry bilaterally with bilateral rhonchi, normal S1S2, soft abdomen, PEG tube in place, has bilateral feet drop and hands contractures and weakness/spasticity.    1- COVID-19 pneumonia in settings of progressive ALS disease: patient was not hypoxic though he is on some oxygen for comfort. No indication for dexamethasone or remdesivir. He was well determined that he would like to pursue comfort care and not undergo any invasive intervention or active treatment of his disease. We will keep im comfortable, morphine PRN, scopolamine patch, Ativan PRN, and Robinul PRN. We will use CPAP at night as may help to make him more comfortable (recommended by pulmonary as outpatient but did not start using it yet)   Presented with shortness of breath in the setting of ALS/MND and concern for aspiration. He was found to have COVID-19 pneumonia but opted for comfort measures. He was provided comfort medications. He passed away prior to transitioning to a nursing facility to pursue hospice care."
	"1836656-1"	"1836656-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient 59 y.o. male who presents the ED today from Hospital for further evaluation of aspiration shortness of breath.  Patient has ALS, states that he feels like he is getting worse slowly, is not having difficulty swallowing, states that he wants to focus on his comfort, and go inpatient hospice route.  Patient is currently DNR and has a power-of-attorney currently, who is at bedside with him today.  Patient denies any symptoms of fever, endorses coughing episodes and severe anxiety, but no other symptoms at this time.  Of note,  contact information for provider who cared for the patient at the outside facility not available in our electronic  health record.   On exam, he is ill appearing, cahectic, in mild respiratory distress, on nasal canula, following commands, has good air entry bilaterally with bilateral rhonchi, normal S1S2, soft abdomen, PEG tube in place, has bilateral feet drop and hands contractures and weakness/spasticity.    1- COVID-19 pneumonia in settings of progressive ALS disease: patient was not hypoxic though he is on some oxygen for comfort. No indication for dexamethasone or remdesivir. He was well determined that he would like to pursue comfort care and not undergo any invasive intervention or active treatment of his disease. We will keep im comfortable, morphine PRN, scopolamine patch, Ativan PRN, and Robinul PRN. We will use CPAP at night as may help to make him more comfortable (recommended by pulmonary as outpatient but did not start using it yet)   Presented with shortness of breath in the setting of ALS/MND and concern for aspiration. He was found to have COVID-19 pneumonia but opted for comfort measures. He was provided comfort medications. He passed away prior to transitioning to a nursing facility to pursue hospice care."
	"1836656-1"	"1836656-1"	"DISEASE PROGRESSION"	"10061818"	"50-59 years"	"50-59"	"Patient 59 y.o. male who presents the ED today from Hospital for further evaluation of aspiration shortness of breath.  Patient has ALS, states that he feels like he is getting worse slowly, is not having difficulty swallowing, states that he wants to focus on his comfort, and go inpatient hospice route.  Patient is currently DNR and has a power-of-attorney currently, who is at bedside with him today.  Patient denies any symptoms of fever, endorses coughing episodes and severe anxiety, but no other symptoms at this time.  Of note,  contact information for provider who cared for the patient at the outside facility not available in our electronic  health record.   On exam, he is ill appearing, cahectic, in mild respiratory distress, on nasal canula, following commands, has good air entry bilaterally with bilateral rhonchi, normal S1S2, soft abdomen, PEG tube in place, has bilateral feet drop and hands contractures and weakness/spasticity.    1- COVID-19 pneumonia in settings of progressive ALS disease: patient was not hypoxic though he is on some oxygen for comfort. No indication for dexamethasone or remdesivir. He was well determined that he would like to pursue comfort care and not undergo any invasive intervention or active treatment of his disease. We will keep im comfortable, morphine PRN, scopolamine patch, Ativan PRN, and Robinul PRN. We will use CPAP at night as may help to make him more comfortable (recommended by pulmonary as outpatient but did not start using it yet)   Presented with shortness of breath in the setting of ALS/MND and concern for aspiration. He was found to have COVID-19 pneumonia but opted for comfort measures. He was provided comfort medications. He passed away prior to transitioning to a nursing facility to pursue hospice care."
	"1836656-1"	"1836656-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"Patient 59 y.o. male who presents the ED today from Hospital for further evaluation of aspiration shortness of breath.  Patient has ALS, states that he feels like he is getting worse slowly, is not having difficulty swallowing, states that he wants to focus on his comfort, and go inpatient hospice route.  Patient is currently DNR and has a power-of-attorney currently, who is at bedside with him today.  Patient denies any symptoms of fever, endorses coughing episodes and severe anxiety, but no other symptoms at this time.  Of note,  contact information for provider who cared for the patient at the outside facility not available in our electronic  health record.   On exam, he is ill appearing, cahectic, in mild respiratory distress, on nasal canula, following commands, has good air entry bilaterally with bilateral rhonchi, normal S1S2, soft abdomen, PEG tube in place, has bilateral feet drop and hands contractures and weakness/spasticity.    1- COVID-19 pneumonia in settings of progressive ALS disease: patient was not hypoxic though he is on some oxygen for comfort. No indication for dexamethasone or remdesivir. He was well determined that he would like to pursue comfort care and not undergo any invasive intervention or active treatment of his disease. We will keep im comfortable, morphine PRN, scopolamine patch, Ativan PRN, and Robinul PRN. We will use CPAP at night as may help to make him more comfortable (recommended by pulmonary as outpatient but did not start using it yet)   Presented with shortness of breath in the setting of ALS/MND and concern for aspiration. He was found to have COVID-19 pneumonia but opted for comfort measures. He was provided comfort medications. He passed away prior to transitioning to a nursing facility to pursue hospice care."
	"1836656-1"	"1836656-1"	"GASTROSTOMY"	"10048978"	"50-59 years"	"50-59"	"Patient 59 y.o. male who presents the ED today from Hospital for further evaluation of aspiration shortness of breath.  Patient has ALS, states that he feels like he is getting worse slowly, is not having difficulty swallowing, states that he wants to focus on his comfort, and go inpatient hospice route.  Patient is currently DNR and has a power-of-attorney currently, who is at bedside with him today.  Patient denies any symptoms of fever, endorses coughing episodes and severe anxiety, but no other symptoms at this time.  Of note,  contact information for provider who cared for the patient at the outside facility not available in our electronic  health record.   On exam, he is ill appearing, cahectic, in mild respiratory distress, on nasal canula, following commands, has good air entry bilaterally with bilateral rhonchi, normal S1S2, soft abdomen, PEG tube in place, has bilateral feet drop and hands contractures and weakness/spasticity.    1- COVID-19 pneumonia in settings of progressive ALS disease: patient was not hypoxic though he is on some oxygen for comfort. No indication for dexamethasone or remdesivir. He was well determined that he would like to pursue comfort care and not undergo any invasive intervention or active treatment of his disease. We will keep im comfortable, morphine PRN, scopolamine patch, Ativan PRN, and Robinul PRN. We will use CPAP at night as may help to make him more comfortable (recommended by pulmonary as outpatient but did not start using it yet)   Presented with shortness of breath in the setting of ALS/MND and concern for aspiration. He was found to have COVID-19 pneumonia but opted for comfort measures. He was provided comfort medications. He passed away prior to transitioning to a nursing facility to pursue hospice care."
	"1836656-1"	"1836656-1"	"GENERAL PHYSICAL CONDITION ABNORMAL"	"10058911"	"50-59 years"	"50-59"	"Patient 59 y.o. male who presents the ED today from Hospital for further evaluation of aspiration shortness of breath.  Patient has ALS, states that he feels like he is getting worse slowly, is not having difficulty swallowing, states that he wants to focus on his comfort, and go inpatient hospice route.  Patient is currently DNR and has a power-of-attorney currently, who is at bedside with him today.  Patient denies any symptoms of fever, endorses coughing episodes and severe anxiety, but no other symptoms at this time.  Of note,  contact information for provider who cared for the patient at the outside facility not available in our electronic  health record.   On exam, he is ill appearing, cahectic, in mild respiratory distress, on nasal canula, following commands, has good air entry bilaterally with bilateral rhonchi, normal S1S2, soft abdomen, PEG tube in place, has bilateral feet drop and hands contractures and weakness/spasticity.    1- COVID-19 pneumonia in settings of progressive ALS disease: patient was not hypoxic though he is on some oxygen for comfort. No indication for dexamethasone or remdesivir. He was well determined that he would like to pursue comfort care and not undergo any invasive intervention or active treatment of his disease. We will keep im comfortable, morphine PRN, scopolamine patch, Ativan PRN, and Robinul PRN. We will use CPAP at night as may help to make him more comfortable (recommended by pulmonary as outpatient but did not start using it yet)   Presented with shortness of breath in the setting of ALS/MND and concern for aspiration. He was found to have COVID-19 pneumonia but opted for comfort measures. He was provided comfort medications. He passed away prior to transitioning to a nursing facility to pursue hospice care."
	"1836656-1"	"1836656-1"	"JOINT CONTRACTURE"	"10023201"	"50-59 years"	"50-59"	"Patient 59 y.o. male who presents the ED today from Hospital for further evaluation of aspiration shortness of breath.  Patient has ALS, states that he feels like he is getting worse slowly, is not having difficulty swallowing, states that he wants to focus on his comfort, and go inpatient hospice route.  Patient is currently DNR and has a power-of-attorney currently, who is at bedside with him today.  Patient denies any symptoms of fever, endorses coughing episodes and severe anxiety, but no other symptoms at this time.  Of note,  contact information for provider who cared for the patient at the outside facility not available in our electronic  health record.   On exam, he is ill appearing, cahectic, in mild respiratory distress, on nasal canula, following commands, has good air entry bilaterally with bilateral rhonchi, normal S1S2, soft abdomen, PEG tube in place, has bilateral feet drop and hands contractures and weakness/spasticity.    1- COVID-19 pneumonia in settings of progressive ALS disease: patient was not hypoxic though he is on some oxygen for comfort. No indication for dexamethasone or remdesivir. He was well determined that he would like to pursue comfort care and not undergo any invasive intervention or active treatment of his disease. We will keep im comfortable, morphine PRN, scopolamine patch, Ativan PRN, and Robinul PRN. We will use CPAP at night as may help to make him more comfortable (recommended by pulmonary as outpatient but did not start using it yet)   Presented with shortness of breath in the setting of ALS/MND and concern for aspiration. He was found to have COVID-19 pneumonia but opted for comfort measures. He was provided comfort medications. He passed away prior to transitioning to a nursing facility to pursue hospice care."
	"1836656-1"	"1836656-1"	"MOTOR NEURONE DISEASE"	"10028003"	"50-59 years"	"50-59"	"Patient 59 y.o. male who presents the ED today from Hospital for further evaluation of aspiration shortness of breath.  Patient has ALS, states that he feels like he is getting worse slowly, is not having difficulty swallowing, states that he wants to focus on his comfort, and go inpatient hospice route.  Patient is currently DNR and has a power-of-attorney currently, who is at bedside with him today.  Patient denies any symptoms of fever, endorses coughing episodes and severe anxiety, but no other symptoms at this time.  Of note,  contact information for provider who cared for the patient at the outside facility not available in our electronic  health record.   On exam, he is ill appearing, cahectic, in mild respiratory distress, on nasal canula, following commands, has good air entry bilaterally with bilateral rhonchi, normal S1S2, soft abdomen, PEG tube in place, has bilateral feet drop and hands contractures and weakness/spasticity.    1- COVID-19 pneumonia in settings of progressive ALS disease: patient was not hypoxic though he is on some oxygen for comfort. No indication for dexamethasone or remdesivir. He was well determined that he would like to pursue comfort care and not undergo any invasive intervention or active treatment of his disease. We will keep im comfortable, morphine PRN, scopolamine patch, Ativan PRN, and Robinul PRN. We will use CPAP at night as may help to make him more comfortable (recommended by pulmonary as outpatient but did not start using it yet)   Presented with shortness of breath in the setting of ALS/MND and concern for aspiration. He was found to have COVID-19 pneumonia but opted for comfort measures. He was provided comfort medications. He passed away prior to transitioning to a nursing facility to pursue hospice care."
	"1836656-1"	"1836656-1"	"MUSCLE SPASTICITY"	"10028335"	"50-59 years"	"50-59"	"Patient 59 y.o. male who presents the ED today from Hospital for further evaluation of aspiration shortness of breath.  Patient has ALS, states that he feels like he is getting worse slowly, is not having difficulty swallowing, states that he wants to focus on his comfort, and go inpatient hospice route.  Patient is currently DNR and has a power-of-attorney currently, who is at bedside with him today.  Patient denies any symptoms of fever, endorses coughing episodes and severe anxiety, but no other symptoms at this time.  Of note,  contact information for provider who cared for the patient at the outside facility not available in our electronic  health record.   On exam, he is ill appearing, cahectic, in mild respiratory distress, on nasal canula, following commands, has good air entry bilaterally with bilateral rhonchi, normal S1S2, soft abdomen, PEG tube in place, has bilateral feet drop and hands contractures and weakness/spasticity.    1- COVID-19 pneumonia in settings of progressive ALS disease: patient was not hypoxic though he is on some oxygen for comfort. No indication for dexamethasone or remdesivir. He was well determined that he would like to pursue comfort care and not undergo any invasive intervention or active treatment of his disease. We will keep im comfortable, morphine PRN, scopolamine patch, Ativan PRN, and Robinul PRN. We will use CPAP at night as may help to make him more comfortable (recommended by pulmonary as outpatient but did not start using it yet)   Presented with shortness of breath in the setting of ALS/MND and concern for aspiration. He was found to have COVID-19 pneumonia but opted for comfort measures. He was provided comfort medications. He passed away prior to transitioning to a nursing facility to pursue hospice care."
	"1836656-1"	"1836656-1"	"PERONEAL NERVE PALSY"	"10034701"	"50-59 years"	"50-59"	"Patient 59 y.o. male who presents the ED today from Hospital for further evaluation of aspiration shortness of breath.  Patient has ALS, states that he feels like he is getting worse slowly, is not having difficulty swallowing, states that he wants to focus on his comfort, and go inpatient hospice route.  Patient is currently DNR and has a power-of-attorney currently, who is at bedside with him today.  Patient denies any symptoms of fever, endorses coughing episodes and severe anxiety, but no other symptoms at this time.  Of note,  contact information for provider who cared for the patient at the outside facility not available in our electronic  health record.   On exam, he is ill appearing, cahectic, in mild respiratory distress, on nasal canula, following commands, has good air entry bilaterally with bilateral rhonchi, normal S1S2, soft abdomen, PEG tube in place, has bilateral feet drop and hands contractures and weakness/spasticity.    1- COVID-19 pneumonia in settings of progressive ALS disease: patient was not hypoxic though he is on some oxygen for comfort. No indication for dexamethasone or remdesivir. He was well determined that he would like to pursue comfort care and not undergo any invasive intervention or active treatment of his disease. We will keep im comfortable, morphine PRN, scopolamine patch, Ativan PRN, and Robinul PRN. We will use CPAP at night as may help to make him more comfortable (recommended by pulmonary as outpatient but did not start using it yet)   Presented with shortness of breath in the setting of ALS/MND and concern for aspiration. He was found to have COVID-19 pneumonia but opted for comfort measures. He was provided comfort medications. He passed away prior to transitioning to a nursing facility to pursue hospice care."
	"1836656-1"	"1836656-1"	"POSITIVE AIRWAY PRESSURE THERAPY"	"10086397"	"50-59 years"	"50-59"	"Patient 59 y.o. male who presents the ED today from Hospital for further evaluation of aspiration shortness of breath.  Patient has ALS, states that he feels like he is getting worse slowly, is not having difficulty swallowing, states that he wants to focus on his comfort, and go inpatient hospice route.  Patient is currently DNR and has a power-of-attorney currently, who is at bedside with him today.  Patient denies any symptoms of fever, endorses coughing episodes and severe anxiety, but no other symptoms at this time.  Of note,  contact information for provider who cared for the patient at the outside facility not available in our electronic  health record.   On exam, he is ill appearing, cahectic, in mild respiratory distress, on nasal canula, following commands, has good air entry bilaterally with bilateral rhonchi, normal S1S2, soft abdomen, PEG tube in place, has bilateral feet drop and hands contractures and weakness/spasticity.    1- COVID-19 pneumonia in settings of progressive ALS disease: patient was not hypoxic though he is on some oxygen for comfort. No indication for dexamethasone or remdesivir. He was well determined that he would like to pursue comfort care and not undergo any invasive intervention or active treatment of his disease. We will keep im comfortable, morphine PRN, scopolamine patch, Ativan PRN, and Robinul PRN. We will use CPAP at night as may help to make him more comfortable (recommended by pulmonary as outpatient but did not start using it yet)   Presented with shortness of breath in the setting of ALS/MND and concern for aspiration. He was found to have COVID-19 pneumonia but opted for comfort measures. He was provided comfort medications. He passed away prior to transitioning to a nursing facility to pursue hospice care."
	"1836656-1"	"1836656-1"	"RESPIRATORY DISTRESS"	"10038687"	"50-59 years"	"50-59"	"Patient 59 y.o. male who presents the ED today from Hospital for further evaluation of aspiration shortness of breath.  Patient has ALS, states that he feels like he is getting worse slowly, is not having difficulty swallowing, states that he wants to focus on his comfort, and go inpatient hospice route.  Patient is currently DNR and has a power-of-attorney currently, who is at bedside with him today.  Patient denies any symptoms of fever, endorses coughing episodes and severe anxiety, but no other symptoms at this time.  Of note,  contact information for provider who cared for the patient at the outside facility not available in our electronic  health record.   On exam, he is ill appearing, cahectic, in mild respiratory distress, on nasal canula, following commands, has good air entry bilaterally with bilateral rhonchi, normal S1S2, soft abdomen, PEG tube in place, has bilateral feet drop and hands contractures and weakness/spasticity.    1- COVID-19 pneumonia in settings of progressive ALS disease: patient was not hypoxic though he is on some oxygen for comfort. No indication for dexamethasone or remdesivir. He was well determined that he would like to pursue comfort care and not undergo any invasive intervention or active treatment of his disease. We will keep im comfortable, morphine PRN, scopolamine patch, Ativan PRN, and Robinul PRN. We will use CPAP at night as may help to make him more comfortable (recommended by pulmonary as outpatient but did not start using it yet)   Presented with shortness of breath in the setting of ALS/MND and concern for aspiration. He was found to have COVID-19 pneumonia but opted for comfort measures. He was provided comfort medications. He passed away prior to transitioning to a nursing facility to pursue hospice care."
	"1836656-1"	"1836656-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"Patient 59 y.o. male who presents the ED today from Hospital for further evaluation of aspiration shortness of breath.  Patient has ALS, states that he feels like he is getting worse slowly, is not having difficulty swallowing, states that he wants to focus on his comfort, and go inpatient hospice route.  Patient is currently DNR and has a power-of-attorney currently, who is at bedside with him today.  Patient denies any symptoms of fever, endorses coughing episodes and severe anxiety, but no other symptoms at this time.  Of note,  contact information for provider who cared for the patient at the outside facility not available in our electronic  health record.   On exam, he is ill appearing, cahectic, in mild respiratory distress, on nasal canula, following commands, has good air entry bilaterally with bilateral rhonchi, normal S1S2, soft abdomen, PEG tube in place, has bilateral feet drop and hands contractures and weakness/spasticity.    1- COVID-19 pneumonia in settings of progressive ALS disease: patient was not hypoxic though he is on some oxygen for comfort. No indication for dexamethasone or remdesivir. He was well determined that he would like to pursue comfort care and not undergo any invasive intervention or active treatment of his disease. We will keep im comfortable, morphine PRN, scopolamine patch, Ativan PRN, and Robinul PRN. We will use CPAP at night as may help to make him more comfortable (recommended by pulmonary as outpatient but did not start using it yet)   Presented with shortness of breath in the setting of ALS/MND and concern for aspiration. He was found to have COVID-19 pneumonia but opted for comfort measures. He was provided comfort medications. He passed away prior to transitioning to a nursing facility to pursue hospice care."
	"1840544-1"	"1840544-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Resident was on hospice care, terminal prognosis, end of life prior to vaccination. 11/2/21 residents O2 was decreased and resident declined shortly after."
	"1840544-1"	"1840544-1"	"OXYGEN SATURATION DECREASED"	"10033318"	"50-59 years"	"50-59"	"Resident was on hospice care, terminal prognosis, end of life prior to vaccination. 11/2/21 residents O2 was decreased and resident declined shortly after."
	"1843324-1"	"1843324-1"	"BRAIN INJURY"	"10067967"	"50-59 years"	"50-59"	"headache started 36 hrs post vaccine and continued.  Symptoms seemed to get worse daily including general malaise, sinus congestion, body aches and fever started 09/05/2021.  Home tested 09/06/2021 positive for covid.  Up uintil then she had remained alert and oriented.  Husband noticed change in breathing at approx 1000 on 09/06/2021 and attempted to get her up to go to hospital when she went  into respiratory arrest.  911 called and CPR initiated.  Was eventually helicopter transported to hospital, placed on vent.   Vent dc'd 09/08/2021 and she died.   Spoke with a person who received the same lot # of vaccine, same date, given just prior to and she also tested positive for covid on 09/05/2021 and was in ER on that date. Neither of them had any common friends or had been in the same location."
	"1843324-1"	"1843324-1"	"CHEST X-RAY ABNORMAL"	"10008499"	"50-59 years"	"50-59"	"headache started 36 hrs post vaccine and continued.  Symptoms seemed to get worse daily including general malaise, sinus congestion, body aches and fever started 09/05/2021.  Home tested 09/06/2021 positive for covid.  Up uintil then she had remained alert and oriented.  Husband noticed change in breathing at approx 1000 on 09/06/2021 and attempted to get her up to go to hospital when she went  into respiratory arrest.  911 called and CPR initiated.  Was eventually helicopter transported to hospital, placed on vent.   Vent dc'd 09/08/2021 and she died.   Spoke with a person who received the same lot # of vaccine, same date, given just prior to and she also tested positive for covid on 09/05/2021 and was in ER on that date. Neither of them had any common friends or had been in the same location."
	"1843324-1"	"1843324-1"	"COMPUTERISED TOMOGRAM HEAD ABNORMAL"	"10072168"	"50-59 years"	"50-59"	"headache started 36 hrs post vaccine and continued.  Symptoms seemed to get worse daily including general malaise, sinus congestion, body aches and fever started 09/05/2021.  Home tested 09/06/2021 positive for covid.  Up uintil then she had remained alert and oriented.  Husband noticed change in breathing at approx 1000 on 09/06/2021 and attempted to get her up to go to hospital when she went  into respiratory arrest.  911 called and CPR initiated.  Was eventually helicopter transported to hospital, placed on vent.   Vent dc'd 09/08/2021 and she died.   Spoke with a person who received the same lot # of vaccine, same date, given just prior to and she also tested positive for covid on 09/05/2021 and was in ER on that date. Neither of them had any common friends or had been in the same location."
	"1843324-1"	"1843324-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"headache started 36 hrs post vaccine and continued.  Symptoms seemed to get worse daily including general malaise, sinus congestion, body aches and fever started 09/05/2021.  Home tested 09/06/2021 positive for covid.  Up uintil then she had remained alert and oriented.  Husband noticed change in breathing at approx 1000 on 09/06/2021 and attempted to get her up to go to hospital when she went  into respiratory arrest.  911 called and CPR initiated.  Was eventually helicopter transported to hospital, placed on vent.   Vent dc'd 09/08/2021 and she died.   Spoke with a person who received the same lot # of vaccine, same date, given just prior to and she also tested positive for covid on 09/05/2021 and was in ER on that date. Neither of them had any common friends or had been in the same location."
	"1843324-1"	"1843324-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"headache started 36 hrs post vaccine and continued.  Symptoms seemed to get worse daily including general malaise, sinus congestion, body aches and fever started 09/05/2021.  Home tested 09/06/2021 positive for covid.  Up uintil then she had remained alert and oriented.  Husband noticed change in breathing at approx 1000 on 09/06/2021 and attempted to get her up to go to hospital when she went  into respiratory arrest.  911 called and CPR initiated.  Was eventually helicopter transported to hospital, placed on vent.   Vent dc'd 09/08/2021 and she died.   Spoke with a person who received the same lot # of vaccine, same date, given just prior to and she also tested positive for covid on 09/05/2021 and was in ER on that date. Neither of them had any common friends or had been in the same location."
	"1843324-1"	"1843324-1"	"HEADACHE"	"10019211"	"50-59 years"	"50-59"	"headache started 36 hrs post vaccine and continued.  Symptoms seemed to get worse daily including general malaise, sinus congestion, body aches and fever started 09/05/2021.  Home tested 09/06/2021 positive for covid.  Up uintil then she had remained alert and oriented.  Husband noticed change in breathing at approx 1000 on 09/06/2021 and attempted to get her up to go to hospital when she went  into respiratory arrest.  911 called and CPR initiated.  Was eventually helicopter transported to hospital, placed on vent.   Vent dc'd 09/08/2021 and she died.   Spoke with a person who received the same lot # of vaccine, same date, given just prior to and she also tested positive for covid on 09/05/2021 and was in ER on that date. Neither of them had any common friends or had been in the same location."
	"1843324-1"	"1843324-1"	"LABORATORY TEST ABNORMAL"	"10023547"	"50-59 years"	"50-59"	"headache started 36 hrs post vaccine and continued.  Symptoms seemed to get worse daily including general malaise, sinus congestion, body aches and fever started 09/05/2021.  Home tested 09/06/2021 positive for covid.  Up uintil then she had remained alert and oriented.  Husband noticed change in breathing at approx 1000 on 09/06/2021 and attempted to get her up to go to hospital when she went  into respiratory arrest.  911 called and CPR initiated.  Was eventually helicopter transported to hospital, placed on vent.   Vent dc'd 09/08/2021 and she died.   Spoke with a person who received the same lot # of vaccine, same date, given just prior to and she also tested positive for covid on 09/05/2021 and was in ER on that date. Neither of them had any common friends or had been in the same location."
	"1843324-1"	"1843324-1"	"MALAISE"	"10025482"	"50-59 years"	"50-59"	"headache started 36 hrs post vaccine and continued.  Symptoms seemed to get worse daily including general malaise, sinus congestion, body aches and fever started 09/05/2021.  Home tested 09/06/2021 positive for covid.  Up uintil then she had remained alert and oriented.  Husband noticed change in breathing at approx 1000 on 09/06/2021 and attempted to get her up to go to hospital when she went  into respiratory arrest.  911 called and CPR initiated.  Was eventually helicopter transported to hospital, placed on vent.   Vent dc'd 09/08/2021 and she died.   Spoke with a person who received the same lot # of vaccine, same date, given just prior to and she also tested positive for covid on 09/05/2021 and was in ER on that date. Neither of them had any common friends or had been in the same location."
	"1843324-1"	"1843324-1"	"MECHANICAL VENTILATION"	"10067221"	"50-59 years"	"50-59"	"headache started 36 hrs post vaccine and continued.  Symptoms seemed to get worse daily including general malaise, sinus congestion, body aches and fever started 09/05/2021.  Home tested 09/06/2021 positive for covid.  Up uintil then she had remained alert and oriented.  Husband noticed change in breathing at approx 1000 on 09/06/2021 and attempted to get her up to go to hospital when she went  into respiratory arrest.  911 called and CPR initiated.  Was eventually helicopter transported to hospital, placed on vent.   Vent dc'd 09/08/2021 and she died.   Spoke with a person who received the same lot # of vaccine, same date, given just prior to and she also tested positive for covid on 09/05/2021 and was in ER on that date. Neither of them had any common friends or had been in the same location."
	"1843324-1"	"1843324-1"	"MULTIPLE ORGAN DYSFUNCTION SYNDROME"	"10077361"	"50-59 years"	"50-59"	"headache started 36 hrs post vaccine and continued.  Symptoms seemed to get worse daily including general malaise, sinus congestion, body aches and fever started 09/05/2021.  Home tested 09/06/2021 positive for covid.  Up uintil then she had remained alert and oriented.  Husband noticed change in breathing at approx 1000 on 09/06/2021 and attempted to get her up to go to hospital when she went  into respiratory arrest.  911 called and CPR initiated.  Was eventually helicopter transported to hospital, placed on vent.   Vent dc'd 09/08/2021 and she died.   Spoke with a person who received the same lot # of vaccine, same date, given just prior to and she also tested positive for covid on 09/05/2021 and was in ER on that date. Neither of them had any common friends or had been in the same location."
	"1843324-1"	"1843324-1"	"PAIN"	"10033371"	"50-59 years"	"50-59"	"headache started 36 hrs post vaccine and continued.  Symptoms seemed to get worse daily including general malaise, sinus congestion, body aches and fever started 09/05/2021.  Home tested 09/06/2021 positive for covid.  Up uintil then she had remained alert and oriented.  Husband noticed change in breathing at approx 1000 on 09/06/2021 and attempted to get her up to go to hospital when she went  into respiratory arrest.  911 called and CPR initiated.  Was eventually helicopter transported to hospital, placed on vent.   Vent dc'd 09/08/2021 and she died.   Spoke with a person who received the same lot # of vaccine, same date, given just prior to and she also tested positive for covid on 09/05/2021 and was in ER on that date. Neither of them had any common friends or had been in the same location."
	"1843324-1"	"1843324-1"	"PNEUMONIA"	"10035664"	"50-59 years"	"50-59"	"headache started 36 hrs post vaccine and continued.  Symptoms seemed to get worse daily including general malaise, sinus congestion, body aches and fever started 09/05/2021.  Home tested 09/06/2021 positive for covid.  Up uintil then she had remained alert and oriented.  Husband noticed change in breathing at approx 1000 on 09/06/2021 and attempted to get her up to go to hospital when she went  into respiratory arrest.  911 called and CPR initiated.  Was eventually helicopter transported to hospital, placed on vent.   Vent dc'd 09/08/2021 and she died.   Spoke with a person who received the same lot # of vaccine, same date, given just prior to and she also tested positive for covid on 09/05/2021 and was in ER on that date. Neither of them had any common friends or had been in the same location."
	"1843324-1"	"1843324-1"	"PYREXIA"	"10037660"	"50-59 years"	"50-59"	"headache started 36 hrs post vaccine and continued.  Symptoms seemed to get worse daily including general malaise, sinus congestion, body aches and fever started 09/05/2021.  Home tested 09/06/2021 positive for covid.  Up uintil then she had remained alert and oriented.  Husband noticed change in breathing at approx 1000 on 09/06/2021 and attempted to get her up to go to hospital when she went  into respiratory arrest.  911 called and CPR initiated.  Was eventually helicopter transported to hospital, placed on vent.   Vent dc'd 09/08/2021 and she died.   Spoke with a person who received the same lot # of vaccine, same date, given just prior to and she also tested positive for covid on 09/05/2021 and was in ER on that date. Neither of them had any common friends or had been in the same location."
	"1843324-1"	"1843324-1"	"RESPIRATION ABNORMAL"	"10038647"	"50-59 years"	"50-59"	"headache started 36 hrs post vaccine and continued.  Symptoms seemed to get worse daily including general malaise, sinus congestion, body aches and fever started 09/05/2021.  Home tested 09/06/2021 positive for covid.  Up uintil then she had remained alert and oriented.  Husband noticed change in breathing at approx 1000 on 09/06/2021 and attempted to get her up to go to hospital when she went  into respiratory arrest.  911 called and CPR initiated.  Was eventually helicopter transported to hospital, placed on vent.   Vent dc'd 09/08/2021 and she died.   Spoke with a person who received the same lot # of vaccine, same date, given just prior to and she also tested positive for covid on 09/05/2021 and was in ER on that date. Neither of them had any common friends or had been in the same location."
	"1843324-1"	"1843324-1"	"RESPIRATORY ARREST"	"10038669"	"50-59 years"	"50-59"	"headache started 36 hrs post vaccine and continued.  Symptoms seemed to get worse daily including general malaise, sinus congestion, body aches and fever started 09/05/2021.  Home tested 09/06/2021 positive for covid.  Up uintil then she had remained alert and oriented.  Husband noticed change in breathing at approx 1000 on 09/06/2021 and attempted to get her up to go to hospital when she went  into respiratory arrest.  911 called and CPR initiated.  Was eventually helicopter transported to hospital, placed on vent.   Vent dc'd 09/08/2021 and she died.   Spoke with a person who received the same lot # of vaccine, same date, given just prior to and she also tested positive for covid on 09/05/2021 and was in ER on that date. Neither of them had any common friends or had been in the same location."
	"1843324-1"	"1843324-1"	"RESUSCITATION"	"10038749"	"50-59 years"	"50-59"	"headache started 36 hrs post vaccine and continued.  Symptoms seemed to get worse daily including general malaise, sinus congestion, body aches and fever started 09/05/2021.  Home tested 09/06/2021 positive for covid.  Up uintil then she had remained alert and oriented.  Husband noticed change in breathing at approx 1000 on 09/06/2021 and attempted to get her up to go to hospital when she went  into respiratory arrest.  911 called and CPR initiated.  Was eventually helicopter transported to hospital, placed on vent.   Vent dc'd 09/08/2021 and she died.   Spoke with a person who received the same lot # of vaccine, same date, given just prior to and she also tested positive for covid on 09/05/2021 and was in ER on that date. Neither of them had any common friends or had been in the same location."
	"1843324-1"	"1843324-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"headache started 36 hrs post vaccine and continued.  Symptoms seemed to get worse daily including general malaise, sinus congestion, body aches and fever started 09/05/2021.  Home tested 09/06/2021 positive for covid.  Up uintil then she had remained alert and oriented.  Husband noticed change in breathing at approx 1000 on 09/06/2021 and attempted to get her up to go to hospital when she went  into respiratory arrest.  911 called and CPR initiated.  Was eventually helicopter transported to hospital, placed on vent.   Vent dc'd 09/08/2021 and she died.   Spoke with a person who received the same lot # of vaccine, same date, given just prior to and she also tested positive for covid on 09/05/2021 and was in ER on that date. Neither of them had any common friends or had been in the same location."
	"1843324-1"	"1843324-1"	"SINUS CONGESTION"	"10040742"	"50-59 years"	"50-59"	"headache started 36 hrs post vaccine and continued.  Symptoms seemed to get worse daily including general malaise, sinus congestion, body aches and fever started 09/05/2021.  Home tested 09/06/2021 positive for covid.  Up uintil then she had remained alert and oriented.  Husband noticed change in breathing at approx 1000 on 09/06/2021 and attempted to get her up to go to hospital when she went  into respiratory arrest.  911 called and CPR initiated.  Was eventually helicopter transported to hospital, placed on vent.   Vent dc'd 09/08/2021 and she died.   Spoke with a person who received the same lot # of vaccine, same date, given just prior to and she also tested positive for covid on 09/05/2021 and was in ER on that date. Neither of them had any common friends or had been in the same location."
	"1845305-1"	"1845305-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"passed away from Covid-19 Pneumonia 24OCT2021; Caught Covid-19 20OCT2021/Mom developed a cough; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of COVID-19 PNEUMONIA (passed away from Covid-19 Pneumonia 24OCT2021) and COVID-19 (Caught Covid-19 20OCT2021/Mom developed a cough) in a 58-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 040A21A and 016M20A) for COVID-19 vaccination.     No Medical History information was reported.   On 13-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 23-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 20-Oct-2021,  after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced COVID-19 (Caught Covid-19 20OCT2021/Mom developed a cough) (seriousness criterion hospitalization). On 24-Oct-2021, the patient experienced COVID-19 PNEUMONIA (passed away from Covid-19 Pneumonia 24OCT2021) (seriousness criteria death, hospitalization and medically significant). The patient died on 24-Oct-2021. The reported cause of death was COVID-19 pneumonia. It is unknown if an autopsy was performed. At the time of death, COVID-19 (Caught Covid-19 20OCT2021/Mom developed a cough) outcome was unknown.            No Concomitant medication were provided by the reporter  No treatment medications were provided by the reporter  This case concerns a 58-year-old, female patient with no relevant medical history reported, who experienced the unexpected events of COVID-19 Pneumonia and COVID-19. The events occurred 6 months and 28 days after the second dose of mRNA-1273 had a fatal outcome, with death occurring the following day. No autopsy report was disclosed. The rechallenge was not applicable since the events happened after the second dose. The benefit-risk relationship of mRNA-1273 in not affected by this report.   This case was linked to MOD-2021-365577 (Patient Link).; Sender's Comments: This case concerns a 58-year-old, female patient with no relevant medical history reported, who experienced the unexpected events of COVID-19 Pneumonia and COVID-19. The events occurred 6 months and 28 days after the second dose of mRNA-1273 had a fatal outcome, with death occurring the following day. No autopsy report was disclosed. The rechallenge was not applicable since the events happened after the second dose. The benefit-risk relationship of mRNA-1273 in not affected by this report.; Reported Cause(s) of Death: COVID-19 pneumonia"
	"1845305-1"	"1845305-1"	"COVID-19 PNEUMONIA"	"10084380"	"50-59 years"	"50-59"	"passed away from Covid-19 Pneumonia 24OCT2021; Caught Covid-19 20OCT2021/Mom developed a cough; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of COVID-19 PNEUMONIA (passed away from Covid-19 Pneumonia 24OCT2021) and COVID-19 (Caught Covid-19 20OCT2021/Mom developed a cough) in a 58-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 040A21A and 016M20A) for COVID-19 vaccination.     No Medical History information was reported.   On 13-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 23-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 20-Oct-2021,  after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced COVID-19 (Caught Covid-19 20OCT2021/Mom developed a cough) (seriousness criterion hospitalization). On 24-Oct-2021, the patient experienced COVID-19 PNEUMONIA (passed away from Covid-19 Pneumonia 24OCT2021) (seriousness criteria death, hospitalization and medically significant). The patient died on 24-Oct-2021. The reported cause of death was COVID-19 pneumonia. It is unknown if an autopsy was performed. At the time of death, COVID-19 (Caught Covid-19 20OCT2021/Mom developed a cough) outcome was unknown.            No Concomitant medication were provided by the reporter  No treatment medications were provided by the reporter  This case concerns a 58-year-old, female patient with no relevant medical history reported, who experienced the unexpected events of COVID-19 Pneumonia and COVID-19. The events occurred 6 months and 28 days after the second dose of mRNA-1273 had a fatal outcome, with death occurring the following day. No autopsy report was disclosed. The rechallenge was not applicable since the events happened after the second dose. The benefit-risk relationship of mRNA-1273 in not affected by this report.   This case was linked to MOD-2021-365577 (Patient Link).; Sender's Comments: This case concerns a 58-year-old, female patient with no relevant medical history reported, who experienced the unexpected events of COVID-19 Pneumonia and COVID-19. The events occurred 6 months and 28 days after the second dose of mRNA-1273 had a fatal outcome, with death occurring the following day. No autopsy report was disclosed. The rechallenge was not applicable since the events happened after the second dose. The benefit-risk relationship of mRNA-1273 in not affected by this report.; Reported Cause(s) of Death: COVID-19 pneumonia"
	"1846241-1"	"1846241-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Individual had breakthrough infection and expired."
	"1846241-1"	"1846241-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Individual had breakthrough infection and expired."
	"1846241-1"	"1846241-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"Individual had breakthrough infection and expired."
	"1846241-1"	"1846241-1"	"VACCINE BREAKTHROUGH INFECTION"	"10067923"	"50-59 years"	"50-59"	"Individual had breakthrough infection and expired."
	"1846342-1"	"1846342-1"	"BLOOD GLUCOSE INCREASED"	"10005557"	"50-59 years"	"50-59"	"pt diagnosed positive for COVID by PCP; pt presents to ED afterwards c/o myalgias x 4 days; BS was greatly elevated in the ED; DKA; admitted to hospital; AHRF secondary to COVID pneumonia; intubated on mechanical ventilation with prone positioning; pt's condition declined and he passed away in the hospital"
	"1846342-1"	"1846342-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"pt diagnosed positive for COVID by PCP; pt presents to ED afterwards c/o myalgias x 4 days; BS was greatly elevated in the ED; DKA; admitted to hospital; AHRF secondary to COVID pneumonia; intubated on mechanical ventilation with prone positioning; pt's condition declined and he passed away in the hospital"
	"1846342-1"	"1846342-1"	"COVID-19 PNEUMONIA"	"10084380"	"50-59 years"	"50-59"	"pt diagnosed positive for COVID by PCP; pt presents to ED afterwards c/o myalgias x 4 days; BS was greatly elevated in the ED; DKA; admitted to hospital; AHRF secondary to COVID pneumonia; intubated on mechanical ventilation with prone positioning; pt's condition declined and he passed away in the hospital"
	"1846342-1"	"1846342-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"pt diagnosed positive for COVID by PCP; pt presents to ED afterwards c/o myalgias x 4 days; BS was greatly elevated in the ED; DKA; admitted to hospital; AHRF secondary to COVID pneumonia; intubated on mechanical ventilation with prone positioning; pt's condition declined and he passed away in the hospital"
	"1846342-1"	"1846342-1"	"DIABETIC KETOACIDOSIS"	"10012671"	"50-59 years"	"50-59"	"pt diagnosed positive for COVID by PCP; pt presents to ED afterwards c/o myalgias x 4 days; BS was greatly elevated in the ED; DKA; admitted to hospital; AHRF secondary to COVID pneumonia; intubated on mechanical ventilation with prone positioning; pt's condition declined and he passed away in the hospital"
	"1846342-1"	"1846342-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"50-59 years"	"50-59"	"pt diagnosed positive for COVID by PCP; pt presents to ED afterwards c/o myalgias x 4 days; BS was greatly elevated in the ED; DKA; admitted to hospital; AHRF secondary to COVID pneumonia; intubated on mechanical ventilation with prone positioning; pt's condition declined and he passed away in the hospital"
	"1846342-1"	"1846342-1"	"GENERAL PHYSICAL HEALTH DETERIORATION"	"10049438"	"50-59 years"	"50-59"	"pt diagnosed positive for COVID by PCP; pt presents to ED afterwards c/o myalgias x 4 days; BS was greatly elevated in the ED; DKA; admitted to hospital; AHRF secondary to COVID pneumonia; intubated on mechanical ventilation with prone positioning; pt's condition declined and he passed away in the hospital"
	"1846342-1"	"1846342-1"	"MECHANICAL VENTILATION"	"10067221"	"50-59 years"	"50-59"	"pt diagnosed positive for COVID by PCP; pt presents to ED afterwards c/o myalgias x 4 days; BS was greatly elevated in the ED; DKA; admitted to hospital; AHRF secondary to COVID pneumonia; intubated on mechanical ventilation with prone positioning; pt's condition declined and he passed away in the hospital"
	"1846342-1"	"1846342-1"	"MYALGIA"	"10028411"	"50-59 years"	"50-59"	"pt diagnosed positive for COVID by PCP; pt presents to ED afterwards c/o myalgias x 4 days; BS was greatly elevated in the ED; DKA; admitted to hospital; AHRF secondary to COVID pneumonia; intubated on mechanical ventilation with prone positioning; pt's condition declined and he passed away in the hospital"
	"1846342-1"	"1846342-1"	"RESPIRATORY FAILURE"	"10038695"	"50-59 years"	"50-59"	"pt diagnosed positive for COVID by PCP; pt presents to ED afterwards c/o myalgias x 4 days; BS was greatly elevated in the ED; DKA; admitted to hospital; AHRF secondary to COVID pneumonia; intubated on mechanical ventilation with prone positioning; pt's condition declined and he passed away in the hospital"
	"1846342-1"	"1846342-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"pt diagnosed positive for COVID by PCP; pt presents to ED afterwards c/o myalgias x 4 days; BS was greatly elevated in the ED; DKA; admitted to hospital; AHRF secondary to COVID pneumonia; intubated on mechanical ventilation with prone positioning; pt's condition declined and he passed away in the hospital"
	"1846534-1"	"1846534-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Individual had a breakthrough infection and expired."
	"1846534-1"	"1846534-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Individual had a breakthrough infection and expired."
	"1846534-1"	"1846534-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"Individual had a breakthrough infection and expired."
	"1846534-1"	"1846534-1"	"VACCINE BREAKTHROUGH INFECTION"	"10067923"	"50-59 years"	"50-59"	"Individual had a breakthrough infection and expired."
	"1848220-1"	"1848220-1"	"AUTOPSY"	"10050117"	"50-59 years"	"50-59"	"She was completely fine before the vaccine. The morning after, she started having trouble breathing. It attacked her heart, caused inflammation of the heart, until it forced fluid into the lungs (because of the failing heart), making it impossible for her to breathe. She died. We found our loved one on the ground, where she'd been laying in the hot sun for hours, where she'd tried desperately to get air in. She was blue, foaming at the mouth, from the fluid pushed into her lungs. By 1:00pm, less than 12 hours after getting the vaccine, my sister was dead."
	"1848220-1"	"1848220-1"	"CYANOSIS"	"10011703"	"50-59 years"	"50-59"	"She was completely fine before the vaccine. The morning after, she started having trouble breathing. It attacked her heart, caused inflammation of the heart, until it forced fluid into the lungs (because of the failing heart), making it impossible for her to breathe. She died. We found our loved one on the ground, where she'd been laying in the hot sun for hours, where she'd tried desperately to get air in. She was blue, foaming at the mouth, from the fluid pushed into her lungs. By 1:00pm, less than 12 hours after getting the vaccine, my sister was dead."
	"1848220-1"	"1848220-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"She was completely fine before the vaccine. The morning after, she started having trouble breathing. It attacked her heart, caused inflammation of the heart, until it forced fluid into the lungs (because of the failing heart), making it impossible for her to breathe. She died. We found our loved one on the ground, where she'd been laying in the hot sun for hours, where she'd tried desperately to get air in. She was blue, foaming at the mouth, from the fluid pushed into her lungs. By 1:00pm, less than 12 hours after getting the vaccine, my sister was dead."
	"1848220-1"	"1848220-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"She was completely fine before the vaccine. The morning after, she started having trouble breathing. It attacked her heart, caused inflammation of the heart, until it forced fluid into the lungs (because of the failing heart), making it impossible for her to breathe. She died. We found our loved one on the ground, where she'd been laying in the hot sun for hours, where she'd tried desperately to get air in. She was blue, foaming at the mouth, from the fluid pushed into her lungs. By 1:00pm, less than 12 hours after getting the vaccine, my sister was dead."
	"1848220-1"	"1848220-1"	"FOAMING AT MOUTH"	"10062654"	"50-59 years"	"50-59"	"She was completely fine before the vaccine. The morning after, she started having trouble breathing. It attacked her heart, caused inflammation of the heart, until it forced fluid into the lungs (because of the failing heart), making it impossible for her to breathe. She died. We found our loved one on the ground, where she'd been laying in the hot sun for hours, where she'd tried desperately to get air in. She was blue, foaming at the mouth, from the fluid pushed into her lungs. By 1:00pm, less than 12 hours after getting the vaccine, my sister was dead."
	"1848220-1"	"1848220-1"	"MYOCARDITIS"	"10028606"	"50-59 years"	"50-59"	"She was completely fine before the vaccine. The morning after, she started having trouble breathing. It attacked her heart, caused inflammation of the heart, until it forced fluid into the lungs (because of the failing heart), making it impossible for her to breathe. She died. We found our loved one on the ground, where she'd been laying in the hot sun for hours, where she'd tried desperately to get air in. She was blue, foaming at the mouth, from the fluid pushed into her lungs. By 1:00pm, less than 12 hours after getting the vaccine, my sister was dead."
	"1848220-1"	"1848220-1"	"PULMONARY OEDEMA"	"10037423"	"50-59 years"	"50-59"	"She was completely fine before the vaccine. The morning after, she started having trouble breathing. It attacked her heart, caused inflammation of the heart, until it forced fluid into the lungs (because of the failing heart), making it impossible for her to breathe. She died. We found our loved one on the ground, where she'd been laying in the hot sun for hours, where she'd tried desperately to get air in. She was blue, foaming at the mouth, from the fluid pushed into her lungs. By 1:00pm, less than 12 hours after getting the vaccine, my sister was dead."
	"1850464-1"	"1850464-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Pt was found deceased at home on 11/06/2021."
	"1850726-1"	"1850726-1"	"APHASIA"	"10002948"	"50-59 years"	"50-59"	"Headache, body aches, complained about not being able to get out of bed, couldn't talk, suffered heart attack."
	"1850726-1"	"1850726-1"	"HEADACHE"	"10019211"	"50-59 years"	"50-59"	"Headache, body aches, complained about not being able to get out of bed, couldn't talk, suffered heart attack."
	"1850726-1"	"1850726-1"	"MOBILITY DECREASED"	"10048334"	"50-59 years"	"50-59"	"Headache, body aches, complained about not being able to get out of bed, couldn't talk, suffered heart attack."
	"1850726-1"	"1850726-1"	"MYOCARDIAL INFARCTION"	"10028596"	"50-59 years"	"50-59"	"Headache, body aches, complained about not being able to get out of bed, couldn't talk, suffered heart attack."
	"1850726-1"	"1850726-1"	"PAIN"	"10033371"	"50-59 years"	"50-59"	"Headache, body aches, complained about not being able to get out of bed, couldn't talk, suffered heart attack."
	"1850726-1"	"1850726-1"	"RESUSCITATION"	"10038749"	"50-59 years"	"50-59"	"Headache, body aches, complained about not being able to get out of bed, couldn't talk, suffered heart attack."
	"1850960-1"	"1850960-1"	"ACUTE MYOCARDIAL INFARCTION"	"10000891"	"50-59 years"	"50-59"	"Admitted to hospital on 11/5/2021 with community acquired pneumonia, COPD exacerbation, benign essential htn, on 11/5/2021.  On 11/7 developed acute STEMI, likely RV infarct at ~8am.  Code STEMI, transferred to hospital for emergent cardiac cath, possible PCI.  Noted to have cardiogenic shock, respiratory failure, Acute mycodardial infarct, lactic acidosis, which was deemed non-survivable.  Expired at 1:25 pm on 11/7/2021"
	"1850960-1"	"1850960-1"	"CARDIAC INDEX DECREASED"	"10007577"	"50-59 years"	"50-59"	"Admitted to hospital on 11/5/2021 with community acquired pneumonia, COPD exacerbation, benign essential htn, on 11/5/2021.  On 11/7 developed acute STEMI, likely RV infarct at ~8am.  Code STEMI, transferred to hospital for emergent cardiac cath, possible PCI.  Noted to have cardiogenic shock, respiratory failure, Acute mycodardial infarct, lactic acidosis, which was deemed non-survivable.  Expired at 1:25 pm on 11/7/2021"
	"1850960-1"	"1850960-1"	"CARDIOGENIC SHOCK"	"10007625"	"50-59 years"	"50-59"	"Admitted to hospital on 11/5/2021 with community acquired pneumonia, COPD exacerbation, benign essential htn, on 11/5/2021.  On 11/7 developed acute STEMI, likely RV infarct at ~8am.  Code STEMI, transferred to hospital for emergent cardiac cath, possible PCI.  Noted to have cardiogenic shock, respiratory failure, Acute mycodardial infarct, lactic acidosis, which was deemed non-survivable.  Expired at 1:25 pm on 11/7/2021"
	"1850960-1"	"1850960-1"	"CATHETERISATION CARDIAC ABNORMAL"	"10007816"	"50-59 years"	"50-59"	"Admitted to hospital on 11/5/2021 with community acquired pneumonia, COPD exacerbation, benign essential htn, on 11/5/2021.  On 11/7 developed acute STEMI, likely RV infarct at ~8am.  Code STEMI, transferred to hospital for emergent cardiac cath, possible PCI.  Noted to have cardiogenic shock, respiratory failure, Acute mycodardial infarct, lactic acidosis, which was deemed non-survivable.  Expired at 1:25 pm on 11/7/2021"
	"1850960-1"	"1850960-1"	"CHRONIC OBSTRUCTIVE PULMONARY DISEASE"	"10009033"	"50-59 years"	"50-59"	"Admitted to hospital on 11/5/2021 with community acquired pneumonia, COPD exacerbation, benign essential htn, on 11/5/2021.  On 11/7 developed acute STEMI, likely RV infarct at ~8am.  Code STEMI, transferred to hospital for emergent cardiac cath, possible PCI.  Noted to have cardiogenic shock, respiratory failure, Acute mycodardial infarct, lactic acidosis, which was deemed non-survivable.  Expired at 1:25 pm on 11/7/2021"
	"1850960-1"	"1850960-1"	"CONDITION AGGRAVATED"	"10010264"	"50-59 years"	"50-59"	"Admitted to hospital on 11/5/2021 with community acquired pneumonia, COPD exacerbation, benign essential htn, on 11/5/2021.  On 11/7 developed acute STEMI, likely RV infarct at ~8am.  Code STEMI, transferred to hospital for emergent cardiac cath, possible PCI.  Noted to have cardiogenic shock, respiratory failure, Acute mycodardial infarct, lactic acidosis, which was deemed non-survivable.  Expired at 1:25 pm on 11/7/2021"
	"1850960-1"	"1850960-1"	"CORONARY ARTERY OCCLUSION"	"10011086"	"50-59 years"	"50-59"	"Admitted to hospital on 11/5/2021 with community acquired pneumonia, COPD exacerbation, benign essential htn, on 11/5/2021.  On 11/7 developed acute STEMI, likely RV infarct at ~8am.  Code STEMI, transferred to hospital for emergent cardiac cath, possible PCI.  Noted to have cardiogenic shock, respiratory failure, Acute mycodardial infarct, lactic acidosis, which was deemed non-survivable.  Expired at 1:25 pm on 11/7/2021"
	"1850960-1"	"1850960-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Admitted to hospital on 11/5/2021 with community acquired pneumonia, COPD exacerbation, benign essential htn, on 11/5/2021.  On 11/7 developed acute STEMI, likely RV infarct at ~8am.  Code STEMI, transferred to hospital for emergent cardiac cath, possible PCI.  Noted to have cardiogenic shock, respiratory failure, Acute mycodardial infarct, lactic acidosis, which was deemed non-survivable.  Expired at 1:25 pm on 11/7/2021"
	"1850960-1"	"1850960-1"	"ESSENTIAL HYPERTENSION"	"10015488"	"50-59 years"	"50-59"	"Admitted to hospital on 11/5/2021 with community acquired pneumonia, COPD exacerbation, benign essential htn, on 11/5/2021.  On 11/7 developed acute STEMI, likely RV infarct at ~8am.  Code STEMI, transferred to hospital for emergent cardiac cath, possible PCI.  Noted to have cardiogenic shock, respiratory failure, Acute mycodardial infarct, lactic acidosis, which was deemed non-survivable.  Expired at 1:25 pm on 11/7/2021"
	"1850960-1"	"1850960-1"	"LACTIC ACIDOSIS"	"10023676"	"50-59 years"	"50-59"	"Admitted to hospital on 11/5/2021 with community acquired pneumonia, COPD exacerbation, benign essential htn, on 11/5/2021.  On 11/7 developed acute STEMI, likely RV infarct at ~8am.  Code STEMI, transferred to hospital for emergent cardiac cath, possible PCI.  Noted to have cardiogenic shock, respiratory failure, Acute mycodardial infarct, lactic acidosis, which was deemed non-survivable.  Expired at 1:25 pm on 11/7/2021"
	"1850960-1"	"1850960-1"	"MULTIPLE ORGAN DYSFUNCTION SYNDROME"	"10077361"	"50-59 years"	"50-59"	"Admitted to hospital on 11/5/2021 with community acquired pneumonia, COPD exacerbation, benign essential htn, on 11/5/2021.  On 11/7 developed acute STEMI, likely RV infarct at ~8am.  Code STEMI, transferred to hospital for emergent cardiac cath, possible PCI.  Noted to have cardiogenic shock, respiratory failure, Acute mycodardial infarct, lactic acidosis, which was deemed non-survivable.  Expired at 1:25 pm on 11/7/2021"
	"1850960-1"	"1850960-1"	"PNEUMONIA"	"10035664"	"50-59 years"	"50-59"	"Admitted to hospital on 11/5/2021 with community acquired pneumonia, COPD exacerbation, benign essential htn, on 11/5/2021.  On 11/7 developed acute STEMI, likely RV infarct at ~8am.  Code STEMI, transferred to hospital for emergent cardiac cath, possible PCI.  Noted to have cardiogenic shock, respiratory failure, Acute mycodardial infarct, lactic acidosis, which was deemed non-survivable.  Expired at 1:25 pm on 11/7/2021"
	"1850960-1"	"1850960-1"	"RESPIRATORY FAILURE"	"10038695"	"50-59 years"	"50-59"	"Admitted to hospital on 11/5/2021 with community acquired pneumonia, COPD exacerbation, benign essential htn, on 11/5/2021.  On 11/7 developed acute STEMI, likely RV infarct at ~8am.  Code STEMI, transferred to hospital for emergent cardiac cath, possible PCI.  Noted to have cardiogenic shock, respiratory failure, Acute mycodardial infarct, lactic acidosis, which was deemed non-survivable.  Expired at 1:25 pm on 11/7/2021"
	"1851630-1"	"1851630-1"	"CEREBRAL HAEMORRHAGE"	"10008111"	"50-59 years"	"50-59"	"On 09/17/2021, exactly 8 days after patient's first injection of Pfizer Covid-19 vaccine, the patient suddenly had numb hands and left side of face was droopy.  I called 911. Patient became unresponsive in the ambulance and required intubation. CT results determined that he suffered a wet stroke from a massive brain bleed on the right side of brain. He died the next day on  09/18/2021"
	"1851630-1"	"1851630-1"	"CEREBROVASCULAR ACCIDENT"	"10008190"	"50-59 years"	"50-59"	"On 09/17/2021, exactly 8 days after patient's first injection of Pfizer Covid-19 vaccine, the patient suddenly had numb hands and left side of face was droopy.  I called 911. Patient became unresponsive in the ambulance and required intubation. CT results determined that he suffered a wet stroke from a massive brain bleed on the right side of brain. He died the next day on  09/18/2021"
	"1851630-1"	"1851630-1"	"COMPUTERISED TOMOGRAM HEAD ABNORMAL"	"10072168"	"50-59 years"	"50-59"	"On 09/17/2021, exactly 8 days after patient's first injection of Pfizer Covid-19 vaccine, the patient suddenly had numb hands and left side of face was droopy.  I called 911. Patient became unresponsive in the ambulance and required intubation. CT results determined that he suffered a wet stroke from a massive brain bleed on the right side of brain. He died the next day on  09/18/2021"
	"1851630-1"	"1851630-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"On 09/17/2021, exactly 8 days after patient's first injection of Pfizer Covid-19 vaccine, the patient suddenly had numb hands and left side of face was droopy.  I called 911. Patient became unresponsive in the ambulance and required intubation. CT results determined that he suffered a wet stroke from a massive brain bleed on the right side of brain. He died the next day on  09/18/2021"
	"1851630-1"	"1851630-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"50-59 years"	"50-59"	"On 09/17/2021, exactly 8 days after patient's first injection of Pfizer Covid-19 vaccine, the patient suddenly had numb hands and left side of face was droopy.  I called 911. Patient became unresponsive in the ambulance and required intubation. CT results determined that he suffered a wet stroke from a massive brain bleed on the right side of brain. He died the next day on  09/18/2021"
	"1851630-1"	"1851630-1"	"FACIAL PARALYSIS"	"10016062"	"50-59 years"	"50-59"	"On 09/17/2021, exactly 8 days after patient's first injection of Pfizer Covid-19 vaccine, the patient suddenly had numb hands and left side of face was droopy.  I called 911. Patient became unresponsive in the ambulance and required intubation. CT results determined that he suffered a wet stroke from a massive brain bleed on the right side of brain. He died the next day on  09/18/2021"
	"1851630-1"	"1851630-1"	"HYPOAESTHESIA"	"10020937"	"50-59 years"	"50-59"	"On 09/17/2021, exactly 8 days after patient's first injection of Pfizer Covid-19 vaccine, the patient suddenly had numb hands and left side of face was droopy.  I called 911. Patient became unresponsive in the ambulance and required intubation. CT results determined that he suffered a wet stroke from a massive brain bleed on the right side of brain. He died the next day on  09/18/2021"
	"1851630-1"	"1851630-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"50-59 years"	"50-59"	"On 09/17/2021, exactly 8 days after patient's first injection of Pfizer Covid-19 vaccine, the patient suddenly had numb hands and left side of face was droopy.  I called 911. Patient became unresponsive in the ambulance and required intubation. CT results determined that he suffered a wet stroke from a massive brain bleed on the right side of brain. He died the next day on  09/18/2021"
	"1854042-1"	"1854042-1"	"ANTICOAGULANT THERAPY"	"10053468"	"50-59 years"	"50-59"	"Had been previously admitted from 8/27-8/31 with +COVID and acute hypoxemia and discharged with good oxygenation on dexamethasone and levoquin for UTI.  Admitted again on 9/2 due to worsening dyspnea from covid pneumonia. Treated with zyvox and zosyn on high flow oxygen. Continued to decline and admitted to ICU on 9/3 and intubated. Given remdesevir and continues steroids. Found bilateral IJ and subclavian vein thrombosis. Transitioned from eliquis to lovenox. Unable to be weaned from the ventilator. Family involved in care and transitioned patient to comfort care and patient was extubated and passed on 9/11/21."
	"1854042-1"	"1854042-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Had been previously admitted from 8/27-8/31 with +COVID and acute hypoxemia and discharged with good oxygenation on dexamethasone and levoquin for UTI.  Admitted again on 9/2 due to worsening dyspnea from covid pneumonia. Treated with zyvox and zosyn on high flow oxygen. Continued to decline and admitted to ICU on 9/3 and intubated. Given remdesevir and continues steroids. Found bilateral IJ and subclavian vein thrombosis. Transitioned from eliquis to lovenox. Unable to be weaned from the ventilator. Family involved in care and transitioned patient to comfort care and patient was extubated and passed on 9/11/21."
	"1854042-1"	"1854042-1"	"COVID-19 PNEUMONIA"	"10084380"	"50-59 years"	"50-59"	"Had been previously admitted from 8/27-8/31 with +COVID and acute hypoxemia and discharged with good oxygenation on dexamethasone and levoquin for UTI.  Admitted again on 9/2 due to worsening dyspnea from covid pneumonia. Treated with zyvox and zosyn on high flow oxygen. Continued to decline and admitted to ICU on 9/3 and intubated. Given remdesevir and continues steroids. Found bilateral IJ and subclavian vein thrombosis. Transitioned from eliquis to lovenox. Unable to be weaned from the ventilator. Family involved in care and transitioned patient to comfort care and patient was extubated and passed on 9/11/21."
	"1854042-1"	"1854042-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Had been previously admitted from 8/27-8/31 with +COVID and acute hypoxemia and discharged with good oxygenation on dexamethasone and levoquin for UTI.  Admitted again on 9/2 due to worsening dyspnea from covid pneumonia. Treated with zyvox and zosyn on high flow oxygen. Continued to decline and admitted to ICU on 9/3 and intubated. Given remdesevir and continues steroids. Found bilateral IJ and subclavian vein thrombosis. Transitioned from eliquis to lovenox. Unable to be weaned from the ventilator. Family involved in care and transitioned patient to comfort care and patient was extubated and passed on 9/11/21."
	"1854042-1"	"1854042-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"Had been previously admitted from 8/27-8/31 with +COVID and acute hypoxemia and discharged with good oxygenation on dexamethasone and levoquin for UTI.  Admitted again on 9/2 due to worsening dyspnea from covid pneumonia. Treated with zyvox and zosyn on high flow oxygen. Continued to decline and admitted to ICU on 9/3 and intubated. Given remdesevir and continues steroids. Found bilateral IJ and subclavian vein thrombosis. Transitioned from eliquis to lovenox. Unable to be weaned from the ventilator. Family involved in care and transitioned patient to comfort care and patient was extubated and passed on 9/11/21."
	"1854042-1"	"1854042-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"50-59 years"	"50-59"	"Had been previously admitted from 8/27-8/31 with +COVID and acute hypoxemia and discharged with good oxygenation on dexamethasone and levoquin for UTI.  Admitted again on 9/2 due to worsening dyspnea from covid pneumonia. Treated with zyvox and zosyn on high flow oxygen. Continued to decline and admitted to ICU on 9/3 and intubated. Given remdesevir and continues steroids. Found bilateral IJ and subclavian vein thrombosis. Transitioned from eliquis to lovenox. Unable to be weaned from the ventilator. Family involved in care and transitioned patient to comfort care and patient was extubated and passed on 9/11/21."
	"1854042-1"	"1854042-1"	"GENERAL PHYSICAL HEALTH DETERIORATION"	"10049438"	"50-59 years"	"50-59"	"Had been previously admitted from 8/27-8/31 with +COVID and acute hypoxemia and discharged with good oxygenation on dexamethasone and levoquin for UTI.  Admitted again on 9/2 due to worsening dyspnea from covid pneumonia. Treated with zyvox and zosyn on high flow oxygen. Continued to decline and admitted to ICU on 9/3 and intubated. Given remdesevir and continues steroids. Found bilateral IJ and subclavian vein thrombosis. Transitioned from eliquis to lovenox. Unable to be weaned from the ventilator. Family involved in care and transitioned patient to comfort care and patient was extubated and passed on 9/11/21."
	"1854042-1"	"1854042-1"	"HYPOXIA"	"10021143"	"50-59 years"	"50-59"	"Had been previously admitted from 8/27-8/31 with +COVID and acute hypoxemia and discharged with good oxygenation on dexamethasone and levoquin for UTI.  Admitted again on 9/2 due to worsening dyspnea from covid pneumonia. Treated with zyvox and zosyn on high flow oxygen. Continued to decline and admitted to ICU on 9/3 and intubated. Given remdesevir and continues steroids. Found bilateral IJ and subclavian vein thrombosis. Transitioned from eliquis to lovenox. Unable to be weaned from the ventilator. Family involved in care and transitioned patient to comfort care and patient was extubated and passed on 9/11/21."
	"1854042-1"	"1854042-1"	"INTENSIVE CARE"	"10022519"	"50-59 years"	"50-59"	"Had been previously admitted from 8/27-8/31 with +COVID and acute hypoxemia and discharged with good oxygenation on dexamethasone and levoquin for UTI.  Admitted again on 9/2 due to worsening dyspnea from covid pneumonia. Treated with zyvox and zosyn on high flow oxygen. Continued to decline and admitted to ICU on 9/3 and intubated. Given remdesevir and continues steroids. Found bilateral IJ and subclavian vein thrombosis. Transitioned from eliquis to lovenox. Unable to be weaned from the ventilator. Family involved in care and transitioned patient to comfort care and patient was extubated and passed on 9/11/21."
	"1854042-1"	"1854042-1"	"JUGULAR VEIN THROMBOSIS"	"10023237"	"50-59 years"	"50-59"	"Had been previously admitted from 8/27-8/31 with +COVID and acute hypoxemia and discharged with good oxygenation on dexamethasone and levoquin for UTI.  Admitted again on 9/2 due to worsening dyspnea from covid pneumonia. Treated with zyvox and zosyn on high flow oxygen. Continued to decline and admitted to ICU on 9/3 and intubated. Given remdesevir and continues steroids. Found bilateral IJ and subclavian vein thrombosis. Transitioned from eliquis to lovenox. Unable to be weaned from the ventilator. Family involved in care and transitioned patient to comfort care and patient was extubated and passed on 9/11/21."
	"1854042-1"	"1854042-1"	"MECHANICAL VENTILATION"	"10067221"	"50-59 years"	"50-59"	"Had been previously admitted from 8/27-8/31 with +COVID and acute hypoxemia and discharged with good oxygenation on dexamethasone and levoquin for UTI.  Admitted again on 9/2 due to worsening dyspnea from covid pneumonia. Treated with zyvox and zosyn on high flow oxygen. Continued to decline and admitted to ICU on 9/3 and intubated. Given remdesevir and continues steroids. Found bilateral IJ and subclavian vein thrombosis. Transitioned from eliquis to lovenox. Unable to be weaned from the ventilator. Family involved in care and transitioned patient to comfort care and patient was extubated and passed on 9/11/21."
	"1854042-1"	"1854042-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"Had been previously admitted from 8/27-8/31 with +COVID and acute hypoxemia and discharged with good oxygenation on dexamethasone and levoquin for UTI.  Admitted again on 9/2 due to worsening dyspnea from covid pneumonia. Treated with zyvox and zosyn on high flow oxygen. Continued to decline and admitted to ICU on 9/3 and intubated. Given remdesevir and continues steroids. Found bilateral IJ and subclavian vein thrombosis. Transitioned from eliquis to lovenox. Unable to be weaned from the ventilator. Family involved in care and transitioned patient to comfort care and patient was extubated and passed on 9/11/21."
	"1854042-1"	"1854042-1"	"SUBCLAVIAN VEIN THROMBOSIS"	"10049446"	"50-59 years"	"50-59"	"Had been previously admitted from 8/27-8/31 with +COVID and acute hypoxemia and discharged with good oxygenation on dexamethasone and levoquin for UTI.  Admitted again on 9/2 due to worsening dyspnea from covid pneumonia. Treated with zyvox and zosyn on high flow oxygen. Continued to decline and admitted to ICU on 9/3 and intubated. Given remdesevir and continues steroids. Found bilateral IJ and subclavian vein thrombosis. Transitioned from eliquis to lovenox. Unable to be weaned from the ventilator. Family involved in care and transitioned patient to comfort care and patient was extubated and passed on 9/11/21."
	"1854042-1"	"1854042-1"	"URINARY TRACT INFECTION"	"10046571"	"50-59 years"	"50-59"	"Had been previously admitted from 8/27-8/31 with +COVID and acute hypoxemia and discharged with good oxygenation on dexamethasone and levoquin for UTI.  Admitted again on 9/2 due to worsening dyspnea from covid pneumonia. Treated with zyvox and zosyn on high flow oxygen. Continued to decline and admitted to ICU on 9/3 and intubated. Given remdesevir and continues steroids. Found bilateral IJ and subclavian vein thrombosis. Transitioned from eliquis to lovenox. Unable to be weaned from the ventilator. Family involved in care and transitioned patient to comfort care and patient was extubated and passed on 9/11/21."
	"1854176-1"	"1854176-1"	"AIRWAY PEAK PRESSURE INCREASED"	"10068853"	"50-59 years"	"50-59"	"Admitted 9/27 due to multi-focal pneumonia, +COVID, No supplemental oxygen needed . Treated for bacterial superimposed infection with omnicef and azythromycin. Requested discharge home on 9/28. Returned to hospital ED on 10/1 with worsening Shortness of breath, O2 saturation 75% on room air and altered mental status. O2 given with saturation up to 95%. Respiratory status continued to decline and intubated on 10/3. Treated for candida with eraxis x 7 days. Due to hx of staph epi bacteremia, porta cath and dialysis tunnel catheter removed 10/5. Pt. in septic shock due to pneumonia. on CRRT due to renal failure. Developed pneumothorax and pneumomediastinum with subsequent chest tube placement x 2. Bronchoscopy on 10/9 due to elevated peak airway pressures. Failed ventilator weaning. Required pressors for each dialysis session. Discussion with family for trach and peg tube placement. Family requested comfort care on 10/14."
	"1854176-1"	"1854176-1"	"BACTERIAL INFECTION"	"10060945"	"50-59 years"	"50-59"	"Admitted 9/27 due to multi-focal pneumonia, +COVID, No supplemental oxygen needed . Treated for bacterial superimposed infection with omnicef and azythromycin. Requested discharge home on 9/28. Returned to hospital ED on 10/1 with worsening Shortness of breath, O2 saturation 75% on room air and altered mental status. O2 given with saturation up to 95%. Respiratory status continued to decline and intubated on 10/3. Treated for candida with eraxis x 7 days. Due to hx of staph epi bacteremia, porta cath and dialysis tunnel catheter removed 10/5. Pt. in septic shock due to pneumonia. on CRRT due to renal failure. Developed pneumothorax and pneumomediastinum with subsequent chest tube placement x 2. Bronchoscopy on 10/9 due to elevated peak airway pressures. Failed ventilator weaning. Required pressors for each dialysis session. Discussion with family for trach and peg tube placement. Family requested comfort care on 10/14."
	"1854176-1"	"1854176-1"	"BRONCHOSCOPY"	"10006479"	"50-59 years"	"50-59"	"Admitted 9/27 due to multi-focal pneumonia, +COVID, No supplemental oxygen needed . Treated for bacterial superimposed infection with omnicef and azythromycin. Requested discharge home on 9/28. Returned to hospital ED on 10/1 with worsening Shortness of breath, O2 saturation 75% on room air and altered mental status. O2 given with saturation up to 95%. Respiratory status continued to decline and intubated on 10/3. Treated for candida with eraxis x 7 days. Due to hx of staph epi bacteremia, porta cath and dialysis tunnel catheter removed 10/5. Pt. in septic shock due to pneumonia. on CRRT due to renal failure. Developed pneumothorax and pneumomediastinum with subsequent chest tube placement x 2. Bronchoscopy on 10/9 due to elevated peak airway pressures. Failed ventilator weaning. Required pressors for each dialysis session. Discussion with family for trach and peg tube placement. Family requested comfort care on 10/14."
	"1854176-1"	"1854176-1"	"CANDIDA INFECTION"	"10074170"	"50-59 years"	"50-59"	"Admitted 9/27 due to multi-focal pneumonia, +COVID, No supplemental oxygen needed . Treated for bacterial superimposed infection with omnicef and azythromycin. Requested discharge home on 9/28. Returned to hospital ED on 10/1 with worsening Shortness of breath, O2 saturation 75% on room air and altered mental status. O2 given with saturation up to 95%. Respiratory status continued to decline and intubated on 10/3. Treated for candida with eraxis x 7 days. Due to hx of staph epi bacteremia, porta cath and dialysis tunnel catheter removed 10/5. Pt. in septic shock due to pneumonia. on CRRT due to renal failure. Developed pneumothorax and pneumomediastinum with subsequent chest tube placement x 2. Bronchoscopy on 10/9 due to elevated peak airway pressures. Failed ventilator weaning. Required pressors for each dialysis session. Discussion with family for trach and peg tube placement. Family requested comfort care on 10/14."
	"1854176-1"	"1854176-1"	"CATHETER REMOVAL"	"10052916"	"50-59 years"	"50-59"	"Admitted 9/27 due to multi-focal pneumonia, +COVID, No supplemental oxygen needed . Treated for bacterial superimposed infection with omnicef and azythromycin. Requested discharge home on 9/28. Returned to hospital ED on 10/1 with worsening Shortness of breath, O2 saturation 75% on room air and altered mental status. O2 given with saturation up to 95%. Respiratory status continued to decline and intubated on 10/3. Treated for candida with eraxis x 7 days. Due to hx of staph epi bacteremia, porta cath and dialysis tunnel catheter removed 10/5. Pt. in septic shock due to pneumonia. on CRRT due to renal failure. Developed pneumothorax and pneumomediastinum with subsequent chest tube placement x 2. Bronchoscopy on 10/9 due to elevated peak airway pressures. Failed ventilator weaning. Required pressors for each dialysis session. Discussion with family for trach and peg tube placement. Family requested comfort care on 10/14."
	"1854176-1"	"1854176-1"	"CENTRAL VENOUS CATHETER REMOVAL"	"10067098"	"50-59 years"	"50-59"	"Admitted 9/27 due to multi-focal pneumonia, +COVID, No supplemental oxygen needed . Treated for bacterial superimposed infection with omnicef and azythromycin. Requested discharge home on 9/28. Returned to hospital ED on 10/1 with worsening Shortness of breath, O2 saturation 75% on room air and altered mental status. O2 given with saturation up to 95%. Respiratory status continued to decline and intubated on 10/3. Treated for candida with eraxis x 7 days. Due to hx of staph epi bacteremia, porta cath and dialysis tunnel catheter removed 10/5. Pt. in septic shock due to pneumonia. on CRRT due to renal failure. Developed pneumothorax and pneumomediastinum with subsequent chest tube placement x 2. Bronchoscopy on 10/9 due to elevated peak airway pressures. Failed ventilator weaning. Required pressors for each dialysis session. Discussion with family for trach and peg tube placement. Family requested comfort care on 10/14."
	"1854176-1"	"1854176-1"	"CHEST TUBE INSERTION"	"10050522"	"50-59 years"	"50-59"	"Admitted 9/27 due to multi-focal pneumonia, +COVID, No supplemental oxygen needed . Treated for bacterial superimposed infection with omnicef and azythromycin. Requested discharge home on 9/28. Returned to hospital ED on 10/1 with worsening Shortness of breath, O2 saturation 75% on room air and altered mental status. O2 given with saturation up to 95%. Respiratory status continued to decline and intubated on 10/3. Treated for candida with eraxis x 7 days. Due to hx of staph epi bacteremia, porta cath and dialysis tunnel catheter removed 10/5. Pt. in septic shock due to pneumonia. on CRRT due to renal failure. Developed pneumothorax and pneumomediastinum with subsequent chest tube placement x 2. Bronchoscopy on 10/9 due to elevated peak airway pressures. Failed ventilator weaning. Required pressors for each dialysis session. Discussion with family for trach and peg tube placement. Family requested comfort care on 10/14."
	"1854176-1"	"1854176-1"	"CONDITION AGGRAVATED"	"10010264"	"50-59 years"	"50-59"	"Admitted 9/27 due to multi-focal pneumonia, +COVID, No supplemental oxygen needed . Treated for bacterial superimposed infection with omnicef and azythromycin. Requested discharge home on 9/28. Returned to hospital ED on 10/1 with worsening Shortness of breath, O2 saturation 75% on room air and altered mental status. O2 given with saturation up to 95%. Respiratory status continued to decline and intubated on 10/3. Treated for candida with eraxis x 7 days. Due to hx of staph epi bacteremia, porta cath and dialysis tunnel catheter removed 10/5. Pt. in septic shock due to pneumonia. on CRRT due to renal failure. Developed pneumothorax and pneumomediastinum with subsequent chest tube placement x 2. Bronchoscopy on 10/9 due to elevated peak airway pressures. Failed ventilator weaning. Required pressors for each dialysis session. Discussion with family for trach and peg tube placement. Family requested comfort care on 10/14."
	"1854176-1"	"1854176-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Admitted 9/27 due to multi-focal pneumonia, +COVID, No supplemental oxygen needed . Treated for bacterial superimposed infection with omnicef and azythromycin. Requested discharge home on 9/28. Returned to hospital ED on 10/1 with worsening Shortness of breath, O2 saturation 75% on room air and altered mental status. O2 given with saturation up to 95%. Respiratory status continued to decline and intubated on 10/3. Treated for candida with eraxis x 7 days. Due to hx of staph epi bacteremia, porta cath and dialysis tunnel catheter removed 10/5. Pt. in septic shock due to pneumonia. on CRRT due to renal failure. Developed pneumothorax and pneumomediastinum with subsequent chest tube placement x 2. Bronchoscopy on 10/9 due to elevated peak airway pressures. Failed ventilator weaning. Required pressors for each dialysis session. Discussion with family for trach and peg tube placement. Family requested comfort care on 10/14."
	"1854176-1"	"1854176-1"	"DIALYSIS"	"10061105"	"50-59 years"	"50-59"	"Admitted 9/27 due to multi-focal pneumonia, +COVID, No supplemental oxygen needed . Treated for bacterial superimposed infection with omnicef and azythromycin. Requested discharge home on 9/28. Returned to hospital ED on 10/1 with worsening Shortness of breath, O2 saturation 75% on room air and altered mental status. O2 given with saturation up to 95%. Respiratory status continued to decline and intubated on 10/3. Treated for candida with eraxis x 7 days. Due to hx of staph epi bacteremia, porta cath and dialysis tunnel catheter removed 10/5. Pt. in septic shock due to pneumonia. on CRRT due to renal failure. Developed pneumothorax and pneumomediastinum with subsequent chest tube placement x 2. Bronchoscopy on 10/9 due to elevated peak airway pressures. Failed ventilator weaning. Required pressors for each dialysis session. Discussion with family for trach and peg tube placement. Family requested comfort care on 10/14."
	"1854176-1"	"1854176-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"Admitted 9/27 due to multi-focal pneumonia, +COVID, No supplemental oxygen needed . Treated for bacterial superimposed infection with omnicef and azythromycin. Requested discharge home on 9/28. Returned to hospital ED on 10/1 with worsening Shortness of breath, O2 saturation 75% on room air and altered mental status. O2 given with saturation up to 95%. Respiratory status continued to decline and intubated on 10/3. Treated for candida with eraxis x 7 days. Due to hx of staph epi bacteremia, porta cath and dialysis tunnel catheter removed 10/5. Pt. in septic shock due to pneumonia. on CRRT due to renal failure. Developed pneumothorax and pneumomediastinum with subsequent chest tube placement x 2. Bronchoscopy on 10/9 due to elevated peak airway pressures. Failed ventilator weaning. Required pressors for each dialysis session. Discussion with family for trach and peg tube placement. Family requested comfort care on 10/14."
	"1854176-1"	"1854176-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"50-59 years"	"50-59"	"Admitted 9/27 due to multi-focal pneumonia, +COVID, No supplemental oxygen needed . Treated for bacterial superimposed infection with omnicef and azythromycin. Requested discharge home on 9/28. Returned to hospital ED on 10/1 with worsening Shortness of breath, O2 saturation 75% on room air and altered mental status. O2 given with saturation up to 95%. Respiratory status continued to decline and intubated on 10/3. Treated for candida with eraxis x 7 days. Due to hx of staph epi bacteremia, porta cath and dialysis tunnel catheter removed 10/5. Pt. in septic shock due to pneumonia. on CRRT due to renal failure. Developed pneumothorax and pneumomediastinum with subsequent chest tube placement x 2. Bronchoscopy on 10/9 due to elevated peak airway pressures. Failed ventilator weaning. Required pressors for each dialysis session. Discussion with family for trach and peg tube placement. Family requested comfort care on 10/14."
	"1854176-1"	"1854176-1"	"HAEMOFILTRATION"	"10053090"	"50-59 years"	"50-59"	"Admitted 9/27 due to multi-focal pneumonia, +COVID, No supplemental oxygen needed . Treated for bacterial superimposed infection with omnicef and azythromycin. Requested discharge home on 9/28. Returned to hospital ED on 10/1 with worsening Shortness of breath, O2 saturation 75% on room air and altered mental status. O2 given with saturation up to 95%. Respiratory status continued to decline and intubated on 10/3. Treated for candida with eraxis x 7 days. Due to hx of staph epi bacteremia, porta cath and dialysis tunnel catheter removed 10/5. Pt. in septic shock due to pneumonia. on CRRT due to renal failure. Developed pneumothorax and pneumomediastinum with subsequent chest tube placement x 2. Bronchoscopy on 10/9 due to elevated peak airway pressures. Failed ventilator weaning. Required pressors for each dialysis session. Discussion with family for trach and peg tube placement. Family requested comfort care on 10/14."
	"1854176-1"	"1854176-1"	"MENTAL STATUS CHANGES"	"10048294"	"50-59 years"	"50-59"	"Admitted 9/27 due to multi-focal pneumonia, +COVID, No supplemental oxygen needed . Treated for bacterial superimposed infection with omnicef and azythromycin. Requested discharge home on 9/28. Returned to hospital ED on 10/1 with worsening Shortness of breath, O2 saturation 75% on room air and altered mental status. O2 given with saturation up to 95%. Respiratory status continued to decline and intubated on 10/3. Treated for candida with eraxis x 7 days. Due to hx of staph epi bacteremia, porta cath and dialysis tunnel catheter removed 10/5. Pt. in septic shock due to pneumonia. on CRRT due to renal failure. Developed pneumothorax and pneumomediastinum with subsequent chest tube placement x 2. Bronchoscopy on 10/9 due to elevated peak airway pressures. Failed ventilator weaning. Required pressors for each dialysis session. Discussion with family for trach and peg tube placement. Family requested comfort care on 10/14."
	"1854176-1"	"1854176-1"	"OXYGEN SATURATION DECREASED"	"10033318"	"50-59 years"	"50-59"	"Admitted 9/27 due to multi-focal pneumonia, +COVID, No supplemental oxygen needed . Treated for bacterial superimposed infection with omnicef and azythromycin. Requested discharge home on 9/28. Returned to hospital ED on 10/1 with worsening Shortness of breath, O2 saturation 75% on room air and altered mental status. O2 given with saturation up to 95%. Respiratory status continued to decline and intubated on 10/3. Treated for candida with eraxis x 7 days. Due to hx of staph epi bacteremia, porta cath and dialysis tunnel catheter removed 10/5. Pt. in septic shock due to pneumonia. on CRRT due to renal failure. Developed pneumothorax and pneumomediastinum with subsequent chest tube placement x 2. Bronchoscopy on 10/9 due to elevated peak airway pressures. Failed ventilator weaning. Required pressors for each dialysis session. Discussion with family for trach and peg tube placement. Family requested comfort care on 10/14."
	"1854176-1"	"1854176-1"	"PNEUMOMEDIASTINUM"	"10050184"	"50-59 years"	"50-59"	"Admitted 9/27 due to multi-focal pneumonia, +COVID, No supplemental oxygen needed . Treated for bacterial superimposed infection with omnicef and azythromycin. Requested discharge home on 9/28. Returned to hospital ED on 10/1 with worsening Shortness of breath, O2 saturation 75% on room air and altered mental status. O2 given with saturation up to 95%. Respiratory status continued to decline and intubated on 10/3. Treated for candida with eraxis x 7 days. Due to hx of staph epi bacteremia, porta cath and dialysis tunnel catheter removed 10/5. Pt. in septic shock due to pneumonia. on CRRT due to renal failure. Developed pneumothorax and pneumomediastinum with subsequent chest tube placement x 2. Bronchoscopy on 10/9 due to elevated peak airway pressures. Failed ventilator weaning. Required pressors for each dialysis session. Discussion with family for trach and peg tube placement. Family requested comfort care on 10/14."
	"1854176-1"	"1854176-1"	"PNEUMONIA"	"10035664"	"50-59 years"	"50-59"	"Admitted 9/27 due to multi-focal pneumonia, +COVID, No supplemental oxygen needed . Treated for bacterial superimposed infection with omnicef and azythromycin. Requested discharge home on 9/28. Returned to hospital ED on 10/1 with worsening Shortness of breath, O2 saturation 75% on room air and altered mental status. O2 given with saturation up to 95%. Respiratory status continued to decline and intubated on 10/3. Treated for candida with eraxis x 7 days. Due to hx of staph epi bacteremia, porta cath and dialysis tunnel catheter removed 10/5. Pt. in septic shock due to pneumonia. on CRRT due to renal failure. Developed pneumothorax and pneumomediastinum with subsequent chest tube placement x 2. Bronchoscopy on 10/9 due to elevated peak airway pressures. Failed ventilator weaning. Required pressors for each dialysis session. Discussion with family for trach and peg tube placement. Family requested comfort care on 10/14."
	"1854176-1"	"1854176-1"	"PNEUMOTHORAX"	"10035759"	"50-59 years"	"50-59"	"Admitted 9/27 due to multi-focal pneumonia, +COVID, No supplemental oxygen needed . Treated for bacterial superimposed infection with omnicef and azythromycin. Requested discharge home on 9/28. Returned to hospital ED on 10/1 with worsening Shortness of breath, O2 saturation 75% on room air and altered mental status. O2 given with saturation up to 95%. Respiratory status continued to decline and intubated on 10/3. Treated for candida with eraxis x 7 days. Due to hx of staph epi bacteremia, porta cath and dialysis tunnel catheter removed 10/5. Pt. in septic shock due to pneumonia. on CRRT due to renal failure. Developed pneumothorax and pneumomediastinum with subsequent chest tube placement x 2. Bronchoscopy on 10/9 due to elevated peak airway pressures. Failed ventilator weaning. Required pressors for each dialysis session. Discussion with family for trach and peg tube placement. Family requested comfort care on 10/14."
	"1854176-1"	"1854176-1"	"RENAL FAILURE"	"10038435"	"50-59 years"	"50-59"	"Admitted 9/27 due to multi-focal pneumonia, +COVID, No supplemental oxygen needed . Treated for bacterial superimposed infection with omnicef and azythromycin. Requested discharge home on 9/28. Returned to hospital ED on 10/1 with worsening Shortness of breath, O2 saturation 75% on room air and altered mental status. O2 given with saturation up to 95%. Respiratory status continued to decline and intubated on 10/3. Treated for candida with eraxis x 7 days. Due to hx of staph epi bacteremia, porta cath and dialysis tunnel catheter removed 10/5. Pt. in septic shock due to pneumonia. on CRRT due to renal failure. Developed pneumothorax and pneumomediastinum with subsequent chest tube placement x 2. Bronchoscopy on 10/9 due to elevated peak airway pressures. Failed ventilator weaning. Required pressors for each dialysis session. Discussion with family for trach and peg tube placement. Family requested comfort care on 10/14."
	"1854176-1"	"1854176-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"Admitted 9/27 due to multi-focal pneumonia, +COVID, No supplemental oxygen needed . Treated for bacterial superimposed infection with omnicef and azythromycin. Requested discharge home on 9/28. Returned to hospital ED on 10/1 with worsening Shortness of breath, O2 saturation 75% on room air and altered mental status. O2 given with saturation up to 95%. Respiratory status continued to decline and intubated on 10/3. Treated for candida with eraxis x 7 days. Due to hx of staph epi bacteremia, porta cath and dialysis tunnel catheter removed 10/5. Pt. in septic shock due to pneumonia. on CRRT due to renal failure. Developed pneumothorax and pneumomediastinum with subsequent chest tube placement x 2. Bronchoscopy on 10/9 due to elevated peak airway pressures. Failed ventilator weaning. Required pressors for each dialysis session. Discussion with family for trach and peg tube placement. Family requested comfort care on 10/14."
	"1854176-1"	"1854176-1"	"SEPTIC SHOCK"	"10040070"	"50-59 years"	"50-59"	"Admitted 9/27 due to multi-focal pneumonia, +COVID, No supplemental oxygen needed . Treated for bacterial superimposed infection with omnicef and azythromycin. Requested discharge home on 9/28. Returned to hospital ED on 10/1 with worsening Shortness of breath, O2 saturation 75% on room air and altered mental status. O2 given with saturation up to 95%. Respiratory status continued to decline and intubated on 10/3. Treated for candida with eraxis x 7 days. Due to hx of staph epi bacteremia, porta cath and dialysis tunnel catheter removed 10/5. Pt. in septic shock due to pneumonia. on CRRT due to renal failure. Developed pneumothorax and pneumomediastinum with subsequent chest tube placement x 2. Bronchoscopy on 10/9 due to elevated peak airway pressures. Failed ventilator weaning. Required pressors for each dialysis session. Discussion with family for trach and peg tube placement. Family requested comfort care on 10/14."
	"1854176-1"	"1854176-1"	"SUPERINFECTION"	"10042566"	"50-59 years"	"50-59"	"Admitted 9/27 due to multi-focal pneumonia, +COVID, No supplemental oxygen needed . Treated for bacterial superimposed infection with omnicef and azythromycin. Requested discharge home on 9/28. Returned to hospital ED on 10/1 with worsening Shortness of breath, O2 saturation 75% on room air and altered mental status. O2 given with saturation up to 95%. Respiratory status continued to decline and intubated on 10/3. Treated for candida with eraxis x 7 days. Due to hx of staph epi bacteremia, porta cath and dialysis tunnel catheter removed 10/5. Pt. in septic shock due to pneumonia. on CRRT due to renal failure. Developed pneumothorax and pneumomediastinum with subsequent chest tube placement x 2. Bronchoscopy on 10/9 due to elevated peak airway pressures. Failed ventilator weaning. Required pressors for each dialysis session. Discussion with family for trach and peg tube placement. Family requested comfort care on 10/14."
	"1854176-1"	"1854176-1"	"WEANING FAILURE"	"10066829"	"50-59 years"	"50-59"	"Admitted 9/27 due to multi-focal pneumonia, +COVID, No supplemental oxygen needed . Treated for bacterial superimposed infection with omnicef and azythromycin. Requested discharge home on 9/28. Returned to hospital ED on 10/1 with worsening Shortness of breath, O2 saturation 75% on room air and altered mental status. O2 given with saturation up to 95%. Respiratory status continued to decline and intubated on 10/3. Treated for candida with eraxis x 7 days. Due to hx of staph epi bacteremia, porta cath and dialysis tunnel catheter removed 10/5. Pt. in septic shock due to pneumonia. on CRRT due to renal failure. Developed pneumothorax and pneumomediastinum with subsequent chest tube placement x 2. Bronchoscopy on 10/9 due to elevated peak airway pressures. Failed ventilator weaning. Required pressors for each dialysis session. Discussion with family for trach and peg tube placement. Family requested comfort care on 10/14."
	"1857371-1"	"1857371-1"	"COUGH"	"10011224"	"50-59 years"	"50-59"	"Patient developed a cough with increase sputum production that lasted over several days starting approximately 10/22 and patient died on 10/28/2021."
	"1857371-1"	"1857371-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient developed a cough with increase sputum production that lasted over several days starting approximately 10/22 and patient died on 10/28/2021."
	"1857371-1"	"1857371-1"	"SPUTUM INCREASED"	"10041812"	"50-59 years"	"50-59"	"Patient developed a cough with increase sputum production that lasted over several days starting approximately 10/22 and patient died on 10/28/2021."
	"1857591-1"	"1857591-1"	"AMMONIA"	"10050287"	"50-59 years"	"50-59"	"Pt started complaining to family of progressive fatigue, n/v, and tremor that started within days to 1 week after 2nd dose of Moderna. Saw PCP several times for progressive symptoms over the next 2-3 months. Presented to ICU after found down for up to 24 hours. Serum ammonia levels were found to be 436 on presentation. Despite CRRT/HD, ammonia scavengers, low protein diet, pt never woke from coma and expired after being placed on comfort care. Later found to have partial OTC deficiency with no prior episodes of hyperammonemia. Also, no known family hx of any urea cycle disorders."
	"1857591-1"	"1857591-1"	"COMA"	"10010071"	"50-59 years"	"50-59"	"Pt started complaining to family of progressive fatigue, n/v, and tremor that started within days to 1 week after 2nd dose of Moderna. Saw PCP several times for progressive symptoms over the next 2-3 months. Presented to ICU after found down for up to 24 hours. Serum ammonia levels were found to be 436 on presentation. Despite CRRT/HD, ammonia scavengers, low protein diet, pt never woke from coma and expired after being placed on comfort care. Later found to have partial OTC deficiency with no prior episodes of hyperammonemia. Also, no known family hx of any urea cycle disorders."
	"1857591-1"	"1857591-1"	"CYTOGENETIC ANALYSIS"	"10059882"	"50-59 years"	"50-59"	"Pt started complaining to family of progressive fatigue, n/v, and tremor that started within days to 1 week after 2nd dose of Moderna. Saw PCP several times for progressive symptoms over the next 2-3 months. Presented to ICU after found down for up to 24 hours. Serum ammonia levels were found to be 436 on presentation. Despite CRRT/HD, ammonia scavengers, low protein diet, pt never woke from coma and expired after being placed on comfort care. Later found to have partial OTC deficiency with no prior episodes of hyperammonemia. Also, no known family hx of any urea cycle disorders."
	"1857591-1"	"1857591-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Pt started complaining to family of progressive fatigue, n/v, and tremor that started within days to 1 week after 2nd dose of Moderna. Saw PCP several times for progressive symptoms over the next 2-3 months. Presented to ICU after found down for up to 24 hours. Serum ammonia levels were found to be 436 on presentation. Despite CRRT/HD, ammonia scavengers, low protein diet, pt never woke from coma and expired after being placed on comfort care. Later found to have partial OTC deficiency with no prior episodes of hyperammonemia. Also, no known family hx of any urea cycle disorders."
	"1857591-1"	"1857591-1"	"FATIGUE"	"10016256"	"50-59 years"	"50-59"	"Pt started complaining to family of progressive fatigue, n/v, and tremor that started within days to 1 week after 2nd dose of Moderna. Saw PCP several times for progressive symptoms over the next 2-3 months. Presented to ICU after found down for up to 24 hours. Serum ammonia levels were found to be 436 on presentation. Despite CRRT/HD, ammonia scavengers, low protein diet, pt never woke from coma and expired after being placed on comfort care. Later found to have partial OTC deficiency with no prior episodes of hyperammonemia. Also, no known family hx of any urea cycle disorders."
	"1857591-1"	"1857591-1"	"HAEMODIALYSIS"	"10018875"	"50-59 years"	"50-59"	"Pt started complaining to family of progressive fatigue, n/v, and tremor that started within days to 1 week after 2nd dose of Moderna. Saw PCP several times for progressive symptoms over the next 2-3 months. Presented to ICU after found down for up to 24 hours. Serum ammonia levels were found to be 436 on presentation. Despite CRRT/HD, ammonia scavengers, low protein diet, pt never woke from coma and expired after being placed on comfort care. Later found to have partial OTC deficiency with no prior episodes of hyperammonemia. Also, no known family hx of any urea cycle disorders."
	"1857591-1"	"1857591-1"	"HAEMOFILTRATION"	"10053090"	"50-59 years"	"50-59"	"Pt started complaining to family of progressive fatigue, n/v, and tremor that started within days to 1 week after 2nd dose of Moderna. Saw PCP several times for progressive symptoms over the next 2-3 months. Presented to ICU after found down for up to 24 hours. Serum ammonia levels were found to be 436 on presentation. Despite CRRT/HD, ammonia scavengers, low protein diet, pt never woke from coma and expired after being placed on comfort care. Later found to have partial OTC deficiency with no prior episodes of hyperammonemia. Also, no known family hx of any urea cycle disorders."
	"1857591-1"	"1857591-1"	"INTENSIVE CARE"	"10022519"	"50-59 years"	"50-59"	"Pt started complaining to family of progressive fatigue, n/v, and tremor that started within days to 1 week after 2nd dose of Moderna. Saw PCP several times for progressive symptoms over the next 2-3 months. Presented to ICU after found down for up to 24 hours. Serum ammonia levels were found to be 436 on presentation. Despite CRRT/HD, ammonia scavengers, low protein diet, pt never woke from coma and expired after being placed on comfort care. Later found to have partial OTC deficiency with no prior episodes of hyperammonemia. Also, no known family hx of any urea cycle disorders."
	"1857591-1"	"1857591-1"	"ORNITHINE TRANSCARBAMOYLASE DEFICIENCY"	"10052450"	"50-59 years"	"50-59"	"Pt started complaining to family of progressive fatigue, n/v, and tremor that started within days to 1 week after 2nd dose of Moderna. Saw PCP several times for progressive symptoms over the next 2-3 months. Presented to ICU after found down for up to 24 hours. Serum ammonia levels were found to be 436 on presentation. Despite CRRT/HD, ammonia scavengers, low protein diet, pt never woke from coma and expired after being placed on comfort care. Later found to have partial OTC deficiency with no prior episodes of hyperammonemia. Also, no known family hx of any urea cycle disorders."
	"1857591-1"	"1857591-1"	"TREMOR"	"10044565"	"50-59 years"	"50-59"	"Pt started complaining to family of progressive fatigue, n/v, and tremor that started within days to 1 week after 2nd dose of Moderna. Saw PCP several times for progressive symptoms over the next 2-3 months. Presented to ICU after found down for up to 24 hours. Serum ammonia levels were found to be 436 on presentation. Despite CRRT/HD, ammonia scavengers, low protein diet, pt never woke from coma and expired after being placed on comfort care. Later found to have partial OTC deficiency with no prior episodes of hyperammonemia. Also, no known family hx of any urea cycle disorders."
	"1857596-1"	"1857596-1"	"ACTIVATED PARTIAL THROMBOPLASTIN TIME"	"10000630"	"50-59 years"	"50-59"	"DIAGNOSIS 1. Acute chest pain    2. Elevated troponin level    3. SOB (shortness of breath)    4. Elevated d-dimer    DECEASED"
	"1857596-1"	"1857596-1"	"BLOOD MAGNESIUM"	"10005651"	"50-59 years"	"50-59"	"DIAGNOSIS 1. Acute chest pain    2. Elevated troponin level    3. SOB (shortness of breath)    4. Elevated d-dimer    DECEASED"
	"1857596-1"	"1857596-1"	"CHEST PAIN"	"10008479"	"50-59 years"	"50-59"	"DIAGNOSIS 1. Acute chest pain    2. Elevated troponin level    3. SOB (shortness of breath)    4. Elevated d-dimer    DECEASED"
	"1857596-1"	"1857596-1"	"CHEST X-RAY"	"10008498"	"50-59 years"	"50-59"	"DIAGNOSIS 1. Acute chest pain    2. Elevated troponin level    3. SOB (shortness of breath)    4. Elevated d-dimer    DECEASED"
	"1857596-1"	"1857596-1"	"COMPUTERISED TOMOGRAM THORAX"	"10053875"	"50-59 years"	"50-59"	"DIAGNOSIS 1. Acute chest pain    2. Elevated troponin level    3. SOB (shortness of breath)    4. Elevated d-dimer    DECEASED"
	"1857596-1"	"1857596-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"DIAGNOSIS 1. Acute chest pain    2. Elevated troponin level    3. SOB (shortness of breath)    4. Elevated d-dimer    DECEASED"
	"1857596-1"	"1857596-1"	"DIFFERENTIAL WHITE BLOOD CELL COUNT"	"10012784"	"50-59 years"	"50-59"	"DIAGNOSIS 1. Acute chest pain    2. Elevated troponin level    3. SOB (shortness of breath)    4. Elevated d-dimer    DECEASED"
	"1857596-1"	"1857596-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"DIAGNOSIS 1. Acute chest pain    2. Elevated troponin level    3. SOB (shortness of breath)    4. Elevated d-dimer    DECEASED"
	"1857596-1"	"1857596-1"	"ELECTROCARDIOGRAM"	"10014362"	"50-59 years"	"50-59"	"DIAGNOSIS 1. Acute chest pain    2. Elevated troponin level    3. SOB (shortness of breath)    4. Elevated d-dimer    DECEASED"
	"1857596-1"	"1857596-1"	"FIBRIN D DIMER INCREASED"	"10016581"	"50-59 years"	"50-59"	"DIAGNOSIS 1. Acute chest pain    2. Elevated troponin level    3. SOB (shortness of breath)    4. Elevated d-dimer    DECEASED"
	"1857596-1"	"1857596-1"	"FULL BLOOD COUNT"	"10017411"	"50-59 years"	"50-59"	"DIAGNOSIS 1. Acute chest pain    2. Elevated troponin level    3. SOB (shortness of breath)    4. Elevated d-dimer    DECEASED"
	"1857596-1"	"1857596-1"	"INTERNATIONAL NORMALISED RATIO"	"10022591"	"50-59 years"	"50-59"	"DIAGNOSIS 1. Acute chest pain    2. Elevated troponin level    3. SOB (shortness of breath)    4. Elevated d-dimer    DECEASED"
	"1857596-1"	"1857596-1"	"METABOLIC FUNCTION TEST"	"10062191"	"50-59 years"	"50-59"	"DIAGNOSIS 1. Acute chest pain    2. Elevated troponin level    3. SOB (shortness of breath)    4. Elevated d-dimer    DECEASED"
	"1857596-1"	"1857596-1"	"PROTHROMBIN TIME"	"10037056"	"50-59 years"	"50-59"	"DIAGNOSIS 1. Acute chest pain    2. Elevated troponin level    3. SOB (shortness of breath)    4. Elevated d-dimer    DECEASED"
	"1857596-1"	"1857596-1"	"TROPONIN I"	"10050397"	"50-59 years"	"50-59"	"DIAGNOSIS 1. Acute chest pain    2. Elevated troponin level    3. SOB (shortness of breath)    4. Elevated d-dimer    DECEASED"
	"1857596-1"	"1857596-1"	"TROPONIN INCREASED"	"10058267"	"50-59 years"	"50-59"	"DIAGNOSIS 1. Acute chest pain    2. Elevated troponin level    3. SOB (shortness of breath)    4. Elevated d-dimer    DECEASED"
	"1857987-1"	"1857987-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Systemic: Heart Attack-Severe, Additional Details: 11/1/21 received moderna booster and first flu shot ever 11/2 headache, didn't feel well 11/3 pain in right leg- collapsed at md and couldn't be revived. Mother describes him as healthy and no underlying conditions thought clot earlier this year and pt using asa. We are told md ruled death heart attack as a result of pulmonary embolism."
	"1857987-1"	"1857987-1"	"HEADACHE"	"10019211"	"50-59 years"	"50-59"	"Systemic: Heart Attack-Severe, Additional Details: 11/1/21 received moderna booster and first flu shot ever 11/2 headache, didn't feel well 11/3 pain in right leg- collapsed at md and couldn't be revived. Mother describes him as healthy and no underlying conditions thought clot earlier this year and pt using asa. We are told md ruled death heart attack as a result of pulmonary embolism."
	"1857987-1"	"1857987-1"	"MALAISE"	"10025482"	"50-59 years"	"50-59"	"Systemic: Heart Attack-Severe, Additional Details: 11/1/21 received moderna booster and first flu shot ever 11/2 headache, didn't feel well 11/3 pain in right leg- collapsed at md and couldn't be revived. Mother describes him as healthy and no underlying conditions thought clot earlier this year and pt using asa. We are told md ruled death heart attack as a result of pulmonary embolism."
	"1857987-1"	"1857987-1"	"MYOCARDIAL INFARCTION"	"10028596"	"50-59 years"	"50-59"	"Systemic: Heart Attack-Severe, Additional Details: 11/1/21 received moderna booster and first flu shot ever 11/2 headache, didn't feel well 11/3 pain in right leg- collapsed at md and couldn't be revived. Mother describes him as healthy and no underlying conditions thought clot earlier this year and pt using asa. We are told md ruled death heart attack as a result of pulmonary embolism."
	"1857987-1"	"1857987-1"	"PAIN IN EXTREMITY"	"10033425"	"50-59 years"	"50-59"	"Systemic: Heart Attack-Severe, Additional Details: 11/1/21 received moderna booster and first flu shot ever 11/2 headache, didn't feel well 11/3 pain in right leg- collapsed at md and couldn't be revived. Mother describes him as healthy and no underlying conditions thought clot earlier this year and pt using asa. We are told md ruled death heart attack as a result of pulmonary embolism."
	"1857987-1"	"1857987-1"	"PULMONARY EMBOLISM"	"10037377"	"50-59 years"	"50-59"	"Systemic: Heart Attack-Severe, Additional Details: 11/1/21 received moderna booster and first flu shot ever 11/2 headache, didn't feel well 11/3 pain in right leg- collapsed at md and couldn't be revived. Mother describes him as healthy and no underlying conditions thought clot earlier this year and pt using asa. We are told md ruled death heart attack as a result of pulmonary embolism."
	"1857987-1"	"1857987-1"	"SYNCOPE"	"10042772"	"50-59 years"	"50-59"	"Systemic: Heart Attack-Severe, Additional Details: 11/1/21 received moderna booster and first flu shot ever 11/2 headache, didn't feel well 11/3 pain in right leg- collapsed at md and couldn't be revived. Mother describes him as healthy and no underlying conditions thought clot earlier this year and pt using asa. We are told md ruled death heart attack as a result of pulmonary embolism."
	"1858442-1"	"1858442-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Not feeling well. Decedent found deceased 2 days after vaccine."
	"1858442-1"	"1858442-1"	"MALAISE"	"10025482"	"50-59 years"	"50-59"	"Not feeling well. Decedent found deceased 2 days after vaccine."
	"1860168-1"	"1860168-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Died; Inappropriate schedule of vaccine administered; This spontaneous case was reported by a consumer and describes the occurrence of DEATH (Died) in a 58-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 076C21A and 046C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below.     No Medical History information was reported.   On 20-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 27-Oct-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 27-Oct-2021, the patient experienced INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Inappropriate schedule of vaccine administered). The patient died on 30-Oct-2021. The cause of death was not reported. It is unknown if an autopsy was performed. At the time of death, INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Inappropriate schedule of vaccine administered) had resolved.            No concomitant medication provided.  1st dose was given on 20Sep2021 with lot number 046C21A.  Reporter states that she was fine with no illnesses prior to getting the vaccine.  Company Comment: This case concerns a 58-year-old, female patient with no relevant medical history, who experienced the unexpected serious fatal adverse event of death. Inappropriate schedule of product administration was considered an additional event. The event death occurred approximately 1 month and 10 days after the second dose of Moderna COVID-19 vaccine with fatal outcome. Death occurred on 30-Oct-2021 and no autopsy results were available at the time of the report. Cause of death was reported as unknown. The rechallenge was not applicable due to the fatal outcome. The benefit-risk relationship of Moderna COVID-19 vaccine is not affected by this report.; Sender's Comments: This case concerns a 58-year-old, female patient with no relevant medical history, who experienced the unexpected serious fatal adverse event of death. Inappropriate schedule of product administration was considered an additional event. The event death occurred approximately 1 month and 10 days after the second dose of Moderna COVID-19 vaccine with fatal outcome. Death occurred on 30-Oct-2021 and no autopsy results were available at the time of the report. Cause of death was reported as unknown. The rechallenge was not applicable due to the fatal outcome. The benefit-risk relationship of Moderna COVID-19 vaccine is not affected by this report.; Reported Cause(s) of Death: Unknown cause of death"
	"1860168-1"	"1860168-1"	"INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION"	"10081572"	"50-59 years"	"50-59"	"Died; Inappropriate schedule of vaccine administered; This spontaneous case was reported by a consumer and describes the occurrence of DEATH (Died) in a 58-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 076C21A and 046C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below.     No Medical History information was reported.   On 20-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 27-Oct-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 27-Oct-2021, the patient experienced INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Inappropriate schedule of vaccine administered). The patient died on 30-Oct-2021. The cause of death was not reported. It is unknown if an autopsy was performed. At the time of death, INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Inappropriate schedule of vaccine administered) had resolved.            No concomitant medication provided.  1st dose was given on 20Sep2021 with lot number 046C21A.  Reporter states that she was fine with no illnesses prior to getting the vaccine.  Company Comment: This case concerns a 58-year-old, female patient with no relevant medical history, who experienced the unexpected serious fatal adverse event of death. Inappropriate schedule of product administration was considered an additional event. The event death occurred approximately 1 month and 10 days after the second dose of Moderna COVID-19 vaccine with fatal outcome. Death occurred on 30-Oct-2021 and no autopsy results were available at the time of the report. Cause of death was reported as unknown. The rechallenge was not applicable due to the fatal outcome. The benefit-risk relationship of Moderna COVID-19 vaccine is not affected by this report.; Sender's Comments: This case concerns a 58-year-old, female patient with no relevant medical history, who experienced the unexpected serious fatal adverse event of death. Inappropriate schedule of product administration was considered an additional event. The event death occurred approximately 1 month and 10 days after the second dose of Moderna COVID-19 vaccine with fatal outcome. Death occurred on 30-Oct-2021 and no autopsy results were available at the time of the report. Cause of death was reported as unknown. The rechallenge was not applicable due to the fatal outcome. The benefit-risk relationship of Moderna COVID-19 vaccine is not affected by this report.; Reported Cause(s) of Death: Unknown cause of death"
	"1865036-1"	"1865036-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"pt had a short stay in the hosp from 9/27 - 9/28/21 with positive test for COVID; dc'd to home; presents to ED with increasing SOB and altered mental status; O2 sats @ 72% on RA; encephalopathic; positive for COVID pneumonia; intubation required; renal failure on CRRT and transitioned to hemodialysis, didn't tolerate well and required pressors; condition declined and worsened; comfort care measures instituted and pt died in the hosp"
	"1865036-1"	"1865036-1"	"COVID-19 PNEUMONIA"	"10084380"	"50-59 years"	"50-59"	"pt had a short stay in the hosp from 9/27 - 9/28/21 with positive test for COVID; dc'd to home; presents to ED with increasing SOB and altered mental status; O2 sats @ 72% on RA; encephalopathic; positive for COVID pneumonia; intubation required; renal failure on CRRT and transitioned to hemodialysis, didn't tolerate well and required pressors; condition declined and worsened; comfort care measures instituted and pt died in the hosp"
	"1865036-1"	"1865036-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"pt had a short stay in the hosp from 9/27 - 9/28/21 with positive test for COVID; dc'd to home; presents to ED with increasing SOB and altered mental status; O2 sats @ 72% on RA; encephalopathic; positive for COVID pneumonia; intubation required; renal failure on CRRT and transitioned to hemodialysis, didn't tolerate well and required pressors; condition declined and worsened; comfort care measures instituted and pt died in the hosp"
	"1865036-1"	"1865036-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"pt had a short stay in the hosp from 9/27 - 9/28/21 with positive test for COVID; dc'd to home; presents to ED with increasing SOB and altered mental status; O2 sats @ 72% on RA; encephalopathic; positive for COVID pneumonia; intubation required; renal failure on CRRT and transitioned to hemodialysis, didn't tolerate well and required pressors; condition declined and worsened; comfort care measures instituted and pt died in the hosp"
	"1865036-1"	"1865036-1"	"ENCEPHALOPATHY"	"10014625"	"50-59 years"	"50-59"	"pt had a short stay in the hosp from 9/27 - 9/28/21 with positive test for COVID; dc'd to home; presents to ED with increasing SOB and altered mental status; O2 sats @ 72% on RA; encephalopathic; positive for COVID pneumonia; intubation required; renal failure on CRRT and transitioned to hemodialysis, didn't tolerate well and required pressors; condition declined and worsened; comfort care measures instituted and pt died in the hosp"
	"1865036-1"	"1865036-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"50-59 years"	"50-59"	"pt had a short stay in the hosp from 9/27 - 9/28/21 with positive test for COVID; dc'd to home; presents to ED with increasing SOB and altered mental status; O2 sats @ 72% on RA; encephalopathic; positive for COVID pneumonia; intubation required; renal failure on CRRT and transitioned to hemodialysis, didn't tolerate well and required pressors; condition declined and worsened; comfort care measures instituted and pt died in the hosp"
	"1865036-1"	"1865036-1"	"GENERAL PHYSICAL HEALTH DETERIORATION"	"10049438"	"50-59 years"	"50-59"	"pt had a short stay in the hosp from 9/27 - 9/28/21 with positive test for COVID; dc'd to home; presents to ED with increasing SOB and altered mental status; O2 sats @ 72% on RA; encephalopathic; positive for COVID pneumonia; intubation required; renal failure on CRRT and transitioned to hemodialysis, didn't tolerate well and required pressors; condition declined and worsened; comfort care measures instituted and pt died in the hosp"
	"1865036-1"	"1865036-1"	"HAEMODIALYSIS"	"10018875"	"50-59 years"	"50-59"	"pt had a short stay in the hosp from 9/27 - 9/28/21 with positive test for COVID; dc'd to home; presents to ED with increasing SOB and altered mental status; O2 sats @ 72% on RA; encephalopathic; positive for COVID pneumonia; intubation required; renal failure on CRRT and transitioned to hemodialysis, didn't tolerate well and required pressors; condition declined and worsened; comfort care measures instituted and pt died in the hosp"
	"1865036-1"	"1865036-1"	"MENTAL STATUS CHANGES"	"10048294"	"50-59 years"	"50-59"	"pt had a short stay in the hosp from 9/27 - 9/28/21 with positive test for COVID; dc'd to home; presents to ED with increasing SOB and altered mental status; O2 sats @ 72% on RA; encephalopathic; positive for COVID pneumonia; intubation required; renal failure on CRRT and transitioned to hemodialysis, didn't tolerate well and required pressors; condition declined and worsened; comfort care measures instituted and pt died in the hosp"
	"1865036-1"	"1865036-1"	"RENAL FAILURE"	"10038435"	"50-59 years"	"50-59"	"pt had a short stay in the hosp from 9/27 - 9/28/21 with positive test for COVID; dc'd to home; presents to ED with increasing SOB and altered mental status; O2 sats @ 72% on RA; encephalopathic; positive for COVID pneumonia; intubation required; renal failure on CRRT and transitioned to hemodialysis, didn't tolerate well and required pressors; condition declined and worsened; comfort care measures instituted and pt died in the hosp"
	"1865036-1"	"1865036-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"pt had a short stay in the hosp from 9/27 - 9/28/21 with positive test for COVID; dc'd to home; presents to ED with increasing SOB and altered mental status; O2 sats @ 72% on RA; encephalopathic; positive for COVID pneumonia; intubation required; renal failure on CRRT and transitioned to hemodialysis, didn't tolerate well and required pressors; condition declined and worsened; comfort care measures instituted and pt died in the hosp"
	"1865373-1"	"1865373-1"	"CIRCULATORY COLLAPSE"	"10009192"	"50-59 years"	"50-59"	"I am the epidemiologist reporting on behalf of 59 year-old female patient.  Patient received two doses of the Pfizer vaccine, according to immunization records. The first dose was on 03/31/21 and the second was on 04/21/2021.  The patient died 4/30/21 (nine days post dose 2) in hospital emergency room (outpatient). The death certificate lists ?cardiovascular collapse? as the immediate cause of death. Interval between onset and death is listed as ?5 minutes.? Known underlying health conditions include (but are not limited to) diabetes."
	"1865373-1"	"1865373-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"I am the epidemiologist reporting on behalf of 59 year-old female patient.  Patient received two doses of the Pfizer vaccine, according to immunization records. The first dose was on 03/31/21 and the second was on 04/21/2021.  The patient died 4/30/21 (nine days post dose 2) in hospital emergency room (outpatient). The death certificate lists ?cardiovascular collapse? as the immediate cause of death. Interval between onset and death is listed as ?5 minutes.? Known underlying health conditions include (but are not limited to) diabetes."
	"1865597-1"	"1865597-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient passed away on 10/22/2021"
	"1865612-1"	"1865612-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"I am the epidemiologist reporting on behalf of 57 year-old male patient.  Patient received one dose of the Pfizer vaccine on 04/06/2021, according to immunization records.  The patient passed away on 4/09/2021 (3 days post first dose, hospital emergency room). The death certificate lists ?cardiac arrest? as the immediate cause of death. No additional information regarding underlying conditions that may have contributed to this death is available."
	"1865612-1"	"1865612-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"I am the epidemiologist reporting on behalf of 57 year-old male patient.  Patient received one dose of the Pfizer vaccine on 04/06/2021, according to immunization records.  The patient passed away on 4/09/2021 (3 days post first dose, hospital emergency room). The death certificate lists ?cardiac arrest? as the immediate cause of death. No additional information regarding underlying conditions that may have contributed to this death is available."
	"1865615-1"	"1865615-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Patient passed away on 10/21/2021"
	"1867659-1"	"1867659-1"	"BLOOD TEST"	"10061726"	"50-59 years"	"50-59"	"death"
	"1867659-1"	"1867659-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"death"
	"1867933-1"	"1867933-1"	"BACK PAIN"	"10003988"	"50-59 years"	"50-59"	""Patient said he ""was not feeling well"", night before and in the morning. Went to work at 8:30 am and collapsed while on the phone at work at 11:10 am. Had heavy breathing and retrieved a pulse while on ambulance but then lost pulse at arrival of hospital.""
	"1867933-1"	"1867933-1"	"CONDITION AGGRAVATED"	"10010264"	"50-59 years"	"50-59"	""Patient said he ""was not feeling well"", night before and in the morning. Went to work at 8:30 am and collapsed while on the phone at work at 11:10 am. Had heavy breathing and retrieved a pulse while on ambulance but then lost pulse at arrival of hospital.""
	"1867933-1"	"1867933-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	""Patient said he ""was not feeling well"", night before and in the morning. Went to work at 8:30 am and collapsed while on the phone at work at 11:10 am. Had heavy breathing and retrieved a pulse while on ambulance but then lost pulse at arrival of hospital.""
	"1867933-1"	"1867933-1"	"MALAISE"	"10025482"	"50-59 years"	"50-59"	""Patient said he ""was not feeling well"", night before and in the morning. Went to work at 8:30 am and collapsed while on the phone at work at 11:10 am. Had heavy breathing and retrieved a pulse while on ambulance but then lost pulse at arrival of hospital.""
	"1867933-1"	"1867933-1"	"PULSE ABSENT"	"10037469"	"50-59 years"	"50-59"	""Patient said he ""was not feeling well"", night before and in the morning. Went to work at 8:30 am and collapsed while on the phone at work at 11:10 am. Had heavy breathing and retrieved a pulse while on ambulance but then lost pulse at arrival of hospital.""
	"1867933-1"	"1867933-1"	"SYNCOPE"	"10042772"	"50-59 years"	"50-59"	""Patient said he ""was not feeling well"", night before and in the morning. Went to work at 8:30 am and collapsed while on the phone at work at 11:10 am. Had heavy breathing and retrieved a pulse while on ambulance but then lost pulse at arrival of hospital.""
	"1869372-1"	"1869372-1"	"ARRHYTHMIA"	"10003119"	"50-59 years"	"50-59"	"At her home, dyspnea, pulselessness, 1:30 am 10/26/21, treatment 911 per husband, CPR until relieved by medics, EKG indicated pulseless cardiac arrhythmia treated with cardio-conversion X3, intubated, transported to the Emergency Room.  Probable rhythm capable of some cardiac output."
	"1869372-1"	"1869372-1"	"CARDIAC MONITORING"	"10053438"	"50-59 years"	"50-59"	"At her home, dyspnea, pulselessness, 1:30 am 10/26/21, treatment 911 per husband, CPR until relieved by medics, EKG indicated pulseless cardiac arrhythmia treated with cardio-conversion X3, intubated, transported to the Emergency Room.  Probable rhythm capable of some cardiac output."
	"1869372-1"	"1869372-1"	"CARDIOVERSION"	"10007661"	"50-59 years"	"50-59"	"At her home, dyspnea, pulselessness, 1:30 am 10/26/21, treatment 911 per husband, CPR until relieved by medics, EKG indicated pulseless cardiac arrhythmia treated with cardio-conversion X3, intubated, transported to the Emergency Room.  Probable rhythm capable of some cardiac output."
	"1869372-1"	"1869372-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"At her home, dyspnea, pulselessness, 1:30 am 10/26/21, treatment 911 per husband, CPR until relieved by medics, EKG indicated pulseless cardiac arrhythmia treated with cardio-conversion X3, intubated, transported to the Emergency Room.  Probable rhythm capable of some cardiac output."
	"1869372-1"	"1869372-1"	"ELECTROCARDIOGRAM ABNORMAL"	"10014363"	"50-59 years"	"50-59"	"At her home, dyspnea, pulselessness, 1:30 am 10/26/21, treatment 911 per husband, CPR until relieved by medics, EKG indicated pulseless cardiac arrhythmia treated with cardio-conversion X3, intubated, transported to the Emergency Room.  Probable rhythm capable of some cardiac output."
	"1869372-1"	"1869372-1"	"ELECTROENCEPHALOGRAM"	"10014407"	"50-59 years"	"50-59"	"At her home, dyspnea, pulselessness, 1:30 am 10/26/21, treatment 911 per husband, CPR until relieved by medics, EKG indicated pulseless cardiac arrhythmia treated with cardio-conversion X3, intubated, transported to the Emergency Room.  Probable rhythm capable of some cardiac output."
	"1869372-1"	"1869372-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"50-59 years"	"50-59"	"At her home, dyspnea, pulselessness, 1:30 am 10/26/21, treatment 911 per husband, CPR until relieved by medics, EKG indicated pulseless cardiac arrhythmia treated with cardio-conversion X3, intubated, transported to the Emergency Room.  Probable rhythm capable of some cardiac output."
	"1869372-1"	"1869372-1"	"MECHANICAL VENTILATION"	"10067221"	"50-59 years"	"50-59"	"At her home, dyspnea, pulselessness, 1:30 am 10/26/21, treatment 911 per husband, CPR until relieved by medics, EKG indicated pulseless cardiac arrhythmia treated with cardio-conversion X3, intubated, transported to the Emergency Room.  Probable rhythm capable of some cardiac output."
	"1869372-1"	"1869372-1"	"PULSE ABSENT"	"10037469"	"50-59 years"	"50-59"	"At her home, dyspnea, pulselessness, 1:30 am 10/26/21, treatment 911 per husband, CPR until relieved by medics, EKG indicated pulseless cardiac arrhythmia treated with cardio-conversion X3, intubated, transported to the Emergency Room.  Probable rhythm capable of some cardiac output."
	"1869372-1"	"1869372-1"	"RESUSCITATION"	"10038749"	"50-59 years"	"50-59"	"At her home, dyspnea, pulselessness, 1:30 am 10/26/21, treatment 911 per husband, CPR until relieved by medics, EKG indicated pulseless cardiac arrhythmia treated with cardio-conversion X3, intubated, transported to the Emergency Room.  Probable rhythm capable of some cardiac output."
	"1869372-1"	"1869372-1"	"ULTRASOUND SCAN"	"10045434"	"50-59 years"	"50-59"	"At her home, dyspnea, pulselessness, 1:30 am 10/26/21, treatment 911 per husband, CPR until relieved by medics, EKG indicated pulseless cardiac arrhythmia treated with cardio-conversion X3, intubated, transported to the Emergency Room.  Probable rhythm capable of some cardiac output."
	"1869372-1"	"1869372-1"	"VENTRICULAR HYPOKINESIA"	"10050510"	"50-59 years"	"50-59"	"At her home, dyspnea, pulselessness, 1:30 am 10/26/21, treatment 911 per husband, CPR until relieved by medics, EKG indicated pulseless cardiac arrhythmia treated with cardio-conversion X3, intubated, transported to the Emergency Room.  Probable rhythm capable of some cardiac output."
	"1869456-1"	"1869456-1"	"ANXIETY"	"10002855"	"50-59 years"	"50-59"	"VAERS  9 Nov 2021, 11:00  Day Zero:  Is in usual state of health 1/2 dose Pfizer Covid vaccine given IM at  Pharmacy.  18 hours post vaccine required Ativan to aid sleep.  10 Nov 2021,  Day one:  hour 24, subject experienced moderate fatigue, pillow  and dyspnea due to increasing weakness, treated with acetaminophen  hour 32 post vaccine given Ativan (for sleep) hour 42 post vaccine required 0.5 ml morphine via G-Tube for pain and air hunger,   11 Nov 2021, Day two:  subject is clinical better hour 57 required Ativan for sleep  12 Nov 2021, Day three:   Hour 70 required 0.5 ml Morphine for malaise, pain discomfort resistant to acetaminophen hour 84 required Ativan for sleep   13 Nov 2021, Day four:  Subject experienced rapid deterioration in respiratory status hour 92 required Ativan for anxiety, air hunger, dyspnea hour 95 required 0.5 ml Morphine sulfate  for anxiety, air hunger, dyspnea hour 96 at patient request non-invasive ventilator tidal volume increased by 15% to 450 ml,  hour 98 on advise of Hospice nurse both Morphine and Ativan were both given at 0.5 ml doses  Subject expired at 12:40 pm Nov 9th , 2021, 98 hours after Pfizer Booster dose given"
	"1869456-1"	"1869456-1"	"ASTHENIA"	"10003549"	"50-59 years"	"50-59"	"VAERS  9 Nov 2021, 11:00  Day Zero:  Is in usual state of health 1/2 dose Pfizer Covid vaccine given IM at  Pharmacy.  18 hours post vaccine required Ativan to aid sleep.  10 Nov 2021,  Day one:  hour 24, subject experienced moderate fatigue, pillow  and dyspnea due to increasing weakness, treated with acetaminophen  hour 32 post vaccine given Ativan (for sleep) hour 42 post vaccine required 0.5 ml morphine via G-Tube for pain and air hunger,   11 Nov 2021, Day two:  subject is clinical better hour 57 required Ativan for sleep  12 Nov 2021, Day three:   Hour 70 required 0.5 ml Morphine for malaise, pain discomfort resistant to acetaminophen hour 84 required Ativan for sleep   13 Nov 2021, Day four:  Subject experienced rapid deterioration in respiratory status hour 92 required Ativan for anxiety, air hunger, dyspnea hour 95 required 0.5 ml Morphine sulfate  for anxiety, air hunger, dyspnea hour 96 at patient request non-invasive ventilator tidal volume increased by 15% to 450 ml,  hour 98 on advise of Hospice nurse both Morphine and Ativan were both given at 0.5 ml doses  Subject expired at 12:40 pm Nov 9th , 2021, 98 hours after Pfizer Booster dose given"
	"1869456-1"	"1869456-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"VAERS  9 Nov 2021, 11:00  Day Zero:  Is in usual state of health 1/2 dose Pfizer Covid vaccine given IM at  Pharmacy.  18 hours post vaccine required Ativan to aid sleep.  10 Nov 2021,  Day one:  hour 24, subject experienced moderate fatigue, pillow  and dyspnea due to increasing weakness, treated with acetaminophen  hour 32 post vaccine given Ativan (for sleep) hour 42 post vaccine required 0.5 ml morphine via G-Tube for pain and air hunger,   11 Nov 2021, Day two:  subject is clinical better hour 57 required Ativan for sleep  12 Nov 2021, Day three:   Hour 70 required 0.5 ml Morphine for malaise, pain discomfort resistant to acetaminophen hour 84 required Ativan for sleep   13 Nov 2021, Day four:  Subject experienced rapid deterioration in respiratory status hour 92 required Ativan for anxiety, air hunger, dyspnea hour 95 required 0.5 ml Morphine sulfate  for anxiety, air hunger, dyspnea hour 96 at patient request non-invasive ventilator tidal volume increased by 15% to 450 ml,  hour 98 on advise of Hospice nurse both Morphine and Ativan were both given at 0.5 ml doses  Subject expired at 12:40 pm Nov 9th , 2021, 98 hours after Pfizer Booster dose given"
	"1869456-1"	"1869456-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"VAERS  9 Nov 2021, 11:00  Day Zero:  Is in usual state of health 1/2 dose Pfizer Covid vaccine given IM at  Pharmacy.  18 hours post vaccine required Ativan to aid sleep.  10 Nov 2021,  Day one:  hour 24, subject experienced moderate fatigue, pillow  and dyspnea due to increasing weakness, treated with acetaminophen  hour 32 post vaccine given Ativan (for sleep) hour 42 post vaccine required 0.5 ml morphine via G-Tube for pain and air hunger,   11 Nov 2021, Day two:  subject is clinical better hour 57 required Ativan for sleep  12 Nov 2021, Day three:   Hour 70 required 0.5 ml Morphine for malaise, pain discomfort resistant to acetaminophen hour 84 required Ativan for sleep   13 Nov 2021, Day four:  Subject experienced rapid deterioration in respiratory status hour 92 required Ativan for anxiety, air hunger, dyspnea hour 95 required 0.5 ml Morphine sulfate  for anxiety, air hunger, dyspnea hour 96 at patient request non-invasive ventilator tidal volume increased by 15% to 450 ml,  hour 98 on advise of Hospice nurse both Morphine and Ativan were both given at 0.5 ml doses  Subject expired at 12:40 pm Nov 9th , 2021, 98 hours after Pfizer Booster dose given"
	"1869456-1"	"1869456-1"	"FATIGUE"	"10016256"	"50-59 years"	"50-59"	"VAERS  9 Nov 2021, 11:00  Day Zero:  Is in usual state of health 1/2 dose Pfizer Covid vaccine given IM at  Pharmacy.  18 hours post vaccine required Ativan to aid sleep.  10 Nov 2021,  Day one:  hour 24, subject experienced moderate fatigue, pillow  and dyspnea due to increasing weakness, treated with acetaminophen  hour 32 post vaccine given Ativan (for sleep) hour 42 post vaccine required 0.5 ml morphine via G-Tube for pain and air hunger,   11 Nov 2021, Day two:  subject is clinical better hour 57 required Ativan for sleep  12 Nov 2021, Day three:   Hour 70 required 0.5 ml Morphine for malaise, pain discomfort resistant to acetaminophen hour 84 required Ativan for sleep   13 Nov 2021, Day four:  Subject experienced rapid deterioration in respiratory status hour 92 required Ativan for anxiety, air hunger, dyspnea hour 95 required 0.5 ml Morphine sulfate  for anxiety, air hunger, dyspnea hour 96 at patient request non-invasive ventilator tidal volume increased by 15% to 450 ml,  hour 98 on advise of Hospice nurse both Morphine and Ativan were both given at 0.5 ml doses  Subject expired at 12:40 pm Nov 9th , 2021, 98 hours after Pfizer Booster dose given"
	"1869456-1"	"1869456-1"	"MALAISE"	"10025482"	"50-59 years"	"50-59"	"VAERS  9 Nov 2021, 11:00  Day Zero:  Is in usual state of health 1/2 dose Pfizer Covid vaccine given IM at  Pharmacy.  18 hours post vaccine required Ativan to aid sleep.  10 Nov 2021,  Day one:  hour 24, subject experienced moderate fatigue, pillow  and dyspnea due to increasing weakness, treated with acetaminophen  hour 32 post vaccine given Ativan (for sleep) hour 42 post vaccine required 0.5 ml morphine via G-Tube for pain and air hunger,   11 Nov 2021, Day two:  subject is clinical better hour 57 required Ativan for sleep  12 Nov 2021, Day three:   Hour 70 required 0.5 ml Morphine for malaise, pain discomfort resistant to acetaminophen hour 84 required Ativan for sleep   13 Nov 2021, Day four:  Subject experienced rapid deterioration in respiratory status hour 92 required Ativan for anxiety, air hunger, dyspnea hour 95 required 0.5 ml Morphine sulfate  for anxiety, air hunger, dyspnea hour 96 at patient request non-invasive ventilator tidal volume increased by 15% to 450 ml,  hour 98 on advise of Hospice nurse both Morphine and Ativan were both given at 0.5 ml doses  Subject expired at 12:40 pm Nov 9th , 2021, 98 hours after Pfizer Booster dose given"
	"1869456-1"	"1869456-1"	"PAIN"	"10033371"	"50-59 years"	"50-59"	"VAERS  9 Nov 2021, 11:00  Day Zero:  Is in usual state of health 1/2 dose Pfizer Covid vaccine given IM at  Pharmacy.  18 hours post vaccine required Ativan to aid sleep.  10 Nov 2021,  Day one:  hour 24, subject experienced moderate fatigue, pillow  and dyspnea due to increasing weakness, treated with acetaminophen  hour 32 post vaccine given Ativan (for sleep) hour 42 post vaccine required 0.5 ml morphine via G-Tube for pain and air hunger,   11 Nov 2021, Day two:  subject is clinical better hour 57 required Ativan for sleep  12 Nov 2021, Day three:   Hour 70 required 0.5 ml Morphine for malaise, pain discomfort resistant to acetaminophen hour 84 required Ativan for sleep   13 Nov 2021, Day four:  Subject experienced rapid deterioration in respiratory status hour 92 required Ativan for anxiety, air hunger, dyspnea hour 95 required 0.5 ml Morphine sulfate  for anxiety, air hunger, dyspnea hour 96 at patient request non-invasive ventilator tidal volume increased by 15% to 450 ml,  hour 98 on advise of Hospice nurse both Morphine and Ativan were both given at 0.5 ml doses  Subject expired at 12:40 pm Nov 9th , 2021, 98 hours after Pfizer Booster dose given"
	"1869456-1"	"1869456-1"	"PULMONARY FUNCTION TEST DECREASED"	"10061922"	"50-59 years"	"50-59"	"VAERS  9 Nov 2021, 11:00  Day Zero:  Is in usual state of health 1/2 dose Pfizer Covid vaccine given IM at  Pharmacy.  18 hours post vaccine required Ativan to aid sleep.  10 Nov 2021,  Day one:  hour 24, subject experienced moderate fatigue, pillow  and dyspnea due to increasing weakness, treated with acetaminophen  hour 32 post vaccine given Ativan (for sleep) hour 42 post vaccine required 0.5 ml morphine via G-Tube for pain and air hunger,   11 Nov 2021, Day two:  subject is clinical better hour 57 required Ativan for sleep  12 Nov 2021, Day three:   Hour 70 required 0.5 ml Morphine for malaise, pain discomfort resistant to acetaminophen hour 84 required Ativan for sleep   13 Nov 2021, Day four:  Subject experienced rapid deterioration in respiratory status hour 92 required Ativan for anxiety, air hunger, dyspnea hour 95 required 0.5 ml Morphine sulfate  for anxiety, air hunger, dyspnea hour 96 at patient request non-invasive ventilator tidal volume increased by 15% to 450 ml,  hour 98 on advise of Hospice nurse both Morphine and Ativan were both given at 0.5 ml doses  Subject expired at 12:40 pm Nov 9th , 2021, 98 hours after Pfizer Booster dose given"
	"1869769-1"	"1869769-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"Pt received booster shot of Moderna covid vaccine on 11/5/2021.  On 11/6/2021 at approx. 0930, pt was found to be unresponsive and asystolic at the nursing home. Last known well was 0600.  After pt was found unresponsive and asystolic, CPR was started and pt was then taken to hospital via squad where resuscitative efforts were continued by ambulance staff and hospital staff.  Pt was pronounced dead at 1013 on the morning on 11/6/21"
	"1869769-1"	"1869769-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Pt received booster shot of Moderna covid vaccine on 11/5/2021.  On 11/6/2021 at approx. 0930, pt was found to be unresponsive and asystolic at the nursing home. Last known well was 0600.  After pt was found unresponsive and asystolic, CPR was started and pt was then taken to hospital via squad where resuscitative efforts were continued by ambulance staff and hospital staff.  Pt was pronounced dead at 1013 on the morning on 11/6/21"
	"1869769-1"	"1869769-1"	"RESUSCITATION"	"10038749"	"50-59 years"	"50-59"	"Pt received booster shot of Moderna covid vaccine on 11/5/2021.  On 11/6/2021 at approx. 0930, pt was found to be unresponsive and asystolic at the nursing home. Last known well was 0600.  After pt was found unresponsive and asystolic, CPR was started and pt was then taken to hospital via squad where resuscitative efforts were continued by ambulance staff and hospital staff.  Pt was pronounced dead at 1013 on the morning on 11/6/21"
	"1869769-1"	"1869769-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"50-59 years"	"50-59"	"Pt received booster shot of Moderna covid vaccine on 11/5/2021.  On 11/6/2021 at approx. 0930, pt was found to be unresponsive and asystolic at the nursing home. Last known well was 0600.  After pt was found unresponsive and asystolic, CPR was started and pt was then taken to hospital via squad where resuscitative efforts were continued by ambulance staff and hospital staff.  Pt was pronounced dead at 1013 on the morning on 11/6/21"
	"1872793-1"	"1872793-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	""1. Day 3 after shot woke up feeling ill. 2. First week of September, right leg and foot were swelling up. Dr. prescribed lasix. 3. September 10, 2021 û EKG. Indicated ""Sinus tachycardia. Probable left atrial enlargement.  4. September 16, 2021 decided to not walk/run my dog today and went to ER instead.  I thought perhaps I was dehydrated from the Lasix and would receive fluids and be sent home.  ER doctor indicated that they had seen my same symptoms with Covid-19 and also with the Covid-19 vaccines.  ER advise would have to admit me based upon symptoms.  5. Could find no medical reason for my symptoms. Dr. (cardiology) said diagnosis will be through deducing what I DO NOT have. 6.  Dr. said she thought I had an infection somewhere in my body that impacted my heart. 7. Was told I had heart function of around 20%. 8. Hospitalized for a week. Given several bags of different multiple antibiotics everyday. 9. September 18, 2021 û Dr. said may start a beta blocker on 09/19/2021. Mentioned Lisinopril.  40 IV 2x per day. IV is double dose of Lisinopril. Significant change after given meds without permission or consent.  Given meds to lower blood pressure even though BP was in the 80s and 90s. Meds given and no follow-up to see if I was okay.  Began having troubling breathing asking for oxygen and emergency inhaler. Denied oxygen. Emergency inhaler rarely ever came. September 21, 2021 û Cardiology said no reason to keep in hospital any longer. Dr came in, and said that she was internal medicine.  She said that my kidneys were being taxed and wanted to keep me overnight, start Jardiance and give me fluids.  I advised Dr.  that I was going home today and would not be taking Jardiance. The nurse was uncertain what to do since I refused the Jardiance so asked Dr. who said that she would have to ""write an Addendum to speciality hospital"".  I realized that Dr. had said something out loud that I had no knowledge of what was going on.  I am at this hospital not a patient of this speciality hospital so why and how is this speciality hospital involved or even have knowledge of my situation?  I didn't authorize transmission nor sharing of my medical or any other information with this speciality hospital.  Heart medications given in hospital without my knowlege and consent were by different doctors: Lasix (diuretic) Entresto (BP medication Metoprolol (Beta Blocker) Aldactone (lowers BP/diuretic)   October 11, 2021 - Jaundice. Hospitalized. Never made it home. Here's what happened: I developed multisystem inflammation and multisystem failure that medical professionals could not stop. My muscles disappeared as if to disintegrate. I was in ICU for several weeks and stabbed with needles up to 24 times a day for those several weeks, while also receiving 6 or 7 IVs at the same time (continuously). It was constant torture that I cannot describe. I was no longer treated as a human with feelings and a life. I was nothing more than a covid vaccine human guinea pig and the doctors excited to participate in my fascinating progression unto death.   Died November 1, 2021  Death experience described by patient.  The nursing staff at hospital, indicated that the doctors are not allowed to submit information about reactions nor deaths to the covid-19 vaccine or they will be fired and blacklisted. We were begged to get the information to you and the public.""
	"1872793-1"	"1872793-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	""1. Day 3 after shot woke up feeling ill. 2. First week of September, right leg and foot were swelling up. Dr. prescribed lasix. 3. September 10, 2021 û EKG. Indicated ""Sinus tachycardia. Probable left atrial enlargement.  4. September 16, 2021 decided to not walk/run my dog today and went to ER instead.  I thought perhaps I was dehydrated from the Lasix and would receive fluids and be sent home.  ER doctor indicated that they had seen my same symptoms with Covid-19 and also with the Covid-19 vaccines.  ER advise would have to admit me based upon symptoms.  5. Could find no medical reason for my symptoms. Dr. (cardiology) said diagnosis will be through deducing what I DO NOT have. 6.  Dr. said she thought I had an infection somewhere in my body that impacted my heart. 7. Was told I had heart function of around 20%. 8. Hospitalized for a week. Given several bags of different multiple antibiotics everyday. 9. September 18, 2021 û Dr. said may start a beta blocker on 09/19/2021. Mentioned Lisinopril.  40 IV 2x per day. IV is double dose of Lisinopril. Significant change after given meds without permission or consent.  Given meds to lower blood pressure even though BP was in the 80s and 90s. Meds given and no follow-up to see if I was okay.  Began having troubling breathing asking for oxygen and emergency inhaler. Denied oxygen. Emergency inhaler rarely ever came. September 21, 2021 û Cardiology said no reason to keep in hospital any longer. Dr came in, and said that she was internal medicine.  She said that my kidneys were being taxed and wanted to keep me overnight, start Jardiance and give me fluids.  I advised Dr.  that I was going home today and would not be taking Jardiance. The nurse was uncertain what to do since I refused the Jardiance so asked Dr. who said that she would have to ""write an Addendum to speciality hospital"".  I realized that Dr. had said something out loud that I had no knowledge of what was going on.  I am at this hospital not a patient of this speciality hospital so why and how is this speciality hospital involved or even have knowledge of my situation?  I didn't authorize transmission nor sharing of my medical or any other information with this speciality hospital.  Heart medications given in hospital without my knowlege and consent were by different doctors: Lasix (diuretic) Entresto (BP medication Metoprolol (Beta Blocker) Aldactone (lowers BP/diuretic)   October 11, 2021 - Jaundice. Hospitalized. Never made it home. Here's what happened: I developed multisystem inflammation and multisystem failure that medical professionals could not stop. My muscles disappeared as if to disintegrate. I was in ICU for several weeks and stabbed with needles up to 24 times a day for those several weeks, while also receiving 6 or 7 IVs at the same time (continuously). It was constant torture that I cannot describe. I was no longer treated as a human with feelings and a life. I was nothing more than a covid vaccine human guinea pig and the doctors excited to participate in my fascinating progression unto death.   Died November 1, 2021  Death experience described by patient.  The nursing staff at hospital, indicated that the doctors are not allowed to submit information about reactions nor deaths to the covid-19 vaccine or they will be fired and blacklisted. We were begged to get the information to you and the public.""
	"1872793-1"	"1872793-1"	"EJECTION FRACTION DECREASED"	"10050528"	"50-59 years"	"50-59"	""1. Day 3 after shot woke up feeling ill. 2. First week of September, right leg and foot were swelling up. Dr. prescribed lasix. 3. September 10, 2021 û EKG. Indicated ""Sinus tachycardia. Probable left atrial enlargement.  4. September 16, 2021 decided to not walk/run my dog today and went to ER instead.  I thought perhaps I was dehydrated from the Lasix and would receive fluids and be sent home.  ER doctor indicated that they had seen my same symptoms with Covid-19 and also with the Covid-19 vaccines.  ER advise would have to admit me based upon symptoms.  5. Could find no medical reason for my symptoms. Dr. (cardiology) said diagnosis will be through deducing what I DO NOT have. 6.  Dr. said she thought I had an infection somewhere in my body that impacted my heart. 7. Was told I had heart function of around 20%. 8. Hospitalized for a week. Given several bags of different multiple antibiotics everyday. 9. September 18, 2021 û Dr. said may start a beta blocker on 09/19/2021. Mentioned Lisinopril.  40 IV 2x per day. IV is double dose of Lisinopril. Significant change after given meds without permission or consent.  Given meds to lower blood pressure even though BP was in the 80s and 90s. Meds given and no follow-up to see if I was okay.  Began having troubling breathing asking for oxygen and emergency inhaler. Denied oxygen. Emergency inhaler rarely ever came. September 21, 2021 û Cardiology said no reason to keep in hospital any longer. Dr came in, and said that she was internal medicine.  She said that my kidneys were being taxed and wanted to keep me overnight, start Jardiance and give me fluids.  I advised Dr.  that I was going home today and would not be taking Jardiance. The nurse was uncertain what to do since I refused the Jardiance so asked Dr. who said that she would have to ""write an Addendum to speciality hospital"".  I realized that Dr. had said something out loud that I had no knowledge of what was going on.  I am at this hospital not a patient of this speciality hospital so why and how is this speciality hospital involved or even have knowledge of my situation?  I didn't authorize transmission nor sharing of my medical or any other information with this speciality hospital.  Heart medications given in hospital without my knowlege and consent were by different doctors: Lasix (diuretic) Entresto (BP medication Metoprolol (Beta Blocker) Aldactone (lowers BP/diuretic)   October 11, 2021 - Jaundice. Hospitalized. Never made it home. Here's what happened: I developed multisystem inflammation and multisystem failure that medical professionals could not stop. My muscles disappeared as if to disintegrate. I was in ICU for several weeks and stabbed with needles up to 24 times a day for those several weeks, while also receiving 6 or 7 IVs at the same time (continuously). It was constant torture that I cannot describe. I was no longer treated as a human with feelings and a life. I was nothing more than a covid vaccine human guinea pig and the doctors excited to participate in my fascinating progression unto death.   Died November 1, 2021  Death experience described by patient.  The nursing staff at hospital, indicated that the doctors are not allowed to submit information about reactions nor deaths to the covid-19 vaccine or they will be fired and blacklisted. We were begged to get the information to you and the public.""
	"1872793-1"	"1872793-1"	"ELECTROCARDIOGRAM ABNORMAL"	"10014363"	"50-59 years"	"50-59"	""1. Day 3 after shot woke up feeling ill. 2. First week of September, right leg and foot were swelling up. Dr. prescribed lasix. 3. September 10, 2021 û EKG. Indicated ""Sinus tachycardia. Probable left atrial enlargement.  4. September 16, 2021 decided to not walk/run my dog today and went to ER instead.  I thought perhaps I was dehydrated from the Lasix and would receive fluids and be sent home.  ER doctor indicated that they had seen my same symptoms with Covid-19 and also with the Covid-19 vaccines.  ER advise would have to admit me based upon symptoms.  5. Could find no medical reason for my symptoms. Dr. (cardiology) said diagnosis will be through deducing what I DO NOT have. 6.  Dr. said she thought I had an infection somewhere in my body that impacted my heart. 7. Was told I had heart function of around 20%. 8. Hospitalized for a week. Given several bags of different multiple antibiotics everyday. 9. September 18, 2021 û Dr. said may start a beta blocker on 09/19/2021. Mentioned Lisinopril.  40 IV 2x per day. IV is double dose of Lisinopril. Significant change after given meds without permission or consent.  Given meds to lower blood pressure even though BP was in the 80s and 90s. Meds given and no follow-up to see if I was okay.  Began having troubling breathing asking for oxygen and emergency inhaler. Denied oxygen. Emergency inhaler rarely ever came. September 21, 2021 û Cardiology said no reason to keep in hospital any longer. Dr came in, and said that she was internal medicine.  She said that my kidneys were being taxed and wanted to keep me overnight, start Jardiance and give me fluids.  I advised Dr.  that I was going home today and would not be taking Jardiance. The nurse was uncertain what to do since I refused the Jardiance so asked Dr. who said that she would have to ""write an Addendum to speciality hospital"".  I realized that Dr. had said something out loud that I had no knowledge of what was going on.  I am at this hospital not a patient of this speciality hospital so why and how is this speciality hospital involved or even have knowledge of my situation?  I didn't authorize transmission nor sharing of my medical or any other information with this speciality hospital.  Heart medications given in hospital without my knowlege and consent were by different doctors: Lasix (diuretic) Entresto (BP medication Metoprolol (Beta Blocker) Aldactone (lowers BP/diuretic)   October 11, 2021 - Jaundice. Hospitalized. Never made it home. Here's what happened: I developed multisystem inflammation and multisystem failure that medical professionals could not stop. My muscles disappeared as if to disintegrate. I was in ICU for several weeks and stabbed with needles up to 24 times a day for those several weeks, while also receiving 6 or 7 IVs at the same time (continuously). It was constant torture that I cannot describe. I was no longer treated as a human with feelings and a life. I was nothing more than a covid vaccine human guinea pig and the doctors excited to participate in my fascinating progression unto death.   Died November 1, 2021  Death experience described by patient.  The nursing staff at hospital, indicated that the doctors are not allowed to submit information about reactions nor deaths to the covid-19 vaccine or they will be fired and blacklisted. We were begged to get the information to you and the public.""
	"1872793-1"	"1872793-1"	"INFECTION"	"10021789"	"50-59 years"	"50-59"	""1. Day 3 after shot woke up feeling ill. 2. First week of September, right leg and foot were swelling up. Dr. prescribed lasix. 3. September 10, 2021 û EKG. Indicated ""Sinus tachycardia. Probable left atrial enlargement.  4. September 16, 2021 decided to not walk/run my dog today and went to ER instead.  I thought perhaps I was dehydrated from the Lasix and would receive fluids and be sent home.  ER doctor indicated that they had seen my same symptoms with Covid-19 and also with the Covid-19 vaccines.  ER advise would have to admit me based upon symptoms.  5. Could find no medical reason for my symptoms. Dr. (cardiology) said diagnosis will be through deducing what I DO NOT have. 6.  Dr. said she thought I had an infection somewhere in my body that impacted my heart. 7. Was told I had heart function of around 20%. 8. Hospitalized for a week. Given several bags of different multiple antibiotics everyday. 9. September 18, 2021 û Dr. said may start a beta blocker on 09/19/2021. Mentioned Lisinopril.  40 IV 2x per day. IV is double dose of Lisinopril. Significant change after given meds without permission or consent.  Given meds to lower blood pressure even though BP was in the 80s and 90s. Meds given and no follow-up to see if I was okay.  Began having troubling breathing asking for oxygen and emergency inhaler. Denied oxygen. Emergency inhaler rarely ever came. September 21, 2021 û Cardiology said no reason to keep in hospital any longer. Dr came in, and said that she was internal medicine.  She said that my kidneys were being taxed and wanted to keep me overnight, start Jardiance and give me fluids.  I advised Dr.  that I was going home today and would not be taking Jardiance. The nurse was uncertain what to do since I refused the Jardiance so asked Dr. who said that she would have to ""write an Addendum to speciality hospital"".  I realized that Dr. had said something out loud that I had no knowledge of what was going on.  I am at this hospital not a patient of this speciality hospital so why and how is this speciality hospital involved or even have knowledge of my situation?  I didn't authorize transmission nor sharing of my medical or any other information with this speciality hospital.  Heart medications given in hospital without my knowlege and consent were by different doctors: Lasix (diuretic) Entresto (BP medication Metoprolol (Beta Blocker) Aldactone (lowers BP/diuretic)   October 11, 2021 - Jaundice. Hospitalized. Never made it home. Here's what happened: I developed multisystem inflammation and multisystem failure that medical professionals could not stop. My muscles disappeared as if to disintegrate. I was in ICU for several weeks and stabbed with needles up to 24 times a day for those several weeks, while also receiving 6 or 7 IVs at the same time (continuously). It was constant torture that I cannot describe. I was no longer treated as a human with feelings and a life. I was nothing more than a covid vaccine human guinea pig and the doctors excited to participate in my fascinating progression unto death.   Died November 1, 2021  Death experience described by patient.  The nursing staff at hospital, indicated that the doctors are not allowed to submit information about reactions nor deaths to the covid-19 vaccine or they will be fired and blacklisted. We were begged to get the information to you and the public.""
	"1872793-1"	"1872793-1"	"INFLAMMATION"	"10061218"	"50-59 years"	"50-59"	""1. Day 3 after shot woke up feeling ill. 2. First week of September, right leg and foot were swelling up. Dr. prescribed lasix. 3. September 10, 2021 û EKG. Indicated ""Sinus tachycardia. Probable left atrial enlargement.  4. September 16, 2021 decided to not walk/run my dog today and went to ER instead.  I thought perhaps I was dehydrated from the Lasix and would receive fluids and be sent home.  ER doctor indicated that they had seen my same symptoms with Covid-19 and also with the Covid-19 vaccines.  ER advise would have to admit me based upon symptoms.  5. Could find no medical reason for my symptoms. Dr. (cardiology) said diagnosis will be through deducing what I DO NOT have. 6.  Dr. said she thought I had an infection somewhere in my body that impacted my heart. 7. Was told I had heart function of around 20%. 8. Hospitalized for a week. Given several bags of different multiple antibiotics everyday. 9. September 18, 2021 û Dr. said may start a beta blocker on 09/19/2021. Mentioned Lisinopril.  40 IV 2x per day. IV is double dose of Lisinopril. Significant change after given meds without permission or consent.  Given meds to lower blood pressure even though BP was in the 80s and 90s. Meds given and no follow-up to see if I was okay.  Began having troubling breathing asking for oxygen and emergency inhaler. Denied oxygen. Emergency inhaler rarely ever came. September 21, 2021 û Cardiology said no reason to keep in hospital any longer. Dr came in, and said that she was internal medicine.  She said that my kidneys were being taxed and wanted to keep me overnight, start Jardiance and give me fluids.  I advised Dr.  that I was going home today and would not be taking Jardiance. The nurse was uncertain what to do since I refused the Jardiance so asked Dr. who said that she would have to ""write an Addendum to speciality hospital"".  I realized that Dr. had said something out loud that I had no knowledge of what was going on.  I am at this hospital not a patient of this speciality hospital so why and how is this speciality hospital involved or even have knowledge of my situation?  I didn't authorize transmission nor sharing of my medical or any other information with this speciality hospital.  Heart medications given in hospital without my knowlege and consent were by different doctors: Lasix (diuretic) Entresto (BP medication Metoprolol (Beta Blocker) Aldactone (lowers BP/diuretic)   October 11, 2021 - Jaundice. Hospitalized. Never made it home. Here's what happened: I developed multisystem inflammation and multisystem failure that medical professionals could not stop. My muscles disappeared as if to disintegrate. I was in ICU for several weeks and stabbed with needles up to 24 times a day for those several weeks, while also receiving 6 or 7 IVs at the same time (continuously). It was constant torture that I cannot describe. I was no longer treated as a human with feelings and a life. I was nothing more than a covid vaccine human guinea pig and the doctors excited to participate in my fascinating progression unto death.   Died November 1, 2021  Death experience described by patient.  The nursing staff at hospital, indicated that the doctors are not allowed to submit information about reactions nor deaths to the covid-19 vaccine or they will be fired and blacklisted. We were begged to get the information to you and the public.""
	"1872793-1"	"1872793-1"	"INTENSIVE CARE"	"10022519"	"50-59 years"	"50-59"	""1. Day 3 after shot woke up feeling ill. 2. First week of September, right leg and foot were swelling up. Dr. prescribed lasix. 3. September 10, 2021 û EKG. Indicated ""Sinus tachycardia. Probable left atrial enlargement.  4. September 16, 2021 decided to not walk/run my dog today and went to ER instead.  I thought perhaps I was dehydrated from the Lasix and would receive fluids and be sent home.  ER doctor indicated that they had seen my same symptoms with Covid-19 and also with the Covid-19 vaccines.  ER advise would have to admit me based upon symptoms.  5. Could find no medical reason for my symptoms. Dr. (cardiology) said diagnosis will be through deducing what I DO NOT have. 6.  Dr. said she thought I had an infection somewhere in my body that impacted my heart. 7. Was told I had heart function of around 20%. 8. Hospitalized for a week. Given several bags of different multiple antibiotics everyday. 9. September 18, 2021 û Dr. said may start a beta blocker on 09/19/2021. Mentioned Lisinopril.  40 IV 2x per day. IV is double dose of Lisinopril. Significant change after given meds without permission or consent.  Given meds to lower blood pressure even though BP was in the 80s and 90s. Meds given and no follow-up to see if I was okay.  Began having troubling breathing asking for oxygen and emergency inhaler. Denied oxygen. Emergency inhaler rarely ever came. September 21, 2021 û Cardiology said no reason to keep in hospital any longer. Dr came in, and said that she was internal medicine.  She said that my kidneys were being taxed and wanted to keep me overnight, start Jardiance and give me fluids.  I advised Dr.  that I was going home today and would not be taking Jardiance. The nurse was uncertain what to do since I refused the Jardiance so asked Dr. who said that she would have to ""write an Addendum to speciality hospital"".  I realized that Dr. had said something out loud that I had no knowledge of what was going on.  I am at this hospital not a patient of this speciality hospital so why and how is this speciality hospital involved or even have knowledge of my situation?  I didn't authorize transmission nor sharing of my medical or any other information with this speciality hospital.  Heart medications given in hospital without my knowlege and consent were by different doctors: Lasix (diuretic) Entresto (BP medication Metoprolol (Beta Blocker) Aldactone (lowers BP/diuretic)   October 11, 2021 - Jaundice. Hospitalized. Never made it home. Here's what happened: I developed multisystem inflammation and multisystem failure that medical professionals could not stop. My muscles disappeared as if to disintegrate. I was in ICU for several weeks and stabbed with needles up to 24 times a day for those several weeks, while also receiving 6 or 7 IVs at the same time (continuously). It was constant torture that I cannot describe. I was no longer treated as a human with feelings and a life. I was nothing more than a covid vaccine human guinea pig and the doctors excited to participate in my fascinating progression unto death.   Died November 1, 2021  Death experience described by patient.  The nursing staff at hospital, indicated that the doctors are not allowed to submit information about reactions nor deaths to the covid-19 vaccine or they will be fired and blacklisted. We were begged to get the information to you and the public.""
	"1872793-1"	"1872793-1"	"JAUNDICE"	"10023126"	"50-59 years"	"50-59"	""1. Day 3 after shot woke up feeling ill. 2. First week of September, right leg and foot were swelling up. Dr. prescribed lasix. 3. September 10, 2021 û EKG. Indicated ""Sinus tachycardia. Probable left atrial enlargement.  4. September 16, 2021 decided to not walk/run my dog today and went to ER instead.  I thought perhaps I was dehydrated from the Lasix and would receive fluids and be sent home.  ER doctor indicated that they had seen my same symptoms with Covid-19 and also with the Covid-19 vaccines.  ER advise would have to admit me based upon symptoms.  5. Could find no medical reason for my symptoms. Dr. (cardiology) said diagnosis will be through deducing what I DO NOT have. 6.  Dr. said she thought I had an infection somewhere in my body that impacted my heart. 7. Was told I had heart function of around 20%. 8. Hospitalized for a week. Given several bags of different multiple antibiotics everyday. 9. September 18, 2021 û Dr. said may start a beta blocker on 09/19/2021. Mentioned Lisinopril.  40 IV 2x per day. IV is double dose of Lisinopril. Significant change after given meds without permission or consent.  Given meds to lower blood pressure even though BP was in the 80s and 90s. Meds given and no follow-up to see if I was okay.  Began having troubling breathing asking for oxygen and emergency inhaler. Denied oxygen. Emergency inhaler rarely ever came. September 21, 2021 û Cardiology said no reason to keep in hospital any longer. Dr came in, and said that she was internal medicine.  She said that my kidneys were being taxed and wanted to keep me overnight, start Jardiance and give me fluids.  I advised Dr.  that I was going home today and would not be taking Jardiance. The nurse was uncertain what to do since I refused the Jardiance so asked Dr. who said that she would have to ""write an Addendum to speciality hospital"".  I realized that Dr. had said something out loud that I had no knowledge of what was going on.  I am at this hospital not a patient of this speciality hospital so why and how is this speciality hospital involved or even have knowledge of my situation?  I didn't authorize transmission nor sharing of my medical or any other information with this speciality hospital.  Heart medications given in hospital without my knowlege and consent were by different doctors: Lasix (diuretic) Entresto (BP medication Metoprolol (Beta Blocker) Aldactone (lowers BP/diuretic)   October 11, 2021 - Jaundice. Hospitalized. Never made it home. Here's what happened: I developed multisystem inflammation and multisystem failure that medical professionals could not stop. My muscles disappeared as if to disintegrate. I was in ICU for several weeks and stabbed with needles up to 24 times a day for those several weeks, while also receiving 6 or 7 IVs at the same time (continuously). It was constant torture that I cannot describe. I was no longer treated as a human with feelings and a life. I was nothing more than a covid vaccine human guinea pig and the doctors excited to participate in my fascinating progression unto death.   Died November 1, 2021  Death experience described by patient.  The nursing staff at hospital, indicated that the doctors are not allowed to submit information about reactions nor deaths to the covid-19 vaccine or they will be fired and blacklisted. We were begged to get the information to you and the public.""
	"1872793-1"	"1872793-1"	"LEFT ATRIAL ENLARGEMENT"	"10051860"	"50-59 years"	"50-59"	""1. Day 3 after shot woke up feeling ill. 2. First week of September, right leg and foot were swelling up. Dr. prescribed lasix. 3. September 10, 2021 û EKG. Indicated ""Sinus tachycardia. Probable left atrial enlargement.  4. September 16, 2021 decided to not walk/run my dog today and went to ER instead.  I thought perhaps I was dehydrated from the Lasix and would receive fluids and be sent home.  ER doctor indicated that they had seen my same symptoms with Covid-19 and also with the Covid-19 vaccines.  ER advise would have to admit me based upon symptoms.  5. Could find no medical reason for my symptoms. Dr. (cardiology) said diagnosis will be through deducing what I DO NOT have. 6.  Dr. said she thought I had an infection somewhere in my body that impacted my heart. 7. Was told I had heart function of around 20%. 8. Hospitalized for a week. Given several bags of different multiple antibiotics everyday. 9. September 18, 2021 û Dr. said may start a beta blocker on 09/19/2021. Mentioned Lisinopril.  40 IV 2x per day. IV is double dose of Lisinopril. Significant change after given meds without permission or consent.  Given meds to lower blood pressure even though BP was in the 80s and 90s. Meds given and no follow-up to see if I was okay.  Began having troubling breathing asking for oxygen and emergency inhaler. Denied oxygen. Emergency inhaler rarely ever came. September 21, 2021 û Cardiology said no reason to keep in hospital any longer. Dr came in, and said that she was internal medicine.  She said that my kidneys were being taxed and wanted to keep me overnight, start Jardiance and give me fluids.  I advised Dr.  that I was going home today and would not be taking Jardiance. The nurse was uncertain what to do since I refused the Jardiance so asked Dr. who said that she would have to ""write an Addendum to speciality hospital"".  I realized that Dr. had said something out loud that I had no knowledge of what was going on.  I am at this hospital not a patient of this speciality hospital so why and how is this speciality hospital involved or even have knowledge of my situation?  I didn't authorize transmission nor sharing of my medical or any other information with this speciality hospital.  Heart medications given in hospital without my knowlege and consent were by different doctors: Lasix (diuretic) Entresto (BP medication Metoprolol (Beta Blocker) Aldactone (lowers BP/diuretic)   October 11, 2021 - Jaundice. Hospitalized. Never made it home. Here's what happened: I developed multisystem inflammation and multisystem failure that medical professionals could not stop. My muscles disappeared as if to disintegrate. I was in ICU for several weeks and stabbed with needles up to 24 times a day for those several weeks, while also receiving 6 or 7 IVs at the same time (continuously). It was constant torture that I cannot describe. I was no longer treated as a human with feelings and a life. I was nothing more than a covid vaccine human guinea pig and the doctors excited to participate in my fascinating progression unto death.   Died November 1, 2021  Death experience described by patient.  The nursing staff at hospital, indicated that the doctors are not allowed to submit information about reactions nor deaths to the covid-19 vaccine or they will be fired and blacklisted. We were begged to get the information to you and the public.""
	"1872793-1"	"1872793-1"	"MALAISE"	"10025482"	"50-59 years"	"50-59"	""1. Day 3 after shot woke up feeling ill. 2. First week of September, right leg and foot were swelling up. Dr. prescribed lasix. 3. September 10, 2021 û EKG. Indicated ""Sinus tachycardia. Probable left atrial enlargement.  4. September 16, 2021 decided to not walk/run my dog today and went to ER instead.  I thought perhaps I was dehydrated from the Lasix and would receive fluids and be sent home.  ER doctor indicated that they had seen my same symptoms with Covid-19 and also with the Covid-19 vaccines.  ER advise would have to admit me based upon symptoms.  5. Could find no medical reason for my symptoms. Dr. (cardiology) said diagnosis will be through deducing what I DO NOT have. 6.  Dr. said she thought I had an infection somewhere in my body that impacted my heart. 7. Was told I had heart function of around 20%. 8. Hospitalized for a week. Given several bags of different multiple antibiotics everyday. 9. September 18, 2021 û Dr. said may start a beta blocker on 09/19/2021. Mentioned Lisinopril.  40 IV 2x per day. IV is double dose of Lisinopril. Significant change after given meds without permission or consent.  Given meds to lower blood pressure even though BP was in the 80s and 90s. Meds given and no follow-up to see if I was okay.  Began having troubling breathing asking for oxygen and emergency inhaler. Denied oxygen. Emergency inhaler rarely ever came. September 21, 2021 û Cardiology said no reason to keep in hospital any longer. Dr came in, and said that she was internal medicine.  She said that my kidneys were being taxed and wanted to keep me overnight, start Jardiance and give me fluids.  I advised Dr.  that I was going home today and would not be taking Jardiance. The nurse was uncertain what to do since I refused the Jardiance so asked Dr. who said that she would have to ""write an Addendum to speciality hospital"".  I realized that Dr. had said something out loud that I had no knowledge of what was going on.  I am at this hospital not a patient of this speciality hospital so why and how is this speciality hospital involved or even have knowledge of my situation?  I didn't authorize transmission nor sharing of my medical or any other information with this speciality hospital.  Heart medications given in hospital without my knowlege and consent were by different doctors: Lasix (diuretic) Entresto (BP medication Metoprolol (Beta Blocker) Aldactone (lowers BP/diuretic)   October 11, 2021 - Jaundice. Hospitalized. Never made it home. Here's what happened: I developed multisystem inflammation and multisystem failure that medical professionals could not stop. My muscles disappeared as if to disintegrate. I was in ICU for several weeks and stabbed with needles up to 24 times a day for those several weeks, while also receiving 6 or 7 IVs at the same time (continuously). It was constant torture that I cannot describe. I was no longer treated as a human with feelings and a life. I was nothing more than a covid vaccine human guinea pig and the doctors excited to participate in my fascinating progression unto death.   Died November 1, 2021  Death experience described by patient.  The nursing staff at hospital, indicated that the doctors are not allowed to submit information about reactions nor deaths to the covid-19 vaccine or they will be fired and blacklisted. We were begged to get the information to you and the public.""
	"1872793-1"	"1872793-1"	"MULTIPLE ORGAN DYSFUNCTION SYNDROME"	"10077361"	"50-59 years"	"50-59"	""1. Day 3 after shot woke up feeling ill. 2. First week of September, right leg and foot were swelling up. Dr. prescribed lasix. 3. September 10, 2021 û EKG. Indicated ""Sinus tachycardia. Probable left atrial enlargement.  4. September 16, 2021 decided to not walk/run my dog today and went to ER instead.  I thought perhaps I was dehydrated from the Lasix and would receive fluids and be sent home.  ER doctor indicated that they had seen my same symptoms with Covid-19 and also with the Covid-19 vaccines.  ER advise would have to admit me based upon symptoms.  5. Could find no medical reason for my symptoms. Dr. (cardiology) said diagnosis will be through deducing what I DO NOT have. 6.  Dr. said she thought I had an infection somewhere in my body that impacted my heart. 7. Was told I had heart function of around 20%. 8. Hospitalized for a week. Given several bags of different multiple antibiotics everyday. 9. September 18, 2021 û Dr. said may start a beta blocker on 09/19/2021. Mentioned Lisinopril.  40 IV 2x per day. IV is double dose of Lisinopril. Significant change after given meds without permission or consent.  Given meds to lower blood pressure even though BP was in the 80s and 90s. Meds given and no follow-up to see if I was okay.  Began having troubling breathing asking for oxygen and emergency inhaler. Denied oxygen. Emergency inhaler rarely ever came. September 21, 2021 û Cardiology said no reason to keep in hospital any longer. Dr came in, and said that she was internal medicine.  She said that my kidneys were being taxed and wanted to keep me overnight, start Jardiance and give me fluids.  I advised Dr.  that I was going home today and would not be taking Jardiance. The nurse was uncertain what to do since I refused the Jardiance so asked Dr. who said that she would have to ""write an Addendum to speciality hospital"".  I realized that Dr. had said something out loud that I had no knowledge of what was going on.  I am at this hospital not a patient of this speciality hospital so why and how is this speciality hospital involved or even have knowledge of my situation?  I didn't authorize transmission nor sharing of my medical or any other information with this speciality hospital.  Heart medications given in hospital without my knowlege and consent were by different doctors: Lasix (diuretic) Entresto (BP medication Metoprolol (Beta Blocker) Aldactone (lowers BP/diuretic)   October 11, 2021 - Jaundice. Hospitalized. Never made it home. Here's what happened: I developed multisystem inflammation and multisystem failure that medical professionals could not stop. My muscles disappeared as if to disintegrate. I was in ICU for several weeks and stabbed with needles up to 24 times a day for those several weeks, while also receiving 6 or 7 IVs at the same time (continuously). It was constant torture that I cannot describe. I was no longer treated as a human with feelings and a life. I was nothing more than a covid vaccine human guinea pig and the doctors excited to participate in my fascinating progression unto death.   Died November 1, 2021  Death experience described by patient.  The nursing staff at hospital, indicated that the doctors are not allowed to submit information about reactions nor deaths to the covid-19 vaccine or they will be fired and blacklisted. We were begged to get the information to you and the public.""
	"1872793-1"	"1872793-1"	"MUSCLE ATROPHY"	"10028289"	"50-59 years"	"50-59"	""1. Day 3 after shot woke up feeling ill. 2. First week of September, right leg and foot were swelling up. Dr. prescribed lasix. 3. September 10, 2021 û EKG. Indicated ""Sinus tachycardia. Probable left atrial enlargement.  4. September 16, 2021 decided to not walk/run my dog today and went to ER instead.  I thought perhaps I was dehydrated from the Lasix and would receive fluids and be sent home.  ER doctor indicated that they had seen my same symptoms with Covid-19 and also with the Covid-19 vaccines.  ER advise would have to admit me based upon symptoms.  5. Could find no medical reason for my symptoms. Dr. (cardiology) said diagnosis will be through deducing what I DO NOT have. 6.  Dr. said she thought I had an infection somewhere in my body that impacted my heart. 7. Was told I had heart function of around 20%. 8. Hospitalized for a week. Given several bags of different multiple antibiotics everyday. 9. September 18, 2021 û Dr. said may start a beta blocker on 09/19/2021. Mentioned Lisinopril.  40 IV 2x per day. IV is double dose of Lisinopril. Significant change after given meds without permission or consent.  Given meds to lower blood pressure even though BP was in the 80s and 90s. Meds given and no follow-up to see if I was okay.  Began having troubling breathing asking for oxygen and emergency inhaler. Denied oxygen. Emergency inhaler rarely ever came. September 21, 2021 û Cardiology said no reason to keep in hospital any longer. Dr came in, and said that she was internal medicine.  She said that my kidneys were being taxed and wanted to keep me overnight, start Jardiance and give me fluids.  I advised Dr.  that I was going home today and would not be taking Jardiance. The nurse was uncertain what to do since I refused the Jardiance so asked Dr. who said that she would have to ""write an Addendum to speciality hospital"".  I realized that Dr. had said something out loud that I had no knowledge of what was going on.  I am at this hospital not a patient of this speciality hospital so why and how is this speciality hospital involved or even have knowledge of my situation?  I didn't authorize transmission nor sharing of my medical or any other information with this speciality hospital.  Heart medications given in hospital without my knowlege and consent were by different doctors: Lasix (diuretic) Entresto (BP medication Metoprolol (Beta Blocker) Aldactone (lowers BP/diuretic)   October 11, 2021 - Jaundice. Hospitalized. Never made it home. Here's what happened: I developed multisystem inflammation and multisystem failure that medical professionals could not stop. My muscles disappeared as if to disintegrate. I was in ICU for several weeks and stabbed with needles up to 24 times a day for those several weeks, while also receiving 6 or 7 IVs at the same time (continuously). It was constant torture that I cannot describe. I was no longer treated as a human with feelings and a life. I was nothing more than a covid vaccine human guinea pig and the doctors excited to participate in my fascinating progression unto death.   Died November 1, 2021  Death experience described by patient.  The nursing staff at hospital, indicated that the doctors are not allowed to submit information about reactions nor deaths to the covid-19 vaccine or they will be fired and blacklisted. We were begged to get the information to you and the public.""
	"1872793-1"	"1872793-1"	"PERIPHERAL SWELLING"	"10048959"	"50-59 years"	"50-59"	""1. Day 3 after shot woke up feeling ill. 2. First week of September, right leg and foot were swelling up. Dr. prescribed lasix. 3. September 10, 2021 û EKG. Indicated ""Sinus tachycardia. Probable left atrial enlargement.  4. September 16, 2021 decided to not walk/run my dog today and went to ER instead.  I thought perhaps I was dehydrated from the Lasix and would receive fluids and be sent home.  ER doctor indicated that they had seen my same symptoms with Covid-19 and also with the Covid-19 vaccines.  ER advise would have to admit me based upon symptoms.  5. Could find no medical reason for my symptoms. Dr. (cardiology) said diagnosis will be through deducing what I DO NOT have. 6.  Dr. said she thought I had an infection somewhere in my body that impacted my heart. 7. Was told I had heart function of around 20%. 8. Hospitalized for a week. Given several bags of different multiple antibiotics everyday. 9. September 18, 2021 û Dr. said may start a beta blocker on 09/19/2021. Mentioned Lisinopril.  40 IV 2x per day. IV is double dose of Lisinopril. Significant change after given meds without permission or consent.  Given meds to lower blood pressure even though BP was in the 80s and 90s. Meds given and no follow-up to see if I was okay.  Began having troubling breathing asking for oxygen and emergency inhaler. Denied oxygen. Emergency inhaler rarely ever came. September 21, 2021 û Cardiology said no reason to keep in hospital any longer. Dr came in, and said that she was internal medicine.  She said that my kidneys were being taxed and wanted to keep me overnight, start Jardiance and give me fluids.  I advised Dr.  that I was going home today and would not be taking Jardiance. The nurse was uncertain what to do since I refused the Jardiance so asked Dr. who said that she would have to ""write an Addendum to speciality hospital"".  I realized that Dr. had said something out loud that I had no knowledge of what was going on.  I am at this hospital not a patient of this speciality hospital so why and how is this speciality hospital involved or even have knowledge of my situation?  I didn't authorize transmission nor sharing of my medical or any other information with this speciality hospital.  Heart medications given in hospital without my knowlege and consent were by different doctors: Lasix (diuretic) Entresto (BP medication Metoprolol (Beta Blocker) Aldactone (lowers BP/diuretic)   October 11, 2021 - Jaundice. Hospitalized. Never made it home. Here's what happened: I developed multisystem inflammation and multisystem failure that medical professionals could not stop. My muscles disappeared as if to disintegrate. I was in ICU for several weeks and stabbed with needles up to 24 times a day for those several weeks, while also receiving 6 or 7 IVs at the same time (continuously). It was constant torture that I cannot describe. I was no longer treated as a human with feelings and a life. I was nothing more than a covid vaccine human guinea pig and the doctors excited to participate in my fascinating progression unto death.   Died November 1, 2021  Death experience described by patient.  The nursing staff at hospital, indicated that the doctors are not allowed to submit information about reactions nor deaths to the covid-19 vaccine or they will be fired and blacklisted. We were begged to get the information to you and the public.""
	"1872793-1"	"1872793-1"	"SINUS TACHYCARDIA"	"10040752"	"50-59 years"	"50-59"	""1. Day 3 after shot woke up feeling ill. 2. First week of September, right leg and foot were swelling up. Dr. prescribed lasix. 3. September 10, 2021 û EKG. Indicated ""Sinus tachycardia. Probable left atrial enlargement.  4. September 16, 2021 decided to not walk/run my dog today and went to ER instead.  I thought perhaps I was dehydrated from the Lasix and would receive fluids and be sent home.  ER doctor indicated that they had seen my same symptoms with Covid-19 and also with the Covid-19 vaccines.  ER advise would have to admit me based upon symptoms.  5. Could find no medical reason for my symptoms. Dr. (cardiology) said diagnosis will be through deducing what I DO NOT have. 6.  Dr. said she thought I had an infection somewhere in my body that impacted my heart. 7. Was told I had heart function of around 20%. 8. Hospitalized for a week. Given several bags of different multiple antibiotics everyday. 9. September 18, 2021 û Dr. said may start a beta blocker on 09/19/2021. Mentioned Lisinopril.  40 IV 2x per day. IV is double dose of Lisinopril. Significant change after given meds without permission or consent.  Given meds to lower blood pressure even though BP was in the 80s and 90s. Meds given and no follow-up to see if I was okay.  Began having troubling breathing asking for oxygen and emergency inhaler. Denied oxygen. Emergency inhaler rarely ever came. September 21, 2021 û Cardiology said no reason to keep in hospital any longer. Dr came in, and said that she was internal medicine.  She said that my kidneys were being taxed and wanted to keep me overnight, start Jardiance and give me fluids.  I advised Dr.  that I was going home today and would not be taking Jardiance. The nurse was uncertain what to do since I refused the Jardiance so asked Dr. who said that she would have to ""write an Addendum to speciality hospital"".  I realized that Dr. had said something out loud that I had no knowledge of what was going on.  I am at this hospital not a patient of this speciality hospital so why and how is this speciality hospital involved or even have knowledge of my situation?  I didn't authorize transmission nor sharing of my medical or any other information with this speciality hospital.  Heart medications given in hospital without my knowlege and consent were by different doctors: Lasix (diuretic) Entresto (BP medication Metoprolol (Beta Blocker) Aldactone (lowers BP/diuretic)   October 11, 2021 - Jaundice. Hospitalized. Never made it home. Here's what happened: I developed multisystem inflammation and multisystem failure that medical professionals could not stop. My muscles disappeared as if to disintegrate. I was in ICU for several weeks and stabbed with needles up to 24 times a day for those several weeks, while also receiving 6 or 7 IVs at the same time (continuously). It was constant torture that I cannot describe. I was no longer treated as a human with feelings and a life. I was nothing more than a covid vaccine human guinea pig and the doctors excited to participate in my fascinating progression unto death.   Died November 1, 2021  Death experience described by patient.  The nursing staff at hospital, indicated that the doctors are not allowed to submit information about reactions nor deaths to the covid-19 vaccine or they will be fired and blacklisted. We were begged to get the information to you and the public.""
	"1872949-1"	"1872949-1"	"ACUTE MYOCARDIAL INFARCTION"	"10000891"	"50-59 years"	"50-59"	"I am the epidemiologist reporting on behalf of 59 year-old male patient.  Patient received one dose of the Pfizer vaccine on 4/06/2021, according to immunization records.  The patient passed away on 4/08/2021 (2 days post first dose, hospital inpatient). The death certificate lists ?ST Elevation, Myocardial Infarction? as the immediate cause of death due to or as a consequence of acute cholecystitis and diabetic ketoacidosis. No additional information regarding underlying conditions that may have contributed to this death is available."
	"1872949-1"	"1872949-1"	"CHOLECYSTITIS ACUTE"	"10008614"	"50-59 years"	"50-59"	"I am the epidemiologist reporting on behalf of 59 year-old male patient.  Patient received one dose of the Pfizer vaccine on 4/06/2021, according to immunization records.  The patient passed away on 4/08/2021 (2 days post first dose, hospital inpatient). The death certificate lists ?ST Elevation, Myocardial Infarction? as the immediate cause of death due to or as a consequence of acute cholecystitis and diabetic ketoacidosis. No additional information regarding underlying conditions that may have contributed to this death is available."
	"1872949-1"	"1872949-1"	"CONDITION AGGRAVATED"	"10010264"	"50-59 years"	"50-59"	"I am the epidemiologist reporting on behalf of 59 year-old male patient.  Patient received one dose of the Pfizer vaccine on 4/06/2021, according to immunization records.  The patient passed away on 4/08/2021 (2 days post first dose, hospital inpatient). The death certificate lists ?ST Elevation, Myocardial Infarction? as the immediate cause of death due to or as a consequence of acute cholecystitis and diabetic ketoacidosis. No additional information regarding underlying conditions that may have contributed to this death is available."
	"1872949-1"	"1872949-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"I am the epidemiologist reporting on behalf of 59 year-old male patient.  Patient received one dose of the Pfizer vaccine on 4/06/2021, according to immunization records.  The patient passed away on 4/08/2021 (2 days post first dose, hospital inpatient). The death certificate lists ?ST Elevation, Myocardial Infarction? as the immediate cause of death due to or as a consequence of acute cholecystitis and diabetic ketoacidosis. No additional information regarding underlying conditions that may have contributed to this death is available."
	"1872949-1"	"1872949-1"	"DIABETIC KETOACIDOSIS"	"10012671"	"50-59 years"	"50-59"	"I am the epidemiologist reporting on behalf of 59 year-old male patient.  Patient received one dose of the Pfizer vaccine on 4/06/2021, according to immunization records.  The patient passed away on 4/08/2021 (2 days post first dose, hospital inpatient). The death certificate lists ?ST Elevation, Myocardial Infarction? as the immediate cause of death due to or as a consequence of acute cholecystitis and diabetic ketoacidosis. No additional information regarding underlying conditions that may have contributed to this death is available."
	"1873297-1"	"1873297-1"	"COVID-19 PNEUMONIA"	"10084380"	"50-59 years"	"50-59"	"Patient came to ED with worsening SOB.  Patient was admitted for pneumonia due to COVID and hypoxia."
	"1873297-1"	"1873297-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"Patient came to ED with worsening SOB.  Patient was admitted for pneumonia due to COVID and hypoxia."
	"1873297-1"	"1873297-1"	"HYPOXIA"	"10021143"	"50-59 years"	"50-59"	"Patient came to ED with worsening SOB.  Patient was admitted for pneumonia due to COVID and hypoxia."
	"1876715-1"	"1876715-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"Vaccine dose #1 given 4/3/2021 Lot # EW0151 Pfizer  Patient had a cardiac arrest at home at died in the ED. Not a covid related death."
	"1876715-1"	"1876715-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Vaccine dose #1 given 4/3/2021 Lot # EW0151 Pfizer  Patient had a cardiac arrest at home at died in the ED. Not a covid related death."
	"1876807-1"	"1876807-1"	"ASPIRATION PLEURAL CAVITY"	"10003522"	"50-59 years"	"50-59"	"54M presented with respiratory failure secondary to pleural effusion. The patient was admitted to medsurg and started on diuretics. Plans were made for us guided thoracentesis and likely paracentesis, as well. The patient decompensated, requiring emergent thoracentesis. He was placed on bipap at that time and started on zosyn. When I arrived to hospital day after admission, stat response was called to patient's room and he was rapidly transported to the ICU for intubation and to be started on vasopressors as he had become confused and hypotensive. It was not clear why. In the ICU, he was intubated and started on vasopressors. Central line was placed. He was transfused two units, but lactic started climbing and his hgb did not improve appropriately. Massive transfusion protocol was initiated. Patient's family was contacted by intensivist, and ultimately they decided to withdraw life sustaining treatment.    The patient expired on 10/3 @ 1650 due to hemorrhagic shock secondary to upper GI bleeding in the context of chronic decompensated cirrhosis of the liver."
	"1876807-1"	"1876807-1"	"BLOOD LACTIC ACID INCREASED"	"10005635"	"50-59 years"	"50-59"	"54M presented with respiratory failure secondary to pleural effusion. The patient was admitted to medsurg and started on diuretics. Plans were made for us guided thoracentesis and likely paracentesis, as well. The patient decompensated, requiring emergent thoracentesis. He was placed on bipap at that time and started on zosyn. When I arrived to hospital day after admission, stat response was called to patient's room and he was rapidly transported to the ICU for intubation and to be started on vasopressors as he had become confused and hypotensive. It was not clear why. In the ICU, he was intubated and started on vasopressors. Central line was placed. He was transfused two units, but lactic started climbing and his hgb did not improve appropriately. Massive transfusion protocol was initiated. Patient's family was contacted by intensivist, and ultimately they decided to withdraw life sustaining treatment.    The patient expired on 10/3 @ 1650 due to hemorrhagic shock secondary to upper GI bleeding in the context of chronic decompensated cirrhosis of the liver."
	"1876807-1"	"1876807-1"	"CONFUSIONAL STATE"	"10010305"	"50-59 years"	"50-59"	"54M presented with respiratory failure secondary to pleural effusion. The patient was admitted to medsurg and started on diuretics. Plans were made for us guided thoracentesis and likely paracentesis, as well. The patient decompensated, requiring emergent thoracentesis. He was placed on bipap at that time and started on zosyn. When I arrived to hospital day after admission, stat response was called to patient's room and he was rapidly transported to the ICU for intubation and to be started on vasopressors as he had become confused and hypotensive. It was not clear why. In the ICU, he was intubated and started on vasopressors. Central line was placed. He was transfused two units, but lactic started climbing and his hgb did not improve appropriately. Massive transfusion protocol was initiated. Patient's family was contacted by intensivist, and ultimately they decided to withdraw life sustaining treatment.    The patient expired on 10/3 @ 1650 due to hemorrhagic shock secondary to upper GI bleeding in the context of chronic decompensated cirrhosis of the liver."
	"1876807-1"	"1876807-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"54M presented with respiratory failure secondary to pleural effusion. The patient was admitted to medsurg and started on diuretics. Plans were made for us guided thoracentesis and likely paracentesis, as well. The patient decompensated, requiring emergent thoracentesis. He was placed on bipap at that time and started on zosyn. When I arrived to hospital day after admission, stat response was called to patient's room and he was rapidly transported to the ICU for intubation and to be started on vasopressors as he had become confused and hypotensive. It was not clear why. In the ICU, he was intubated and started on vasopressors. Central line was placed. He was transfused two units, but lactic started climbing and his hgb did not improve appropriately. Massive transfusion protocol was initiated. Patient's family was contacted by intensivist, and ultimately they decided to withdraw life sustaining treatment.    The patient expired on 10/3 @ 1650 due to hemorrhagic shock secondary to upper GI bleeding in the context of chronic decompensated cirrhosis of the liver."
	"1876807-1"	"1876807-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"50-59 years"	"50-59"	"54M presented with respiratory failure secondary to pleural effusion. The patient was admitted to medsurg and started on diuretics. Plans were made for us guided thoracentesis and likely paracentesis, as well. The patient decompensated, requiring emergent thoracentesis. He was placed on bipap at that time and started on zosyn. When I arrived to hospital day after admission, stat response was called to patient's room and he was rapidly transported to the ICU for intubation and to be started on vasopressors as he had become confused and hypotensive. It was not clear why. In the ICU, he was intubated and started on vasopressors. Central line was placed. He was transfused two units, but lactic started climbing and his hgb did not improve appropriately. Massive transfusion protocol was initiated. Patient's family was contacted by intensivist, and ultimately they decided to withdraw life sustaining treatment.    The patient expired on 10/3 @ 1650 due to hemorrhagic shock secondary to upper GI bleeding in the context of chronic decompensated cirrhosis of the liver."
	"1876807-1"	"1876807-1"	"GENERAL PHYSICAL HEALTH DETERIORATION"	"10049438"	"50-59 years"	"50-59"	"54M presented with respiratory failure secondary to pleural effusion. The patient was admitted to medsurg and started on diuretics. Plans were made for us guided thoracentesis and likely paracentesis, as well. The patient decompensated, requiring emergent thoracentesis. He was placed on bipap at that time and started on zosyn. When I arrived to hospital day after admission, stat response was called to patient's room and he was rapidly transported to the ICU for intubation and to be started on vasopressors as he had become confused and hypotensive. It was not clear why. In the ICU, he was intubated and started on vasopressors. Central line was placed. He was transfused two units, but lactic started climbing and his hgb did not improve appropriately. Massive transfusion protocol was initiated. Patient's family was contacted by intensivist, and ultimately they decided to withdraw life sustaining treatment.    The patient expired on 10/3 @ 1650 due to hemorrhagic shock secondary to upper GI bleeding in the context of chronic decompensated cirrhosis of the liver."
	"1876807-1"	"1876807-1"	"HAEMOGLOBIN"	"10018876"	"50-59 years"	"50-59"	"54M presented with respiratory failure secondary to pleural effusion. The patient was admitted to medsurg and started on diuretics. Plans were made for us guided thoracentesis and likely paracentesis, as well. The patient decompensated, requiring emergent thoracentesis. He was placed on bipap at that time and started on zosyn. When I arrived to hospital day after admission, stat response was called to patient's room and he was rapidly transported to the ICU for intubation and to be started on vasopressors as he had become confused and hypotensive. It was not clear why. In the ICU, he was intubated and started on vasopressors. Central line was placed. He was transfused two units, but lactic started climbing and his hgb did not improve appropriately. Massive transfusion protocol was initiated. Patient's family was contacted by intensivist, and ultimately they decided to withdraw life sustaining treatment.    The patient expired on 10/3 @ 1650 due to hemorrhagic shock secondary to upper GI bleeding in the context of chronic decompensated cirrhosis of the liver."
	"1876807-1"	"1876807-1"	"HYPOTENSION"	"10021097"	"50-59 years"	"50-59"	"54M presented with respiratory failure secondary to pleural effusion. The patient was admitted to medsurg and started on diuretics. Plans were made for us guided thoracentesis and likely paracentesis, as well. The patient decompensated, requiring emergent thoracentesis. He was placed on bipap at that time and started on zosyn. When I arrived to hospital day after admission, stat response was called to patient's room and he was rapidly transported to the ICU for intubation and to be started on vasopressors as he had become confused and hypotensive. It was not clear why. In the ICU, he was intubated and started on vasopressors. Central line was placed. He was transfused two units, but lactic started climbing and his hgb did not improve appropriately. Massive transfusion protocol was initiated. Patient's family was contacted by intensivist, and ultimately they decided to withdraw life sustaining treatment.    The patient expired on 10/3 @ 1650 due to hemorrhagic shock secondary to upper GI bleeding in the context of chronic decompensated cirrhosis of the liver."
	"1876807-1"	"1876807-1"	"INTENSIVE CARE"	"10022519"	"50-59 years"	"50-59"	"54M presented with respiratory failure secondary to pleural effusion. The patient was admitted to medsurg and started on diuretics. Plans were made for us guided thoracentesis and likely paracentesis, as well. The patient decompensated, requiring emergent thoracentesis. He was placed on bipap at that time and started on zosyn. When I arrived to hospital day after admission, stat response was called to patient's room and he was rapidly transported to the ICU for intubation and to be started on vasopressors as he had become confused and hypotensive. It was not clear why. In the ICU, he was intubated and started on vasopressors. Central line was placed. He was transfused two units, but lactic started climbing and his hgb did not improve appropriately. Massive transfusion protocol was initiated. Patient's family was contacted by intensivist, and ultimately they decided to withdraw life sustaining treatment.    The patient expired on 10/3 @ 1650 due to hemorrhagic shock secondary to upper GI bleeding in the context of chronic decompensated cirrhosis of the liver."
	"1876807-1"	"1876807-1"	"PLEURAL EFFUSION"	"10035598"	"50-59 years"	"50-59"	"54M presented with respiratory failure secondary to pleural effusion. The patient was admitted to medsurg and started on diuretics. Plans were made for us guided thoracentesis and likely paracentesis, as well. The patient decompensated, requiring emergent thoracentesis. He was placed on bipap at that time and started on zosyn. When I arrived to hospital day after admission, stat response was called to patient's room and he was rapidly transported to the ICU for intubation and to be started on vasopressors as he had become confused and hypotensive. It was not clear why. In the ICU, he was intubated and started on vasopressors. Central line was placed. He was transfused two units, but lactic started climbing and his hgb did not improve appropriately. Massive transfusion protocol was initiated. Patient's family was contacted by intensivist, and ultimately they decided to withdraw life sustaining treatment.    The patient expired on 10/3 @ 1650 due to hemorrhagic shock secondary to upper GI bleeding in the context of chronic decompensated cirrhosis of the liver."
	"1876807-1"	"1876807-1"	"POSITIVE AIRWAY PRESSURE THERAPY"	"10086397"	"50-59 years"	"50-59"	"54M presented with respiratory failure secondary to pleural effusion. The patient was admitted to medsurg and started on diuretics. Plans were made for us guided thoracentesis and likely paracentesis, as well. The patient decompensated, requiring emergent thoracentesis. He was placed on bipap at that time and started on zosyn. When I arrived to hospital day after admission, stat response was called to patient's room and he was rapidly transported to the ICU for intubation and to be started on vasopressors as he had become confused and hypotensive. It was not clear why. In the ICU, he was intubated and started on vasopressors. Central line was placed. He was transfused two units, but lactic started climbing and his hgb did not improve appropriately. Massive transfusion protocol was initiated. Patient's family was contacted by intensivist, and ultimately they decided to withdraw life sustaining treatment.    The patient expired on 10/3 @ 1650 due to hemorrhagic shock secondary to upper GI bleeding in the context of chronic decompensated cirrhosis of the liver."
	"1876807-1"	"1876807-1"	"RESPIRATORY FAILURE"	"10038695"	"50-59 years"	"50-59"	"54M presented with respiratory failure secondary to pleural effusion. The patient was admitted to medsurg and started on diuretics. Plans were made for us guided thoracentesis and likely paracentesis, as well. The patient decompensated, requiring emergent thoracentesis. He was placed on bipap at that time and started on zosyn. When I arrived to hospital day after admission, stat response was called to patient's room and he was rapidly transported to the ICU for intubation and to be started on vasopressors as he had become confused and hypotensive. It was not clear why. In the ICU, he was intubated and started on vasopressors. Central line was placed. He was transfused two units, but lactic started climbing and his hgb did not improve appropriately. Massive transfusion protocol was initiated. Patient's family was contacted by intensivist, and ultimately they decided to withdraw life sustaining treatment.    The patient expired on 10/3 @ 1650 due to hemorrhagic shock secondary to upper GI bleeding in the context of chronic decompensated cirrhosis of the liver."
	"1876807-1"	"1876807-1"	"SHOCK HAEMORRHAGIC"	"10049771"	"50-59 years"	"50-59"	"54M presented with respiratory failure secondary to pleural effusion. The patient was admitted to medsurg and started on diuretics. Plans were made for us guided thoracentesis and likely paracentesis, as well. The patient decompensated, requiring emergent thoracentesis. He was placed on bipap at that time and started on zosyn. When I arrived to hospital day after admission, stat response was called to patient's room and he was rapidly transported to the ICU for intubation and to be started on vasopressors as he had become confused and hypotensive. It was not clear why. In the ICU, he was intubated and started on vasopressors. Central line was placed. He was transfused two units, but lactic started climbing and his hgb did not improve appropriately. Massive transfusion protocol was initiated. Patient's family was contacted by intensivist, and ultimately they decided to withdraw life sustaining treatment.    The patient expired on 10/3 @ 1650 due to hemorrhagic shock secondary to upper GI bleeding in the context of chronic decompensated cirrhosis of the liver."
	"1876807-1"	"1876807-1"	"TRANSFUSION"	"10066152"	"50-59 years"	"50-59"	"54M presented with respiratory failure secondary to pleural effusion. The patient was admitted to medsurg and started on diuretics. Plans were made for us guided thoracentesis and likely paracentesis, as well. The patient decompensated, requiring emergent thoracentesis. He was placed on bipap at that time and started on zosyn. When I arrived to hospital day after admission, stat response was called to patient's room and he was rapidly transported to the ICU for intubation and to be started on vasopressors as he had become confused and hypotensive. It was not clear why. In the ICU, he was intubated and started on vasopressors. Central line was placed. He was transfused two units, but lactic started climbing and his hgb did not improve appropriately. Massive transfusion protocol was initiated. Patient's family was contacted by intensivist, and ultimately they decided to withdraw life sustaining treatment.    The patient expired on 10/3 @ 1650 due to hemorrhagic shock secondary to upper GI bleeding in the context of chronic decompensated cirrhosis of the liver."
	"1876807-1"	"1876807-1"	"UPPER GASTROINTESTINAL HAEMORRHAGE"	"10046274"	"50-59 years"	"50-59"	"54M presented with respiratory failure secondary to pleural effusion. The patient was admitted to medsurg and started on diuretics. Plans were made for us guided thoracentesis and likely paracentesis, as well. The patient decompensated, requiring emergent thoracentesis. He was placed on bipap at that time and started on zosyn. When I arrived to hospital day after admission, stat response was called to patient's room and he was rapidly transported to the ICU for intubation and to be started on vasopressors as he had become confused and hypotensive. It was not clear why. In the ICU, he was intubated and started on vasopressors. Central line was placed. He was transfused two units, but lactic started climbing and his hgb did not improve appropriately. Massive transfusion protocol was initiated. Patient's family was contacted by intensivist, and ultimately they decided to withdraw life sustaining treatment.    The patient expired on 10/3 @ 1650 due to hemorrhagic shock secondary to upper GI bleeding in the context of chronic decompensated cirrhosis of the liver."
	"1877258-1"	"1877258-1"	"ACUTE KIDNEY INJURY"	"10069339"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 5/14/2021 and 6/04/2021. Presented to an ED  on 11/2/21 with right hand numbness and tingling and transient slurred speech.  Admitted and diagnosed with left parietal lobe infarct per MRI and received TPA.  In the early am of 11/6 he decompensated and requiring intubation. Taken to cath lab where an Impella CP was placed in the right femoral site. Required extreme high doses of inotropes and pressors with fever spikes.  Diagnosed with COVID- PCR + on 11/5/2021. Transferred to another Medical Center for ECMO. Patient noted to have lactic acidosis up to 20 on 11/5/2021, AKI with oliguria requiring CRRT, transaminitis with AST and ALT > 7000, and development of compartment syndrome requiring fasciotomies of RLE.  Patient required continued support of ECMO.  Code status was changed to DNAR-AND and he expired 11/10 am."
	"1877258-1"	"1877258-1"	"ALANINE AMINOTRANSFERASE INCREASED"	"10001551"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 5/14/2021 and 6/04/2021. Presented to an ED  on 11/2/21 with right hand numbness and tingling and transient slurred speech.  Admitted and diagnosed with left parietal lobe infarct per MRI and received TPA.  In the early am of 11/6 he decompensated and requiring intubation. Taken to cath lab where an Impella CP was placed in the right femoral site. Required extreme high doses of inotropes and pressors with fever spikes.  Diagnosed with COVID- PCR + on 11/5/2021. Transferred to another Medical Center for ECMO. Patient noted to have lactic acidosis up to 20 on 11/5/2021, AKI with oliguria requiring CRRT, transaminitis with AST and ALT > 7000, and development of compartment syndrome requiring fasciotomies of RLE.  Patient required continued support of ECMO.  Code status was changed to DNAR-AND and he expired 11/10 am."
	"1877258-1"	"1877258-1"	"ANTICOAGULANT THERAPY"	"10053468"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 5/14/2021 and 6/04/2021. Presented to an ED  on 11/2/21 with right hand numbness and tingling and transient slurred speech.  Admitted and diagnosed with left parietal lobe infarct per MRI and received TPA.  In the early am of 11/6 he decompensated and requiring intubation. Taken to cath lab where an Impella CP was placed in the right femoral site. Required extreme high doses of inotropes and pressors with fever spikes.  Diagnosed with COVID- PCR + on 11/5/2021. Transferred to another Medical Center for ECMO. Patient noted to have lactic acidosis up to 20 on 11/5/2021, AKI with oliguria requiring CRRT, transaminitis with AST and ALT > 7000, and development of compartment syndrome requiring fasciotomies of RLE.  Patient required continued support of ECMO.  Code status was changed to DNAR-AND and he expired 11/10 am."
	"1877258-1"	"1877258-1"	"ASPARTATE AMINOTRANSFERASE INCREASED"	"10003481"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 5/14/2021 and 6/04/2021. Presented to an ED  on 11/2/21 with right hand numbness and tingling and transient slurred speech.  Admitted and diagnosed with left parietal lobe infarct per MRI and received TPA.  In the early am of 11/6 he decompensated and requiring intubation. Taken to cath lab where an Impella CP was placed in the right femoral site. Required extreme high doses of inotropes and pressors with fever spikes.  Diagnosed with COVID- PCR + on 11/5/2021. Transferred to another Medical Center for ECMO. Patient noted to have lactic acidosis up to 20 on 11/5/2021, AKI with oliguria requiring CRRT, transaminitis with AST and ALT > 7000, and development of compartment syndrome requiring fasciotomies of RLE.  Patient required continued support of ECMO.  Code status was changed to DNAR-AND and he expired 11/10 am."
	"1877258-1"	"1877258-1"	"CEREBRAL INFARCTION"	"10008118"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 5/14/2021 and 6/04/2021. Presented to an ED  on 11/2/21 with right hand numbness and tingling and transient slurred speech.  Admitted and diagnosed with left parietal lobe infarct per MRI and received TPA.  In the early am of 11/6 he decompensated and requiring intubation. Taken to cath lab where an Impella CP was placed in the right femoral site. Required extreme high doses of inotropes and pressors with fever spikes.  Diagnosed with COVID- PCR + on 11/5/2021. Transferred to another Medical Center for ECMO. Patient noted to have lactic acidosis up to 20 on 11/5/2021, AKI with oliguria requiring CRRT, transaminitis with AST and ALT > 7000, and development of compartment syndrome requiring fasciotomies of RLE.  Patient required continued support of ECMO.  Code status was changed to DNAR-AND and he expired 11/10 am."
	"1877258-1"	"1877258-1"	"COMPARTMENT SYNDROME"	"10010121"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 5/14/2021 and 6/04/2021. Presented to an ED  on 11/2/21 with right hand numbness and tingling and transient slurred speech.  Admitted and diagnosed with left parietal lobe infarct per MRI and received TPA.  In the early am of 11/6 he decompensated and requiring intubation. Taken to cath lab where an Impella CP was placed in the right femoral site. Required extreme high doses of inotropes and pressors with fever spikes.  Diagnosed with COVID- PCR + on 11/5/2021. Transferred to another Medical Center for ECMO. Patient noted to have lactic acidosis up to 20 on 11/5/2021, AKI with oliguria requiring CRRT, transaminitis with AST and ALT > 7000, and development of compartment syndrome requiring fasciotomies of RLE.  Patient required continued support of ECMO.  Code status was changed to DNAR-AND and he expired 11/10 am."
	"1877258-1"	"1877258-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 5/14/2021 and 6/04/2021. Presented to an ED  on 11/2/21 with right hand numbness and tingling and transient slurred speech.  Admitted and diagnosed with left parietal lobe infarct per MRI and received TPA.  In the early am of 11/6 he decompensated and requiring intubation. Taken to cath lab where an Impella CP was placed in the right femoral site. Required extreme high doses of inotropes and pressors with fever spikes.  Diagnosed with COVID- PCR + on 11/5/2021. Transferred to another Medical Center for ECMO. Patient noted to have lactic acidosis up to 20 on 11/5/2021, AKI with oliguria requiring CRRT, transaminitis with AST and ALT > 7000, and development of compartment syndrome requiring fasciotomies of RLE.  Patient required continued support of ECMO.  Code status was changed to DNAR-AND and he expired 11/10 am."
	"1877258-1"	"1877258-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 5/14/2021 and 6/04/2021. Presented to an ED  on 11/2/21 with right hand numbness and tingling and transient slurred speech.  Admitted and diagnosed with left parietal lobe infarct per MRI and received TPA.  In the early am of 11/6 he decompensated and requiring intubation. Taken to cath lab where an Impella CP was placed in the right femoral site. Required extreme high doses of inotropes and pressors with fever spikes.  Diagnosed with COVID- PCR + on 11/5/2021. Transferred to another Medical Center for ECMO. Patient noted to have lactic acidosis up to 20 on 11/5/2021, AKI with oliguria requiring CRRT, transaminitis with AST and ALT > 7000, and development of compartment syndrome requiring fasciotomies of RLE.  Patient required continued support of ECMO.  Code status was changed to DNAR-AND and he expired 11/10 am."
	"1877258-1"	"1877258-1"	"DYSARTHRIA"	"10013887"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 5/14/2021 and 6/04/2021. Presented to an ED  on 11/2/21 with right hand numbness and tingling and transient slurred speech.  Admitted and diagnosed with left parietal lobe infarct per MRI and received TPA.  In the early am of 11/6 he decompensated and requiring intubation. Taken to cath lab where an Impella CP was placed in the right femoral site. Required extreme high doses of inotropes and pressors with fever spikes.  Diagnosed with COVID- PCR + on 11/5/2021. Transferred to another Medical Center for ECMO. Patient noted to have lactic acidosis up to 20 on 11/5/2021, AKI with oliguria requiring CRRT, transaminitis with AST and ALT > 7000, and development of compartment syndrome requiring fasciotomies of RLE.  Patient required continued support of ECMO.  Code status was changed to DNAR-AND and he expired 11/10 am."
	"1877258-1"	"1877258-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 5/14/2021 and 6/04/2021. Presented to an ED  on 11/2/21 with right hand numbness and tingling and transient slurred speech.  Admitted and diagnosed with left parietal lobe infarct per MRI and received TPA.  In the early am of 11/6 he decompensated and requiring intubation. Taken to cath lab where an Impella CP was placed in the right femoral site. Required extreme high doses of inotropes and pressors with fever spikes.  Diagnosed with COVID- PCR + on 11/5/2021. Transferred to another Medical Center for ECMO. Patient noted to have lactic acidosis up to 20 on 11/5/2021, AKI with oliguria requiring CRRT, transaminitis with AST and ALT > 7000, and development of compartment syndrome requiring fasciotomies of RLE.  Patient required continued support of ECMO.  Code status was changed to DNAR-AND and he expired 11/10 am."
	"1877258-1"	"1877258-1"	"FASCIOTOMY"	"10016237"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 5/14/2021 and 6/04/2021. Presented to an ED  on 11/2/21 with right hand numbness and tingling and transient slurred speech.  Admitted and diagnosed with left parietal lobe infarct per MRI and received TPA.  In the early am of 11/6 he decompensated and requiring intubation. Taken to cath lab where an Impella CP was placed in the right femoral site. Required extreme high doses of inotropes and pressors with fever spikes.  Diagnosed with COVID- PCR + on 11/5/2021. Transferred to another Medical Center for ECMO. Patient noted to have lactic acidosis up to 20 on 11/5/2021, AKI with oliguria requiring CRRT, transaminitis with AST and ALT > 7000, and development of compartment syndrome requiring fasciotomies of RLE.  Patient required continued support of ECMO.  Code status was changed to DNAR-AND and he expired 11/10 am."
	"1877258-1"	"1877258-1"	"HYPOAESTHESIA"	"10020937"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 5/14/2021 and 6/04/2021. Presented to an ED  on 11/2/21 with right hand numbness and tingling and transient slurred speech.  Admitted and diagnosed with left parietal lobe infarct per MRI and received TPA.  In the early am of 11/6 he decompensated and requiring intubation. Taken to cath lab where an Impella CP was placed in the right femoral site. Required extreme high doses of inotropes and pressors with fever spikes.  Diagnosed with COVID- PCR + on 11/5/2021. Transferred to another Medical Center for ECMO. Patient noted to have lactic acidosis up to 20 on 11/5/2021, AKI with oliguria requiring CRRT, transaminitis with AST and ALT > 7000, and development of compartment syndrome requiring fasciotomies of RLE.  Patient required continued support of ECMO.  Code status was changed to DNAR-AND and he expired 11/10 am."
	"1877258-1"	"1877258-1"	"LACTIC ACIDOSIS"	"10023676"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 5/14/2021 and 6/04/2021. Presented to an ED  on 11/2/21 with right hand numbness and tingling and transient slurred speech.  Admitted and diagnosed with left parietal lobe infarct per MRI and received TPA.  In the early am of 11/6 he decompensated and requiring intubation. Taken to cath lab where an Impella CP was placed in the right femoral site. Required extreme high doses of inotropes and pressors with fever spikes.  Diagnosed with COVID- PCR + on 11/5/2021. Transferred to another Medical Center for ECMO. Patient noted to have lactic acidosis up to 20 on 11/5/2021, AKI with oliguria requiring CRRT, transaminitis with AST and ALT > 7000, and development of compartment syndrome requiring fasciotomies of RLE.  Patient required continued support of ECMO.  Code status was changed to DNAR-AND and he expired 11/10 am."
	"1877258-1"	"1877258-1"	"LUNG ASSIST DEVICE THERAPY"	"10082527"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 5/14/2021 and 6/04/2021. Presented to an ED  on 11/2/21 with right hand numbness and tingling and transient slurred speech.  Admitted and diagnosed with left parietal lobe infarct per MRI and received TPA.  In the early am of 11/6 he decompensated and requiring intubation. Taken to cath lab where an Impella CP was placed in the right femoral site. Required extreme high doses of inotropes and pressors with fever spikes.  Diagnosed with COVID- PCR + on 11/5/2021. Transferred to another Medical Center for ECMO. Patient noted to have lactic acidosis up to 20 on 11/5/2021, AKI with oliguria requiring CRRT, transaminitis with AST and ALT > 7000, and development of compartment syndrome requiring fasciotomies of RLE.  Patient required continued support of ECMO.  Code status was changed to DNAR-AND and he expired 11/10 am."
	"1877258-1"	"1877258-1"	"MAGNETIC RESONANCE IMAGING HEAD ABNORMAL"	"10085256"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 5/14/2021 and 6/04/2021. Presented to an ED  on 11/2/21 with right hand numbness and tingling and transient slurred speech.  Admitted and diagnosed with left parietal lobe infarct per MRI and received TPA.  In the early am of 11/6 he decompensated and requiring intubation. Taken to cath lab where an Impella CP was placed in the right femoral site. Required extreme high doses of inotropes and pressors with fever spikes.  Diagnosed with COVID- PCR + on 11/5/2021. Transferred to another Medical Center for ECMO. Patient noted to have lactic acidosis up to 20 on 11/5/2021, AKI with oliguria requiring CRRT, transaminitis with AST and ALT > 7000, and development of compartment syndrome requiring fasciotomies of RLE.  Patient required continued support of ECMO.  Code status was changed to DNAR-AND and he expired 11/10 am."
	"1877258-1"	"1877258-1"	"OLIGURIA"	"10030302"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 5/14/2021 and 6/04/2021. Presented to an ED  on 11/2/21 with right hand numbness and tingling and transient slurred speech.  Admitted and diagnosed with left parietal lobe infarct per MRI and received TPA.  In the early am of 11/6 he decompensated and requiring intubation. Taken to cath lab where an Impella CP was placed in the right femoral site. Required extreme high doses of inotropes and pressors with fever spikes.  Diagnosed with COVID- PCR + on 11/5/2021. Transferred to another Medical Center for ECMO. Patient noted to have lactic acidosis up to 20 on 11/5/2021, AKI with oliguria requiring CRRT, transaminitis with AST and ALT > 7000, and development of compartment syndrome requiring fasciotomies of RLE.  Patient required continued support of ECMO.  Code status was changed to DNAR-AND and he expired 11/10 am."
	"1877258-1"	"1877258-1"	"PARAESTHESIA"	"10033775"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 5/14/2021 and 6/04/2021. Presented to an ED  on 11/2/21 with right hand numbness and tingling and transient slurred speech.  Admitted and diagnosed with left parietal lobe infarct per MRI and received TPA.  In the early am of 11/6 he decompensated and requiring intubation. Taken to cath lab where an Impella CP was placed in the right femoral site. Required extreme high doses of inotropes and pressors with fever spikes.  Diagnosed with COVID- PCR + on 11/5/2021. Transferred to another Medical Center for ECMO. Patient noted to have lactic acidosis up to 20 on 11/5/2021, AKI with oliguria requiring CRRT, transaminitis with AST and ALT > 7000, and development of compartment syndrome requiring fasciotomies of RLE.  Patient required continued support of ECMO.  Code status was changed to DNAR-AND and he expired 11/10 am."
	"1877258-1"	"1877258-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 5/14/2021 and 6/04/2021. Presented to an ED  on 11/2/21 with right hand numbness and tingling and transient slurred speech.  Admitted and diagnosed with left parietal lobe infarct per MRI and received TPA.  In the early am of 11/6 he decompensated and requiring intubation. Taken to cath lab where an Impella CP was placed in the right femoral site. Required extreme high doses of inotropes and pressors with fever spikes.  Diagnosed with COVID- PCR + on 11/5/2021. Transferred to another Medical Center for ECMO. Patient noted to have lactic acidosis up to 20 on 11/5/2021, AKI with oliguria requiring CRRT, transaminitis with AST and ALT > 7000, and development of compartment syndrome requiring fasciotomies of RLE.  Patient required continued support of ECMO.  Code status was changed to DNAR-AND and he expired 11/10 am."
	"1877258-1"	"1877258-1"	"TRANSAMINASES INCREASED"	"10054889"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 5/14/2021 and 6/04/2021. Presented to an ED  on 11/2/21 with right hand numbness and tingling and transient slurred speech.  Admitted and diagnosed with left parietal lobe infarct per MRI and received TPA.  In the early am of 11/6 he decompensated and requiring intubation. Taken to cath lab where an Impella CP was placed in the right femoral site. Required extreme high doses of inotropes and pressors with fever spikes.  Diagnosed with COVID- PCR + on 11/5/2021. Transferred to another Medical Center for ECMO. Patient noted to have lactic acidosis up to 20 on 11/5/2021, AKI with oliguria requiring CRRT, transaminitis with AST and ALT > 7000, and development of compartment syndrome requiring fasciotomies of RLE.  Patient required continued support of ECMO.  Code status was changed to DNAR-AND and he expired 11/10 am."
	"1877258-1"	"1877258-1"	"VENTRICULAR ASSIST DEVICE INSERTION"	"10052371"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 5/14/2021 and 6/04/2021. Presented to an ED  on 11/2/21 with right hand numbness and tingling and transient slurred speech.  Admitted and diagnosed with left parietal lobe infarct per MRI and received TPA.  In the early am of 11/6 he decompensated and requiring intubation. Taken to cath lab where an Impella CP was placed in the right femoral site. Required extreme high doses of inotropes and pressors with fever spikes.  Diagnosed with COVID- PCR + on 11/5/2021. Transferred to another Medical Center for ECMO. Patient noted to have lactic acidosis up to 20 on 11/5/2021, AKI with oliguria requiring CRRT, transaminitis with AST and ALT > 7000, and development of compartment syndrome requiring fasciotomies of RLE.  Patient required continued support of ECMO.  Code status was changed to DNAR-AND and he expired 11/10 am."
	"1877261-1"	"1877261-1"	"ACUTE RESPIRATORY FAILURE"	"10001053"	"50-59 years"	"50-59"	"Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Moderna Vaccines on 5/22/2021 and 6/19/2021. Patient presented to ED on 10/18/2021 with complaints of general malaise, diarrhea, and fever. Hospitalized for sepsis, Covid-19 + upon admission. Received: dexamethasone, remdesivir, baricitinib, broad spectrum antibiotics, paralytics, methylprednisolone, prednisone, and vasopressors. Required mechanical ventilation on 10/24/2021 with continued respiratory decompensation. Patient developed bacterial infection with pseudomonas aerugenosa. Patient's renal function also continued to decline requiring CRRT. On 11/10/2021, CRRT clotted off and patient unstable. Patient receiving norepinephrine and vasopressin with maxed ventilator settings and episodes of V tach. Patient was changed to DNR per husband's wishes and patient expired on 11/11/2021 at 0003."
	"1877261-1"	"1877261-1"	"BACTERIAL INFECTION"	"10060945"	"50-59 years"	"50-59"	"Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Moderna Vaccines on 5/22/2021 and 6/19/2021. Patient presented to ED on 10/18/2021 with complaints of general malaise, diarrhea, and fever. Hospitalized for sepsis, Covid-19 + upon admission. Received: dexamethasone, remdesivir, baricitinib, broad spectrum antibiotics, paralytics, methylprednisolone, prednisone, and vasopressors. Required mechanical ventilation on 10/24/2021 with continued respiratory decompensation. Patient developed bacterial infection with pseudomonas aerugenosa. Patient's renal function also continued to decline requiring CRRT. On 11/10/2021, CRRT clotted off and patient unstable. Patient receiving norepinephrine and vasopressin with maxed ventilator settings and episodes of V tach. Patient was changed to DNR per husband's wishes and patient expired on 11/11/2021 at 0003."
	"1877261-1"	"1877261-1"	"BRONCHOALVEOLAR LAVAGE ABNORMAL"	"10063078"	"50-59 years"	"50-59"	"Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Moderna Vaccines on 5/22/2021 and 6/19/2021. Patient presented to ED on 10/18/2021 with complaints of general malaise, diarrhea, and fever. Hospitalized for sepsis, Covid-19 + upon admission. Received: dexamethasone, remdesivir, baricitinib, broad spectrum antibiotics, paralytics, methylprednisolone, prednisone, and vasopressors. Required mechanical ventilation on 10/24/2021 with continued respiratory decompensation. Patient developed bacterial infection with pseudomonas aerugenosa. Patient's renal function also continued to decline requiring CRRT. On 11/10/2021, CRRT clotted off and patient unstable. Patient receiving norepinephrine and vasopressin with maxed ventilator settings and episodes of V tach. Patient was changed to DNR per husband's wishes and patient expired on 11/11/2021 at 0003."
	"1877261-1"	"1877261-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Moderna Vaccines on 5/22/2021 and 6/19/2021. Patient presented to ED on 10/18/2021 with complaints of general malaise, diarrhea, and fever. Hospitalized for sepsis, Covid-19 + upon admission. Received: dexamethasone, remdesivir, baricitinib, broad spectrum antibiotics, paralytics, methylprednisolone, prednisone, and vasopressors. Required mechanical ventilation on 10/24/2021 with continued respiratory decompensation. Patient developed bacterial infection with pseudomonas aerugenosa. Patient's renal function also continued to decline requiring CRRT. On 11/10/2021, CRRT clotted off and patient unstable. Patient receiving norepinephrine and vasopressin with maxed ventilator settings and episodes of V tach. Patient was changed to DNR per husband's wishes and patient expired on 11/11/2021 at 0003."
	"1877261-1"	"1877261-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Moderna Vaccines on 5/22/2021 and 6/19/2021. Patient presented to ED on 10/18/2021 with complaints of general malaise, diarrhea, and fever. Hospitalized for sepsis, Covid-19 + upon admission. Received: dexamethasone, remdesivir, baricitinib, broad spectrum antibiotics, paralytics, methylprednisolone, prednisone, and vasopressors. Required mechanical ventilation on 10/24/2021 with continued respiratory decompensation. Patient developed bacterial infection with pseudomonas aerugenosa. Patient's renal function also continued to decline requiring CRRT. On 11/10/2021, CRRT clotted off and patient unstable. Patient receiving norepinephrine and vasopressin with maxed ventilator settings and episodes of V tach. Patient was changed to DNR per husband's wishes and patient expired on 11/11/2021 at 0003."
	"1877261-1"	"1877261-1"	"DIARRHOEA"	"10012735"	"50-59 years"	"50-59"	"Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Moderna Vaccines on 5/22/2021 and 6/19/2021. Patient presented to ED on 10/18/2021 with complaints of general malaise, diarrhea, and fever. Hospitalized for sepsis, Covid-19 + upon admission. Received: dexamethasone, remdesivir, baricitinib, broad spectrum antibiotics, paralytics, methylprednisolone, prednisone, and vasopressors. Required mechanical ventilation on 10/24/2021 with continued respiratory decompensation. Patient developed bacterial infection with pseudomonas aerugenosa. Patient's renal function also continued to decline requiring CRRT. On 11/10/2021, CRRT clotted off and patient unstable. Patient receiving norepinephrine and vasopressin with maxed ventilator settings and episodes of V tach. Patient was changed to DNR per husband's wishes and patient expired on 11/11/2021 at 0003."
	"1877261-1"	"1877261-1"	"HAEMOFILTRATION"	"10053090"	"50-59 years"	"50-59"	"Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Moderna Vaccines on 5/22/2021 and 6/19/2021. Patient presented to ED on 10/18/2021 with complaints of general malaise, diarrhea, and fever. Hospitalized for sepsis, Covid-19 + upon admission. Received: dexamethasone, remdesivir, baricitinib, broad spectrum antibiotics, paralytics, methylprednisolone, prednisone, and vasopressors. Required mechanical ventilation on 10/24/2021 with continued respiratory decompensation. Patient developed bacterial infection with pseudomonas aerugenosa. Patient's renal function also continued to decline requiring CRRT. On 11/10/2021, CRRT clotted off and patient unstable. Patient receiving norepinephrine and vasopressin with maxed ventilator settings and episodes of V tach. Patient was changed to DNR per husband's wishes and patient expired on 11/11/2021 at 0003."
	"1877261-1"	"1877261-1"	"MALAISE"	"10025482"	"50-59 years"	"50-59"	"Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Moderna Vaccines on 5/22/2021 and 6/19/2021. Patient presented to ED on 10/18/2021 with complaints of general malaise, diarrhea, and fever. Hospitalized for sepsis, Covid-19 + upon admission. Received: dexamethasone, remdesivir, baricitinib, broad spectrum antibiotics, paralytics, methylprednisolone, prednisone, and vasopressors. Required mechanical ventilation on 10/24/2021 with continued respiratory decompensation. Patient developed bacterial infection with pseudomonas aerugenosa. Patient's renal function also continued to decline requiring CRRT. On 11/10/2021, CRRT clotted off and patient unstable. Patient receiving norepinephrine and vasopressin with maxed ventilator settings and episodes of V tach. Patient was changed to DNR per husband's wishes and patient expired on 11/11/2021 at 0003."
	"1877261-1"	"1877261-1"	"MECHANICAL VENTILATION"	"10067221"	"50-59 years"	"50-59"	"Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Moderna Vaccines on 5/22/2021 and 6/19/2021. Patient presented to ED on 10/18/2021 with complaints of general malaise, diarrhea, and fever. Hospitalized for sepsis, Covid-19 + upon admission. Received: dexamethasone, remdesivir, baricitinib, broad spectrum antibiotics, paralytics, methylprednisolone, prednisone, and vasopressors. Required mechanical ventilation on 10/24/2021 with continued respiratory decompensation. Patient developed bacterial infection with pseudomonas aerugenosa. Patient's renal function also continued to decline requiring CRRT. On 11/10/2021, CRRT clotted off and patient unstable. Patient receiving norepinephrine and vasopressin with maxed ventilator settings and episodes of V tach. Patient was changed to DNR per husband's wishes and patient expired on 11/11/2021 at 0003."
	"1877261-1"	"1877261-1"	"PSEUDOMONAS INFECTION"	"10061471"	"50-59 years"	"50-59"	"Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Moderna Vaccines on 5/22/2021 and 6/19/2021. Patient presented to ED on 10/18/2021 with complaints of general malaise, diarrhea, and fever. Hospitalized for sepsis, Covid-19 + upon admission. Received: dexamethasone, remdesivir, baricitinib, broad spectrum antibiotics, paralytics, methylprednisolone, prednisone, and vasopressors. Required mechanical ventilation on 10/24/2021 with continued respiratory decompensation. Patient developed bacterial infection with pseudomonas aerugenosa. Patient's renal function also continued to decline requiring CRRT. On 11/10/2021, CRRT clotted off and patient unstable. Patient receiving norepinephrine and vasopressin with maxed ventilator settings and episodes of V tach. Patient was changed to DNR per husband's wishes and patient expired on 11/11/2021 at 0003."
	"1877261-1"	"1877261-1"	"PYREXIA"	"10037660"	"50-59 years"	"50-59"	"Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Moderna Vaccines on 5/22/2021 and 6/19/2021. Patient presented to ED on 10/18/2021 with complaints of general malaise, diarrhea, and fever. Hospitalized for sepsis, Covid-19 + upon admission. Received: dexamethasone, remdesivir, baricitinib, broad spectrum antibiotics, paralytics, methylprednisolone, prednisone, and vasopressors. Required mechanical ventilation on 10/24/2021 with continued respiratory decompensation. Patient developed bacterial infection with pseudomonas aerugenosa. Patient's renal function also continued to decline requiring CRRT. On 11/10/2021, CRRT clotted off and patient unstable. Patient receiving norepinephrine and vasopressin with maxed ventilator settings and episodes of V tach. Patient was changed to DNR per husband's wishes and patient expired on 11/11/2021 at 0003."
	"1877261-1"	"1877261-1"	"RENAL IMPAIRMENT"	"10062237"	"50-59 years"	"50-59"	"Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Moderna Vaccines on 5/22/2021 and 6/19/2021. Patient presented to ED on 10/18/2021 with complaints of general malaise, diarrhea, and fever. Hospitalized for sepsis, Covid-19 + upon admission. Received: dexamethasone, remdesivir, baricitinib, broad spectrum antibiotics, paralytics, methylprednisolone, prednisone, and vasopressors. Required mechanical ventilation on 10/24/2021 with continued respiratory decompensation. Patient developed bacterial infection with pseudomonas aerugenosa. Patient's renal function also continued to decline requiring CRRT. On 11/10/2021, CRRT clotted off and patient unstable. Patient receiving norepinephrine and vasopressin with maxed ventilator settings and episodes of V tach. Patient was changed to DNR per husband's wishes and patient expired on 11/11/2021 at 0003."
	"1877261-1"	"1877261-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Moderna Vaccines on 5/22/2021 and 6/19/2021. Patient presented to ED on 10/18/2021 with complaints of general malaise, diarrhea, and fever. Hospitalized for sepsis, Covid-19 + upon admission. Received: dexamethasone, remdesivir, baricitinib, broad spectrum antibiotics, paralytics, methylprednisolone, prednisone, and vasopressors. Required mechanical ventilation on 10/24/2021 with continued respiratory decompensation. Patient developed bacterial infection with pseudomonas aerugenosa. Patient's renal function also continued to decline requiring CRRT. On 11/10/2021, CRRT clotted off and patient unstable. Patient receiving norepinephrine and vasopressin with maxed ventilator settings and episodes of V tach. Patient was changed to DNR per husband's wishes and patient expired on 11/11/2021 at 0003."
	"1877261-1"	"1877261-1"	"SEPSIS"	"10040047"	"50-59 years"	"50-59"	"Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Moderna Vaccines on 5/22/2021 and 6/19/2021. Patient presented to ED on 10/18/2021 with complaints of general malaise, diarrhea, and fever. Hospitalized for sepsis, Covid-19 + upon admission. Received: dexamethasone, remdesivir, baricitinib, broad spectrum antibiotics, paralytics, methylprednisolone, prednisone, and vasopressors. Required mechanical ventilation on 10/24/2021 with continued respiratory decompensation. Patient developed bacterial infection with pseudomonas aerugenosa. Patient's renal function also continued to decline requiring CRRT. On 11/10/2021, CRRT clotted off and patient unstable. Patient receiving norepinephrine and vasopressin with maxed ventilator settings and episodes of V tach. Patient was changed to DNR per husband's wishes and patient expired on 11/11/2021 at 0003."
	"1877261-1"	"1877261-1"	"SPUTUM CULTURE POSITIVE"	"10051612"	"50-59 years"	"50-59"	"Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Moderna Vaccines on 5/22/2021 and 6/19/2021. Patient presented to ED on 10/18/2021 with complaints of general malaise, diarrhea, and fever. Hospitalized for sepsis, Covid-19 + upon admission. Received: dexamethasone, remdesivir, baricitinib, broad spectrum antibiotics, paralytics, methylprednisolone, prednisone, and vasopressors. Required mechanical ventilation on 10/24/2021 with continued respiratory decompensation. Patient developed bacterial infection with pseudomonas aerugenosa. Patient's renal function also continued to decline requiring CRRT. On 11/10/2021, CRRT clotted off and patient unstable. Patient receiving norepinephrine and vasopressin with maxed ventilator settings and episodes of V tach. Patient was changed to DNR per husband's wishes and patient expired on 11/11/2021 at 0003."
	"1877261-1"	"1877261-1"	"THROMBOSIS IN DEVICE"	"10062546"	"50-59 years"	"50-59"	"Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Moderna Vaccines on 5/22/2021 and 6/19/2021. Patient presented to ED on 10/18/2021 with complaints of general malaise, diarrhea, and fever. Hospitalized for sepsis, Covid-19 + upon admission. Received: dexamethasone, remdesivir, baricitinib, broad spectrum antibiotics, paralytics, methylprednisolone, prednisone, and vasopressors. Required mechanical ventilation on 10/24/2021 with continued respiratory decompensation. Patient developed bacterial infection with pseudomonas aerugenosa. Patient's renal function also continued to decline requiring CRRT. On 11/10/2021, CRRT clotted off and patient unstable. Patient receiving norepinephrine and vasopressin with maxed ventilator settings and episodes of V tach. Patient was changed to DNR per husband's wishes and patient expired on 11/11/2021 at 0003."
	"1877261-1"	"1877261-1"	"VENTRICULAR TACHYCARDIA"	"10047302"	"50-59 years"	"50-59"	"Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Moderna Vaccines on 5/22/2021 and 6/19/2021. Patient presented to ED on 10/18/2021 with complaints of general malaise, diarrhea, and fever. Hospitalized for sepsis, Covid-19 + upon admission. Received: dexamethasone, remdesivir, baricitinib, broad spectrum antibiotics, paralytics, methylprednisolone, prednisone, and vasopressors. Required mechanical ventilation on 10/24/2021 with continued respiratory decompensation. Patient developed bacterial infection with pseudomonas aerugenosa. Patient's renal function also continued to decline requiring CRRT. On 11/10/2021, CRRT clotted off and patient unstable. Patient receiving norepinephrine and vasopressin with maxed ventilator settings and episodes of V tach. Patient was changed to DNR per husband's wishes and patient expired on 11/11/2021 at 0003."
	"1877360-1"	"1877360-1"	"ACUTE RESPIRATORY DISTRESS SYNDROME"	"10001052"	"50-59 years"	"50-59"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen (J&J) Vaccine on 3/6/2021. Presented to ED on 10/21/2021 with complaints of chest pain and shortness of breath for approximately 1 week. Per patient she tested positive with a COVID home test on the prior Thursday. Hospitalized for COVID pneumonia and acute respiratory failure.  Developed ARDS and required mechanical ventilation. Unable to wean off vent and received trach and PEG. Throughout hospitalization patient received: dexamethasone, baricitinib, broad spectrum antibiotics, paralytics, remdesivir, and pressors. Suffered cardiac arrest on 11/10/2021 with ROSC. Expired on 11/11/2021."
	"1877360-1"	"1877360-1"	"ACUTE RESPIRATORY FAILURE"	"10001053"	"50-59 years"	"50-59"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen (J&J) Vaccine on 3/6/2021. Presented to ED on 10/21/2021 with complaints of chest pain and shortness of breath for approximately 1 week. Per patient she tested positive with a COVID home test on the prior Thursday. Hospitalized for COVID pneumonia and acute respiratory failure.  Developed ARDS and required mechanical ventilation. Unable to wean off vent and received trach and PEG. Throughout hospitalization patient received: dexamethasone, baricitinib, broad spectrum antibiotics, paralytics, remdesivir, and pressors. Suffered cardiac arrest on 11/10/2021 with ROSC. Expired on 11/11/2021."
	"1877360-1"	"1877360-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen (J&J) Vaccine on 3/6/2021. Presented to ED on 10/21/2021 with complaints of chest pain and shortness of breath for approximately 1 week. Per patient she tested positive with a COVID home test on the prior Thursday. Hospitalized for COVID pneumonia and acute respiratory failure.  Developed ARDS and required mechanical ventilation. Unable to wean off vent and received trach and PEG. Throughout hospitalization patient received: dexamethasone, baricitinib, broad spectrum antibiotics, paralytics, remdesivir, and pressors. Suffered cardiac arrest on 11/10/2021 with ROSC. Expired on 11/11/2021."
	"1877360-1"	"1877360-1"	"CHEST PAIN"	"10008479"	"50-59 years"	"50-59"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen (J&J) Vaccine on 3/6/2021. Presented to ED on 10/21/2021 with complaints of chest pain and shortness of breath for approximately 1 week. Per patient she tested positive with a COVID home test on the prior Thursday. Hospitalized for COVID pneumonia and acute respiratory failure.  Developed ARDS and required mechanical ventilation. Unable to wean off vent and received trach and PEG. Throughout hospitalization patient received: dexamethasone, baricitinib, broad spectrum antibiotics, paralytics, remdesivir, and pressors. Suffered cardiac arrest on 11/10/2021 with ROSC. Expired on 11/11/2021."
	"1877360-1"	"1877360-1"	"CHEST X-RAY ABNORMAL"	"10008499"	"50-59 years"	"50-59"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen (J&J) Vaccine on 3/6/2021. Presented to ED on 10/21/2021 with complaints of chest pain and shortness of breath for approximately 1 week. Per patient she tested positive with a COVID home test on the prior Thursday. Hospitalized for COVID pneumonia and acute respiratory failure.  Developed ARDS and required mechanical ventilation. Unable to wean off vent and received trach and PEG. Throughout hospitalization patient received: dexamethasone, baricitinib, broad spectrum antibiotics, paralytics, remdesivir, and pressors. Suffered cardiac arrest on 11/10/2021 with ROSC. Expired on 11/11/2021."
	"1877360-1"	"1877360-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen (J&J) Vaccine on 3/6/2021. Presented to ED on 10/21/2021 with complaints of chest pain and shortness of breath for approximately 1 week. Per patient she tested positive with a COVID home test on the prior Thursday. Hospitalized for COVID pneumonia and acute respiratory failure.  Developed ARDS and required mechanical ventilation. Unable to wean off vent and received trach and PEG. Throughout hospitalization patient received: dexamethasone, baricitinib, broad spectrum antibiotics, paralytics, remdesivir, and pressors. Suffered cardiac arrest on 11/10/2021 with ROSC. Expired on 11/11/2021."
	"1877360-1"	"1877360-1"	"COVID-19 PNEUMONIA"	"10084380"	"50-59 years"	"50-59"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen (J&J) Vaccine on 3/6/2021. Presented to ED on 10/21/2021 with complaints of chest pain and shortness of breath for approximately 1 week. Per patient she tested positive with a COVID home test on the prior Thursday. Hospitalized for COVID pneumonia and acute respiratory failure.  Developed ARDS and required mechanical ventilation. Unable to wean off vent and received trach and PEG. Throughout hospitalization patient received: dexamethasone, baricitinib, broad spectrum antibiotics, paralytics, remdesivir, and pressors. Suffered cardiac arrest on 11/10/2021 with ROSC. Expired on 11/11/2021."
	"1877360-1"	"1877360-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen (J&J) Vaccine on 3/6/2021. Presented to ED on 10/21/2021 with complaints of chest pain and shortness of breath for approximately 1 week. Per patient she tested positive with a COVID home test on the prior Thursday. Hospitalized for COVID pneumonia and acute respiratory failure.  Developed ARDS and required mechanical ventilation. Unable to wean off vent and received trach and PEG. Throughout hospitalization patient received: dexamethasone, baricitinib, broad spectrum antibiotics, paralytics, remdesivir, and pressors. Suffered cardiac arrest on 11/10/2021 with ROSC. Expired on 11/11/2021."
	"1877360-1"	"1877360-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen (J&J) Vaccine on 3/6/2021. Presented to ED on 10/21/2021 with complaints of chest pain and shortness of breath for approximately 1 week. Per patient she tested positive with a COVID home test on the prior Thursday. Hospitalized for COVID pneumonia and acute respiratory failure.  Developed ARDS and required mechanical ventilation. Unable to wean off vent and received trach and PEG. Throughout hospitalization patient received: dexamethasone, baricitinib, broad spectrum antibiotics, paralytics, remdesivir, and pressors. Suffered cardiac arrest on 11/10/2021 with ROSC. Expired on 11/11/2021."
	"1877360-1"	"1877360-1"	"GASTROSTOMY"	"10048978"	"50-59 years"	"50-59"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen (J&J) Vaccine on 3/6/2021. Presented to ED on 10/21/2021 with complaints of chest pain and shortness of breath for approximately 1 week. Per patient she tested positive with a COVID home test on the prior Thursday. Hospitalized for COVID pneumonia and acute respiratory failure.  Developed ARDS and required mechanical ventilation. Unable to wean off vent and received trach and PEG. Throughout hospitalization patient received: dexamethasone, baricitinib, broad spectrum antibiotics, paralytics, remdesivir, and pressors. Suffered cardiac arrest on 11/10/2021 with ROSC. Expired on 11/11/2021."
	"1877360-1"	"1877360-1"	"INTERSTITIAL LUNG DISEASE"	"10022611"	"50-59 years"	"50-59"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen (J&J) Vaccine on 3/6/2021. Presented to ED on 10/21/2021 with complaints of chest pain and shortness of breath for approximately 1 week. Per patient she tested positive with a COVID home test on the prior Thursday. Hospitalized for COVID pneumonia and acute respiratory failure.  Developed ARDS and required mechanical ventilation. Unable to wean off vent and received trach and PEG. Throughout hospitalization patient received: dexamethasone, baricitinib, broad spectrum antibiotics, paralytics, remdesivir, and pressors. Suffered cardiac arrest on 11/10/2021 with ROSC. Expired on 11/11/2021."
	"1877360-1"	"1877360-1"	"LUNG OPACITY"	"10081792"	"50-59 years"	"50-59"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen (J&J) Vaccine on 3/6/2021. Presented to ED on 10/21/2021 with complaints of chest pain and shortness of breath for approximately 1 week. Per patient she tested positive with a COVID home test on the prior Thursday. Hospitalized for COVID pneumonia and acute respiratory failure.  Developed ARDS and required mechanical ventilation. Unable to wean off vent and received trach and PEG. Throughout hospitalization patient received: dexamethasone, baricitinib, broad spectrum antibiotics, paralytics, remdesivir, and pressors. Suffered cardiac arrest on 11/10/2021 with ROSC. Expired on 11/11/2021."
	"1877360-1"	"1877360-1"	"MECHANICAL VENTILATION"	"10067221"	"50-59 years"	"50-59"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen (J&J) Vaccine on 3/6/2021. Presented to ED on 10/21/2021 with complaints of chest pain and shortness of breath for approximately 1 week. Per patient she tested positive with a COVID home test on the prior Thursday. Hospitalized for COVID pneumonia and acute respiratory failure.  Developed ARDS and required mechanical ventilation. Unable to wean off vent and received trach and PEG. Throughout hospitalization patient received: dexamethasone, baricitinib, broad spectrum antibiotics, paralytics, remdesivir, and pressors. Suffered cardiac arrest on 11/10/2021 with ROSC. Expired on 11/11/2021."
	"1877360-1"	"1877360-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen (J&J) Vaccine on 3/6/2021. Presented to ED on 10/21/2021 with complaints of chest pain and shortness of breath for approximately 1 week. Per patient she tested positive with a COVID home test on the prior Thursday. Hospitalized for COVID pneumonia and acute respiratory failure.  Developed ARDS and required mechanical ventilation. Unable to wean off vent and received trach and PEG. Throughout hospitalization patient received: dexamethasone, baricitinib, broad spectrum antibiotics, paralytics, remdesivir, and pressors. Suffered cardiac arrest on 11/10/2021 with ROSC. Expired on 11/11/2021."
	"1877360-1"	"1877360-1"	"STAPHYLOCOCCAL INFECTION"	"10058080"	"50-59 years"	"50-59"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen (J&J) Vaccine on 3/6/2021. Presented to ED on 10/21/2021 with complaints of chest pain and shortness of breath for approximately 1 week. Per patient she tested positive with a COVID home test on the prior Thursday. Hospitalized for COVID pneumonia and acute respiratory failure.  Developed ARDS and required mechanical ventilation. Unable to wean off vent and received trach and PEG. Throughout hospitalization patient received: dexamethasone, baricitinib, broad spectrum antibiotics, paralytics, remdesivir, and pressors. Suffered cardiac arrest on 11/10/2021 with ROSC. Expired on 11/11/2021."
	"1877360-1"	"1877360-1"	"TRACHEAL ASPIRATE CULTURE"	"10084653"	"50-59 years"	"50-59"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen (J&J) Vaccine on 3/6/2021. Presented to ED on 10/21/2021 with complaints of chest pain and shortness of breath for approximately 1 week. Per patient she tested positive with a COVID home test on the prior Thursday. Hospitalized for COVID pneumonia and acute respiratory failure.  Developed ARDS and required mechanical ventilation. Unable to wean off vent and received trach and PEG. Throughout hospitalization patient received: dexamethasone, baricitinib, broad spectrum antibiotics, paralytics, remdesivir, and pressors. Suffered cardiac arrest on 11/10/2021 with ROSC. Expired on 11/11/2021."
	"1877360-1"	"1877360-1"	"TRACHEOSTOMY"	"10044320"	"50-59 years"	"50-59"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen (J&J) Vaccine on 3/6/2021. Presented to ED on 10/21/2021 with complaints of chest pain and shortness of breath for approximately 1 week. Per patient she tested positive with a COVID home test on the prior Thursday. Hospitalized for COVID pneumonia and acute respiratory failure.  Developed ARDS and required mechanical ventilation. Unable to wean off vent and received trach and PEG. Throughout hospitalization patient received: dexamethasone, baricitinib, broad spectrum antibiotics, paralytics, remdesivir, and pressors. Suffered cardiac arrest on 11/10/2021 with ROSC. Expired on 11/11/2021."
	"1877549-1"	"1877549-1"	"ABDOMINAL PAIN"	"10000081"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"ACUTE KIDNEY INJURY"	"10069339"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"ACUTE RESPIRATORY DISTRESS SYNDROME"	"10001052"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"ALANINE AMINOTRANSFERASE INCREASED"	"10001551"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"ATRIAL FIBRILLATION"	"10003658"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"BACK PAIN"	"10003988"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"BACTERIAL TEST"	"10068074"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"BICYTOPENIA"	"10058956"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"BIOPSY BONE MARROW"	"10004737"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"BIOPSY SKIN NORMAL"	"10004875"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"BLOOD BILIRUBIN INCREASED"	"10005364"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"BLOOD CREATININE INCREASED"	"10005483"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"BLOOD CULTURE NEGATIVE"	"10005486"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"BLOOD IMMUNOGLOBULIN G"	"10005593"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"BLOOD TEST NORMAL"	"10050540"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"BRONCHOALVEOLAR LAVAGE NORMAL"	"10063077"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"BRONCHOSCOPY"	"10006479"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"CHEST PAIN"	"10008479"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"CHEST X-RAY NORMAL"	"10008500"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"CLOSTRIDIUM TEST"	"10070270"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"COMPUTERISED TOMOGRAM ABDOMEN ABNORMAL"	"10057798"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"COMPUTERISED TOMOGRAM HEAD NORMAL"	"10072167"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"COMPUTERISED TOMOGRAM NORMAL"	"10010236"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"COMPUTERISED TOMOGRAM SPINE"	"10081777"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"CONDITION AGGRAVATED"	"10010264"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"CRYOGLOBULINAEMIA"	"10011474"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"CRYOGLOBULINS PRESENT"	"10011478"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"CSF GLUCOSE INCREASED"	"10050763"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"CSF LYMPHOCYTE COUNT INCREASED"	"10011549"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"CSF PROTEIN NORMAL"	"10011576"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"CSF WHITE BLOOD CELL COUNT INCREASED"	"10053805"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"DIALYSIS"	"10061105"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"DISSEMINATED INTRAVASCULAR COAGULATION"	"10013442"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"DRUG SCREEN POSITIVE"	"10049177"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"ECHOCARDIOGRAM"	"10014113"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"EJECTION FRACTION NORMAL"	"10064144"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"ENCEPHALOPATHY"	"10014625"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"FUNGAL TEST"	"10070457"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"GASTROINTESTINAL WALL THICKENING"	"10075724"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"GENERALISED OEDEMA"	"10018092"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"GRAM STAIN"	"10018654"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"HAEMOFILTRATION"	"10053090"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"HAEMOPHAGOCYTIC LYMPHOHISTIOCYTOSIS"	"10071583"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"HEPARIN-INDUCED THROMBOCYTOPENIA TEST"	"10050829"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"HEPATIC STEATOSIS"	"10019708"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"HEPATITIS B VIRUS TEST"	"10068415"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"HEPATITIS C VIRUS TEST"	"10068416"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"HERPES SIMPLEX TEST NEGATIVE"	"10077970"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"HYPERFERRITINAEMIA"	"10075046"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"HYPERKALAEMIA"	"10020646"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"HYPOCOMPLEMENTAEMIA"	"10020974"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"HYPOTENSION"	"10021097"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"HYPOXIA"	"10021143"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"INFECTION"	"10021789"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"INFLAMMATION"	"10061218"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"LABORATORY TEST ABNORMAL"	"10023547"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"LEUKOCYTOSIS"	"10024378"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"LUMBAR PUNCTURE NORMAL"	"10025002"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"LUNG OPACITY"	"10081792"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"MENTAL STATUS CHANGES"	"10048294"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"METABOLIC ACIDOSIS"	"10027417"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"MULTIPLE ORGAN DYSFUNCTION SYNDROME"	"10077361"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"MYOCLONUS"	"10028622"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"PLATELET TRANSFUSION"	"10035543"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"PLEURAL EFFUSION"	"10035598"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"POLYMERASE CHAIN REACTION"	"10050967"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"POSITIVE AIRWAY PRESSURE THERAPY"	"10086397"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"PROCALCITONIN INCREASED"	"10067081"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"PULMONARY ALVEOLAR HAEMORRHAGE"	"10037313"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"PULMONARY HAEMORRHAGE"	"10037394"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"PYREXIA"	"10037660"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"RASH"	"10037844"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"RENAL FAILURE"	"10038435"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"RENAL FUSION ANOMALY"	"10068033"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"RESPIRATORY FAILURE"	"10038695"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"RHEUMATOLOGICAL EXAMINATION"	"10084263"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"SEPSIS"	"10040047"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"SERUM FERRITIN INCREASED"	"10040250"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"SHOCK"	"10040560"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"SKIN DISCOLOURATION"	"10040829"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"TRANSFUSION"	"10066152"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"TROPONIN INCREASED"	"10058267"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"ULTRASOUND ABDOMEN ABNORMAL"	"10052039"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"ULTRASOUND DOPPLER ABNORMAL"	"10045413"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"URINE ANALYSIS NORMAL"	"10061578"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"URINE OUTPUT DECREASED"	"10059895"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"VARICELLA VIRUS TEST NEGATIVE"	"10070445"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"VASCULITIS"	"10047115"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"VENTILATION/PERFUSION SCAN"	"10047264"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1877549-1"	"1877549-1"	"VENTILATION/PERFUSION SCAN NORMAL"	"10047266"	"50-59 years"	"50-59"	""From admission H&P dated 9/12/21 by Doctor: ""History per chart and collateral given patient's encephalopathy. The patient was reportedly in USOH when she began experiencing abdominal pain. She reportedly started a short course of penicillin as an outpatient for this abdominal pain. She presented to the Hospital with worsening abdominal pain, worsening of her chronic low back pain, and chest pain. Mild leukocytosis with elevated ALT and bilirubin on admission. Troponin was elevated to 0.44, but down-trended and deemed to be non-cardiac after evaluation by cardiology. CXR, UA not concerning for infection. CT-AP showed diffuse colonic wall thickening, mild pulmonary interstitial opacities, small bilateral pleural effusions, and a horseshoe kidney. V/Q scan without PE, ultrasound of LE showed patents. TTE with normal EF, RUQUS without biliary dilation, only mild fatty infiltration of the liver. Stool-filled colon - had pain relief with aggressive bowel regimen and bowel movement.    Due to persistent fevers and back pain with elevated procalcitonin, the patient was started empirically on ceftriaxone and vancomycin. Negative CT-spine for infection.   Course complicated by 2x episodes of afib with RVR, the second one requiring amiodarone and beta blocker. She also developed an AKI with Cr rising to peak of 3.56 over the course of days. Intermittent hypotension requiring pressors. Renal consulted, workup concerning for glomerulonephritis, revealed hypocomplementemia, ferritin >80,000, and monoclonal IgG kappa. She refused a bone marrow biopsy. Her urine output dropped to near-anuric, and she became encephalopathic with myoclonus. At this point, she was started on every other day dialysis. No head imaging performed.   Other diagnostic studies included utox (positive for morphine and oxycodone), APAP level (undetectible), Hep C, HepB, C.Diff,    Due to the elevated ferritin and concern for HLH, he was evaluated by hematology, started on dexamethasone. She had hypoxemic respiratory failure requiring bipap that was ultimately weaned to nasal cannula.   Past medical history of major depressive disorder and chronic lower back pain. Notably, she had severe osteomyeletis of the LUE, LLE requiring extensive surgery""   HOSPITAL COURSE:  Patient had an unfortunately complicated hospital course. As above, she was transferred from an outside facility with a constellation of clinical and lab abnormalities including fever of unknown origin, abdominal/chest pain, anuric renal failure requiring iHD, respiratory failure, and encephalopathy as well as cryoglobulinemia, hypocomplementemia and hyperferritniemia (>80K) and developing bicytopenia with concern for, though not diagnosis of, HLH from unclear trigger.  While pursuing workup for unifying diagnosis she developed progressive multiorgan failure as will be discussed below. In regards to diagnostics for underlying diagnosis, with the assistance of multiple consulting services (infectious diseases, heme/onc, rheumatology, nephrology) she underwent broad workup for diagnosis of and trigger of HLH v. Alternative inflammatory/rheumatologic process including bone marrow biopsy (in progress) , rheumatologic workup (notable for low complement levels and reported cryoglobulinemia at OSH), infectious workup via blood/BAL/LP (negative/in progress). Realization that cryoglobulins + at OSH as well as development of chest/abdomen rash and discolored toes raised question of cryoblobulinemic vasculitis. She was empirically treated with 1g IV methylpred then 40mg IV dex/day while awaiting results and diagnostics which unfortunately were not complete prior to her death and remains a question, hopefully to be answered by pending autopsy. Despite gradual improvement in several body systems (hemodynamics, hypoxemia), she developed DIC and pulmonary hemorrhage on the day of her death which ultimately led to her death as described below.    Multiorgan failure will be described below by system:  # Hypoxemic respiratory failure: Intubated for airway protection and hypoxemia upon admission to UWMC. Treated for ARDS with LPV possibly secondary to infection, though notably BAL and other infectious workup remained unremarkable throughout her stay. Hypoxemia improved enough with UF for volume removal and empiric ABX to move towards SBT pt was not able to be extubated. On the day of Patient's death, she developed bloody secretions from ETT so underwent repeat bronchoscopy. BAL diagnostic of alveolar hemorrhage with progressively bloody lavage aliquots. She was re-pulsed with IV methylpred and provided platelet replacement with concern for DAH or pulmonary vasculitis on 9/17 though developed severe pulmonary hemorrhage early on 9/18. Despite MTP and DDAVP to try and stabilize coagulopathy/hemorrhage, she ultimately lost >3L blood from ETT and died following this significant pulmonary hemorrhage (see code note and death note from today's date).    # Shock: Developed distributive shock requiring 3 vasopressors for support early in her stay. She received empiric antimicrobials, high dose steroids and ID workup with no revealing cause for sepsis. Hemodynamics showed signs of improvement leading up to day of death with vasopressors nearly weaned off.    #anuric renal failure- Complicated by anascarca, hyperkalemia and metabolic acidosis. By microscopy related to tubular injury, considered possibly related to cryoglobulinemia v. Vasculitis though unable to pursue renal biopsy due to instability. Required intermittent SLED/SCUF while admitted.    # Encephalopathy: Again, unclear etiology of altered mental status. Initially considered related to sedation and metabolic abnormalities and initial CT head WNL and LP without clear infectious cause (though some studies remain in progress), though remained profoundly encephalopathic following wean of sedatives.  Other considerations have included CNS involvement of primary underlying diagnosis (cryoglobulinemic vasculitis), undiagnosed infection, NCSE, etc.    # DIC # Bicytopenia Likely related to underlying unifying diagnosis. Other considerations included MAHA though no evidence of hemolysis, negative HIT assay, HLH.  Progressive throughout stay requiring cryo transfusion and multiple PLT transfusions on day of death.""
	"1878047-1"	"1878047-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Wet cough, diarrhea, 88% on RA, encephalopathic, DNR patient- expired, etc."
	"1878047-1"	"1878047-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Wet cough, diarrhea, 88% on RA, encephalopathic, DNR patient- expired, etc."
	"1878047-1"	"1878047-1"	"DIARRHOEA"	"10012735"	"50-59 years"	"50-59"	"Wet cough, diarrhea, 88% on RA, encephalopathic, DNR patient- expired, etc."
	"1878047-1"	"1878047-1"	"ENCEPHALOPATHY"	"10014625"	"50-59 years"	"50-59"	"Wet cough, diarrhea, 88% on RA, encephalopathic, DNR patient- expired, etc."
	"1878047-1"	"1878047-1"	"PRODUCTIVE COUGH"	"10036790"	"50-59 years"	"50-59"	"Wet cough, diarrhea, 88% on RA, encephalopathic, DNR patient- expired, etc."
	"1878047-1"	"1878047-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"Wet cough, diarrhea, 88% on RA, encephalopathic, DNR patient- expired, etc."
	"1879616-1"	"1879616-1"	"ANGIOPLASTY"	"10002475"	"50-59 years"	"50-59"	"Patient died / Cause of Death Cardiac Arrest; racing heart rate; started having shortness of breath; heaviness in chest; fatigue; This is a spontaneous report from a contactable consumer. This consumer reported for a 50-year-old male patient that, A 50-year-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot Number: ER8735) via an unspecified route of administration on 03May2021 (at the age of 50-years-old), as DOSE 2, SINGLE for COVID-19 immunisation. Medical history included diabetes mellitus and Other medical history: diagnosed with diabetes while in hospital. Patient had no Known allergies.The patient's concomitant medications were not reported. Historical vaccine included the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot Number: EW0150) on 12Apr2021 as DOSE 1, SINGLE for COVID-19 immunisation. On 14Jun2021, patient died due to cardiac arrest, shortness of breath, racing heart rate, fatigue, heaviness in chest. Date of death: 09Jul2021. Autopsy was not performed. He was hospitalized for 15 days. Patient received treatment included medication. He did not have covid prior to vaccination. He was not tested for covid post vaccination. He was on other medicines in two weeks which included multivitamins. Patient did not take any other vaccine in four weeks. The patient underwent lab tests and procedures which included angioplasty: no blockage on, cardiac electrophysiologic study: unknown results on, cardiac stress test: unknown results on, echocardiogram: unknown results on.The outcome for the events was fatal.  The lot number for the vaccine, BNT162B2 was not provided and will be requested during follow up.; Reported Cause(s) of Death: Cardiac arrest"
	"1879616-1"	"1879616-1"	"CARDIAC ARREST"	"10007515"	"50-59 years"	"50-59"	"Patient died / Cause of Death Cardiac Arrest; racing heart rate; started having shortness of breath; heaviness in chest; fatigue; This is a spontaneous report from a contactable consumer. This consumer reported for a 50-year-old male patient that, A 50-year-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot Number: ER8735) via an unspecified route of administration on 03May2021 (at the age of 50-years-old), as DOSE 2, SINGLE for COVID-19 immunisation. Medical history included diabetes mellitus and Other medical history: diagnosed with diabetes while in hospital. Patient had no Known allergies.The patient's concomitant medications were not reported. Historical vaccine included the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot Number: EW0150) on 12Apr2021 as DOSE 1, SINGLE for COVID-19 immunisation. On 14Jun2021, patient died due to cardiac arrest, shortness of breath, racing heart rate, fatigue, heaviness in chest. Date of death: 09Jul2021. Autopsy was not performed. He was hospitalized for 15 days. Patient received treatment included medication. He did not have covid prior to vaccination. He was not tested for covid post vaccination. He was on other medicines in two weeks which included multivitamins. Patient did not take any other vaccine in four weeks. The patient underwent lab tests and procedures which included angioplasty: no blockage on, cardiac electrophysiologic study: unknown results on, cardiac stress test: unknown results on, echocardiogram: unknown results on.The outcome for the events was fatal.  The lot number for the vaccine, BNT162B2 was not provided and will be requested during follow up.; Reported Cause(s) of Death: Cardiac arrest"
	"1879616-1"	"1879616-1"	"CARDIAC ELECTROPHYSIOLOGIC STUDY"	"10061739"	"50-59 years"	"50-59"	"Patient died / Cause of Death Cardiac Arrest; racing heart rate; started having shortness of breath; heaviness in chest; fatigue; This is a spontaneous report from a contactable consumer. This consumer reported for a 50-year-old male patient that, A 50-year-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot Number: ER8735) via an unspecified route of administration on 03May2021 (at the age of 50-years-old), as DOSE 2, SINGLE for COVID-19 immunisation. Medical history included diabetes mellitus and Other medical history: diagnosed with diabetes while in hospital. Patient had no Known allergies.The patient's concomitant medications were not reported. Historical vaccine included the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot Number: EW0150) on 12Apr2021 as DOSE 1, SINGLE for COVID-19 immunisation. On 14Jun2021, patient died due to cardiac arrest, shortness of breath, racing heart rate, fatigue, heaviness in chest. Date of death: 09Jul2021. Autopsy was not performed. He was hospitalized for 15 days. Patient received treatment included medication. He did not have covid prior to vaccination. He was not tested for covid post vaccination. He was on other medicines in two weeks which included multivitamins. Patient did not take any other vaccine in four weeks. The patient underwent lab tests and procedures which included angioplasty: no blockage on, cardiac electrophysiologic study: unknown results on, cardiac stress test: unknown results on, echocardiogram: unknown results on.The outcome for the events was fatal.  The lot number for the vaccine, BNT162B2 was not provided and will be requested during follow up.; Reported Cause(s) of Death: Cardiac arrest"
	"1879616-1"	"1879616-1"	"CARDIAC STRESS TEST"	"10061027"	"50-59 years"	"50-59"	"Patient died / Cause of Death Cardiac Arrest; racing heart rate; started having shortness of breath; heaviness in chest; fatigue; This is a spontaneous report from a contactable consumer. This consumer reported for a 50-year-old male patient that, A 50-year-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot Number: ER8735) via an unspecified route of administration on 03May2021 (at the age of 50-years-old), as DOSE 2, SINGLE for COVID-19 immunisation. Medical history included diabetes mellitus and Other medical history: diagnosed with diabetes while in hospital. Patient had no Known allergies.The patient's concomitant medications were not reported. Historical vaccine included the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot Number: EW0150) on 12Apr2021 as DOSE 1, SINGLE for COVID-19 immunisation. On 14Jun2021, patient died due to cardiac arrest, shortness of breath, racing heart rate, fatigue, heaviness in chest. Date of death: 09Jul2021. Autopsy was not performed. He was hospitalized for 15 days. Patient received treatment included medication. He did not have covid prior to vaccination. He was not tested for covid post vaccination. He was on other medicines in two weeks which included multivitamins. Patient did not take any other vaccine in four weeks. The patient underwent lab tests and procedures which included angioplasty: no blockage on, cardiac electrophysiologic study: unknown results on, cardiac stress test: unknown results on, echocardiogram: unknown results on.The outcome for the events was fatal.  The lot number for the vaccine, BNT162B2 was not provided and will be requested during follow up.; Reported Cause(s) of Death: Cardiac arrest"
	"1879616-1"	"1879616-1"	"CHEST DISCOMFORT"	"10008469"	"50-59 years"	"50-59"	"Patient died / Cause of Death Cardiac Arrest; racing heart rate; started having shortness of breath; heaviness in chest; fatigue; This is a spontaneous report from a contactable consumer. This consumer reported for a 50-year-old male patient that, A 50-year-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot Number: ER8735) via an unspecified route of administration on 03May2021 (at the age of 50-years-old), as DOSE 2, SINGLE for COVID-19 immunisation. Medical history included diabetes mellitus and Other medical history: diagnosed with diabetes while in hospital. Patient had no Known allergies.The patient's concomitant medications were not reported. Historical vaccine included the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot Number: EW0150) on 12Apr2021 as DOSE 1, SINGLE for COVID-19 immunisation. On 14Jun2021, patient died due to cardiac arrest, shortness of breath, racing heart rate, fatigue, heaviness in chest. Date of death: 09Jul2021. Autopsy was not performed. He was hospitalized for 15 days. Patient received treatment included medication. He did not have covid prior to vaccination. He was not tested for covid post vaccination. He was on other medicines in two weeks which included multivitamins. Patient did not take any other vaccine in four weeks. The patient underwent lab tests and procedures which included angioplasty: no blockage on, cardiac electrophysiologic study: unknown results on, cardiac stress test: unknown results on, echocardiogram: unknown results on.The outcome for the events was fatal.  The lot number for the vaccine, BNT162B2 was not provided and will be requested during follow up.; Reported Cause(s) of Death: Cardiac arrest"
	"1879616-1"	"1879616-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"Patient died / Cause of Death Cardiac Arrest; racing heart rate; started having shortness of breath; heaviness in chest; fatigue; This is a spontaneous report from a contactable consumer. This consumer reported for a 50-year-old male patient that, A 50-year-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot Number: ER8735) via an unspecified route of administration on 03May2021 (at the age of 50-years-old), as DOSE 2, SINGLE for COVID-19 immunisation. Medical history included diabetes mellitus and Other medical history: diagnosed with diabetes while in hospital. Patient had no Known allergies.The patient's concomitant medications were not reported. Historical vaccine included the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot Number: EW0150) on 12Apr2021 as DOSE 1, SINGLE for COVID-19 immunisation. On 14Jun2021, patient died due to cardiac arrest, shortness of breath, racing heart rate, fatigue, heaviness in chest. Date of death: 09Jul2021. Autopsy was not performed. He was hospitalized for 15 days. Patient received treatment included medication. He did not have covid prior to vaccination. He was not tested for covid post vaccination. He was on other medicines in two weeks which included multivitamins. Patient did not take any other vaccine in four weeks. The patient underwent lab tests and procedures which included angioplasty: no blockage on, cardiac electrophysiologic study: unknown results on, cardiac stress test: unknown results on, echocardiogram: unknown results on.The outcome for the events was fatal.  The lot number for the vaccine, BNT162B2 was not provided and will be requested during follow up.; Reported Cause(s) of Death: Cardiac arrest"
	"1879616-1"	"1879616-1"	"ECHOCARDIOGRAM"	"10014113"	"50-59 years"	"50-59"	"Patient died / Cause of Death Cardiac Arrest; racing heart rate; started having shortness of breath; heaviness in chest; fatigue; This is a spontaneous report from a contactable consumer. This consumer reported for a 50-year-old male patient that, A 50-year-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot Number: ER8735) via an unspecified route of administration on 03May2021 (at the age of 50-years-old), as DOSE 2, SINGLE for COVID-19 immunisation. Medical history included diabetes mellitus and Other medical history: diagnosed with diabetes while in hospital. Patient had no Known allergies.The patient's concomitant medications were not reported. Historical vaccine included the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot Number: EW0150) on 12Apr2021 as DOSE 1, SINGLE for COVID-19 immunisation. On 14Jun2021, patient died due to cardiac arrest, shortness of breath, racing heart rate, fatigue, heaviness in chest. Date of death: 09Jul2021. Autopsy was not performed. He was hospitalized for 15 days. Patient received treatment included medication. He did not have covid prior to vaccination. He was not tested for covid post vaccination. He was on other medicines in two weeks which included multivitamins. Patient did not take any other vaccine in four weeks. The patient underwent lab tests and procedures which included angioplasty: no blockage on, cardiac electrophysiologic study: unknown results on, cardiac stress test: unknown results on, echocardiogram: unknown results on.The outcome for the events was fatal.  The lot number for the vaccine, BNT162B2 was not provided and will be requested during follow up.; Reported Cause(s) of Death: Cardiac arrest"
	"1879616-1"	"1879616-1"	"FATIGUE"	"10016256"	"50-59 years"	"50-59"	"Patient died / Cause of Death Cardiac Arrest; racing heart rate; started having shortness of breath; heaviness in chest; fatigue; This is a spontaneous report from a contactable consumer. This consumer reported for a 50-year-old male patient that, A 50-year-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot Number: ER8735) via an unspecified route of administration on 03May2021 (at the age of 50-years-old), as DOSE 2, SINGLE for COVID-19 immunisation. Medical history included diabetes mellitus and Other medical history: diagnosed with diabetes while in hospital. Patient had no Known allergies.The patient's concomitant medications were not reported. Historical vaccine included the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot Number: EW0150) on 12Apr2021 as DOSE 1, SINGLE for COVID-19 immunisation. On 14Jun2021, patient died due to cardiac arrest, shortness of breath, racing heart rate, fatigue, heaviness in chest. Date of death: 09Jul2021. Autopsy was not performed. He was hospitalized for 15 days. Patient received treatment included medication. He did not have covid prior to vaccination. He was not tested for covid post vaccination. He was on other medicines in two weeks which included multivitamins. Patient did not take any other vaccine in four weeks. The patient underwent lab tests and procedures which included angioplasty: no blockage on, cardiac electrophysiologic study: unknown results on, cardiac stress test: unknown results on, echocardiogram: unknown results on.The outcome for the events was fatal.  The lot number for the vaccine, BNT162B2 was not provided and will be requested during follow up.; Reported Cause(s) of Death: Cardiac arrest"
	"1879616-1"	"1879616-1"	"HEART RATE INCREASED"	"10019303"	"50-59 years"	"50-59"	"Patient died / Cause of Death Cardiac Arrest; racing heart rate; started having shortness of breath; heaviness in chest; fatigue; This is a spontaneous report from a contactable consumer. This consumer reported for a 50-year-old male patient that, A 50-year-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot Number: ER8735) via an unspecified route of administration on 03May2021 (at the age of 50-years-old), as DOSE 2, SINGLE for COVID-19 immunisation. Medical history included diabetes mellitus and Other medical history: diagnosed with diabetes while in hospital. Patient had no Known allergies.The patient's concomitant medications were not reported. Historical vaccine included the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot Number: EW0150) on 12Apr2021 as DOSE 1, SINGLE for COVID-19 immunisation. On 14Jun2021, patient died due to cardiac arrest, shortness of breath, racing heart rate, fatigue, heaviness in chest. Date of death: 09Jul2021. Autopsy was not performed. He was hospitalized for 15 days. Patient received treatment included medication. He did not have covid prior to vaccination. He was not tested for covid post vaccination. He was on other medicines in two weeks which included multivitamins. Patient did not take any other vaccine in four weeks. The patient underwent lab tests and procedures which included angioplasty: no blockage on, cardiac electrophysiologic study: unknown results on, cardiac stress test: unknown results on, echocardiogram: unknown results on.The outcome for the events was fatal.  The lot number for the vaccine, BNT162B2 was not provided and will be requested during follow up.; Reported Cause(s) of Death: Cardiac arrest"
	"1880619-1"	"1880619-1"	"ACUTE KIDNEY INJURY"	"10069339"	"50-59 years"	"50-59"	"pt to ED with increasing weakness; positive for COVID; CA pt on chemotherapy; septic shock; AHRF; ARF; started on remdesivir, dexamethasone, barcitinib; unable to tolerate dialysis, became hypotensive and hypoxic; DNR; pt died in the hospital"
	"1880619-1"	"1880619-1"	"ACUTE RESPIRATORY FAILURE"	"10001053"	"50-59 years"	"50-59"	"pt to ED with increasing weakness; positive for COVID; CA pt on chemotherapy; septic shock; AHRF; ARF; started on remdesivir, dexamethasone, barcitinib; unable to tolerate dialysis, became hypotensive and hypoxic; DNR; pt died in the hospital"
	"1880619-1"	"1880619-1"	"ASTHENIA"	"10003549"	"50-59 years"	"50-59"	"pt to ED with increasing weakness; positive for COVID; CA pt on chemotherapy; septic shock; AHRF; ARF; started on remdesivir, dexamethasone, barcitinib; unable to tolerate dialysis, became hypotensive and hypoxic; DNR; pt died in the hospital"
	"1880619-1"	"1880619-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"pt to ED with increasing weakness; positive for COVID; CA pt on chemotherapy; septic shock; AHRF; ARF; started on remdesivir, dexamethasone, barcitinib; unable to tolerate dialysis, became hypotensive and hypoxic; DNR; pt died in the hospital"
	"1880619-1"	"1880619-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"pt to ED with increasing weakness; positive for COVID; CA pt on chemotherapy; septic shock; AHRF; ARF; started on remdesivir, dexamethasone, barcitinib; unable to tolerate dialysis, became hypotensive and hypoxic; DNR; pt died in the hospital"
	"1880619-1"	"1880619-1"	"DIALYSIS RELATED COMPLICATION"	"10071946"	"50-59 years"	"50-59"	"pt to ED with increasing weakness; positive for COVID; CA pt on chemotherapy; septic shock; AHRF; ARF; started on remdesivir, dexamethasone, barcitinib; unable to tolerate dialysis, became hypotensive and hypoxic; DNR; pt died in the hospital"
	"1880619-1"	"1880619-1"	"HYPOTENSION"	"10021097"	"50-59 years"	"50-59"	"pt to ED with increasing weakness; positive for COVID; CA pt on chemotherapy; septic shock; AHRF; ARF; started on remdesivir, dexamethasone, barcitinib; unable to tolerate dialysis, became hypotensive and hypoxic; DNR; pt died in the hospital"
	"1880619-1"	"1880619-1"	"HYPOXIA"	"10021143"	"50-59 years"	"50-59"	"pt to ED with increasing weakness; positive for COVID; CA pt on chemotherapy; septic shock; AHRF; ARF; started on remdesivir, dexamethasone, barcitinib; unable to tolerate dialysis, became hypotensive and hypoxic; DNR; pt died in the hospital"
	"1880619-1"	"1880619-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"pt to ED with increasing weakness; positive for COVID; CA pt on chemotherapy; septic shock; AHRF; ARF; started on remdesivir, dexamethasone, barcitinib; unable to tolerate dialysis, became hypotensive and hypoxic; DNR; pt died in the hospital"
	"1880619-1"	"1880619-1"	"SEPTIC SHOCK"	"10040070"	"50-59 years"	"50-59"	"pt to ED with increasing weakness; positive for COVID; CA pt on chemotherapy; septic shock; AHRF; ARF; started on remdesivir, dexamethasone, barcitinib; unable to tolerate dialysis, became hypotensive and hypoxic; DNR; pt died in the hospital"
	"1880626-1"	"1880626-1"	"ACUTE MYOCARDIAL INFARCTION"	"10000891"	"50-59 years"	"50-59"	"Increased fatigue and SOB 1 week after receiving vaccine, Acute MI 4 weeks after vaccine administration"
	"1880626-1"	"1880626-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"Increased fatigue and SOB 1 week after receiving vaccine, Acute MI 4 weeks after vaccine administration"
	"1880626-1"	"1880626-1"	"FATIGUE"	"10016256"	"50-59 years"	"50-59"	"Increased fatigue and SOB 1 week after receiving vaccine, Acute MI 4 weeks after vaccine administration"
	"1880706-1"	"1880706-1"	"CARDIO-RESPIRATORY ARREST"	"10007617"	"50-59 years"	"50-59"	"PMH:  HTN, DM, morbid obesity; pt c/o SOB, fatigue, cough, nausea, anorexia x2wks, worsening past 3 dys; positive for COVID; COVID pneumonia with HRF; placed on BiPAP, remdesivir, dexamethasone, baricitinib; eventually required intubation with mechanical ventilation; pt coded and died in the hosp"
	"1880706-1"	"1880706-1"	"COUGH"	"10011224"	"50-59 years"	"50-59"	"PMH:  HTN, DM, morbid obesity; pt c/o SOB, fatigue, cough, nausea, anorexia x2wks, worsening past 3 dys; positive for COVID; COVID pneumonia with HRF; placed on BiPAP, remdesivir, dexamethasone, baricitinib; eventually required intubation with mechanical ventilation; pt coded and died in the hosp"
	"1880706-1"	"1880706-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"PMH:  HTN, DM, morbid obesity; pt c/o SOB, fatigue, cough, nausea, anorexia x2wks, worsening past 3 dys; positive for COVID; COVID pneumonia with HRF; placed on BiPAP, remdesivir, dexamethasone, baricitinib; eventually required intubation with mechanical ventilation; pt coded and died in the hosp"
	"1880706-1"	"1880706-1"	"COVID-19 PNEUMONIA"	"10084380"	"50-59 years"	"50-59"	"PMH:  HTN, DM, morbid obesity; pt c/o SOB, fatigue, cough, nausea, anorexia x2wks, worsening past 3 dys; positive for COVID; COVID pneumonia with HRF; placed on BiPAP, remdesivir, dexamethasone, baricitinib; eventually required intubation with mechanical ventilation; pt coded and died in the hosp"
	"1880706-1"	"1880706-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"PMH:  HTN, DM, morbid obesity; pt c/o SOB, fatigue, cough, nausea, anorexia x2wks, worsening past 3 dys; positive for COVID; COVID pneumonia with HRF; placed on BiPAP, remdesivir, dexamethasone, baricitinib; eventually required intubation with mechanical ventilation; pt coded and died in the hosp"
	"1880706-1"	"1880706-1"	"DECREASED APPETITE"	"10061428"	"50-59 years"	"50-59"	"PMH:  HTN, DM, morbid obesity; pt c/o SOB, fatigue, cough, nausea, anorexia x2wks, worsening past 3 dys; positive for COVID; COVID pneumonia with HRF; placed on BiPAP, remdesivir, dexamethasone, baricitinib; eventually required intubation with mechanical ventilation; pt coded and died in the hosp"
	"1880706-1"	"1880706-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"PMH:  HTN, DM, morbid obesity; pt c/o SOB, fatigue, cough, nausea, anorexia x2wks, worsening past 3 dys; positive for COVID; COVID pneumonia with HRF; placed on BiPAP, remdesivir, dexamethasone, baricitinib; eventually required intubation with mechanical ventilation; pt coded and died in the hosp"
	"1880706-1"	"1880706-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"50-59 years"	"50-59"	"PMH:  HTN, DM, morbid obesity; pt c/o SOB, fatigue, cough, nausea, anorexia x2wks, worsening past 3 dys; positive for COVID; COVID pneumonia with HRF; placed on BiPAP, remdesivir, dexamethasone, baricitinib; eventually required intubation with mechanical ventilation; pt coded and died in the hosp"
	"1880706-1"	"1880706-1"	"FATIGUE"	"10016256"	"50-59 years"	"50-59"	"PMH:  HTN, DM, morbid obesity; pt c/o SOB, fatigue, cough, nausea, anorexia x2wks, worsening past 3 dys; positive for COVID; COVID pneumonia with HRF; placed on BiPAP, remdesivir, dexamethasone, baricitinib; eventually required intubation with mechanical ventilation; pt coded and died in the hosp"
	"1880706-1"	"1880706-1"	"MECHANICAL VENTILATION"	"10067221"	"50-59 years"	"50-59"	"PMH:  HTN, DM, morbid obesity; pt c/o SOB, fatigue, cough, nausea, anorexia x2wks, worsening past 3 dys; positive for COVID; COVID pneumonia with HRF; placed on BiPAP, remdesivir, dexamethasone, baricitinib; eventually required intubation with mechanical ventilation; pt coded and died in the hosp"
	"1880706-1"	"1880706-1"	"NAUSEA"	"10028813"	"50-59 years"	"50-59"	"PMH:  HTN, DM, morbid obesity; pt c/o SOB, fatigue, cough, nausea, anorexia x2wks, worsening past 3 dys; positive for COVID; COVID pneumonia with HRF; placed on BiPAP, remdesivir, dexamethasone, baricitinib; eventually required intubation with mechanical ventilation; pt coded and died in the hosp"
	"1880706-1"	"1880706-1"	"POSITIVE AIRWAY PRESSURE THERAPY"	"10086397"	"50-59 years"	"50-59"	"PMH:  HTN, DM, morbid obesity; pt c/o SOB, fatigue, cough, nausea, anorexia x2wks, worsening past 3 dys; positive for COVID; COVID pneumonia with HRF; placed on BiPAP, remdesivir, dexamethasone, baricitinib; eventually required intubation with mechanical ventilation; pt coded and died in the hosp"
	"1880706-1"	"1880706-1"	"RESPIRATORY FAILURE"	"10038695"	"50-59 years"	"50-59"	"PMH:  HTN, DM, morbid obesity; pt c/o SOB, fatigue, cough, nausea, anorexia x2wks, worsening past 3 dys; positive for COVID; COVID pneumonia with HRF; placed on BiPAP, remdesivir, dexamethasone, baricitinib; eventually required intubation with mechanical ventilation; pt coded and died in the hosp"
	"1880706-1"	"1880706-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"PMH:  HTN, DM, morbid obesity; pt c/o SOB, fatigue, cough, nausea, anorexia x2wks, worsening past 3 dys; positive for COVID; COVID pneumonia with HRF; placed on BiPAP, remdesivir, dexamethasone, baricitinib; eventually required intubation with mechanical ventilation; pt coded and died in the hosp"
	"1884880-1"	"1884880-1"	"BRONCHOGRAM ABNORMAL"	"10006466"	"50-59 years"	"50-59"	"Pt had first Pfizer Covid vaccine on 01/08/2021 Lot: EL140. Pt reported that symptoms of fever and cough began on 08/07/2021. On 08/09/2021, pt went to ER and tested positive for Covid. Called the office on 08/11/2021 to report Covid symptoms; advised to call hospital and arrange for Monoclonal Antibody Therapy. Also, to return to ER if symptoms worsen. Coroner's office was called on 08/12/2021 per friend after well check by PD. Explained to clerk at  Coroner's Office what VAERS Reporting entails.  Clerk was unsure and asked that clinic submit report. Autopsy Report signed on 11/03/2021 Findings: 1. Complications of Covid-19 infection A. Positive NP swab for covid B. Several day history of fever. 2. Diabetes mellitus and kidney failure"
	"1884880-1"	"1884880-1"	"CARDIOMEGALY"	"10007632"	"50-59 years"	"50-59"	"Pt had first Pfizer Covid vaccine on 01/08/2021 Lot: EL140. Pt reported that symptoms of fever and cough began on 08/07/2021. On 08/09/2021, pt went to ER and tested positive for Covid. Called the office on 08/11/2021 to report Covid symptoms; advised to call hospital and arrange for Monoclonal Antibody Therapy. Also, to return to ER if symptoms worsen. Coroner's office was called on 08/12/2021 per friend after well check by PD. Explained to clerk at  Coroner's Office what VAERS Reporting entails.  Clerk was unsure and asked that clinic submit report. Autopsy Report signed on 11/03/2021 Findings: 1. Complications of Covid-19 infection A. Positive NP swab for covid B. Several day history of fever. 2. Diabetes mellitus and kidney failure"
	"1884880-1"	"1884880-1"	"CHEST X-RAY ABNORMAL"	"10008499"	"50-59 years"	"50-59"	"Pt had first Pfizer Covid vaccine on 01/08/2021 Lot: EL140. Pt reported that symptoms of fever and cough began on 08/07/2021. On 08/09/2021, pt went to ER and tested positive for Covid. Called the office on 08/11/2021 to report Covid symptoms; advised to call hospital and arrange for Monoclonal Antibody Therapy. Also, to return to ER if symptoms worsen. Coroner's office was called on 08/12/2021 per friend after well check by PD. Explained to clerk at  Coroner's Office what VAERS Reporting entails.  Clerk was unsure and asked that clinic submit report. Autopsy Report signed on 11/03/2021 Findings: 1. Complications of Covid-19 infection A. Positive NP swab for covid B. Several day history of fever. 2. Diabetes mellitus and kidney failure"
	"1884880-1"	"1884880-1"	"COUGH"	"10011224"	"50-59 years"	"50-59"	"Pt had first Pfizer Covid vaccine on 01/08/2021 Lot: EL140. Pt reported that symptoms of fever and cough began on 08/07/2021. On 08/09/2021, pt went to ER and tested positive for Covid. Called the office on 08/11/2021 to report Covid symptoms; advised to call hospital and arrange for Monoclonal Antibody Therapy. Also, to return to ER if symptoms worsen. Coroner's office was called on 08/12/2021 per friend after well check by PD. Explained to clerk at  Coroner's Office what VAERS Reporting entails.  Clerk was unsure and asked that clinic submit report. Autopsy Report signed on 11/03/2021 Findings: 1. Complications of Covid-19 infection A. Positive NP swab for covid B. Several day history of fever. 2. Diabetes mellitus and kidney failure"
	"1884880-1"	"1884880-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Pt had first Pfizer Covid vaccine on 01/08/2021 Lot: EL140. Pt reported that symptoms of fever and cough began on 08/07/2021. On 08/09/2021, pt went to ER and tested positive for Covid. Called the office on 08/11/2021 to report Covid symptoms; advised to call hospital and arrange for Monoclonal Antibody Therapy. Also, to return to ER if symptoms worsen. Coroner's office was called on 08/12/2021 per friend after well check by PD. Explained to clerk at  Coroner's Office what VAERS Reporting entails.  Clerk was unsure and asked that clinic submit report. Autopsy Report signed on 11/03/2021 Findings: 1. Complications of Covid-19 infection A. Positive NP swab for covid B. Several day history of fever. 2. Diabetes mellitus and kidney failure"
	"1884880-1"	"1884880-1"	"INTERSTITIAL LUNG DISEASE"	"10022611"	"50-59 years"	"50-59"	"Pt had first Pfizer Covid vaccine on 01/08/2021 Lot: EL140. Pt reported that symptoms of fever and cough began on 08/07/2021. On 08/09/2021, pt went to ER and tested positive for Covid. Called the office on 08/11/2021 to report Covid symptoms; advised to call hospital and arrange for Monoclonal Antibody Therapy. Also, to return to ER if symptoms worsen. Coroner's office was called on 08/12/2021 per friend after well check by PD. Explained to clerk at  Coroner's Office what VAERS Reporting entails.  Clerk was unsure and asked that clinic submit report. Autopsy Report signed on 11/03/2021 Findings: 1. Complications of Covid-19 infection A. Positive NP swab for covid B. Several day history of fever. 2. Diabetes mellitus and kidney failure"
	"1884880-1"	"1884880-1"	"LUNG CONSOLIDATION"	"10025080"	"50-59 years"	"50-59"	"Pt had first Pfizer Covid vaccine on 01/08/2021 Lot: EL140. Pt reported that symptoms of fever and cough began on 08/07/2021. On 08/09/2021, pt went to ER and tested positive for Covid. Called the office on 08/11/2021 to report Covid symptoms; advised to call hospital and arrange for Monoclonal Antibody Therapy. Also, to return to ER if symptoms worsen. Coroner's office was called on 08/12/2021 per friend after well check by PD. Explained to clerk at  Coroner's Office what VAERS Reporting entails.  Clerk was unsure and asked that clinic submit report. Autopsy Report signed on 11/03/2021 Findings: 1. Complications of Covid-19 infection A. Positive NP swab for covid B. Several day history of fever. 2. Diabetes mellitus and kidney failure"
	"1884880-1"	"1884880-1"	"PNEUMONIA"	"10035664"	"50-59 years"	"50-59"	"Pt had first Pfizer Covid vaccine on 01/08/2021 Lot: EL140. Pt reported that symptoms of fever and cough began on 08/07/2021. On 08/09/2021, pt went to ER and tested positive for Covid. Called the office on 08/11/2021 to report Covid symptoms; advised to call hospital and arrange for Monoclonal Antibody Therapy. Also, to return to ER if symptoms worsen. Coroner's office was called on 08/12/2021 per friend after well check by PD. Explained to clerk at  Coroner's Office what VAERS Reporting entails.  Clerk was unsure and asked that clinic submit report. Autopsy Report signed on 11/03/2021 Findings: 1. Complications of Covid-19 infection A. Positive NP swab for covid B. Several day history of fever. 2. Diabetes mellitus and kidney failure"
	"1884880-1"	"1884880-1"	"PULMONARY HILAR ENLARGEMENT"	"10065291"	"50-59 years"	"50-59"	"Pt had first Pfizer Covid vaccine on 01/08/2021 Lot: EL140. Pt reported that symptoms of fever and cough began on 08/07/2021. On 08/09/2021, pt went to ER and tested positive for Covid. Called the office on 08/11/2021 to report Covid symptoms; advised to call hospital and arrange for Monoclonal Antibody Therapy. Also, to return to ER if symptoms worsen. Coroner's office was called on 08/12/2021 per friend after well check by PD. Explained to clerk at  Coroner's Office what VAERS Reporting entails.  Clerk was unsure and asked that clinic submit report. Autopsy Report signed on 11/03/2021 Findings: 1. Complications of Covid-19 infection A. Positive NP swab for covid B. Several day history of fever. 2. Diabetes mellitus and kidney failure"
	"1884880-1"	"1884880-1"	"PYREXIA"	"10037660"	"50-59 years"	"50-59"	"Pt had first Pfizer Covid vaccine on 01/08/2021 Lot: EL140. Pt reported that symptoms of fever and cough began on 08/07/2021. On 08/09/2021, pt went to ER and tested positive for Covid. Called the office on 08/11/2021 to report Covid symptoms; advised to call hospital and arrange for Monoclonal Antibody Therapy. Also, to return to ER if symptoms worsen. Coroner's office was called on 08/12/2021 per friend after well check by PD. Explained to clerk at  Coroner's Office what VAERS Reporting entails.  Clerk was unsure and asked that clinic submit report. Autopsy Report signed on 11/03/2021 Findings: 1. Complications of Covid-19 infection A. Positive NP swab for covid B. Several day history of fever. 2. Diabetes mellitus and kidney failure"
	"1884880-1"	"1884880-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"Pt had first Pfizer Covid vaccine on 01/08/2021 Lot: EL140. Pt reported that symptoms of fever and cough began on 08/07/2021. On 08/09/2021, pt went to ER and tested positive for Covid. Called the office on 08/11/2021 to report Covid symptoms; advised to call hospital and arrange for Monoclonal Antibody Therapy. Also, to return to ER if symptoms worsen. Coroner's office was called on 08/12/2021 per friend after well check by PD. Explained to clerk at  Coroner's Office what VAERS Reporting entails.  Clerk was unsure and asked that clinic submit report. Autopsy Report signed on 11/03/2021 Findings: 1. Complications of Covid-19 infection A. Positive NP swab for covid B. Several day history of fever. 2. Diabetes mellitus and kidney failure"
	"1884995-1"	"1884995-1"	"CEREBROVASCULAR ACCIDENT"	"10008190"	"50-59 years"	"50-59"	"Stroke, death"
	"1884995-1"	"1884995-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Stroke, death"
	"1885359-1"	"1885359-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"death ALTERED MENTAL STATUS FACIAL DROOP G45.9 - Transient cerebral ischemic attack, unspecified"
	"1885359-1"	"1885359-1"	"FACIAL PARALYSIS"	"10016062"	"50-59 years"	"50-59"	"death ALTERED MENTAL STATUS FACIAL DROOP G45.9 - Transient cerebral ischemic attack, unspecified"
	"1885359-1"	"1885359-1"	"MENTAL STATUS CHANGES"	"10048294"	"50-59 years"	"50-59"	"death ALTERED MENTAL STATUS FACIAL DROOP G45.9 - Transient cerebral ischemic attack, unspecified"
	"1885359-1"	"1885359-1"	"TRANSIENT ISCHAEMIC ATTACK"	"10044390"	"50-59 years"	"50-59"	"death ALTERED MENTAL STATUS FACIAL DROOP G45.9 - Transient cerebral ischemic attack, unspecified"
	"1888979-1"	"1888979-1"	"AUTOPSY"	"10050117"	"50-59 years"	"50-59"	"My brother died from a heart attack just 21 days after receiving his Moderna vaccine."
	"1888979-1"	"1888979-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"My brother died from a heart attack just 21 days after receiving his Moderna vaccine."
	"1888979-1"	"1888979-1"	"MYOCARDIAL INFARCTION"	"10028596"	"50-59 years"	"50-59"	"My brother died from a heart attack just 21 days after receiving his Moderna vaccine."
	"1893982-1"	"1893982-1"	"ACUTE RESPIRATORY FAILURE"	"10001053"	"50-59 years"	"50-59"	"Deceased 11/17/2021; Hospitalized 11/10/2021; COVID-19 positive 11/10/2021; fully vaccinated  BRIEF OVERVIEW:  Admission Date: 11/10/2021   DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Acute respiratory failure [J96.00] COVID [U07.1] COVID-19 [U07.1]   HOSPITAL COURSE: Patient is a 57 y.o. female who initially presented on 11/10 for 3-4 days of worsening shortness of breath, diarrhea, and nonproductive cough.  She had pitting edema and signs of fluid overload on CXR and was diagnosed with COVID on arrival.  She is on 5 L oxygen at baseline and was started on high-flow nasal cannula and initially admitted to hospitalist service.    She was diuresed aggressively. She was started on steroids; did not qualify for Remdesivir due to kidney function.Her oxygen requirements continued to increase and she was transitioned to 100% high-flow nasal cannula with non-rebreather mask. Overnight on 11/11, she desated into low 80s and was placed on BIPAP and transferred to ICU service due to concern for impending intubation.    Her respiratory status declined and was intubated on 11/13.  We had multiple conversations about her likely poor prognosis considering her baseline respiratory status, and patient elected to proceed with intubation at that time.  She was sedated and paralyzed, and she subsequent required initiation of norepinephrine. Her respiratory status continued to worsen and we began proning on 11/14. She responded to proning and was continued on a 20:4 proning schedule.   Palliative care was consulted on 11/15 after family expressed concern about patient's grim prognosis and likelihood of tracheostomy and long-term care even if she survived this illness. On 11/16, palliative spoke with all first-degree relatives, and they decided to transition to DNR and comfort care. Paralytics turned off and patient pronounced dead on 11/17/21 at 12:45AM. Family at bedside, condolences offered."
	"1893982-1"	"1893982-1"	"CHEST X-RAY ABNORMAL"	"10008499"	"50-59 years"	"50-59"	"Deceased 11/17/2021; Hospitalized 11/10/2021; COVID-19 positive 11/10/2021; fully vaccinated  BRIEF OVERVIEW:  Admission Date: 11/10/2021   DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Acute respiratory failure [J96.00] COVID [U07.1] COVID-19 [U07.1]   HOSPITAL COURSE: Patient is a 57 y.o. female who initially presented on 11/10 for 3-4 days of worsening shortness of breath, diarrhea, and nonproductive cough.  She had pitting edema and signs of fluid overload on CXR and was diagnosed with COVID on arrival.  She is on 5 L oxygen at baseline and was started on high-flow nasal cannula and initially admitted to hospitalist service.    She was diuresed aggressively. She was started on steroids; did not qualify for Remdesivir due to kidney function.Her oxygen requirements continued to increase and she was transitioned to 100% high-flow nasal cannula with non-rebreather mask. Overnight on 11/11, she desated into low 80s and was placed on BIPAP and transferred to ICU service due to concern for impending intubation.    Her respiratory status declined and was intubated on 11/13.  We had multiple conversations about her likely poor prognosis considering her baseline respiratory status, and patient elected to proceed with intubation at that time.  She was sedated and paralyzed, and she subsequent required initiation of norepinephrine. Her respiratory status continued to worsen and we began proning on 11/14. She responded to proning and was continued on a 20:4 proning schedule.   Palliative care was consulted on 11/15 after family expressed concern about patient's grim prognosis and likelihood of tracheostomy and long-term care even if she survived this illness. On 11/16, palliative spoke with all first-degree relatives, and they decided to transition to DNR and comfort care. Paralytics turned off and patient pronounced dead on 11/17/21 at 12:45AM. Family at bedside, condolences offered."
	"1893982-1"	"1893982-1"	"CONDITION AGGRAVATED"	"10010264"	"50-59 years"	"50-59"	"Deceased 11/17/2021; Hospitalized 11/10/2021; COVID-19 positive 11/10/2021; fully vaccinated  BRIEF OVERVIEW:  Admission Date: 11/10/2021   DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Acute respiratory failure [J96.00] COVID [U07.1] COVID-19 [U07.1]   HOSPITAL COURSE: Patient is a 57 y.o. female who initially presented on 11/10 for 3-4 days of worsening shortness of breath, diarrhea, and nonproductive cough.  She had pitting edema and signs of fluid overload on CXR and was diagnosed with COVID on arrival.  She is on 5 L oxygen at baseline and was started on high-flow nasal cannula and initially admitted to hospitalist service.    She was diuresed aggressively. She was started on steroids; did not qualify for Remdesivir due to kidney function.Her oxygen requirements continued to increase and she was transitioned to 100% high-flow nasal cannula with non-rebreather mask. Overnight on 11/11, she desated into low 80s and was placed on BIPAP and transferred to ICU service due to concern for impending intubation.    Her respiratory status declined and was intubated on 11/13.  We had multiple conversations about her likely poor prognosis considering her baseline respiratory status, and patient elected to proceed with intubation at that time.  She was sedated and paralyzed, and she subsequent required initiation of norepinephrine. Her respiratory status continued to worsen and we began proning on 11/14. She responded to proning and was continued on a 20:4 proning schedule.   Palliative care was consulted on 11/15 after family expressed concern about patient's grim prognosis and likelihood of tracheostomy and long-term care even if she survived this illness. On 11/16, palliative spoke with all first-degree relatives, and they decided to transition to DNR and comfort care. Paralytics turned off and patient pronounced dead on 11/17/21 at 12:45AM. Family at bedside, condolences offered."
	"1893982-1"	"1893982-1"	"COUGH"	"10011224"	"50-59 years"	"50-59"	"Deceased 11/17/2021; Hospitalized 11/10/2021; COVID-19 positive 11/10/2021; fully vaccinated  BRIEF OVERVIEW:  Admission Date: 11/10/2021   DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Acute respiratory failure [J96.00] COVID [U07.1] COVID-19 [U07.1]   HOSPITAL COURSE: Patient is a 57 y.o. female who initially presented on 11/10 for 3-4 days of worsening shortness of breath, diarrhea, and nonproductive cough.  She had pitting edema and signs of fluid overload on CXR and was diagnosed with COVID on arrival.  She is on 5 L oxygen at baseline and was started on high-flow nasal cannula and initially admitted to hospitalist service.    She was diuresed aggressively. She was started on steroids; did not qualify for Remdesivir due to kidney function.Her oxygen requirements continued to increase and she was transitioned to 100% high-flow nasal cannula with non-rebreather mask. Overnight on 11/11, she desated into low 80s and was placed on BIPAP and transferred to ICU service due to concern for impending intubation.    Her respiratory status declined and was intubated on 11/13.  We had multiple conversations about her likely poor prognosis considering her baseline respiratory status, and patient elected to proceed with intubation at that time.  She was sedated and paralyzed, and she subsequent required initiation of norepinephrine. Her respiratory status continued to worsen and we began proning on 11/14. She responded to proning and was continued on a 20:4 proning schedule.   Palliative care was consulted on 11/15 after family expressed concern about patient's grim prognosis and likelihood of tracheostomy and long-term care even if she survived this illness. On 11/16, palliative spoke with all first-degree relatives, and they decided to transition to DNR and comfort care. Paralytics turned off and patient pronounced dead on 11/17/21 at 12:45AM. Family at bedside, condolences offered."
	"1893982-1"	"1893982-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Deceased 11/17/2021; Hospitalized 11/10/2021; COVID-19 positive 11/10/2021; fully vaccinated  BRIEF OVERVIEW:  Admission Date: 11/10/2021   DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Acute respiratory failure [J96.00] COVID [U07.1] COVID-19 [U07.1]   HOSPITAL COURSE: Patient is a 57 y.o. female who initially presented on 11/10 for 3-4 days of worsening shortness of breath, diarrhea, and nonproductive cough.  She had pitting edema and signs of fluid overload on CXR and was diagnosed with COVID on arrival.  She is on 5 L oxygen at baseline and was started on high-flow nasal cannula and initially admitted to hospitalist service.    She was diuresed aggressively. She was started on steroids; did not qualify for Remdesivir due to kidney function.Her oxygen requirements continued to increase and she was transitioned to 100% high-flow nasal cannula with non-rebreather mask. Overnight on 11/11, she desated into low 80s and was placed on BIPAP and transferred to ICU service due to concern for impending intubation.    Her respiratory status declined and was intubated on 11/13.  We had multiple conversations about her likely poor prognosis considering her baseline respiratory status, and patient elected to proceed with intubation at that time.  She was sedated and paralyzed, and she subsequent required initiation of norepinephrine. Her respiratory status continued to worsen and we began proning on 11/14. She responded to proning and was continued on a 20:4 proning schedule.   Palliative care was consulted on 11/15 after family expressed concern about patient's grim prognosis and likelihood of tracheostomy and long-term care even if she survived this illness. On 11/16, palliative spoke with all first-degree relatives, and they decided to transition to DNR and comfort care. Paralytics turned off and patient pronounced dead on 11/17/21 at 12:45AM. Family at bedside, condolences offered."
	"1893982-1"	"1893982-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Deceased 11/17/2021; Hospitalized 11/10/2021; COVID-19 positive 11/10/2021; fully vaccinated  BRIEF OVERVIEW:  Admission Date: 11/10/2021   DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Acute respiratory failure [J96.00] COVID [U07.1] COVID-19 [U07.1]   HOSPITAL COURSE: Patient is a 57 y.o. female who initially presented on 11/10 for 3-4 days of worsening shortness of breath, diarrhea, and nonproductive cough.  She had pitting edema and signs of fluid overload on CXR and was diagnosed with COVID on arrival.  She is on 5 L oxygen at baseline and was started on high-flow nasal cannula and initially admitted to hospitalist service.    She was diuresed aggressively. She was started on steroids; did not qualify for Remdesivir due to kidney function.Her oxygen requirements continued to increase and she was transitioned to 100% high-flow nasal cannula with non-rebreather mask. Overnight on 11/11, she desated into low 80s and was placed on BIPAP and transferred to ICU service due to concern for impending intubation.    Her respiratory status declined and was intubated on 11/13.  We had multiple conversations about her likely poor prognosis considering her baseline respiratory status, and patient elected to proceed with intubation at that time.  She was sedated and paralyzed, and she subsequent required initiation of norepinephrine. Her respiratory status continued to worsen and we began proning on 11/14. She responded to proning and was continued on a 20:4 proning schedule.   Palliative care was consulted on 11/15 after family expressed concern about patient's grim prognosis and likelihood of tracheostomy and long-term care even if she survived this illness. On 11/16, palliative spoke with all first-degree relatives, and they decided to transition to DNR and comfort care. Paralytics turned off and patient pronounced dead on 11/17/21 at 12:45AM. Family at bedside, condolences offered."
	"1893982-1"	"1893982-1"	"DIARRHOEA"	"10012735"	"50-59 years"	"50-59"	"Deceased 11/17/2021; Hospitalized 11/10/2021; COVID-19 positive 11/10/2021; fully vaccinated  BRIEF OVERVIEW:  Admission Date: 11/10/2021   DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Acute respiratory failure [J96.00] COVID [U07.1] COVID-19 [U07.1]   HOSPITAL COURSE: Patient is a 57 y.o. female who initially presented on 11/10 for 3-4 days of worsening shortness of breath, diarrhea, and nonproductive cough.  She had pitting edema and signs of fluid overload on CXR and was diagnosed with COVID on arrival.  She is on 5 L oxygen at baseline and was started on high-flow nasal cannula and initially admitted to hospitalist service.    She was diuresed aggressively. She was started on steroids; did not qualify for Remdesivir due to kidney function.Her oxygen requirements continued to increase and she was transitioned to 100% high-flow nasal cannula with non-rebreather mask. Overnight on 11/11, she desated into low 80s and was placed on BIPAP and transferred to ICU service due to concern for impending intubation.    Her respiratory status declined and was intubated on 11/13.  We had multiple conversations about her likely poor prognosis considering her baseline respiratory status, and patient elected to proceed with intubation at that time.  She was sedated and paralyzed, and she subsequent required initiation of norepinephrine. Her respiratory status continued to worsen and we began proning on 11/14. She responded to proning and was continued on a 20:4 proning schedule.   Palliative care was consulted on 11/15 after family expressed concern about patient's grim prognosis and likelihood of tracheostomy and long-term care even if she survived this illness. On 11/16, palliative spoke with all first-degree relatives, and they decided to transition to DNR and comfort care. Paralytics turned off and patient pronounced dead on 11/17/21 at 12:45AM. Family at bedside, condolences offered."
	"1893982-1"	"1893982-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"Deceased 11/17/2021; Hospitalized 11/10/2021; COVID-19 positive 11/10/2021; fully vaccinated  BRIEF OVERVIEW:  Admission Date: 11/10/2021   DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Acute respiratory failure [J96.00] COVID [U07.1] COVID-19 [U07.1]   HOSPITAL COURSE: Patient is a 57 y.o. female who initially presented on 11/10 for 3-4 days of worsening shortness of breath, diarrhea, and nonproductive cough.  She had pitting edema and signs of fluid overload on CXR and was diagnosed with COVID on arrival.  She is on 5 L oxygen at baseline and was started on high-flow nasal cannula and initially admitted to hospitalist service.    She was diuresed aggressively. She was started on steroids; did not qualify for Remdesivir due to kidney function.Her oxygen requirements continued to increase and she was transitioned to 100% high-flow nasal cannula with non-rebreather mask. Overnight on 11/11, she desated into low 80s and was placed on BIPAP and transferred to ICU service due to concern for impending intubation.    Her respiratory status declined and was intubated on 11/13.  We had multiple conversations about her likely poor prognosis considering her baseline respiratory status, and patient elected to proceed with intubation at that time.  She was sedated and paralyzed, and she subsequent required initiation of norepinephrine. Her respiratory status continued to worsen and we began proning on 11/14. She responded to proning and was continued on a 20:4 proning schedule.   Palliative care was consulted on 11/15 after family expressed concern about patient's grim prognosis and likelihood of tracheostomy and long-term care even if she survived this illness. On 11/16, palliative spoke with all first-degree relatives, and they decided to transition to DNR and comfort care. Paralytics turned off and patient pronounced dead on 11/17/21 at 12:45AM. Family at bedside, condolences offered."
	"1893982-1"	"1893982-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"50-59 years"	"50-59"	"Deceased 11/17/2021; Hospitalized 11/10/2021; COVID-19 positive 11/10/2021; fully vaccinated  BRIEF OVERVIEW:  Admission Date: 11/10/2021   DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Acute respiratory failure [J96.00] COVID [U07.1] COVID-19 [U07.1]   HOSPITAL COURSE: Patient is a 57 y.o. female who initially presented on 11/10 for 3-4 days of worsening shortness of breath, diarrhea, and nonproductive cough.  She had pitting edema and signs of fluid overload on CXR and was diagnosed with COVID on arrival.  She is on 5 L oxygen at baseline and was started on high-flow nasal cannula and initially admitted to hospitalist service.    She was diuresed aggressively. She was started on steroids; did not qualify for Remdesivir due to kidney function.Her oxygen requirements continued to increase and she was transitioned to 100% high-flow nasal cannula with non-rebreather mask. Overnight on 11/11, she desated into low 80s and was placed on BIPAP and transferred to ICU service due to concern for impending intubation.    Her respiratory status declined and was intubated on 11/13.  We had multiple conversations about her likely poor prognosis considering her baseline respiratory status, and patient elected to proceed with intubation at that time.  She was sedated and paralyzed, and she subsequent required initiation of norepinephrine. Her respiratory status continued to worsen and we began proning on 11/14. She responded to proning and was continued on a 20:4 proning schedule.   Palliative care was consulted on 11/15 after family expressed concern about patient's grim prognosis and likelihood of tracheostomy and long-term care even if she survived this illness. On 11/16, palliative spoke with all first-degree relatives, and they decided to transition to DNR and comfort care. Paralytics turned off and patient pronounced dead on 11/17/21 at 12:45AM. Family at bedside, condolences offered."
	"1893982-1"	"1893982-1"	"HYPERVOLAEMIA"	"10020919"	"50-59 years"	"50-59"	"Deceased 11/17/2021; Hospitalized 11/10/2021; COVID-19 positive 11/10/2021; fully vaccinated  BRIEF OVERVIEW:  Admission Date: 11/10/2021   DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Acute respiratory failure [J96.00] COVID [U07.1] COVID-19 [U07.1]   HOSPITAL COURSE: Patient is a 57 y.o. female who initially presented on 11/10 for 3-4 days of worsening shortness of breath, diarrhea, and nonproductive cough.  She had pitting edema and signs of fluid overload on CXR and was diagnosed with COVID on arrival.  She is on 5 L oxygen at baseline and was started on high-flow nasal cannula and initially admitted to hospitalist service.    She was diuresed aggressively. She was started on steroids; did not qualify for Remdesivir due to kidney function.Her oxygen requirements continued to increase and she was transitioned to 100% high-flow nasal cannula with non-rebreather mask. Overnight on 11/11, she desated into low 80s and was placed on BIPAP and transferred to ICU service due to concern for impending intubation.    Her respiratory status declined and was intubated on 11/13.  We had multiple conversations about her likely poor prognosis considering her baseline respiratory status, and patient elected to proceed with intubation at that time.  She was sedated and paralyzed, and she subsequent required initiation of norepinephrine. Her respiratory status continued to worsen and we began proning on 11/14. She responded to proning and was continued on a 20:4 proning schedule.   Palliative care was consulted on 11/15 after family expressed concern about patient's grim prognosis and likelihood of tracheostomy and long-term care even if she survived this illness. On 11/16, palliative spoke with all first-degree relatives, and they decided to transition to DNR and comfort care. Paralytics turned off and patient pronounced dead on 11/17/21 at 12:45AM. Family at bedside, condolences offered."
	"1893982-1"	"1893982-1"	"INTENSIVE CARE"	"10022519"	"50-59 years"	"50-59"	"Deceased 11/17/2021; Hospitalized 11/10/2021; COVID-19 positive 11/10/2021; fully vaccinated  BRIEF OVERVIEW:  Admission Date: 11/10/2021   DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Acute respiratory failure [J96.00] COVID [U07.1] COVID-19 [U07.1]   HOSPITAL COURSE: Patient is a 57 y.o. female who initially presented on 11/10 for 3-4 days of worsening shortness of breath, diarrhea, and nonproductive cough.  She had pitting edema and signs of fluid overload on CXR and was diagnosed with COVID on arrival.  She is on 5 L oxygen at baseline and was started on high-flow nasal cannula and initially admitted to hospitalist service.    She was diuresed aggressively. She was started on steroids; did not qualify for Remdesivir due to kidney function.Her oxygen requirements continued to increase and she was transitioned to 100% high-flow nasal cannula with non-rebreather mask. Overnight on 11/11, she desated into low 80s and was placed on BIPAP and transferred to ICU service due to concern for impending intubation.    Her respiratory status declined and was intubated on 11/13.  We had multiple conversations about her likely poor prognosis considering her baseline respiratory status, and patient elected to proceed with intubation at that time.  She was sedated and paralyzed, and she subsequent required initiation of norepinephrine. Her respiratory status continued to worsen and we began proning on 11/14. She responded to proning and was continued on a 20:4 proning schedule.   Palliative care was consulted on 11/15 after family expressed concern about patient's grim prognosis and likelihood of tracheostomy and long-term care even if she survived this illness. On 11/16, palliative spoke with all first-degree relatives, and they decided to transition to DNR and comfort care. Paralytics turned off and patient pronounced dead on 11/17/21 at 12:45AM. Family at bedside, condolences offered."
	"1893982-1"	"1893982-1"	"OEDEMA"	"10030095"	"50-59 years"	"50-59"	"Deceased 11/17/2021; Hospitalized 11/10/2021; COVID-19 positive 11/10/2021; fully vaccinated  BRIEF OVERVIEW:  Admission Date: 11/10/2021   DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Acute respiratory failure [J96.00] COVID [U07.1] COVID-19 [U07.1]   HOSPITAL COURSE: Patient is a 57 y.o. female who initially presented on 11/10 for 3-4 days of worsening shortness of breath, diarrhea, and nonproductive cough.  She had pitting edema and signs of fluid overload on CXR and was diagnosed with COVID on arrival.  She is on 5 L oxygen at baseline and was started on high-flow nasal cannula and initially admitted to hospitalist service.    She was diuresed aggressively. She was started on steroids; did not qualify for Remdesivir due to kidney function.Her oxygen requirements continued to increase and she was transitioned to 100% high-flow nasal cannula with non-rebreather mask. Overnight on 11/11, she desated into low 80s and was placed on BIPAP and transferred to ICU service due to concern for impending intubation.    Her respiratory status declined and was intubated on 11/13.  We had multiple conversations about her likely poor prognosis considering her baseline respiratory status, and patient elected to proceed with intubation at that time.  She was sedated and paralyzed, and she subsequent required initiation of norepinephrine. Her respiratory status continued to worsen and we began proning on 11/14. She responded to proning and was continued on a 20:4 proning schedule.   Palliative care was consulted on 11/15 after family expressed concern about patient's grim prognosis and likelihood of tracheostomy and long-term care even if she survived this illness. On 11/16, palliative spoke with all first-degree relatives, and they decided to transition to DNR and comfort care. Paralytics turned off and patient pronounced dead on 11/17/21 at 12:45AM. Family at bedside, condolences offered."
	"1893982-1"	"1893982-1"	"OXYGEN SATURATION DECREASED"	"10033318"	"50-59 years"	"50-59"	"Deceased 11/17/2021; Hospitalized 11/10/2021; COVID-19 positive 11/10/2021; fully vaccinated  BRIEF OVERVIEW:  Admission Date: 11/10/2021   DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Acute respiratory failure [J96.00] COVID [U07.1] COVID-19 [U07.1]   HOSPITAL COURSE: Patient is a 57 y.o. female who initially presented on 11/10 for 3-4 days of worsening shortness of breath, diarrhea, and nonproductive cough.  She had pitting edema and signs of fluid overload on CXR and was diagnosed with COVID on arrival.  She is on 5 L oxygen at baseline and was started on high-flow nasal cannula and initially admitted to hospitalist service.    She was diuresed aggressively. She was started on steroids; did not qualify for Remdesivir due to kidney function.Her oxygen requirements continued to increase and she was transitioned to 100% high-flow nasal cannula with non-rebreather mask. Overnight on 11/11, she desated into low 80s and was placed on BIPAP and transferred to ICU service due to concern for impending intubation.    Her respiratory status declined and was intubated on 11/13.  We had multiple conversations about her likely poor prognosis considering her baseline respiratory status, and patient elected to proceed with intubation at that time.  She was sedated and paralyzed, and she subsequent required initiation of norepinephrine. Her respiratory status continued to worsen and we began proning on 11/14. She responded to proning and was continued on a 20:4 proning schedule.   Palliative care was consulted on 11/15 after family expressed concern about patient's grim prognosis and likelihood of tracheostomy and long-term care even if she survived this illness. On 11/16, palliative spoke with all first-degree relatives, and they decided to transition to DNR and comfort care. Paralytics turned off and patient pronounced dead on 11/17/21 at 12:45AM. Family at bedside, condolences offered."
	"1893982-1"	"1893982-1"	"PARALYSIS"	"10033799"	"50-59 years"	"50-59"	"Deceased 11/17/2021; Hospitalized 11/10/2021; COVID-19 positive 11/10/2021; fully vaccinated  BRIEF OVERVIEW:  Admission Date: 11/10/2021   DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Acute respiratory failure [J96.00] COVID [U07.1] COVID-19 [U07.1]   HOSPITAL COURSE: Patient is a 57 y.o. female who initially presented on 11/10 for 3-4 days of worsening shortness of breath, diarrhea, and nonproductive cough.  She had pitting edema and signs of fluid overload on CXR and was diagnosed with COVID on arrival.  She is on 5 L oxygen at baseline and was started on high-flow nasal cannula and initially admitted to hospitalist service.    She was diuresed aggressively. She was started on steroids; did not qualify for Remdesivir due to kidney function.Her oxygen requirements continued to increase and she was transitioned to 100% high-flow nasal cannula with non-rebreather mask. Overnight on 11/11, she desated into low 80s and was placed on BIPAP and transferred to ICU service due to concern for impending intubation.    Her respiratory status declined and was intubated on 11/13.  We had multiple conversations about her likely poor prognosis considering her baseline respiratory status, and patient elected to proceed with intubation at that time.  She was sedated and paralyzed, and she subsequent required initiation of norepinephrine. Her respiratory status continued to worsen and we began proning on 11/14. She responded to proning and was continued on a 20:4 proning schedule.   Palliative care was consulted on 11/15 after family expressed concern about patient's grim prognosis and likelihood of tracheostomy and long-term care even if she survived this illness. On 11/16, palliative spoke with all first-degree relatives, and they decided to transition to DNR and comfort care. Paralytics turned off and patient pronounced dead on 11/17/21 at 12:45AM. Family at bedside, condolences offered."
	"1893982-1"	"1893982-1"	"POLYURIA"	"10036142"	"50-59 years"	"50-59"	"Deceased 11/17/2021; Hospitalized 11/10/2021; COVID-19 positive 11/10/2021; fully vaccinated  BRIEF OVERVIEW:  Admission Date: 11/10/2021   DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Acute respiratory failure [J96.00] COVID [U07.1] COVID-19 [U07.1]   HOSPITAL COURSE: Patient is a 57 y.o. female who initially presented on 11/10 for 3-4 days of worsening shortness of breath, diarrhea, and nonproductive cough.  She had pitting edema and signs of fluid overload on CXR and was diagnosed with COVID on arrival.  She is on 5 L oxygen at baseline and was started on high-flow nasal cannula and initially admitted to hospitalist service.    She was diuresed aggressively. She was started on steroids; did not qualify for Remdesivir due to kidney function.Her oxygen requirements continued to increase and she was transitioned to 100% high-flow nasal cannula with non-rebreather mask. Overnight on 11/11, she desated into low 80s and was placed on BIPAP and transferred to ICU service due to concern for impending intubation.    Her respiratory status declined and was intubated on 11/13.  We had multiple conversations about her likely poor prognosis considering her baseline respiratory status, and patient elected to proceed with intubation at that time.  She was sedated and paralyzed, and she subsequent required initiation of norepinephrine. Her respiratory status continued to worsen and we began proning on 11/14. She responded to proning and was continued on a 20:4 proning schedule.   Palliative care was consulted on 11/15 after family expressed concern about patient's grim prognosis and likelihood of tracheostomy and long-term care even if she survived this illness. On 11/16, palliative spoke with all first-degree relatives, and they decided to transition to DNR and comfort care. Paralytics turned off and patient pronounced dead on 11/17/21 at 12:45AM. Family at bedside, condolences offered."
	"1893982-1"	"1893982-1"	"POSITIVE AIRWAY PRESSURE THERAPY"	"10086397"	"50-59 years"	"50-59"	"Deceased 11/17/2021; Hospitalized 11/10/2021; COVID-19 positive 11/10/2021; fully vaccinated  BRIEF OVERVIEW:  Admission Date: 11/10/2021   DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Acute respiratory failure [J96.00] COVID [U07.1] COVID-19 [U07.1]   HOSPITAL COURSE: Patient is a 57 y.o. female who initially presented on 11/10 for 3-4 days of worsening shortness of breath, diarrhea, and nonproductive cough.  She had pitting edema and signs of fluid overload on CXR and was diagnosed with COVID on arrival.  She is on 5 L oxygen at baseline and was started on high-flow nasal cannula and initially admitted to hospitalist service.    She was diuresed aggressively. She was started on steroids; did not qualify for Remdesivir due to kidney function.Her oxygen requirements continued to increase and she was transitioned to 100% high-flow nasal cannula with non-rebreather mask. Overnight on 11/11, she desated into low 80s and was placed on BIPAP and transferred to ICU service due to concern for impending intubation.    Her respiratory status declined and was intubated on 11/13.  We had multiple conversations about her likely poor prognosis considering her baseline respiratory status, and patient elected to proceed with intubation at that time.  She was sedated and paralyzed, and she subsequent required initiation of norepinephrine. Her respiratory status continued to worsen and we began proning on 11/14. She responded to proning and was continued on a 20:4 proning schedule.   Palliative care was consulted on 11/15 after family expressed concern about patient's grim prognosis and likelihood of tracheostomy and long-term care even if she survived this illness. On 11/16, palliative spoke with all first-degree relatives, and they decided to transition to DNR and comfort care. Paralytics turned off and patient pronounced dead on 11/17/21 at 12:45AM. Family at bedside, condolences offered."
	"1893982-1"	"1893982-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"Deceased 11/17/2021; Hospitalized 11/10/2021; COVID-19 positive 11/10/2021; fully vaccinated  BRIEF OVERVIEW:  Admission Date: 11/10/2021   DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Acute respiratory failure [J96.00] COVID [U07.1] COVID-19 [U07.1]   HOSPITAL COURSE: Patient is a 57 y.o. female who initially presented on 11/10 for 3-4 days of worsening shortness of breath, diarrhea, and nonproductive cough.  She had pitting edema and signs of fluid overload on CXR and was diagnosed with COVID on arrival.  She is on 5 L oxygen at baseline and was started on high-flow nasal cannula and initially admitted to hospitalist service.    She was diuresed aggressively. She was started on steroids; did not qualify for Remdesivir due to kidney function.Her oxygen requirements continued to increase and she was transitioned to 100% high-flow nasal cannula with non-rebreather mask. Overnight on 11/11, she desated into low 80s and was placed on BIPAP and transferred to ICU service due to concern for impending intubation.    Her respiratory status declined and was intubated on 11/13.  We had multiple conversations about her likely poor prognosis considering her baseline respiratory status, and patient elected to proceed with intubation at that time.  She was sedated and paralyzed, and she subsequent required initiation of norepinephrine. Her respiratory status continued to worsen and we began proning on 11/14. She responded to proning and was continued on a 20:4 proning schedule.   Palliative care was consulted on 11/15 after family expressed concern about patient's grim prognosis and likelihood of tracheostomy and long-term care even if she survived this illness. On 11/16, palliative spoke with all first-degree relatives, and they decided to transition to DNR and comfort care. Paralytics turned off and patient pronounced dead on 11/17/21 at 12:45AM. Family at bedside, condolences offered."
	"1894933-1"	"1894933-1"	"COVID-19 PNEUMONIA"	"10084380"	"50-59 years"	"50-59"	"Pt. died in the hospital of complications of SARS CoV2 pneumonia.  Underlying h/o chronic end-stage renal disease requiring hemodialysis preceding her acute illness."
	"1894933-1"	"1894933-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Pt. died in the hospital of complications of SARS CoV2 pneumonia.  Underlying h/o chronic end-stage renal disease requiring hemodialysis preceding her acute illness."
	"1897280-1"	"1897280-1"	"COUGH"	"10011224"	"50-59 years"	"50-59"	"patient presented to emergency department on 11/5/21 with shortness of breath, cough and fever. covid-19 specimen taken and came back positive patient was admitted for further management of covid-19 patient did require treatment for symptoms associated with covid-19 infection. treatment with dexamethasone patient was intubated on 11/9/21 and extubated on 11/13/21 patient's condition worsened requiring transfer to the intensive care unit on 11/7/21 patient expired on 11/13/21"
	"1897280-1"	"1897280-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"patient presented to emergency department on 11/5/21 with shortness of breath, cough and fever. covid-19 specimen taken and came back positive patient was admitted for further management of covid-19 patient did require treatment for symptoms associated with covid-19 infection. treatment with dexamethasone patient was intubated on 11/9/21 and extubated on 11/13/21 patient's condition worsened requiring transfer to the intensive care unit on 11/7/21 patient expired on 11/13/21"
	"1897280-1"	"1897280-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"patient presented to emergency department on 11/5/21 with shortness of breath, cough and fever. covid-19 specimen taken and came back positive patient was admitted for further management of covid-19 patient did require treatment for symptoms associated with covid-19 infection. treatment with dexamethasone patient was intubated on 11/9/21 and extubated on 11/13/21 patient's condition worsened requiring transfer to the intensive care unit on 11/7/21 patient expired on 11/13/21"
	"1897280-1"	"1897280-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"patient presented to emergency department on 11/5/21 with shortness of breath, cough and fever. covid-19 specimen taken and came back positive patient was admitted for further management of covid-19 patient did require treatment for symptoms associated with covid-19 infection. treatment with dexamethasone patient was intubated on 11/9/21 and extubated on 11/13/21 patient's condition worsened requiring transfer to the intensive care unit on 11/7/21 patient expired on 11/13/21"
	"1897280-1"	"1897280-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"50-59 years"	"50-59"	"patient presented to emergency department on 11/5/21 with shortness of breath, cough and fever. covid-19 specimen taken and came back positive patient was admitted for further management of covid-19 patient did require treatment for symptoms associated with covid-19 infection. treatment with dexamethasone patient was intubated on 11/9/21 and extubated on 11/13/21 patient's condition worsened requiring transfer to the intensive care unit on 11/7/21 patient expired on 11/13/21"
	"1897280-1"	"1897280-1"	"INTENSIVE CARE"	"10022519"	"50-59 years"	"50-59"	"patient presented to emergency department on 11/5/21 with shortness of breath, cough and fever. covid-19 specimen taken and came back positive patient was admitted for further management of covid-19 patient did require treatment for symptoms associated with covid-19 infection. treatment with dexamethasone patient was intubated on 11/9/21 and extubated on 11/13/21 patient's condition worsened requiring transfer to the intensive care unit on 11/7/21 patient expired on 11/13/21"
	"1897280-1"	"1897280-1"	"PYREXIA"	"10037660"	"50-59 years"	"50-59"	"patient presented to emergency department on 11/5/21 with shortness of breath, cough and fever. covid-19 specimen taken and came back positive patient was admitted for further management of covid-19 patient did require treatment for symptoms associated with covid-19 infection. treatment with dexamethasone patient was intubated on 11/9/21 and extubated on 11/13/21 patient's condition worsened requiring transfer to the intensive care unit on 11/7/21 patient expired on 11/13/21"
	"1897280-1"	"1897280-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"patient presented to emergency department on 11/5/21 with shortness of breath, cough and fever. covid-19 specimen taken and came back positive patient was admitted for further management of covid-19 patient did require treatment for symptoms associated with covid-19 infection. treatment with dexamethasone patient was intubated on 11/9/21 and extubated on 11/13/21 patient's condition worsened requiring transfer to the intensive care unit on 11/7/21 patient expired on 11/13/21"
	"1897811-1"	"1897811-1"	"BIOPSY"	"10004720"	"50-59 years"	"50-59"	"Nausea and vomitting began after second dose. Patient also started a new medication, Rebylsus, the same time he recieved the injections. Nausea and vomitting progressed despite discontinuing the medication. Eventually diagnosed with esophageal adenocarcinoma"
	"1897811-1"	"1897811-1"	"NAUSEA"	"10028813"	"50-59 years"	"50-59"	"Nausea and vomitting began after second dose. Patient also started a new medication, Rebylsus, the same time he recieved the injections. Nausea and vomitting progressed despite discontinuing the medication. Eventually diagnosed with esophageal adenocarcinoma"
	"1897811-1"	"1897811-1"	"OESOPHAGEAL ADENOCARCINOMA"	"10030137"	"50-59 years"	"50-59"	"Nausea and vomitting began after second dose. Patient also started a new medication, Rebylsus, the same time he recieved the injections. Nausea and vomitting progressed despite discontinuing the medication. Eventually diagnosed with esophageal adenocarcinoma"
	"1897811-1"	"1897811-1"	"VOMITING"	"10047700"	"50-59 years"	"50-59"	"Nausea and vomitting began after second dose. Patient also started a new medication, Rebylsus, the same time he recieved the injections. Nausea and vomitting progressed despite discontinuing the medication. Eventually diagnosed with esophageal adenocarcinoma"
	"1897823-1"	"1897823-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 3/13/2021 and 4/3/2021.  Patient presented to ED on 11/5/2021 with 1 day worsening of shortness of breath and labored breathing. Patient increased home 0xygen from 2L to 5L, with pulse ox readings in the 60s while on the 5L. Oxygen requirements escalated over following days. Patient's COVID treated with dexamethasone, remdesivir and antibiotics. Intubated on day 9 of admission. Resuscitation efforts limited to intubation only per patient request.  Expired on 11/18/2021."
	"1897823-1"	"1897823-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 3/13/2021 and 4/3/2021.  Patient presented to ED on 11/5/2021 with 1 day worsening of shortness of breath and labored breathing. Patient increased home 0xygen from 2L to 5L, with pulse ox readings in the 60s while on the 5L. Oxygen requirements escalated over following days. Patient's COVID treated with dexamethasone, remdesivir and antibiotics. Intubated on day 9 of admission. Resuscitation efforts limited to intubation only per patient request.  Expired on 11/18/2021."
	"1897823-1"	"1897823-1"	"DYSPNOEA"	"10013968"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 3/13/2021 and 4/3/2021.  Patient presented to ED on 11/5/2021 with 1 day worsening of shortness of breath and labored breathing. Patient increased home 0xygen from 2L to 5L, with pulse ox readings in the 60s while on the 5L. Oxygen requirements escalated over following days. Patient's COVID treated with dexamethasone, remdesivir and antibiotics. Intubated on day 9 of admission. Resuscitation efforts limited to intubation only per patient request.  Expired on 11/18/2021."
	"1897823-1"	"1897823-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 3/13/2021 and 4/3/2021.  Patient presented to ED on 11/5/2021 with 1 day worsening of shortness of breath and labored breathing. Patient increased home 0xygen from 2L to 5L, with pulse ox readings in the 60s while on the 5L. Oxygen requirements escalated over following days. Patient's COVID treated with dexamethasone, remdesivir and antibiotics. Intubated on day 9 of admission. Resuscitation efforts limited to intubation only per patient request.  Expired on 11/18/2021."
	"1897823-1"	"1897823-1"	"NUCLEIC ACID TEST"	"10083356"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 3/13/2021 and 4/3/2021.  Patient presented to ED on 11/5/2021 with 1 day worsening of shortness of breath and labored breathing. Patient increased home 0xygen from 2L to 5L, with pulse ox readings in the 60s while on the 5L. Oxygen requirements escalated over following days. Patient's COVID treated with dexamethasone, remdesivir and antibiotics. Intubated on day 9 of admission. Resuscitation efforts limited to intubation only per patient request.  Expired on 11/18/2021."
	"1897823-1"	"1897823-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 3/13/2021 and 4/3/2021.  Patient presented to ED on 11/5/2021 with 1 day worsening of shortness of breath and labored breathing. Patient increased home 0xygen from 2L to 5L, with pulse ox readings in the 60s while on the 5L. Oxygen requirements escalated over following days. Patient's COVID treated with dexamethasone, remdesivir and antibiotics. Intubated on day 9 of admission. Resuscitation efforts limited to intubation only per patient request.  Expired on 11/18/2021."
	"1903479-1"	"1903479-1"	"ERYTHEMA"	"10015150"	"50-59 years"	"50-59"	"red swollen arm with fever to it for 3/4 days after it cleared up leg cramps occured frequently."
	"1903479-1"	"1903479-1"	"MUSCLE SPASMS"	"10028334"	"50-59 years"	"50-59"	"red swollen arm with fever to it for 3/4 days after it cleared up leg cramps occured frequently."
	"1903479-1"	"1903479-1"	"PERIPHERAL SWELLING"	"10048959"	"50-59 years"	"50-59"	"red swollen arm with fever to it for 3/4 days after it cleared up leg cramps occured frequently."
	"1903479-1"	"1903479-1"	"SKIN WARM"	"10040952"	"50-59 years"	"50-59"	"red swollen arm with fever to it for 3/4 days after it cleared up leg cramps occured frequently."
	"1905072-1"	"1905072-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Case was fully vaccinated against Covid19, and became infected with Covid-19 on 7/12/2021. She died on 7/15/2021 with Covid Pneumonia listed as a secondary diagnosis contributing to her death."
	"1905072-1"	"1905072-1"	"COVID-19 PNEUMONIA"	"10084380"	"50-59 years"	"50-59"	"Case was fully vaccinated against Covid19, and became infected with Covid-19 on 7/12/2021. She died on 7/15/2021 with Covid Pneumonia listed as a secondary diagnosis contributing to her death."
	"1905072-1"	"1905072-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Case was fully vaccinated against Covid19, and became infected with Covid-19 on 7/12/2021. She died on 7/15/2021 with Covid Pneumonia listed as a secondary diagnosis contributing to her death."
	"1905809-1"	"1905809-1"	"ACUTE RESPIRATORY FAILURE"	"10001053"	"50-59 years"	"50-59"	"Onset of COVID symptoms 11/8, tested positive for COVID 11/10/21.  admitted from the floor earlier today for acute hypoxic respiratory failure secondary to Covid PNA. Patient was initially a transfer from a hospital on 11/13. Admitted after he needed NIPPV.  Intubated 11/17 and paralyzed and proned 11/17.  Deceased 11/28/21."
	"1905809-1"	"1905809-1"	"COVID-19"	"10084268"	"50-59 years"	"50-59"	"Onset of COVID symptoms 11/8, tested positive for COVID 11/10/21.  admitted from the floor earlier today for acute hypoxic respiratory failure secondary to Covid PNA. Patient was initially a transfer from a hospital on 11/13. Admitted after he needed NIPPV.  Intubated 11/17 and paralyzed and proned 11/17.  Deceased 11/28/21."
	"1905809-1"	"1905809-1"	"COVID-19 PNEUMONIA"	"10084380"	"50-59 years"	"50-59"	"Onset of COVID symptoms 11/8, tested positive for COVID 11/10/21.  admitted from the floor earlier today for acute hypoxic respiratory failure secondary to Covid PNA. Patient was initially a transfer from a hospital on 11/13. Admitted after he needed NIPPV.  Intubated 11/17 and paralyzed and proned 11/17.  Deceased 11/28/21."
	"1905809-1"	"1905809-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Onset of COVID symptoms 11/8, tested positive for COVID 11/10/21.  admitted from the floor earlier today for acute hypoxic respiratory failure secondary to Covid PNA. Patient was initially a transfer from a hospital on 11/13. Admitted after he needed NIPPV.  Intubated 11/17 and paralyzed and proned 11/17.  Deceased 11/28/21."
	"1905809-1"	"1905809-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"50-59 years"	"50-59"	"Onset of COVID symptoms 11/8, tested positive for COVID 11/10/21.  admitted from the floor earlier today for acute hypoxic respiratory failure secondary to Covid PNA. Patient was initially a transfer from a hospital on 11/13. Admitted after he needed NIPPV.  Intubated 11/17 and paralyzed and proned 11/17.  Deceased 11/28/21."
	"1905809-1"	"1905809-1"	"INTENSIVE CARE"	"10022519"	"50-59 years"	"50-59"	"Onset of COVID symptoms 11/8, tested positive for COVID 11/10/21.  admitted from the floor earlier today for acute hypoxic respiratory failure secondary to Covid PNA. Patient was initially a transfer from a hospital on 11/13. Admitted after he needed NIPPV.  Intubated 11/17 and paralyzed and proned 11/17.  Deceased 11/28/21."
	"1905809-1"	"1905809-1"	"MALAISE"	"10025482"	"50-59 years"	"50-59"	"Onset of COVID symptoms 11/8, tested positive for COVID 11/10/21.  admitted from the floor earlier today for acute hypoxic respiratory failure secondary to Covid PNA. Patient was initially a transfer from a hospital on 11/13. Admitted after he needed NIPPV.  Intubated 11/17 and paralyzed and proned 11/17.  Deceased 11/28/21."
	"1905809-1"	"1905809-1"	"MECHANICAL VENTILATION"	"10067221"	"50-59 years"	"50-59"	"Onset of COVID symptoms 11/8, tested positive for COVID 11/10/21.  admitted from the floor earlier today for acute hypoxic respiratory failure secondary to Covid PNA. Patient was initially a transfer from a hospital on 11/13. Admitted after he needed NIPPV.  Intubated 11/17 and paralyzed and proned 11/17.  Deceased 11/28/21."
	"1905809-1"	"1905809-1"	"PARALYSIS"	"10033799"	"50-59 years"	"50-59"	"Onset of COVID symptoms 11/8, tested positive for COVID 11/10/21.  admitted from the floor earlier today for acute hypoxic respiratory failure secondary to Covid PNA. Patient was initially a transfer from a hospital on 11/13. Admitted after he needed NIPPV.  Intubated 11/17 and paralyzed and proned 11/17.  Deceased 11/28/21."
	"1905809-1"	"1905809-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"50-59 years"	"50-59"	"Onset of COVID symptoms 11/8, tested positive for COVID 11/10/21.  admitted from the floor earlier today for acute hypoxic respiratory failure secondary to Covid PNA. Patient was initially a transfer from a hospital on 11/13. Admitted after he needed NIPPV.  Intubated 11/17 and paralyzed and proned 11/17.  Deceased 11/28/21."
	"1906259-1"	"1906259-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Death"
	"1906259-1"	"1906259-1"	"FULL BLOOD COUNT"	"10017411"	"50-59 years"	"50-59"	"Death"
	"1906259-1"	"1906259-1"	"ORGAN FAILURE"	"10053159"	"50-59 years"	"50-59"	"Death"
	"1906259-1"	"1906259-1"	"SEPSIS"	"10040047"	"50-59 years"	"50-59"	"Death"
	"1910053-1"	"1910053-1"	"DEATH"	"10011906"	"50-59 years"	"50-59"	"Double pneumonia with blood clots in lungs.  Sepsis.  Extremely low oxygen levels in blood.  Extremely low blood pressure.  Rapid breathing - over 60 per minute.  5-day ICU stay at Hospital.   Death."
	"1910053-1"	"1910053-1"	"HYPOTENSION"	"10021097"	"50-59 years"	"50-59"	"Double pneumonia with blood clots in lungs.  Sepsis.  Extremely low oxygen levels in blood.  Extremely low blood pressure.  Rapid breathing - over 60 per minute.  5-day ICU stay at Hospital.   Death."
	"1910053-1"	"1910053-1"	"INTENSIVE CARE"	"10022519"	"50-59 years"	"50-59"	"Double pneumonia with blood clots in lungs.  Sepsis.  Extremely low oxygen levels in blood.  Extremely low blood pressure.  Rapid breathing - over 60 per minute.  5-day ICU stay at Hospital.   Death."
	"1910053-1"	"1910053-1"	"OXYGEN SATURATION DECREASED"	"10033318"	"50-59 years"	"50-59"	"Double pneumonia with blood clots in lungs.  Sepsis.  Extremely low oxygen levels in blood.  Extremely low blood pressure.  Rapid breathing - over 60 per minute.  5-day ICU stay at Hospital.   Death."
	"1910053-1"	"1910053-1"	"PNEUMONIA"	"10035664"	"50-59 years"	"50-59"	"Double pneumonia with blood clots in lungs.  Sepsis.  Extremely low oxygen levels in blood.  Extremely low blood pressure.  Rapid breathing - over 60 per minute.  5-day ICU stay at Hospital.   Death."
	"1910053-1"	"1910053-1"	"PULMONARY THROMBOSIS"	"10037437"	"50-59 years"	"50-59"	"Double pneumonia with blood clots in lungs.  Sepsis.  Extremely low oxygen levels in blood.  Extremely low blood pressure.  Rapid breathing - over 60 per minute.  5-day ICU stay at Hospital.   Death."
	"1910053-1"	"1910053-1"	"RESPIRATORY RATE INCREASED"	"10038712"	"50-59 years"	"50-59"	"Double pneumonia with blood clots in lungs.  Sepsis.  Extremely low oxygen levels in blood.  Extremely low blood pressure.  Rapid breathing - over 60 per minute.  5-day ICU stay at Hospital.   Death."
	"1910053-1"	"1910053-1"	"SEPSIS"	"10040047"	"50-59 years"	"50-59"	"Double pneumonia with blood clots in lungs.  Sepsis.  Extremely low oxygen levels in blood.  Extremely low blood pressure.  Rapid breathing - over 60 per minute.  5-day ICU stay at Hospital.   Death."
	"1919665-1"	"1919665-1"	"BLOOD TEST"	"10061726"	"50-59 years"	"50-59"	""death / Death cause Ventricular Fibrillation; This is a spontaneous report received from contactable reporter consumer via COVID-19 Adverse Event Self-Reporting Solution.  A 58 year-old female patient (not pregnant) received BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE), administered in arm left, administration date 17May2021 (Lot number: EW0167) at the age of 57 years as dose 2, single for covid-19 immunisation. Relevant medical history included: ""pain in her knees"" (unspecified if ongoing). The patient's concomitant medications were not reported. Vaccination history included: Bnt162b2 (Dose Number: 1, Batch/Lot No: EN6206, Location of injection: Arm Right), administration date: 26Apr2021, when the patient was 58 years old, for Covid-19 immunization.  The following information was reported: VENTRICULAR FIBRILLATION (death, hospitalization, disability, life threatening) with onset 15Aug2021,at 16:00, outcome ""fatal"", described as ""death / death cause ventricular fibrillation"". The patient was hospitalized for ventricular fibrillation (hospitalization duration: 3 day(s)). The patient underwent the following laboratory tests and procedures: blood test: (16Aug2021) negative (elaborated as covid test type post vaccination: blood test). It was unknown if therapeutic measures were taken as a result of ventricular fibrillation. The patient date of death was 17Aug2021. The reported cause of death was ventricular fibrillation. No autopsy was performed.; Reported Cause(s) of Death: Ventricular fibrillation""
	"1919665-1"	"1919665-1"	"VENTRICULAR FIBRILLATION"	"10047290"	"50-59 years"	"50-59"	""death / Death cause Ventricular Fibrillation; This is a spontaneous report received from contactable reporter consumer via COVID-19 Adverse Event Self-Reporting Solution.  A 58 year-old female patient (not pregnant) received BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE), administered in arm left, administration date 17May2021 (Lot number: EW0167) at the age of 57 years as dose 2, single for covid-19 immunisation. Relevant medical history included: ""pain in her knees"" (unspecified if ongoing). The patient's concomitant medications were not reported. Vaccination history included: Bnt162b2 (Dose Number: 1, Batch/Lot No: EN6206, Location of injection: Arm Right), administration date: 26Apr2021, when the patient was 58 years old, for Covid-19 immunization.  The following information was reported: VENTRICULAR FIBRILLATION (death, hospitalization, disability, life threatening) with onset 15Aug2021,at 16:00, outcome ""fatal"", described as ""death / death cause ventricular fibrillation"". The patient was hospitalized for ventricular fibrillation (hospitalization duration: 3 day(s)). The patient underwent the following laboratory tests and procedures: blood test: (16Aug2021) negative (elaborated as covid test type post vaccination: blood test). It was unknown if therapeutic measures were taken as a result of ventricular fibrillation. The patient date of death was 17Aug2021. The reported cause of death was ventricular fibrillation. No autopsy was performed.; Reported Cause(s) of Death: Ventricular fibrillation""
"---"
"Dataset: The Vaccine Adverse Event Reporting System (VAERS)"
"Query Parameters:"
"Title: 211214 CDC covid VAERS report - all reports.txt"
"Age: 50-59 years"
"Date Died: 2020; 2021"
"Date of Onset: 2020; 2021"
"Date Report Completed: 2020; 2021"
"Date Report Received: 2020; 2021"
"Date Vaccinated: 2020; 2021"
"State / Territory: The United States/Territories/Unknown"
"Vaccine Products: COVID19 VACCINE (COVID19)"
"VAERS ID: All"
"Group By: VAERS ID; Symptoms; Age"
"Show Totals: False"
"Show Zero Values: Disabled"
"---"
"Help: See http://wonder.cdc.gov/wonder/help/vaers.html for more information."
"---"
"Query Date: Dec 14, 2021 3:39:32 PM"
"---"
"Suggested Citation: Accessed at http://wonder.cdc.gov/vaers.html on Dec 14, 2021 3:39:32 PM"
"---"
Messages:
"1. The full results are too long to be displayed, only non-zero rows are available."
"2. VAERS data in CDC WONDER are updated every Friday. Hence, results for the same query can change from week to week."
"3. These results are for 652 total events."
"4. When grouped by VAERS ID, results initially don't show Events Reported, Percent, or totals. Use Quick or More Options to"
"restore them, if you wish."
"5. Click on a VAERS ID to see a report containing detailed information for the event."
"---"
Footnotes:
"1. Submitting a report to VAERS does not mean that healthcare personnel or the vaccine caused or contributed to the adverse"
"event (possible side effect)."
"---"
Caveats:
"1. <p> VAERS accepts reports of adverse events and reactions that occur following vaccination. Healthcare providers, vaccine"
"manufacturers, and the public can submit reports to VAERS. While very important in monitoring vaccine safety, VAERS reports"
"alone cannot be used to determine if a vaccine caused or contributed to an adverse event or illness. The reports may contain"
"information that is incomplete, inaccurate, coincidental, or unverifiable. Most reports to VAERS are voluntary, which means they"
"are subject to biases. This creates specific limitations on how the data can be used scientifically. Data from VAERS reports"
"should always be interpreted with these limitations in mind. </p> <p> The strengths of VAERS are that it is national in scope"
"and can quickly provide an early warning of a safety problem with a vaccine. As part of CDC and FDA's multi-system approach to"
"post-licensure vaccine safety monitoring, VAERS is designed to rapidly detect unusual or unexpected patterns of adverse events,"
"also known as ""safety signals."" If a safety signal is found in VAERS, further studies can be done in safety systems such as"
"the CDC's Vaccine Safety Datalink (VSD) or the Clinical Immunization Safety Assessment (CISA) project. These systems do not have"
"the same limitations as VAERS, and can better assess health risks and possible connections between adverse events and a vaccine."
"</p> <p> Key considerations and limitations of VAERS data: <ul><li> Vaccine providers are encouraged to report any clinically"
"significant health problem following vaccination to VAERS, whether or not they believe the vaccine was the cause. </li><li>"
"Reports may include incomplete, inaccurate, coincidental and unverified information. </li><li> The number of reports alone"
"cannot be interpreted or used to reach conclusions about the existence, severity, frequency, or rates of problems associated"
"with vaccines. </li><li> VAERS data are limited to vaccine adverse event reports received between 1990 and the most recent date"
"for which data are available. </li><li> VAERS data do not represent all known safety information for a vaccine and should be"
"interpreted in the context of other scientific information. </li></ul> </p>"
"2."
"3. Some items may have more than 1 occurrence in any single event report, such as Symptoms, Vaccine Products, Manufacturers, and"
"Event Categories. If data are grouped by any of these items, then the number in the Events Reported column may exceed the total"
"number of unique events. If percentages are shown, then the associated percentage of total unique event reports will exceed 100%"
"in such cases. For example, the number of Symptoms mentioned is likely to exceed the number of events reported, because many"
"reports include more than 1 Symptom. When more than 1 Symptom occurs in a single report, then the percentage of Symptoms to"
"unique events is more than 100%. More information: http://wonder.cdc.gov/wonder/help/vaers.html#Suppress."
"4. Data contains VAERS reports processed as of 12/03/2021. The VAERS data in WONDER are updated weekly, yet the VAERS system"
"receives continuous updates including revisions and new reports for preceding time periods. Duplicate event reports and/or"
"reports determined to be false are removed from VAERS. More information: http://wonder.cdc.gov/wonder/help/vaers.html#Reporting."
"5. About COVID19 vaccines: <UL><LI> For more information on how many persons have been vaccinated in the US for COVID19 to date,"
"see https://covid.cdc.gov/covid-data-tracker/#vaccinations/: <a target= .. </LI><LI> One report may state that the patient"
"received more than one brand of COVID-19 vaccine on the same visit. This is a reporting error, but explains why the total number"
"of reports may not equal the total number of COVID-19 vaccine doses. </LI></UL>"